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      A Novel Setup and Protocol to Measure the Range of Motion of the Wrist and the Hand

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          Abstract

          The human hand is important for the performance of activities of daily living which are directly related to quality of life. Various conditions, such as Duchenne muscular dystrophy (DMD) can affect the function of the human hand and wrist. The ability to assess the impairment in the hand and the wrist by measuring the range of motion (ROM), is essential for the development of effective rehabilitation protocols. Currently the clinical standard is the goniometer. In this study we explore the feasibility and reliability of an optical sensor (Leap motion sensor) in measuring active hand/wrist ROM. We measured the hand/wrist ROM of 20 healthy adults with the goniometer and the Leap motion sensor, in order to check the agreement between the two methods and additionally, we performed a test-retest of the Leap motion sensor with 12 of them, to assess its reliability. The results suggest low agreement between the goniometer and the leap motion sensor, yet showing a large decrease in measurement time and high reliability when using the later. Despite the low agreement between the two methods, we believe that the Leap motion sensor shows potential to contribute to the development of hand rehabilitation protocols and be used with patients in a clinical setting.

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          Most cited references29

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          Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity.

          Clinical measurement of range of motion is a fundamental evaluation procedure with ubiquitous application in physical therapy. Objective measurements of ROM and correct interpretation of the measurement results can have a substantial impact on the development of the scientific basis of therapeutic interventions. The purpose of this article is to review the related literature on the reliability and validity of goniometric measurements of the extremities. Special emphasis is placed on how the reliability of goniometry is influenced by instrumentation and procedures, differences among joint actions and body regions, passive versus active measurements, intratester versus intertester measurements, and different patient types. Our discussion of validity encourages objective interpretation of the meaning of ROM measurements in light of the purposes and the limitations of goniometry. We conclude that clinicians should adopt standardized methods of testing and should interpret and report goniometric results as ROM measurements only, not as measurements of factors that may affect ROM.
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            An Analysis of the Precision and Reliability of the Leap Motion Sensor and Its Suitability for Static and Dynamic Tracking

            We present the results of an evaluation of the performance of the Leap Motion Controller with the aid of a professional, high-precision, fast motion tracking system. A set of static and dynamic measurements was performed with different numbers of tracking objects and configurations. For the static measurements, a plastic arm model simulating a human arm was used. A set of 37 reference locations was selected to cover the controller's sensory space. For the dynamic measurements, a special V-shaped tool, consisting of two tracking objects maintaining a constant distance between them, was created to simulate two human fingers. In the static scenario, the standard deviation was less than 0.5 mm. The linear correlation revealed a significant increase in the standard deviation when moving away from the controller. The results of the dynamic scenario revealed the inconsistent performance of the controller, with a significant drop in accuracy for samples taken more than 250 mm above the controller's surface. The Leap Motion Controller undoubtedly represents a revolutionary input device for gesture-based human-computer interaction; however, due to its rather limited sensory space and inconsistent sampling frequency, in its current configuration it cannot currently be used as a professional tracking system.
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              Assessment of hand kinematics using inertial and magnetic sensors

              Background Assessment of hand kinematics is important when evaluating hand functioning. Major drawbacks of current sensing glove systems are lack of rotational observability in particular directions, labour intensive calibration methods which are sensitive to wear and lack of an absolute hand orientation estimate. Methods We propose an ambulatory system using inertial sensors that can be placed on the hand, fingers and thumb. It allows a full 3D reconstruction of all finger and thumb joints as well as the absolute orientation of the hand. The system was experimentally evaluated for the static accuracy, dynamic range and repeatability. Results The RMS position norm difference of the fingertip compared to an optical system was 5±0.5 mm (mean ± standard deviation) for flexion-extension and 12.4±3.0 mm for combined flexion-extension abduction-adduction movements of the index finger. The difference between index and thumb tips during a pinching movement was 6.5±2.1 mm. The dynamic range of the sensing system and filter was adequate to reconstruct full 80 degrees movements of the index finger performed at 116 times per minute, which was limited by the range of the gyroscope. Finally, the reliability study showed a mean range difference over five subjects of 1.1±0.4 degrees for a flat hand test and 1.8±0.6 degrees for a plastic mold clenching test, which is smaller than other reported data gloves. Conclusion Compared to existing data gloves, this research showed that inertial and magnetic sensors are of interest for ambulatory analysis of the human hand and finger kinematics in terms of static accuracy, dynamic range and repeatability. It allows for estimation of multi-degree of freedom joint movements using low-cost sensors.
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                Author and article information

                Journal
                Sensors (Basel)
                Sensors (Basel)
                sensors
                Sensors (Basel, Switzerland)
                MDPI
                1424-8220
                25 September 2018
                October 2018
                : 18
                : 10
                : 3230
                Affiliations
                [1 ]Department of Biomechanical Engineering, Technical Medical Centre, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; amendes06@ 123456hotmail.com (A.M.); a.bergsma@ 123456utwente.nl (A.B.); h.f.j.m.koopman@ 123456utwente.nl (B.F.J.M.K.)
                [2 ]Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Reinier Postlaan 4, 6525 GC Nijmegen, The Netherlands; n.h.rijken@ 123456utwente.nl (N.H.M.R.); Mariska.Janssen@ 123456radboudumc.nl (M.M.H.P.J.)
                Author notes
                [* ]Correspondence: k.nizamis@ 123456utwente.nl ; Tel.: +31-644-110-130
                Author information
                https://orcid.org/0000-0002-6965-0242
                https://orcid.org/0000-0003-2177-5115
                Article
                sensors-18-03230
                10.3390/s18103230
                6210232
                30257521
                3d6739b0-8653-4dda-979e-387cfcaa519d
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 23 August 2018
                : 21 September 2018
                Categories
                Article

                Biomedical engineering
                distal upper extremities,goniometer,hand,leap motion sensor,motion capture,range-of-motion,rehabilitation,wrist

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