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Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Collaborative Specialization

Machine Learning in Health and Biomedical Sciences

Supervisor

MacDermid, Joy C.

Abstract

Wearable sensors have become the study topic of researchers across various clinical disciplines, presenting promising avenues for their integration into clinical practices. Inertial measurement units (IMUs) have become significantly notable among the variety of sensor types, due to their non-invasive, and lightweight design. Moreover, they are increasingly used and applied in novel motion technologies since IMUs collect precise motion and orientation data when attached to specified body regions. In this dissertation, a wearable sensor system known as the Motion Shirt, equipped with 5 IMU sensors, has been developed and embedded into a flexible garment, enables continuous and accurate arms and shoulders motion data. A rigorous validation study has been conducted to investigate the efficacy and reliability of the Motion Shirt. A cohort of patients on the waitlist of shoulder joint replacement (SJR) surgery were recruited and their motion performance in a standard test, the Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA) were compared against the Dartfish Motion Analyzer, a widely utilized tool in motion analysis. The Motion Shirt's validity was revealed through this comprehensive test and its accuracy was also studied across different tasks of the FIT-HaNSA and participants’ performances. Reliability of the Motion Shirt was assessed in another study by evaluating the intraclass correlation coefficient of collected arcs of motions in similar cohort of patients on the waitlist of SJR surgery during the FIT-HaNSA test. A moderate to excellent reliability was achieved in all three tasks of the FIT-HaNSA test across both elevation and plane of elevation axes. Furthermore, A longitudinal study on a cohort of patients who have undergone SJR surgery was conducted to assess the Motion Shirt’s ability in collecting motion outcomes and recovery patterns. After comparing the motion data, it was demonstrated that significant and notable outcomes such as number of moves and promptness were improved, and thus the Motion Shirt further proved its efficacy in recording upper limb motion data over longer periods of data collection. Wearable sensor applications were not only investigated in clinical contexts, but also were studied through their demonstration in smartphones. In this regard, a systematic review is conducted to assess the smartphone applications on the assessment of range of motion in upper limbs considering the rising trend of smartphone sensor and photography applications. Routine clinical and rehabilitation practice can significantly improve through the inclusion of wearable sensor systems such as the Motion Shirt as well as smartphone applications. Additionally, patients’ quality of life and assessment of health care professionals can be ameliorated via this novel technology. This paradigm shift to remote rehabilitation and monitoring not only improves patient care, but also prepares the door for the creation of novel, patient-centered rehabilitation programs suited to the specific needs of musculoskeletal patients.

Summary for Lay Audience

Wearable sensors are becoming increasingly important in healthcare research, offering new ways to improve patient care. One type of sensor, the inertial measurement unit (IMU), is particularly useful because it is lightweight and non-invasive. These sensors can accurately track motion and orientation when attached to the body. In my research, I developed a wearable sensor system called the Motion Shirt, which uses five IMU sensors embedded in a flexible garment to monitor arm and shoulder movements continuously and accurately.

To ensure the Motion Shirt works effectively, I conducted several studies. First, I tested its accuracy by comparing it to a widely used motion analysis tool called the Dartfish Motion Analyzer. I recruited patients who were waiting for shoulder joint replacement (SJR) surgery and asked them to perform a standard set of movements. The Motion Shirt proved to be very accurate in tracking their movements.

Next, I assessed the reliability of the Motion Shirt by checking how consistently it measured movements over time. I found that the Motion Shirt had moderate to excellent reliability in all tasks, meaning it provided consistent and dependable data.

Additionally, I conducted a long-term study with patients who had already undergone SJR surgery. This study showed that the Motion Shirt could effectively track their recovery progress, providing valuable information about improvements in their movement and responsiveness over time.

Beyond the Motion Shirt, I also reviewed how wearable sensors, including those in smartphones, can be used in clinical settings. These technologies can greatly enhance routine clinical and rehabilitation practices, making them more efficient and personalized. By enabling remote monitoring and rehabilitation, these sensors can improve patient care and quality of life.

In summary, the Motion Shirt and similar wearable sensor technologies have the potential to revolutionize healthcare by providing accurate, reliable, and long-term monitoring of patients' movements, ultimately leading to better outcomes and more tailored rehabilitation programs.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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