Validity and Reliability of Inertial Measurement Units in Active Range of Motion Assessment in the Hip Joint
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Instrumentation
- Universal plastic goniometer with a length of 20.32 cm, obtaining a measurement every 1° on a 360° scale.
- Baseline digital inclinometer (Fabrication Enterprises, White Plains, NY, USA). The manufacturer ensured a measurement accuracy of 0.5°.
- IMU by “RSQ Motion” (RSQ Technologies, Poznan, Poland). The RSQ Motion system is a class I medical device with a measuring function, manufactured under the RSQ Technologies brand, intended for the analysis of body movement. “RSQ Motion Sensor” performs measurements using MEMS sensors: accelerometer, gyroscope, and magnetometer. These data are sent as a digital electrical signal to a microcontroller, which processes it, filters it and calculates the orientation of the Motion Sensor and presents it in the form of quaternions. A quaternion is a mathematical construct with four dimensions resembling a complex number. “RSQ Motion” system incorporates a Madgwick algorithm for performing quaternion calculations. Details regarding the construction of the sensor and the mathematical procedures used for the measurement of orientation can be found in a previously published work [24]. The module with the microcontroller has a built-in Bluetooth low-energy antenna and communicates with the RSQ Motion Hub or an application using this protocol. The accuracy of the sensors was tested in laboratory conditions by comparing it to the Kuka robot (0.15°). The results showed excellent accuracy and repeatability, which allows us to believe that the device used will not affect the final results [25].
2.3. Study Protocol
2.3.1. Active Hip Flexion in Standing Position
- IMU: The device is calibrated according to the protocol and zeroed at fixed vertical reference. The sensor is attached with a sticker 5 cm above the patella of the examined limb. When the maximum range of motion is reached, the recording is made by clicking the button on the so-called “clicker” and saved in a connected application.
- Inclinometer: The device is zeroed at a fixed vertical surface. The measurement is made by placing the inclinometer on the distal part of the thigh. The recording is made at the same time as IMU.
- Goniometer: The axis is placed at the height of the greater trochanter; one arm is directed along the femur, and the other vertically, parallel to the wall. The measurement is made right after the inclinometer and IMU.
2.3.2. Active External and Internal Rotation in the Prone Position
- IMU: The device is calibrated according to the protocol and zeroed at a fixed vertical surface. The sensor is attached with a sticker 5 cm proximal to the ankle joint of the examined limb. When the maximum range of motion is reached, the recording is made by clicking the button on the so-called “clicker” and saved in a connected application.
