Abstract
Wearable inertial measurement units (IMUs) may provide useful, objective information to clinicians interested in quantifying head movements as patients’ progress through vestibular rehabilitation. The purpose of this study was to validate an IMU-based algorithm against criterion data (motion capture) to estimate average head and trunk range of motion (ROM) and average peak velocity. Ten participants completed two trials of standing and walking tasks while moving the head with and without moving the trunk. Validity was assessed using a combination of Intra-class Correlation Coefficients (ICC), root mean square error (RMSE), and percent error. Bland-Altman plots were used to assess bias. Excellent agreement was found between the IMU and criterion data for head ROM and peak rotational velocity (average ICC > 0.9). The trunk showed good agreement for most conditions (average ICC > 0.8). Average RMSE for both ROM (head = 2.64°; trunk = 2.48°) and peak rotational velocity (head = 11.76 °/s; trunk = 7.37 °/s) was low. The average percent error was below 5% for head and trunk ROM and peak rotational velocity. No clear pattern of bias was found for any measure across conditions. Findings suggest IMUs may provide a promising solution for estimating head and trunk movement, and a practical solution for tracking progression throughout rehabilitation or home exercise monitoring.
Highlights
Individuals with mild traumatic brain injury suffering from impaired vestibular and ocular-motor impairments may be prescribed vestibular rehabilitation consisting of head and trunk movements during physical therapy
Head and trunk movements can be compromised in this population, as the perceived head position relative to the trunk is generally impaired in individuals with vestibular pathologies [4]
up and (U/D) are displayed for one healthy participant (Figure 1) and one participant with mild traumatic brain injury (mTBI) (Figure 2)
Summary
Individuals with mild traumatic brain injury (mTBI) suffering from impaired vestibular and ocular-motor impairments may be prescribed vestibular rehabilitation consisting of head and trunk movements during physical therapy. Vestibular rehabilitation typically includes gradual increases in the range of motion (ROM) and velocity of head movements and has shown promising improvements in the reduction of symptoms and greater overall function in mTBI patients [1,2,3]. Avoidance behavior and maladaptive strategies, such as limiting the head ROM and rotational velocity, may be used in an effort to minimize symptoms [4]. These subtle impaired movements, such as head and trunk velocity, are often not detected visually [5], and have the potential to interfere with successful rehabilitation. The ability to quantify and track these movements both within the clinic and during a home exercise program may be highly beneficial
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