Uso de sensores inerciales en fisioterapia: Una aproximación a procesos de evaluación del movimiento humano / Use of inertial sensors in physiotherapy: an approach to human movement assessment processes

Resumen Introducción: Los sensores inerciales o unidad de medición inercial (IMU) del inglés Inertial measurement unit, son pequeños dispositivos capaces de medir la aceleración lineal y la velocidad angular, siendo útiles en el área de la salud para la cuantificación y valoración objetiva del movimiento corporal humano. Objetivo: Analizar la información sobre el uso de sensores inerciales como una aproximación a los procesos de evaluación del movimiento corporal humano. Materiales y métodos: Se realizó búsqueda en bases de datos, empleando términos: sensores inerciales, salud, fisioterapia, acelerómetro, actividad física, movimiento y rehabilitación, y sus combinaciones. Como criterios de exclusión se tuvo: artículos exclusivos del campo de ingeniería con información no aplicable a fisioterapia. Resultados: Una IMU es compatible con aplicaciones (APP), con el objetivo de obtener datos de movimiento tridimensionales y como evaluación e intervención, o que permita cuantificar los resultados de la acción motora. Conclusiones: Las IMU tienen amplias posibilidades en áreas afines a la rehabilitación y otras referentes al entrenamiento y el área deportiva; por lo, cual es necesario estandarizar protocolos que permitan la medición de patrones motores que favorezcan los procesos de rehabilitación.

Abstract Introduction: Inertial measurement units (IMU) are small devices capable of measuring linear acceleration and angular velocity. Therefore, they are useful in the health field for the quantification and objective assessment of the human body movement. Objective: To analyze information about the inertial sensors usage, as a way to approach to processes of evaluation of the human body movement. Materials and methods: A database search was performed, using the following terms: inertial sensors, health, physiotherapy, accelerometer physical activity, movement, rehabilitation and their multiple combinations. The exclusion criteria were exclusive articles from the engineering field covering information not relevant for physical therapy. Results: IMUs are devices that are compatible with applications, which can obtain three-dimensional movement data. They can also be used for assessment and intervention to quantify results of motor action. Conclusions: IMUs may have wide applications in fields such as rehabilitation, training and sports. As a result, it is necessary to standardize protocols to measure motor patterns and facilitate rehabilitation processes.

Use of wearable inertial sensors for the assessment of spatiotemporal gait variables in children: A systematic review

Abstract Aim: The present study aimed to perform a literature review on the use of wearable inertial sensors for gait analysis of children in clinical practice. Methods: Searches were performed in the MEDLINE, EMBASE, Cochrane Library, and PEDro databases for studies involving children or adolescents submitted to gait analysis with the use of wearable inertial sensors. No restrictions were imposed regarding the date of publication or language. Results: Three hundred twenty articles were retrieved, 14 of which met the eligibility criteria and were selected for the present systematic review. Two independent reviewers assessed the risk of bias and study quality using the ROBINS-I and AXIS scale. The studies included in the present review reported multiple outcomes of kinematic gait assessments calculated from the signals provided by the wearable sensors, performed in a hospital setting, outpatient clinic, and a familiar environment, with several types of pediatric conditions. Conclusion: The findings suggest that wearable sensors are effective for the evaluation of quantitative gait variables in children with different pediatric conditions, enabling an objective analysis that should prove useful in the processes of clinical diagnosis and rehabilitation. However, given the relatively small number of studies published on this topic, it is difficult to make strong recommendations regarding the most appropriate equipment, sensor placement, and outcomes for assessing gait in children.

Objective evaluation versus subjective evaluation of flexion tests in the pelvic limb of horses / Avaliação objetiva versus avaliação subjetiva dos testes de flexão no membro pélvico de cavalos

The agreement between subjective and objective evaluation methods was studied to identify claudication in the pelvic limbs of horses before and after flexion tests were performed. Twenty-nine horses were equipped with a wireless system of inertial sensors and evaluated during seven times while trotting. Videos were recorded to be evaluated by three veterinarians, with different levels of experience, to evaluate the agreement between the two different methods and between the evaluators. The evaluators and the objective evaluation had a low rate of agreement, with the exception of moderate agreement between the objective evaluation and evaluator 1 to identify lameness after the left total flexion and moderate agreement in evaluating the response to the tests, between objective evaluation and evaluator 2, after right distal flexion. This shows that there was a low agreement among the evaluators and between them and the objective evaluation for identifying lameness, measuring the degree of lameness and the response to the flexion tests.(AU)

