Toward Accurate Clinical Spasticity Assessment: Validation of Movement Speed and Joint Angle Assessments Using Smartphones and Camera Tracking

Megan Banky; Ross A Clark; Benjamin F Mentiplay; John H Olver; Michelle B Kahn; Gavin Williams

doi:10.1016/j.apmr.2018.11.026

Toward Accurate Clinical Spasticity Assessment: Validation of Movement Speed and Joint Angle Assessments Using Smartphones and Camera Tracking

Arch Phys Med Rehabil. 2019 Aug;100(8):1482-1491. doi: 10.1016/j.apmr.2018.11.026. Epub 2019 Jan 24.

Authors

Megan Banky¹, Ross A Clark², Benjamin F Mentiplay³, John H Olver⁴, Michelle B Kahn⁵, Gavin Williams⁶

Affiliations

¹ Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia; School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia. Electronic address: megan.banky@epworth.org.au.
² School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia.
³ Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.
⁴ Epworth Monash Rehabilitation Medicine Unit, Melbourne, Australia.
⁵ Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia; School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia.
⁶ Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia; Department of Physiotherapy, University of Melbourne, Melbourne, Australia.

PMID: 30684484
DOI: 10.1016/j.apmr.2018.11.026

Abstract

Objective: To investigate whether a three-dimensional (3-D) camera (Microsoft Kinect) and a smartphone can be used to accurately quantify the joint angular velocity and range of motion (ROM) compared to a criterion-standard 3-D motion analysis system during a lower limb spasticity assessment.

Design: Observational, criterion-standard comparison study.

Setting: Large rehabilitation center.

Participants: A convenience sample of 35 controls, 35 patients with a neurologic condition, and 34 rehabilitation professionals (physiotherapists and rehabilitation doctors) participated (N=104).

Interventions: Not applicable.

Main outcome measures: The Modified Tardieu Scale was used to assess spasticity of the quadriceps, hamstrings, soleus, and gastrocnemius. Data for each trial were collected concurrently using the criterion-standard Optitrack 3-D motion analysis (3DMA) system, Microsoft Kinect, and a smartphone. Each healthy control participant was assessed by 1 health professional and each patient with a neurological condition was assessed by 3 health professionals. Spearman correlation coefficient and intraclass correlation coefficient with 95% confidence intervals were used to report the strength of the relationships investigated.

Results: The smartphone and Microsoft Kinect demonstrated excellent concurrent validity with the 3DMA system. Overall, 74.8% of the relationships investigated demonstrated a very strong (≥0.80) correlation across all of the testing parameters. The Microsoft Kinect was superior to the smartphone for measuring joint start and end angle, the smartphone was superior for measuring joint angular velocity, and the 2 systems were comparable for measuring total joint ROM.

Conclusions: These findings provide preliminary evidence that user-friendly, low-cost technologies can be used to facilitate accurate measurements of joint angular velocity and angles during a lower limb spasticity assessment in a clinical setting.

Keywords: Muscle spasticity; Outcome assessment (health care); Rehabilitation; Technology.

Publication types

Comparative Study
Observational Study
Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Acceleration
Adult
Aged
Aged, 80 and over
Case-Control Studies
Female
Humans
Imaging, Three-Dimensional*
Male
Middle Aged
Muscle Spasticity*
Range of Motion, Articular*
Reproducibility of Results
Smartphone*
Software