Understanding overall shoulder function and health: the value of specific quantitative vs. qualitative shoulder range of motion on patient-reported outcome measures.

HYPOTHESIS AND BACKGROUND: It is known that, though widely used, shoulder range of motion (ROM) measurements are not standardized and have a high rate of intra- and interobserver differences. Particularly, the inconsistency in quantitative and qualitative measurements and their relationship to patient-reported outcome measures (PROMs) make shoulder health difficult to determine. METHODS: This was a prospective study of 147 patients who presented with a chief complaint of shoulder pain to the orthopedic sports medicine and shoulder clinic of a single fellowship-trained surgeon. Measured by 1 examiner, quantitative ROM measurements were taken with a goniometer and qualitative ROM measured by the anatomic level that the patient could reach. The following PROMs were used as well: American Shoulder and Elbow Surgeons shoulder score, Single Assessment Numeric Evaluation, Shoulder Pain and Disability Index, Oxford Shoulder Score, Disabilities of the Arm, Shoulder, and Hand questionnaire, 12-Item Short Form Health Survey, and Patient-Reported Outcomes Measurement Information System pain interference short form 6a (PROMIS 6a). Statistical analysis was performed with SPSS using the Pearson correlation and 2-sample t test. The Benjamini-Hochberg correction was used to determine the P value at which statistical significance was reached to correct for multiple comparisons. RESULTS: Qualitative internal rotation (IR) (the hand behind back reach test) and qualitative forward flexion (FF) correlated with all goniometer angle measurements and PROMs (both shoulder and general health scores). These qualitative measures proved to be an appropriate proxy for IR and FF goniometer measurements. Qualitative external rotation (ER) was not a good substitute for quantitative ER measurement. Quantitative ER correlated with all PROMs. As ROM increased when measured by quantitative ER, qualitative IR, and qualitative FF, shoulder and general health PROMs incrementally increased as well. DISCUSSION/CONCLUSIONS: Qualitative IR measurement, the hand-behind-back reach test, is an adequate substitution for IR goniometer angle as well as a strong representation of global shoulder ROM, shoulder health, and general health while factoring in patient age. Qualitative FF measurement is also an appropriate proxy for quantitative FF and represents global shoulder and general health without factoring in age. Quantitative ER, via goniometer angle, is a better assessment of the shoulder than qualitative ER and is a representation of overall shoulder and general health. We recommend the use of quantitative ER, qualitative IR, and qualitative FF measurements to best understand a patient's overall shoulder health and its impact on their overall health.

Optical Goniometer Paired with Digital Monte Carlo Twin to Determine the Optical Properties of Turbid Media.

We present a goniometer designed for capturing spectral and angular-resolved data from scattering and absorbing media. The experimental apparatus is complemented by a comprehensive Monte Carlo simulation, meticulously replicating the radiative transport processes within the instrument's optical components and simulating scattering and absorption across arbitrary volumes. Consequently, we were able to construct a precise digital replica, or "twin", of the experimental setup. This digital counterpart enabled us to tackle the inverse problem of deducing optical parameters such as absorption and scattering coefficients, along with the scattering anisotropy factor from measurements. We achieved this by fitting Monte Carlo simulations to our goniometric measurements using a Levenberg-Marquardt algorithm. Validation of our approach was performed using polystyrene particles, characterized by Mie scattering, supplemented by a theoretical analysis of algorithmic convergence. Ultimately, we demonstrate strong agreement between optical parameters derived using our novel methodology and those obtained via established measurement protocols.

High-Precision Determination of NMR Interaction Parameters by Measurement of Single Crystals: A Review of Classical and Advanced Methods.

In this review, the process of extracting precise values for NMR interaction tensors from single crystal samples is systematically explored. Starting with a description of the orientation dependence of the considered interactions, i.e., chemical shift, dipolar, and quadrupole interaction, the techniques for acquiring and analysing single-crystal spectra are outlined. This includes the 'classical' approach, which requires the acquisition of three rotation patterns around three rotation axes that are orthogonal to each other, as well as more recent strategies aimed at reducing the number of required NMR spectra. One such strategy is the 'single-rotation method', which exploits the symmetry relations between tensors in the crystal structure to reduce the necessary amount of orientation-dependent data. This concept may be extended to additionally include the orientation of the goniometer axis itself in the data fit, which may be termed the 'minimal-rotation method'. Other, more exotic schemes, such as the use of specialised probe designs or the investigation of single crystals under magic-angle-spinning, are also briefly discussed. Actual values of NMR interaction tensors as determined from the various single-crystal methods have been collected and are provided in tables for spin I=1/2, I=1, and half-integer spins with I>1/2.

