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Abdollah V, Noamani A, Ralston J, Ho C, Rouhani H. Effect of test duration and sensor location on the reliability of standing balance parameters derived using body-mounted accelerometers. Biomed Eng Online 2024; 23:2. [PMID: 38167089 PMCID: PMC10763154 DOI: 10.1186/s12938-023-01196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Balance parameters derived from wearable sensor measurements during postural sway have been shown to be sensitive to experimental variables such as test duration, sensor number, and sensor location that influence the magnitude and frequency-related properties of measured center-of-mass (COM) and center-of-pressure (COP) excursions. In this study, we investigated the effects of test duration, the number of sensors, and sensor location on the reliability of standing balance parameters derived using body-mounted accelerometers. METHODS Twelve volunteers without any prior history of balance disorders were enrolled in the study. They were asked to perform two 2-min quiet standing tests with two different testing conditions (eyes open and eyes closed). Five inertial measurement units (IMUs) were employed to capture postural sway data from each participant. IMUs were attached to the participants' right legs, the second sacral vertebra, sternum, and the left mastoid processes. Balance parameters of interest were calculated for the single head, sternum, and sacrum accelerometers, as well as, a three-sensor combination (leg, sacrum, and sternum). Accelerometer data were used to estimate COP-based and COM-based balance parameters during quiet standing. To examine the effect of test duration and sensor location, each 120-s recording from different sensor locations was segmented into 20-, 30-, 40-, 50-, 60-, 70-, 80-, 90-, 100-, and 110-s intervals. For each of these time intervals, time- and frequency-domain balance parameters were calculated for all sensor locations. RESULTS Most COM-based and COP-based balance parameters could be derived reliably for clinical applications (Intraclass-Correlation Coefficient, ICC ≥ 0.90) with a minimum test duration of 70 and 110 s, respectively. The exceptions were COP-based parameters obtained using a sacrum-mounted sensor, especially in the eyes-closed condition, which could not be reliably used for clinical applications even with a 120-s test duration. CONCLUSIONS Most standing balance parameters can be reliably measured using a single head- or sternum-mounted sensor within a 120-s test duration. For other sensor locations, the minimum test duration may be longer and may depend on the specific test conditions.
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Affiliation(s)
- Vahid Abdollah
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Alireza Noamani
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | | | - Chester Ho
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB, Canada
- Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Hossein Rouhani
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada.
- Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.
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Bhat SG, Shin AY, Kaufman KR. Upper extremity asymmetry due to nerve injuries or central neurologic conditions: a scoping review. J Neuroeng Rehabil 2023; 20:151. [PMID: 37940959 PMCID: PMC10634143 DOI: 10.1186/s12984-023-01277-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Peripheral nerve injuries and central neurologic conditions can result in extensive disabilities. In cases with unilateral impairment, assessing the asymmetry between the upper extremity has been used to assess outcomes of treatment and severity of injury. A wide variety of validated and novel tests and sensors have been utilized to determine the upper extremity asymmetry. The purpose of this article is to review the literature and define the current state of the art for describing upper extremity asymmetry in patients with peripheral nerve injuries or central neurologic conditions. METHOD An electronic literature search of PubMed, Scopus, Web of Science, OVID was performed for publications between 2000 to 2022. Eligibility criteria were subjects with neurological conditions/injuries who were analyzed for dissimilarities in use between the upper extremities. Data related to study population, target condition/injury, types of tests performed, sensors used, real-world data collection, outcome measures of interest, and results of the study were extracted. Sackett's Level of Evidence was used to judge the quality of the articles. RESULTS Of the 7281 unique articles, 112 articles met the inclusion criteria for the review. Eight target conditions/injuries were identified (Brachial Plexus Injury, Cerebral Palsy, Multiple Sclerosis, Parkinson's Disease, Peripheral Nerve Injury, Spinal Cord Injury, Schizophrenia, and stroke). The tests performed were classified into thirteen categories based on the nature of the test and data collected. The general results related to upper extremity asymmetry were listed for all the reviewed articles. Stroke was the most studied condition, followed by cerebral palsy, with kinematics and strength measurement tests being the most frequently used tests. Studies with a level of evidence level II and III increased between 2000 and 2021. The use of real-world evidence-based data, and objective data collection tests also increased in the same period. CONCLUSION Adequately powered randomized controlled trials should be used to study upper extremity asymmetry. Neurological conditions other than stroke should be studied further. Upper extremity asymmetry should be measured using objective outcome measures like motion tracking and activity monitoring in the patient's daily living environment.
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Affiliation(s)
- Sandesh G Bhat
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Alexander Y Shin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
- Motion Analysis Laboratory, Mayo Clinic, DAHLC 4-214A, 200 First Street SW, Rochester, MN, 55905, USA.
