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Antonacci C, Longo UG, Nazarian A, Schena E, Carnevale A. Monitoring Scapular Kinematics through Wearable Magneto-Inertial Measurement Units: State of the Art and New Frontiers. SENSORS (BASEL, SWITZERLAND) 2023; 23:6940. [PMID: 37571723 PMCID: PMC10422625 DOI: 10.3390/s23156940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
Monitoring shoulder kinematics, including the scapular segment, is of great relevance in the orthopaedic field. Among wearable systems, magneto-inertial measurement units (M-IMUs) represent a valid alternative for applications in unstructured environments. The aim of this systematic literature review is to report and describe the existing methods to estimate 3D scapular movements through wearable systems integrating M-IMUs. A comprehensive search of PubMed, IEEE Xplore, and Web of Science was performed, and results were included up to May 2023. A total of 14 articles was included. The results showed high heterogeneity among studies regarding calibration procedures, tasks executed, and the population. Two different techniques were described, i.e., with the x-axis aligned with the cranial edge of the scapular spine or positioned on the flat surface of the acromion with the x-axis perpendicular to the scapular spine. Sensor placement affected the scapular motion and, also, the kinematic output. Further studies should be conducted to establish a universal protocol that reduces the variability among studies. Establishing a protocol that can be carried out without difficulty or pain by patients with shoulder musculoskeletal disorders could be of great clinical relevance for patients and clinicians to monitor 3D scapular kinematics in unstructured settings or during common clinical practice.
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Affiliation(s)
- Carla Antonacci
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (C.A.); (A.C.)
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy;
| | - Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (C.A.); (A.C.)
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy
| | - Ara Nazarian
- Carl J. Shapiro Department of Orthopaedic Surgery and Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 20115, USA;
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy;
| | - Arianna Carnevale
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (C.A.); (A.C.)
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Wolff A, Sama A, Lenhoff M, Daluiski A. The use of wearable inertial sensors effectively quantify arm asymmetry during gait in children with unilateral spastic cerebral palsy. J Hand Ther 2022; 35:148-150. [PMID: 32571600 DOI: 10.1016/j.jht.2020.03.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/23/2020] [Accepted: 03/31/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Aviva Wolff
- Leon Root, MD Motion Analysis Laboratory, Department of Rehabilitation, Hospital for Special Surgery, New York, NY, USA.
| | - Andrew Sama
- Leon Root, MD Motion Analysis Laboratory, Department of Rehabilitation, Hospital for Special Surgery, New York, NY, USA; University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mark Lenhoff
- Leon Root, MD Motion Analysis Laboratory, Department of Rehabilitation, Hospital for Special Surgery, New York, NY, USA
| | - Aaron Daluiski
- Leon Root, MD Motion Analysis Laboratory, Department of Rehabilitation, Hospital for Special Surgery, New York, NY, USA
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Day JM, Jones T, Eiben K, Berger Y. Scapular motion is accelerated in asymptomatic individuals with dyskinesis: An observational study. J Bodyw Mov Ther 2021; 26:134-140. [PMID: 33992234 DOI: 10.1016/j.jbmt.2020.12.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/15/2020] [Accepted: 12/19/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Individuals with shoulder and upper extremity pathology often present with altered scapular motion. Few studies have looked at variations in scapular acceleration as a way of quantifying scapular motion. The purpose was to determine the effectiveness of wireless accelerometers for detecting changes in acceleration in individuals with scapular dyskinesis. MATERIALS/METHODS Twenty-seven asymptomatic college students (mean age 24 (SD ± 1.54), 65% female, 93% right handed) were visually screened for scapular dyskinesis using previously described criteria. Of the students recruited, fifteen students were determined to have scapular dyskinesis. After securing a wireless accelerometer (MyoResearch 3D DTS) on the dominate scapula, the participants performed five repetitions of standing scaption from 0 to 140°. Linear scapular accelerations along three orthogonal axes (frontal-y, transverse-z, and sagittal-x) were collected. Intraclass correlation coefficients (ICC3, k) were used to determine the between day intra-rater reliability while a one-way analysis of variance was used to determine differences in acceleration between those with and without dyskinesis. RESULTS There was good between day intra-rater reliability for the average of all three axes (ICC = 0.79) and for the x and y axes (ICC > 0.78). Reliability was poor (ICC = 0.31) for the z-axis. There was a significant increase in overall acceleration of the scapula in those with dyskinesis (p = .039). There was also a significant increase in acceleration along the y-axis for those with dyskinesis (p = .003) but not for the other axes (p > .16). CONCLUSION Wireless accelerometers reliably quantify scapular acceleration in healthy individuals. In a healthy population with dyskinesis, the overall magnitude of scapular acceleration was greater when compared to a healthy group without dyskinesis.
