Applying the OMERACT Truth filter to a New Electronic Spinal Mobility Index for Axial Spondyloarthritis Based on Inertial Measurement Unit (IMU) Sensors

Philip Gardiner, Dawn Small, Pedro Machado, Karla Munoz Esquivel, Joan Condell, Juan Luis Garrido-Castro

Research output: Contribution to conferencePoster

Abstract

Background: Loss of spinal mobility is one of the most characteristic problems for people with axial spondyloarthritis (axSpA) and is predictive of loss of function. Traditional measures such as the BASMI fail to capture many elements of spinal mobility and lack responsiveness to change. Inertial Motion Unit (IMU) sensors can be used to accurately measure spinal movement without requiring significant operator expertise.
Objectives: The primary objective of this study was to test the reliability of these new tools in patients with axSpA and to develop a new composite spinal mobility index. Our secondary objective was to apply the OMERACT ‘Truth’ filter to evaluate the new index for bias, for clinical relevance, and for convergent validity with existing measures 
Methods: Patients with axSpA fulfilling ASAS classification criteria were recruited. ViMove system was used to obtain ROM by attaching two IMU sensors at the cervical (Occiput-T3) and lumbar spine (L1-Sacrum). Intra-rater, inter-rater and test-retest reliability of IMU tests were assessed by intraclass correlation coefficients (ICC). The maximum range of movement for anterior flexion/extension (AFE), lateral flexion (Left+Right) and rotation (Left+Right) were obtained for the lumbar and cervical region. These six values were used in a composite score (IMU-ASMI) which referenced equivalent ROM values from normal subjects in an earlier criterion validity study. Pearson correlation coefficients with BASFI were calculated for each component as well as the overall score.
Results: The study included 40 patients (12 females, 28 males) with a mean age of 48 (27-41). Subjects had a wide range of severity of axSpA. The mean BASMI was 4.8 (range 0.7 to 8.2, SD 1.9). The mean IMU-ASMI was 4.0 (range 0.1-9.2, SD 2.1). The sensor based measurements had good to excellent reliability ( Table 1 ) and correlated closely with BASMI (r=0.79). The mean BASFI was 4.6 and the IMU-ASMI correlated closely with BASFI (r=0.71).Face Validity: Each IMU test presents spinal movement in angles and can also be represented as a normalized severity index analogous to BASMI. The mean cervical and lumbar IMU-ASMIs were 3.5 and 4.4 units, respectively.
Construct Validity: Do IMU movements correlate with their corresponding traditional measurements? As expected, the closest correlations were between IMU and goniometer cervical rotation (r=0.85) and between IMU and tape measure lumbar side flexion (r=0.84). Correlations between Schober’s test and IMU lumbar AFE and between tragus to wall and IMU cervical FE were moderate (r=0.62, 0.65).Do IMU movements correlate with BASFI? Correlation coefficients were as follows: lumbar AFE -0.57; rotation -0.59; side flexion -0.45; cervical F/E -0.55; rotation -0.61; side flexion -0.39. BASFI correlations with BASMI were comparable.
Content Validity/Comprehensiveness: No major ceiling or floor bias issues were found in the composite indices. Intermalleolar distance (BASMI) represents hip rather than spinal mobility, but it correlates with BASFI and is not in the IMU-ASMI. IMU-ASMI includes lumbar rotation which accounts for 27% (0-53%) of the lumbar mobility score.Table 1Results of ICC for different IMU spinal mobility testsCervicalLumbarMovementAFELatRotAFELatRotIMU- ASMIIntra-rater0.950.870.970.890.840.760.96Inter-rater0.960.960.980.940.940.770.98Test-retest0.880.960.850.910.940.810.97
Conclusion: IMU sensors can be used by non-experts to accurately and reliably measure spinal mobility in patients with axSpA. Lumbar rotation is an important new outcome measure.
REFERENCES:[1] Tugwell P, et al. J Rheum 2014 41(5):1000-1004
Acknowledgement: This study was funded by FOREUM (www.foreum.org)Disclosure of Interests: Philip Gardiner Grant/research support from: Educational support to attend rheumatology conferences from AbbVie, Abbott, MSD, Novartis, Amgen, Pfizer, Roche, UCB., Speakers bureau: Menarini, Dawn Small Employee of: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Paid instructor for: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Pedro Machado Consultant for: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Speakers bureau: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Karla Munoz Esquivel: None declared, Joan Condell: None declared, Antonio Cuesta-Vargas: None declared, Juan L. Garrido-Castro: None declared

