Wearable motion sensors, specifically, Inertial Measurement Units, are useful tools for the assessment of orientation and movement during sleep. The DOTs platform (Xsens, Enschede, The Netherlands) has shown promise for this purpose. This pilot study aimed to assess its feasibility and validity for recording sleep biomechanics. Feasibility was assessed using four metrics: Drift, Battery Life, Reliability of Recording, and Participant Comfort. Each metric was rated as Stop (least successful), Continue But Modify Protocol, Continue But Monitor Closely, or Continue Without Modifications (most successful). A convenience sample of ten adults slept for one night with a DOT unit attached to their sternum, abdomen, and left and right legs. A survey was administered the following day to assess participant comfort wearing the DOTs. A subset of five participants underwent a single evaluation in a Vicon (Oxford Metrics, England, Oxford) motion analysis lab to assess XSENS DOTs’ validity. With the two systems recording simultaneously, participants were prompted through a series of movements intended to mimic typical sleep biomechanics (rolling over in lying), and the outputs of both systems were compared to assess the level of agreement. The DOT platform performed well on all metrics, with Drift, Battery Life, and Recording Reliability being rated as Continue Without Modifications. Participant Comfort was rated as Continue But Monitor Closely. The DOT Platform demonstrated an extremely high level of agreement with the Vicon motion analysis lab (difference of < 0.025°). Using the Xsens DOT platform to assess sleep biomechanics is feasible and valid in adult populations. Future studies should further investigate the feasibility of using this data capture method for extended periods (e.g., multiple days) and in other groups (e.g., paediatric populations).

Purpose: The assessment of sleep biomechanics (comprising movement and position during sleep) is of interest in a wide variety of clinical and research settings. However, there is no standard method by which sleep biomechanics are measured. This study aimed to (1) compare the intra- and inter-rater reliability of the current clinical standard, manually coded overnight videography, and (2) compare sleep position recorded using overnight videography to sleep position recorded using the XSENS DOT wearable sensor platform. Methods: Ten healthy adult volunteers slept for one night with XSENS DOT units in situ (on their chest, pelvis, and left and right thighs), with three infrared video cameras recording concurrently. Ten clips per participant were edited from the video. Sleeping position in each clip was coded by six experienced allied health professionals using the novel Body Orientation During Sleep (BODS) Framework, comprising 12 sections in a 360-degree circle. Intra-rater reliability was assessed by calculating the differences between the BODS ratings from repeated clips and the percentage who were rated with a maximum of one section of the XSENS DOT value; the same methodology was used to establish the level of agreement between the XSENS DOT and allied health professional ratings of overnight videography. Bennett’s S-Score was used to assess inter-rater reliability. Results: High intra-rater reliability (90% of ratings with maximum difference of one section) and moderate inter-rater reliability (Bennett’s S-Score 0.466 to 0.632) were demonstrated in the BODS ratings. The raters demonstrated high levels of agreement overall with the XSENS DOT platform, with 90% of ratings from allied health raters being within the range of at least 1 section of the BODS (as compared to the corresponding XSENS DOT produced rating). Conclusions: The current clinical standard for assessing sleep biomechanics, manually rated overnight videography (as rated using the BODS Framework) demonstrated acceptable intra- and inter-rater reliability. Further, the XSENS DOT platform demonstrated satisfactory levels of agreement as compared to the current clinical standard, providing confidence for its use in future studies of sleep biomechanics.

AimTo identify the most frequently reported non‐instrumented measures of gait, activity, and participation in children with cerebral palsy (CP) after undergoing gait corrective orthopaedic surgery.MethodFour databases were searched from database inception to the 9th December 2021 for studies that evaluated functional outcomes for children with CP under 18 years undergoing gait corrective orthopaedic surgery.ResultsOf 547 citations, 44 publications (n = 3535 participants, n = 1789 males, mean age 10 years 5 months [SD = 3 years 3 months], Gross Motor Function Classification System levels I–III at the time of surgery) were eligible for inclusion. Fourteen different outcome measures were used: one measure of gait, 10 measures of activity, and three measures of participation. Gait was measured with the Edinburgh Visual Gait Scale (EVGS; 4 out of 44). The most common activity and participation measures were the Functional Mobility Scale (FMS; 15 out of 44) and Pediatric Outcomes Data Collection Instrument (11 out of 44) respectively. No studies reported a combination of gait, activity, and participation measures.InterpretationThe EVGS and FMS should be considered as core outcome measures in gait corrective orthopaedic surgery, while a measure of participation is unclear. Additional considerations for developing a comprehensive suite of outcomes include identifying a combination of clinical measures and performance‐reflective questionnaires that are standardized for children with CP undergoing surgery and meaningful to clinicians and families.