An Inertial Measurement Unit-Based Wireless System for Shoulder Motion Assessment in Patients with Cervical Spinal Cord Injury: A Validation Pilot Study in a Clinical Setting.

Riccardo Bravi,Giacomo Lucchesi,Eros Quarta,Alessio Martinelli,Diego Minciacchi,Lorenzo Biotti,Ilaria Nannini,Erez James Cohen,Sara Jayousi,Lorenzo Mucchi,Stefano Caputo,Gabriele Righi,Giulio Del Popolo,Stefano Grasso

doi:10.3390/s21041057

Abstract

Residual motion of upper limbs in individuals who experienced cervical spinal cord injury (CSCI) is vital to achieve functional independence. Several interventions were developed to restore shoulder range of motion (ROM) in CSCI patients. However, shoulder ROM assessment in clinical practice is commonly limited to use of a simple goniometer. Conventional goniometric measurements are operator-dependent and require significant time and effort. Therefore, innovative technology for supporting medical personnel in objectively and reliably measuring the efficacy of treatments for shoulder ROM in CSCI patients would be extremely desirable. This study evaluated the validity of a customized wireless wearable sensors (Inertial Measurement Units—IMUs) system for shoulder ROM assessment in CSCI patients in clinical setting. Eight CSCI patients and eight healthy controls performed four shoulder movements (forward flexion, abduction, and internal and external rotation) with dominant arm. Every movement was evaluated with a goniometer by different testers and with the IMU system at the same time. Validity was evaluated by comparing IMUs and goniometer measurements using Intraclass Correlation Coefficient (ICC) and Limits of Agreement (LOA). inter-tester reliability of IMUs and goniometer measurements was also investigated. Preliminary results provide essential information on the accuracy of the proposed wireless wearable sensors system in acquiring objective measurements of the shoulder movements in CSCI patients.

Highlights

Within limited literature regarding the concurrent validation of Inertial Measurement Unit (IMU) sensors against goniometer in assessing shoulder range of motion (ROM), we found little similarities with other studies though the differences in research methodology may interfere with comparisons
This work aimed to provide a methodological study on the validity of a customized wireless wearable IMU-based sensors system to measure the shoulder ROM in patients with cervical spinal cord injury
Laboratory and clinical trials have been performed to evaluate the accuracy of the IMU-based system, and to compare it to the goniometerbased measurements taken by sanitary operators

Summary

Introduction

Spinal cord injury (SCI) is a debilitating neurological condition which can result in a total or partial motor and sensory function impairment below the site of the injury, associated with a various degree of bladder, bowel and sexual dysfunctions [1]. The sensory and/or motor impairment is caused by the loss of communication between the brain areas devoted to motor/sensory processing and the axons of neural cells controlled by spinal cord levels below the injury site and innervating the body surface. Lesions at lower spinal segments (i.e., sacral, lumbar, or thoracic) cause the loss of motor and/or sensory function in lower limbs and trunk (paraplegia) while more rostral lesions (i.e., cervical) involve lower limbs, trunk, and upper limbs (tetraplegia). Spinal cord injury can be graded on the basis of motor and sensory dysfunction as follows: no motor or sensory function is preserved; sensory function preserved but not motor function; both motor and sensory functions are—partially—preserved below the neurological level [3]

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