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Wearable sensors are increasingly used to provide objective quantification of spatiotemporal and kinematic parameters post-stroke. This study aimed to evaluate the practical value of sensor-based gait reports in delivering augmented feedback and informing the development of home training programmes following a 2-week supervised intensive intervention after stroke. Four patients with chronic stroke were assessed on four occasions (pre- and post-intervention, 3-month, and 6-month follow-ups) using clinical gait tests, during which a portable sensor-based system recorded kinematic data. The meaningfulness of individual changes in gait parameters was interpreted based on established minimal detectable change values (MDC). Three participants improved their gait speed, joint angles, and/or cadence in the Ten-Metre Walk Test, and three participants improved their walking distance in the Six-Minute Walk Test. The improvements were most evident at the 3-month follow-up (with the most obvious changes above MDC estimates) and indicated the reappearance of normal gait patterns, adjustments of gait patterns, or a combination of both. Participants showed interest in and understanding of the information derived from the gait reports (ratings of 5–10 out of 10). In conclusion, augmented feedback derived from gait reports provides a valuable complement to traditional clinical assessments used in stroke rehabilitation to optimize treatment outcomes.

Otitis Media (OM) is a prevalent condition in children that can lead to hearing impairment and significant healthcare costs. Inaccuracy in primary care and equipment cost in developing countries are concerning issues in OM diagnostics. Acoustic Reflectometry (AR) offers a low-cost, non-invasive diagnostic alternative, though it has fallen short on accuracy in previous studies. The primary aim of this study was to establish a computational simulation and an experimental model able to reproduce AR performed on human individuals to enable further research and accuracy improvement. The secondary aim was to perform a sensitivity analysis on AR instrument user error. Simulations and experiments were validated against measurements from human individuals with OM and normal ears, respectively. The results reveal that the simulation sufficiently reproduces human AR measurements and distinguishes an ear with OM from a healthy ear. The experiment delivered satisfying measurements on OM but underperformed in a normal ear scenario. The simulations and experiments overpredicted sound reflection in OM. The sensitivity study showed promising robustness of AR, concluding that computational simulation is a viable tool and complement to an experimental approach in research of AR. Future efforts should focus on paediatric models and partially filled middle ear simulations to promote clinical relevance.

The modified Mallet scale (MMS) is commonly used to grade shoulder function in brachial plexus birth injury (BPBI) but has limited sensitivity and cannot grade scapulothoracic and glenohumeral mobility. This study aims to evaluate if the addition of a wearable inertial movement unit (IMU) system could improve clinical assessment based on MMS. The system validity was analyzed with simultaneous measurements with the IMU system and an optical camera system in three asymptomatic individuals. Test–retest and interrater reliability were analyzed in nine asymptomatic individuals and six BPBI patients. IMUs were placed on the upper arm, forearm, scapula, and thorax. Peak angles, range of motion, and average joint angular speed in the shoulder, scapulothoracic, glenohumeral, and elbow joints were analyzed during mobility assessments and MMS tasks. In the validity tests, clusters of reflective markers were placed on the sensors. The validity was high with an error standard deviation below 3.6°. Intraclass correlation coefficients showed that 90.3% of the 69 outcome scores showed good-to-excellent test–retest reliability, and 41% of the scores gave significant differences between BPBI patients and controls with good-to-excellent test–retest reliability. The interrater reliability was moderate to excellent, implying that standardization is important if the patient is followed-up longitudinally.

