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Ermann J. A Move Toward Precision: Innovations in Measuring Spinal Mobility in Axial Spondyloarthritis. J Rheumatol 2023; 50:1362-1363. [PMID: 37778767 DOI: 10.3899/jrheum.2023-0852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
- Joerg Ermann
- J. Ermann, MD, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.
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Functional Range of Motion of the Cervical Spine in Cervical Fusion Patients During Activities of Daily Living. J Biomech 2023; 152:111528. [PMID: 36989970 DOI: 10.1016/j.jbiomech.2023.111528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 01/19/2023] [Accepted: 03/02/2023] [Indexed: 03/17/2023]
Abstract
Following cervical spine fusion there is a reduction in maximum range of motion (ROM) but how this impacts activity of daily living (ADLs) and quality of life is unknown. This study's purpose is to quantify maximum and functional cervical spine ROM in patients with multi-level cervical fusion (>3 levels) compared to controls during ADLs and to correlate functional range of motion with scores from patient reported outcomes measures (PROs) including the Comparative Pain Scale (CPS), Fear Avoidance Belief Questionnaire (FABQ), and Neck Disability Index (NDI). An inertial measurement unit (IMU) system quantified ROM during ADLs in the extension/flexion, lateral bending, and axial rotation directions of motion. The reliability of this system was compared to standard optical motion tracking. Fourteen participants (8 females, age = 60.0 years (18.7) (median, (interquartile range)) with a history of multi-level cervical fusion (years post-op 0.9 (0.7)) were compared to 16 controls (13 females, age = 52.1 years (15.8)). PROs were collected for each participant. Fusion participants had significantly decreased maximum ROM in all directions of motion. Fusion participants had decreased ROM for some ADLs (backing up a car, using a phone, donning socks, negotiating stairs). CPS, FABQ, and NDI scores were significantly increased in fusion participants. Reductions in two activities (backing up a car, stair negotiation) correlated with a combination of increased PRO scores. Cervical fusion decreases maximum ROM and is correlated with increased PROs in some ADLs, however there is minimal impact on functional ROM. Investigation into velocity and acceleration may yield categorization of pathologic movement.
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Maguire S, Wilson F, Gallagher P, O'Shea FD. Worse scores but similar patterns of disease activity: interpreting outcomes in women with axial spondyloarthropathy. Scand J Rheumatol 2023; 52:142-149. [PMID: 35048786 DOI: 10.1080/03009742.2021.2007609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of sex on disease activity in axial spondylitis (axSpA). METHOD Data were extracted from the Ankylosing Spondylitis Registry of Ireland (ASRI). In this cross-sectional study, patients were analysed on the basis of sex, with a series of comparison analyses performed. RESULTS Overall, 886 participants were enrolled in the ASRI [232 (26.2%) women, 644 (72.6%) men]. Females recorded significantly worse Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (4.57 vs 3.83, p < 0.01) and Ankylosing Spondylitis Quality of Life questionnaire (ASQoL) (7.51 vs 6.12, p < 0.01) scores than males. There was a stronger correlation in the Bath Ankylosing Spondylitis Functional and Metrology Indices (BASFI and BASMI) in females (rs = 0.619, p < 0.01) than in males (rs = 0.572, p < 0.01). Analysis of factors in BASDAI revealed that the higher total scores in females compared to males were due not to any single component, but to worse scores in all six components of the BASDAI combined. Ranking of components by severity between sexes revealed identical ranking in four of the six components of the BASDAI. CONCLUSIONS Women with axSpA reported significantly worse disease activity, quality of life, and functional ability than men. However, the BASDAI capturedsimilar patterns of disease activity. Limitation of spinal mobility in women with axSpA corresponded to greater impairment in functional ability. Further evaluation of disease monitoring tools is required to ensure that disease activity is accurately captured in men and women with axSpA.