- Inclinometer: The device is zeroed at a fixed vertical surface. The measurement is made by placing the inclinometer along the tibia underneath the IMU sensor. The recording is made at the same time as IMU.
- Goniometer: Axis of rotation set at the tibial tuberosity. Movable arm along the edge of the tibia; stationary arm set perpendicular to the couch.
2.4. Statistical Analysis
3. Results
3.1. Hip Flexion in Standing Position
3.1.1. Concurrent Validity
3.1.2. Inter-Rater Reliability
3.1.3. Intra-Rater Reliability
3.2. Hip Prone Internal Rotation
3.2.1. Concurrent Validity for Hip Prone Internal Rotation
3.2.2. Inter-Rater Reliability for Prone Internal Rotation
3.2.3. Intra-Rater Reliability for Prone Internal Rotation
3.3. Hip Prone External Rotation
3.3.1. Concurrent Validity for Prone External Rotation
3.3.2. Inter-Rater Reliability for Prone External Rotation
3.3.3. Intra-Rater Reliability for Prone External Rotation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Tester 1 | Tester 2 | |||||
---|---|---|---|---|---|---|
ICC | Bias (°) | LOA (°) | ICC | Bias (°) | LOA (°) | |
IMU vs. INCL | 0.88 | 3.3 ± 2.9 | −2.4; 9.0 | 0.90 | 1.3 ± 3.2 | −5.0; 7.6 |
IMU vs. GON | 0.90 | −3.5 ± 3.2 | −9.8; 2.8 | 0.91 | −3.8 ± 3.7 | −11.1; 3.4 |
INCL vs. GON | 0.94 | −6.8 ± 4.1 | −14.8; 1.3 | 0.93 | −5.1 ± 3.6 | −12.22; 2.0 |
Flexion | Tester 1 Mean ± SD (Min–Max) | Tester 2 Mean ± SD (Min–Max) | ICC | SEM (°) | MDC95 (%) (°) | Bias (°) ±SE | LOA (°) |
---|---|---|---|---|---|---|---|
IMU | 107.4 ± 8.2 (91.1–130.1) | 107.1 ± 7.8 (89.3–129.6) | 0.58 | 1.0 | 2.8 | 1.0 ± 10.9 | −20.4; 22.4 |
Inclinometer | 104.0 ± 8.8 (90.4–128.9) | 105.8 ± 7.9 (93.0–127.8) | 0.59 | 0.7 | 1.9 | −1.8 ± 7.4 | −16.4; 12.8 |
Goniometer | 110.9 ± 6.7 (101.0–134.0) | 111.0 ± 6.2 (100.0–128.0) | 0.58 | 0.6 | 1.6 | −0.2 ± 6.1 | −12.7; 11.8 |
Flexion | Test Mean ± SD (Min–Max) | Retest Mean ± SD (Min–Max) | ICC | SEM (°) | MDC95 (%) (°) | Bias (°) ±SE | LOA (°) |
---|---|---|---|---|---|---|---|
IMU | 106.0 ± 7.2 (89.3–129.6) | 106.8 ± 7.7 (89.2–133.8) | 0.94 | 0.4 | 1.1 | −1.4 ± 4.1 | −9.6; 6.7 |
Inclinometer | 104.3 ± 6.9 (93.0–127.8) | 105.8 ± 7.5 (93.0–138.0) | 0.87 | 0.4 | 1.1 | −2.0 ± 4.3 | −10.5; 6.5 |
Goniometer | 109.8 ± 5.6 (100.0–128.0) | 110.1 ± 6.0 (100.0–131.0) | 0.91 | 0.3 | 0.9 | −0.9 ± 3.5 | −7.7; 5.9 |
Tester 1 | Tester 2 | |||||
---|---|---|---|---|---|---|
ICC | Bias (°) | LOA (°) | ICC | Bias (°) | LOA (°) | |
IMU vs. INCL | 0.97 | −1.7 ± 2.6 | −6.8; 3.3 | 0.99 | −0.3 ± 10.1 | −20.1; 19.5 |
IMU vs. GON | 0.99 | −1.9 ± 2.8 | −7.6; 3.7 | 0.97 | −0.2 ± 10.0 | −19.8; 19.4 |
INCL vs. GON | 0.99 | −0.2 ± 1.6 | −3.3; 2.8 | 0.98 | 0.1 ± 1.7 | −3.3; 3.6 |
Internal Rotation | Tester 1 Mean ± SD (Min–Max) (°) | Tester 2 Mean ± SD (Min–Max) (°) | ICC | SEM (°) | MDC95 (%) (°) | Bias (°) ±SE | LOA (°) |
---|---|---|---|---|---|---|---|
IMU | 33.4 ± 12.0 (10.1–61.4) | 33.3 ± 12.1 (10.6–58.9) | 0.02 | 1.6 | 4.3 | 0.1 ± 16.8 | −32.8; 33.6 |
