Development and Validation of the Motion Shirt: A Wearable Sensor System for Monitoring Upper Limb Motion in Shoulder Joint Replacement Patients
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.