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Affiliation(s)
- S Maguire
- Department of Rheumatology, St James' Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - F Wilson
- Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland
| | - P Gallagher
- Department of Rheumatology, St Vincent's Hospital, Dublin, Ireland
| | - F D O'Shea
- Department of Rheumatology, St James' Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
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A Wearable System Based on Multiple Magnetic and Inertial Measurement Units for Spine Mobility Assessment: A Reliability Study for the Evaluation of Ankylosing Spondylitis. SENSORS 2022; 22:s22041332. [PMID: 35214234 PMCID: PMC8875397 DOI: 10.3390/s22041332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022]
Abstract
Spinal mobility assessment is essential for the diagnostic of patients with ankylosing spondylitis. BASMI is a routine clinical evaluation of the spine; its measurements are made with goniometers and tape measures, implying systematic errors, subjectivity, and low sensitivity. Therefore, it is crucial to develop better mobility assessment methods. The design, implementation, and evaluation of a novel system for assessing the entire spine’s motion are presented. It consists of 16 magnetic and inertial measurement units (MIMUs) communicated wirelessly with a computer. The system evaluates the patient’s movements by implementing a sensor fusion of the triaxial gyroscope, accelerometer, and magnetometer signals using a Kalman filter. Fifteen healthy participants were assessed with the system through six movements involving the entire spine to calculate continuous kinematics and maximum range of motion (RoM). The intrarater reliability was computed over the observed RoM, showing excellent reliability levels (intraclass correlation >0.9) in five of the six movements. The results demonstrate the feasibility of the system for further clinical studies with patients. The system has the potential to improve the BASMI method. To the best of our knowledge, our system involves the highest number of sensors, thus providing more objective information than current similar systems.
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Callaghan MJ, Hughes T, Davin J, Hayes R, Hough N, Torpey D, Perry D, Dawson S, Murray E, Jones RK. Effect of a cervical collar on head and neck acceleration profiles during emergency spinal immobilisation and extrication procedures in elite football (soccer) players: protocol for a randomised, controlled cross-over trial. BMJ Open Sport Exerc Med 2021; 7:e001157. [PMID: 35028158 PMCID: PMC8718494 DOI: 10.1136/bmjsem-2021-001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
When immobilisation after a cervical spine or head injury is required, the role of the rigid cervical collar is unclear and controversial. There is a need for further studies investigating the use of a rigid cervical collar when head and neck trauma occurs in sport. This study will compare present practice (immobilisation with a cervical collar) to the same procedure without a collar during a simulated spinal immobilisation and extraction scenario from the field of play to the side-line in football (soccer). It will use a prospective cohort within-subjects cross over randomised, controlled trial design. Healthy participants will assume the role of players with a head or neck injury. Clinical practitioners will perform the immobilisation and extrication procedure according to current clinical guidelines. Three dimensional linear and angular acceleration profiles of the head and torso will be measured and the time taken to complete the procedure. The interventions will be a ‘cervical collar’ or ‘no collar’ in random order. Data from the IMUs will be transferred wirelessly to a computer for analysis. Accordingly, within-subject differences between each condition (collar vs no collar) will be assessed with parametric or non-parametric inferential statistics. Statistical significance will be set at p<0.05. Trial registration number:ISRCTN16515969
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Affiliation(s)
- Michael J Callaghan
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
- Medical Department, Manchester United FC, Manchester, UK
- Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Tom Hughes
- Medical Department, Manchester United FC, Manchester, UK
- Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - John Davin
- Medical Department, Manchester United FC, Manchester, UK
| | - Russell Hayes
- Medical Department, Manchester United FC, Manchester, UK
| | - Neil Hough
- Medical Department, Manchester United FC, Manchester, UK
| | - Daniel Torpey
- Medical Department, Manchester United FC, Manchester, UK
| | - David Perry
- Medical Department, Manchester United FC, Manchester, UK
| | - Sam Dawson
- Medical Department, Manchester United FC, Manchester, UK
| | - Eoghan Murray
- Medical Department, Manchester United FC, Manchester, UK
| | - Richard K Jones
- School of Health and Society, University of Salford, Salford, UK
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The Intra- and Inter-Rater Reliability of a Hip Rotation Range-of-Motion Measurement Using a Smartphone Application in Academy Football (Soccer) Players. Sports (Basel) 2021; 9:sports9110148. [PMID: 34822348 PMCID: PMC8623895 DOI: 10.3390/sports9110148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022] Open
Abstract
The clinical assessment of hip rotation range-of-motion (ROM) is important for managing hip and groin injuries in footballers. Previously published reliability studies on hip ROM have employed protocols that are difficult to replicate under everyday clinical conditions. This single trial, intra- and inter-rater reliability study included 41 male academy football (soccer) players, aged 14–15 years, from one European football academy. Passive hip internal rotation (IR) and external rotation (ER) ROM were measured in supine with hip and knee flexed to 90°. The ROM was determined using a smartphone application, with the smartphone attached to the lower leg. The tests were performed on two separate occasions, one week apart, by two different physiotherapists and on both sides (left and right hips). Reliability was evaluated using Intra-Class Correlation Coefficients (ICCs) and Minimal Detectable Change (MDC). Hip IR and ER ROM displayed moderate to good intra-rater agreement (ICCs 0.54–0.75), with MDCs ranging from 10.9° to 16.4°. Inter-rater reliability displayed poor to moderate reliability (ICCs 0.33–0.75), with MDCs ranging from 11.7° to 16.5°. A hip rotation ROM test using a smartphone application and a protocol closely reflecting everyday clinical conditions displayed moderate to good intra-rater reliability and poor to moderate inter-rater reliability. Due to the high MDCs, the practical applicability of this test procedure is limited and further refinement is necessary.