A concordância entre métodos de avaliação subjetiva e objetiva foi estudada para identificar claudicação nos membros pélvicos antes e após a realização dos testes de flexão. Vinte e nove cavalos foram equipados com um sistema de sensores inerciais sem fio e avaliados durante sete momentos enquanto troteavam. Vídeos foram gravados para serem avaliados por três veterinários com diferentes níveis de experiência, a fim de avaliar a concordância entre os dois métodos diferentes e entre os avaliadores. Os avaliadores e a avaliação objetiva tiveram uma baixa taxa de concordância, com exceção de uma moderada concordância entre avaliação objetiva e avaliador 1 para identificar claudicação após o teste de flexão total esquerdo e uma moderada concordância na avaliação da resposta aos testes, entre avaliação objetiva e avaliador 2, após o teste de flexão distal direito. Isso demonstra que houve uma baixa concordância entre os avaliadores e entre estes e a avaliação objetiva para identificação da claudicação, mensuração do grau de claudicação e resposta aos testes de flexão.(AU)

Gait variability and symmetry assessment with inertial sensors for quantitative discrimination of Trendelenburg sign in total hip arthroplasty patients: a pilot study based on convenience sampling

Abstract Introduction The aim of this pilot study based on convenience sampling was to analyze the feasibility to quantitatively discriminate Trendelenburg sign (TS), a characteristic drop in pelvic position during gait in hip disfunctions, in patients with total hip arthroplasty (THA), by assessing gait variability and symmetry using inertial sensors. Methods Thirteen patients with right THA, divided into two groups with (GTS, n=4) and without TS (GnTS, n=9) assessed by experienced physician, were enrolled in the study. Harris Hip Score was applied for specific evaluation of THA. The protocol consisted in walking on a level treadmill during 3 minutes with two inertial sensors attached at anterior superior iliac spine of both sides. For each left and right step, features were extracted from the Y-axis gyroscope signals: peak value, mean absolute value, standard deviation and range. For each feature, a symmetry ratio was calculated as the ratio between left and right side. Results No significant differences were found in Harris Hip Score between groups. The variability assessed by standard deviation for left step, contralateral to the replaced side, was significantly larger for GTS group (p<0.001). Significant differences in the symmetry ratios were found between GTS and GnTS for all features extracted from gyroscopes Y-axis (W=144, p<0.001). The symmetry ratios for GnTS group were approximately equal one (except for range), whereas for the GTS group they exceed the 10% criterion. Conclusion The variability and symmetry ratios of gait features extracted from inertial sensors were successful to discriminate TS in THA patients.

Initiatory Application of Three-dimensional Asymmetry on Anterior-cruciate-ligament Rupture Gait Analysis / 中国康复理论与实践

@#Objective Gait analysis plays an important role in the description of the site and degree of injury in the lower limbs, and symmetry is an important indicator of gait characteristics. The aim of this study is to quantitatively describe gait information and its asymmetry in three-dimensional space, dig deeper into gait information and improve the analysis of abnormal gait characteristics.Methods The information about the change of coronal-sagittal plane angle in different parts was obtained based on the inertial gait sensor, and the gait space vector was inverted to build the movement curve and form a motion symmetry detection method based on three-dimensional space angle vector distance. The characteristics of normal subjects (control group) and the anterior cruciate ligament (ACL) rupture patients (patients group) were analyzed from July, 2017 to January, 2018, and its effectiveness was verified.Results There was a better discrimination effect in the calf, thigh and knee asymmetry, etc., between the control group and the patient group (P<0.05). The characteristics of the calf space motion vector were highest among the control group and the patient group, and the discrimination was relatively stable, and not various with gender, age, height or body mass index.Conclusion The time-coronal-sagittal vector diagrams of left and right limbs were obtained by inertial sensor and the average of the square of the Euclidean distances in space at the selected gait cycle time points was calculated in three-dimensional space, which could be used as a gait asymmetry analysis method.

The application of data gloves in the evaluation of patients with hand injuries / 中华物理医学与康复杂志

Objective To develop a data glove evaluation system to assist rehabilitation physicians and therapists in assessing the degree of rehabilitation of hand-wounded patients. Methods A data glove containing 136-axis inertial sensors was designed and produced. It was tested on 10 healthy subjects and 3 hand trauma pa-tients admitted to the Department of Rehabilitation Medicine at Run Run Shaw Hospital. The glove transmitted ac-celeration and angular velocity components in the X, Y and Z directions to a computer terminal, allowing the ben-ding angles of the subject′s finger joints to be calculated. Traditional protractor measurements were used to verify to what extent the data glove accurately reflected the hand and joint activity. Results Compared with the traditional protractor measurement method, the data glove quickly gave accurate maximum bending angles both in healthy and hand-wounded subjects . Such data can facilitate the rehabilitation of hand injuries. Conclusions The data glove produced in this study can effectively assist rehabilitation doctors and therapists in assessing the recovery of hand-injured patients.

