• dynamic standing balance
• older adults
• sensory stimulation training

• Grant Number JP20K20494, and JP21H04580. Japan Society for the Promotion of Science

• health monitoring
• information and communication technologies
• internet of things
• personalized healthcare
• sensors

• Humans
• Wearable Electronic Devices
• Monitoring, Physiologic/instrumentation
• Monitoring, Physiologic/methods
• Biosensing Techniques/instrumentation
• Monitoring, Ambulatory/instrumentation
• Monitoring, Ambulatory/methods

• 872752 European Union's Horizon 907 2020 programme
• 101017331 European Union's Horizon 907 2020 programme
• SmartHUB project on Medical & Social ICT for Territorial Assistance Fondazione Cassa di 908 Risparmio di Firenze
• Smart Body Area Networks (SmartBAN) Technical Committee, European Telecommunication Standard Institute (ETSI)

• Closed-loop platform
• Continuous operation
• Haptic feedback
• Posture correction
• Robotic surgery training
• Wireless power transfer

• Humans
• Wearable Electronic Devices
• Biosensing Techniques/instrumentation
• Equipment Design
• Touch
• User-Computer Interface
• Feedback, Sensory
• Wireless Technology
• Robotic Surgical Procedures/instrumentation
• Robotics/instrumentation

• feedback
• gait disorders
• haptic technology
• neurologic
• postural balance
• stroke rehabilitation

• sensory augmentation
• sensory substitution
• vestibular hypofunction
• vestibular management
• vestibular rehabilitation
• wearable devices

• Humans
• Gait/physiology
• Foot/physiology
• Walking/physiology
• Mechanical Phenomena
• Leg
• Biomechanical Phenomena

• Cueing
• Festination
• Freezing of gait
• Machine learning
• Movement
• Parkinson’s disease
• Somatosensory
• Vibration
• Wearable

• Humans
• Cues
• Parkinson Disease/diagnosis
• Gait Disorders, Neurologic
• Walking
• Gait/physiology
• Wearable Electronic Devices

• Wellcome Trust
• ISSF 204826/Z/16/Z Wellcome Trust
• EIT Health

• acuity of vibration sensation
• aging
• intensity discrimination
• lifespan
• sensory augmentation

• P30 AG028740 NIA NIH HHS
• R15 HD093086 NICHD NIH HHS
• T32 AG062728 NIA NIH HHS
• National Institutes of Health

• feedback
• foot–floor contact angle
• gait training
• inertial measurement unit
• slip

• Accidental Falls/prevention & control
• Biomechanical Phenomena
• Feasibility Studies
• Feedback
• Gait/physiology
• Humans

• P30 AG024824 NIA NIH HHS
• P30 AG024827 NIA NIH HHS

• Biofeedback, Psychology
• Biomechanical Phenomena
• Cognition
• Foot
• Gait
• Humans
• Wearable Electronic Devices

• ACL
• Change of direction
• Jumping
• Sports
• Wearable

Technological development of motion and posture analyses is rapidly progressing, especially in rehabilitation settings and sport biomechanics. Consequently, clear discrimination among different measurement systems is required to diversify their use as needed. This review aims to resume the currently used motion and posture analysis systems, clarify and suggest the appropriate approaches suitable for specific cases or contexts. The currently gold standard systems of motion analysis, widely used in clinical settings, present several limitations related to marker placement or long procedure time. Fully automated and markerless systems are overcoming these drawbacks for conducting biomechanical studies, especially outside laboratories. Similarly, new posture analysis techniques are emerging, often driven by the need for fast and non-invasive methods to obtain high-precision results. These new technologies have also become effective for children or adolescents with non-specific back pain and postural insufficiencies. The evolutions of these methods aim to standardize measurements and provide manageable tools in clinical practice for the early diagnosis of musculoskeletal pathologies and to monitor daily improvements of each patient. Herein, these devices and their uses are described, providing researchers, clinicians, orthopedics, physical therapists, and sports coaches an effective guide to use new technologies in their practice as instruments of diagnosis, therapy, and prevention.