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Future Challenges and Critical Approach to Metrology in Patients with Axial Spondyloarthritis. Diagnostics (Basel) 2021; 11:diagnostics11091533. [PMID: 34573875 PMCID: PMC8465528 DOI: 10.3390/diagnostics11091533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Axial spondyloarthritis (axSpA) is a rheumatic inflammatory chronic disease that mainly affects the spine, producing inflammation and structural damage at the vertebral level (erosions, syndesmophytes, and bony bridges) [...].
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O’Grady M, O’Dwyer T, Connolly J, Condell J, Esquivel KM, O’Shea FD, Gardiner P, Wilson F. Measuring Spinal Mobility Using an Inertial Measurement Unit System: A Reliability Study in Axial Spondyloarthritis. Diagnostics (Basel) 2021; 11:diagnostics11030490. [PMID: 33801982 PMCID: PMC8001996 DOI: 10.3390/diagnostics11030490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 01/13/2023] Open
Abstract
The objectives of this study were to evaluate the reliability of wearable inertial motion unit (IMU) sensors in measuring spinal range of motion under supervised and unsupervised conditions in both laboratory and ambulatory settings. A secondary aim of the study was to evaluate the reliability of composite IMU metrology scores (IMU-ASMI (Amb)). Forty people with axSpA participated in this clinical measurement study. Participant spinal mobility was assessed by conventional metrology (Bath Ankylosing Spondylitis Metrology Index, linear version—BASMILin) and by a wireless IMU sensor-based system which measured lumbar flexion-extension, lateral flexion and rotation. Each sensor-based movement test was converted to a normalized index and used to calculate IMU-ASMI (Amb) scores. Test-retest reliability was evaluated using intra-class correlation coefficients (ICC). There was good to excellent agreement for all spinal range of movements (ICC > 0.85) and IMU-ASMI (Amb) scores (ICC > 0.87) across all conditions. Correlations between IMU-ASMI (Amb) scores and conventional metrology were strong (Pearson correlation ≥ 0.85). An IMU sensor-based system is a reliable way of measuring spinal lumbar mobility in axSpA under supervised and unsupervised conditions. While not a replacement for established clinical measures, composite IMU-ASMI (Amb) scores may be reliably used as a proxy measure of spinal mobility.
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Affiliation(s)
- Megan O’Grady
- Discipline of Physiotherapy, Trinity College Dublin, D08 W9RT Dublin, Ireland; (T.O.); (F.W.)
- Correspondence:
| | - Tom O’Dwyer
- Discipline of Physiotherapy, Trinity College Dublin, D08 W9RT Dublin, Ireland; (T.O.); (F.W.)
- Independent Researcher, D08 W9RT Dublin, Ireland
| | - James Connolly
- Letterkenny Institute of Technology, Letterkenny, F92 FC93 Donegal, Ireland;
| | - Joan Condell
- Magee Campus, Intelligent Systems Research Centre, Faculty of Computing, Engineering and the Built Environment, Ulster University, Derry/Londonderry BT48 7JL, UK; (J.C.); (K.M.E.)
| | - Karla Muñoz Esquivel
- Magee Campus, Intelligent Systems Research Centre, Faculty of Computing, Engineering and the Built Environment, Ulster University, Derry/Londonderry BT48 7JL, UK; (J.C.); (K.M.E.)
| | - Finbar D. O’Shea
- Rheumatology Department, St James’s Hospital, D08 NHY1 Dublin, Ireland;
| | - Philip Gardiner
- Western Health and Social Care Trust, Londonderry BT47 6SB, UK;
| | - Fiona Wilson
- Discipline of Physiotherapy, Trinity College Dublin, D08 W9RT Dublin, Ireland; (T.O.); (F.W.)
