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      Wearable systems for shoulder kinematics assessment: a systematic review

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          Abstract

          Background

          Wearable sensors are acquiring more and more influence in diagnostic and rehabilitation field to assess motor abilities of people with neurological or musculoskeletal impairments. The aim of this systematic literature review is to analyze the wearable systems for monitoring shoulder kinematics and their applicability in clinical settings and rehabilitation.

          Methods

          A comprehensive search of PubMed, Medline, Google Scholar and IEEE Xplore was performed and results were included up to July 2019. All studies concerning wearable sensors to assess shoulder kinematics were retrieved.

          Results

          Seventy-three studies were included because they have fulfilled the inclusion criteria. The results showed that magneto and/or inertial sensors are the most used. Wearable sensors measuring upper limb and/or shoulder kinematics have been proposed to be applied in patients with different pathological conditions such as stroke, multiple sclerosis, osteoarthritis, rotator cuff tear. Sensors placement and method of attachment were broadly heterogeneous among the examined studies.

          Conclusions

          Wearable systems are a promising solution to provide quantitative and meaningful clinical information about progress in a rehabilitation pathway and to extrapolate meaningful parameters in the diagnosis of shoulder pathologies. There is a strong need for development of this novel technologies which undeniably serves in shoulder evaluation and therapy.

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          Most cited references74

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          Estimation of IMU and MARG orientation using a gradient descent algorithm.

          This paper presents a novel orientation algorithm designed to support a computationally efficient, wearable inertial human motion tracking system for rehabilitation applications. It is applicable to inertial measurement units (IMUs) consisting of tri-axis gyroscopes and accelerometers, and magnetic angular rate and gravity (MARG) sensor arrays that also include tri-axis magnetometers. The MARG implementation incorporates magnetic distortion compensation. The algorithm uses a quaternion representation, allowing accelerometer and magnetometer data to be used in an analytically derived and optimised gradient descent algorithm to compute the direction of the gyroscope measurement error as a quaternion derivative. Performance has been evaluated empirically using a commercially available orientation sensor and reference measurements of orientation obtained using an optical measurement system. Performance was also benchmarked against the propriety Kalman-based algorithm of orientation sensor. Results indicate the algorithm achieves levels of accuracy matching that of the Kalman based algorithm; < 0.8° static RMS error, < 1.7° dynamic RMS error. The implications of the low computational load and ability to operate at small sampling rates significantly reduces the hardware and power necessary for wearable inertial movement tracking, enabling the creation of lightweight, inexpensive systems capable of functioning for extended periods of time. © 2011 IEEE
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            Survey of Motion Tracking Methods Based on Inertial Sensors: A Focus on Upper Limb Human Motion

            Motion tracking based on commercial inertial measurements units (IMUs) has been widely studied in the latter years as it is a cost-effective enabling technology for those applications in which motion tracking based on optical technologies is unsuitable. This measurement method has a high impact in human performance assessment and human-robot interaction. IMU motion tracking systems are indeed self-contained and wearable, allowing for long-lasting tracking of the user motion in situated environments. After a survey on IMU-based human tracking, five techniques for motion reconstruction were selected and compared to reconstruct a human arm motion. IMU based estimation was matched against motion tracking based on the Vicon marker-based motion tracking system considered as ground truth. Results show that all but one of the selected models perform similarly (about 35 mm average position estimation error).
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              Ambulatory measurement of shoulder and elbow kinematics through inertial and magnetic sensors.

              Inertial and magnetic measurement systems (IMMSs) are a new generation of motion analysis systems which may diffuse the measurement of upper-limb kinematics to ambulatory settings. Based on the MT9B IMMS (Xsens Technologies, NL), we therefore developed a protocol that measures the scapulothoracic, humerothoracic and elbow 3D kinematics. To preliminarily evaluate the protocol, a 23-year-old subject performed six tasks involving shoulder and elbow single-joint-angle movements. Criteria for protocol validity were limited cross-talk with the other joint-angles during each task; scapulohumeral-rhythm close to literature results; and constant carrying-angle. To assess the accuracy of the MT9B when measuring the upper-limb kinematics through the protocol, we compared the MT9B estimations during the six tasks, plus other four, with the estimations of an optoelectronic system (the gold standard), in terms of RMS error, correlation coefficient (r), and the amplitude ratio (m). Results indicate that the criteria for protocol validity were met for all tasks. For the joint angles mainly involved in each movement, the MT9B estimations presented RMS errors 0.99 and 0.9 < m < 1.09. It appears therefore that (1) the protocol in combination with the MT9B is valid for, and (2) the MT9B in combination with the protocol is accurate when, measuring shoulder and elbow kinematics, during the tasks tested, in ambulatory settings.
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                Author and article information

                Contributors
                arianna.carnevale@unicampus.it
                +39-06-2254-1613 , g.longo@unicampus.it
                e.schena@unicampus.it
                c.massaroni@unicampus.it
                d.lopresti@unicampus.it
                a.berton@unicampus.it
                v.candela@unicampus.it
                denaro.cbm@gmail.com
                Journal
                BMC Musculoskelet Disord
                BMC Musculoskelet Disord
                BMC Musculoskeletal Disorders
                BioMed Central (London )
                1471-2474
                15 November 2019
                15 November 2019
                2019
                : 20
                : 546
                Affiliations
                [1 ]ISNI 0000 0004 1757 5329, GRID grid.9657.d, Department of Orthopaedic and Trauma Surgery, , Campus Bio-Medico University, ; Via Álvaro del Portillo, 200, 00128 Rome, Italy
                [2 ]ISNI 0000 0004 1757 5329, GRID grid.9657.d, Unit of Measurements and Biomedical Instrumentation, , Campus Bio-Medico University, ; Via Álvaro del Portillo, 21, 00128 Rome, Italy
                Author information
                http://orcid.org/0000-0003-4063-9821
                Article
                2930
                10.1186/s12891-019-2930-4
                6858749
                31731893
                1f01a63f-b50d-4118-a6db-c679cc2673c9
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 July 2019
                : 31 October 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Orthopedics
                shoulder kinematics,upper limb,wearable system,inertial sensors,smart textile
                Orthopedics
                shoulder kinematics, upper limb, wearable system, inertial sensors, smart textile

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