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Grip H, Källströmer A, Öhberg F. Validity and Reliability of Wearable Motion Sensors for Clinical Assessment of Shoulder Function in Brachial Plexus Birth Injury. SENSORS (BASEL, SWITZERLAND) 2022; 22:9557. [PMID: 36502259 PMCID: PMC9736020 DOI: 10.3390/s22239557] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
The modified Mallet scale (MMS) is commonly used to grade shoulder function in brachial plexus birth injury (BPBI) but has limited sensitivity and cannot grade scapulothoracic and glenohumeral mobility. This study aims to evaluate if the addition of a wearable inertial movement unit (IMU) system could improve clinical assessment based on MMS. The system validity was analyzed with simultaneous measurements with the IMU system and an optical camera system in three asymptomatic individuals. Test-retest and interrater reliability were analyzed in nine asymptomatic individuals and six BPBI patients. IMUs were placed on the upper arm, forearm, scapula, and thorax. Peak angles, range of motion, and average joint angular speed in the shoulder, scapulothoracic, glenohumeral, and elbow joints were analyzed during mobility assessments and MMS tasks. In the validity tests, clusters of reflective markers were placed on the sensors. The validity was high with an error standard deviation below 3.6°. Intraclass correlation coefficients showed that 90.3% of the 69 outcome scores showed good-to-excellent test-retest reliability, and 41% of the scores gave significant differences between BPBI patients and controls with good-to-excellent test-retest reliability. The interrater reliability was moderate to excellent, implying that standardization is important if the patient is followed-up longitudinally.
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Affiliation(s)
- Helena Grip
- Department of Biomedical Engineering, Radiation Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Anna Källströmer
- Department of Surgical and Perioperative Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Fredrik Öhberg
- Department of Biomedical Engineering, Radiation Sciences, Umeå University, 901 87 Umeå, Sweden
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Lustosa L, Silva AEL, Carvalho RDP, Vargas CD. Upper limb joint coordination preserves hand kinematics after a traumatic brachial plexus injury. Front Hum Neurosci 2022; 16:944638. [PMID: 36277047 PMCID: PMC9583840 DOI: 10.3389/fnhum.2022.944638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTraumatic brachial plexus injury (TBPI) causes a sensorimotor deficit in upper limb (UL) movements.ObjectiveOur aim was to investigate the arm–forearm coordination of both the injured and uninjured UL of TBPI subjects.MethodsTBPI participants (n = 13) and controls (n = 10) matched in age, gender, and anthropometric characteristics were recruited. Kinematics from the shoulder, elbow, wrist, and index finger markers were collected, while upstanding participants transported a cup to their mouth and returned the UL to a starting position. The UL coordination was measured through the relative phase (RP) between arm and forearm phase angles and analyzed as a function of the hand kinematics.ResultsFor all participants, the hand transport had a shorter time to peak velocity (p < 0.01) compared to the return. Also, for the control and the uninjured TBPI UL, the RP showed a coordination pattern that favored forearm movements in the peak velocity of the transport phase (p < 0.001). TBPI participants' injured UL showed a longer movement duration in comparison to controls (p < 0.05), but no differences in peak velocity, time to peak velocity, and trajectory length, indicating preserved hand kinematics. The RP of the injured UL revealed altered coordination in favor of arm movements compared to controls and the uninjured UL (p < 0.001). Finally, TBPI participants' uninjured UL showed altered control of arm and forearm phase angles during the deceleration of hand movements compared to controls (p < 0.05).ConclusionThese results suggest that UL coordination is reorganized after a TBPI so as to preserve hand kinematics.
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Affiliation(s)
- Luiggi Lustosa
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Elisa Lemos Silva
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel de Paula Carvalho
- Departamento de Ciências do Movimento Humano, Instituto Saúde e Sociedade, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Claudia D. Vargas
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Claudia D. Vargas
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Bo F, Yerebakan M, Dai Y, Wang W, Li J, Hu B, Gao S. IMU-Based Monitoring for Assistive Diagnosis and Management of IoHT: A Review. Healthcare (Basel) 2022; 10:healthcare10071210. [PMID: 35885736 PMCID: PMC9318359 DOI: 10.3390/healthcare10071210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 01/22/2023] Open
Abstract
With the rapid development of Internet of Things (IoT) technologies, traditional disease diagnoses carried out in medical institutions can now be performed remotely at home or even ambient environments, yielding the concept of the Internet of Health Things (IoHT). Among the diverse IoHT applications, inertial measurement unit (IMU)-based systems play a significant role in the detection of diseases in many fields, such as neurological, musculoskeletal, and mental. However, traditional numerical interpretation methods have proven to be challenging to provide satisfying detection accuracies owing to the low quality of raw data, especially under strong electromagnetic interference (EMI). To address this issue, in recent years, machine learning (ML)-based techniques have been proposed to smartly map IMU-captured data on disease detection and progress. After a decade of development, the combination of IMUs and ML algorithms for assistive disease diagnosis has become a hot topic, with an increasing number of studies reported yearly. A systematic search was conducted in four databases covering the aforementioned topic for articles published in the past six years. Eighty-one articles were included and discussed concerning two aspects: different ML techniques and application scenarios. This review yielded the conclusion that, with the help of ML technology, IMUs can serve as a crucial element in disease diagnosis, severity assessment, characteristic estimation, and monitoring during the rehabilitation process. Furthermore, it summarizes the state-of-the-art, analyzes challenges, and provides foreseeable future trends for developing IMU-ML systems for IoHT.
