Heightened clinical utility of smartphone versus body-worn inertial system for shoulder function B-B score

PLoS One. 2017 Mar 20;12(3):e0174365. doi: 10.1371/journal.pone.0174365. eCollection 2017.

Abstract

Background: The B-B Score is a straightforward kinematic shoulder function score including only two movements (hand to the Back + lift hand as to change a Bulb) that demonstrated sound measurement properties for patients for various shoulder pathologies. However, the B-B Score results using a smartphone or a reference system have not yet been compared. Provided that the measurement properties are comparable, the use of a smartphone would offer substantial practical advantages. This study investigated the concurrent validity of a smartphone and a reference inertial system for the measurement of the kinematic shoulder function B-B Score.

Methods: Sixty-five patients with shoulder conditions (with rotator cuff conditions, adhesive capsulitis and proximal humerus fracture) and 20 healthy participants were evaluated using a smartphone and a reference inertial system. Measurements were performed twice, alternating between two evaluators. The B-B Score differences between groups, differences between devices, relationship between devices, intra- and inter-evaluator reproducibility were analysed.

Results: The smartphone mean scores (SD) were 94.1 (11.1) for controls and 54.1 (18.3) for patients (P < 0.01). The difference between devices was non-significant for the control (P = 0.16) and the patient group (P = 0.81). The analysis of the relationship between devices showed 0.97 ICC, -0.6 bias and -13.2 to 12.0 limits of agreement (LOA). The smartphone intra-evaluator ICC was 0.92, the bias 1.5 and the LOA -17.4 to 20.3. The smartphone inter-evaluator ICC was 0.92, the bias 1.5 and the LOA -16.9 to 20.0.

Conclusions: The B-B Score results measured with a smartphone were comparable to those of an inertial system. While single measurements diverged in some cases, the intra- and inter-evaluator reproducibility was excellent and was equivalent between devices. The B-B score measured with a smartphone is straightforward and as efficient as a reference inertial system measurement.

Publication types

  • Clinical Trial
  • Validation Study

MeSH terms

  • Accelerometry* / instrumentation
  • Adult
  • Biomechanical Phenomena
  • Female
  • Humans
  • Humerus / injuries
  • Injury Severity Score
  • Joint Diseases / diagnosis*
  • Joint Diseases / physiopathology
  • Male
  • Middle Aged
  • Movement / physiology
  • Observer Variation
  • Prospective Studies
  • Reproducibility of Results
  • Severity of Illness Index*
  • Shoulder / physiopathology*
  • Shoulder Injuries / diagnosis*
  • Shoulder Injuries / physiopathology
  • Smartphone*
  • Surveys and Questionnaires

Grants and funding

Funded by Swiss National Science Foundation Grant number 135061 http://p3.snf.ch/Project-135061. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.