Accuracy and Validity of a Single Inertial Measurement Unit-Based System to Determine Upper Limb Kinematics for Medically Underserved Populations
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SUBMITTER: Hughes C
PROVIDER: S-EPMC9271671 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundUpper-limb impairments in stroke patients are usually measured in clinical setting using standard clinical assessment. In addition, kinematic analysis using opto-electronic systems has been used in the laboratory setting to map arm recovery. Such kinematic measurements cannot capture the actual function of the upper extremity in daily life. The aim of this study is to longitudinally explore the complementarity of post-stroke upper-limb recovery measured by standard clinical assessments and daily-life recorded kinematics.MethodsThe study was designed as an observational, single-group study to evaluate rehabilitation progress in a clinical and home environment, with a full-body sensor system in stroke patients. Kinematic data were recorded with a full-body motion capture suit during clinical assessment and self-directed activities of daily living. The measurements were performed at three time points for 3 h: (1) 2 weeks before discharge of the rehabilitation clinic, (2) right after discharge, and (3) 4 weeks after discharge. The kinematic analysis of reaching movements uses the position and orientation of each body segment to derive the joint angles. Newly developed metrics for classifying activity and quality of upper extremity movement were applied.ResultsThe data of four stroke patients (three mildly impaired, one sever impaired) were included in this study. The arm motor function assessment improved during the inpatient rehabilitation, but declined in the first 4 weeks after discharge. A change in the data (kinematics and new metrics) from the daily-life recording was seen in in all patients. Despite this worsening patients increased the number of reaches they performed during daily life in their home environment.ConclusionIt is feasible to measure arm kinematics using Inertial Measurement Unit sensors during daily life in stroke patients at the different stages of rehabilitation. Our results from the daily-life recordings complemented the data from the clinical assessments and illustrate the potential to identify stroke patient characteristics, based on kinematics, reaching counts, and work area.Clinical trial registrationhttps://clinicaltrials.gov, identifier NCT02118363.
| S-EPMC5906540 | biostudies-literature
Project description:The estimate of a consistent and clinically meaningful joint kinematics using wearable inertial and magnetic sensors requires a sensor-to-segment coordinate system calibration. State-of-the-art calibration procedures for the upper limb are based on functional movements and/or pre-determined postures, which are difficult to implement in subjects that have impaired mobility or are bedridden in acute units. The aim of this study was to develop and validate an alternative calibration procedure based on the direct identification of palpable anatomical landmarks (ALs) for an inertial and magnetic sensor-based upper limb movement analysis protocol. The proposed calibration procedure provides an estimate of three-dimensional shoulder/elbow angular kinematics and the linear trajectory of the wrist according to the standards proposed by the International Society of Biomechanics. The validity of the method was assessed against a camera-based optoelectronic system during uniaxial joint rotations and a reach-to-grasp task. Joint angular kinematics was found as characterised by a low-biased range of motion (<-2.6°), a low root mean square deviation (RMSD) (<4.4°) and a high waveform similarity coefficient (R2 >?0.995) with respect to the gold standard. Except for the cranio-caudal direction, the linear trajectory of the wrist was characterised by a low-biased range of motion (<11?mm) together with a low RMSD (8?mm) and high waveform similarity (R2 >?0.968). The proposed method enabled the estimation of reliable joint kinematics without requiring any active involvement of the patient during the calibration procedure, complying with the metrological standards and requirements of clinical movement analysis.
| S-EPMC6783441 | biostudies-literature
Project description:The use of inertial measurement units (IMUs) has gained popularity for the estimation of lower limb kinematics. However, implementations in clinical practice are still lacking. The aim of this review is twofold-to evaluate the methodological requirements for IMU-based joint kinematic estimation to be applicable in a clinical setting, and to suggest future research directions. Studies within the PubMed, Web Of Science and EMBASE databases were screened for eligibility, based on the following inclusion criteria: (1) studies must include a methodological description of how kinematic variables were obtained for the lower limb, (2) kinematic data must have been acquired by means of IMUs, (3) studies must have validated the implemented method against a golden standard reference system. Information on study characteristics, signal processing characteristics and study results was assessed and discussed. This review shows that methods for lower limb joint kinematics are inherently application dependent. Sensor restrictions are generally compensated with biomechanically inspired assumptions and prior information. Awareness of the possible adaptations in the IMU-based kinematic estimates by incorporating such prior information and assumptions is necessary, before drawing clinical decisions. Future research should focus on alternative validation methods, subject-specific IMU-based biomechanical joint models and disturbed movement patterns in real-world settings.
