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      Inertial Measurement Units for Clinical Movement Analysis: Reliability and Concurrent Validity

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          Abstract

          The aim of this study was to investigate the reliability and concurrent validity of a commercially available Xsens MVN BIOMECH inertial-sensor-based motion capture system during clinically relevant functional activities. A clinician with no prior experience of motion capture technologies and an experienced clinical movement scientist each assessed 26 healthy participants within each of two sessions using a camera-based motion capture system and the MVN BIOMECH system. Participants performed overground walking, squatting, and jumping. Sessions were separated by 4 ± 3 days. Reliability was evaluated using intraclass correlation coefficient and standard error of measurement, and validity was evaluated using the coefficient of multiple correlation and the linear fit method. Day-to-day reliability was generally fair-to-excellent in all three planes for hip, knee, and ankle joint angles in all three tasks. Within-day (between-rater) reliability was fair-to-excellent in all three planes during walking and squatting, and poor-to-high during jumping. Validity was excellent in the sagittal plane for hip, knee, and ankle joint angles in all three tasks and acceptable in frontal and transverse planes in squat and jump activity across joints. Our results suggest that the MVN BIOMECH system can be used by a clinician to quantify lower-limb joint angles in clinically relevant movements.

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          Most cited references47

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          Two simple methods for determining gait events during treadmill and overground walking using kinematic data.

          The determination of gait events such as heel strike and toe-off provide the basis for defining stance and swing phases of gait cycles. Two algorithms for determining event times for treadmill and overground walking based solely on kinematic data are presented. Kinematic data from treadmill walking trials lasting 20-45s were collected from three subject populations (healthy young, n=7; multiple sclerosis, n=7; stroke, n=4). Overground walking trials consisted of approximately eight successful passes over two force plates for a healthy subject population (n=5). Time of heel strike and toe-off were determined using the two new computational techniques and compared to events detected using vertical ground reaction force (GRF) as a gold standard. The two algorithms determined 94% of the treadmill events from healthy subjects within one frame (0.0167s) of the GRF events. In the impaired populations, 89% of treadmill events were within two frames (0.0334s) of the GRF events. For overground trials, 98% of events were within two frames. Automatic event detection from the two kinematic-based algorithms will aid researchers by accurately determining gait events during the analysis of treadmill and overground walking.
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            The reliability of three-dimensional kinematic gait measurements: a systematic review.

            Three-dimensional kinematic measures of gait are routinely used in clinical gait analysis and provide a key outcome measure for gait research and clinical practice. This systematic review identifies and evaluates current evidence for the inter-session and inter-assessor reliability of three-dimensional kinematic gait analysis (3DGA) data. A targeted search strategy identified reports that fulfilled the search criteria. The quality of full-text reports were tabulated and evaluated for quality using a customised critical appraisal tool. Fifteen full manuscripts and eight abstracts were included. Studies addressed both within-assessor and between-assessor reliability, with most examining healthy adults. Four full-text reports evaluated reliability in people with gait pathologies. The highest reliability indices occurred in the hip and knee in the sagittal plane, with lowest errors in pelvic rotation and obliquity and hip abduction. Lowest reliability and highest error frequently occurred in the hip and knee transverse plane. Methodological quality varied, with key limitations in sample descriptions and strategies for statistical analysis. Reported reliability indices and error magnitudes varied across gait variables and studies. Most studies providing estimates of data error reported values (S.D. or S.E.) of less than 5 degrees , with the exception of hip and knee rotation. This review provides evidence that clinically acceptable errors are possible in gait analysis. Variability between studies, however, suggests that they are not always achieved.
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              The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument

              Background: COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) is an initiative of an international multidisciplinary team of researchers who aim to improve the selection of outcome measurement instruments both in research and in clinical practice by developing tools for selecting the most appropriate available instrument. Method: In this paper these tools are described, i.e. the COSMIN taxonomy and definition of measurement properties; the COSMIN checklist to evaluate the methodological quality of studies on measurement properties; a search filter for finding studies on measurement properties; a protocol for systematic reviews of outcome measurement instruments; a database of systematic reviews of outcome measurement instruments; and a guideline for selecting outcome measurement instruments for Core Outcome Sets in clinical trials. Currently, we are updating the COSMIN checklist, particularly the standards for content validity studies. Also new standards for studies using Item Response Theory methods will be developed. Additionally, in the future we want to develop standards for studies on the quality of non-patient reported outcome measures, such as clinician-reported outcomes and performance-based outcomes. Conclusions: In summary, we plea for more standardization in the use of outcome measurement instruments, for conducting high quality systematic reviews on measurement instruments in which the best available outcome measurement instrument is recommended, and for stopping the use of poor outcome measurement instruments.
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                Author and article information

                Journal
                Sensors (Basel)
                Sensors (Basel)
                sensors
                Sensors (Basel, Switzerland)
                MDPI
                1424-8220
                28 February 2018
                March 2018
                : 18
                : 3
                : 719
                Affiliations
                [1 ]School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff CF24 0AB, Wales, UK; NicholasKA@ 123456cardiff.ac.uk (K.N.); ButtonK@ 123456cardiff.ac.uk (K.B.); SparkesV@ 123456cardiff.ac.uk (V.S.); SheeranL@ 123456cardiff.ac.uk (L.S.); DaviesJ@ 123456cardiff.ac.uk (J.L.D.)
                [2 ]Arthritis Research UK Biomechanics and Bioengineering Centre, Cardiff University, Cardiff CF10 3AXB, Wales, UK
                [3 ]Cardiff and Vale University Health Board, Heath Park, Cardiff CF14 4XW, Wales, UK
                Author notes
                [* ]Correspondence: Al-AmriM@ 123456cardiff.ac.uk ; Tel.: +44-292-068-7115
                Author information
                https://orcid.org/0000-0003-2806-0462
                https://orcid.org/0000-0003-1073-9901
                Article
                sensors-18-00719
                10.3390/s18030719
                5876797
                29495600
                45b547a3-69b2-4be4-b52c-51c4b4ce54af
                © 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
                : 15 January 2018
                : 26 February 2018
                Categories
                Article

                Biomedical engineering
                inertial measurement units,motion analysis,kinematics,gait,functional activity,repeatability,reliability,biomechanics

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