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Neurological disorders such as stroke, Parkinson's disease (PD), and severe traumatic brain injury (sTBI) are leading global causes of disability and mortality. This study aimed to assess the ability to walk of patients with sTBI, stroke, and PD, identifying the differences in dynamic postural stability, symmetry, and smoothness during various dynamic motor tasks. Sixty people with neurological disorders and 20 healthy participants were recruited. Inertial measurement unit (IMU) sensors were employed to measure spatiotemporal parameters and gait quality indices during different motor tasks. The Mini-BESTest, Berg Balance Scale, and Dynamic Gait Index Scoring were also used to evaluate balance and gait. People with stroke exhibited the most compromised biomechanical patterns, with lower walking speed, increased stride duration, and decreased stride frequency. They also showed higher upper body instability and greater variability in gait stability indices, as well as less gait symmetry and smoothness. PD and sTBI patients displayed significantly different temporal parameters and differences in stability parameters only at the pelvis level and in the smoothness index during both linear and curved paths. This study provides a biomechanical characterization of dynamic stability, symmetry, and smoothness in people with stroke, sTBI, and PD using an IMU-based ecological assessment. [ABSTRACT FROM AUTHOR]

Neurorehabilitation research in patients with traumatic brain injury (TBI) showed how vestibular rehabilitation (VR) treatments positively affect concussion-related symptoms, but no studies have been carried out in patients with severe TBI (sTBI) during post-acute intensive neurorehabilitation. We aimed at testing this effect by combining sensor-based gait analysis and clinical scales assessment. We hypothesized that integrating VR in post-acute neurorehabilitation training might improve gait quality and activity of daily living (ADL) in sTBI patients. A two-arm, single-blind randomized controlled trial with 8 weeks of follow-up was performed including thirty sTBI inpatients that underwent an 8-week rehabilitation program including either a VR or a conventional program. Gait quality parameters were obtained using body-mounted magneto-inertial sensors during instrumented linear and curvilinear walking tests. A 4X2 mixed model ANOVA was used to investigate session–group interactions and main effects. Patients undergoing VR exhibited improvements in ADL, showing early improvements in clinical scores. Sensor-based assessment of curvilinear pathways highlighted significant VR-related improvements in gait smoothness over time (p < 0.05), whereas both treatments exhibited distinct improvements in gait quality. Integrating VR in conventional neurorehabilitation is a suitable strategy to improve gait smoothness and ADL in sTBI patients. Instrumented protocols are further promoted as an additional measure to quantify the efficacy of neurorehabilitation treatments. [ABSTRACT FROM AUTHOR]

Wearable technologies are often indicated as tools that can enable the in-field collection of quantitative biomechanical data, unobtrusively, for extended periods of time, and with few spatial limitations. Despite many claims about their potential for impact in the area of injury prevention and management, there seems to be little attention to grounding this potential in biomechanical research linking quantities from wearables to musculoskeletal injuries, and to assessing the readiness of these biomechanical approaches for being implemented in real practice. We performed a systematic scoping review to characterise and critically analyse the state of the art of research using wearable technologies to study musculoskeletal injuries in sport from a biomechanical perspective. A total of 4952 articles were retrieved from the Web of Science, Scopus, and PubMed databases; 165 were included. Multiple study features—such as research design, scope, experimental settings, and applied context—were summarised and assessed. We also proposed an injury-research readiness classification tool to gauge the maturity of biomechanical approaches using wearables. Five main conclusions emerged from this review, which we used as a springboard to propose guidelines and good practices for future research and dissemination in the field. [ABSTRACT FROM AUTHOR]

Recent technological developments have led to the production of inexpensive, non-invasive, miniature magneto-inertial sensors, ideal for obtaining sport performance measures during training or competition. This systematic review evaluates current evidence and the future potential of their use in sport performance evaluation. Articles published in English (April 2017) were searched in Web-of-Science, Scopus, Pubmed, and Sport-Discus databases. A keyword search of titles, abstracts and keywords which included studies using accelerometers, gyroscopes and/or magnetometers to analyse sport motor-tasks performed by athletes (excluding risk of injury, physical activity, and energy expenditure) resulted in 2040 papers. Papers and reference list screening led to the selection of 286 studies and 23 reviews. Information on sport, motor-tasks, participants, device characteristics, sensor position and fixing, experimental setting and performance indicators was extracted. The selected papers dealt with motor capacity assessment (51 papers), technique analysis (163), activity classification (19), and physical demands assessment (61). Focus was placed mainly on elite and sub-elite athletes (59%) performing their sport in-field during training (62%) and competition (7%). Measuring movement outdoors created opportunities in winter sports (8%), water sports (16%), team sports (25%), and other outdoor activities (27%). Indications on the reliability of sensor-based performance indicators are provided, together with critical considerations and future trends. [ABSTRACT FROM AUTHOR]

