Impact of Minimally Invasive Intra-Capsular Metatarsal Osteotomy on Plantar Pressure Decrease: A Cross-Sectional Study

Background: Metatarsalgia is a common pathology that is initially treated conservatively, but failure to do so requires surgery, such as the minimally invasive distal metatarsal osteotomy (DICMO). Methods: In this prospective study of 65 patients with primary metatarsalgia who underwent DICMO, plantar pressures, American Orthopaedic Foot and Ankle Society MetaTarsoPhalangeal-InterPhalangeal scale (AOFAS-MTP-IP) and Visual Analog Scale (VAS) were evaluated pre-operatively and post-operatively and there was a subgroup in which an inclinometer was used to observe the importance of the inclination of the osteotomy. Results: The results show a significant reduction in plantar pressures after DICMO surgery without overloading the adjacent radii, especially in the subgroup with an inclinometer to guide the osteotomy. The AOFAS-MTP-IP scale evidenced a marked improvement in metatarsal function and alignment with scores close to normal. The VAS scale showed a substantial decrease in pain after DICMO osteotomy. Conclusions: DICMO, with an inclinometer for a 45° osteotomy, proved to be a safe and effective procedure for primary metatarsalgia, although further comparative studies are needed to confirm its superiority.

Shoulder Proprioception: A Review

The purpose of this review is to provide a comprehensive resource for shoulder proprioception assessment and its integration into clinical decision making as well as targeted rehabilitation protocols. Data for this review were acquired from peer-reviewed articles from computerized online databases, namely PubMed and Medline, published between 1906 and 2021. The development of digital/smart phone goniometers can improve shoulder joint range of motion (ROM) measurements and demonstrate comparable measurement accuracy to the universal standard goniometer. The inclinometer offers a portable and cost-effective method for measuring shoulder joint angles and arcs of motion in the vertical plane. Two types of dynamometers, the computerized isokinetic machine and the handheld hydraulic dynamometer, are reliable tools for objective shoulder rotator cuff strength assessment. Motion analysis systems are highly advanced modalities that create three-dimensional models of motion arcs using a series of cameras and reflective beads, offering unparalleled precision in shoulder proprioception measurement; however, they require time-consuming calibration and skilled operators. Advancements in wearable devices and compact mobile technology such as iPhone applications may make three-dimensional motion analysis more affordable and practical for outpatient settings in the future. The complex interplay between proprioception and shoulder dysfunction is not fully understood; however, shoulder proprioception can likely both contribute to and be caused by shoulder pathology. In patients with rotator cuff tears, glenohumeral osteoarthritis, and shoulder instability, clinicians can track proprioception to understand a patient's disease progression or response to treatment. Finally, rehabilitation programs targeting shoulder proprioception have shown promising initial results in restoring function and returning athletes to play.

Thoracic Spine Mobility and Posture: Correlation and Predictive Values in Physically Independent Older Adults

The posture undergoes changes during aging and may serve as a marker for the evaluation of the thoracic spine. This study aimed to correlate the variables for the evaluation of thoracic spine mobility and propose predictive equation models from the measurements of the thoracic Schober test and the digital inclinometer in older adults. The mobility of thoracic flexion and extension by levels (T1, T8 and T12) of 41 older adult subjects (66 ± 7 years) was quantified with a digital inclinometer (degrees) and Schober's test (cm). There was a moderate positive correlation between the digital inclinometer and the Schober test at T1 (r = .69), T12 (r = .60), and total flexion levels T1 to T12 (r = .74). Simple linear regression equations showed that thoracic Schober predicts thoracic mobility measures for these same levels. Moderate to strong correlations were observed between the inclinometer and the Schober Test measurements. The development of predictive equation models based on the thoracic Schober test could potentially enhance the ability to predict spinal mobility in physically independent older adults.

Improving the Accuracy of Metatarsal Osteotomies in Minimally Invasive Foot Surgery Using a Digital Inclinometer: Preliminary Study

Minimally invasive foot surgery (MIS) has become a common procedure to treat various pathologies, and accuracy in the angle of metatarsal osteotomies is crucial to ensure optimal results. This randomized controlled trial with 37 patients investigates whether the implementation of a digital inclinometer can improve the accuracy of osteotomies compared to traditional freehand techniques. Patients were randomly allocated to group A (n = 15) receiving inclinometer-assisted surgery or group B (n = 22) receiving conventional surgery. Osteotomies were performed and outcomes were evaluated using an inclinometer. The inclinometer group showed a significant decrease in plantar pressure from 684.1 g/cm2 pretreatment to 449.5 g/cm2 post-treatment (p < 0.001, Cohen's d = 5.477). The control group decreased from 584.5 g/cm2 to 521.5 g/cm2 (p = 0.001, Cohen's d = 0.801). The effect size between groups was large (Cohen's d = -2.572, p < 0.001). The findings indicate a significant improvement in accuracy and reduction in outliers when using an inclinometer, suggesting that this technology has the potential to improve surgical practice and patient outcomes in minimally invasive metatarsal osteotomies.

Contemporary, non-navigation, cup orientation techniques improve accuracy and eliminate differences seen between the anterior and posterior approach in THA

BACKGROUND

This study aimed to: (1) Determine the ability to achieve the surgeons' desired cup orientation, without navigation, using contemporary measures with the anterior- (AA) and posterior- approaches (PA); and (2) assess whether surgical approach is associated with cup orientation accuracy, as previously reported, when contemporary measures are used.

METHODS

A prospective, 2-centre, multi-surgeon study of 400 THAs (200 AA; 200 PA) was performed. Intraoperative radiographs were obtained with the AA. A digital inclinometer and 3-point pelvic support were used with the PA. With the PA, intraoperative cup inclination at impaction was recorded. Radiographic inclination/anteversion (RI/RA) was measured from intraoperative radiographs (AA-only) and from postoperative radiographs for all cases. Optimum inclination/anteversion was defined as 40°/20° (±10°). The difference between intra- and postoperative orientations allowed for determination of the difference in pelvic position at impaction.

RESULTS

Optimum RI and RA were achieved in 91.3% (n = 365) and 92% (n = 368) of cases respectively. Optimum cup orientation was detected in 84% of cases (n = 336). There was equivalent ability to achieve cup orientation between approaches (AA: 82.5% vs. PA: 85.5%; p = 0.41). The use of an inclinometer in the PA was associated with a smaller variability of inclination at implantation (10° vs. 14°) and counteracted the greater difference in pelvic position (4.4° vs. 2.1°) seen with the PA.

CONCLUSIONS

Over 80% of cases can have optimum orientation without navigation, using simple, cheap contemporary measures. Such measures eliminate differences between approaches, related to patient position. Narrower implantation angles will further reduce variability in cup orientation achieved.

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.

Effect of Lumbar Spine Mobility and Postural Alignment on Menstrual Pain in Young Women

(1) Background: Studies indicate that 45 to 95% of women suffer from painful periods. Despite frequent incidence, the problem is still underestimated. Menstruation-related ailments often correlate with high absenteeism at school and work, as well as limitation of social and scientific activity. The aim of this study was to assess the relationship between the size of the curvature, the mobility of the spine in the sagittal plane, and menstrual pain in young women. (2) Methods: The analysis included 224 women aged 18-26, mean of 21.56 ± 1.95, studying at the College of Medical Sciences of the University of Rzeszów. For this purpose, the measurement of the anterior-posterior curvature of the spine with a gravitational inclinometer, the Schober test and the authors' questionnaire related to menstruation were used. (3) Results: The data analysis demonstrated a significant difference between the group with menstrual pain (MP) and the control group without pain (CG), where the angle of the lumbar sacral transition (p = 0.034), thoracolumbar transition (p = 0.044) and lumbar lordosis (p = 0.006) were statistically significantly lower in MP compared to CG. There were no significant differences in the measurement of the so-called smartphone hump and between the mobility of the lumbar spine and menstrual pain in any of the groups. (4) Conclusions: Women with menstrual pain are characterized by reduced lumbar lordosis and thoracic kyphosis, while sagittal mobility of the spine does not affect pain.