Inclinometer | 35.2 ± 11.5 (12.0–60.2) | 34.2 ± 11.5 (10.8–58.5) | 0.04 | 1.5 | 4.1 | 0.6 ± 15.9 | −30.5; 31.7 |
Goniometer | 35.4 ± 11.4 (12.0–60.0) | 34.4 ± 11.5 (11.0–57.0) | 0.04 | 1.5 | 4.1 | 0.9 ± 15.8 | −30.0; 31.2 |
Internal Rotation | Test Mean ± SD (Min–Max) (°) | Retest Mean ± SD (Min–Max) (°) | ICC | SEM (°) | MDC95 (%) (°) | Bias ± SE | LOA (°) |
---|---|---|---|---|---|---|---|
IMU | 32.4 ± 12.3 (10.6–58.9) | 32.0 ± 11.9 (10.2–60.7) | 0.96 | 0.3 | 0.7 | 0.3 ± 2.8 | −5.1; 5.8 |
Inclinometer | 33.6 ± 11.5 (10.8–58.5) | 33.2 ± 11.3 (11.9–59.0) | 0.99 | 0.2 | 0.6 | 0.3 ± 2.5 | −4.6; 5.2 |
Goniometer | 33.6 ± 11.6 (11.0–57.0) | 33.2 ± 11.5 (12.0–60.0) | 0.99 | 0.2 | 0.6 | 0.3 ± 2.5 | −4.6; 5.2 |
Tester 1 | Tester 2 | |||||
---|---|---|---|---|---|---|
ICC | Bias (°) | LOA (°) | ICC | Bias (°) | LOA (°) | |
IMU vs. INCL | 0.88 | −1.0 ± 3.3 | −7.5; 5.4 | 0.95 | −0.4 ± 3.2 | −6.6; 5.8 |
IMU vs. GON | 0.97 | 1.1 ± 3.4 | −5.6; 7.8 | 0.99 | 1.1 ± 2.6 | −4.0; 6.2 |
INCL vs. GON | 0.99 | 2.1 ± 2.4 | −2.5; 6.8 | 0.96 | 1.5 ± 2.4 | −3.2; 6.2 |
External Rotation | Tester 1 Mean ± SD (Min–Max) (°) | Tester 2 Mean ± SD (Min–Max) (°) | ICC | SEM (°) | MDC95 (%) (°) | Bias ± SE | LOA (°) |
---|---|---|---|---|---|---|---|
IMU | 44.4 ± 6.6 (25.0–56.3) | 43.6 ± 7.8 (24.1–55.4) | −0.29 | 1.1 | 3.0 | 0.8 ± 11.5 | −21.8; 23.4 |
Inclinometer | 45.5 ± 7.3 (30.0–60.4) | 44.0 ± 8.4 (25.8–64.7) | −0.24 | 1.2 | 3.2 | 1.4 ± 11.4 | −22.8; 25.7 |
Goniometer | 43.3 ± 7.3 (25.0–59.0) | 42.5 ± 7.6 (24.0–57.0) | −0.33 | 1.1 | 3.0 | 0.8 ± 12.1 | −22.8; 24.4 |
External Rotation | Test Mean ± SD (Min–Max) (°) | Retest Mean ± SD (Min–Max) (°) | ICC | SEM (°) | MDC95 (%) (°) | Bias ± SE | LOA (°) |
---|---|---|---|---|---|---|---|
IMU | 44.5 ± 6.9 (27.7–55.4) | 44.8 ± 7.2 (30.9–60.1) | 0.98 | 0.3 | 0.8 | −0.2 ± 3.1 | −6.3; 5.8 |
Inclinometer | 44.9 ± 7.7 (29.4–64.7) | 44.3 ± 7.6 (27.3–50.2) | 0.95 | 0.3 | 0.8 | 0.7 ± 3.2 | −5.6; 7.0 |
Goniometer | 43.3 ± 6.9 (27.0–57.0) | 3.7 ± 7.5 (26.0–58.0) | 0.97 | 0.2 | 0.7 | −0.3 ± 2.6 | −5.3; 4.8 |
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Stołowski, Ł.; Niedziela, M.; Lubiatowski, B.; Lubiatowski, P.; Piontek, T. Validity and Reliability of Inertial Measurement Units in Active Range of Motion Assessment in the Hip Joint. Sensors 2023, 23, 8782. https://doi.org/10.3390/s23218782
Stołowski Ł, Niedziela M, Lubiatowski B, Lubiatowski P, Piontek T. Validity and Reliability of Inertial Measurement Units in Active Range of Motion Assessment in the Hip Joint. Sensors. 2023; 23(21):8782. https://doi.org/10.3390/s23218782
Chicago/Turabian StyleStołowski, Łukasz, Maciej Niedziela, Bartłomiej Lubiatowski, Przemysław Lubiatowski, and Tomasz Piontek. 2023. "Validity and Reliability of Inertial Measurement Units in Active Range of Motion Assessment in the Hip Joint" Sensors 23, no. 21: 8782. https://doi.org/10.3390/s23218782