Table 1.
Descriptive analysis of the studies considered in the review according to the PICO method.
References | Participants involved in the study | Measurement details | Aims | Findings | |||
---|---|---|---|---|---|---|---|
Motor task | Parameters/indexes name (acronym) | Instrumentation | Body part | ||||
Monticone et al. (46) |
N = 20: • 10 LBP (7 F, 3 M; Age = 58.9 ± 16.4 y; BMI = 27.4 ± 4.9 kg/m2); • 10 HS (4 F, 6 M; Age = 56.6 ± 14.4 y; BMI = 25.2 ± 3.1 kg/m2). |
Spinal stabilizing exercises in addition to usual-care rehabilitation (passive mobilisatio, stretching, and postural control); • Individual cognitive–behavioral training. |
Gait parameters: velocity, cadence, step length, step time, and single support time of both sides. | GAITRite-Walkway System (CIR System Inc., Clifton, NJ). | - | To evaluate the effect of a multidisciplinary rehabilitation program on disability, kinesiophobia, catastrophizing, pain, quality of life and gait disturbances in patients with chronic LBP. | The findings indicate that the treatment was beneficial in terms of gait cadence, as well as the positive impact of cognitive–behavioral therapy on non-spinal motor tasks, which improved health and favored a return to work and usual activities. |
Lee et al. (47) |
N = 35 HS: • 18 (5 F, 13 M; Age = 21.7 ± 2.3 y) participated in the in-laboratory experiments; • 18 (4 F, 14 M; Age = 23.4 ± 4.2 y) in the free-living experiments; one subject participated in both. |
• Laboratory experiments: Walking; Buttoning a shirt Bilateral; Tying shoelaces; Typing on a keyboard; Folding a towel; Cutting putty dough with a fork and a knife; Opening a screw-top jar; Taking the cap off of a bottle and drinking; Flipping pages of a magazine. • Free-living experiments: Normal daily routines. |
The ratio of limb use; • Limb-use intensity (i.e., acceleration magnitude). |
Miniaturized sensor (Arcus, ArcSecond Inc., USA) consisted of a three-axis accelerometer, a local memory for data storage, a 170 mAh battery, and an ultra-low-power 32-bit microprocessor in a waterproof enclosure. | Hands. | To investigate the use of finger-worn accelerometers to monitor gross arm and fine hand movement; to examine the validity of the proposed approach by collecting and analyzing data from neurologically intact individuals in a laboratory and a free-living environment as a preliminary step toward developing a system suitable to monitor stroke survivors in the home and community setting; to describe a comprehensive approach integrating both a clinical- and functional status-based pathology and an adapted rehabilitation prescription. | The results establish the validity of the proposed measure of real-world upper-limb function derived using data collected by means of finger-worn accelerometers. |
Richmond et al. (48) |
N = 56: • 29 HS (21 F, 8 M; Age = 47 ± 15 y; H = 1.69 ± 0.08 m; W = 72.4 ± 14.2 kg; BMI = 25.3 ± 4.0 kg/m2); • 27 MS (20 F, 7 M; Age = 48 ± 12 y; H = 1.66 ± 0.08 m; W = 68.6 ± 9.2 kg; BMI = 24.9 ± 3.8 kg/m2). |
Walking task. | Phase coordination index (PCI). | Six tri-axial Opal™ body-worn inertial monitoring units (IMUs). | Sternum, lower back (L4/L5 region), wrists and feet. | To identify the temporal actions underlying bilateral coordination in people with MS and how bilateral coordination is affected by gait speed augmentation in these individuals. | People with MS exhibited poorer left-right coordinated stepping patterns during gait compared to neurotypical peers across walking conditions. This assessment highlights Phase Coordination Index as a potential target for future rehabilitative interventions for subjects with MS and individualized rehabilitation strategies aimed at improving the health span and overall quality of life for subjects with MS. |
Cimarras-Otal et al., (49) |
N = 18: • 10 LBP (2 F, 8 M; Age = 42.25 ± 7.28 y; H = 1.69 ± 0.05 m; W = 72.75 ± 15.79 kg; BMI = 25.12 ± 4.69 kg/m2); • 8 HS (4 F, 4 M; Age = 42.20 ± 5.59 y; H = 1.68 ± 0.09 m; W = 68.27 ± 12.80 kg; BMI = 23.80 ± 2.34 kg/m2). |
Flexion-lumbar extension. | • Angle and flexion; • Bending speed; • Root mean square (RMS) of EMG signal; • Angle, bending speed, and flexion-extension ratio (FER). |
