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Date Presented 03/28/20 This study compared reliability recordings of shoulder ranges of motion using goniometer and VR methods. The results of this study demonstrate that the use of VR can be a reliable clinical tool equal or superior to goniometer methods currently used for examinations. These results have implications for OT curricular changes in the future. Primary Author and Speaker: Kimberly Putnam Additional Authors and Speakers: Danielle Ruotolo Contributing Authors: Kimber-Leigh Burkhart, Connor Sheridan, Patrick Carley

The purpose of this research study is to compare the reliability of measuring active cervical range of motion performed with the universal goniometer with an FDA approved XRHealth virtual reality computer program and the Oculus Rift. Methods: The design of the study is a single-blinded randomized controlled study. A sample size of 40 adults was recruited via email, posters, and person to person recruitment. The sample was comprised of males and females, ages 20 to 72-year-old. Equipment included a large universal goniometer with 12-inch arms and a covered full circle plastic body, oculus rift with a computer, VR Health System, chair with arms and a gait belt to control for trunk movements. All four investigators underwent a training session in the measurement of cervical range of motion utilizing a universal goniometer. Each participant was measured with each tool twice. Results: Virtual reality demonstrated a statistically significant difference from the standard goniometer methods at a 99% confidence level (p=0.01). Both tools (goniometer and virtual reality) were found to have good to excellent inter-rater reliability. Conclusion: This study suggests a virtual reality method can be used as a reliable clinical tool in comparison with the universal goniometric cervical active range of motion measurement. Recommendations for future studies should be focused on establishing the validity of virtual reality as an assessment tool using a larger sample size with a wide age range and those who have current cervical discomfort or are experiencing functional limitations in cervical ranges of motion.

Hasbro Games in East Longmeadow, Massachusetts sought to evaluate the impact of their year-long companyinstituted footwear insole program after removing floor mats. The employees subjectively reported reduced aches and pains while standing and working on concrete factory floors with the insoles; but because there was no objective data to substantiate their responses, the actual mechanism influencing the reported reductions in aches and pains remained unknown.Hasbro and the American International College's physical therapy program collaboratively designed a study using electromyography (EMG) to investigate the potential difference in lower leg muscle activity with and without the insoles. Of the several employees who volunteered, 43 were randomly selected to participate in the EMG insole study.All participants reported standing or walking on concrete floors for 60 to 90 percent of their workday.Results of the EMG study disclosed a consistent reduction in lower leg muscle activity for both of the muscle groups using the company-issued polyurethane insoles compared with no insoles. There was a statistically significant reduction for peak and average Medial Gastrocnemius muscle activity and peak Tibialis Anterior with insole trials.While there was a reduction in average Tibialis Anterior muscle activity, the level was not statistically significant.Reducing lower leg muscle activity would have an accumulating beneficial effect for employees throughout daily, weekly, and annual work tasks. The greatest potential may be realized for those engaged in the utilities, transportation, hospitality, and service sectors of the economy.

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