Efecto de un entrenamiento deportivo en el compartimiento angular de la extremidad inferior en niños futbolistas de entre 11 y 12 años / Effect of sports training in angular compartment of the lower limbs in children footballers aged 11 to 12 years old

Resumen: La lesión del ligamento cruzado anterior (LCA) constituye una causa importante de reposo en deportistas. En su mayoría, las lesiones del LCA no requieren contacto externo y se asocian con factores de riesgo biomecánicos que aumentan la tensión en el LCA: el aumento del ángulo de valgo de rodilla (VR), flexión de cadera (FC) y una menor flexión de rodilla (FR). El LCA requiere cooperación de los grupos musculares perirrodilla, por lo que la fatiga producida por el ejercicio alteraría el balance y pondría en riesgo a este ligamento. El objetivo del estudio es determinar el comportamiento angular antes y después de una carga física para FC, FR y VR en niños nacidos en los años 2002-2003. Se realizó un estudio clínico no aleatorizado. La muestra consistió en 50 alumnos de escuelas de fútbol nacidos en los años 2002 y 2003. Se comparó el comportamiento angular de FC, FR y VR antes y después de realizar un entrenamiento estandarizado. El comportamiento angular fue medido a través de la realización de la prueba DJ, con datos obtenidos por sensores inerciales. Posterior al ejercicio, aumentaron las tres variables; sólo fue significativo el incremento en la flexión de cadera. Por otra parte, destaca la diferencia encontrada tanto en reposo como postejercicios entre la extremidad de apoyo y la hábil en el peak de valgo angular. Se concluyó que el comportamiento angular de FC aumenta significativamente en ambas extremidades postentrenamiento y que se deben aplicar medidas preventivas para el manejo del valgo en la extremidad de apoyo.

Abstract: Anterior Cruciate Ligament (ACL) injury is an important cause of days lost in athletes. Most ACL injuries are non-contact and are associated with biomechanical risk factors that increase tension in the ACL: increased knee valgus (KV) and hip flexion (HF) and decreased flexion of knee (KF). Muscle around the knee contributes to knee stability, so fatigue produced by exercise could alter knee balance, increasing LCA tension. The aim of the study is to determine the angular behavior before and after a physical load for CF, RR and RV in children born in 2002-2003. A non-randomized clinical trial was conducted. The sample consisted of 50 students from soccer schools born between 2002 and 2003. The angular behavior of CF, RR and VR was compared, before and after performing standardized training. The angular behavior was measured by performing the DJ test with data obtained by inertial sensors. After exercise, the 3 variables increased, but only HF reached significant difference. Other important finding was the difference found in KV between the dominant leg and the support limb, at both times: rest and post exercise. It was concluded that the angular behavior of CF increases significantly in both limbs post-exercise and that preventive measures should be applied for the management of valgus in the supporting limb.

Diseño e implementación de sistema de plantilla para medición de presiones y cinemática del pie / Design and implementation of system for measurement pressures and foot kinematics

Este es un trabajo donde se desarrolló e implementó un sistema integrado que combina una plan-tilla instrumentada con sensores de presión y un módulo de sensores inerciales compuesto por un acelerómetro y un giroscopio, los cuales permitio la medición de variables baropodométricas (presiones plantares) y variables cinemáticas (aceleración, velocidad angular y desplazamiento angular) del pie. El sistema resultante le deja al especialista realizar un estudio biomecánico del pie a través del análisis estático y/o dinámico del movimiento y la visualización en pantalla de da-tos cuantitativos e información cualitativa, para la evaluación e intervención de los deportistas.

This paper presents the development and implementation of an integrated system that combi-nesan insole instrumented with pressure sensors and an inertial sensor module consists of an accelerometer and a gyroscope, which allows measurement of baropodometric variables (plantar pressures) and kinematic variables (acceleration, angular rate, and angular displacement) of the foot. The resulting system allows the specialist to conduct a foot biomechanical study through static and/or dynamic analysis and screen display of quantitative data and qualitative informa-tion, whose analysis allows prevention and intervention programs for musculoskeletal disorders that may affect the performance of athletes.