• Motion capture
• Gait analysis
• Inertial measurement unit
• Wearable devices
• Rasterstereography
• Posture

• Humans
• Walking/physiology
• Wearable Electronic Devices
• Feasibility Studies
• Male
• Female
• Biofeedback, Psychology/instrumentation
• Young Adult
• Knee/physiology
• Adult
• Knee Joint/physiology
• Gait/physiology
• Biomechanical Phenomena

• assessment
• haptic
• neurorehabiliation
• somatosensory
• stroke
• training

The gold standard for objective body posture examination is posturography. Body movements are detected through the use of force platforms that assess static and dynamic balance (conventional posturography). In recent years, new technologies like wearable sensors (mobile posturography) have been applied during complex dynamic activities to diagnose and rehabilitate balance disorders. They are used in healthy people, especially in the aging population, for detecting falls in the older adults, in the rehabilitation of different neurological, osteoarticular, and muscular system diseases, and in vestibular disorders. Mobile devices are portable, lightweight, and less expensive than conventional posturography. The vibrotactile system can consist of an accelerometer (linear acceleration measurement), gyroscopes (angular acceleration measurement), and magnetometers (heading measurement, relative to the Earth’s magnetic field). The sensors may be mounted to the trunk (most often in the lumbar region of the spine, and the pelvis), wrists, arms, sternum, feet, or shins. Some static and dynamic clinical tests have been performed with the use of wearable sensors. Smartphones are widely used as a mobile computing platform and to evaluate the results or monitor the patient during the movement and rehabilitation. There are various mobile applications for smartphone-based balance systems. Future research should focus on validating the sensitivity and reliability of mobile device measurements compared to conventional posturography.

Smartphone based mobile devices are limited to one sensor lumbar level posturography and offer basic clinical evaluation. Single or multi sensor mobile posturography is available from different manufacturers and offers single to multi-level measurements, providing more data and in some instances even performing sophisticated clinical balance tests.

• clinical tests with sensors
• dizziness
• imbalance
• mobile posturography
• older adults
• telephone applications

This present review includes a systematic search for peer-reviewed articles published between March 2009 and March 2020 that evaluated the effects of wearable devices with biofeedback on the biomechanics of running. The included articles did not focus on physiological and metabolic metrics. Articles with patients, animals, orthoses, exoskeletons and virtual reality were not included. Following the PRISMA guidelines, 417 articles were first identified, and nineteen were selected following the removal of duplicates and articles which did not meet the inclusion criteria. Most reviewed articles reported a significant reduction in positive peak acceleration, which was found to be related to tibial stress fractures in running. Some previous studies provided biofeedback aiming to increase stride frequencies. They produced some positive effects on running, as they reduced vertical load in knee and ankle joints and vertical displacement of the body and increased knee flexion. Some other parameters, including contact ground time and speed, were fed back by wearable devices for running. Such devices reduced running time and increased swing phase time. This article reviews challenges in this area and suggests future studies can evaluate the long-term effects in running biomechanics produced by wearable devices with biofeedback.

• biofeedback
• biomechanics
• gait retraining
• performance
• running
• technique
• wearable device

• Biofeedback, Psychology
• Biomechanical Phenomena
• Female
• Gait
• Humans
• Male
• Running
• Wearable Electronic Devices

• gait event detection
• inertial measurement units
• spatiotemporal gait
• step length
• step time

• chronic disease management
• health monitoring
• medical field
• public health
• rehabilitation.
• wearable

• health
• mHealth
• mobile
• monitoring
• older
• self-report
• sensor
• visualization
• wearable

• Aged
• Humans
• Monitoring, Physiologic
• Self Report
• Self-Management
• Smartphone
• Telemedicine

• 1181162 Fondo Nacional de Desarrollo Científico y Tecnológico
• 21180784 Comisión Nacional de Investigación Científica y Tecnológica