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Affiliation(s)
- Fan Bo
- Smart Sensing Research and Development Center, Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, China; (F.B.); (W.W.)
- School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Mustafa Yerebakan
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL 32611, USA;
| | - Yanning Dai
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing 100191, China;
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
| | - Weibing Wang
- Smart Sensing Research and Development Center, Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, China; (F.B.); (W.W.)
- School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jia Li
- Smart Sensing Research and Development Center, Institute of Microelectronics, Chinese Academy of Sciences, Beijing 100029, China; (F.B.); (W.W.)
- School of Microelectronics, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: (J.L.); (B.H.); (S.G.)
| | - Boyi Hu
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL 32611, USA;
- Correspondence: (J.L.); (B.H.); (S.G.)
| | - Shuo Gao
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing 100191, China;
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
- Correspondence: (J.L.); (B.H.); (S.G.)
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Souza L, Lustosa L, Silva AEL, Martins JV, Pozzo T, Vargas CD. Kinematic Changes in the Uninjured Limb After a Traumatic Brachial Plexus Injury. Front Hum Neurosci 2021; 15:777776. [PMID: 34955793 PMCID: PMC8696281 DOI: 10.3389/fnhum.2021.777776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/18/2021] [Indexed: 12/04/2022] Open
Abstract
Background: Traumatic brachial plexus injury (TBPI) typically causes sensory, motor and autonomic deficits of the affected upper limb. Recent studies have suggested that a unilateral TBPI can also affect the cortical representations associated to the uninjured limb. Objective: To investigate the kinematic features of the uninjured upper limb in participants with TBPI. Methods: Eleven participants with unilateral TBPI and twelve healthy controls matched in gender, age and anthropometric characteristics were recruited. Kinematic parameters collected from the index finger marker were measured while participants performed a free-endpoint whole-body reaching task and a cup-to-mouth task with the uninjured upper limb in a standing position. Results: For the whole-body reaching task, lower time to peak velocity (p = 0.01), lower peak of velocity (p = 0.003), greater movement duration (p = 0.04) and shorter trajectory length (p = 0.01) were observed in the TBPI group compared to the control group. For the cup-to-mouth task, only a lower time to peak velocity was found for the TBPI group compared to the control group (p = 0.02). Interestingly, no differences between groups were observed for the finger endpoint height parameter in either of the tasks. Taken together, these results suggest that TBPI leads to a higher cost for motor planning when it comes to movements of the uninjured limb as compared to healthy participants. This cost is even higher in a task with a greater postural balance challenge. Conclusion: This study expands the current knowledge on bilateral sensorimotor alterations after unilateral TBPI and should guide rehabilitation after a peripheral injury.
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Affiliation(s)
- Lidiane Souza
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil.,Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiggi Lustosa
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil.,Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Elisa Lemos Silva
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Vicente Martins
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thierry Pozzo
- INSERM UMR 1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
| | - Claudia D Vargas
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil.,Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto - Universidade Federal Rio de Janeiro, Rio de Janeiro, Brazil
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Abdollah V, Dief TN, Ralston J, Ho C, Rouhani H. Investigating the validity of a single tri-axial accelerometer mounted on the head for monitoring the activities of daily living and the timed-up and go test. Gait Posture 2021; 90:137-140. [PMID: 34481263 DOI: 10.1016/j.gaitpost.2021.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Quantitative assessments of activities of daily living (ADL) play an essential role in evaluating the impact of disease and interventions on people's quality of life. Motion capture systems traditionally used for quantitative assessments of postural transitions and movement associated with ADL are limited to the laboratory setting. Wearable accelerometers can remove these limitations and enable easier-to-use, longer-term, and remote functional evaluations. OBJECTIVE To investigate the validity of a single tri-axial accelerometer mounted on the head for monitoring postural transition and the timed-up-and-go test. METHODS Two accelerometers with a sampling frequency of 100 Hz were attached to twelve able-bodied study participants' sternum and right mastoid process. We developed algorithms for the functional calibration of accelerometers and the detection of the postural transitions by measuring the head inclination angle and variations of the gravitational components of the accelerometer readout. Participants performed a battery of ADL tests involving a wide variety of postural transitions. The head-mounted accelerometers results were compared with a sternum-mounted accelerometer and validated against a video motion capture system as a gold standard reference. RESULTS AND SIGNIFICANCE The results indicate that, utilizing our proposed algorithm, a single tri-axial accelerometer mounted on the head can deliver high accuracy (>95 %), sensitivity (>90 %), and specificity (100 %) for detecting both postural transitions and walking events. Together with the small size and unobtrusive placement of the head-mounted accelerometer, these results demonstrate an attractive solution for the reliable assessment of ADLs and clinical evaluations based on functional tests such as the timed-up-and-go test.
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Affiliation(s)
- Vahid Abdollah
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada; Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Tarek N Dief
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - John Ralston
- PROTXX Medical Ltd. 120, 4838 Richard Road SW, Calgary, Alberta, Canada
| | - Chester Ho
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Hossein Rouhani
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada.
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