Conference

ConferenceEuropean Congress of Rheumatology of the European League Against Rheumatism 2019
Abbreviated titleEULAR
CountrySpain
CityMADRID
Period12/06/1915/06/19
Internet address

Fingerprint

Reproducibility of Results
Rheum
Lumbosacral Region
Sacrum
Organized Financing
Disclosure
Rheumatology
Consultants
Hip
Reference Values
Spine
Outcome Assessment (Health Care)

Keywords

  • axial spondyloarthritis
  • spinal mobility
  • Inertial Measurement Unit (IMU) sensors
  • reliability
  • accuracy

Cite this

Gardiner, P., Small, D., Machado, P., Munoz Esquivel, K., Condell, J., & Garrido-Castro, J. L. (2019). Applying the OMERACT Truth filter to a New Electronic Spinal Mobility Index for Axial Spondyloarthritis Based on Inertial Measurement Unit (IMU) Sensors. SAT 0659. Poster session presented at European Congress of Rheumatology of the European League Against Rheumatism 2019, MADRID, Spain.
Gardiner, Philip ; Small, Dawn ; Machado, Pedro ; Munoz Esquivel, Karla ; Condell, Joan ; Garrido-Castro, Juan Luis. / Applying the OMERACT Truth filter to a New Electronic Spinal Mobility Index for Axial Spondyloarthritis Based on Inertial Measurement Unit (IMU) Sensors. Poster session presented at European Congress of Rheumatology of the European League Against Rheumatism 2019, MADRID, Spain.
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abstract = "Background: Loss of spinal mobility is one of the most characteristic problems for people with axial spondyloarthritis (axSpA) and is predictive of loss of function. Traditional measures such as the BASMI fail to capture many elements of spinal mobility and lack responsiveness to change. Inertial Motion Unit (IMU) sensors can be used to accurately measure spinal movement without requiring significant operator expertise.Objectives: The primary objective of this study was to test the reliability of these new tools in patients with axSpA and to develop a new composite spinal mobility index. Our secondary objective was to apply the OMERACT ‘Truth’ filter to evaluate the new index for bias, for clinical relevance, and for convergent validity with existing measures Methods: Patients with axSpA fulfilling ASAS classification criteria were recruited. ViMove system was used to obtain ROM by attaching two IMU sensors at the cervical (Occiput-T3) and lumbar spine (L1-Sacrum). Intra-rater, inter-rater and test-retest reliability of IMU tests were assessed by intraclass correlation coefficients (ICC). The maximum range of movement for anterior flexion/extension (AFE), lateral flexion (Left+Right) and rotation (Left+Right) were obtained for the lumbar and cervical region. These six values were used in a composite score (IMU-ASMI) which referenced equivalent ROM values from normal subjects in an earlier criterion validity study. Pearson correlation coefficients with BASFI were calculated for each component as well as the overall score.Results: The study included 40 patients (12 females, 28 males) with a mean age of 48 (27-41). Subjects had a wide range of severity of axSpA. The mean BASMI was 4.8 (range 0.7 to 8.2, SD 1.9). The mean IMU-ASMI was 