Measurement and Correction of Pointing Error Caused by Radio Telescope Alidade Deformation based on Biaxial Inclination Sensor

One of the key reasons for the deterioration of antenna pointing accuracy for radio telescopes is the deformation and tilt of antenna alidades, which primarily result from track unevenness and thermal gradients. A high-precision inclinometer measurement system is installed to investigate the tilt of the antenna alidade and the pointing errors caused thermally. An environment control box with a leveling base was designed to reduce the interference of the external environment, which proved to be effective in guaranteeing the zero-point stability and repeat accuracy of the inclinometer. The tilt of the alidade caused by the track unevenness was measured by a test of slowly rotating the antenna along the azimuth at windless nighttime. A 5-day antenna stationary test and a 48 h astronomical pointing error measurement were performed, which proved the inclinometer measurement system is capable of measuring the thermally induced inclinations with acceptable accuracy. Through a preliminary compensation experiment, the pointing error is compensated from 37″ to 12″, which shows that the application of the system has a good effect on improving the pointing accuracy of the antenna. The system with high measurement accuracy, good system stability, and low computational complexity, proves an effective tool for the radio telescope to solve the problem of real-time measurement and compensation for antenna pointing errors.

Application and Development of Fiber Optic Gyroscope Inertial Navigation System in Underground Space

Fiber Optic Gyroscope Inertial Navigation System (FOG-INS) is a navigation system using fiber optic gyroscopes and accelerometers, which can offer high-precision position, velocity, and attitude information for carriers. FOG-INS is widely used in aerospace, marine ships, and vehicle navigation. In recent years, it has also played an important role in underground space. For example, in the deep earth, FOG-INS can be used in directional well drilling, which can enhance recovery in resource exploitation. While, in shallow earth, FOG-INS is a high-precision positioning technique that can guide construction in trenchless underground pipelaying. This article extensively reviews the application status and latest progress of FOG-INS in underground space from three aspects-FOG inclinometer, FOG drilling tool attitude measurement while drilling (MWD) unit, and FOG pipe-jacking guidance system. First, measurement principles and product technologies are introduced. Second, the research hot spots are summarized. Finally, the key technical issues and future trends for development are put forward. The findings of this work are useful for further research in the field of FOG-INS in underground space, which not only provides new ideas and directions for scientific research, but also offers guidance for subsequent engineering applications.

An Electrochemical Tilt Sensor with Double-Band Electrodes Fabricated by Wire Winding

This paper presents the principle, design, fabrication, and characterization of Molecular Electronic Transducer (MET) dual-axis tilt sensors. The proposed sensor has a 3D-printed cylindrical channel inserted with four double-band electrodes and partially filled with a liquid electrolyte. The double-band electrodes were fabricated by wire winding with a ~0.1 mm anode-cathode distance under controlled tension. It allows the electrode to become any 3D coil rather than a 2D structure by microfabrication and exhibits good repeatability (±10%). The tilting changes the electrolyte level and electrode-electrolyte contact area, resulting in Faradaic current changes. The x-axis and the y-axis sensitivity reach 0.121 V/° and 0.154 V/°, respectively.

Quantifying the Effect of Monitor Wear Time and Monitor Type on the Estimate of Sedentary Time in People with COPD: Systematic Review and Meta-Analysis

In studies that have reported device-based measures of sedentary time (ST) in people with chronic obstructive pulmonary disease (COPD), we explored if the monitor type and monitor wear time moderated the estimate of this measure. Five electronic databases were searched in January 2021. Studies were included if >70% of participants had stable COPD, and measures of ST (min/day) were collected using wearable technology. Meta-regression was used to examine the influence of moderators on ST, monitor type, and wear time. The studies identified were a total of 1153, and 36 had usable data for meta-analyses. The overall pooled estimate of ST (mean [95% CI]) was 524 min/day [482 to 566] with moderate heterogeneity among effect sizes (I2 = 42%). Monitor wear time, as well as the interaction of monitor wear time and monitor type, were moderators of ST (p < 0.001). The largest difference (−318 min; 95% CI [−212 to −424]) was seen between studies where participants wore a device without a thigh inclinometer for 24 h (and removed sleep during analysis) (675 min, 95% CI [589 to 752]) and studies where participants wore a device with a thigh inclinometer for 12 h only (356 min; 95% CI [284 to 430]). In people with COPD, the monitor wear time and the interaction of the monitor wear time and the monitor type moderated the estimate of ST.

A Novel Elastomer-Based Inclinometer for Ultrasensitive Bridge Rotation Measurement

Bridge deformation consists of cross-section rotation and deflection, which are crucial parameters for bridge capacity evaluation and damage detection. The maximum value of deflection usually happens at mid-span while for rotation it happens at two-ends. Therefore, compared with deflection, rotation is more convenient for in-situ measurement since the bridge pier can be the reference point. In this study, a high-precision inclinometer for bridge rotation measurement was conceptualized, designed, and validated. The proposed inclinometer converted the small rotation of bridge section into the deformation of an elastomer. Strain gauges were then utilized to measure the elastomer deformation and thus the bridge rotation can be obtained. The dimensions and modulus of the elastomer were designed and chosen based on the theoretical analysis. Characteristics of the inclinometer were calibrated in lab and in-situ experiments at an in-service bridge were conducted to validate its feasibility and robustness. Test results showed that the proposed inclinometer had excellent performance in resolution and accuracy, which indicate its great potential for future bridge health monitoring.

Can the use of an inclinometer improve acetabular cup inclination in total hip arthroplasty? A review of the literature

INTRODUCTION

The angle of acetabular (cup) radiographic inclination is an important measurement in total hip arthroplasty (THA) procedures. Abnormal radiographic inclination is associated with dislocation, edge loading and higher failure rates. Consistently achieving a satisfactory radiographic inclination remains a challenge. Inclinometers have been increasingly used over the last decade. This paper reviews the literature to determine whether using an inclinometer improves the accuracy of acetabular cup inclination in THA.

METHODS

A systematic literature search was performed. The following search terms were used: ('hip' OR 'hip replacement' OR 'hip arthroplasty' OR 'primary hip replacement' OR 'THR' OR 'THA' OR 'Acetabular cup Inclination') AND ('Inclinometer'). Titles and abstracts were screened for relevance. Both radiographic and operative inclination comparisons were included.

RESULTS

7 studies met the inclusion criteria. 2 were randomised control trials with level I evidence, and the remaining studies were cohort studies with level III/IV evidence. 5 were clinical and 2 experimental. In total there were 16 cohorts: 7 using an inclinometer, 6 freehand, and 3 using MAG techniques. All studies comparing radiographic inclination and 1 of 2 studies comparing operative inclination showed an improvement in the attainment of the optimal inclination. Similarly, the use of an inclinometer showed a reduction in the number of outliers when compared to MAG and freehand techniques.

DISCUSSION

This review demonstrates that using an inclinometer improved the surgeon's ability to achieve their intended inclination (both operative and radiographic) and reduced the incidence of positioning outside the safe-zone. However, only 2 of the studies were randomised control trials and these resulted in opposing conclusions. Therefore, further studies looking at the use of inclinometers would prove useful in understanding their true benefit.

