1
|
Preatoni E, Bergamini E, Fantozzi S, Giraud LI, Orejel Bustos AS, Vannozzi G, Camomilla V. The Use of Wearable Sensors for Preventing, Assessing, and Informing Recovery from Sport-Related Musculoskeletal Injuries: A Systematic Scoping Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:3225. [PMID: 35590914 PMCID: PMC9105988 DOI: 10.3390/s22093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023]
Abstract
Wearable technologies are often indicated as tools that can enable the in-field collection of quantitative biomechanical data, unobtrusively, for extended periods of time, and with few spatial limitations. Despite many claims about their potential for impact in the area of injury prevention and management, there seems to be little attention to grounding this potential in biomechanical research linking quantities from wearables to musculoskeletal injuries, and to assessing the readiness of these biomechanical approaches for being implemented in real practice. We performed a systematic scoping review to characterise and critically analyse the state of the art of research using wearable technologies to study musculoskeletal injuries in sport from a biomechanical perspective. A total of 4952 articles were retrieved from the Web of Science, Scopus, and PubMed databases; 165 were included. Multiple study features-such as research design, scope, experimental settings, and applied context-were summarised and assessed. We also proposed an injury-research readiness classification tool to gauge the maturity of biomechanical approaches using wearables. Five main conclusions emerged from this review, which we used as a springboard to propose guidelines and good practices for future research and dissemination in the field.
Collapse
Affiliation(s)
- Ezio Preatoni
- Department for Health, University of Bath, Bath BA2 7AY, UK; (E.P.); (L.I.G.)
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath BA2 7AY, UK
| | - Elena Bergamini
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy; (E.B.); (A.S.O.B.); (V.C.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy
| | - Silvia Fantozzi
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy;
- Health Sciences and Technologies—Interdepartmental Centre for Industrial Research, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Lucie I. Giraud
- Department for Health, University of Bath, Bath BA2 7AY, UK; (E.P.); (L.I.G.)
| | - Amaranta S. Orejel Bustos
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy; (E.B.); (A.S.O.B.); (V.C.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy; (E.B.); (A.S.O.B.); (V.C.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy
| | - Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy; (E.B.); (A.S.O.B.); (V.C.)
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), University of Rome “Foro Italico”, Piazza L. de Bosis 6, 00135 Rome, Italy
| |
Collapse
|
2
|
Rooks TF, Novotny BL, McGovern SM, Winegar A, Shivers BL, Brozoski FT. Evaluation of Head and Body Kinematics Experienced During Parachute Opening Shock. Mil Med 2021; 186:e1149-e1156. [PMID: 33277987 DOI: 10.1093/milmed/usaa519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/19/2020] [Accepted: 11/30/2020] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The U.S. Army conducts airborne operations in order to insert soldiers into combat. Military airborne operations are physically demanding activities with a unique loading environment compared with normal duties. A significant amount of research surrounding airborne operations has focused on assessing the incidence and type of associated injuries as well as the potential risk factors for injuries. During parachute opening shock and other high-acceleration events (e.g., fixed wing flight or vehicle crashes), the neck may be vulnerable to injury if inertial loads overcome the voluntary muscular control of the cervical spine and soft tissue structures. A recent epidemiological survey of sport skydivers showed that the neck, shoulders, and back were the most frequently reported sites of musculoskeletal pain. In addition, the survey indicated that wing loading (a measure of the jumper's weight divided by the size of the parachute canopy) was a potential contributing factor for developing musculoskeletal pain. Recently, there have been efforts to measure the severity of parachute opening shock as an additional potential risk factor for injury; however, no studies have measured both head and body accelerations and no studies have measured head or body angular rate during parachute opening shock. The purpose of this study was to measure and characterize the accelerations and angular rates of both the head and body during parachute opening shock as well as investigate potential factors contributing to higher severity opening shock, which may link to the development of musculoskeletal pain or injury. MATERIALS AND METHODS Data were collected from the U.S. Army Parachute Team, The Golden Knights, under an approved Medical Research and Material Command Institutional Review Board protocol. Subjects were instrumented with a helmet- and body-mounted sensor package, which included three angular rate sensors and three single-axis accelerometers each. Data were collected at 2,500 samples per second. Kruskal-Wallis tests were used to determine if helmet-mounted equipment (e.g., cameras), neck length, neck circumference, or wing loading (the ratio of jump weight to the size of the main parachute canopy) affected the accelerations or angular rates of the head or body. RESULTS A total of 54 jumps conducted by 19 experienced free-fall jumpers were analyzed. For the head, the mean (± SD) resultant accelerations and angular rates were 5.8 (± 1.6) g and 255.9 (± 74.2) degrees per second (deg/s), respectively. For the body, the resultant accelerations and angular rates were 4.3 (± 1.5) g and 181.3 (± 61.2) deg/s, respectively. A wing loading above 1.4 pounds per square foot (lb/ft2) was found to have a significant effect on head (P = .001) and body (P = .001) resultant acceleration as well as body angular rate about the Y-axis (P = .001). CONCLUSIONS There is evidence to suggest that wing loading has an influence on individual head and body resultant accelerations. However, no significant effects were found for the other variables (e.g., neck length and circumference, helmet-mounted equipment, etc.). Future research should focus on identifying additional factors that result in changes in accelerations and angular rates of the head and body during parachute opening shock events.
