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Inertial measurement of motion with Attitude and Heading Reference Systems (AHRS) is emerging as an alternative to 3D motion capture systems in biomechanics. The objectives of this study are: 1) to describe the absolute and relative accuracy of multiple units of commercially available AHRS under various types of motion; and 2) to evaluate the effect of motion velocity on the accuracy of these measurements. The criterion validity of accuracy was established under controlled conditions using an instrumented Gimbal table. AHRS modules were carefully attached to the center plate of the Gimbal table and put through experimental static and dynamic conditions. Static and absolute accuracy was assessed by comparing the AHRS orientation measurement to those obtained using an optical gold standard. Relative accuracy was assessed by measuring the variation in relative orientation between modules during trials. Evaluated AHRS systems demonstrated good absolute static accuracy (mean error < 0.5(o)) and clinically acceptable absolute accuracy under condition of slow motions (mean error between 0.5(o) and 3.1(o)). In slow motions, relative accuracy varied from 2(o) to 7(o) depending on the type of AHRS and the type of rotation. Absolute and relative accuracy were significantly affected (p<0.05) by velocity during sustained motions. The extent of that effect varied across AHRS. Absolute and relative accuracy of AHRS are affected by environmental magnetic perturbations and conditions of motions. Relative accuracy of AHRS is mostly affected by the ability of all modules to locate the same global reference coordinate system at all time. Existing AHRS systems can be considered for use in clinical biomechanics under constrained conditions of use. While their individual capacity to track absolute motion is relatively consistent, the use of multiple AHRS modules to compute relative motion between rigid bodies needs to be optimized according to the conditions of operation.

Background: A mid-fidelity simulation mannequin, equipped with an instrumented cervical and lumbar spine, was developed to investigate best practices and train healthcare professionals in applying spinal motion restrictions (SMRs) during the early mobilization and transfer of accident victims with suspected spine injury. The study objectives are to (1) examine accuracy of the cervical and lumbar motions measured with the mannequin; and (2) confirm that the speed of motion has no bearing on this accuracy. Methods: Accuracy was evaluated by concurrently comparing the orientation data obtained with the mannequin with that from an optoelectronic system. The mannequin’s head and pelvis were moved in all anatomical planes of motion at different speeds. Results: Accuracy, assessed by root-mean-square error, varied between 0.7° and 1.5° in all anatomical planes of motion. Bland–Altman analysis revealed a bias ranging from −0.7° to 0.6°, with the absolute limit of agreement remaining below 3.5°. The minimal detectable change varied between 1.3° and 2.6°. Motion speed demonstrated no impact on accuracy. Conclusions: The results of this validation study confirm the mannequin’s potential to provide accurate measurements of cervical and lumbar motion during simulation scenarios for training and research on the application of SMR.

Interest in 3D inertial motion tracking devices (AHRS) has been growing rapidly among the biomechanical community. Although the convenience of such tracking devices seems to open a whole new world of possibilities for evaluation in clinical biomechanics, its limitations haven't been extensively documented. The objectives of this study are: 1) to assess the change in absolute and relative accuracy of multiple units of 3 commercially available AHRS over time; and 2) to identify different sources of errors affecting AHRS accuracy and to document how they may affect the measurements over time. This study used an instrumented Gimbal table on which AHRS modules were carefully attached and put through a series of velocity-controlled sustained motions including 2 minutes motion trials (2MT) and 12 minutes multiple dynamic phases motion trials (12MDP). Absolute accuracy was assessed by comparison of the AHRS orientation measurements to those of an optical gold standard. Relative accuracy was evaluated using the variation in relative orientation between modules during the trials. Both absolute and relative accuracy decreased over time during 2MT. 12MDP trials showed a significant decrease in accuracy over multiple phases, but accuracy could be enhanced significantly by resetting the reference point and/or compensating for initial Inertial frame estimation reference for each phase. The variation in AHRS accuracy observed between the different systems and with time can be attributed in part to the dynamic estimation error, but also and foremost, to the ability of AHRS units to locate the same Inertial frame. Mean accuracies obtained under the Gimbal table sustained conditions of motion suggest that AHRS are promising tools for clinical mobility assessment under constrained conditions of use. However, improvement in magnetic compensation and alignment between AHRS modules are desirable in order for AHRS to reach their full potential in capturing clinical outcomes.

