The aim of this study was to investigate the reliability and concurrent validity of a commercially available Xsens MVN BIOMECH inertial-sensor-based motion capture system during clinically relevant functional activities. A clinician with no prior experience of motion capture technologies and an experienced clinical movement scientist each assessed 26 healthy participants within each of two sessions using a camera-based motion capture system and the MVN BIOMECH system. Participants performed overground walking, squatting, and jumping. Sessions were separated by 4 ± 3 days. Reliability was evaluated using intraclass correlation coefficient and standard error of measurement, and validity was evaluated using the coefficient of multiple correlation and the linear fit method. Day-to-day reliability was generally fair-to-excellent in all three planes for hip, knee, and ankle joint angles in all three tasks. Within-day (between-rater) reliability was fair-to-excellent in all three planes during walking and squatting, and poor-to-high during jumping. Validity was excellent in the sagittal plane for hip, knee, and ankle joint angles in all three tasks and acceptable in frontal and transverse planes in squat and jump activity across joints. Our results suggest that the MVN BIOMECH system can be used by a clinician to quantify lower-limb joint angles in clinically relevant movements.

Wearable sensors may enable the assessment of movement in a real-world setting, but they are not yet a standard practice in the analysis of movement due to the unknown accuracy and reliability with respect to different functional activities. Here, we established the concurrent validity and test–retest reliability of accelerations and orientations measured using affordable novel sensors during squats, jumps, walking and stair ambulation. In this observational study, participants underwent three data collection sessions during one day. Accelerations and orientations from sacrum, thigh and shank were collected using these sensors and already validated gold-standard sensors as the criterion method. We assessed validity by comparing the similarity of signal waveforms with the Linear Fit Method and by comparing mean differences in range values with the Bland–Altman plots. Reliability was assessed by calculating interclass correlation coefficient and standard error of measurements of the range values. Concurrent validity was from fair to excellent in 91% of the cases for accelerations and in 84.4% for orientations. Test–retest reliability of accelerations was from fair to excellent in 97% of cases when the sensors were attached by a researcher, and in 84.4% of cases when the sensors were attached by participants. Test–retest reliability of orientations was from fair to excellent in 88.9% of cases when the sensors were attached by a researcher, and in 68.9% of cases when the sensors were attached by participants. In conclusion, the new affordable sensors provide accurate measures of accelerations and orientations during multiple functional activities in healthy adults. Reliability of the orientations may depend on the ability to replicate the same position of the sensor under test–retest conditions.

Wireless pressure insoles may enable the assessment of movement biomechanics in a real-world setting, and thus play an important role in the recommendation of clinical management, but they are not yet a gold standard due to the unknown accuracy and reliability with respect to different functional activities. Here, we compare novel wireless pressure insoles with force plates and examine the test–retest reliability of the insoles for measuring vertical ground reaction forces (vGRFs) and trajectories of the center of pressure (COP). In this observational study, healthy adults underwent two data collection sessions during one day. The Bland–Altman analysis was used to compare the outcomes measured with the two instruments during squats, jumps, and the sit-to-stand test. Test–retest reliability was assessed by the interclass correlation coefficient and the standard error of measurement for the outcomes during squats, jumps, walking, and stair ambulation. Trajectories of the COP in the anterior–posterior direction were comparable between the two systems during all activities. The insoles consistently measured shorter trajectories of the COP in the medial–lateral direction (except jumps) and lower vGRFs than the force plates. Test–retest reliability of the insoles was fair to high or excellent for all outcomes during all activities. In conclusion, the insoles provide reliable measures of vGRFs and trajectories of the COP during multiple functional activities in healthy adults. Although the insoles do not produce identical results to the force plate, the qualitative similarity and consistency between the two systems confirm the insoles can be used to measure these outcomes, based on the purpose and accuracy required.

Objective: To evaluate current evidence for the effectiveness of virtual reality (VR) interventions in improving neurocognitive performance in individuals who have sustained a traumatic brain injury (TBI). Methods: A systematic literature search across multiple databases (PubMed, EMBASE, Web of Science) for articles of relevance. Studies were evaluated according to study design, patient cohort, VR intervention, neurocognitive parameters assessed, and outcome. VR interventions were evaluated qualitatively with respect to methodology and extent of immersion and quantitatively with respect to intervention duration. Outcomes: Our search yielded 324 articles, of which only 13 studies including 132 patients with TBI met inclusion criteria. A wide range of VR interventions and cognitive outcome measures is reported. Cognitive measures included learning and memory, attention, executive function, community skills, problem solving, route learning, and attitudes about driving. Several studies (n = 10) reported statistically significant improvements in outcome, and 2 studies demonstrated successful translation to real-life performance. Conclusions: VR interventions hold significant potential for improving neurocognitive performance in patients with TBI. While there is some evidence for translation of gains to activities of daily living, further studies are required to confirm the validity of cognitive measures and reliable translation to real-life performance.

Dual-task paradigms have been increasingly used to assess the interaction between cognitive demands and the control of balance and gait. The interaction between functional and cognitive demands can alter movement patterns and increase knee instability in individuals with knee conditions, such as knee anterior cruciate ligament (ACL) injury or osteoarthritis (OA). However, there is no consensus on the effects of dual-task on gait mechanics and balance in those individuals. This systematic scoping review aims to examine the impact of dual-task gait and standing balance on motor and cognitive performance in individuals with knee OA or ACL injury. A comprehensive search of MEDLINE, PubMed, Web of Science, and EMBASE electronic databases up until December 2019 was carried out. Inclusion criteria was limited to include dual-task studies that combined cognitive tasks performed simultaneously with gait or standing balance in individuals with knee OA or ACL injuries. In total, fifteen studies met the inclusion criteria, nine articles examined dual-task effects on balance, and six articles reported the effects of dual-task on gait. The total number of individuals included was 230 individuals with ACL injuries, and 168 individuals with knee OA. A decline in gait and balance performance during dual-task testing is present among individuals with ACL injury and/or ACL reconstruction and knee OA. Further research is required, but dual taking assessment could potentially be used to identify individuals at risk of falling or further injury and could be used to develop targeted rehabilitation protocols. A variety of outcome measures have been used across the studies included, making comparisons difficult. The authors, therefore, recommend developing a standardized set of biomechanical balance variables.

With the growing number of people affected by osteoarthritis, wearable technology may enable the provision of care outside a traditional clinical setting and thus transform how healthcare is delivered for this patient group. Here, we mapped the available empirical evidence on the utilization of wearable technology in a real-world setting in people with knee osteoarthritis. From an analysis of 68 studies, we found that the use of accelerometers for physical activity assessment is the most prevalent mode of use of wearable technology in this population. We identify low technical complexity and cost, ability to connect with a healthcare professional, and consistency in the analysis of the data as the most critical facilitators for the feasibility of using wearable technology in a real-world setting. To fully realize the clinical potential of wearable technology for people with knee osteoarthritis, this review highlights the need for more research employing wearables for information sharing and treatment, increased inter-study consistency through standardization and improved reporting, and increased representation of vulnerable populations.