Evaluation of proprioception in patients who underwent ACL reconstruction: measurement in functional position

Background/aim

Anterior cruciate ligament (ACL) injuries cause mechanoreceptor loss in the joint; therefore, proprioceptive deficits are observed after injury. In particular, proprioceptive measurements made in the functional position give more accurate results, and this is an area that requires further studies. This study aimed to evaluate proprioception in patients who had undergone ACL reconstruction (ACLR) in functional positions used in daily life (closed kinetic chain position), according to joint angles where ACL injuries occur more frequently, in comparison with healthy controls.

Materials and methods

Thirty-four participants who underwent ACLR using a hamstring tendon graft (aged 29.18 ± 8.16 years; body mass index (BMI), 26.58 ± 4.02 kg/cm²) and 31 healthy participants (aged 27.35 ± 5.74 years; BMI, 24.76 ± 2.98 kg/cm²) were included. Proprioception was assessed with an active angle repetition test, using an inclinometer in the closed kinetic chain position while standing. Participants were asked to perform single-leg squats until the angle at the knee joint was 30°. After the targeted angle was defined, the participants were asked to find the targeted angle. The difference between the targeted angle and the angle reached by the participants was calculated.

Results

A statistically significant difference in the active joint position sense was found among the ACLR extremity, uninvolved extremity, and control extremity (p < 0.05). The proprioceptive sense between the two extremities in the ACLR group was similar, and the proprioceptive sense was worse than that of the control group.

Conclusion

To our knowledge, this is the first study to evaluate closed kinetic chain position in patients who underwent ACLR, and it showed that proprioceptive sense was still poor in patients with ACLR compared with the control group, even if an average of 24 months have elapsed since surgery.

Sagittal standing spinal alignment and back pain in 8 to 12-year-old children from the Region of Murcia, Spain: The ISQUIOS Program

BACKGROUND

The child's spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP).

OBJECTIVE

The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children.

METHODS

This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children's parents or legal guardians filled in a questionnaire according to the children's responses about the BP suffered in the previous week and the preceding year.

RESULTS

The mean angular value of thoracic kyphosis was 36.08 ± 8.99∘ and significantly higher in males than in females (p= 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46∘, being higher in females than in men (p< 0.01). The thoracic curve tends to increase by age (p= 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20∘) than those who did not have LBP in the preceding week (32.24 ± 7.30∘). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009-1.160, p= 0.028).

CONCLUSIONS

To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33∘. The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages.

A Temperature Independent Inclinometer Based on a Tapered Fiber Bragg Grating in a Fiber Ring Laser

We demonstrate a new concept for an all-fiber inclinometer based on a tapered fiber Bragg grating (tFBG) in a fiber ring laser (FRL) with the capability of measuring the tilt angle and temperature simultaneously. The sensor performance is analyzed theoretically and investigated experimentally. The dependence of tilt angle on the spectral response in variable temperature conditions was measured. Two inclinometers with different lengths have been fabricated and characterized in FRL. The sensitivity is 0.583 dB/° and 0.849 dB/°, respectively, in the range of 0° to 90°. Thanks to the FRL system, narrow 3-dB bandwidth (<0.1 nm) and high optical signal-to-noise ratio (~60 dB) are achieved. The tFBG in the FRL system can be used for working as a temperature insensitive inclinometer. The results suggested that the proposed inclinometer has the advantages of compact size and convenient manufacture, enhancing its potential for application prospect.

Electric-Contact Tilt Sensors: A Review

A review of various kinds of solid tilts sensors, using a free mechanical member for generation of electric-contact (mostly a ball), is presented. Standard and original solutions are discussed. The latest patents are described. A classification of the existing solutions with respect to their sensing principle is proposed. Possible types of the electric/electronic circuits are discussed. Advantages of these sensors are emphasized: mainly optional operation without power supply, resistance to electrostatic discharges, and simplicity of signal processing. Technological details are briefly introduced, along with miniaturization prospects. Additionally, liquid tilt sensors are succinctly characterized. The most typical tilt sensing techniques are concisely compared.

An Integrated Positioning and Attitude Determination System for Immersed Tunnel Elements: A Simulation Study

Immersed tunnel elements need to be exactly controlled during their immersion process. Position and attitude of the element should be determined quickly and accurately to navigate the element from the holding area to the final location in the tunnel trench. In this paper, a newly-developed positioning and attitude determination system, integrating a 3-antenna Global Navigation Satellite System (GNSS) system, an inclinometer and a range-measurement system, is presented. The system is designed to provide the absolute position of both ends of the element with sufficient accuracy in real time. Special attention in the accuracy analysis is paid to the influence of GNSS multipath error and sound speed profile. Simulations are conducted to illustrate the performance of the system in different scenarios. If both elements are very close, the accuracies of the system are higher than 0.02 m in the directions perpendicular to and along the tunnel axis.

A novel mechanical inclinometer device to measure acetabular cup inclination in total hip arthroplasty

It is well recognised that acetabular cup orientation influences patient function and implant survival post-THR. Reliable intra-operative determination of cup orientation remains a challenge. We describe the design and testing of a novel mechanical inclinometer to measure intra-operative acetabular cup inclination. The aim was to design a generic inclinometer to measure acetabular inclination to within + 5° without requiring modification to existing instrumentation while remaining easy to handle, robust/reusable, and sterilizable. The device was drafted using CAD software, prototyped using a 3D printer and constructed using stainless steel. Two experiments were undertaken to test accuracy: (1) the absolute accuracy was tested; (2) placement of an acetabular component using the device was compared to a freehand technique using a sawbone pelvis. 18 surgeons were asked to place an uncemented acetabular cup in a saw bone pelvis to a target of 40°. The average root-mean-square error was 1.1° (SD: 0.9°). Comparison showed that with the freehand component placement 50% of the surgeons were outside the specified range (35°-45°) where all participants achieved placement within range when using the inclinometer. This work demonstrates that the design and initial testing of a mechanical inclinometer which is suitable for use in determining the acetabular cup inclination in THR.

Assessment of the Range of Movement of the Lower Limb in Sport: Advantages of the ROM-SPORT I Battery

Range of movement (ROM) assessment is an important strategy to increase physical-technical performance and minimize the risk of sports-related injuries. Currently, there is no consensus regarding which ROM assessment method is the most appropriate. The main objective of this study was to perform a systematic review of the test batteries available for the assessment of lower limb ROM; additionally, we compare the ROM-SPORT I battery with those previously reported in the literature. The systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The identification of publications was made by using the databases SciELO, Medline, Scopus, PubMed, and Web of Science. Based on the inclusion criteria, sixteen publications were selected and analyzed. The ROM-SPORT I battery is the most valid of the analyzed methods. This battery evaluates the ROM of eleven lower limb movements. The inclinometer with a telescopic arm and a box is a simpler, more comfortable, and faster procedure than others. The Lumbosant support and use of two examiners are essential to avoid compensatory movements to obtain reliable measurements during ROM assessment. The ROM-SPORT I is a field-based battery of tests that may be used by sports professionals, clinics, and researchers in applied settings to accurately assess and monitor lower extremity ROM.