| S-EPMC7038336 | biostudies-literature
Project description:Precise and objective assessments of upper limb movement quality after strokes in functional task conditions are an important prerequisite to improve understanding of the pathophysiology of movement deficits and to prove the effectiveness of interventions. Herein, a wearable inertial sensing system was used to capture movements from the fingers to the trunk in 10 chronic stroke subjects when performing reach-to-grasp activities with the affected and non-affected upper limb. It was investigated whether the factors, tested arm, object weight, and target height, affect the expressions of range of motion in trunk compensation and flexion-extension of the elbow, wrist, and finger during object displacement. The relationship between these metrics and clinically measured impairment was explored. Nine subjects were included in the analysis, as one had to be excluded due to defective data. The tested arm and target height showed strong effects on all metrics, while an increased object weight showed effects on trunk compensation. High inter- and intrasubject variability was found in all metrics without clear relationships to clinical measures. Relating all metrics to each other resulted in significant negative correlations between trunk compensation and elbow flexion-extension in the affected arm. The findings support the clinical usability of sensor-based motion analysis.
| S-EPMC7506737 | biostudies-literature
Project description:Upper trunk (UT) kinematics in runners and its relationship with lower limbs has been poorly investigated, although it is acknowledged that dynamic stability of the upper body is a primary objective of human locomotion. This study aimed to explore UT kinematics according to gender and level of training and in relation to lower limb run patterns described through the presence of: overstriding, crossover, excessive protonation, and pelvic drop. Lower body variables chosen to describe running pattern were those that are frequently modified during gait-retraining with the goal of reducing injury risk. Eighty-seven recreational runners (28 females and 59 males, age 41?±?10 years) performed a one minute run test on a treadmill at self-selected speed. UT kinematics was measured using an inertial measurement unit, while run features were assessed through an optoelectronic system and video analysis. Accelerations and root-mean-square on mediolateral and anteroposterior axes, normalized using the vertical component of the acceleration, were estimated to describe UT stability. Results showed no significant differences in the normalized UT acceleration root-mean-square according to gender and level of training as well as according to the presence of overstriding, crossover, and excessive protonation. The only running strategy studied in this work that showed a significant relationship with UT stability was the presence of excessive pelvic drop. The latter was significantly associated (p=0.020) to a decrease in the normalized acceleration root-mean-square along the mediolateral direction. Although the excessive pelvic drop seemed to have a positive effect in stabilizing the upper body, concerns remain on the effect of a poor control of the pelvis on the biomechanics of lower limbs. Results obtained confirm the hypothesis that the lower body is able to respond to varying impact load conditions to maintain UT stability.
| S-EPMC6988689 | biostudies-literature
Project description:Variability of multi-joint essential tremor (ET) between patients and within the two upper limbs makes a visual assessment for the determination of botulinum toxin type A (BoNT-A) injections challenging. Kinematic tremor analysis guidance has succeeded in overcoming this challenge by making effective long-term unilateral BoNT-A injections for disabling ET. In this open-label study, 31 ET participants received three bilateral arm BoNT-A injection cycles over 30 weeks with follow-ups six-weeks post-treatment. Whole-arm kinematic assessment of tremor using a customized, automated algorithm provided muscle selection and dosing per muscle without clinician's assessment. Efficacy endpoints included Fahn-Tolosa-Marin tremor scale, quality of life (QoL) questionnaire, and maximum grip strength. BoNT-A reduced tremor amplitude by 47.7% in both the arms at week-6 (p < 0.005) that persisted from weeks 18?30. QoL was improved by 26.5% (p < 0.005) over the treatment period. Functional interference due to tremor was reduced by 30% (p < 0.005) from weeks 6?30. Maximum grip strength was reduced at week 6 (p = 0.001) but was not functionally impaired for the participants. Effective bilateral ET therapy by personalized BoNT-A injections could be achieved using computer-assisted tremor analysis. By removing variability inherent within the clinical assessments, this standardized tremor analysis method enabled patients to have improved bimanual upper limb functionality after the first treatment.