Among workers performing hand-intensive tasks, musculoskeletal disorders in the upper extremities are more frequent in women than in men. However, risk assessments are generally not sex-specific, and it is not known whether exposures in regular work differ between females and males. The aim of this study was to compare measured wrist joint velocity and muscle activity between men and women performing identical tasks. Participants (28 female–male pairs) performed one of eighteen hand-intensive on-site tasks. Wrist velocity was measured using inertial units. Forearm muscle activity was measured via surface electromyography and normalized to maximal voluntary electrical activation (MVE). The 10th, 50th, and 90th percentiles and time in muscle recovery (< 0.5 %MVE) were computed. Between-sex differences were tested using the Wilcoxon signed-rank test. Wrist angular velocities did not significantly differ between sexes in any percentile (all p > 0.374). The muscle activity was significantly higher in female workers (p < 0.001–0.004), ranging from 1.3 to 2.8 times higher, and they spent less time in muscle recovery (p < 0.001). In hand-intensive tasks involving women and men, risk assessments should prioritize assessments of women to ensure protection against work-related musculoskeletal disorders for all workers.

This co-creation study aimed to develop a smartphone self-test application for balance and leg strength in collaboration between older adults and the research team. The paper describes older participants’ preferences for, and their contribution to, the application design. Technology to assess movements is available in smartphones with built-in sensors, and one of the challenges is to develop a valuable self-test for older adults. The participants contributed to the design of the application’s instructions and user interface. Multiple data collection methods were used: user-test with Think aloud method, mock-ups, homework assignment as co-researcher, audio and video recordings. Qualitative content analysis with a deductive-inductive approach was used, guided by the Optimized Honeycomb model for user experience (UX) as a categorization matrix. The analysis resulted in 17 subcategories within the seven facets of the UX Honeycomb model (findable, accessible, usable, desirable, credible, useful, and valuable), and describes the older participants’ preferences and experiences. The main results were participants’ desire to know why, to get clear and appropriate information, and expectations of the self-test to be useful. It was feasible and valuable to develop the self-test application in co-creation with the intended user-group, in order to get direct feedback and suggestions for the development.

The evolving use of sensors to objectively assess movements is a potentially valuable addition to clinical assessments. We have developed a new self-test application prototype, MyBalance, in the context of fall prevention aimed for use by older adults in order to independently assess balance and functional leg strength. The objective of this study was to investigate the new self-test application for concurrent validity between clinical instruments and variables collected with a smartphone. The prototype has two test procedures: static standing balance test in two positions, and leg strength test performed as a sit-to-stand test. Thirty-one older adults were assessed for balance and functional leg strength, in an outpatient physiotherapy setting, using seven different clinical assessments and three sensor-tests. The results show that clinical instruments and sensor measurements correlate to a higher degree for the smartphone leg strength test. For balance tests, only a few moderate correlations were seen in the Feet Together position and no significant correlations for the Semi Tandem Stance. This study served as a first step to develop a smartphone self-test application for older adults to assess functional balance at home. Further research is needed to test validity, reliability, and user-experience of this new self-test application.

Otitis media (OM) in children is a common infection in primary care, contributing to a significant global health and economic burden. In high-income countries, diagnostic inaccuracy leads to over-diagnosis of acute OM (AOM) and over-prescribing of antibiotics, which may contribute to antibiotic resistance. To investigate the diagnostic accuracy and the influence of artificial intelligence (AI) in diagnosing OM among primary care physicians and medical students. A diagnostic accuracy study in which primary care physicians and medical students diagnosed AOM, OM with effusion (OME), and normal eardrums using 21 high-quality digital images, both without and with a fictitious AI support. We estimated the technological impact of the fictitious AI support. Overall diagnostic accuracy was 64% without, and 75% with AI support. The most experienced physicians reached 69% without, and 80% with AI; the least experienced 61% without, and 73% with AI; medical students reached 64% without, and 74% with AI. Accuracy for AOM was 77% without and 86% with AI, and for OME 46% without and 66% with AI. Mean diagnostic confidence increased significantly with AI support. The technological impact was 1.4. Automation bias was 1.2 overall, 0.9 for the most experienced and 1.2 for the least experienced physicians. We report modest diagnostic accuracy for OM among primary care physicians and medical students. The fictitious AI support system improved both accuracy and diagnostic confidence and reduced over-diagnosis. The most experienced physicians achieved the highest accuracy, the less experienced were more often misled by the fictitious AI.