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Affiliation(s)
- Joseph M Day
- Department of Physical Therapy, University of Dayton, Fitz Hall, Room 209B 300, College Park Ave, Dayton, OH, 45469, USA.
| | - Taylor Jones
- Department of Physical Therapy, University of Dayton, Fitz Hall, Room 209B 300, College Park Ave, Dayton, OH, 45469, USA.
| | - Kayla Eiben
- Department of Physical Therapy, University of Dayton, Fitz Hall, Room 209B 300, College Park Ave, Dayton, OH, 45469, USA.
| | - Yitz Berger
- Department of Physical Therapy, University of Dayton, Fitz Hall, Room 209B 300, College Park Ave, Dayton, OH, 45469, USA.
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Roldán-Jiménez C, Cuesta-Vargas AI, Martín JM. Discriminating the precision of inertial sensors between healthy and damaged shoulders during scaption movement: A cross-sectional study. Clin Biomech (Bristol, Avon) 2021; 82:105257. [PMID: 33406457 DOI: 10.1016/j.clinbiomech.2020.105257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Shoulder assessment in rehabilitation is focused on kinematic properties due to the variability of symptomatology and clinical expression of shoulder injuries. AIM To perform a receiver operating characteristic analysis of the kinematic variables involved in the functional mobility of the shoulder that allow the identification of discriminating variables between healthy and diseased shoulders during scaption motion. METHOD Analytical cross-sectional study of diagnostic effectiveness was performed in 27 subjects suffering from shoulder damage and 14 asymptomatic controls. Scaption kinematics were evaluated using four inertial sensors placed on the humerus, scapula, forearm and sternum. Three variables (mobility, velocity and acceleration) were obtained from each sensor and the norm of the resultant vector was calculated from each axis. A discriminatory receiver operating characteristic analysis was performed, obtaining the area under the curve, sensitivity and specificity. FINDINGS Significant differences from both the resultant vectors and the axis depended on the body segment analysed were observed. Greater movement velocity and acceleration were observed in the asymptomatic group. Receiver operating characteristic analysis, scapular protraction-retraction mobility distinguished with a diagnostic sensitivity of 83.3% and specificity of 90.9% between asymptomatic and shoulder-damaged patients. These diagnosis values were 83.3% and 72.7% for scapular anterior-posterior velocity. Scapular kinematics, in terms of mobility and velocity, are the key variables in shoulder assessment. INTERPRETATION This study discriminated between patients suffering from shoulder damage and asymptomatic subjects based on shoulder kinematics during scaption motion. Scapular mobility and velocity were found to be key variables in shoulder assessment, along with the humerus.
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Affiliation(s)
- Cristina Roldán-Jiménez
- Department of Physiotherapy, University of Málaga, 29071 Málaga, Spain; Biomedical Research Institute of Málaga (IBIMA), (F-14), Spain
| | - Antonio I Cuesta-Vargas
- Department of Physiotherapy, University of Málaga, 29071 Málaga, Spain; Biomedical Research Institute of Málaga (IBIMA), (F-14), Spain; School of Clinical Science, Faculty of Health Science, Queensland University Technology, Australia.