| S-EPMC6409675 | biostudies-literature
Project description:BackgroundInertial measurements (IMUs) facilitate the measurement of human motion outside the motion laboratory. A commonly used open-source software for musculoskeletal simulation and analysis of human motion, OpenSim, includes a tool to enable kinematics analysis of IMU data. However, it only enables offline analysis, i.e., analysis after the data has been collected. Extending OpenSim's functionality to allow real-time kinematics analysis would allow real-time feedback for the subject during the measurement session and has uses in e.g., rehabilitation, robotics, and ergonomics.MethodsWe developed an open-source software library for real-time inverse kinematics (IK) analysis of IMU data using OpenSim. The software library reads data from IMUs and uses multithreading for concurrent calculation of IK. Its operation delays and throughputs were measured with a varying number of IMUs and parallel computing IK threads using two different musculoskeletal models, one a lower-body and torso model and the other a full-body model. We published the code under an open-source license on GitHub.ResultsA standard desktop computer calculated full-body inverse kinematics from treadmill walking at 1.5 m/s with data from 12 IMUs in real-time with a mean delay below 55 ms and reached a throughput of more than 90 samples per second. A laptop computer had similar delays and reached a throughput above 60 samples per second with treadmill walking. Minimal walking kinematics, motion of lower extremities and torso, were calculated from treadmill walking data in real-time with a throughput of 130 samples per second on the laptop and 180 samples per second on the desktop computer, with approximately half the delay of full-body kinematics.ConclusionsThe software library enabled real-time inverse kinematical analysis with different numbers of IMUs and customizable musculoskeletal models. The performance results show that subject-specific full-body motion analysis is feasible in real-time, while a laptop computer and IMUs allowed the use of the method outside the motion laboratory.
| S-EPMC10082569 | biostudies-literature
Project description:Background: In children with unilateral cerebral palsy (uCP) virtually nothing is known on the relation between structural brain damage and upper limb (UL) kinematics quantified with three-dimensional movement analysis (3DMA). This explorative study aimed to (1) investigate differences in UL kinematics between children with different lesion timings, i.e., periventricular white matter (PWM) vs. cortical and deep gray matter (CDGM) lesions and (2) to explore the relation between UL kinematics and lesion location and extent within each lesion timing group. Methods: Forty-eight children (age 10.4 ± 2.7 year; 29 boys; 21 right-sided; 33 PWM; 15 CDGM) underwent an UL 3DMA during a reach-to-grasp task. Spatiotemporal parameters [movement duration, (timing of) maximum velocity, trajectory straightness], the Arm Profile Score (APS) and Arm Variable Scores (AVS) were extracted. The APS and AVS refer to the total amount of movement pathology and movement deviations of the wrist, elbow, shoulder, scapula and trunk respectively. Brain lesion location and extent were scored based on FLAIR-images using a semi-quantitative MRI-scale. Results: Children with CDGM lesions showed more aberrant spatiotemporal parameters (p < 0.03) and more movement pathology (APS, p = 0.003) compared to the PWM group, mostly characterized by increased wrist flexion (p = 0.01). In the CDGM group, moderate to high correlations were found between lesion location and extent and duration, timing of maximum velocity and trajectory straightness (r = 0.53-0.90). Lesion location and extent were further moderately correlated with distal UL movement pathology (wrist flexion/extension, elbow pronation/supination, elbow flexion/extension; r = 0.50-0.65) and with the APS (r = 0.51-0.63). In the PWM group, only a few and low correlations were observed, mostly between damage to the PLIC and higher AVS of elbow flexion/extension, shoulder elevation and trunk rotation (r = 0.35-0.42). Regression analysis revealed damage to the temporal lobe with lesion timing as interactor (27%, p = 0.002) and the posterior limb of the internal capsule (PLIC) (7%, p = 0.04) as the strongest predictors, explaining 34% of the variance in APS. Conclusion: UL kinematic deviations are more influenced by lesion location and extent in children with later (CDGM) versus earlier lesions (PWM), except for proximal movement pathology. Damage to the PLIC is a significant predictor for UL movement pathology irrespective of lesion timing.