Upper body movements during walking provide information about balance control and gait stability. Typically developing (TD) children normally present a progressive decrease of accelerations from the pelvis to the head, whereas children with cerebral palsy (CP) exhibit a general increase of upper body accelerations. However, the literature describing how they are transmitted from the pelvis to the head is lacking. This study proposes a multilevel motion sensor approach to characterize upper body accelerations and how they propagate from pelvis to head in children with CP, comparing with their TD peers. Two age- and gender-matched groups of 20 children performed a 10m walking test at self-selected speed while wearing three magneto-inertial sensors located at pelvis, sternum, and head levels. The root mean square value of the accelerations at each level was computed in a local anatomical frame and its variation from lower to upper levels was described using attenuation coefficients. Between-group differences were assessed performing an ANCOVA, while the mutual dependence between acceleration components and the relationship between biomechanical parameters and typical clinical scores were investigated using Regression Analysis and Spearman’s Correlation, respectively (α = 0.05). New insights were obtained on how the CP group managed the transmission of accelerations through the upper body. Despite a significant reduction of the acceleration from pelvis to sternum, children with CP do not compensate for large accelerations, which are greater than in TD children. Furthermore, those with CP showed negative sternum-to-head attenuations, in agreement with the documented rigidity of the head-trunk system observed in this population. In addition, the estimated parameters proved to correlate with the scores used in daily clinical practice. The proposed multilevel approach was fruitful in highlighting CP-TD gait differences, supported the in-field quantitative gait assessment in children with CP and might prove beneficial to designing innovative intervention protocols based on pelvis stabilization. [ABSTRACT FROM AUTHOR]

As participation in wheelchair sports increases, the need of quantitative assessment of biomechanical performance indicators and of sports- and population-specific training protocols has become central. The present study focuses on junior wheelchair basketball and aims at (i) proposing a method to identify biomechanical performance indicators of wheelchair propulsion using an instrumented in-field test and (ii) developing a training program specific for the considered population and assessing its efficacy using the proposed method. Twelve athletes (10 M, 2 F, age = 17.1 ± 2.7 years, years of practice = 4.5 ± 1.8) equipped with wheelchair- and wrist-mounted inertial sensors performed a 20-metre sprint test. Biomechanical parameters related to propulsion timing, progression force, and coordination were estimated from the measured accelerations and used in a regression model where the time to complete the test was set as dependent variable. Force- and coordination-related parameters accounted for 80% of the dependent variable variance. Based on these results, a training program was designed and administered for three months to six of the athletes (the others acting as control group). The biomechanical indicators proved to be effective in providing additional information about the wheelchair propulsion technique with respect to the final test outcome and demonstrated the efficacy of the developed program. [ABSTRACT FROM AUTHOR]

In human movement analysis, 3D body segment orientation can be obtained through the numerical integration of gyroscope signals. These signals, however, are affected by errors that, for the case of micro-electro-mechanical systems, are mainly due to: constant bias, scale factor, white noise, and bias instability. The aim of this study is to assess how the orientation estimation accuracy is affected by each of these disturbances, and whether it is influenced by the angular velocity magnitude and 3D distribution across the gyroscope axes. Reference angular velocity signals, either constant or representative of human walking, were corrupted with each of the four noise types within a simulation framework. The magnitude of the angular velocity affected the error in the orientation estimation due to each noise type, except for the white noise. Additionally, the error caused by the constant bias was also influenced by the angular velocity 3D distribution. As the orientation error depends not only on the noise itself but also on the signal it is applied to, different sensor placements could enhance or mitigate the error due to each disturbance, and special attention must be paid in providing and interpreting measures of accuracy for orientation estimation algorithms. [ABSTRACT FROM AUTHOR]

Magnetic and inertial measurement units are an emerging technology to obtain 3D orientation of body segments in human movement analysis. In this respect, sensor fusion is used to limit the drift errors resulting from the gyroscope data integration by exploiting accelerometer and magnetic aiding sensors. The present study aims at investigating the effectiveness of sensor fusion methods under different experimental conditions. Manual and locomotion tasks, differing in time duration, measurement volume, presence/absence of static phases, and out-of-plane movements, were performed by six subjects, and recorded by one unit located on the forearm or the lower trunk, respectively. Two sensor fusion methods, representative of the stochastic (Extended Kalman Filter) and complementary (Non-linear observer) filtering, were selected, and their accuracy was assessed in terms of attitude (pitch and roll angles) and heading (yaw angle) errors using stereophotogrammetric data as a reference. The sensor fusion approaches provided significantly more accurate results than gyroscope data integration. Accuracy improved mostly for heading and when the movement exhibited stationary phases, evenly distributed 3D rotations, it occurred in a small volume, and its duration was greater than approximately 20 s. These results were independent from the specific sensor fusion method used. Practice guidelines for improving the outcome accuracy are provided. [ABSTRACT FROM AUTHOR]

The interest and competitiveness in sports for persons with disabilities has increased significantly in the recent years, creating a demand for technological tools supporting practice. Wearable sensors offer non-invasive, portable and overall convenient ways to monitor sports practice. This systematic review aims at providing current evidence on the application of wearable sensors in sports for persons with disability. A search for articles published in English before May 2020 was performed on Scopus, Web-Of-Science, PubMed and EBSCO databases, searching titles, abstracts and keywords with a search string involving terms regarding wearable sensors, sports and disability. After full paper screening, 39 studies were included. Inertial and EMG sensors were the most commonly adopted wearable technologies, while wheelchair sports were the most investigated. Four main target applications of wearable sensors relevant to sports for people with disability were identified and discussed: athlete classification, injury prevention, performance characterization for training optimization and equipment customization. The collected evidence provides an overview on the application of wearable sensors in sports for persons with disability, providing useful indication for researchers, coaches and trainers. Several gaps in the different target applications are highlighted altogether with recommendation on future directions. [ABSTRACT FROM AUTHOR]