Browsing by Person "Pichonnaz, Claude"

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Enhancing clinically-relevant shoulder function assessment using only essential movements
(2015-03) Pichonnaz, Claude; Lcureux, E.; Bassin, J-P; Duc, C.; Farron, A.; Aminian, K.; Jolles, B. M.; Gleeson, Nigel
Kinematic functional evaluation with body-worn sensors provides discriminative and responsive scores after shoulder surgery, but the optimal movements' combination has not yet been scientifically investigated. The aim of this study was the development of a simplified shoulder function kinematic score including only essential movements. The P Score, a seven-movement kinematic score developed on 31 healthy participants and 35 patients before surgery and at 3, 6 and 12-months after shoulder surgery, served as a reference. Principal component analysis and multiple regression were used to create simplified scoring models. The candidate models were compared to the reference score. ROC curve for shoulder pathology detection and correlations with clinical questionnaires were calculated. The B-B Score (hand to the Back and hand upwards as to change a Bulb) showed no difference to the P Score in time*score interaction (P > .05) and its relation with the reference score was highly linear (R2 > .97). Absolute value of correlations with clinical questionnaires ranged from 0.51 to 0.77. Sensitivity was 97% and specificity 94%. The B-B and reference scores are equivalent for the measurement of group responses. The validated simplified scoring model presents practical advantages that facilitate the objective evaluation of shoulder function in clinical practice.
ENHANCING KINEMATIC SHOULDER FUNCTION EVALUATION THROUGH A VALID, SIMPLE AND CLINICALLY APPLICABLE SCORE
(Queen Margaret University, Edinburgh, 2019) Pichonnaz, Claude
Introduction Controversies surrounding Patient-Reported Outcome Measures (PROMs) and the cumbersome-nature of movement analysis-based (MAB) methods for shoulder function evaluation make the exploration of alternatives needed. Research aimed at the simplification of MAB outcome measures had demonstrated previously that the B-B Score, which relies on two movements only, was valid for out-of-laboratory evaluations of shoulder function. Nevertheless, further investigations were needed to optimise testing procedures, test the B-B Score’s capability of acquisition using a user-friendly device, and critically evaluate its measurement properties in comparison to current methods. Objective The aim of this thesis was to develop and assess the simplest possible MAB shoulder function scoring procedure for clinical measurement. Methods The research included four steps: 1) Optimisation of the B-B Score testing procedure (Phase 1 study [data-driven]), 2) Comparison of measurements using a smartphone or an inertial sensor system (Phase 2 study [data-driven]), 3) Validation in frequentlyoccurring pathologies (rotator cuff conditions, instability, fracture, capsulitis) (Phase 3 study [data-driven]), 4) Benchmarking of the new approach with concurrent MAB outcome measures and PROMs (literature review). Results Amongst the tested methods, the B-B score was optimised by using the mean of three replicates in the computation of the range of accelerations by angular velocities. The comparison of easily-used smartphone and reference device showed non-significant differences and excellent relationships between measurements (Intraclass Correlation Coefficient [ICC=0.97]). The smartphone’s B-B Score intra-rater and inter-rater reliability was excellent (ICC=0.92), but limits of agreement could reach up to ±19.4%. The score was responsive (area under the curve [AUC≥0.70]) and demonstrated excellent discriminative power between patients and controls (AUC≥0.90), except for shoulder instability (AUC=0.67). The correlations with PROMs were moderate to high. The benchmarking established that the measurement properties of the B-B Score compared equivalently with those of PROMs and MAB outcome measures, except for shoulder instability. Conclusion Shoulder function can be efficiently evaluated using a simple scoring procedure performed with a smartphone, which facilitates its objective assessment. Further research is needed to understand how best to reduce the effects of variability associated with single measurements in order to optimise clinical applicability and to explore the B-B Score’s properties in other situations requiring functional assessments of the shoulder. . Keywords: shoulder, shoulder function; outcome assessment; validation studies, reliability and validity; inertial sensors; smartphone sensors; body-worn sensors; kinematics; sensitivity and specificity.
Heightened clinical utility of smartphone versus body-worn inertial system for shoulder function B-B score
(PLOS, 2017-03-20) Nordez, Antoine; Pichonnaz, Claude; Aminian, Kamiar; Ancey, Cline; Jaccard, Herv; Lcureux, Estelle; Duc, Cyntia; Farron, Alain; Jolles, Brigitte M.; Gleeson, Nigel
Background The B-B Score is a straightforward kinematic shoulder function score including only two movements (hand to the Back + lift hand as to change a Bulb) that demonstrated sound measurement properties for patients for various shoulder pathologies. However, the B-B Score results using a smartphone or a reference system have not yet been compared. Provided that the measurement properties are comparable, the use of a smartphone would offer substantial practical advantages. This study investigated the concurrent validity of a smartphone and a reference inertial system for the measurement of the kinematic shoulder function B-B Score. Methods Sixty-five patients with shoulder conditions (with rotator cuff conditions, adhesive capsulitis and proximal humerus fracture) and 20 healthy participants were evaluated using a smartphone and a reference inertial system. Measurements were performed twice, alternating between two evaluators. The B-B Score differences between groups, differences between devices, relationship between devices, intra- and inter-evaluator reproducibility were analysed. Results The smartphone mean scores (SD) were 94.1 (11.1) for controls and 54.1 (18.3) for patients (P < 0.01). The difference between devices was non-significant for the control (P = 0.16) and the patient group (P = 0.81). The analysis of the relationship between devices showed 0.97 ICC, -0.6 bias and -13.2 to 12.0 limits of agreement (LOA). The smartphone intra-evaluator ICC was 0.92, the bias 1.5 and the LOA -17.4 to 20.3. The smartphone inter-evaluator ICC was 0.92, the bias 1.5 and the LOA -16.9 to 20.0. Conclusions The B-B Score results measured with a smartphone were comparable to those of an inertial system. While single measurements diverged in some cases, the intra- and inter-evaluator reproducibility was excellent and was equivalent between devices. The B-B score measured with a smartphone is straightforward and as efficient as a reference inertial system measurement.