This study aimed to determine the intra- and inter-device accuracy and reliability of wearable athletic tracking devices, under controlled laboratory conditions. A total of nineteen portable accelerometers (Catapult OptimEye S5) were mounted to an aluminum bracket, bolted directly to an Unholtz Dickie 20K electrodynamic shaker table, and subjected to a series of oscillations in each of three orthogonal directions (front-back, side to side, and up-down), at four levels of peak acceleration (0.1g, 0.5g, 1.0g, and 3.0g), each repeated five times resulting in a total of 60 tests per unit, for a total of 1140 records. Data from each accelerometer was recorded at a sampling frequency of 100Hz. Peak accelerations recorded by the devices, Catapult PlayerLoad™, and calculated player load (using Catapult’s Cartesian formula) were used for the analysis. The devices demonstrated excellent intradevice reliability and mixed interdevice reliability. Differences were found between devices for mean peak accelerations and PlayerLoad™ for each direction and level of acceleration. Interdevice effect sizes ranged from a mean of 0.54 (95% CI: 0.34–0.74) (small) to 1.20 (95% CI: 1.08–1.30) (large) and ICCs ranged from 0.77 (95% CI: 0.62–0.89) (very large) to 1.0 (95% CI: 0.99–1.0) (nearly perfect) depending upon the magnitude and direction of the applied motion. When compared to the player load determined using the Cartesian formula, the Catapult reported PlayerLoad™ was consistently lower by approximately 15%. These results emphasize the need for industry wide standards in reporting validity, reliability and the magnitude of measurement errors. It is recommended that device reliability and accuracy are periodically quantified.

: Increased risk of skeletal fractures due to bone mass loss is a major public health problem resulting in significant morbidity and mortality, particularly in the case of hip fractures. Current clinical methods based on two-dimensional measures of bone mineral density (areal BMD or aBMD) are often unable to identify individuals at risk of fracture. We investigated predictions of fracture risk based on statistical shape and density modeling (SSDM) methods using a case-cohort sample of individuals from the Osteoporotic Fractures in Men (MrOS) study. Baseline quantitative computed tomography (QCT) data of the right femur were obtained for 513 individuals, including 45 who fractured a hip during follow-up (mean 6.9 year observation, validated by physician review). QCT data were processed for 450 individuals (including 40 fracture cases) to develop individual models describing three-dimensional bone geometry and density distribution. Comparison of mean fracture and non-case models indicated complex structural differences that appear to be responsible for resistance to hip fracture. Logistic regressions were used to model the relation of baseline hip BMD and SSDM weighting factors to the occurrence of hip fracture. Area under the receiver operating characteristic (ROC) curve (AUC) for a prediction model based on weighting factors and adjusted by age was significantly greater than AUC for a prediction model based on aBMD and age (0.94 versus 0.83, respectively). The SSDM-based prediction model adjusted by age correctly identified 55% of the fracture cases (and 94.7% of the non-cases), whereas the clinical standard aBMD correctly identified 10% of the fracture cases (and 91.3% of the non-cases). SSDM identifies subtle changes in combinations of structural bone traits (eg, geometric and BMD distribution traits) that appear to indicate fracture risk. Investigation of important structural differences in the proximal femur between fracture and no-fracture cases may lead to improved prediction of those at risk for future hip fracture. © 2014 American Society for Bone and Mineral Research.

Skeletal fractures associated with bone mass loss are a major clinical problem and economic burden, and lead to significant morbidity and mortality in the ageing population. Clinical image-based measures of bone mass show only moderate correlative strength with bone strength. However, engineering models derived from clinical image data predict bone strength with significantly greater accuracy. Currently, image-based finite element (FE) models are time consuming to construct and are non-parametric. The goal of this study was to develop a parametric proximal femur FE model based on a statistical shape and density model (SSDM) derived from clinical image data. A small number of independent SSDM parameters described the shape and bone density distribution of a set of cadaver femurs and captured the variability affecting proximal femur FE strength predictions. Finally, a three-dimensional FE model of an ‘unknown’ femur was reconstructed from the SSDM with an average spatial error of 0.016 mm and an average bone density error of 0.037 g/cm³.