title: Objective evaluation of shoulder function using body-fixed sensors: a new way to detect early treatment failures?
abstract: BACKGROUND
  Variable definitions of outcome (Constant score, Simple Shoulder Test [SST]) have been used to assess outcome after shoulder treatment, although none has been accepted as the universal standard. Physicians lack an objective method to reliably assess the activity of their patients in dynamic conditions. Our purpose was to clinically validate the shoulder kinematic scores given by a portable movement analysis device, using the activities of daily living described in the SST as a reference. The secondary objective was to determine whether this device could be used to document the effectiveness of shoulder treatments (for glenohumeral osteoarthritis and rotator cuff disease) and detect early failures.
  
  
  METHODS
  A clinical trial including 34 patients and a control group of 31 subjects over an observation period of 1 year was set up. Evaluations were made at baseline and 3, 6, and 12 months after surgery by 2 independent observers. Miniature sensors (3-dimensional gyroscopes and accelerometers) allowed kinematic scores to be computed. They were compared with the regular outcome scores: SST; Disabilities of the Arm, Shoulder and Hand; American Shoulder and Elbow Surgeons; and Constant.
  
  
  RESULTS
  Good to excellent correlations (0.61-0.80) were found between kinematics and clinical scores. Significant differences were found at each follow-up in comparison with the baseline status for all the kinematic scores (P < .015). The kinematic scores were able to point out abnormal patient outcomes at the first postoperative follow-up.
  
  
  CONCLUSIONS
  Kinematic scores add information to the regular outcome tools. They offer an effective way to measure the functional performance of patients with shoulder pathology and have the potential to detect early treatment failures.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. Brigitte.Jolles-Haeberli@chuv.ch
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Jolles
authors.forename: Cyntia
authors.initials: C
authors.lastname: Duc
authors.forename: Brian
authors.initials: B
authors.lastname: Coley
authors.forename: Kamair
authors.initials: K
authors.lastname: Aminian
authors.forename: Claude
authors.initials: C
authors.lastname: Pichonnaz
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Bassin
authors.forename: Alain
authors.initials: A
authors.lastname: Farron
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000465:Algorithms; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D009068:Movement; D010003:Osteoarthritis / Q000601:surgery; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*