• Gait modification
• Knee osteoarthritis
• Wearable sensing and feedback

• balance
• biofeedback
• postural control
• somatosensory integration
• vibrotactile feedback

Progressive gait dysfunction is one of the primary motor symptoms in people with Parkinson’s disease (PD). It is generally expressed as reduced step length and gait speed and as increased variability in step time and step length. People with PD also exhibit stooped posture which disrupts gait and impedes social interaction. The gait and posture impairments are usually resistant to the pharmacological treatment, worsen as the disease progresses, increase the likelihood of falls, and result in higher rates of hospitalization and mortality. These impairments may be caused by perceptual deficiencies (poor spatial awareness and loss of temporal rhythmicity) due to the disruptions in processing intrinsic information related to movement initiation and execution which can result in misperceptions of the actual effort required to perform a desired movement and maintain a stable posture. Consequently, people with PD often depend on external cues during execution of motor tasks. Numerous studies involving open-loop cues have shown improvements in gait and freezing of gait (FoG) in people with PD. However, the benefits of cueing may be limited, since cues are provided in a consistent/rhythmic manner irrespective of how well a person follows them. This limitation can be addressed by providing feedback in real-time to the user about performance (closed-loop cueing) which may help to improve movement patterns. Some studies that used closed-loop cueing observed improvements in gait and posture in PD, but the treadmill-based setup in a laboratory would not be accessible outside of a research setting, and the skills learned may not readily and completely transfer to overground locomotion in the community. Technologies suitable for cueing outside of laboratory environments could facilitate movement practice during daily activities at home or in the community and could strongly reinforce movement patterns and improve clinical outcomes. This narrative review presents an overview of cueing paradigms that have been utilized to improve gait and posture in people with PD and recommends development of closed-loop wearable systems that can be used at home or in the community to improve gait and posture in PD.

• Parkinson’s disease
• cueing
• gait
• posture
• rehabilitation
• wearable sensors

• Aged
• Cognition/physiology
• Gait/physiology
• Gait Disorders, Neurologic/physiopathology
• Gait Disorders, Neurologic/rehabilitation
• Humans
• Parkinson Disease/physiopathology
• Parkinson Disease/rehabilitation
• Posture/physiology

• R21 NR017484 NINR NIH HHS
• 1R21NR017484 NIH HHS

Rehabilitation following knee injury or surgery is critical for recovery of function and independence. However, patient non-adherence remains a significant barrier to success. Remote rehabilitation using mobile health (mHealth) technologies have potential for improving adherence to and execution of home exercise. We developed a remote rehabilitation management system combining two wireless inertial measurement units (IMUs) with an interactive mobile application and a web-based clinician portal (interACTION). However, in order to translate interACTION into the clinical setting, it was first necessary to verify the efficacy of measuring knee motion during rehabilitation exercises for physical therapy and determine if visual feedback significantly improves the participant’s ability to perform the exercises correctly. Therefore, the aim of this study was to verify the accuracy of the IMU-based knee angle measurement system during three common physical therapy exercises, quantify the effect of visual feedback on exercise performance, and understand the qualitative experience of the user interface through survey data. A convenience sample of ten healthy control participants were recruited for an IRB-approved protocol. Using the interACTION application in a controlled laboratory environment, participants performed ten repetitions of three knee rehabilitation exercises: heel slides, short arc quadriceps contractions, and sit-to-stand. The heel slide exercise was completed without feedback from the mobile application, then all exercises were performed with visual feedback. Exercises were recorded simultaneously by the IMU motion tracking sensors and a video-based motion tracking system. Validation showed moderate to good agreement between the two systems for all exercises and accuracy was within three degrees. Based on custom usability survey results, interACTION was well received. Overall, this study demonstrated the potential of interACTION to measure range of motion during rehabilitation exercises for physical therapy and visual feedback significantly improved the participant’s ability to perform the exercises correctly.

