Association between wrist-worn free-living accelerometry and hand grip strength in middle-aged and older adults.

INTRODUCTION: Wrist-worn activity monitors have seen widespread adoption in recent times, particularly in young and sport-oriented cohorts, while their usage among older adults has remained relatively low. The main limitations are in regards to the lack of medical insights that current mainstream activity trackers can provide to older subjects. One of the most important research areas under investigation currently is the possibility of extrapolating clinical information from these wearable devices. METHODS: The research question of this study is understanding whether accelerometry data collected for 7-days in free-living environments using a consumer-based wristband device, in conjunction with data-driven machine learning algorithms, is able to predict hand grip strength and possible conditions categorized by hand grip strength in a general population consisting of middle-aged and older adults. RESULTS: The results of the regression analysis reveal that the performance of the developed models is notably superior to a simple mean-predicting dummy regressor. While the improvement in absolute terms may appear modest, the mean absolute error (6.32 kg for males and 4.53 kg for females) falls within the range considered sufficiently accurate for grip strength estimation. The classification models, instead, excel in categorizing individuals as frail/pre-frail, or healthy, depending on the T-score levels applied for frailty/pre-frailty definition. While cut-off values for frailty vary, the results suggest that the models can moderately detect characteristics associated with frailty (AUC-ROC: 0.70 for males, and 0.76 for females) and viably detect characteristics associated with frailty/pre-frailty (AUC-ROC: 0.86 for males, and 0.87 for females). CONCLUSIONS: The results of this study can enable the adoption of wearable devices as an efficient tool for clinical assessment in older adults with multimorbidities, improving and advancing integrated care, diagnosis and early screening of a number of widespread diseases.

A dataset for fatigue estimation during shoulder internal and external rotation movements using wearables.

Wearable sensors have recently been extensively used in sports science, physical rehabilitation, and industry providing feedback on physical fatigue. Information obtained from wearable sensors can be analyzed by predictive analytics methods, such as machine learning algorithms, to determine fatigue during shoulder joint movements, which have complex biomechanics. The presented dataset aims to provide data collected via wearable sensors during a fatigue protocol involving dynamic shoulder internal rotation (IR) and external rotation (ER) movements. Thirty-four healthy subjects performed shoulder IR and ER movements with different percentages of maximal voluntary isometric contraction (MVIC) force until they reached the maximal exertion. The dataset includes demographic information, anthropometric measurements, MVIC force measurements, and digital data captured via surface electromyography, inertial measurement unit, and photoplethysmography, as well as self-reported assessments using the Borg rating scale of perceived exertion and the Karolinska sleepiness scale. This comprehensive dataset provides valuable insights into physical fatigue assessment, allowing the development of fatigue detection/prediction algorithms and the study of human biomechanical characteristics during shoulder movements within a fatigue protocol.

Implementation of a Frailty Care Bundle (FCB) Targeting Mobilisation, Nutrition and Cognitive Engagement to Reduce Hospital Associated Decline in Older Orthopaedic Trauma Patients: Pretest-Posttest Intervention Study.

Objective: To implement and evaluate a Frailty Care Bundle (FCB) targeting mobilisation, nutrition, and cognition in older trauma patients to reduce hospital associated decline. Methods: We used a two group, pretest-posttest design. The FCB intervention was delivered on two orthopaedic wards and two rehabilitation wards, guided by behaviour change theory (COM-B) to implement changes in ward routines (patient mobility goals, nurse assisted mobilisation, mealtimes, communication). Primary outcomes were patient participants' return to pre-trauma functional capability (modified Barthel Index - mBI) at 6-8 weeks post-hospital discharge and average hospital daily step-count. Statistical analysis compared pre versus post FCB group differences using ordinal regression and log-linear models. Results: We recruited 120 patients (pre n=60 and post n=60), and 74 (pre n=43, post n=36) were retained at follow-up. Median age was 78 years and 83% were female. There was a non-significant trend for higher mBI scores (improved function) in the post compared to pre FCB group (OR 2.29, 95% CI 0.98-5.36), associated with an average 11% increase in step-count. Conclusion: It was feasible, during the Covid-19 pandemic, for multidisciplinary teams to implement elements of the FCB. Clinical facilitation supported teams to prioritise fundamental care above competing demands, but sustainability requires ongoing attention. ISRCTN registry: ISRCTN15145850 (https://doi.org/10.1186/ISRCTN15145850).