Advances on Measuring Deep-Seated Ground Deformations Using Robotized Inclinometer System

In the field of geo-hazards and geo-engineering, monitoring networks represent a key element for the geological risk assessment and the design and management of large infrastructures construction. In the last decade, we have observed a strong development on remote sensing techniques but just small changes in the subsoil observations. However, this type of measurement is very important to have a three-dimensional representation of the studied area, since the surface measurements often represent a sum of deformations that develop in a complex way in the subsoil. In this paper, we present a robotic inclinometer system developed to acquire deep-seated ground deformations in boreholes. This instrumentation combines advantages offered by manual inclinometer measurements with a robotized approach that improves the results in term of accuracy, revisiting time, and site accessibility. The Automated Inclinometer System (AIS) allows one to explore automatically all the length of the monitored borehole using just one inclinometer probe with a semi-wireless system. The paper presents the system and a detailed dataset of measurements acquired on three inclinometer tubes installed for the monitoring of the construction phase of the new Line C Metro of Rome. The dataset was acquired in real monitored site and undisturbed conditions and can represent a benchmark for modern inclinometer measurements.

Comparison of Two Handheld Digital Dual Inclinometry Techniques in the Measurement of Lumbar Flexion Active Range of Motion

CONTEXT

An accurate assessment of lumbar spine active range of motion (AROM) is clinically important. Dual inclinometry is recommended as the optimal technique for measuring lumbar flexion AROM; however, the procedures differ in the literature.

OBJECTIVE

To compare 2 different handheld digital dual inclinometry (HDDI) techniques for evaluating lumbar flexion AROM.

DESIGN

The study was a repeated-measures design consisting of 2 trials.

SETTING

Laboratory.

PARTICIPANTS

A sample of 69 adult volunteers (28 men and 41 women; mean age 23.8 [2.4] y) without pain or injury to their back, hips, or abdomen for at least 3 months participated in the study.

INTERVENTION

Using standardized methods, 1 trained tester performed 2 different HDDI measurements of standing lumbar flexion AROM on each subject. Each subject performed one repetition of AROM lumbar flexion per HDDI measurement. The HDDI measures differed in the process for placing the upper inclinometer, with one technique identifying the upper landmark by skilled palpation of the T12 spinous process and the other technique by measuring 15-cm cephalad to the S2 region landmark to approximate the location of the T12 spinous process.

MAIN OUTCOME MEASURES

A dependent t test, Pearson correlation coefficient (r), the 95% limits of agreement, and Bland-Altman plots were used to examine agreement between the techniques.

RESULTS

Dependent t testing showed no significant differences between the techniques (mean difference = 1.2°, P = .11). A strong correlation existed between the 2 HDDI techniques (r = .80, P < .001). The Bland-Altman plot illustrated that 64 of the 69 data points were within the 95% limits of agreement for the 2 techniques.

CONCLUSIONS

The findings suggest that HDDI measurements of lumbar flexion AROM are comparable when using either of the 2 HDDI techniques described. Clinicians can make an evidence-based choice for using either method of measuring lumbar flexion AROM.

A Multi-Module Fixed Inclinometer for Continuous Monitoring of Landslides: Design, Development, and Laboratory Testing

Continuous monitoring of landslides is of basic importance for understanding their behavior, defining their 3D geometry, and providing a basis for early warning purposes. While a number of instrumentations can be used for tracking surface displacement, only automatic or fixed multi-module inclinometers can be used for continuous monitoring of displacement at depth, providing valuable information for landslide geometry reconstruction. Since these instruments are very expensive, thus rarely used, a low-cost and multi-module fixed inclinometer for continuous landslide monitoring has been developed. In this paper, the electronics of the system, including sensor characteristics and optimization, controlling software, and structure are presented. For system development, a single module prototype was first developed and tested in the field to ensure sufficient measuring performance. Subsequently, the multi-module system was designed, assembled, and tested in controlled conditions. Test results indicate the good performance of the system with a displacement measuring accuracy of 0.37% of the length of the inclinometer chain. The linearity test indicates the high linearity of the measures, especially in the range ±20°, which is the typical operating range of such kinds of instrumentations. The thermal efficiency test indicates the high efficiency of the system in preventing measuring errors caused by thermal drifting.

Pattern measures of sedentary behaviour in adults: A literature review

Objective

With sensors, we are increasingly able to assess sitting behaviour during the day. However, there is no consensus among researchers on the best outcome measures for representing the accumulation of sedentary time during the day.

Methods

We analysed the pattern measures of sedentary behaviour. Articles reporting patterns measures in adults, in which behaviour data was collected with a sensor were included. We discuss the strengths and weaknesses of the pattern measures of sedentary behaviour and provide recommendations for choosing objective measures of sedentary behaviour.

Results

Most studies report the number of sitting bouts during the day. Others focus on the number of breaks and/or periods of physical activity. Simple measures of sedentary behaviour were most popular. More complex pattern measures, such as the Gini index or the half-life bout duration, that capture the distribution of lengths of sitting periods in a single number, were reported sparsely. The sedentary patterns that were reported in the various studies were difficult to compare, due to the differences among measurement devices, data analysis protocols and a lack of basic outcome parameters such as total wear-time and total sedentary time.

Conclusions

Objective sedentary measures can be grouped into simple and complex measures of sedentary time accumulation during the day. These measures serve different goals. The answer to the question as to which measures are most suitable to report, is strongly dependent on the research question. We have shown that the reported measures were dependent on (a) the sensing method, (b) the classification method, (c) the experimental and data cleaning protocol and (d) the applied definitions of bouts and breaks. We recommend that studies should always report total wear-time, total sedentary time, number of bouts and at least one measure describing the diversity of bout lengths in the sedentary behaviour such as the half-life bout duration. Additionally, we recommend reporting the measurement conditions and data processing steps.

An Improved Calibration Technique for MEMS Accelerometer-Based Inclinometers

Micro-electro-mechanical system (MEMS) accelerometer-based inclinometers are widelyused to measure deformations of civil structures. To further improve the measurement accuracy, anew calibration technique was proposed in this paper. First, a single-parameter calibration modelwas constructed to obtain accurate angles. Then, an image-processing-based method was designedto obtain the key parameter for the calibration model. An ADXL355 accelerometer-basedinclinometer was calibrated to evaluate the feasibility of the technique. In this validationexperiment, the technique was proven to be reliable and robust. Finally, to evaluate theperformance of the technique, the calibrated MEMS inclinometer was used to measure thedeflections of a scale beam model. The experimental results demonstrate that the proposedtechnique can yield accurate deformation measurements for MEMS inclinometers. .

Validity and reliability of two Smartphone applications to measure the lower and upper cervical spine range of motion in subjects with chronic cervical pain

BACKGROUND

Cervical pain is the biggest musculoskeletal health problem in industrialised countries. There is an important association between this and decrease in range of motion.

OBJECTIVE

Estimate the validity and reliability intra and inter examiner of two Smartphone apps regarding the measurement of lower and upper cervical spine range of motion in subjects with chronic cervical pain.

METHODS

A cross-sectional study was conducted. The sample consisted of 25 subjects with chronic cervical pain. An examiner made a measurement of the range of motion using the CROM device as a gold standard, afterwards, another examiner did the same using a Smartphone, in order to establish validity. After this, the Smartphone examiner and a new examiner simultaneously conducted the intra and inter examiner reliability.

RESULTS

Measurement of the lower and upper cervical spine range show an excellent validity (> 0.75), with an excellent intra and inter reliability (> 0.75) in all movements except flexion of upper cervical spine (0.75-0.65).

CONCLUSION

The two Smartphone applications used in this study showed an excellent validity compared to the CROM. The intra and inter reliability is excellent for all movements, except for the upper cervical spine flexion.

Changes in Self-Reported Health and Psychosocial Outcomes in Older Adults Enrolled in Sedentary Behavior Intervention Study

PURPOSE

To estimate changes in self-reported health and psychosocial factors associated with a 12-week sedentary behavior intervention for older adults.

DESIGN

Exploratory secondary analysis of pilot randomized controlled trial.

SETTING

Kaiser Permanente Washington.