4.0 (range 0.1-9.2, SD 2.1). The sensor based measurements had good to excellent reliability ( Table 1 ) and correlated closely with BASMI (r=0.79). The mean BASFI was 4.6 and the IMU-ASMI correlated closely with BASFI (r=0.71).Face Validity: Each IMU test presents spinal movement in angles and can also be represented as a normalized severity index analogous to BASMI. The mean cervical and lumbar IMU-ASMIs were 3.5 and 4.4 units, respectively.Construct Validity: Do IMU movements correlate with their corresponding traditional measurements? As expected, the closest correlations were between IMU and goniometer cervical rotation (r=0.85) and between IMU and tape measure lumbar side flexion (r=0.84). Correlations between Schober’s test and IMU lumbar AFE and between tragus to wall and IMU cervical FE were moderate (r=0.62, 0.65).Do IMU movements correlate with BASFI? Correlation coefficients were as follows: lumbar AFE -0.57; rotation -0.59; side flexion -0.45; cervical F/E -0.55; rotation -0.61; side flexion -0.39. BASFI correlations with BASMI were comparable.Content Validity/Comprehensiveness: No major ceiling or floor bias issues were found in the composite indices. Intermalleolar distance (BASMI) represents hip rather than spinal mobility, but it correlates with BASFI and is not in the IMU-ASMI. IMU-ASMI includes lumbar rotation which accounts for 27{\%} (0-53{\%}) of the lumbar mobility score.Table 1Results of ICC for different IMU spinal mobility testsCervicalLumbarMovementAFELatRotAFELatRotIMU- ASMIIntra-rater0.950.870.970.890.840.760.96Inter-rater0.960.960.980.940.940.770.98Test-retest0.880.960.850.910.940.810.97Conclusion: IMU sensors can be used by non-experts to accurately and reliably measure spinal mobility in patients with axSpA. Lumbar rotation is an important new outcome measure.REFERENCES:[1] Tugwell P, et al. J Rheum 2014 41(5):1000-1004Acknowledgement: This study was funded by FOREUM (www.foreum.org)Disclosure of Interests: Philip Gardiner Grant/research support from: Educational support to attend rheumatology conferences from AbbVie, Abbott, MSD, Novartis, Amgen, Pfizer, Roche, UCB., Speakers bureau: Menarini, Dawn Small Employee of: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Paid instructor for: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Pedro Machado Consultant for: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Speakers bureau: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Karla Munoz Esquivel: None declared, Joan Condell: None declared, Antonio Cuesta-Vargas: None declared, Juan L. Garrido-Castro: None declared",
keywords = "axial spondyloarthritis, spinal mobility, Inertial Measurement Unit (IMU) sensors, reliability, accuracy",
author = "Philip Gardiner and Dawn Small and Pedro Machado and {Munoz Esquivel}, Karla and Joan Condell and Garrido-Castro, {Juan Luis}",
year = "2019",
month = "6",
day = "15",
language = "English",
pages = "SAT 0659",
note = "European Congress of Rheumatology of the European League Against Rheumatism 2019, EULAR ; Conference date: 12-06-2019 Through 15-06-2019",
url = "https://2019-meeting.com/eular/",