| | - Jaime Martín Martín
- Biomedical Research Institute of Málaga (IBIMA), (F-14), Spain; University of Medicine, Department of Human Anatomy, Legal Medicine and History of Science; Area of Legal Medicine, Spain
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Burns D, Razmjou H, Shaw J, Richards R, McLachlin S, Hardisty M, Henry P, Whyne C. Adherence Tracking With Smart Watches for Shoulder Physiotherapy in Rotator Cuff Pathology: Protocol for a Longitudinal Cohort Study. JMIR Res Protoc 2020; 9:e17841. [PMID: 32623366 PMCID: PMC7381014 DOI: 10.2196/17841] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/26/2020] [Accepted: 04/26/2020] [Indexed: 12/12/2022] Open
Abstract
Background Physiotherapy is essential for the successful rehabilitation of common shoulder injuries and following shoulder surgery. Patients may receive some training and supervision for shoulder physiotherapy through private pay or private insurance, but they are typically responsible for performing most of their physiotherapy independently at home. It is unknown how often patients perform their home exercises and if these exercises are performed correctly without supervision. There are no established tools for measuring this. It is, therefore, unclear if the full benefit of shoulder physiotherapy treatments is being realized. Objective The proposed research will (1) validate a smartwatch and machine learning (ML) approach for evaluating adherence to shoulder exercise participation and technique in a clinical patient population with rotator cuff pathology; (2) quantify the rate of home physiotherapy adherence, determine the effects of adherence on recovery, and identify barriers to successful adherence; and (3) develop and pilot test an ethically conscious adherence-driven rehabilitation program that individualizes patient care based on their capacity to effectively participate in their home physiotherapy. Methods This research will be conducted in 2 phases. The first phase is a prospective longitudinal cohort study, involving 120 patients undergoing physiotherapy for rotator cuff pathology. Patients will be issued a smartwatch that will record 9-axis inertial sensor data while they perform physiotherapy exercises both in the clinic and in the home setting. The data collected in the clinic under supervision will be used to train and validate our ML algorithms that classify shoulder physiotherapy exercise. The validated algorithms will then be used to assess home physiotherapy adherence from the inertial data collected at home. Validated outcome measures, including the Disabilities of the Arm, Shoulder, and Hand questionnaire; Numeric Pain Rating Scale; range of motion; shoulder strength; and work status, will be collected pretreatment, monthly through treatment, and at a final follow-up of 12 months. We will then relate improvement in patient outcomes to measured physiotherapy adherence and patient baseline variables in univariate and multivariate analyses. The second phase of this research will involve the evaluation of a novel rehabilitation program in a cohort of 20 patients. The program will promote patient physiotherapy engagement via the developed technology and support adherence-driven care decisions. Results As of December 2019, 71 patients were screened for enrollment in the noninterventional validation phase of this study; 65 patients met the inclusion and exclusion criteria. Of these, 46 patients consented and 19 declined to participate in the study. Only 2 patients de-enrolled from the study and data collection is ongoing for the remaining 44. Conclusions This study will provide new and important insights into shoulder physiotherapy adherence, the relationship between adherence and recovery, barriers to better adherence, and methods for addressing them. International Registered Report Identifier (IRRID) DERR1-10.2196/17841
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Affiliation(s)
- David Burns
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Helen Razmjou
- Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Working Condition Program, Holland Orthopedic and Arthritic Centre, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - James Shaw
- Women's College Research Institute, Toronto, ON, Canada.,Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
| | - Robin Richards
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Stewart McLachlin
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Michael Hardisty
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Patrick Henry
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Cari Whyne
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Carnevale A, Longo UG, Schena E, Massaroni C, Lo Presti D, Berton A, Candela V, Denaro V. Wearable systems for shoulder kinematics assessment: a systematic review. BMC Musculoskelet Disord 2019; 20:546. [PMID: 31731893 PMCID: PMC6858749 DOI: 10.1186/s12891-019-2930-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Wearable sensors are acquiring more and more influence in diagnostic and rehabilitation field to assess motor abilities of people with neurological or musculoskeletal impairments. The aim of this systematic literature review is to analyze the wearable systems for monitoring shoulder kinematics and their applicability in clinical settings and rehabilitation. METHODS A comprehensive search of PubMed, Medline, Google Scholar and IEEE Xplore was performed and results were included up to July 2019. All studies concerning wearable sensors to assess shoulder kinematics were retrieved. RESULTS Seventy-three studies were included because they have fulfilled the inclusion criteria. The results showed that magneto and/or inertial sensors are the most used. Wearable sensors measuring upper limb and/or shoulder kinematics have been proposed to be applied in patients with different pathological conditions such as stroke, multiple sclerosis, osteoarthritis, rotator cuff tear. Sensors placement and method of attachment were broadly heterogeneous among the examined studies. CONCLUSIONS Wearable systems are a promising solution to provide quantitative and meaningful clinical information about progress in a rehabilitation pathway and to extrapolate meaningful parameters in the diagnosis of shoulder pathologies. There is a strong need for development of this novel technologies which undeniably serves in shoulder evaluation and therapy.
