Accuracy and repeatability of smartphone sensors for measuring shank-to-vertical angle

Abstract

Background: Assessments of human movement are clinically important. However, accurate measurements are often unavailable due to the need for expensive equipment or intensive processing. For orthotists and therapists, shank-to-vertical angle is one critical measure used to assess gait and guide prescriptions. Smartphone-based sensors may provide a widely available platform to expand access to this measurement. Objectives: Assess accuracy and repeatability of smartphone-based measurement of shank-to-vertical angle compared to marker-based 3D motion analysis. Study design: Repeated-measures. Methods: Four licensed clinicians (two physical therapists and two orthotists) measured shank-to-vertical angle during gait with a smartphone attached to the anterior or lateral shank surface of unimpaired adults. We compared the shank-to-vertical angle calculated from the smartphone’s inertial measurement unit to marker-based measurements. Each clinician completed three sessions/day on two days with each participant to assess repeatability. Results: Average absolute differences in shank-to-vertical angle measured with a smartphone versus marker-based 3D motion analysis during gait were 0.67 ± 0.25° and 4.89 ± 0.72°, with anterior or lateral smartphone positions, respectively. The inter- and intra-day repeatability of shank-to-vertical angle were within 2° for both smartphone positions. Conclusions: Smartphone sensors can be used to measure shank-to-vertical angle with high accuracy and repeatability during unimpaired gait, providing a widely available tool for quantitative gait assessments. Clinical relevance Smartphone sensors demonstrated high accuracy and repeatability for monitoring shank-to-vertical angle during gait. Measurement of shank-to-vertical angle from the front of the shank was more accurate than the side of the shank. Smartphones may expand access to quantitative assessments of gait.