Utilising dynamic motor control index to identify age-related differences in neuromuscular control.

PURPOSE: Considering the relationship between aging and neuromuscular control decline, early detection of age-related changes can ensure that timely interventions are implemented to attenuate or restore neuromuscular deficits. The dynamic motor control index (DMCI), a measure based on variance accounted for (VAF) by one muscle synergy (MS), is a metric used to assess age-related changes in neuromuscular control. The aim of the study was to investigate the use of one-synergy VAF, and consecutively DMCI, in assessing age-related changes in neuromuscular control over a range of exercises with varying difficulty. METHODS: Thirty-one subjects walked on a flat and inclined treadmill, as well as performed forward and lateral stepping up tasks. Motion and muscular activity were recorded, and muscle synergy analysis was conducted using one-synergy VAF, DMCI, and number of synergies. RESULTS: Difference between older and younger group was observed for one-synergy VAF, DMCI for forward stepping up task (one-synergy VAF difference of 2.45 (0.22, 4.68) and DMCI of 9.21 (0.81, 17.61), p = 0.033), but not for lateral stepping up or walking. CONCLUSION: The use of VAF based metrics and specifically DMCI, rather than number of MS, in combination with stepping forward exercise can provide a low-cost and easy to implement approach for assessing neuromuscular control in clinical settings.

Acoustic emissions and age-related changes of the knee.

Acoustic emission (AE) monitoring is currently being widely investigated as a diagnostic tool in orthopedics, in particular for osteoarthritis (OA) diagnostics. Considering that age is one of the main risk factors for OA, investigating age-related changes in joint AEs might provide an additional incentive for further studies and consequent translation to clinical practice. The aim of this study is to investigate age-related changes in knee AE and determine AE hit definition modes as well as AE hit parameters that allow for improved age group differentiation. Knee AEs were recorded from 51 participants in two age groups (18-35 and 50-75 years old) whilst cycling with 30 and 60 rpm cadence. Two AE sensors with 15-40 kHz and 100-450 kHz frequency ranges were used, and three AE event detection modes investigated. Additionally, participants' Knee Osteoarthritis Outcome Scores (KOOS) were recorded. Low frequency sensors (15-40kHz) and hit modes with shortened hit and peak definition times showed the potential to distinguish between age groups. Moreover, a weak correlation was found between only three parameters (AE event median duration, rise time, and signal strength) and age, indicating that changes in joint AE are most likely associated with pathological changes rather than physiological ageing within the healthy norm.Clinical Relevance- the use of AE monitoring was examined in the context of age-related changes in knee health. The study indicates the potential for knee AE monitoring to be used as a quantitative measure of pathological changes in the knee status.

Development of a PPG-based hardware and software system deployable on elbow and thumb for real-time estimation of pulse transit time.

Blood pressure (BP) is a vital parameter used by clinicians to diagnose issues in the human cardiovascular system. Cuff-based BP devices are currently the standard method for on-the-spot and ambulatory BP measurements. However, cuff-based devices are not comfortable and are not suitable for long-term BP monitoring. Many studies have reported a significant correlation between pulse transit time (PTT) with blood pressure. However, this relation is impacted by many internal and external factors which might lower the accuracy of the PTT method. In this paper, we present a novel hardware system consisting of two custom photoplethysmography (PPG) sensors designed particularly for the estimation of PTT. In addition, a software interface and algorithms have been implemented to perform a real-time assessment of the PTT and other features of interest from signals gathered between the brachial artery and the thumb. A preclinical study has been conducted to validate the system. Five healthy volunteer subjects were tested and the results were then compared with those gathered using a reference device. The analysis reports a mean difference among subjects equal to -3.75±7.28 ms. Moreover, the standard deviation values obtained for each individual showed comparable results with the reference device, proving to be a valuable tool to investigate the factors impacting the BP-PTT relationship.Clinical Relevance- The proposed system proved to be a feasible solution to detect blood volume changes providing good quality signals to be used in the study of BP-PTT relationship.

12-year follow-up of the first endothelial keratoplasty without Descemet stripping in a 3-month newborn with Congenital Hereditary Endothelial Dystrophy (CHED).

