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J Acupunct Res > Volume 30(4); 2013 > Article
Kim, Kim, Park, Kim, Lee, Kang, Lee, and Park: Test-retest Reliability and Intratest Repeatability of Measuring Cervical Range of Motion Using Inertial Measurement Unit
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Objectives :

To assess the test-retest reliability and the intratest repeatability in measuring the cervical range of motion of healthy subjects with wireless microelectromechanical system inertial measurement unit(MEMS-IMU) system and to discuss the feasibility of this system in the clinical setting to evaluate the cervical spine musculoskeletal .

Methods :

12 healthy people who were evaluated as no- or mild-disability with neck disability index were participated. Their cervical motion were measured with IMU twice in consecutive two days for the test-retest reliability study. Intratest repeatability was calculated in the two tests separately. The calculated intraclass correlation coefficients(ICC) were discussed and compared with the those of the previous studies.

Results :

Cervical range of motion data were acquired and statistically processed: left rotation(61.64°), right rotation(65.12°), extension(61.98°), flexion(52.81°), left bending(39.31°), right bending(41.08°). ICCs were 0.77∼0.98(intratest repeatability) and 0.74∼0.93 (test-retest reliability) in the primary motion. In the coupling motion, intratest repeatability ICCs were 0.93∼0.99(transverse primary plane), 0.88∼0.97(saggital primay plane), and 0.77∼0.93(coronal primary plane). Test-retest reliability of coupling motion were 0.90∼0.97(transverse primary plane), 0.00∼0.72(saggital primary plane), and 0.04∼0.76(coronal primary plane).

Conclusions :

Several types of range-of-motion devices are now on use in many fields including medicine, but the practicality of the devices in clinical use is questionable for the convenient and economical aspects. In this study, we presented the reliability of cervical range of motion test with the developed wireless MEMS-IMU system and discussed its potential utility in clinical use.

Fig. 1.
MEMS-IMU transmitter
Fig. 2.
A sample of cervical motion data acquired by MEMS-IMU system
Solid line expresses the axial rotation along the transverse plane, while the other two dotted lines express the extension/flexion along the saggital plane and the lateral bending along the coronal plane. Negative values mean left rotation, flexion, and left bending. In this case, the primary motion is axial rotation, and the regular coupling motions are observed.
Table 1.
Cervical Range of Motion and Reliability
Primary plane Motion Day 1 Day 2 ICC(2,2)b 95 % CI
M(SD) ICC(2,1)a 95 % CI M(SD) ICC(2,1)a 95 % CI
Transverse Left rotation 61.64 (9.72) 0.95 0.75∼0.99 58.17 (9.48) 0.97 0.91∼0.99 0.87 0.53∼0.96
Right rotation 65.12 (10.24) 0.92 0.74∼0.98 63.00 (10.78) 0.98 0.93∼0.99 0.93 0.77∼0.98
Sagittal Extension 61.98 (9.50) 0.97 0.91∼0.99 59.37 (10.38) 0.98 0.92∼1.00 0.74 0.14∼0.93
Flexion 52.81 (7.62) 0.91 0.71∼0.97 55.78 (8.5) 0.86 0.58∼0.96 0.84 0.46∼0.96
Coronal Left bending 39.31 (5.75) 0.87 0.60∼0.96 41.18 (5.68) 0.95 0.84∼0.99 0.88 0.55∼0.97
Right bending 41.08 (4.93) 0.93 0.70∼0.98 41.43 (5.33) 0.77 0.30∼0.94 0.89 0.58∼0.97

M : mean(°). SD : standard deviation(°).

ICC : intraclass correlation coefficient. CI : confidence interval.

a: intratest repeatability, ICC(2,1), agreement

b: yest-retest reliability between two consecutive days, ICC(2,2), agreement

Table 2.
Associated Cervical Coupling Motion and Reliability
Primary motion Coupling motion Day 1 Day 2 ICC(2,2)b 95 % CI
M(SD) ICC(2,1)a 95 % CI M(SD) ICC(2,1)a 95 % CI
Left rotation Extension or flexion 0.71 (6.59) 0.93 0.37∼0.99 0.28 (5.69) 0.95 0.84∼0.99 0.91 0.68∼0.97
Lateral bending −1.69 (11.25) 0.98 0.93∼1.00 0.42 (11.22) 0.98 0.93∼1.00 0.97 0.86∼0.99
Right rotation Extension or flexion −3.12 (8.05) 0.98 0.70∼1.00 0.20 (6.42) 0.93 0.79∼0.98 0.90 0.11∼0.98
Lateral bending 1.59 (10.45) 0.98 0.94∼1.00 −0.41 (10.22) 0.99 0.95∼1.00 0.90 0.65∼0.97
Extension Lateral bending 0.86 (4.50) 0.97 0.91∼1.00 −1.00 (3.23) 0.94 0.76∼0.98 0.51 0.00∼0.85
Axial Rotation 11.29 (5.54) 0.96 0.85∼0.99 9.97 (4.41) 0.88 0.64∼0.96 0.13* 0.00∼0.76
Flexion Lateral bending 2.40 (3.19) 0.92 0.74∼0.97 2.90 (3.19) 0.87 0.63∼0.96 0.00* 0.00∼0.65
Axial rotation −3.10 (7.10) 0.93 0.78∼0.98 −0.91 (5.65) 0.93 0.78∼0.98 0.72 0.09∼0.92
Left bending Extension or flexion −9.70 (7.43) 0.81 0.42∼0.94 −9.37 (9.12) 0.93 0.77∼0.98 0.76 0.06∼0.94
Axial rotation −15.08 (8.69) 0.92 0.68∼0.98 −12.34 (6.94) 0.89 0.65∼0.97 0.67 0.00∼0.91
Right bending Extension or flexion −5.04 (7.59) 0.88 0.63∼0.96 −3.05 (6.21) 0.79 0.41∼0.94 0.04* 0.00∼0.76
Axial rotation 14.19 (9.55) 0.93 0.79∼0.98 13.30 (7.42) 0.77 0.18∼0.94 0.71 0.00∼0.92

Positive values mean right rotation, extension, and right bending.

Negative values mean left rotation, flexion, and left bending.

M : mean(°). SD : standard deviation(°).

ICC : intraclass correlation coefficient, CI : confidence interval.

a: intratest repeatability, ICC(2,1), agreement.

b: test-retest reliability between two consecutive days, ICC(2,2), agreement.

*: poor reliabiility.

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