SUBJECTS

Sixty adults aged 60 to 89 with body mass index ≥30 kg/m2.

INTERVENTION

Participants were randomized to the I-STAND intervention or control group. I-STAND involved 6 coaching sessions, a study workbook, Jawbone UP activity tracker to prompt breaks from sitting, and activPAL feedback on objective sitting time.

MEASURES

At baseline and 12-week follow-up, participants completed a survey with validated measures of self-reported health outcomes (depression, stress, memory/concentration, sleep, pain, ability to do daily activities, energy, and quality of life) and modified scales measuring psychosocial factors (perceived benefits/barriers, social support, self-efficacy, and sedentary habit strength) regarding sedentary behavior.

ANALYSIS

Generalized linear models assessed associations between group assignment and change in each self-reported health and psychosocial score, adjusting for baseline scores.

RESULTS

I-STAND participants demonstrated improvements in self-efficacy (β = 0.35, 95% confidence interval [CI]: 0.10 to 0.60) and reduced habit strength (β= -0.23, 95% CI: -0.42 to -0.04) compared to control participants. There were no significant differences in self-reported health outcomes, although power was limited in this exploratory analysis.

CONCLUSION

A sedentary behavior reduction intervention for older adults resulted in improvements for some psychosocial factors. Health outcomes may require longer than 12 weeks to observe improvements.

Can Replacing Sitting Time with Standing Time Improve Adolescents' Cardiometabolic Health?

This study aimed to assess the effects of isotemporal replacement of sitting time (SIT) with standing (STA) on cardiometabolic biomarkers. In this cross-sectional study, male adolescents wore the GT3X+ activity monitor for 7 days to measure the SIT and STA. Moderate-to-vigorous physical activity (MVPA) was estimated by a youth-specific cut-off point. An isotemporal substitution approach was used to examine the effects of replacing different periods of SIT (15, 30, 60, and 120 min) with STA on cardiometabolic biomarkers [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), non-HDL-c, low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), glucose, insulin, HOMA2-β, HOMA2-S, and HOMA2-IR]. Analysis of covariance (ANCOVA) with a post-hoc Bonferroni test was used to compare the adjusted means between the four subgroups that were clustered according to SIT and STA amount. Adolescents (n = 84; age, 16.7 ± 0.9 years) wore GT3X+ for 15.2 ± 2.3 h, for 6.7 ± 0.6 days. Isotemporal substitution of SIT with STA was associated with TC, non-HDL-c, LDL-c, and TG. ANCOVA results showed a statistically significant difference for TC, non-HDL-c, and LDL-c. These findings showed that for male adolescents, sitting less and standing more may be an effective alternative to reduce cardiometabolic biomarker levels related to lipid metabolism, regardless of MVPA.

Reliability of Inclinometer-Derived Passive Range of Motion Measures in Youth with Cerebral Palsy

Aims: This study evaluated, for youth with cerebral palsy (CP), the reliability of passive range of motion (PROM) measures taken with an inclinometer, a device that may be simpler to use than a goniometer. Methods: The PROM for elbow and wrist extension, ankle dorsal flexion (knee flexed 90° and fully extended), and the knee popliteal angle of 30 youth with CP (18 boys, 12 girls, 7.0 ± 3.8 years old, classified in Gross Motor Function Classification levels I-V) was measured using an inclinometer. Two physical therapists took the measures during two different sessions, a maximum of 1 week apart. Results: Good mean intra-rater inter-session, inter-rater intra-session, and inter-rater inter-session reliability (ICC = 0.75-0.89), was found for the elbow, ankle, and knee sites. Absolute reliability for these sites and conditions was 7-14° (90% confident) and 10-16° (95% confident). Reliability values for wrist extension were comparable, albeit slight lower. Conclusions: Similar to published values for goniometry, inclinometery yields reliable upper and lower limb PROM measures from ambulatory and non-ambulatory youth with CP whether measures are carried out by different evaluators within or across sessions or whether measures are performed by the same evaluator across sessions.

Validation of PiezoRx Pedometer Derived Sedentary Time

Although pedometers are valid tools for measuring physical activity, to date they have not been used to assess sedentary time. The primary purpose of this study was to determine if the PiezoRx pedometer is a valid and reliable measure of sedentary time compared to the hip-worn Actical accelerometer. A secondary purpose was to compare sedentary time derived via the Fitbit Flex with that of the Actical. Finally, a third purpose was to compare sedentary time derived from the above devices, with that of the ActivPAL inclinometer. Thirty-five participants ages 11-69 years (M_age= 23.3; 21 Female) wore five devices for up to one week: two PiezoRx pedometers, an Actical, an ActivPAL and a Fitbit Flex. Participants recorded daily wear-time of each device using a log sheet. The average sedentary time calculated from the PiezoRx (716±137.68 min/day) was not different from the Actical (694 ±136.11 min/day, p>0.05), although it was higher than the ActivPAL (475±171.52 min/day) and Fitbit Flex (530±149.94 min/day, all p<0.001). Sedentary time from all devices were significantly correlated with each other, with the strongest relationship seen between the Actical and PiezoRx (R²=0.93, p<0.001). In comparison to the ActivPAL, error in PiezoRx- (R²=0.96), Actical- (R²=0.96) and Fitbit Flex- (R²=0.34) determined sedentary time was strongly associated with standing time (all p<0.001). Sedentary time derived using the PiezoRx pedometer may be statistically equivalent to the Actical accelerometer, but not the ActivPAL inclinometer or Fitbit Flex.

A Highly Sensitive Two-Dimensional Inclinometer Based on Two Etched Chirped-Fiber-Grating Arrays

We present a novel two-dimensional fiber-optic inclinometer with high sensitivity by crisscrossing two etched chirped fiber Bragg gratings (CFBG) arrays. Each array is composed of two symmetrically-arranged CFBGs. By etching away most of the claddings of the CFBGs to expose the evanescent wave, the reflection spectra are highly sensitive to the surrounding index change. When we immerse only part of the CFBG in liquid, the effective index difference induces a superposition peak in the refection spectrum. By interrogating the peak wavelengths of the CFBGs, we can deduce the tilt angle and direction simultaneously. The inclinometer has a resolution of 0.003° in tilt angle measurement and 0.00187 rad in tilt direction measurement. Due to the unique sensing mechanism, the sensor is temperature insensitive. This sensor can be useful in long term continuous monitoring of inclination or in real-time feedback control of tilt angles, especially in harsh environments with violent temperature variation.

The Validity and Reliability of Knee Proprioception Measurement Performed With Inclinometer in Different Positions

CONTEXT

Proprioception is the basic element of the spontaneous control of movement, balance and joint stability. Therefore, it is necessary for the execution of walking and daily and sport activities. Loss of proprioception of the knee, which may cause a new injury, is important to evaluate the position sense of the joint during the rehabilitation period. However, the evaluation methods that are used are very expensive, complicated and non-portable, or the measuring method is difficult to implement.

OBJECTIVE

We demonstrated the validity and reliability of knee proprioception measurements performed in the open kinetic chain position and closed kinetic chain position with a dual inclinometer.

DESIGN

We assessed the validity and intra-tester reliability of a digital inclinometer for measuring the knee joint position sense in different positions.

SETTING

Clinical laboratory.

PARTICIPANTS

We enrolled 22 participants (age = 21.8 ± 0.95 years, height = 172 ± 9.1 cm, weight = 64.9 ± 14 kg) into the study.

INTERVENTION

The same investigator used an inclinometer to take knee proprioception measurements in open and closed kinetic chain positions.

MAIN OUTCOME MEASURES

The relative angular error was calculated by taking the arithmetic average of the difference between the target angle and reproduced angle and was the main outcome measure.

