REVIEW  MOTION ANALYSIS IN ORTHOPEDICS 

Minerva Orthopedics 2021 October;72(5):484-97

DOI: 10.23736/S2784-8469.21.04125-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Wearable sensors for remote patient monitoring in orthopedics

Reed D. GURCHIEK ¹ ✉, Bruce D. BEYNNON ², Cristine E. AGRESTA ³, Rebecca H. CHOQUETTE ², Ryan S. MCGINNIS ¹

¹ Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, USA; ² Department of Orthopedics and Rehabilitation, University of Vermont, Burlington, VT, USA; ³ Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

INTRODUCTION: Mobile health technologies present a new approach for continuous patient monitoring in free-living environments and promise major improvements in the management and early identification of musculoskeletal disease. These advances are driven by a plethora of research dedicated to wearables-based biomechanical analysis enabling characterization of clinically relevant variables that previously required laboratory technology. Remote patient monitoring presents several advantages to the in-lab alternative in terms of observation frequency, accessibility, and ecological validity of patient evaluations. However, the extent to which these developments have translated for remotely monitoring patients with musculoskeletal conditions is unclear. This is addressed in the current review and, specifically, the characterization of human movement in terms of cumulative physical activity (e.g., step count) as an assessment distinct from stride-by-stride analysis (e.g., daily average stride frequency).
EVIDENCE ACQUISITION: The PubMed database was searched for relevant articles using terms related to the use of wearable sensors for remote monitoring of gait in patients with musculoskeletal conditions. References in each identified article were searched for additional studies to include. All outcome variables were categorized as either a measure of cumulative physical activity or as pertaining to a stride-by-stride level analysis.
EVIDENCE SYNTHESIS: Of the 90 studies identified, 87 quantified cumulative physical activity compared to only ten that characterized movement on a stride-by-stride level.
CONCLUSIONS: Indices of cumulative physical activity are the most common metric for remotely monitoring patients with musculoskeletal conditions. Remote biomechanical analysis at a stride-by-stride level is relatively under-utilized considering the vast increase in research devoted to wearables-based algorithm development.

KEY WORDS: Wearable electronic devices; Orthopedics; Musculoskeletal diseases; Remote sensing technology