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Affiliation(s)
- Arianna Carnevale
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Álvaro del Portillo, 21, 00128 Rome, Italy
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Álvaro del Portillo, 21, 00128 Rome, Italy
| | - Daniela Lo Presti
- Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Álvaro del Portillo, 21, 00128 Rome, Italy
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
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Walmsley CP, Williams SA, Grisbrook T, Elliott C, Imms C, Campbell A. Measurement of Upper Limb Range of Motion Using Wearable Sensors: A Systematic Review. SPORTS MEDICINE-OPEN 2018; 4:53. [PMID: 30499058 PMCID: PMC6265374 DOI: 10.1186/s40798-018-0167-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/24/2018] [Indexed: 12/18/2022]
Abstract
Background Wearable sensors are portable measurement tools that are becoming increasingly popular for the measurement of joint angle in the upper limb. With many brands emerging on the market, each with variations in hardware and protocols, evidence to inform selection and application is needed. Therefore, the objectives of this review were related to the use of wearable sensors to calculate upper limb joint angle. We aimed to describe (i) the characteristics of commercial and custom wearable sensors, (ii) the populations for whom researchers have adopted wearable sensors, and (iii) their established psychometric properties. Methods A systematic review of literature was undertaken using the following data bases: MEDLINE, EMBASE, CINAHL, Web of Science, SPORTDiscus, IEEE, and Scopus. Studies were eligible if they met the following criteria: (i) involved humans and/or robotic devices, (ii) involved the application or simulation of wearable sensors on the upper limb, and (iii) calculated a joint angle. Results Of 2191 records identified, 66 met the inclusion criteria. Eight studies compared wearable sensors to a robotic device and 22 studies compared to a motion analysis system. Commercial (n = 13) and custom (n = 7) wearable sensors were identified, each with variations in placement, calibration methods, and fusion algorithms, which were demonstrated to influence accuracy. Conclusion Wearable sensors have potential as viable instruments for measurement of joint angle in the upper limb during active movement. Currently, customised application (i.e. calibration and angle calculation methods) is required to achieve sufficient accuracy (error < 5°). Additional research and standardisation is required to guide clinical application. Trial Registration This systematic review was registered with PROSPERO (CRD42017059935).
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Affiliation(s)
- Corrin P Walmsley
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, 6027, Australia
| | - Sîan A Williams
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, 6027, Australia.,Department of Surgery, University of Auckland, Auckland, 1010, New Zealand
| | - Tiffany Grisbrook
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, 6027, Australia
| | - Catherine Elliott
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, 6027, Australia.,Kids Rehab WA, Perth Children's Hospital, Perth, WA, 6008, Australia
| | - Christine Imms
- Centre for Disability and Development Research, School of Allied Health, Australian Catholic University, Melbourne, VIC, 3065, Australia.
| | - Amity Campbell
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, 6027, Australia
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De Baets L, van der Straaten R, Matheve T, Timmermans A. Shoulder assessment according to the international classification of functioning by means of inertial sensor technologies: A systematic review. Gait Posture 2017; 57:278-294. [PMID: 28683420 DOI: 10.1016/j.gaitpost.2017.06.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/12/2017] [Accepted: 06/23/2017] [Indexed: 02/02/2023]
Abstract
This review investigates current protocols using Inertial Measurement Units (IMUs) in shoulder research, and outlines future paths regarding IMU use for shoulder research. Different databases were searched for relevant articles. Criteria for study selection were (1) research in healthy persons or persons with shoulder problems, (2) IMUs applied as assessment tool for the shoulder (in healthy subjects and shoulder patients) or upper limb (in shoulder patients), (3) peer-reviewed, full-text papers in English or Dutch. Studies with less than five participants and without ethical approval were excluded. Data extraction included (1) study design, (2) participant characteristics, (3) type/brand of IMU, (4) tasks included in the assessment protocol, and (5) outcomes. Risk of bias was assessed using the Downs and Black checklist. Scapulothoracic/glenohumeral and humerothoracic kinematics were reported in respectively 10 and 27 of the 37 included papers. Only one paper in healthy persons assessed, next to scapulothoracic/glenohumeral kinematics, other upper limb joints. IMUs' validity and reliability to capture shoulder function was limited. Considering applied protocols, 39% of the protocols was located on the International-Classification-of-Functioning (ICF) function level, while 38% and 23% were on the 'capacity' and 'actual performance'-sublevel, of the ICF-activity level. Most available IMU-research regarding the shoulder is clinically less relevant, given the widely reported humerothoracic kinematics which do not add to clinical-decision-making, and the absence of protocols assessing the complete upper limb chain. Apart from knowledge on methodological pitfalls and opportunities regarding the use of IMUs, this review provides future research paths.
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Affiliation(s)
- Liesbet De Baets
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Rob van der Straaten
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Thomas Matheve
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Annick Timmermans
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
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