A hip prosthesis design with larger femoral head size may improve functional outcomes compared to the conventional total hip arthroplasty (THA) design. Our aim was to compare the range of motion (RoM) in lower body joints during squats, gait and stair walking using a wearable movement analysis system based on inertial measurement units (IMUs) in three age-matched male groups: 6 males with a conventional THA (THAC), 9 with a large femoral head (LFH) design, and 8 hip- and knee-asymptomatic controls (CTRL). We hypothesized that the LFH design would allow a greater hip RoM, providing movement patterns more like CTRL, and a larger side difference in hip RoM in THAC when compared to LFH and controls. IMUs were attached to the pelvis, thighs and shanks during five trials of squats, gait, and stair ascending/descending performed at self-selected speed. THAC and LFH participants completed the Hip dysfunction and Osteoarthritis Outcome Score (HOOS). The results showed a larger hip RoM during squats in LFH compared to THAC. Side differences in LFH and THAC groups (operated vs. non-operated side) indicated that movement function was not fully recovered in either group, further corroborated by non-maximal mean HOOS scores (LFH: 83 ± 13, THAC: 84 ± 19 groups, vs. normal function 100). The IMU system may have the potential to enhance clinical movement evaluations as an adjunct to clinical scales.

Ordinal scales with low resolution are used to assess arm function in clinic. These scales may be improved by adding objective kinematic measures. The aim was to analyze within-subject, inter-rater and overall reliability (i.e., including within-subject and inter-rater reliability) and check the system’s validity of kinematic measures from inertial sensors for two such protocols on one person. Twenty healthy volunteers repeatedly performed two tasks, finger-to-nose and drinking, during two test sessions with two different raters. Five inertial sensors, on the forearms, upper arms and xiphoid process were used. Comparisons against an optical camera system evaluated the measurement validity. Cycle time, range of motion (ROM) in shoulder and elbow were calculated. Bland–Altman plots and linear mixed models including the generalizability (G) coefficient evaluated the reliability of the measures. Within-subject reliability was good to excellent in both tests (G = 0.80–0.97) and may serve as a baseline when assessing upper extremities in future patient groups. Overall reliability was acceptable to excellent (G = 0.77–0.94) for all parameters except elbow axial rotation in finger-to-nose task and both elbow axial rotation and flexion/extension in drinking task, mainly due to poor inter-rater reliability in these parameters. The low to good reliability for elbow ROM probably relates to high within-subject variability. The sensors provided good to excellent measures of cycle time and shoulder ROM in non-disabled individuals and thus have the potential to improve today’s assessment of arm function.

Objectives The aim of this study was to investigate effects of a multicomponent program promoting physical activity on sedentary behavior, physical activity, and body measures, when relocating from cell offices to either a flex or cell office. Methods The Active Office Design (AOD) study is a longitudinal non-randomized controlled study performed in a municipality in northern Sweden. A subsample of 86 participants were randomly recruited from the AOD study to objectively measure sedentary behavior and physical activity, using ActivPAL and ActiGraph, before and after relocation to the two different office types. The multicomponent program promoting physical activity was performed in both offices. Data were analyzed using linear mixed models. Results Eighteen months after relocation, the total number of steps per work day increased by 21% in the flex office and 3% in the cell office group, compared to baseline. Moderate and vigorous physical activity (MVPA) during work hours increased by 42% in the flex office group and 19% in the cell office group. No changes were seen regarding sitting time at work. Small additive effects for walking and MVPA were seen for both groups during non-work time. Weight increased in the flex office group. Conclusions This long-term study shows that a multicomponent workplace intervention can lead to increased walking time, steps, and MVPA in a flex compared to a cell office. Small additive increases of physical activity were seen during non-work time in both groups. More long-term controlled studies are needed to confirm these results.