RESULTS

We found that the dynamometer-inclinometer had a moderate ICC value (ICC = 0.594, SEM = 1.60, p = 0.005), whereas inclinometer t₁ vs inclinometer t₂ (ICC = 0.778, SEM = 0.62, p < 0.001) and closed kinetic chain position t₁ and closed kinetic chain position t₂ (ICC = 0.888, SEM = 0.63, p < 0.001) had high ICC values.

CONCLUSION

Knee proprioception measurements performed with a dual inclinometer were reliable in the closed kinetic chain position in healthy, sedentary individuals and were valid and reliable in the open kinetic chain position.

Intra-examiner reliability of measurements of ankle range of motion using a modified inclinometer: a pilot study

A modified inclinometer was designed for measuring total ankle range of motion (ROM) in the standing position for a large future study. The purpose of this pilot study was to assess the intra-examiner reliability of this new device in order to see if the examiner would be able to produce equally reliable measurements with this instrument as with a routinely used goniometer. Nineteen young healthy individuals took part in the pilot. The same examiner took the ROM measurements using both devices twice on the same day and one further time 2 or 3 days later. Test-retest reliability was measured using the intraclass correlation coefficient (ICC). The ICC values were 0.86 (95% CI=[0.67; 0.94]) and 0.83 (95% CI=[0.61; 0.93]) for the measurements taken with the goniometer on the same day and for those on two different days. The corresponding values for the modified inclinometer were 0.88 (95% CI=[0.72;0.95]) and 0.81 (95% CI=[0.57; 0.92]). Both instruments were found to have very good test-retest reliability.

Kalman Filters in Geotechnical Monitoring of Ground Subsidence Using Data from MEMS Sensors

The fast development of wireless sensor networks and MEMS make it possible to set up today real-time wireless geotechnical monitoring. To handle interferences and noises from the output data, Kalman filter can be selected as a method to achieve a more realistic estimate of the observations. In this paper, a one-day wireless measurement using accelerometers and inclinometers was deployed on top of a tunnel section under construction in order to monitor ground subsidence. The normal vectors of the sensors were firstly obtained with the help of rotation matrices, and then be projected to the plane of longitudinal section, by which the dip angles over time would be obtained via a trigonometric function. Finally, a centralized Kalman filter was applied to estimate the tilt angles of the sensor nodes based on the data from the embedded accelerometer and the inclinometer. Comparing the results from two sensor nodes deployed away and on the track respectively, the passing of the tunnel boring machine can be identified from unusual performances. Using this method, the ground settlement due to excavation can be measured and a real-time monitoring of ground subsidence can be realized.

Clinical measurements of cervical lordosis using flexirule and inclinometer methods in individuals with and without cervical spine dysfunction: A reliability and validity study

OBJECTIVE

The purposes of this study were to determine the reliability and validity of two clinical measurements of cervical lordosis and to compare these measurements of individuals with cervical spine symptoms to those of asymptomatic individuals.

METHODS

Fifty-seven participants were recruited for the study: 18 following cervical fusion, 20 with neck pain and no surgery, and 19 with no neck pain. Cervical lordosis was measured using a flexible ruler (flexirule) and a modified bubble inclinometer. Intertester and intratester reliability were calculated for both methods. Validity was assessed by correlating measurements taken using both methods to Cobb angles between C2 and C7 on lateral view radiography of the participants in the cervical fusion and the neck pain groups.

RESULTS

Intraclass correlation coefficients (ICCs) revealed good intratester reliability for both methods. Intertester reliability was fair for the flexirule method but good for the inclinometer method. Pearson correlations with radiographic angles were poor for both methods. ANOVAs showed no significant difference in cervical lordosis measurements between asymptomatic and symptomatic groups.

CONCLUSION

Although both the flexirule and inclinometer methods are reliable, neither method correlated with the Cobb angle on the radiography, suggesting these methods may measure different aspects of cervical spine alignment.

Interrater and Intrarater Reliability and Validity of 3 Measurement Methods for Shoulder-Position Sense

CONTEXT

Joint-position sense (JPS) plays a critical role in the stability of shoulder joint. Restoration of JPS is essential to improve rehabilitation outcomes in individuals with shoulder injury. However, the number of affordable and reliable shoulder-JPS measurement methods for everyday clinical practice is limited.

OBJECTIVE

To estimate reliability and validity of 3 simple shoulder-JPS measurement methods.

DESIGN

Cross-sectional study.

PARTICIPANTS

25 healthy men and women.

MAIN OUTCOME MEASURE

Absolute-error scores of JPS in 3 ranges of shoulder flexion (low, mid, and high), measured with a laser pointer, an inclinometer, and a goniometer in 2 separate sessions (48 h apart).

RESULTS

Overall interrater and intrarater intraclass correlation coefficients were .86 and .78 for the laser pointer, .67 and .70 for the inclinometer, and .60 and .50 for the goniometer, respectively. There was excellent reliability in the low range for the laser pointer and inclinometer methods, but fair to good and poor reliability in mid- and high ranges, respectively. All methods showed strong validity.

CONCLUSION

The laser pointer and inclinometer JPS measurement methods are reliable and can be used by clinicians during rehabilitation of shoulder injuries.

A Compact Fiber Inclinometer Using a Thin-Core Fiber with Incorporated an Air-Gap Microcavity Fiber Interferometer

A compact fiber-optic inclinometer is proposed and experimentally demonstrated based on a Fabry-Perot interference (FFPI). The sensing head consists of a short segment of thin-core fiber (TCF) following with a piece of hollow-core fiber (HCF). High-order cladding modes have been excited because of core diameter mismatch. A clear interference spectrum has been obtained as the consequence of interference among the reflected core modes and cladding modes. Fringe contrast of the interference spectrum is highly sensitive to fiber bending with direction independence, and good linearity has been observed during the bending range from 1° to 3° with a sensitivity of 2.71 dB/deg.

Construct validity of posture as a measure of physical function in elderly individuals: Use of a digitalized inclinometer to assess trunk inclination

AIM

The first aim of the present study was to determine the construct validity of evaluating posture as a measure of physical function in elderly individuals. The second aim was to determine reference values for sternum inclination in elderly individuals when measured using a digitalized inclinometer.

METHODS

We included 834 community-dwelling elderly individuals (350 men and 484 women) in this study. We used a digital inclinometer for measuring sternum inclination angle. We evaluated physical functions, including muscle strength, static balance, gait ability and the functional mobility of our study participants. To assess the construct validity of sternum inclination in elderly people, Pearson's correlation coefficient between sternum inclination and participant characteristics was calculated. To determine a reference value of sternum inclination by age, P for trend was calculated.

RESULTS

In men, the sternum inclination angle and sternum inclination index were significantly associated with all anthropometric measures, except static balance. In women, the sternum inclination index was significantly associated with all measures, whereas the sternum inclination angle was associated with all measures except for balance and the Timed Up and Go test. Trend of sternum inclination index by age was significant.

CONCLUSIONS

Our results show that the sternum inclination as a measure of physical function in elderly men and women has construct validity. We determined reference values for sternum inclination of which trend by age was considered. Geriatr Gerontol Int 2016; 16: 1068-1073.

The validity and reliability of a new instrumented device for measuring ankle dorsiflexion range of motion

PURPOSE/BACKGROUND

A restriction in ankle dorsiflexion range of motion (ROM) has been linked to several clinical manifestations such as metatarsalgia, heel pain, nerve entrapment, ankle joint equinus, patellar and ankle injuries. The purpose of the present study was to examine the validity and reliability of the Leg Motion system for measuring ankle dorsiflexion ROM.