The peak force to push a trial tibial insert into position cannot be used to select the correct thickness in total knee arthroplasty.

An objective of a total knee arthroplasty (TKA) is to restore native (i.e. healthy) function, and a crucial step is determining the correct insert thickness for each patient. If the insert is too thick, then stiffness results, and if too thin, then instability results. Two methods to determine the insert thickness are by manually assessing the joint laxity and by using a trial insert with goniometric markings that measures the internal-external rotation of the trial with respect to a mark on the femoral component. The former is qualitative and depends on the surgeon's experience and 'feel' and while the latter is quantitative, it can be used only with an insert with medial ball-in-socket conformity. An unexplored method is to measure the force required to push a trial insert into position. To determine whether this method has merit, the push force was measured in 30 patients undergoing unrestricted kinematically aligned TKA using an insert with ball-in-socket medial conformity, a flat lateral surface, and retention of the posterior cruciate ligament. During surgery, the surgeon determined three appropriate thicknesses to test from a selection ranging from 10 mm to 14 mm in 1 mm increments. The peak push forces going from an insert 1 mm thinner than the correct thickness as determined by an insert goniometer and from the correct thickness to 1 mm thicker were measured. Mean peak forces for the different insert thicknesses were 127 ± 104 N, 127 ± 95 N, and 144 ± 96 N for 1 mm thinner, correct, and 1 mm thicker, respectively, and did not differ (p = 0.3210). As a result, measurement of peak force during trial positioning of a tibial insert cannot be used to identify the correct thickness for all insert designs.

Virtual goniometric measurement of the forearm, wrist, and hand: A double-blind psychometric study of a digital goniometer.

BACKGROUND: Various virtual goniometers have been used for photographic measurements. However, there is no single method that is both reliable and valid for measuring the forearm, wrist, and finger joints. PURPOSE: This study aimed to investigate the criterion validity and intra- and inter-rater reliability of a virtual goniometer for assessing forearm, wrist, and finger joints using screenshots from video recordings and to calculate the standard error of measurement (SEM) and minimum detectable change (MDC). STUDY DESIGN: This is a clinical measurement study. METHODS: Goniometric measurements were performed independently by two observers in 26 healthy participants (49 hands) using a virtual goniometer. Criterion validity was assessed by examining the agreement between virtual and manual goniometer measurements. Reliability was calculated using the intraclass correlation coefficient (ICC) to assess agreement between virtual and manual goniometers and interobserver agreement for virtual measurements. The difference between measurements was analyzed using the Student test and Bland-Altman plots. SEM and MDC were both used to determine the error associated with the measurements. RESULTS: Strong agreement between measurements (ICC = 0.69-0.98) and positive moderate to high correlation (r = 0.52-0.96; p < 0.001) were observed. Bland-Altman plots showed the agreement between the two measurement methods. Intra-rater (ICC = 0.80-0.99) and inter-rater reliability (ICC = 0.76-0.99) were high. SEM was low (2°-4°) and MDC ranged from 4°-12°. CONCLUSIONS: The virtual goniometer proved to be a valid and reliable method for measuring joint angles from screenshots. The inter-rater and intra-rater reliability of the virtual goniometer was high. The average bias between the virtual and manual goniometer was small. Measurement errors were low for forearm, wrist, and hand movements, with the largest measurement errors observed for the second and third fingers.

Spasticity Management Teams, Evaluations, and Tools: A Canadian Cross-Sectional Survey.