SMART-DX (BTS Bioengineering, Italy): BTS FREEEMG 300 electromyographic probes; Six BTS Bioengineering—SDX-C2 3D; Two video cameras BTS VISTA. | Trunk. | To investigate whether an exercise program adapted to the characteristics of the workplace is a useful supplement to general exercise recommendations in assembly line workers with chronic LBP. | Results demonstrated that the implementation of a physical exercise program adapted to the characteristics of the workplace, for workers with chronic LBP, could be an effective treatment to reduce the interference of pain and to improve the functionality of the lumbar spine. |
Schaefer et al. (50) |
N = 28: • 16 subjects with SS (7 F, 9 M; Age = 58 ± 11 y); • 12 HS (6 F, 6 M; Age = 53 ± 16 y). |
Reach-to-grasp. | • Reaching performance: reach path ratio, peak reach velocity, reach time, contact velocity; • Grasping performance: peak aperture, peak grip force. |
Electromagnetic tracking system with nine sensors (The Motion Monitor, Innovative Sports Training, Chicago, IL). | Midsternum; upper arm; forearm; hand; fingernail of each digit. | To determine whether performance of a functional reach-to-grasp movement in people with poststroke hemiparesis is influenced by grip type and/or task goal; to directly test how stroke might alter patterns of performance when moving with multiple grip types and task goals. | Results suggest that even though the ability to move one's arm and hand is often impaired after stroke, reaching and grasping performance can still be modified based on how and why an object will be grasped. Information about how different movement contexts influence performance poststroke may assist therapists in planning how and what to practice during task specific upper extremity training. |
Correia et al. (51) | 13 SCI at level C4–C7 (Age = 54.54 ± 16.23 y). | Grasping. | • Activities of daily living using the Jebsen Taylor Hand; • Active range of motion of the fingers; • Grasp strength for power; • Pinch grasps. |
SOFT ROBOTIC GLOVE, Goniometer, pressure sensor mat. | Hand. | To evaluate the performance of the optimized soft robotic glove in restoring activities of daily living for individuals with tetraplegia resulting from SCI. | Results demonstrated the effectiveness of a fabric based soft robotic glove to improve independent performance of activities of daily living in individuals with hand paralysis resulting from SCI. |
Kim and Martin (52) |
N = 29: • 10 HS (7 M, 3 F; Age = 28.0 ± 11.3 y; W = 81.3 ± 20.3 kg); • 10 SCI (10 M; Age = 39.0 ± 13.7 y; W = 75.2 ± 17.4 kg). • 9 LBP (5M, 4F; Age = 47.8 ± 11.6 y; W = 84.0 ± 29.2 kg). |
Manually moving a hand-held box from an initial position to one of four target shelves. | Precedence Index (PI). | - | Upper body segments. | To characterize the temporal coordination between the torso and hands in SCI and LBP individuals. | Results demonstrated that hands and torso movements show adapted patterns of coordination in the population with injury. Altogether, it is suggested that patterns of temporal coordination, can be effectively used to assess the gravity of injury, progress of rehabilitation and work capacity measurements. |
Bruce-Low et al. (53) | N = 72 LBP (42 M, 30 F; Age = 45.5 ± 14.1 y). | • Maximal lumbar isometric strength; • modified-modified Schober's flexion test; • completion of the Oswestry disability index (ODI); • the visual analog scale (VAS). |
Maximal Strength; • Range of Motion (ROM); • Scober's flexion. |
Lumbar extension machine (MedX, Ocala, FL). | Lumbar part of the spine. | To examine whether the second weekly dynamic training session is actually beneficial in increasing isometric strength, range of motion (ROM) and decreasing perceived pain in subjects with chronic LBP. | Results suggest that in the rehabilitation of workers suffering from chronic lower back pain, resistance training of the lumbar muscles improves isometric strength and ROM. |
Lebde et al. (54) | N = 720 HS (364M, 356F; Age = 52.3 ± 20.9 y; W = 71.4 ± 14.0 kg; H = 1.69 ± 0.1 m; BMI = 24.8 ± 3.8 kg/m2). | Isometric muscle strength of 13 muscle groups; • flexibility of six joints; • 11 functional measures classified as gross motor, fine motor or balance tasks. |
• Isometric muscle strength (N): Shoulder internal/external rotation, Elbow flexion/extension, Grip; Hip abduction, Hip internal/external rotation, Knee flexion/extension, Ankle dorsi/plantarflexion, Toe flexion; • Joint flexibility: Neck flexion/extension, Shoulder internal/external rotation, Elbow flexion/extension, Hip flexion, Hip internal/external rotation, Knee flexion/extension, Ankle dorsi/plantarflexion, walk distance, gait velocity. |