STUDY DESIGN

Descriptive repeated-measures study.

METHODS

Twenty-six healthy male university students were recruited to test the reliability of the Leg Motion system, which is a portable tool used for assessment of ankle dorsiflexion during the weight-bearing lunge test. The participants were tested two times separated by two weeks and measurements were performed at the same time of the day by the same single rater. To test the validity of the Leg Motion system, other maximal ankle dorsiflexion ROM assessments (goniometer, inclinometer and measuring tape) were measured in a single session (i.e., the first test session) during the weight-bearing lunge position using a standard goniometer, a digital inclinometer and a measuring tape measure with the ability to measure to the nearest 0.1 cm.

RESULTS

Paired t-tests showed the absence of significant differences between right and left limb measurements of dorsiflexion in all tests. Mean values ± standard deviations were as follows: Leg Motion test (left 11.6cm±3.9; right 11.9cm ±4.0), tape measure (left 11.6cm±4.0; right 11.8cm±4.2), goniometer (left 40.6º±5.2; right 40.6º±5.2), and digital inclinometer (left 40.0º±5.8; right 39.9º±5.6). The Leg Motion composite values (i.e., average of the two legs) showed a significant (p<0.05) positive correlation with the tape measure (r=0.99), with the goniometer (r=0.66), and with the digital inclinometer (r=0.72).

CONCLUSIONS

The results of the present study provide evidence to support the use of the Leg Motion system as a valid, portable, and easy to use alternative to the weight-bearing lunge test to assess ankle dorsiflexion ROM in healthy participants.

LEVEL OF EVIDENCE

2b.

Inertial sensors as measurement tools of elbow range of motion in gerontology

BACKGROUND AND PURPOSE

Musculoskeletal system deterioration among the aging is a major reason for loss of autonomy and directly affects the quality of life of the elderly. Articular evaluation is part of physiotherapeutic assessment and helps in establishing a precise diagnosis and deciding appropriate therapy. Reference instruments are valid but not easy to use for some joints. The main goal of our study was to determine reliability and intertester reproducibility of the MP-BV, an inertial sensor (the MotionPod(®) [MP]) combined with specific software (BioVal [BV]), for elbow passive range-of-motion measurements in geriatrics.

METHODS

This open, monocentric, randomized study compared inertial sensor to inclinometer in patients hospitalized in an acute, post-acute, and long-term-care gerontology unit.

RESULTS

Seventy-seven patients (mean age 83.5±6.4 years, sex ratio 1.08 [male/female]) were analyzed. The MP-BV was reliable for each of the three measurements (flexion, pronation, and supination) for 24.3% (CI 95% 13.9-32.8) of the patients. Separately, the percentages of reliable measures were 59.7% (49.2-70.5) for flexion, 68.8% (58.4-79.5) for pronation, and 62.3% (51.2-73.1) for supination. The intraclass correlation coefficients were 0.15 (0.07-0.73), 0.46 (0.27-0.98), and 0.50 (0.31-40 0.98) for flexion, pronation, and supination, respectively.

CONCLUSION

This study shows the convenience of the MP-BV in terms of ease of use and of export of measured data. However, this instrument seems less reliable and valuable compared to the reference instruments used to measure elbow range of motion in gerontology.

Passive hip range of motion is reduced in active subjects with chronic low back pain compared to controls

BACKGROUND

Non-specific low back pain is a common condition often without a clear mechanism for its presentation. Recently more attention has been placed on the hip and its potential contributions to non-specific chronic low back pain (NSCLBP). Emphasis in research has mainly been placed on motor control, strength and endurance factors in relation to NSCLBP. Limited focus has been placed on hip mobility and its potential contribution in subjects with NSCLBP.

PURPOSE/AIM

The aim of this study was to compare passive ROM in hip extension, hip internal rotation, hip external rotation and total hip rotation in active subjects with NSCLBP to healthy control subjects. The hypothesis was that active subjects with NSCLBP would present with decreased total hip ROM and greater asymmetry when compared to controls.

DESIGN

Two group case controlled.

SETTING

Clinical research laboratory.

PARTICIPANTS

30 healthy subjects without NSCLBP and 30 active subjects with NSCLBP. Subjects categorized as NSCLBP were experiencing pain in the low back area with or without radicular symptoms of greater than three months duration.

MAIN OUTCOME MEASURE

Passive hip extension (EXT), hip internal rotation (IR), hip external rotation (ER) and total hip rotation ROM. A digital inclinometer was used for measurements.

RESULTS

There was a statistically significant difference (p<0.001) in hip passive extension ROM between the control group and the NSCLBP group bilaterally. Mean hip extension for the control group was 6.88 bilaterally. For the NSCLBP group, the mean hip extension was -4.28 bilaterally. This corresponds to a difference of means between groups of 10.88. There was no statistically significant differences (p>0.05) in hip IR, ER, or total rotation ROM between groups.

CONCLUSIONS

The results of this study indicate that a significant difference in hip extension exists in active subjects with NSCLBP compared to controls. It may be important to consider hip mobility restrictions and their potential impact on assessment of strength in NSLBP subjects. Future studies may be needed to investigate the relationship between measurements and intervention strategies.

LEVEL OF EVIDENCE

2b.

Measuring shoulder external and internal rotation strength and range of motion: comprehensive intra-rater and inter-rater reliability study of several testing protocols

BACKGROUND

Shoulder range of motion (ROM) and strength measurements are imperative in the clinical assessment of the patient's status and progression over time. The method and type of assessment varies among clinicians and institutions. No comprehensive study to date has examined the reliability of a variety of procedures based on different testing equipment and specific patient or shoulder position. The purpose of this study was to establish absolute and relative reliability for several procedures measuring the rotational shoulder ROM and strength into internal (IR) and external (ER) rotation strength.

METHODS

Thirty healthy individuals (15 male, 15 female), with a mean age of 22.1 ± 1.4 years, were examined by 2 examiners who measured ROM with a goniometer and inclinometer and isometric strength with a hand-held dynamometer (HHD) in different patient and shoulder positions. Relative reliability was determined by intraclass correlation coefficients (ICC). Absolute reliability was quantified by standard error of measurement (SEM) and minimal detectable change (MDC). Systematic differences across trials or between testers, as well as differences among similar measurements under different testing circumstances, were analyzed with dependent t tests or repeated-measures analysis of variance in case of 2 or more than 2 conditions, respectively.

RESULTS

Reliability was good to excellent for IR and ER ROM and isometric strength measurements, regardless of patient or shoulder position or equipment used (ICC, 0.85-0.99). For some of the measurements, systematic differences were found across trials or between testers. The patient's position and the equipment used resulted in different outcome measures.

CONCLUSIONS

All procedures examined showed acceptable reliability for clinical use. However, patient position and equipment might influence the results.

Validation of a new method for assessing scapular anterior-posterior tilt

BACKGROUND

Electromagnetic tracking systems have enabled some investigators and clinicians to measure tri-planar scapular motion; yet, they are not practical and affordable options for all clinicians. Currently, the ability to affordably quantify scapular motion is limited to monitoring only the motion of scapular upward rotation, with use of a digital inclinometer.

HYPOTHESIS/PURPOSE

The objective of this study was to determine the criterion-related validity of a modified digital inclinometer when used to measure the motion of scapular anterior-posterior (AP) tilt.

