Cargando…

A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study

Clinical assessment of spinal impairment in Axial Spondyloarthritis is currently performed using the Bath Ankylosing Spondylitis Metrological Index (BASMI). Despite being appreciated for its simplicity, the BASMI index lacks sensitivity and specificity of spinal changes, demonstrating poor associati...

Descripción completa

Detalles Bibliográficos
Autores principales: Franco, Luca, Sengupta, Raj, Wade, Logan, Cazzola, Dario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PeerJ Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845531/
https://www.ncbi.nlm.nih.gov/pubmed/33569248
http://dx.doi.org/10.7717/peerj.10623
_version_ 1783644569955467264
author Franco, Luca
Sengupta, Raj
Wade, Logan
Cazzola, Dario
author_facet Franco, Luca
Sengupta, Raj
Wade, Logan
Cazzola, Dario
author_sort Franco, Luca
collection PubMed
description Clinical assessment of spinal impairment in Axial Spondyloarthritis is currently performed using the Bath Ankylosing Spondylitis Metrological Index (BASMI). Despite being appreciated for its simplicity, the BASMI index lacks sensitivity and specificity of spinal changes, demonstrating poor association with radiographical range of motion (ROM). Inertial measurement units (IMUs) have shown promising results as a cost-effective method to quantitatively examine movement of the human body, however errors due to sensor angular drift have limited their application to a clinical space. Therefore, this article presents a wearable sensor protocol that facilitates unrestrained orientation measurements in space while limiting sensor angular drift through a novel constraint-based approach. Eleven healthy male participants performed five BASMI-inspired functional movements where spinal ROM and continuous kinematics were calculated for five spine segments and four spinal joint levels (lumbar, lower thoracic, upper thoracic and cervical). A Bland–Altman analysis was used to assess the level of agreement on range of motion measurements, whilst intraclass correlation coefficient (ICC), standardised error measurement, and minimum detectable change (MDC) to assess relative and absolute reliability. Continuous kinematics error was investigated through root mean square error (RMSE), maximum absolute error (MAE) and Spearman correlation coefficient (ρ). The overall error in the measurement of continuous kinematic measures was low in both the sagittal (RMSE = 2.1°), and frontal plane (RMSE = 2.3°). ROM limits of agreement (LoA) and minimum detectable change were excellent for the sagittal plane (maximum value LoA 1.9° and MDC 2.4°) and fair for lateral flexion (overall value LoA 4.8° and MDC 5.7°). The reliability analysis showed excellent level of agreement (ICC > 0.9) for both segment and joint ROM across all movements. The results from this study demonstrated better or equivalent accuracy than previous studies and were considered acceptable for application in a clinical setting. The protocol has shown to be a valuable tool for the assessment of spinal ROM and kinematics, but a clinical validation study on Axial Spondyloarthritis patients is required for the development and testing of a novel mobility index.
format Online
Article
Text
id pubmed-7845531
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher PeerJ Inc.
record_format MEDLINE/PubMed
spelling pubmed-78455312021-02-09 A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study Franco, Luca Sengupta, Raj Wade, Logan Cazzola, Dario PeerJ Bioengineering Clinical assessment of spinal impairment in Axial Spondyloarthritis is currently performed using the Bath Ankylosing Spondylitis Metrological Index (BASMI). Despite being appreciated for its simplicity, the BASMI index lacks sensitivity and specificity of spinal changes, demonstrating poor association with radiographical range of motion (ROM). Inertial measurement units (IMUs) have shown promising results as a cost-effective method to quantitatively examine movement of the human body, however errors due to sensor angular drift have limited their application to a clinical space. Therefore, this article presents a wearable sensor protocol that facilitates unrestrained orientation measurements in space while limiting sensor angular drift through a novel constraint-based approach. Eleven healthy male participants performed five BASMI-inspired functional movements where spinal ROM and continuous kinematics were calculated for five spine segments and four spinal joint levels (lumbar, lower thoracic, upper thoracic and cervical). A Bland–Altman analysis was used to assess the level of agreement on range of motion measurements, whilst intraclass correlation coefficient (ICC), standardised error measurement, and minimum detectable change (MDC) to assess relative and absolute reliability. Continuous kinematics error was investigated through root mean square error (RMSE), maximum absolute error (MAE) and Spearman correlation coefficient (ρ). The overall error in the measurement of continuous kinematic measures was low in both the sagittal (RMSE = 2.1°), and frontal plane (RMSE = 2.3°). ROM limits of agreement (LoA) and minimum detectable change were excellent for the sagittal plane (maximum value LoA 1.9° and MDC 2.4°) and fair for lateral flexion (overall value LoA 4.8° and MDC 5.7°). The reliability analysis showed excellent level of agreement (ICC > 0.9) for both segment and joint ROM across all movements. The results from this study demonstrated better or equivalent accuracy than previous studies and were considered acceptable for application in a clinical setting. The protocol has shown to be a valuable tool for the assessment of spinal ROM and kinematics, but a clinical validation study on Axial Spondyloarthritis patients is required for the development and testing of a novel mobility index. PeerJ Inc. 2021-01-26 /pmc/articles/PMC7845531/ /pubmed/33569248 http://dx.doi.org/10.7717/peerj.10623 Text en © 2021 Franco et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
spellingShingle Bioengineering
Franco, Luca
Sengupta, Raj
Wade, Logan
Cazzola, Dario
A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study
title A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study
title_full A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study
title_fullStr A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study
title_full_unstemmed A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study
title_short A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study
title_sort novel imu-based clinical assessment protocol for axial spondyloarthritis: a protocol validation study
topic Bioengineering
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845531/
https://www.ncbi.nlm.nih.gov/pubmed/33569248
http://dx.doi.org/10.7717/peerj.10623
work_keys_str_mv AT francoluca anovelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy
AT senguptaraj anovelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy
AT wadelogan anovelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy
AT cazzoladario anovelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy
AT francoluca novelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy
AT senguptaraj novelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy
AT wadelogan novelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy
AT cazzoladario novelimubasedclinicalassessmentprotocolforaxialspondyloarthritisaprotocolvalidationstudy