Purpose Latissimus dorsi tendon transfer is a surgical option for the treatment of massive irreparable posterosuperior rotator cuff tear. Whether a favourable clinical outcome is due to the latissimus dorsi muscle contraction rather than the passive tenodesis effect remains to be confirmed. The purpose of the current case–control study was to evaluate the shoulder kinematics and latissimus dorsi activation after latissimus dorsi tendon transfer. Methods Eighteen patients suffering from irreparable rotator cuff tear that underwent latissimus dorsi tendon transfer and 18 healthy individuals were examined using a 3D kinematic tracking system and electromyography. Active maximal flexion–extension and abduction–adduction of the humerus were measured for the operated and the contralateral shoulder of the patients and the shoulder of healthy individuals to evaluate the range of motion (ROM) and scapulohumeral rhythm. Electromyographic comparison of isometric contraction between the latissimus dorsi of the operated and contralateral shoulder was carried out. Results After arthroscopic‐assisted latissimus dorsi tendon transfer, patients showed comparable flexion and abduction ROM to their asymptomatic contralateral shoulders and to the shoulders of healthy individuals. Significantly higher scapular ROM values were found between the latissimus dorsi tendon transfer side and the shoulders of healthy individuals. While performing external rotation with 0° shoulder abduction, a greater percentage of the electromyographic peak value (p = 0.047) and a higher latissimus dorsi internal/external rotation ratio (p = 0.004) were noted for the transferred muscle in comparison to the contralateral shoulder. Conclusion Although the arthroscopic‐assisted latissimus dorsi tendon transfer failed to normalize scapulothoracic joint movements of patients, a functional latissimus flap and a shoulder ROM similar to the contralateral side or the shoulder of healthy individuals can be expected after this procedure in patients with massive irreparable posterosuperior rotator cuff tear. Level of evidence III.

Purpose: To evaluate the intra and interobserver reproducibility of a new system that assesses the threedimensional humero-scapulo-thoracic kinematics using wearable technology in an outpatient setting. To obtain normative data with the system for scapular angular motions in three planes. Methods: The SHoW Motion 3D kinematic tracking system is a motion analysis system that uses wireless wearable non-invasive inertial-magnetic sensors to assess the three-dimensional kinematics of the shoulder girdle. The sensors are placed over the skin in the sternum, scapular spine and arm to precisely define angular motions of the humerus and the scapula with three Degrees of Freedom (DOF) for each segment. The system was used to measure the scapular angular motions in three planes (upward/downward rotation, internal/external rotation and anterior/posterior tilt) during two shoulder full-range movements (flexion/extension and abduction/abduction) in both shoulders of 25 healthy volunteers (13 males and 12 females, mean age: 37 [standard deviation 11.1] years). In a first measuring session one examiner made two evaluations alternating with another examiner that made a third evaluation. In a second session, one week apart, the first examiner made a fourth evaluation. A mean curve was computed from the normalized data for each measurement to obtain normative data for scapular angular kinematics. Intra and inter-observer reproducibility was evaluated using Root Mean Square Error Estimation (RMSE) and Coefficients for Multiple Correlations (CMC). Results: Both shoulders of the 25 volunteers were evaluated four times. The two hundred resulting kinematic analyses were pooled to get normative values for relations between humeral elevation angles and the three angular movements of the scapula. The system showed at least very good (CMC > 0.90) intra and inter-observer reproducibility for scapular tilt and upward-downward rotations both in flexion and abduction. For scapular internal-external rotation the results were

Serious Games (SGs) represent a new approach to improve learning processes more effectively and economically than traditional methods. This paper aims to present a SG approach for the electro-mobility context, in order to encourage the use of electric light vehicles. The design of the SG is based on the typical elements of the classic "game" with a real gameplay with different purposes. In this work, the proposed SG aims to raise awareness on environmental issues caused by mobility and actively involve users, on improving livability in the city and on real savings using alternative means to traditional vehicles. The objective of the designed tool is to propose elements of fun and entertainment for tourists or users of electric vehicles in the cities, while giving useful information about the benefits of using such vehicles, discovering touristic and interesting places in the city to discover. In this way, the user is stimulated to explore the artistic and historical aspects of the city through an effective learning process: he/she is encouraged to search the origins and the peculiarities of the monuments. A case study in the city of Bari, Italy, shows the application of the proposed SG tool. *This work is a part of the ELVITEN project. ELVITEN has received funding from the European Union's Horizon 2020 research & innovation programme under Grant Agreement no 769926. Content reflects only the authors' view and European Commission is not responsible for any use that may be made of the information it contains.