BACKGROUND: Endothelial Keratoplasty (EK) is now considered as the standard treatment for Congenital Hereditary Endothelial Dystrophy (CHED) by many surgeons. We present the 12-year clinical outcome of the youngest operated patient with CHED in which we successfully performed a bilateral EK procedure without removing the recipient endothelium-Descemet complex. CASE PRESENTATION: In November 2010 we performed EK without Descemet Stripping in a 3-month female newborn, thinking that the lower manipulation obtained by leaving the recipient endothelium-Descemet complex could be the key factor for the success of our surgery. Such a particular technique was new in newborns. The surgery was a success, but the long-term visual result was not predictable at that time. We followed the patient at 4 months, and then yearly. At the latest visit in October 2022 the visual, cognitive, and motorial developments were normal, with Best-corrected Distance Visual Acuity of 0.4 LogMAR with - 0.75 D sf + 2.75 D cyl @ 105° in the right eye (RE) and 0.4 LogMAR with + 1.50 D sf + 2.50 D cyl @ 60° in the left eye (LE). The endothelial microscope showed an unexpected healthy endothelium, with a cell count of 2383 cells/mm2 in the RE and of 2547 cells/mm2 in the LE from a starting donor count of 2900 cells/mm2. No secondary procedures were performed during the 12-year follow-up. CONCLUSION: EK without Descemet stripping has proved to be a successful procedure over time in our newborn. The unexpected healthy endothelium suggests a role of the Descemet membrane in CHED.

Pars Plana Vitrectomy Alone or Combined with Phacoemulsification to Treat Rhegmatogenous Retinal Detachment: A Systematic Review of the Recent Literature.

Pars plana vitrectomy is today a common first-line procedure for treatment of rhegmatogenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combination of cataract extraction (i.e., phacoemulsification) with pars plana vitrectomy (PPVc) enhances visualization of the peripheral retina and the surgical management of the vitreous base. However, PPVc prolongs the surgical time and is associated with iatrogenic loss of the accommodation function in younger patients, possible postoperative anisometropia, and unexpected refractive results. Performance of pars plana vitrectomy alone (PPVa) requires good technical skills to minimize the risk of lens damage, and quickens cataract development. We retrieved all recent papers that directly compared PPVc and PPVa using parameters that we consider essential when choosing between the two procedures (the success rate of anatomical RRD repair, postoperative refractive error, intra- and postoperative complications, and costs). PPVa and PPVc were generally comparable in terms of RRD anatomical repair. PPVc was associated with fewer intraoperative, but more postoperative, complications. Macula-off RRD PPVc treatment was often associated with undesirable myopic refractive error. PPVa followed by phacoemulsification was the most expensive procedure.

Machine learning based canine posture estimation using inertial data.

The aim of this study was to design a new canine posture estimation system specifically for working dogs. The system was composed of Inertial Measurement Units (IMUs) that are commercially available, and a supervised learning algorithm which was developed for different behaviours. Three IMUs, each containing a 3-axis accelerometer, gyroscope, and magnetometer, were attached to the dogs' chest, back, and neck. To build and test the model, data were collected during a video-recorded behaviour test where the trainee assistance dogs performed static postures (standing, sitting, lying down) and dynamic activities (walking, body shake). Advanced feature extraction techniques were employed for the first time in this field, including statistical, temporal, and spectral methods. The most important features for posture prediction were chosen using Select K Best with ANOVA F-value. The individual contributions of each IMU, sensor, and feature type were analysed using Select K Best scores and Random Forest feature importance. Results showed that the back and chest IMUs were more important than the neck IMU, and the accelerometers were more important than the gyroscopes. The addition of IMUs to the chest and back of dog harnesses is recommended to improve performance. Additionally, statistical and temporal feature domains were more important than spectral feature domains. Three novel cascade arrangements of Random Forest and Isolation Forest were fitted to the dataset. The best classifier achieved an f1-macro of 0.83 and an f1-weighted of 0.90 for the prediction of the five postures, demonstrating a better performance than previous studies. These results were attributed to the data collection methodology (number of subjects and observations, multiple IMUs, use of common working dog breeds) and novel machine learning techniques (advanced feature extraction, feature selection and modelling arrangements) employed. The dataset and code used are publicly available on Mendeley Data and GitHub, respectively.

Posterior capsule dynamics during femtosecond laser lens fragmentation.