Fixed dynamometry (CSMi; HUMAC NORM, Stoughton, Massachusetts, USA); Hand-held dynamometry (Citec dynamometer CT 3001; CIT Technics, Groningen, the Netherlands); A universal goniometer (Baseline, Fabrication Enterprises, White Plains, New York, USA) or digital inclinometer (ankle dorsiflexion lunge test). | Full body. | To generate an age-stratified dataset of normative reference values for work ability in a healthy adult Australian population using the Work Ability Score (WAS) and investigate the association of physical performance factors. | Results identified physical factors associated with work ability that can potentially be targeted to maintain longevity in work. Physical tests may assist in the development of objective job-specific screening tools to assess work ability, supplementing subjective evaluation. |
Taylor-Piliae et al. (55) |
N = 20: • 10 HS (2M, 8F; Age = 74.0 ± 7.0 y); • 10 SS (3M, 7F; Age = 70.0 ± 8.0 y). |
Daily activities. | • Trunk tilt (°); • Type of the participant's postural transitions (e.g., sit-to-stand); • Duration of the participant's postural transitions; • Duration of the participant's locomotion; • Characterization of the participant's locomotion (gait speed and number of steps); • Type of the participant's postures (walking, sitting, standing, lying). |
Kinematic motion sensor (PAMSys, Biosensics LLC, MA, USA) | Trunk. | To determine the feasibility of using a kinematic motion sensor to objectively monitor fall risk and gait in naturalistic environments in community-dwelling stroke survivors. | Results highlight the utility of using objective kinematic motion sensors to monitor fall risk and gait in community-welling stroke survivors—so that strategies can be implemented early on, to reduce the risk of falling in this vulnerable population. As sensor algorithms become increasingly more predictive with less obtrusive applications, for home and community settings. |
Brooks et al. (56) |
N = 64 LBP: • 32 in Group1 (12 M, 20 F; Age = 36.2 ± 8.2 y; H = 171 ± 8.0 cm; W = 80.0 ± 13.8 kg); • 32 in Group2 (12 M, 20 F; Age = (Missing Data) ± 6.3 y; H = 171 ± 9.0 cm; W = 85.5 ± 17.8 kg). |
• Specific Exercise Group (SEG); • general Exercise Group (GEG). |
The onset time. | Electromyography ML138 Bio Amp (common mode rejection ratio >85 dB at 50 Hz, input impedance 200 M Ω) with 16-bit analog-to-digital conversion, sampled at 2000 Hz (ADI instruments, Analog Digital Instruments, Sydney, Australia). | Trunk. | To measure self-rated disability, pain, and the onsets of various trunk muscles in response to a rapid shoulder movement as a measure of anticipatory postural adjustments (APAs), before and after 8 weeks of specific trunk or general exercise in patients with LBP. To verify that that selfrated disability and pain scores would decrease after specific trunk exercise and APAs, whether delayed or not at baseline, would change only after specific trunk exercise | Results show similar between-group changes in trunk muscle onsets were observed. The motor control adaptation seems to reflect a strategy of improved coordination between the trunk muscles with the unilateral shoulder movement. Trunk muscle onsets during rapid limb movement do not seem to be a valid mechanism of action for specific trunk exercise rehabilitation programs |
Shin and Sosnoff (57) |
N = 36: • 18 HS (10 M, 8 F; Age = 22.14 ± 3.07 y; Sitting H = 84.95 ± 4.65 cm; W = 63.03 ± 8.15 kg); • 7 High SCI (5 M, 2 F; Age = 23.27 ± 3.67 y; Sitting H = 78.56 ± 9.57 cm; W = 62.87 ± 13.35 kg); • 11 Low SCI (5 M, 6 F; Age = 21.36 ± 2.29 cm; Sitting H = 86.13 ± 10.95 cm; W = 62.88 ± 9.79 kg). |
• Functional reach test; • leaned forward, backward, side to side, and diagonally by pivoting at the hip joints to trace a circle while leaning as far as possible without losing balance for 1 min; • sitting still for 30 |
• Center of pressure (CoP); • Root mean square (RMS); • Median velocity; • Virtual time to contact (VTC); • Instability index. |
