Inertial and magnetic measurement systems (IMMSs) are a new generation of motion analysis systems which may diffuse the measurement of upper-limb kinematics to ambulatory settings. Based on the MT9B IMMS (Xsens Technologies, NL), we therefore developed a protocol that measures the scapulothoracic, humerothoracic and elbow 3D kinematics. To preliminarily evaluate the protocol, a 23-year-old subject performed six tasks involving shoulder and elbow single-joint-angle movements. Criteria for protocol validity were limited cross-talk with the other joint-angles during each task; scapulohumeral-rhythm close to literature results; and constant carrying-angle. To assess the accuracy of the MT9B when measuring the upper-limb kinematics through the protocol, we compared the MT9B estimations during the six tasks, plus other four, with the estimations of an optoelectronic system (the gold standard), in terms of RMS error, correlation coefficient (r), and the amplitude ratio (m). Results indicate that the criteria for protocol validity were met for all tasks. For the joint angles mainly involved in each movement, the MT9B estimations presented RMS errors <3.6 degrees , r > 0.99 and 0.9 < m < 1.09. It appears therefore that (1) the protocol in combination with the MT9B is valid for, and (2) the MT9B in combination with the protocol is accurate when, measuring shoulder and elbow kinematics, during the tasks tested, in ambulatory settings.

The analysis of the joint kinematics during swimming plays a fundamental role both in sports conditioning and in clinical contexts. Contrary to the traditional video analysis, wearable inertial-magnetic measurements units (IMMUs) allow to analyse both the underwater and aerial phases of the swimming stroke over the whole length of the swimming pool. Furthermore, the rapid calibration and short data processing required by IMMUs provide coaches and athletes with an immediate feedback on swimming kinematics during training. This study aimed to develop a protocol to assess the three-dimensional kinematics of the upper limbs during swimming using IMMUs. Kinematics were evaluated during simulated dry-land swimming trials performed in the laboratory by eight swimmers. A stereo-photogrammetric system was used as the gold standard. The results showed high coefficient of multiple correlation (CMC) values, with median (first-third quartile) of 0.97 (0.93-0.95) and 0.99 (0.97-0.99) for simulated front-crawl and breaststroke, respectively. Furthermore, the joint angles were estimated with an accuracy increasing from distal to proximal joints, with wrist indices showing median CMC values always higher than 0.90. The present findings represent an important step towards the practical use of technology based on IMMUs for the kinematic analysis of swimming in applied contexts.

Walking is one of the fundamental motor tasks executed during aquatic therapy. Previous kinematics analyses conducted using waterproofed video cameras were limited to the sagittal plane and to only one or two consecutive steps. Furthermore, the set-up and post-processing are time-consuming and thus do not allow a prompt assessment of the correct execution of the movements during the aquatic session therapy. The aim of the present study was to estimate the 3D joint kinematics of the lower limbs and thorax-pelvis joints in sagittal and frontal planes during underwater walking using wearable inertial and magnetic sensors. Eleven healthy adults were measured during walking both in shallow water and in dry-land conditions. Eight wearable inertial and magnetic sensors were inserted in waterproofed boxes and fixed to the body segments by means of elastic modular bands. A validated protocol (Outwalk) was used. Gait cycles were automatically segmented and selected if relevant intraclass correlation coefficients values were higher than 0.75. A total of 704 gait cycles for the lower limb joints were normalized in time and averaged to obtain the mean cycle of each joint, among participants. The mean speed in water was 40% lower than that of the dry-land condition. Longer stride duration and shorter stride distance were found in the underwater walking. In the sagittal plane, the knee was more flexed (≈ 23°) and the ankle more dorsiflexed (≈ 9°) at heel strike, and the hip was more flexed at toe-off (≈ 13°) in water than on land. On the frontal plane in the underwater walking, smoother joint angle patterns were observed for thorax-pelvis and hip, and ankle was more inversed at toe-off (≈ 7°) and showed a more inversed mean value (≈ 7°). The results were mainly explained by the effect of the speed in the water as supported by the linear mixed models analysis performed. Thus, it seemed that the combination of speed and environment triggered modifications in the joint angles in underwater gait more than these two factors considered separately. The inertial and magnetic sensors, by means of fast set-up and data analysis, can supply an immediate gait analysis report to the therapist during the aquatic therapy session.

The aims of the present study were the instrumental validation of inertial-magnetic measurements units (IMMUs) in water, and the description of their use in clinical and sports aquatic applications applying customized 3D multi-body models. Firstly, several tests were performed to map the magnetic field in the swimming pool and to identify the best volume for experimental test acquisition with a mean dynamic orientation error lower than 5°. Successively, the gait and the swimming analyses were explored in terms of spatiotemporal and joint kinematics variables. The extraction of only spatiotemporal parameters highlighted several critical issues and the joint kinematic information has shown to be an added value for both rehabilitative and sport training purposes. Furthermore, 3D joint kinematics applied using the IMMUs provided similar quantitative information than that of more expensive and bulky systems but with a simpler and faster setup preparation, a lower time consuming processing phase, as well as the possibility to record and analyze a higher number of strides/strokes without limitations imposed by the cameras.

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