STATISTICAL VALIDATION FOR CLINICAL MEASURES: REPEATABILITY AND AGREEMENT OF A KINECT BASED SOFTWARE

LOPEZ CELANI, NATALIA MARTINA; PEREZ ELISA; EMANUEL TELLO; ALEJANDRO RODRIGO; MAX E. VALENTINUZZI

BioMed Research International

Hindawi

Lugar: El Cairo; Año: 2018

Background: The rehabilitation process is a fundamental stage for recovery, either partial or full, of people capabilities. However, the evaluation of the process is performed by physiatrists and medical doctors, mostly based on their observations, which become into a subjective appreciation of the patient?s evolution. This paper proposes a tracking platform of the movement made by an individual?s upper limb using Kinect? sensor(s) to be applied for the patient during the rehabilitation process. The main contribution of the present work is the development of quantifying software and the statistical validation of their performance, repeatability and clinical use in the rehabilitation process. Method: The proposed software determines joint angles and upper limb trajectories, for the construction of a specific rehabilitation protocol and quantifies the treatment evolution. In turn, the information is presented via a graphical interface that allows the recording, storage and report of the patient?s data. For clinical purposes the software information is statistical validated with three different methodologies, comparing the measures with a goniometer in terms of agreement and repeatability. Results: The agreement of joint angles measured with the proposed software and goniometer is evaluated with Bland-Altman plots, all measurements fell well within the limits of agreement, meaning interchangeability of both techniques. Additionally, the results of Bland Altman analysis of repeatability show a 95% confidence. Finally, the physiotherapist?s qualitative assessment show that two of them evaluated the software as a trustworthy tool, and the third one considered it as an useful tool but it doesn´t inspire enough confidence to replace the goniometer method completely. Conclusion: The main conclusion is that the software is capable of offering a clinical history of the patient useful for quantification of the rehabilitation success. The simplicity, low-cost and visualization possibilities enhance the use of the software Kinect? for rehabilitation and other applications, and the expert?s opinion endorse the choice of our approach for clinical practice. Comparison of the new measurement technique with established goniometric methods determines that the proposed software agree sufficiently to be used interchangeably.