OBJECTIVE: The objective of this study is to determine the physical evaluations and assessment tools used by a group of Canadian healthcare professionals treating adults with spasticity. METHODS: A cross-sectional web-based 19-question survey was developed to determine the types of physical evaluations, tone-related impairment measurements, and assessment tools used in the management of adults with spasticity. The survey was distributed to healthcare professionals from the Canadian Advances in Neuro-Orthopedics for Spasticity Congress database. RESULTS: Eighty study participants (61 physiatrists and 19 other healthcare professionals) completed the survey and were included. Nearly half (46.3%, 37/80) of the participants reported having an inter- or trans-disciplinary team managing individuals with spasticity. Visual observation of movement, available range of motion determination, tone during velocity-dependent passive range of motion looking for a spastic catch, spasticity, and clonus, and evaluation of gait were the most frequently used physical evaluations. The most frequently used spasticity tools were the Modified Ashworth Scale, goniometer, and Goal Attainment Scale. Results were similar in brain- and spinal cord-predominant etiologies. To evaluate goals, qualitative description was used most (37.5%). CONCLUSION: Our findings provide a better understanding of the spasticity management landscape in Canada with respect to staffing, physical evaluations, and outcome measurements used in clinical practice. For all etiologies of spasticity, visual observation of patient movement, Modified Ashworth Scale, and qualitative goal outcomes descriptions were most commonly used to guide treatment and optimize outcomes. Understanding the current practice of spasticity assessment will help provide guidance for clinical evaluation and management of spasticity.

Validity and Reliability of Inertial Measurement Units in Active Range of Motion Assessment in the Hip Joint.

Measuring joint range of motion has traditionally occurred with a universal goniometer, inclinometer, or expensive laboratory systems. The popularity of the inertial measurement unit (IMU) is growing, enabling the small and even single portable device to measure the range of motion. Until now, they were not used to assess hip joint range of motion. Our study aimed to check the validity of IMUs in assessing hip range of motion and compare them to other measurement devices-universal goniometer and inclinometer. Twenty participants completed three hip movements (flexion in standing and prone internal and external rotation) on both hips. Two testers independently assessed each movement with a goniometer, digital inclinometer, and IMU at different time points. To assess the agreement of active hip ROM between devices, Intraclass Correlation Coefficient (ICC) and Bland-Altman analysis were used. Furthermore, inter-rater and intra-rater reliability were also assessed by using ICC and Bland-Altman analysis. Limits of agreement (LOA) were calculated using Bland-Altman plots. The IMU demonstrated good to excellent validity (ICC: 0.87-0.99) compared to the goniometer and digital inclinometer, with LOAs < 9°, across all tested movements. Intra-rater reliability was excellent for all devices (ICC: 0.87-0.99) with LOAs < 7°. However, inter-rater reliability was moderate for flexion (ICC: 0.58-0.59, LOAs < 22.4) and poor for rotations (ICC: -0.33-0.04, LOAs < 7.8°). The present study shows that a single inertial measurement unit (RSQ Motion, RSQ Technologies, Poznan, Poland) could be successfully used to assess the active hip range of motion in healthy subjects, comparable to other methods accuracy.

Video-based Goniometer Applications for Measuring Knee Joint Angles during Walking in Neurological Patients: A Validity, Reliability and Usability Study.

Easy-to-use evaluation of Range Of Motion (ROM) during walking is necessary to make decisions during neurological rehabilitation programs and during follow-up visits in clinical and remote settings. This study discussed goniometer applications (DrGoniometer and Angles - Video Goniometer) that measure knee joint ROM during walking through smartphone cameras. The primary aim of the study is to test the inter-rater and intra-rater reliability of the collected measurements as well as their concurrent validity with an electro-goniometer. The secondary aim is to evaluate the usability of the two mobile applications. A total of 22 patients with Parkinson's disease (18 males, age 72 (8) years), 22 post-stroke patients (17 males, age 61 (13) years), and as many healthy volunteers (8 males, age 45 (5) years) underwent knee joint ROM evaluations during walking. Clinicians and inexperienced examiners used the two mobile applications to calculate the ROM, and then rated their perceived usability through the System Usability Scale (SUS). Intraclass correlation coefficients (ICC) and correlation coefficients (corr) were calculated. Both applications showed good reliability (ICC > 0.69) and validity (corr > 0.61), and acceptable usability (SUS > 68). Smartphone-based video goniometers could be used to assess the knee ROM during walking in neurological patients, because of their acceptable degree of reliability, validity and usability.

