Abstract
The objectives of this study were to evaluate the reliability of wearable inertial motion unit (IMU) sensors in measuring spinal range of motion under supervised and unsupervised conditions in both laboratory and ambulatory settings. A secondary aim of the study was to evaluate the reliability of composite IMU metrology scores (IMU-ASMI (Amb)). Forty people with axSpA participated in this clinical measurement study. Participant spinal mobility was assessed by conventional metrology (Bath Ankylosing Spondylitis Metrology Index, linear version—BASMILin) and by a wireless IMU sensor-based system which measured lumbar flexion-extension, lateral flexion and rotation. Each sensor-based movement test was converted to a normalized index and used to calculate IMU-ASMI (Amb) scores. Test-retest reliability was evaluated using intra-class correlation coefficients (ICC). There was good to excellent agreement for all spinal range of movements (ICC > 0.85) and IMU-ASMI (Amb) scores (ICC > 0.87) across all conditions. Correlations between IMU-ASMI (Amb) scores and conventional metrology were strong (Pearson correlation ≥ 0.85). An IMU sensor-based system is a reliable way of measuring spinal lumbar mobility in axSpA under supervised and unsupervised conditions. While not a replacement for established clinical measures, composite IMU-ASMI (Amb) scores may be reliably used as a proxy measure of spinal mobility.
Highlights
Axial spondyloarthritis is a complex chronic inflammatory disease predominantly affecting the axial skeleton [1]
Spinal mobility has been recognized as an important outcome in the management of axSpA and has been included in the Assessment of Spondyloarthritis International Society (ASAS) core set for clinical assessment in axSpA [6,7]
This study demonstrates the reliability of an inertial motion unit (IMU) sensor-based system for measuring spinal range of motion of individuals with axSpA
Summary
Axial spondyloarthritis (axSpA) is a complex chronic inflammatory disease predominantly affecting the axial skeleton [1]. Spinal mobility has been recognized as an important outcome in the management of axSpA and has been included in the Assessment of Spondyloarthritis International Society (ASAS) core set for clinical assessment in axSpA [6,7]. While the BASMI is a low-cost tool with minimal training and equipment required, it cannot be performed independently, limiting its utility outside of the clinical setting. It lacks the sensitivity to change required to monitor disease progression [9,10,11]. As a result of these concerns, the BASMI failed to achieve approval by the ASAS group as a core outcome measure in axSpA [5]. There is a need for a reliable and sensitive measure of spinal mobility to be used in studies of drug and physical interventions in axSpA
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