• inertial measurement units
• knee
• mHealth
• mobile health
• physical therapy
• rehabilitation

Wearables consist of numerous technologies that are worn on the body and measure parameters such as step count, distance travelled, heart rate and sleep quantity. Recently, various wearable systems have been designed capable of detecting spinal posture and providing live biofeedback when poor posture is sustained. It is hypothesised that long-term use of these wearables may improve spinal posture.

To (1) examine the capabilities of current devices assessing spine posture, (2) to identify studies implementing such devices in the clinical setting and (3) comment on the clinical practicality of integration of such devices into routine care where appropriate.

A comprehensive systematic review was conducted in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) across the following databases: PubMed; MEDLINE; EMBASE; Cochrane; and Scopus. Articles related to wearables systems able to measure spinal posture were selected amongst all published studies dated from 1980 onwards. Extracted data was collected as per a predetermined checklist including device types, study objectives, findings and limitations.

A total of 37 articles were extensively reviewed and analysed in the final review. The proposed wearables most commonly used Inertial Measurement Units (IMUs) as the underlying technology. Wearables measuring spinal posture have been proposed to be used in the following settings: post-operative rehabilitation; treatment of musculoskeletal disorders; diagnosis of pathological spinal posture; monitoring of progression of Parkinson’s Disease; detection of falls; workplace occupational health and safety; comparison of interventions.

This is the first and only study to specifically review wearable devices that monitor spinal posture. Our findings suggest that currently available devices are capable of assessing spinal posture with good accuracy in the clinical setting. However, further validation regarding the long-term use of these technologies and improvements regarding practicality is required for commercialisation.

• Patient outcomes
• Postural assessment
• Spine posture
• Wearable technology

Gait retraining interventions using real-time biofeedback have been proposed to alter the loading across the knee joint in patients with knee osteoarthritis. Despite the demonstrated benefits of these conservative treatments, their clinical adoption is currently obstructed by the high complexity, spatial demands, and cost of optical motion capture systems. In this study we propose and evaluate a wearable visual feedback system for gait retraining of the foot progression angle (FPA).

The primary components of the system are inertial measurement units, which track the human movement without spatial limitations, and an augmented reality headset used to project the visual feedback in the visual field. The adapted gait protocol contained five different target angles ranging from 15 degrees toe-out to 5 degrees toe-in. Eleven healthy participants walked on an instrumented treadmill, and the protocol was performed using both an established laboratory visual feedback driven by optical motion capture, and the proposed wearable system.

The wearable system tracked FPA with an accuracy of 2.4 degrees RMS and ICC=0.94 across all target angles and subjects, when compared to an optical motion capture reference. In addition, the effectiveness of the biofeedback, reflected by the number of steps with FPA value ±2 degrees from the target, was found to be around 50% in both wearable and laboratory approaches. These findings demonstrate that retraining of the FPA using wearable inertial sensing and visual feedback is feasible with effectiveness matching closely an established laboratory method. The proposed wearable setup may reduce the complexity of gait retraining applications and facilitate their transfer to routine clinical practice.

• Augmented reality headset
• Foot progression angle
• Gait retraining
• Inertial sensors
• Knee osteoarthritis
• Real-time biofeedback

• Elderly
• Feedback
• Gait
• Incomplete spinal cord injury
• Inertial measurement units
• Rehabilitation
• Stroke
• Therapy
• Wearable sensor

• Adult
• Aged
• Aged, 80 and over
• Biomechanical Phenomena
• Feedback, Sensory/physiology
• Female
• Gait Disorders, Neurologic/etiology
• Gait Disorders, Neurologic/rehabilitation
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Shoes
• Spinal Cord Injuries/complications
• Spinal Cord Injuries/rehabilitation
• Stroke Rehabilitation/instrumentation
• Stroke Rehabilitation/methods
• Walking/physiology
• Wearable Electronic Devices

• Bundesministerium für Wirtschaft und Energie