| S-EPMC5733007 | biostudies-literature
Project description:3D joint kinematics can provide important information about the quality of movements. Optical motion capture systems (OMC) are considered the gold standard in motion analysis. However, in recent years, inertial measurement units (IMU) have become a promising alternative. The aim of this study was to validate IMU-based 3D joint kinematics of the lower extremities during different movements. Twenty-eight healthy subjects participated in this study. They performed bilateral squats (SQ), single-leg squats (SLS) and countermovement jumps (CMJ). The IMU kinematics was calculated using a recently-described sensor-fusion algorithm. A marker based OMC system served as a reference. Only the technical error based on algorithm performance was considered, incorporating OMC data for the calibration, initialization, and a biomechanical model. To evaluate the validity of IMU-based 3D joint kinematics, root mean squared error (RMSE), range of motion error (ROME), Bland-Altman (BA) analysis as well as the coefficient of multiple correlation (CMC) were calculated. The evaluation was twofold. First, the IMU data was compared to OMC data based on marker clusters; and, second based on skin markers attached to anatomical landmarks. The first evaluation revealed means for RMSE and ROME for all joints and tasks below 3°. The more dynamic task, CMJ, revealed error measures approximately 1° higher than the remaining tasks. Mean CMC values ranged from 0.77 to 1 over all joint angles and all tasks. The second evaluation showed an increase in the RMSE of 2.28°- 2.58° on average for all joints and tasks. Hip flexion revealed the highest average RMSE in all tasks (4.87°- 8.27°). The present study revealed a valid IMU-based approach for the measurement of 3D joint kinematics in functional movements of varying demands. The high validity of the results encourages further development and the extension of the present approach into clinical settings.
| S-EPMC6394915 | biostudies-literature
Project description:This study aimed to assess the validity and reliability of the three-dimensional joint kinematic outcomes obtained by the inertial measurement units (IMUs) for runners with rearfoot strike pattern (RFS) and non-rearfoot strike pattern (NRFS). The IMUs system and optical motion capture system were used to simultaneous collect 3D kinematic of lower extremity joint data from participants running at 12 km/h. The joint angle waveforms showed a high correlation between the two systems after the offset correction in the sagittal plane (NRFS: coefficient of multiple correlation (CMC) = 0.924–0.968, root mean square error (RMSE) = 4.6°–13.7°; RFS: CMC = 0.930–0.965, RMSE = 3.1°–7.7°), but revealed high variability in the frontal and transverse planes (NRFS: CMC = 0.924–0.968, RMSE = 4.6°–13.7°; RFS: CMC = 0.930–0.965, RMSE = 3.1°–7.7°). The between-rater and between-day reliability were shown to be very good to excellent in the sagittal plane (between-rater: NRFS: CMC = 0.967–0.975, RMSE = 1.9°–2.9°, RFS: CMC = 0.922–0.989, RMSE = 1.0°–2.5°; between-day: NRFS: CMC = 0.950–0.978, RMSE = 1.6°–2.7°, RFS: CMC = 0.920–0.989, RMSE = 1.7°–2.2°), whereas the reliability was weak to very good (between-rater: NRFS: CMC = 0.480–0.947, RMSE = 1.1°–2.7°, RFS: CMC = 0.646–0.873, RMSE = 0.7°–2.4°; between-day: NRFS: CMC = 0.666–0.867, RMSE = 0.7°–2.8°, RFS: CMC = 0.321–0.805, RMSE = 0.9°–5.0°) in the frontal and transverse planes across all joints in both types of runners. The IMUs system was a feasible tool for measuring lower extremity joint kinematics in the sagittal plane during running, especially for RFS runners. However, the joint kinematics data in frontal and transverse planes derived by the IMUs system need to be used with caution.
| S-EPMC9793257 | biostudies-literature