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Aranda-Valera IC, Cuesta-Vargas A, Garrido-Castro JL, Gardiner PV, López-Medina C, Machado PM, Condell J, Connolly J, Williams JM, Muñoz-Esquivel K, O’Dwyer T, Castro-Villegas MC, González-Navas C, Collantes-Estévez E. Measuring Spinal Mobility Using an Inertial Measurement Unit System: A Validation Study in Axial Spondyloarthritis. Diagnostics (Basel) 2020; 10:diagnostics10060426. [PMID: 32599741 PMCID: PMC7344521 DOI: 10.3390/diagnostics10060426] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 01/26/2023] Open
Abstract
Portable inertial measurement units (IMUs) are beginning to be used in human motion analysis. These devices can be useful for the evaluation of spinal mobility in individuals with axial spondyloarthritis (axSpA). The objectives of this study were to assess (a) concurrent criterion validity in individuals with axSpA by comparing spinal mobility measured by an IMU sensor-based system vs. optical motion capture as the reference standard; (b) discriminant validity comparing mobility with healthy volunteers; (c) construct validity by comparing mobility results with relevant outcome measures. A total of 70 participants with axSpA and 20 healthy controls were included. Individuals with axSpA completed function and activity questionnaires, and their mobility was measured using conventional metrology for axSpA, an optical motion capture system, and an IMU sensor-based system. The UCOASMI, a metrology index based on measures obtained by motion capture, and the IUCOASMI, the same index using IMU measures, were also calculated. Descriptive and inferential analyses were conducted to show the relationships between outcome measures. There was excellent agreement (ICC > 0.90) between both systems and a significant correlation between the IUCOASMI and conventional metrology (r = 0.91), activity (r = 0.40), function (r = 0.62), quality of life (r = 0.55) and structural change (r = 0.76). This study demonstrates the validity of an IMU system to evaluate spinal mobility in axSpA. These systems are more feasible than optical motion capture systems, and they could be useful in clinical practice.
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Affiliation(s)
- I. Concepción Aranda-Valera
- Faculty of Medicine, University of Córdoba, 14005 Córdoba, Spain; (I.C.A.-V.); (M.C.C.-V.); (C.G.-N.); (E.C.-E.)
- Rheumatology Department, University Hospital Reina Sofía, 14005 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba, 14005 Córdoba, Spain
| | | | - Juan L. Garrido-Castro
- Maimonides Biomedical Research Institute of Cordoba, 14005 Córdoba, Spain
- Computing and Numerical Analysis Department, University of Cordoba, 14014 Córdoba, Spain
- Correspondence:
| | | | - Clementina López-Medina
- Rheumatology Department, University Hospital Reina Sofía, 14005 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba, 14005 Córdoba, Spain
| | - Pedro M. Machado
- Department of Rheumatology, University College London Hospital NHS Foundation Trust, London NW1 2PG, UK;
| | - Joan Condell
- Intelligent Systems Research Centre, University of Ulster, Derry BT48 7JL, UK; (J.C.); (K.M.-E.)
| | - James Connolly
- Letterkenny Institute of Technology, F92 FC93 Letterkenny, Ireland;
| | - Jonathan M. Williams
- Department of Rehabilitation and Sports Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH12 5BB, UK;
| | - Karla Muñoz-Esquivel
- Intelligent Systems Research Centre, University of Ulster, Derry BT48 7JL, UK; (J.C.); (K.M.-E.)
| | - Tom O’Dwyer
- Independent Researcher, D08 W9RT Dublin, Ireland;
| | - M. Carmen Castro-Villegas
- Faculty of Medicine, University of Córdoba, 14005 Córdoba, Spain; (I.C.A.-V.); (M.C.C.-V.); (C.G.-N.); (E.C.-E.)
- Rheumatology Department, University Hospital Reina Sofía, 14005 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba, 14005 Córdoba, Spain
| | - Cristina González-Navas
- Faculty of Medicine, University of Córdoba, 14005 Córdoba, Spain; (I.C.A.-V.); (M.C.C.-V.); (C.G.-N.); (E.C.-E.)
- Rheumatology Department, University Hospital Reina Sofía, 14005 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba, 14005 Córdoba, Spain
| | - Eduardo Collantes-Estévez
- Faculty of Medicine, University of Córdoba, 14005 Córdoba, Spain; (I.C.A.-V.); (M.C.C.-V.); (C.G.-N.); (E.C.-E.)
- Rheumatology Department, University Hospital Reina Sofía, 14005 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba, 14005 Córdoba, Spain
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