Category: Ankle Arthritis; Ankle Introduction/Purpose: Tibiotalar Fusion (TF) and total ankle arthroplasty (TAA) are both viable choices for addressing tibiotalar osteoarthritis. Nevertheless, a definitive agreement on the most effective approach to restore optimal function, particularly in terms of safe emergency braking during car driving, is yet to be established. The primary aim of this investigation was to evaluate the break reaction time (BRT), total braking time (TBT), and maximal braking force (MBF) in individuals who underwent TF and TAA using a validated driving simulator. Secondary outcomes encompassed patient-reported measures of pain and functional outcomes. Methods: This observational study assesses the emergency braking capabilities of individuals undergoing either total ankle arthroplasty (TAA) or tibiotalar fusion (TF) in simulated driving scenarios. The participants were categorized into three groups: 1) TAA, 2) TF, and 3) Healthy Elderly (HE) aged 75 years and older, deemed still fit for driving. To be eligible for evaluation on the driving simulator, patients in the TAA and TF groups were required to have a minimum of a 1-year follow-up. Break reaction time (BRT), total braking time (TBT), and maximal braking force (MBF) were recorded with and without distraction during a single visit to the research center. Additionally, Ankle Osteoarthritis Scale (AOS) results were collected for all participants in TF and TAA. Results: This study, conducted between 2018 and 2022, included a total of 84 participants, with 21 TF, 21 TAA, and the remaining 42 serving as healthy elderly controls (HE). There was no significant difference between the TF and TAA groups with respect to MBF (p=0.4921), BRT (p=0.8734) or TBT (p= 0.7989). The TAA group and the TF group were significantly faster than the HE regarding TBT with a distraction (p=0.0463 and p=0.0049 respectively). The AOS score was significantly better in the TAA group compared to the TF group (p=0.002). Conclusion: The emergency braking capacity in total ankle arthroplasty (TAA) patients is not inferior to that in tibiotalar fusion (TF) patients. Both groups also performed better than elderly drivers meeting a minimally acceptable braking safety threshold. Thus, both treatment options appear to have a similar impact on braking capacity.

Background Alpine skiing rescues are challenging because of the mountainous environment and risks of cervical spine motion (CSM) induced during victims’ extrications (EXs) and downhill evacuations (DEs). The benefits of applying a cervical collar (CC) over manual in-line stabilization without CC (MILS) in terms of spinal motion restriction during simulated alpine rescues are undocumented. Our hypothesis was that CSM recorded using MILS alone is non-inferior to CSM recorded with a CC according to a 10 degrees margin. Methods A total of 32 alpine extrications and 4 downhill evacuations on different slope conditions were performed using a high fidelity mannequin designed with a motion sensors instrumented cervical spine. The primary outcome was the peak extrication 3D excursion angle (Peak 3D θ EX, ) of the mannequin’s head. The secondary objectives were to describe the time to extrication completion (tEX) and to highlight which extrication manipulation is more likely to induce CSM. Results The median Peak 3D θ EX recorded during flat terrain extrications using CC was 10.77° (95% CI 7.31°–16.45°) compared to 13.06° (95% CI 10.20°–30.36°) using MILS, and 16.09° (95% CI 9.07°–37.43°) for CC versus 16.65° (95% CI 13.80°–23.40°) using MILS on a steep slope. Peak 3D θ EX with CC or using MILS during extrications were equivalent according to a 10 degrees non-inferiority hypothesis testing ( p  < 0.05). Time to extrication completion (tEX) was significantly reduced using MILS without CC on a flat terrain with a median duration of 237,3 s (95% CI 197.8 s, 272.2 s) compared to 358.7 s (95% CI 324.1 s, 472.4 s). During downhill evacuations, CSM with and without CC across all terrain conditions were negligible (< 5°). When CC is used; its installation manipulation induces the highest CSM. When EXs are done using MILS without CC, the logroll initiation is the manipulation inducing the highest risk of CSM. Conclusion For experienced ski patrollers, the biomechanical benefits of spinal motion restriction provided by CC over MILS during alpine skiing rescues appear to be marginal and CC use negatively affects rescue time.

As telecommunications technology progresses, telehealth frameworks are becoming more widely adopted in the context of long-term care (LTC) for older adults, both in care facilities and in homes. Today, robots could assist healthcare workers when they provide care to elderly patients, who constitute a particularly vulnerable population during the COVID-19 pandemic. Previous work on user-centered design of assistive technologies in LTC facilities for seniors has identified positive impacts. The need to deal with the effects of the COVID-19 pandemic emphasizes the benefits of this approach, but also highlights some new challenges for which robots could be interesting solutions to be deployed in LTC facilities. This requires customization of telecommunication and audio/video/data processing to address specific clinical requirements and needs. This paper presents OpenTera, an open source telehealth framework, aiming to facilitate prototyping of such solutions by software and robotic designers. Designed as a microservice-oriented platform, OpenTera is an end-to-end solution that employs a series of independent modules for tasks such as data and session management, telehealth, daily assistive tasks/actions, together with smart devices and environments, all connected through the framework. After explaining the framework, we illustrate how OpenTera can be used to implement robotic solutions for different applications identified in LTC facilities and homes, and we describe how we plan to validate them through field trials.

