Assessing Upper Extremity Biomechanics during Activities of Daily Living Using Inertial Measurement Units: Does our Concept of 'Normal' Apply?

[+] Author and Article Information
Ryan/Michael Chapman

Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, NH 03755

Michael/T Torchia

Dartmouth Hitchcock Medical Center, Department of Orthopaedics

John-Erik Bell

Dartmouth Hitchcock Medical Center, Department of Orthopaedics

Douglas/W Van Citters

Dartmouth College, Thayer School of Engineering

1Corresponding author.

ASME doi:10.1115/1.4042433 History: Received January 12, 2018; Revised December 10, 2018


Current shoulder clinical range of motion (ROM) assessments (e.g. goniometric ROM) may not adequately represent shoulder function beyond clinical settings. Relative inertial measurement unit (IMU) motion precisely quantifies nonclinical ROM capturing 'real-world' shoulder function. A novel IMU-based shoulder elevation quantification method was developed (sternum/humerus, respectively). This system was compared to in-laboratory motion capture (MOCAP) during prescribed motions (flexion, abduction, scaption, internal/external rotation). MOCAP/IMU elevation were equivalent all movements (R2=0.96/µError=1.7°, R2=0.96/µError=2.9°, R2=0.98/µError=-0.3°, and R2=0.90/µError=0.4°, respectively). When combined across movements, MOCAP/IMU elevation were equal (R2=0.98/µError=1.4°). Following validation, the system was deployed prospectively capturing continuous shoulder elevation in 10 healthy individuals (4M, 69±20 years) without shoulder pathology for seven consecutive days (13.5±2.9 hours/day). Elevation was calculated continuously and outcome metrics included percent in discrete ROM (e.g. 0-5°, etc.), repeated maximum elevation (i.e. >10 occurrences), and maximum/average elevation. Average elevation was 40±6°. Repeated maximum and maximum were on average 145-150°/169±8°, respectively. Subjects spent the majority of the day (97%) below 90° of elevation, with the most time spent between 25-30° (9.7%). This study demonstrates individuals can achieve large ROMs but do not frequently do so. This is consistent with previously established lab measures. Moreover, they describe typical shoulder utilization and provide postoperative ROM clinical references.

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