Reliability and Validity of a Smartphone Device and Clinical Tools for Thoracic Spine Mobility Assessments.

Quantifying thoracic spine mobility with reliable and valid tools is a challenge for clinicians in practice. The aim of this study is to determine the reliability and validity of a smartphone device, bubble inclinometer and universal goniometer to quantify the static kyphotic curve and active range of motion of the thoracic spine. A total of 17 participants (mean age = 23.7 ± 2.3 years) underwent repeated measurements with three raters, on three separate days performing the lumbar-locked trunk rotation, standing full extension, standing full flexion, standing relaxed curve and seated trunk rotation assessments. Mostly "Good" to "Excellent" intra-rater (ICC ranging from 0.624 to 0.981) and inter-reliability (ICC ranging from 0.671 to 0.968) was achieved with the smartphone and clinical tools. "Excellent" validity (ICC ranging from 0.903 to 0.947) with the smartphone was achieved during lumbar-locked trunk rotation and standing relaxed curve assessment. "Good" validity (ICC ranging from 0.836 to 0.867) of the smartphone was achieved during the seated trunk rotation. The Samsung s9+ smartphone with the iSetSquare mobile application is a reliable and valid tool to use for clinical assessments assessing thoracic spine mobility.

Validation of the shoulder range of motion software for measurement of shoulder ranges of motion in consultation: coupling a red/green/blue-depth video camera to artificial intelligence.

PURPOSE: Clinical evaluation of the shoulder range of motion (RoM) may vary significantly depending on the surgeon. We aim to validate an automatic shoulder RoM measurement system associating image acquisition by an RGB-D (red/green/blue-depth) video camera to an artificial intelligence (AI) algorithm. METHODS: Thirty healthy volunteers were included. A 3D RGB-D sensor that simultaneously generated a colour image and a depth map was used. Then, an open-access convolutional neural network algorithm that was programmed for shoulder recognition provided a 3D motion measure. Each volunteer adopted a randomized position successively. For each position, two observers made a visual (EyeREF) and goniometric measurement (GonioREF), blind to the automated software which was implemented by an orthopaedic surgeon. We evaluated the inter-tester intra-class correlation (ICC) between observers and the concordance correlation coefficient (CCC) between the three methods. RESULTS: For manual evaluations EyeREF and GonioREF, ICC remained constantly excellent for the widest motions in the vertical plane (i.e., abduction and flexion). It was very good for ER1 and IR2 and fairly good for adduction, extension, and ER2. Differences between the measurements' means of EyeREF and shoulder RoM was significant for all motions. Compared to GonioREF, shoulder RoM provided similar results for abduction, adduction, and flexion and EyeREF provided similar results for adduction, ER1, and ER2. The three methods showed an overall good to excellent CCC. The mean bias between the three methods remained under 10° and clinically acceptable. CONCLUSION: RGB-D/AI combination is reliable in measuring shoulder RoM in consultation, compared to classic goniometry and visual observation.

Reliability and validity of expert assessments of hand-wrist physical exposures.

BACKGROUND: General population job-exposure matrices (JEMs) based on expert assessments of physical exposures may be valuable tools for studying occupation-related musculoskeletal disorders. Wrist-hand JEMs are few and the reliability and validity of expert assessments of wrist-hand exposures is uncertain. METHODS: We examined intra- and inter-rater reliability of ratings of five experts of hand-wrist repetition, deviation, force, vibration, and computer work in 33 jobs selected to represent a large exposure variation. The validity of ratings of hand-wrist repetition was examined by comparison with electro-goniometer measurements of wrist angular velocity and mean power frequency (MPF), and the validity of hand-wrist deviation by comparison with goniometer measurements of range of motion (ROM). RESULTS: Intra-rater test-retest and inter-rater Spearman correlation coefficients controlling for rater effects, varied between 0.70 and 0.87. Corresponding kappa statistics of overall agreement showed similar high values, except for wrist deviation (kappa = 0.50). Regression analyses showed strong positive associations between expert assessments of repetition and goniometer measurements of wrist angular velocity (R2 = 0.56, p < 0.0001) and MPF (R2 = 0.37, p < 0.0003), while expert ratings of wrist deviation showed a weak statistically nonsignificant association with goniometer measurements of ROM (R2 = 0.032, p = 0.34). CONCLUSION: The reliability of expert assessments of wrist-hand physical exposures was high. Compared to goniometer measurements, the validity of assessments of wrist-hand repetition was also high, but it was low for assessments of wrist-hand deviation. The results are encouraging for establishing a hand-wrist JEM, but the results for wrist deviation emphasize that expert assessments should be validated against objective measurements.