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Gardiner, P, Small, D, Machado, P, Munoz Esquivel, K, Condell, J & Garrido-Castro, JL 2019, 'Applying the OMERACT Truth filter to a New Electronic Spinal Mobility Index for Axial Spondyloarthritis Based on Inertial Measurement Unit (IMU) Sensors' European Congress of Rheumatology of the European League Against Rheumatism 2019, MADRID, Spain, 12/06/19 - 15/06/19, pp. SAT 0659.

Applying the OMERACT Truth filter to a New Electronic Spinal Mobility Index for Axial Spondyloarthritis Based on Inertial Measurement Unit (IMU) Sensors. / Gardiner, Philip; Small, Dawn; Machado, Pedro; Munoz Esquivel, Karla; Condell, Joan; Garrido-Castro, Juan Luis.

2019. SAT 0659 Poster session presented at European Congress of Rheumatology of the European League Against Rheumatism 2019, MADRID, Spain.

Research output: Contribution to conferencePoster

TY - CONF

T1 - Applying the OMERACT Truth filter to a New Electronic Spinal Mobility Index for Axial Spondyloarthritis Based on Inertial Measurement Unit (IMU) Sensors

AU - Gardiner, Philip

AU - Small, Dawn

AU - Machado, Pedro

AU - Munoz Esquivel, Karla

AU - Condell, Joan

AU - Garrido-Castro, Juan Luis

PY - 2019/6/15

Y1 - 2019/6/15

N2 - Background: Loss of spinal mobility is one of the most characteristic problems for people with axial spondyloarthritis (axSpA) and is predictive of loss of function. Traditional measures such as the BASMI fail to capture many elements of spinal mobility and lack responsiveness to change. Inertial Motion Unit (IMU) sensors can be used to accurately measure spinal movement without requiring significant operator expertise.Objectives: The primary objective of this study was to test the reliability of these new tools in patients with axSpA and to develop a new composite spinal mobility index. Our secondary objective was to apply the OMERACT ‘Truth’ filter to evaluate the new index for bias, for clinical relevance, and for convergent validity with existing measures Methods: Patients with axSpA fulfilling ASAS classification criteria were recruited. ViMove system was used to obtain ROM by attaching two IMU sensors at the cervical (Occiput-T3) and lumbar spine (L1-Sacrum). Intra-rater, inter-rater and test-retest reliability of IMU tests were assessed by intraclass correlation coefficients (ICC). The maximum range of movement for anterior flexion/extension (AFE), lateral flexion (Left+Right) and rotation (Left+Right) were obtained for the lumbar and cervical region. These six values were used in a composite score (IMU-ASMI) which referenced equivalent ROM values from normal subjects in an earlier criterion validity study. Pearson correlation coefficients with BASFI were calculated for each component as well as the overall score.Results: The study included 40 patients (12 females, 28 males) with a mean age of 48 (27-41). Subjects had a wide range of severity of axSpA. The mean BASMI was 4.8 (range 0.7 to 8.2, SD 1.9). The mean IMU-ASMI was 4.0 (range 0.1-9.2, SD 2.1). The sensor based measurements had good to excellent reliability ( Table 1 ) and correlated closely with BASMI (r=0.79). The mean BASFI was 4.6 and the IMU-ASMI correlated closely with BASFI (r=0.71).Face Validity: Each IMU test presents spinal movement in angles and can also be represented as a normalized severity index analogous to BASMI. The mean cervical and lumbar IMU-ASMIs were 3.5 and 4.4 units, respectively.Construct Validity: Do IMU movements correlate with their corresponding traditional measurements? As expected, the closest correlations were between IMU and goniometer cervical rotation (r=0.85) and between IMU and tape measure lumbar side flexion (r=0.84). Correlations between Schober’s test and IMU lumbar AFE and between tragus to wall and IMU cervical FE were moderate (r=0.62, 0.65).Do IMU movements correlate with BASFI? Correlation coefficients were as follows: lumbar AFE -0.57; rotation -0.59; side flexion -0.45; cervical F/E -0.55; rotation -0.61; side flexion -0.39. BASFI correlations with BASMI were comparable.Content Validity/Comprehensiveness: No major ceiling or floor bias issues were found in the composite indices. Intermalleolar distance (BASMI) represents hip rather than spinal mobility, but it correlates with BASFI and is not in the IMU-ASMI. IMU-ASMI includes lumbar rotation which accounts for 27% (0-53%) of the lumbar mobility score.Table 1Results of ICC for different IMU spinal mobility testsCervicalLumbarMovementAFELatRotAFELatRotIMU- ASMIIntra-rater0.950.870.970.890.840.760.96Inter-rater0.960.960.980.940.940.770.98Test-retest0.880.960.850.910.940.810.97Conclusion: IMU sensors can be used by non-experts to accurately and reliably measure spinal mobility in patients with axSpA. Lumbar rotation is an important new outcome measure.REFERENCES:[1] Tugwell P, et al. J Rheum 2014 41(5):1000-1004Acknowledgement: This study was funded by FOREUM (www.foreum.org)Disclosure of Interests: Philip Gardiner Grant/research support from: Educational support to attend rheumatology conferences from AbbVie, Abbott, MSD, Novartis, Amgen, Pfizer, Roche, UCB., Speakers bureau: Menarini, Dawn Small Employee of: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Paid instructor for: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Pedro Machado Consultant for: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Speakers bureau: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Karla Munoz Esquivel: None declared, Joan Condell: None declared, Antonio Cuesta-Vargas: None declared, Juan L. Garrido-Castro: None declared

