A Novel Protocol for Integrated Assessment of Upper Limbs Using the Optoelectronic Motion Analysis System: Validation and Usability in Healthy People
Abstract
1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Data Collections
- Preparation of the subject, positioning the markers (30) on the selected body landmarks.
- The acquisition of 5 HtT trials with each arm;
- Detachment of the markers from the subject.
- Phase 1: instrument preparation and marker preparation (for the test subjects, the part of instrument preparation was excluded from the questionnaire because the subjects were not involved in this operation);
- Phase 2: marker positioning;
- Phase 3: recording the movements with the optoelectronic system;
- Phase 4: removing the markers.
2.3. Data Processing
- Going Phase: Begins when the velocity of the finger marker exceeds 50 mm/s and ends at the onset of the Adjusting Phase.
- Adjusting Phase: This phase was not defined by velocity thresholds, due to the fluctuating nature of speed during fine adjustments. Instead, it was identified based on the distance between the finger and the target, using a threshold set as the average distance plus three standard deviations across five movements. The end of this phase and the start of the Returning Phase were defined using the same criteria.
- Returning Phase: Starts at the conclusion of the Adjusting Phase and ends when the finger marker speed drops below 50 mm/s.
- End-point (finger) metrics: Derived from finger kinematic data, these metrics assess movement speed, accuracy, efficiency, and smoothness.
- Trunk compensation metrics: Calculated from the marker placed on the sternum, these metrics quantified compensatory trunk movements during reaching tasks.
2.4. Statistical Analysis
3. Results
3.1. Time Phases and End-Point Metrics
3.2. Trunk Compensation Metrics
3.3. Range of Motion
3.4. Usability Assessment
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
UL | Upper Limb |
CP | Cerebral Palsy |
MUUL | The Melbourne Assessment of Unilateral Upper Limb Function |
QUEST | Quality of Upper Extremity Skills Test |
SHUEE | Shriners Hospital Upper Extremity Evaluation |
CIMT | Constraint-Induced Movement Therapy |
TRT | Trunk Restraint Therapy |
BAT | Bilateral Arm Therapy |
ICF | International Classification of Functioning |
ISB | International Society of Biomechanics |
HtT | Hit-to-Target |
SUS | System Usability Scale |
ROM | Range of motion |
ICC | intraclass correlation coefficient |
MMV | Mean Movement Velocity |
IC | Index of curvature |
NVP | Number of Velocity Peaks |
MA | motion analysis |
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Baseline Features | |
---|---|
Age [y] (mean—SD; range) | 18.69—SD 12.45; 8.0–41.4 |
Weight [Kg] (mean—SD; range) | 44.5—SD 22.55; 24.00–90.00 |
Height [cm] (mean—SD; range) | 144.5—SD 18.28; 124.0–167.0 |
BMI (mean—SD; range) | 20.03—SD 5.65; 15.06–33.06 |
Thorax coordinate system [23] | Origin: | The origin coincided with suprasternal notch (IJ) |
Y axis: | The line connecting the midpoint between xiphoid process (PX) and T8 and the midpoint between IJ and C7, pointing upward | |
Z axis: | The line perpendicular to the plane formed by IJ, C7, and the midpoint between PX and T8, pointing to the right. | |
X axis: | The common line perpendicular to the Z and Y axis, pointing forwards. | |
Proximal Humerus (note: This reference frame was used to calculate shoulder movement) [23] | Origin: | The origin coincident with GlenoHomeros (GH) |
Y axis: | The line connecting GH and the midpoint of lateral elbow (EL) and medial elbow (EM)), pointing to GH. | |