Validation of an on-screen application-based measurement of shoulder range of motion over telehealth medium.

BACKGROUND: Shoulder range-of-motion (ROM) assessment is vital for the follow-up evaluation of operated patients and for the outcome-based research studies. The aim of this study was to investigate the accuracy and reliability of a remote on-screen application (app)-based method of shoulder ROM measurement through a telehealth medium. MATERIALS AND METHODS: A consultant shoulder surgeon, a board-certified orthopedic resident, and a graduate medical doctor served as the examiners. The cohort consisted of 24 healthy volunteers and 16 symptomatic patients with expected shoulder ROM deficits. Shoulder ROM was first examined physically using a goniometer in the clinic and then over Zoom remote conferencing using the protractor extension app of the Chrome browser. RESULTS: Instrument validity was examined by comparing the goniometer method with the protractor app-based method of the expert shoulder consultant using Bland-Altman analysis. It showed only minor mean differences between the healthy volunteers and the patients in elevation (2.0° and 5.0°, respectively), abduction (2.0° and 3.0°, respectively), external rotation with the elbow adducted (1.9° and 0.2°, respectively), external rotation with the elbow abducted at 90° (0.4° and 4°, respectively), and internal rotation with elbow abducted at 90° (2.3° and 1.2°, respectively), with limits of agreement that were below the well-established minimal clinically important difference values. The intraclass correlation coefficient (ICC) values varied between 0.83 and 0.96 for the volunteers and between 0.90 and 0.98 for the patients, indicating excellent correlation between the 2 methods. The interobserver reliability between 2 examiners for the protractor app-based method as evaluated by ICC scores was excellent; it ranged between 0.86 and 0.98 for the volunteers and between 0.88 and 0.99 for the patients. Comparison of the protractor app-based method with the gold-standard goniometer method for the resident and the graduate doctor showed excellent ICC values. CONCLUSION: A protractor app-based method of measuring shoulder ROM over a telehealth medium is accurate and reliable compared with a clinical goniometer method. This validated method can be used during remote telehealth consultation with significant benefits of saving patients travel and time during the COVID-19 (coronavirus disease 2019) pandemic and even later.

A 3D-Printed Knee Wearable Goniometer with a Mobile-App Interface for Measuring Range of Motion and Monitoring Activities.

Wearable technology has been developed in recent years to monitor biomechanical variables in less restricted environments and in a more affordable way than optical motion capture systems. This paper proposes the development of a 3D printed knee wearable goniometer that uses a Hall-effect sensor to measure the knee flexion angle, which works with a mobile app that shows the angle in real-time as well as the activity the user is performing (standing, sitting, or walking). Detection of the activity is done through an algorithm that uses the knee angle and angular speeds as inputs. The measurements of the wearable are compared with a commercial goniometer, and, with the Aktos-t system, a commercial motion capture system based on inertial sensors, at three speeds of gait (4.0 km/h, 4.5 km/h, and 5.0 km/h) in nine participants. Specifically, the four differences between maximum and minimum peaks in the gait cycle, starting with heel-strike, were compared by using the mean absolute error, which was between 2.46 and 12.49 on average. In addition, the algorithm was able to predict the three activities during online testing in one participant and detected on average 94.66% of the gait cycles performed by the participants during offline testing.

Development of Joint Activity Angle Measurement and Cloud Data Storage System.

