title: Can a physical activity monitor provide a valid measure of arm elevation angle? A study to assess agreement between the SenseWear Mini Armband and the universal goniometer.
abstract: BACKGROUND
  We undertook the current study to assess whether an accelerometer-based physical activity monitor, the SenseWear Mini Armband (SMA), could be used to provide data on static arm elevation, and to assess the agreement between static arm elevation measures obtained using SMA-derived data and those obtained with a universal goniometer.
  
  
  METHODS
  Using a universal goniometer, healthy adult subjects (n = 25, age 30 ± 9 years) had each of right and left arms positioned in a series of set positions between arm-by-side and maximal active arm flexion (anteversion), and arm-by-side and maximal active arm abduction. Subjects wore the SMA throughout positioning, and SMA accelerometer data was used to retrospectively calculate/derive arm elevation angle using a manufacturer-provided algorithm. The Bland-Altman method was used to assess agreement between goniometer-set and SMA-derived arm elevation angles.
  
  
  RESULTS
  There were significant differences between goniometer-set and SMA-derived arm elevation angles for elevation angles ≤ 30 degrees and ≥ 90 degrees (p < 0.05). Bland-Altman plots showed that the greater the angle of elevation, the greater the mean difference between goniometer-set and SMA-derived elevation angles. Adjustment of the manufacturer-provided algorithm for deriving arm elevation angle corrected for this systematic difference, and resulted in 95% limits of agreement ± 12 degrees (flexion) and ± 13 degrees (abduction) across the full range of arm elevation.
  
  
  CONCLUSIONS
  The SMA can be used to record data allowing derivation of static arm elevation angle in the upright position, 95% limits of agreement with the universal goniometer being similar to those reported for digital inclinometers and gyroscopes. Physiotherapists looking for innovative methods of recording upper limb range of motion should consider the potential of accelerometer-based physical activity monitors such as the SMA.
authors.affiliation: The Clinical Research Institute, Suite 6, 16 to 18 Mons Road, Westmead, NSW 2145, Australia. andrew.hirschhorn@me.com.|Department of Physiotherapy, Westmead Hospital, Sydney, Australia. andrew.hirschhorn@me.com.|Department of Physiotherapy, The University of Melbourne, Melbourne, Australia. andrew.hirschhorn@me.com.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hirschhorn
authors.affiliation: Physical Therapy Division, University of Kentucky, Lexington, USA. will.lockhart@uky.edu.
authors.forename: John W
authors.initials: JW
authors.lastname: Lockhart
authors.affiliation: The Clinical Research Institute, Suite 6, 16 to 18 Mons Road, Westmead, NSW 2145, Australia. jb@centralwestphysio.com.au.|Mungovan Breckenridge Physiotherapy and Associates, Sydney, Australia. jb@centralwestphysio.com.au.
authors.forename: John D
authors.initials: JD
authors.lastname: Breckenridge
mesh_terms: D056044:Actigraphy / Q000295:instrumentation*; D000328:Adult; D000465:Algorithms; D053587:Arthrometry, Articular / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D011187:Posture; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D034941:Upper Extremity / Q000502:physiology*; D055815:Young Adult