PURPOSE: The dynamics of the posterior capsule during femtosecond laser lens fragmentation has received little attention in the literature. We analysed the movements of the posterior capsule to identify the rupture risk factors, if any, and to suggest possible modification of the laser spot energy pattern during fragmentation. MATERIALS AND METHODS: Posterior capsule ruptures during fragmentation were identified over a 10-year period of femtosecond laser use. In addition, the dynamics of the posterior capsule were identified through the real-time swept-source OCT lateral view available during the surgeries. RESULTS: Out of the 1465 laser cataract procedures performed, we recorded 1 case of posterior capsule rupture during lens fragmentation, which was caused by eye movement that was detected but ignored by the surgeon. Three types of posterior capsule dynamics were identified, all related to a gas bubble formation during the first part of the lens fragmentation. In eyes with a hard nucleus, the concussion of the posterior capsule was evident, however, with no capsule rupture. DISCUSSION: Maintaining good docking throughout the whole procedure seems important in avoiding a posterior capsule cut by the femtosecond laser. In addition, a Gaussian pattern of spot energy is suggested when fragmenting hard cataracts.

Non-Invasive Assessment of Cartilage Damage of the Human Knee Using Acoustic Emission Monitoring: A Pilot Cadaver Study.

OBJECTIVE: Knee osteoarthritis is currently one of the top causes of disability in older population, a rate that will only increase in the future due to an aging population and the prevalence of obesity. However, objective assessment of treatment outcomes and remote evaluation are still in need of further development. Acoustic emission (AE) monitoring in knee diagnostics has been successfully adopted in the past; however, a wide discrepancy among the adopted AE techniques and analyses exists. This pilot study determined the most suitable metrics to differentiate progressive cartilage damage and the optimal frequency range and placement of AE sensors. METHODS: Knee AEs were recorded in the 100-450 kHz and 15-200kH frequency ranges from a cadaver specimen in knee flexion/extension. Four stages of artificially inflicted cartilage damage and two sensor positions were investigated. RESULTS: AE events in the lower frequency range and the following parameters provided better distinction between intact and damaged knee: hit amplitude, signal strength, and absolute energy. The medial condyle area of the knee was less prone to artefacts and unsystematic noise. Multiple reopenings of the knee compartment in the process of introducing the damage negatively affected the quality of the measurements. CONCLUSION: Results may improve AE recording techniques in future cadaveric and clinical studies. SIGNIFICANCE: This was the first study to evaluate progressive cartilage damage using AEs in a cadaver specimen. The findings of this study encourage further investigation of joint AE monitoring techniques.

Automated and subjective refraction with monofocal, multifocal, and EDOF intraocular lenses: review.

Automated refraction (Scheiner principle) is universally used to start a visual examination. Although the results are reliable in eyes implanted with monofocal intraocular lenses (IOLs), they may be less precise with multifocal (mIOL) or extended depth-of-focus (EDOF) IOLs and can even indicate a refractive error that does not clinically exist. Autorefractor results with monofocal, multifocal, and EDOF IOLs were investigated through literature search analyzing the papers reporting the difference between automated and clinical refraction. The average difference ranged between -0.50 diopter (D) and -1.00 D with most mIOL and EDOF IOLs. The differences in astigmatism were generally much lower. Autorefractors using infrared light cannot measure eyes with high technology IOLs precisely because of the influence of the refractive or of the diffractive near add. The systematic error induced with some IOLs should be mentioned in the IOL label to prevent possible inappropriate refractive procedures to treat apparent myopia.

Light- and drug-induced pupillary dynamics in eyes with a retropupillary iris-claw intraocular lens.

PURPOSE: We evaluated the pupillary characteristics and response to light and drugs in eyes with posterior chamber (PC) placement of iris-claw intraocular lens (IC-IOL). METHODS: In this cross-sectional, comparative study, we included adults with an IC-IOL implanted in the PC of a single eye. We excluded patients with ocular trauma, postoperative IC-IOL displacement or complications, and extended iris atrophy. We used anterior segment optical coherence tomography to perform light-controlled pupillography, measure the pupil diameter (PD), and estimated the pupil circularity under mesopic conditions. PD was also assessed under photopic, scotopic, pharmacological mydriasis, and miosis conditions. The results were compared to those of the fellow eye, phakic, or regular pseudophakic. RESULTS: The IC-IOL and control groups included 30 eyes each. The most frequent reasons for IC-IOL implantation were complicated cataract (37%) and dislocated/luxated prior IOL (33%). Compared to the control group, the IC-IOL group had lower visual acuity, a smaller PD under scotopic conditions (p = 0.0010) and after pharmacological mydriasis (p < 0.0001), and a larger PD after pharmacological miosis (p < 0.0001). Mesopic pupil circularity was comparable between the groups. We also considered ongoing extraocular treatments with possible effects on iris motility. CONCLUSIONS: The pupillary size and profile were similar between the groups in mesopic light. Reduced mydriasis was noted in response to light and drugs, while the degree of miosis was reduced in response to inducing drugs in the IC-IOL compared to the control group. This study complements previous results concerning the PC placement of IC-IOLs by adding original observations on drug-induced pupil motility.