In this study, we developed a range of motion sensing system (ROMSS) to simulate the function of the elbow joint, with errors less than 0.76 degrees and 0.87 degrees in static and dynamic verification by the swinging and angle recognition modules, respectively. In the simulation process, the É£ correlation coefficient of the Pearson difference between the ROMSS and the universal goniometer was 0.90, the standard deviations of the general goniometer measurements were between ±2 degrees and ±2.6 degrees, and the standard deviations between the ROMSS measurements were between ±0.5 degrees and ±1.6 degrees. With the ROMSS, a cloud database was also established; the data measured by the sensor could be uploaded to the cloud database in real-time to provide timely patient information for healthcare professionals. We also developed a mobile app for smartphones to enable patients and healthcare providers to easily trace the data in real-time. Historical data sets with joint activity angles could be retrieved to observe the progress or effectiveness of disease recovery so the quality of care could be properly assessed and maintained.

Evaluation of a New Simplified Inertial Sensor Method against Electrogoniometer for Measuring Wrist Motion in Occupational Studies.

Wrist velocity is an important risk factor for work-related musculoskeletal disorders in the elbow/hand, which is also difficult to assess by observation or self-reports. This study aimed to evaluate a new convenient and low-cost inertial measurement unit (IMU)-based method using gyroscope signals against an electrogoniometer for measuring wrist flexion velocity. Twelve participants performed standard wrist movements and simulated work tasks while equipped with both systems. Two computational algorithms for the IMU-based system, i.e., IMUnorm and IMUflex, were used. For wrist flexion/extension, the mean absolute errors (MAEs) of median wrist flexion velocity compared to the goniometer were <10.1°/s for IMUnorm and <4.1°/s for IMUflex. During wrist deviation and pronation/supination, all methods showed errors, where the IMUnorm method had the largest overestimations. For simulated work tasks, the IMUflex method had small bias and better accuracy than the IMUnorm method compared to the goniometer, with the MAEs of median wrist flexion velocity <5.8°/s. The results suggest that the IMU-based method can be considered as a convenient method to assess wrist motion for occupational studies or ergonomic evaluations for the design of workstations and tools by both researchers and practitioners, and the IMUflex method is preferred. Future studies need to examine algorithms to further improve the accuracy of the IMU-based method in tasks of larger variations, as well as easy calibration procedures.

Clinical reliability and usability of smartphone goniometers for hip range of motion measurement.

[Purpose] This study aimed to utilize the objective measurements and a survey questionnaire for assessing the intra- and inter-rater reliability, measurement time, and usability of a smartphone application type of goniometer to measure the hip joint angles. [Participants and Methods] Three examiners (physiotherapists) measured the hip joint range of motion using universal and smartphone goniometers on 30 daycare center rehabilitation patients. Reliability was calculated using the intra-class correlation coefficient. The examiners completed a questionnaire survey for assessing the usability of the goniometers. [Results] The intra-rater reliability was high, but the inter-rater reliability was low. Measurement times using the two instruments showed no difference. The usability questionnaire findings suggested that the smartphone goniometer was easier to use than the universal goniometer. [Conclusion] Reliability within the raters was high, but reliability among the raters was low. However, both goniometric devices provided a satisfactory range of motion measurement data when a single evaluator used the same device for all measurements.

Investigations of the optical properties of enamel and dentin for early caries detection.

INTRODUCTION: The aim of this study was to experimentally investigate the potential of different light wavelengths to distinguish between healthy and carious tissue using a two-circle goniometer. MATERIALS AND METHODS: Tooth slices were prepared from extracted human teeth that were caries free (n = 15) or had occlusal caries lesions (n = 10). The tooth slices were irradiated with diode laser modules of different wavelengths (532, 650, 780 nm). The transmitted and scattered laser light was spatially measured with a detector rotating on a two-circle goniometer. The anisotropy factor and attenuation coefficients were calculated. RESULTS: Enamel was more transparent than dentin and showed wavelength-dependent attenuation. Healthy dentin showed strong light scattering at all wavelengths, independent of the tested wavelength. The calculated attenuation coefficients of carious and healthy tooth tissue differed significantly (p < 0.05; t test). In contrast to healthy enamel, carious enamel showed lower light transmission and an increase in scattering. Differences in the light attenuation of carious versus healthy dentin were less pronounced than those for enamel. Carious dentin was slightly more transparent than healthy dentin. The light of longer wavelengths showed a better penetration of all tooth structures compared with shorter wavelengths. CONCLUSION: Healthy and carious dentin and enamel exhibited distinct optical properties using laser light at different wavelengths. In dentin, changes in the optical properties caused by caries are significantly less pronounced. CLINICAL RELEVANCE: The clear distinction between healthy and carious enamel makes optical caries diagnostic systems ideal tools for early caries detection.