Collapse
Affiliation(s)
- Tyler F Rooks
- Injury Biomechanics and Protection Group, U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
| | - Brian L Novotny
- Injury Biomechanics and Protection Group, U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA.,Injury Biomechanics and Protection Group, Katmai Health Services, Anchorage, AK 99503, USA
| | - Shannon M McGovern
- Injury Biomechanics and Protection Group, U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA.,Injury Biomechanics and Protection Group, Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830, USA
| | - Andrea Winegar
- Injury Biomechanics and Protection Group, U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA.,Injury Biomechanics and Protection Group, Katmai Health Services, Anchorage, AK 99503, USA
| | - Bethany L Shivers
- Injury Biomechanics and Protection Group, U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
| | - Frederick T Brozoski
- Injury Biomechanics and Protection Group, U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
| |
Collapse
|
3
|
Lo Martire R, Gladh K, Westman A, Äng BO. Neck Muscle EMG-Force Relationship and Its Reliability During Isometric Contractions. SPORTS MEDICINE-OPEN 2017; 3:16. [PMID: 28411326 PMCID: PMC5392189 DOI: 10.1186/s40798-017-0083-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 03/30/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Susceptible to injury, the neck is subject to scientific investigations, frequently aiming to elucidate possible injury mechanisms via surface electromyography (EMG) by indirectly estimating cervical loads. Accurate estimation requires that the EMG-force relationship is known and that its measurement error is quantified. Hence, this study examined the relationship between EMG and isometric force amplitude of the anterior neck (AN), the upper posterior neck (UPN), and the lower posterior neck (LPN) and then assessed the relationships' test-retest reliability across force-percentiles within and between days. METHODS EMG and force data were sampled from 18 participants conducting randomly ordered muscle contractions at 5-90% of maximal voluntary force during three trials over 2 days. EMG-force relationships were modeled with general linear mixed-effects regression. Overall fitted lines' between-trial discrepancies were evaluated. Finally, the reliability of participants' fitted regression lines was quantified by an intraclass correlation coefficient (ICC) and the standard error of measurement (SEM). RESULTS A rectilinear model had the best fit for AN while positively oriented quadratic models had the best fit for UPN and LPN, with mean adjusted conditional coefficients of determination and root mean square errors of 0.97-0.98 and 4-5%, respectively. Overall EMG-force relationships displayed a maximum 6% between-trial discrepancy and over 20% of maximal force, and mean ICC was above 0.79 within day and 0.27-0.61 between days across areas. Corresponding SEM was below 12% both within and between days across areas, excluding UPN between days, for which SEM was higher. CONCLUSIONS EMG-force relationships were elucidated for three neck areas, and provided models allow inferences to be drawn from EMG to force on a group level. Reliability of EMG-force relationship models was higher within than between days, but typically acceptable for all but the lowest contraction intensities, and enables adjustment for measurement imprecision in future studies.