MATERIALS & METHODS

Thirteen volunteers, free from any history of shoulder injury, reported for a single testing session. Each subject underwent a brief shoulder and posture examination in order to confirm the absence of pathology. Subjects actively performed clinically relevant amounts of humeral elevation in the scapular plane while in a seated position. An electromagnetic tracking system (Ascension Technology, Burlington, VT) and a modified inclinometer (Pro 360, Baseline®, Fabrication Enterprises, White Plains, NY) were used to acquire scapular AP tilt over the same shoulder motions. Criterion-related validity was determined using Pearson Product Moment correlations.

RESULTS

Correlation analyses revealed significant moderate to good associations (r = 0.63 to 0.86, p < 0.01) between scapular AP tilt measures obtained with a digital inclinometer and an electromagnetic tracking system.

CONCLUSIONS

A modified digital inclinometer is a moderately valid device to use for the quantification of scapular AP tilt. Further study is warranted to establish reliability and to validate use of the device in patients with shoulder injury or pathology. The modified inclinometer expands the clinician's ability to quantify scapular kinematic motion during the clinical evaluation and rehabilitation process.

LEVEL OF EVIDENCE

Level 3.

Reliability of measurement of glenohumeral internal rotation, external rotation, and total arc of motion in 3 test positions

CONTEXT

Athletes who participate in throwing and racket sports consistently demonstrate adaptive changes in glenohumeral-joint internal and external rotation in the dominant arm. Measurements of these motions have demonstrated excellent intrarater and poor interrater reliability.

OBJECTIVE

To determine intrarater reliability, interrater reliability, and standard error of measurement for shoulder internal rotation, external rotation, and total arc of motion using an inclinometer in 3 testing procedures in National Collegiate Athletic Association Division I baseball and softball athletes.

DESIGN

Cross-sectional study.

SETTING

Athletic department.

PATIENTS OR OTHER PARTICIPANTS

Thirty-eight players participated in the study. Shoulder internal rotation, external rotation, and total arc of motion were measured by 2 investigators in 3 test positions. The standard supine position was compared with a side-lying test position, as well as a supine test position without examiner overpressure.

RESULTS

Excellent intrarater reliability was noted for all 3 test positions and ranges of motion, with intraclass correlation coefficient values ranging from 0.93 to 0.99. RESULTS for interrater reliability were less favorable. Reliability for internal rotation was highest in the side-lying position (0.68) and reliability for external rotation and total arc was highest in the supine-without-overpressure position (0.774 and 0.713, respectively). The supine-with-overpressure position yielded the lowest interrater reliability results in all positions. The side-lying position had the most consistent results, with very little variation among intraclass correlation coefficient values for the various test positions.

CONCLUSIONS

The results of our study clearly indicate that the side-lying test procedure is of equal or greater value than the traditional supine-with-overpressure method.

Patellofemoral pain subjects exhibit decreased passive hip range of motion compared to controls

BACKGROUND

Patellofemoral pain is a common condition without a clear mechanism for its presentation. Recently significant focus has been placed on the hip and its potential role in patellofemoral pain (PFP). The majority of the research has examined hip strength and neuromuscular control. Less attention has been given to hip mobility and its potential role in subjects with PFP.

PURPOSE/AIM

The purpose of this study was to compare passive hip range of motion (ROM) of hip extension and hip internal and external rotation in subjects with PFP and healthy control subjects. The hypothesis was that subjects with PFP would present with less total hip ROM and greater asymmetry than controls.

DESIGN

Two groups, case controlled.

SETTING

Clinical research laboratory.

PARTICIPANTS

30 healthy subjects without pain, radicular symptoms or history of surgery in the low back or lower extremity joints and 30 subjects with a diagnosis of PFP.

MAIN OUTCOME MEASURES

Passive hip extension, hip internal rotation (IR) and hip external rotation (ER). A digital inclinometer was used for measurements.

RESULTS

There was a statistically significant difference (p<0.001) in hip passive extension between the control group and the PFP group bilaterally. Mean hip extension for the control group was 6.8° bilaterally. For the PFP group, the mean hip extension was -4.0° on the left and -4.3° on the right. This corresponds to a difference of means between groups of 10.8° on the left and 11.1° on the right with a standard error of 2.1°. There was no statistically significant difference (p>0.05) in either hip IR or ER ROM or total rotation between or within groups.

CONCLUSIONS

The results of this study indicate that a significant difference in hip extension exists in subjects with PFP compared to controls. These findings suggest that passive hip extension is a variable that should be included within the clinical examination of people with PFP. It may be valuable to consider hip mobility restrictions and their potential impact on assessment of strength and planned intervention in subjects with PFP.

LEVEL OF EVIDENCE

2b.

Reliability of three measures of ankle dorsiflexion range of motion

PURPOSE/BACKGROUND

A variety of methods exist to measure ankle dorsiflexion range of motion (ROM). Few studies have examined the reliability of a novice rater. The purpose of this study was to determine the reliability of ankle ROM measurements using three different techniques in a novice rater.

METHODS

Twenty healthy subjects (mean±SD, age=24±3 years, height=173.2±8.1 cm, mass=72.6±15.2 kg) participated in this study. Ankle dorsiflexion ROM measures were obtained in a weight-bearing lunge position using a standard goniometer, digital inclinometer, and a tape measure using the distance-to-wall technique. All measures were obtained three times per side, with 10 minutes of rest between the first and second set of measures. Intrarater reliability was determined using an intraclass correlation coefficient (ICC(2,3)) and associated 95% confidence intervals (CI). Standard error of measurement (SEM) and the minimal detectable change (MDC) for each measurement technique were also calculated.

RESULTS

The within-session intrarater reliability (ICC(2,3)) estimates for each measure are as follows: tape measure (right 0.98, left 0.99), digital inclinometer (right 0.96; left 0.97), and goniometer (right 0.85; left 0.96). The SEM for the tape measure method ranged from 0.4-0.6 cm and the MDC was between 1.1-1.5 cm. The SEM for the inclinometer was between 1.3-1.4° and the MDC was 3.7-3.8°. The SEM for the goniometer ranged from 1.8-2.8° with an MDC of 5.0-7.7°.

CONCLUSIONS

The results indicate that reliable measures of weight-bearing ankle dorsiflexion ROM can be obtained from a novice rater. All three techniques had good reliability and low measurement error, with the distance-to-wall technique using a tape measure and inclinometer methods resulting in higher reliability coefficients (ICC(2,3)=0.96 to 0.99) and a lower SEM compared to the goniometer (ICC(2,3)=0.85 to 0.96).

LEVEL OF EVIDENCE

2b.

Scapular-Positioning Patterns During Humeral Elevation in Unimpaired Shoulders

OBJECTIVE: To assess scapular-positioning patterns using a static measurement technique. DESIGN AND SETTING: We used a 4-within-factor design to compare scapular upward rotation among subjects. The within factors included side (dominant, nondominant), plane of motion (scapular, sagittal), direction of motion (ascending, descending), and level of humeral rotation (rest, 30 degrees, 60 degrees, 90 degrees, 120 degrees ). SUBJECTS: Twenty-seven subjects with unimpaired shoulders. MEASUREMENTS: We measured scapular position and glenohumeral range of motion using a digital inclinometer and goniometer, respectively. All measurements were performed bilaterally. RESULTS: Between-session repeatability was poor to excellent depending on humeral-elevation angle. The scapular plane demonstrated significantly more scapular upward rotation than did the sagittal plane at 120 degrees of humeral elevation. CONCLUSIONS: The scapula demonstrated a consistent pattern of downward rotation initially from rest to 30 degrees of humeral elevation, followed by an upward rotation after 30 degrees of humeral elevation to the highest level (120 degrees ). Scapular upward rotation is greater in the scapular plane than in the sagittal plane. Therefore, overhead rehabilitation exercises should be performed in the scapular plane, especially in subjects with rotator cuff tendinopathy.