AB - Background: Loss of spinal mobility is one of the most characteristic problems for people with axial spondyloarthritis (axSpA) and is predictive of loss of function. Traditional measures such as the BASMI fail to capture many elements of spinal mobility and lack responsiveness to change. Inertial Motion Unit (IMU) sensors can be used to accurately measure spinal movement without requiring significant operator expertise.Objectives: The primary objective of this study was to test the reliability of these new tools in patients with axSpA and to develop a new composite spinal mobility index. Our secondary objective was to apply the OMERACT ‘Truth’ filter to evaluate the new index for bias, for clinical relevance, and for convergent validity with existing measures Methods: Patients with axSpA fulfilling ASAS classification criteria were recruited. ViMove system was used to obtain ROM by attaching two IMU sensors at the cervical (Occiput-T3) and lumbar spine (L1-Sacrum). Intra-rater, inter-rater and test-retest reliability of IMU tests were assessed by intraclass correlation coefficients (ICC). The maximum range of movement for anterior flexion/extension (AFE), lateral flexion (Left+Right) and rotation (Left+Right) were obtained for the lumbar and cervical region. These six values were used in a composite score (IMU-ASMI) which referenced equivalent ROM values from normal subjects in an earlier criterion validity study. Pearson correlation coefficients with BASFI were calculated for each component as well as the overall score.Results: The study included 40 patients (12 females, 28 males) with a mean age of 48 (27-41). Subjects had a wide range of severity of axSpA. The mean BASMI was 4.8 (range 0.7 to 8.2, SD 1.9). The mean IMU-ASMI was 4.0 (range 0.1-9.2, SD 2.1). The sensor based measurements had good to excellent reliability ( Table 1 ) and correlated closely with BASMI (r=0.79). The mean BASFI was 4.6 and the IMU-ASMI correlated closely with BASFI (r=0.71).Face Validity: Each IMU test presents spinal movement in angles and can also be represented as a normalized severity index analogous to BASMI. The mean cervical and lumbar IMU-ASMIs were 3.5 and 4.4 units, respectively.Construct Validity: Do IMU movements correlate with their corresponding traditional measurements? As expected, the closest correlations were between IMU and goniometer cervical rotation (r=0.85) and between IMU and tape measure lumbar side flexion (r=0.84). Correlations between Schober’s test and IMU lumbar AFE and between tragus to wall and IMU cervical FE were moderate (r=0.62, 0.65).Do IMU movements correlate with BASFI? Correlation coefficients were as follows: lumbar AFE -0.57; rotation -0.59; side flexion -0.45; cervical F/E -0.55; rotation -0.61; side flexion -0.39. BASFI correlations with BASMI were comparable.Content Validity/Comprehensiveness: No major ceiling or floor bias issues were found in the composite indices. Intermalleolar distance (BASMI) represents hip rather than spinal mobility, but it correlates with BASFI and is not in the IMU-ASMI. IMU-ASMI includes lumbar rotation which accounts for 27% (0-53%) of the lumbar mobility score.Table 1Results of ICC for different IMU spinal mobility testsCervicalLumbarMovementAFELatRotAFELatRotIMU- ASMIIntra-rater0.950.870.970.890.840.760.96Inter-rater0.960.960.980.940.940.770.98Test-retest0.880.960.850.910.940.810.97Conclusion: IMU sensors can be used by non-experts to accurately and reliably measure spinal mobility in patients with axSpA. Lumbar rotation is an important new outcome measure.REFERENCES:[1] Tugwell P, et al. J Rheum 2014 41(5):1000-1004Acknowledgement: This study was funded by FOREUM (www.foreum.org)Disclosure of Interests: Philip Gardiner Grant/research support from: Educational support to attend rheumatology conferences from AbbVie, Abbott, MSD, Novartis, Amgen, Pfizer, Roche, UCB., Speakers bureau: Menarini, Dawn Small Employee of: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Paid instructor for: Medical representative - Farmitalia Carlo Erba, Pharmacia, Pharmacia & Upjohn, Yamanouchi/Astellas., Pedro Machado Consultant for: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Speakers bureau: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Karla Munoz Esquivel: None declared, Joan Condell: None declared, Antonio Cuesta-Vargas: None declared, Juan L. Garrido-Castro: None declared

KW - axial spondyloarthritis

KW - spinal mobility

KW - Inertial Measurement Unit (IMU) sensors

KW - reliability

KW - accuracy

UR - http://scientific.sparx-ip.net/archiveeular/?c=a&searchfor=%20philip%20gardiner&view=1&item=2019SAT0659

M3 - Poster

SP - SAT 0659

ER -

Gardiner P, Small D, Machado P, Munoz Esquivel K, Condell J, Garrido-Castro JL. Applying the OMERACT Truth filter to a New Electronic Spinal Mobility Index for Axial Spondyloarthritis Based on Inertial Measurement Unit (IMU) Sensors. 2019. Poster session presented at European Congress of Rheumatology of the European League Against Rheumatism 2019, MADRID, Spain.