Collapse
Affiliation(s)
- Riccardo Lo Martire
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Alfred Nobels allé 23 100, Huddinge, 141 83, Sweden. .,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. .,Department of Aeronautical and Vehicle Engineering, KTH Royal Institute of Technology, Stockholm, Sweden.
| | - Kristofer Gladh
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Alfred Nobels allé 23 100, Huddinge, 141 83, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anton Westman
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Alfred Nobels allé 23 100, Huddinge, 141 83, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Anesthesia and Intensive Care, Karolinska University Hospital, Huddinge, Sweden
| | - Björn O Äng
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Alfred Nobels allé 23 100, Huddinge, 141 83, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| |
Collapse
|
4
|
Westman A, Äng BO. Free Fall Acrobatics to Reduce Neck Loads During Parachute Opening Shock: Evaluation of an Intervention (ACROPOSE). BMJ Open Sport Exerc Med 2016; 2:e000108. [PMID: 27900175 PMCID: PMC5117073 DOI: 10.1136/bmjsem-2015-000108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2016] [Indexed: 12/05/2022] Open
Abstract
Introduction Neck pain is a widespread health problem in the skydiver athlete population, epidemiologically linked to repeated exposure to parachute opening shock (POS). During POS, a parachutist is subjected to considerable deceleration forces. This study aims to evaluate the use of preventive free fall acrobatics to reduce the biomechanical load on the neck of parachutists during parachute opening. Methods and analysis Interventional study with a cross-over, within-subject, repeated measures design. Two consecutive skydives are made on the same day with random ordering of either an ‘intervention jump’ or a ‘control jump’. The intervention jump contains two acrobatic elements prior to main parachute extraction: Reducing parachute deployment airspeed and positioning the human body head high. The primary outcome measure is the magnitude of initial Gx deceleration. All other directions of accelerations will be measured as well, as will magnitudes of multidirectional jerks (rates of changes of accelerations) and lower neck torque. Repeated within group measures analysis of variance will be used to quantify effects, and regression used to test for relationships between the elements of the intervention. Ethics and dissemination Regional Medical Research Ethics Committee of Stockholm approval 2015/1189-31. The intervention protocol has been systematically prevalidated with an emphasis on participant safety. The study will be conducted in compliance with the Declaration of Helsinki, and its results published in peer-reviewed journals, preferably Open Access, to maximise access for the target athlete population. Trial registration number NCT02625896. Pre-results.
Collapse
Affiliation(s)
- Anton Westman
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Anesthesia and Intensive Care Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Björn O Äng
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden; Centre for Clinical Research Dalarna, Falun, Sweden
| |
Collapse
|
5
|
Westman A, Äng BO. Validation of a free fall acrobatics intervention protocol to reduce neck loads during parachute opening shock. BMJ Open Sport Exerc Med 2015; 1:bmjsem-2015-000045. [PMID: 27900113 PMCID: PMC5117032 DOI: 10.1136/bmjsem-2015-000045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 01/26/2023] Open
Abstract
Background Elevated neck pain prevalence among skydivers is associated with exposure to repeated parachute opening shock (POS). A study is planned to evaluate a preventive free fall acrobatics intervention, but prior assessment of the protocol is necessary given the complex and safety-critical study environment. Aim To validate an intervention protocol to reduce POS neck loads. Methods A protocol was developed based on observational data and theoretical calculations. Six experts rated each component of the protocol on a four-point Likert scale, regarding relevance, simplicity/feasibility and safety, and responded to open-ended questions. Two iterations were made, each followed by consensus panel protocol revisions. The content validity index (CVI) was used to quantify ratings. A measure of universal agreement (CVI/UA) was computed as the proportion of components that achieved a rating ≥3 by all raters. For safety, a high-sensitivity CVI/UA was computed with a rating of no <4 (highest score) as acceptable. Results CVI/UA for relevance increased from 0.80 in the first assessment to 1.00 in the second; for simplicity from 0.50 to 0.63; and for safety from 0.70 to 1.00. High-sensitivity CVI/UA for safety increased from 0.10 to 0.75. Responses to open-ended questions included safety concerns for free fall stability, altitude awareness and concerns over comprehensibility. Conclusions The proposed protocol has been improved in assessed relevance, simplicity and safety, and is considered validated for the start of the empirical trial. To what degree complex interventions should be preceded by open prevalidation is discussed.
Collapse
Affiliation(s)
- Anton Westman
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Anesthesia and Intensive Care Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Björn O Äng
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Center for Clinical Research Dalarna, Sweden
| |
Collapse
|