Force platform; AMTI, Inc., 176 Waltham St, Watertown, MA 02472-4800. | Upper body. | To investigate seated postural control in persons with SCI compared with age-matched controls. | Results suggest that VTC analysis is appropriate to investigate seated postural control. It is proposed that including VTC of seated postural control as an outcome measure will provide novel information concerning the effectiveness of various rehabilitation approaches and/or technologies aimed at improving seated postural control in persons with SCI. |
Moreside et al. (58) |
N = 81 • 30 LBP (14 M, 16 F; Age = 40.7 ± 12 y; H = 169.9 ± 9 cm; W =7 7.6 ± 20 kg; BMI = 26.6 ± 6 kg/m2); • 51 HS (24 M, 27 F; Age = 31.5 ± 8 y; H = 171.1 ± 9 cm; W = 71.5 ± 15 kg; BMI = 24.3 ± 4 kg/m2). |
Trunk stability test. | EMG principal component score. | Surface electrodes (Meditrace silver/silver chloride electrodes); 3 AMT-8 EMG systems; An electromagnetic Flock of Birds Motion Capture system. | Trunk. | To compare temporal activation patterns from 24 abdominal and lumbar muscles between healthy subjects and those who reported recovery from recent low back injury. | Results demonstrated that despite perceived readiness to return to work and low pain scores, muscle activation patterns remained altered in this low back injury group, including reduced synergistic coactivation and increased overall amplitudes as well as greater relative amplitude differences during specific phases of the movement. Electromyographic measures provide objective information to help guide therapy and may assist with determining the level of healing and return-to-work readiness after a low back injury. |
Rowley et al. (59) |
N = 38: • 19 LBP (7 M, 12 F; Age = 23.5 ± 2.8 y; H = 170.4 ± 8.4 cm; W = 68.7 ± 10.3 kg; BMI = 23.6 ± 2.47 kg/m2); • 19 HS (2 M, 12 F; Age = 23.9 ± 3.3 y; H = 169.1 ± 10.4 cm; W = 67.1 ± 10.8 kg; BMI = 23.3 ± 1.8 kg/m2). |
The Balance-Dexterity Task protocol. | Mean muscle activation. | Surface EMG (Noraxon Wireless EMG; Scottsdale, AZ; 3,000 Hz); Advanced Medical Technology Inc. force plates (Watertown, MA; 3,000 Hz). | Trunk and hip. | To examine the association between hip and trunk muscle activity during dynamically perturbed single-limb balance using the Balance-Dexterity Task in persons with and without LBP. | Results demonstrated that there were no between-group differences in activation amplitude for any muscle groups tested. Back-healthy control participants increased hip and trunk muscle activation amplitudes in response to the added instability of the spring in a coordinated way, while those in remission from LBP did not. Instead, hip muscle activation and task performance were associated in those with LBP. These findings suggest persons with LBP preferentially, and potentially excessively, utilize hip musculature during challenging dynamic balance tasks. This represents an extrapolation of previous findings where persons with symptomatic LBP had greater hip muscle activity than controls, and this may help explain the dissociated trunk motion observed in those in remission from LBP during the Balance-Dexterity Task. |
Hubley-Kozey et al. (60) |
N = 70: • 35 LBP (Age = 39.6 ± 12 y; H = 170.3 ± 9 cm; W = 79.3 ± 21 kg; BMI = 27.2 ± 6 kg/m2); • 35 HS (Age = 35.5 ± 10 y; H = 171.7 ± 8 cm; W = 76.7 ± 15 kg; BMI = 25.9 ± 4 kg/m2). |
Highly controlled right-to-left transfer task. | • EMG ensemble average waveforms; • PCA model. |
Surface electrodes (Ag/AgCl, 10 mm circular electrodes; Meditrace, Graphics Control Canada Ltd.); Electromagnetic Flock of BirdsTM (FOB) Motion Capture system (Ascension Technology Inc., Burlington, Vermont). | Low back. | To determine if amplitude and temporal characteristics of trunk neuromuscular patterns differ during a dynamic functional task in a group of participants with recent (within 12 weeks) low back injury, but deemed ready to resume normal activities, when compared to those with no similar history of injury (ASYM). | Results demonstrated that despite the perception of readiness to return to work and low pain scores, the temporal and amplitude muscle activation patterns were altered in this low back injury group indicating that differences exist compared to a non-low back injured group. The differences are not just relative amplitude differences among muscles but include differences in the temporal response to the flexion moment. |
F, female; M, male; H, height; W, weight; BMI, body mass index; LBP, subjects with low back pain; SS, subjects who have survived stroke; MS, subjects with multiple sclerosis; SCI, subjects with spinal cord injury; HS, healthy subjects.