Z axis: | The common line perpendicular to the Y and Z axis, pointing to the right | |
X axis: | The line perpendicular to the plane formed by EL, EM, and GH, pointing forward. | |
Distal Humerus (note: This reference frame was used to calculate elbow movement) [25] | Origin: | coincides with midpoint of the elbow |
Y axis: | Forearm axis of rotation. | |
Z axis: | The line perpendicular to the plane formed by Y and the Y axis of the proximal humerus reference frame | |
X axis: | perpendicular to the plane formed by X and Y, POINTing forward | |
Forearm coordinate system [23] | Origin: | The origin coincided with ulnar styloid (US). |
Y axis: | the line connecting US and the midpoint between EL and EM, pointing proximally | |
Z axis: | The common line perpendicular to the X and Y axis, pointing to the right. | |
X axis: | The line perpendicular to the plane through US, radial styloid (RS), and the midpoint between EL and EM, pointing forward | |
Wrist coordinate system [23] | Origin: | The origin of the coordinate systems is located midway between the base and head of second metacarpal. In the transverse plane, it will be at the approximate center of the tubular bone. |
Y axis: | The line parallel to a line from the center of the distal head of the metacarpal to the midpoint of the base of the metacarpal. | |
Z axis: | The common line perpendicular to the X and Y axis. | |
X axis: | The X and Y axis will form a sagittal plane that splits the metacarpal into mirror images |
Metrics | ||
---|---|---|
End-point (finger) | Time | This is calculated as the total time required for completing each task. In addition, the durations of the previous three phases were computed: the going phase, the adjusting phase, and the returning phase [31] |
Adjusting sway Index (ASI) | It is defined as the length of the 3D path described by the fingernail during the adjusting phase, which is a measure of the adjustments made to reach the final position. This represents an expression of the degree of precision [31]. | |
Mean Movement Velocity (MMV) | It is computed during the going phase and represents the mean velocity of the fingernail marker [31]. | |
Index of curvature (IC) | It is calculated as the ratio of the fingernail 3D path length to the linear distance between the initial and the final pointing position and is a representative of movement smoothness during the going phase [32]. | |
Number of Velocity Peaks (NVP) | It is a quality measure of movement smoothness computed from the speed profile of the finger during the entire movement [32]. | |
Trunk compensation | Trunk compensation | It is defined as the length 3D path described by the marker placed on the sternum [33] |
Displacement along z-axis | Displacement of the marker placed on the sternum along the z-axis (towards the target) during the going phase. It quantifies trunk flexion [33]. | |
Displacement along x-axis | Displacement of the marker placed on the sternum along the x-axis during the going phase. It quantifies trunk lateral bending [33]. |
Intra Operator | Inter Operator | |||
---|---|---|---|---|
ICC | ICC Level | ICC | ICC Level | |
T tot | 0.785 | ++ | 0.715 | + |
T Going Phase | 0.738 | + | 0.610 | + |
T Return Phase | 0.725 | + | 0.552 | + |
T Adj Phase | 0.839 | ++ | 0.816 | ++ |
Mean movement velocity (MMV) | 0.896 | ++ | 0.953 | +++ |
Curvature Index (CI) | 0.898 | ++ | 0.898 | ++ |
Adjusting sway Index (ASI) | 0.867 | ++ | 0.793 | ++ |
Number of Velocity Peaks (NVP) | 0.739 | + | 0.721 | + |
Intra Operator | Inter Operator | |||
---|---|---|---|---|
