Quantification of agility testing with inertial sensors after a knee injury

Abstract

Introduction A common criterion in decision making regarding return to sport (RTS) after knee ligament injury is that athletes should achieve symmetrical bilateral movement between the injured limb and the noninjured limb. Body-worn wireless inertial measurement units (IMU) can provide clinicians with valuable information about lower-limb kinematics and athletic performance. Methods The IMU-based novel kinematic metrics were developed. The Transitional Angular Displacement of Segment (TADS) and Symmetry Index (SI) measures that quantify lower-limb motions and interlimb symmetry during the 4-m side step test (FmSST) were developed. Test-retest reliability was measured in 20 healthy adults. Experimental application of the metrics was also determined in 15 National Collegiate Athletic Association Division I collegiate athletes who completed rehabilitation after a knee ligament injury. Results The intraclass correlation coefficient for test-retest reliability for FmSST, TADS right lower limb, TADS left lower limb, and TADS SI was 0.90 (95% confidence interval, [0.61-0.95]); 0.87 [0.63-0.96]; 0.89 [0.64-0.96], and 0.81 [0.58-0.92], respectively. The differences between TADS SI at baseline (preinjury) and RTS were also compared with those between the total times for performing the FmSST at baseline and RTS. There was no significant difference in the FmSST times between baseline and RTS (P = 0.32); however, TADS SI at the time of RTS was significantly lower than at baseline (P = 0.046). A large effect size (d = -1.04) was observed for the change in TADS SI from baseline to RTS. Conclusions Using IMU sensor technology can provide quantitative and discrete analysis to detect kinematic differences during agility after a knee ligament injury in the field or nonlaboratory setting. This approach has the potential to help clinicians improve decisions about rehabilitation at a time when an athlete is reintegrating back into sport.