Reconstruction of the Image Metric of Periodic Structures in an Opto-Digital Angle Measurement System.

Measurement of the object angular position and its change is one of the important tasks in measurement technique. Our method is based on determination of the angular position of a 2D periodical optical pattern (2D mark) at the object, captured by the sensor of a digital camera. System performance can be frustrated by errors in determination of the spot coordinates on the camera sensor; by the presence of lens aberrations; by deviations from the parallelism of the pattern planes and the camera sensor; and by differences between the actual spots positions and the ideal grid. In the paper we discuss the effect of these errors and the way to correct or eliminate them. We have developed the mathematical routine and the corresponding numerical codes for correction of the said errors. The code and the routine we checked in a real experiment. It has shown that the correction decreases the standard deviation in 15 times.

An Inertial Measurement Unit-Based Wireless System for Shoulder Motion Assessment in Patients with Cervical Spinal Cord Injury: A Validation Pilot Study in a Clinical Setting.

Residual motion of upper limbs in individuals who experienced cervical spinal cord injury (CSCI) is vital to achieve functional independence. Several interventions were developed to restore shoulder range of motion (ROM) in CSCI patients. However, shoulder ROM assessment in clinical practice is commonly limited to use of a simple goniometer. Conventional goniometric measurements are operator-dependent and require significant time and effort. Therefore, innovative technology for supporting medical personnel in objectively and reliably measuring the efficacy of treatments for shoulder ROM in CSCI patients would be extremely desirable. This study evaluated the validity of a customized wireless wearable sensors (Inertial Measurement Units-IMUs) system for shoulder ROM assessment in CSCI patients in clinical setting. Eight CSCI patients and eight healthy controls performed four shoulder movements (forward flexion, abduction, and internal and external rotation) with dominant arm. Every movement was evaluated with a goniometer by different testers and with the IMU system at the same time. Validity was evaluated by comparing IMUs and goniometer measurements using Intraclass Correlation Coefficient (ICC) and Limits of Agreement (LOA). inter-tester reliability of IMUs and goniometer measurements was also investigated. Preliminary results provide essential information on the accuracy of the proposed wireless wearable sensors system in acquiring objective measurements of the shoulder movements in CSCI patients.

An analysis of wrist and forearm range of motion using the Dartfish motion analysis system.

STUDY DESIGN: Clinical measurement. INTRODUCTION: Wrist range of motion (ROM) is considered the universal measurement of success for both surgical and non-surgical treatments. A goniometer can be challenging for an individual to use by themselves, whereas the Dartfish app can analyze and provide immediate feedback to monitor and evaluate patients' kinematic changes during recovery after injury. PURPOSE OF STUDY: To establish the validity and reliability of the Dartfish app measuring ROM to be used in clinical applications. METHODS: Twelve healthy participants, (18-25 yrs) , with no previous history of wrist injuries, were recruited for this study. Flexion/extension, radial/ulnar deviation, and supination/pronation range of motion measures were collected using a goniometer (two-arm) and Dartfish video analysis. Statistical analyses, such as t-tests and the Pearson correlation coefficient, as well as reliability analyses, such as intraclass correlation coefficient (ICC) and Bland-Altman plots, were performed. RESULTS: There was no significant difference between the goniometer and Dartfish ROM measurements except for ulnar deviation. The concurrent validity showed nearly perfect correlations between examiners using Dartfish with r-values in the range 0.90-0.99, and between examiner2 and the goniometer showed medium, large, and very large correlations since the values were in the range 0.418-0.829. The ICC for test-retest reliability had an excellent agreement that ranged from 0.993-0.999, and the ICC values for inter-observer reliability had good and excellent agreement, which were in the range 0.893-0.997. CONCLUSION: Overall, the results demonstrated that the Dartfish app was a reliable and valid method to measure wrist and forearm ROM. A patient would be able to easily record their own ROM measurement videos and track their progress during their recovery without the need of their physician to track their progress.