ICC | ICC Level | ICC | ICC Level | |
Thorax Length Going Phase | 0.815 | ++ | 0.834 | ++ |
Antero-posterior Going Phase Displacement | 0.818 | ++ | 0.890 | ++ |
Medio-lateral Going Phase Displacement | 0.768 | ++ | 0.696 | + |
Thorax Length Adjusting Phase | 0.926 | +++ | 0.834 | ++ |
Antero-posterior Adjusting Phase Displacement | 0.882 | ++ | 0.707 | + |
Medio-lateral Adjusting Phase Displacement | 0.956 | +++ | 0.854 | ++ |
Thorax Length Return Phase | 0.870 | ++ | 0.870 | ++ |
Antero-posterior Return Phase Displacement | 0.891 | ++ | 0.888 | ++ |
Medio-lateral Return Phase Displacement | 0.815 | ++ | 0.825 | ++ |
Intra Operator | Inter Operator | |||
---|---|---|---|---|
ICC | ICC Level | ICC | ICC Level | |
ROM Right Shoulder FE | 0.983 | +++ | 0.992 | +++ |
ROM Left Shoulder FE | 0.991 | +++ | 0.992 | +++ |
ROM Right Shoulder AA | 0.906 | +++ | 0.992 | +++ |
ROM Left Shoulder AA | 0.966 | +++ | 0.958 | +++ |
ROM Right Shoulder IE | 0.917 | +++ | 0.965 | +++ |
ROM Left Shoulder IE | 0.949 | +++ | 0.954 | +++ |
ROM Right Elbow FE | 0.959 | +++ | 0.950 | +++ |
ROM Left Elbow FE | 0.978 | +++ | 0.953 | +++ |
ROM Right Elbow PS | 0.755 | ++ | 0.848 | ++ |
ROM Left Elbow PS | 0.838 | ++ | 0.762 | ++ |
ROM Right Wrist FE | 0.967 | +++ | 0.826 | ++ |
ROM Left Wrist FE | 0.949 | +++ | 0.941 | +++ |
ROM Right Wrist UR | 0.934 | +++ | 0.952 | +++ |
ROM Left Wrist UR | 0.949 | +++ | 0.940 | +++ |
ROM Right Thorax FE | 0.869 | ++ | 0.952 | +++ |
ROM Right Thorax ML | 0.640 | + | 0.872 | ++ |
ROM Right Thorax IE | 0.768 | ++ | 0.722 | + |
ROM Right Head FE | 0.705 | + | 0.867 | ++ |
ROM Right Head ML | 0.813 | ++ | 0.857 | ++ |
ROM Right Head IE | 0.832 | ++ | 0.798 | ++ |
Operators | Patient | ||||||
---|---|---|---|---|---|---|---|
Phase | 1 | 2 | 3 | 4 | 1 | 2 | 3 |
Mean | 4.83 | 4.68 | 4.95 | 4.98 | 4.88 | 4.90 | 4.70 |
Standard deviation | 0.38 | 0.47 | 0.22 | 0.16 | 0.33 | 0.30 | 0.56 |
Max | 5.00 | 5.00 | 5.00 | 5.00 | 5.00 | 5.00 | 5.00 |
Min | 4.00 | 4.00 | 4.00 | 4.00 | 4.00 | 4.00 | 3.00 |
T [min] | |||||
---|---|---|---|---|---|
1 | 2 | 3 | 4 | TOT | |
Mean | 2.00 | 6.05 | 10.13 | 1.80 | 19.97 |
Standar deviation | 0.16 | 0.62 | 0.54 | 0.16 | 0.69 |
Max | 2.32 | 7.22 | 11.73 | 2.10 | 21.50 |
Min | 1.77 | 5.17 | 8.85 | 1.20 | 18.73 |
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Molteni, L.E.; Piccinini, L.; Panzeri, D.; Micheletti, E.; Andreoni, G. A Novel Protocol for Integrated Assessment of Upper Limbs Using the Optoelectronic Motion Analysis System: Validation and Usability in Healthy People. Bioengineering 2025, 12, 905. https://doi.org/10.3390/bioengineering12090905
Molteni LE, Piccinini L, Panzeri D, Micheletti E, Andreoni G. A Novel Protocol for Integrated Assessment of Upper Limbs Using the Optoelectronic Motion Analysis System: Validation and Usability in Healthy People. Bioengineering. 2025; 12(9):905. https://doi.org/10.3390/bioengineering12090905
Chicago/Turabian StyleMolteni, Luca Emanuele, Luigi Piccinini, Daniele Panzeri, Ettore Micheletti, and Giuseppe Andreoni. 2025. "A Novel Protocol for Integrated Assessment of Upper Limbs Using the Optoelectronic Motion Analysis System: Validation and Usability in Healthy People" Bioengineering 12, no. 9: 905. https://doi.org/10.3390/bioengineering12090905
APA StyleMolteni, L. E., Piccinini, L., Panzeri, D., Micheletti, E., & Andreoni, G. (2025). A Novel Protocol for Integrated Assessment of Upper Limbs Using the Optoelectronic Motion Analysis System: Validation and Usability in Healthy People. Bioengineering, 12(9), 905. https://doi.org/10.3390/bioengineering12090905