Background Interest in 3D inertial motion tracking devices (AHRS) has been growing rapidly among the biomechanical community. Although the convenience of such tracking devices seems to open a whole new world of possibilities for evaluation in clinical biomechanics, its limitations haven't been extensively documented. The objectives of this study are: 1) to assess the change in absolute and relative accuracy of multiple units of 3 commercially available AHRS over time; and 2) to identify different sources of errors affecting AHRS accuracy and to document how they may affect the measurements over time. Methods This study used an instrumented Gimbal table on which AHRS modules were carefully attached and put through a series of velocity-controlled sustained motions including 2 minutes motion trials (2MT) and 12 minutes multiple dynamic phases motion trials (12MDP). Absolute accuracy was assessed by comparison of the AHRS orientation measurements to those of an optical gold standard. Relative accuracy was evaluated using the variation in relative orientation between modules during the trials. Findings Both absolute and relative accuracy decreased over time during 2MT. 12MDP trials showed a significant decrease in accuracy over multiple phases, but accuracy could be enhanced significantly by resetting the reference point and/or compensating for initial Inertial frame estimation reference for each phase. Interpretation The variation in AHRS accuracy observed between the different systems and with time can be attributed in part to the dynamic estimation error, but also and foremost, to the ability of AHRS units to locate the same Inertial frame. Conclusions Mean accuracies obtained under the Gimbal table sustained conditions of motion suggest that AHRS are promising tools for clinical mobility assessment under constrained conditions of use. However, improvement in magnetic compensation and alignment between AHRS modules are desirable in order for AHRS to reach their full potential in capturing clinical outcomes.

Background Inertial measurement of motion with Attitude and Heading Reference Systems (AHRS) is emerging as an alternative to 3D motion capture systems in biomechanics. The objectives of this study are: 1) to describe the absolute and relative accuracy of multiple units of commercially available AHRS under various types of motion; and 2) to evaluate the effect of motion velocity on the accuracy of these measurements. Methods The criterion validity of accuracy was established under controlled conditions using an instrumented Gimbal table. AHRS modules were carefully attached to the center plate of the Gimbal table and put through experimental static and dynamic conditions. Static and absolute accuracy was assessed by comparing the AHRS orientation measurement to those obtained using an optical gold standard. Relative accuracy was assessed by measuring the variation in relative orientation between modules during trials. Findings Evaluated AHRS systems demonstrated good absolute static accuracy (mean error < 0.5o) and clinically acceptable absolute accuracy under condition of slow motions (mean error between 0.5o and 3.1o). In slow motions, relative accuracy varied from 2o to 7o depending on the type of AHRS and the type of rotation. Absolute and relative accuracy were significantly affected (p<0.05) by velocity during sustained motions. The extent of that effect varied across AHRS. Interpretation Absolute and relative accuracy of AHRS are affected by environmental magnetic perturbations and conditions of motions. Relative accuracy of AHRS is mostly affected by the ability of all modules to locate the same global reference coordinate system at all time. Conclusions Existing AHRS systems can be considered for use in clinical biomechanics under constrained conditions of use. While their individual capacity to track absolute motion is relatively consistent, the use of multiple AHRS modules to compute relative motion between rigid bodies needs to be optimized according to the conditions of operation.

As telecommunications technology progresses, telehealth frameworks are becoming more widely adopted in the context of long-term care (LTC) for older adults, both in care facilities and in homes. Today, robots could assist healthcare workers when they provide care to elderly patients, who constitute a particularly vulnerable population during the COVID-19 pandemic. Previous work on user-centered design of assistive technologies in LTC facilities for seniors has identified positive impacts. The need to deal with the effects of the COVID-19 pandemic emphasizes the benefits of this approach, but also highlights some new challenges for which robots could be interesting solutions to be deployed in LTC facilities. This requires customization of telecommunication and audio/video/data processing to address specific clinical requirements and needs. This paper presents OpenTera, an open source telehealth framework, aiming to facilitate prototyping of such solutions by software and robotic designers. Designed as a microservice-oriented platform, OpenTera is an end-to-end solution that employs a series of independent modules for tasks such as data and session management, telehealth, daily assistive tasks/actions, together with smart devices and environments, all connected through the framework. After explaining the framework, we illustrate how OpenTera can be used to implement robotic solutions for different applications identified in LTC facilities and homes, and we describe how we plan to validate them through field trials.