Acuity and Quality of Vision in Eyes with Epithelial Basement Membrane Dystrophy after Regular Pseudophakia.

PURPOSE: This retrospective case-control study was conducted to quantitatively and qualitatively assess the visual impairment in eyes with Epithelial Basement Membrane Dystrophy (EBMD) after regular cataract surgery. METHODS: EBMD pseudophakic eyes were compared with matched pseudophakic eyes free from surface disorders. At least 3 weeks after surgery we evaluated uncorrected and best-corrected distance visual acuity (UDVA and CDVA), objective aberrometry, Point Spread Function (PSF), Modulation Transfer Function (MTF), and patient complaints. RESULTS: Twenty-five EBMD eyes and 25 control eyes (13 patients per group) were included. Nine patients per group had a monofocal IOL, and four patients had a trifocal IOL. All the EBMD patients complained of postoperative blurred vision with ocular discomfort; intensive use of lubricants induced subjective improvement only in eyes with monofocal IOLs. Postoperative mean UDVA was 0.19 ± 0.16 LogMAR in the EBMD eyes and 0.11 ± 0.04 LogMAR in the control group (p = 0.016). Mean CDVA was 0.18 ± 0.15 LogMAR in the EBMD eyes and 0.06 ± 0.04 LogMAR in the control eyes (p = 0.001). The PSF curve width was significantly worse in the EBMD group (p < 0.001). The MTF cut-off value was lower in the EBMD group than in the control group (p < 0.001). CONCLUSION: After cataract removal, eyes with EBMD had significantly lower UDVA and CDVA than controls. All the aberrometric parameters were significantly worse in EBMD cases. EBMD patients complained about their postoperative visual outcome, while control patients did not.

Refractive Outcome and 5-Year Capsulotomy Rate of Hydrophobic and Hydrophilic IOLs with Similar Optical Design: A Contralateral Study.

INTRODUCTION: To compare the short-term visual and aberrometric outcomes and the long-term capsulotomy incidence in a cohort of patients receiving IOLs with similar structural profile but with a hydrophobic matrix in one eye (PHOB group) and a hydrophilic matrix in the other one (PHIL group). METHODS: In this retrospective, contralateral study, 26 patients sequentially undergoing phacoemulsification were implanted as mentioned above. Refraction and aberrometry were evaluated 6 months after surgery. For the quality of vision, the Hartmann-Shack optical aberration, Double-Pass Modulation Transfer Function (MTF), contrast sensitivity, and dysphotopsia results were compared. Capsulotomy was ascertained and dated by medical chart revision or phone call. RESULTS: All the considered quantitative and qualitative visual parameters tested statistically comparable between PHIL and PHOB group. After 5 years, four patients (16.7%) in the PHOB group and five patients (20.8%) in the PHIL group underwent a Nd:YAG posterior capsulotomy (P > 0.5). CONCLUSION: In this contralateral comparative study, the hydrophobic and hydrophilic matrix of the IOL similarly influenced the visual and aberrometric outcomes. Also the long-term laser capsulotomy incidence did not statistically differ between groups. The posterior IOL profile, rather than matrix hydrophilia, could consistently influence the posterior capsule opacification.

Factors Influencing Continued Wearable Device Use in Older Adult Populations: Quantitative Study.

BACKGROUND: The increased use of wearable sensor technology has highlighted the potential for remote telehealth services such as rehabilitation. Telehealth services incorporating wearable sensors are most likely to appeal to the older adult population in remote and rural areas, who may struggle with long commutes to clinics. However, the usability of such systems often discourages patients from adopting these services. OBJECTIVE: This study aimed to understand the usability factors that most influence whether an older adult will decide to continue using a wearable device. METHODS: Older adults across 4 different regions (Northern Ireland, Ireland, Sweden, and Finland) wore an activity tracker for 7 days under a free-living environment protocol. In total, 4 surveys were administered, and biometrics were measured by the researchers before the trial began. At the end of the trial period, the researchers administered 2 further surveys to gain insights into the perceived usability of the wearable device. These were the standardized System Usability Scale (SUS) and a custom usability questionnaire designed by the research team. Statistical analyses were performed to identify the key factors that affect participants' intention to continue using the wearable device in the future. Machine learning classifiers were used to provide an early prediction of the intention to continue using the wearable device. RESULTS: The study was conducted with older adult volunteers (N=65; mean age 70.52, SD 5.65 years) wearing a Xiaomi Mi Band 3 activity tracker for 7 days in a free-living environment. The results from the SUS survey showed no notable difference in perceived system usability regardless of region, sex, or age, eliminating the notion that usability perception differs based on geographical location, sex, or deviation in participants' age. There was also no statistically significant difference in SUS score between participants who had previously owned a wearable device and those who wore 1 or 2 devices during the trial. The bespoke usability questionnaire determined that the 2 most important factors that influenced an intention to continue device use in an older adult cohort were device comfort (τ=0.34) and whether the device was fit for purpose (τ=0.34). A computational model providing an early identifier of intention to continue device use was developed using these 2 features. Random forest classifiers were shown to provide the highest predictive performance (80% accuracy). After including the top 8 ranked questions from the bespoke questionnaire as features of our model, the accuracy increased to 88%. CONCLUSIONS: This study concludes that comfort and accuracy are the 2 main influencing factors in sustaining wearable device use. This study suggests that the reported factors influencing usability are transferable to other wearable sensor systems. Future work will aim to test this hypothesis using the same methodology on a cohort using other wearable technologies.

One-dioptre toric IOL versus spherical IOL in eyes with low preoperative corneal astigmatism.

PURPOSE: To investigate the advantages/disadvantages of a 1.0 D toric IOL vs spherical IOL after regular phacoemulsification in eyes with preoperative astigmatism ≤ 1 D. METHODS: Retrospective comparative series involving pseudophakic eyes with preoperative topographic astigmatism ≤ 1.0 D implanted either with monofocal 1.0 D Toric IOL (T-group), or with spherical IOL (S-group). The postoperative refractive astigmatism (PRA, i.e. surgically induced + corneal) was the main outcome; also considered in the analyses were the uncorrected and best-corrected distance visual acuity (VA). The data were referred to the last postoperative follow-up visit, 2 to 4 months after surgery. RESULTS: A total of 60 eyes were included: 30 in the T-group and 30 in the S-group, matched for patient's age, laterality, and axial length. Before surgery, the mean corneal astigmatism was 0.62 ± 0.39 D in the T-group and 0.54 ± 0.33 D in the S-group (p = 0.4). In the S-group, PRA was 0.73 ± 0.37 D, higher than the corresponding preoperative corneal astigmatism (p = 0.040). In the T-group, PRA was 0.58 ± 0.31 D; the variation was not statistically significant. Uncorrected VA was significantly better in the T-group vs the S-group (p = 0.007), and the best-corrected VA was comparable in the two groups. CONCLUSION: The present study indicated that in eyes with very low preoperative astigmatism, 1.0 D toric IOLs were able to limit the increase of the PRA instead of those observed with the spherical IOLs. This could support the better uncorrected VA recorded in the T-group.

Test-Retest Reliability of Acoustic Emission Sensing of the Knee during Physical Tasks.

Acoustic emission (AE) sensing is an increasingly researched topic in the context of orthopedics and has a potentially high diagnostic value in the non-invasive assessment of joint disorders, such as osteoarthritis and implant loosening. However, a high level of reliability associated with the technology is necessary to make it appropriate for use as a clinical tool. This paper presents a test-retest and intrasession reliability evaluation of AE measurements of the knee during physical tasks: cycling, knee lifts and single-leg squats. Three sessions, each involving eight healthy volunteers were conducted. For the cycling activity, ICCs ranged from 0.538 to 0.901, while the knee lifts and single-leg squats showed poor reliability (ICC < 0.5). Intrasession ICCs ranged from 0.903 to 0.984 for cycling and from 0.600 to 0.901 for the other tasks. The results of this study show that movement consistency across multiple recordings and minimizing the influence of motion artifacts are essential for higher test reliability. It was shown that motion artifact resistant sensor mounting and the use of baseline movements to assess sensor attachment can improve the sensing reliability of AE techniques. Moreover, constrained movements, specifically cycling, show better inter- and intrasession reliability than unconstrained exercises.