Can shoulder range of movement be measured accurately using the Microsoft Kinect sensor plus Medical Interactive Recovery Assistant (MIRA) software?

Background:: This study compared the accuracy of measuring shoulder range of movement (ROM) with a simple laptop-sensor combination vs. trained observers (shoulder physiotherapists and shoulder surgeons) using motion capture (MoCap) laboratory equipment as the gold standard. Methods: The Microsoft Kinect sensor (Microsoft Corp., Redmond, WA, USA) tracks 3-dimensional human motion. Ordinarily used with an Xbox (Microsoft Corp.) video game console, Medical Interactive Recovery Assistant (MIRA) software (MIRA Rehab Ltd., London, UK) allows this small sensor to measure shoulder movement with a standard computer. Shoulder movements of 49 healthy volunteers were simultaneously measured by trained observers, MoCap, and the MIRA device. Internal rotation was assessed with the shoulder abducted 90 degrees and external rotation with the shoulder adducted. Visual estimation and MIRA measurements were compared with gold standard MoCap measurements for agreement using Bland-Altman methods. Results: There were 1670 measurements analyzed. The MIRA evaluations of all 4 cardinal shoulder movements were significantly more precise, with narrower limits of agreement, than the measurements of trained observers. MIRA achieved +/- 11 degrees (95% confidence interval [CI], 8.7 degrees-12.6 degrees) for forward flexion vs. +/- 16 degrees (95% CI, 14.6 degrees-17.6 degrees) by trained observers. For abduction, MIRA showed +/- 11 degrees (95% CI, 8.7 degrees-12.8 degrees) against +/- 15 degrees (95% CI, 13.4 degrees-16.2 degrees) for trained observers. MIRA attained +/- 10 degrees (95% CI, 8.1 degrees-11.9 degrees) during external rotation measurement, whereas trained observers only reached +/- 21 degrees (95% CI, 18.7 degrees-22.6 degrees). For internal rotation, MIRA achieved +/- 9 degrees (95% CI, 7.2 degrees-10.4 degrees), which was again better than TOs at +/- 18 degrees (95% CI, 16.0 degrees-19.3 degrees). Conclusions: A laptop combined with a Microsoft Kinect sensor and the MIRA software can measure shoulder movements with acceptable levels of accuracy. This technology, which can be easily set up, may also allow precise shoulder ROM measurement outside the clinic setting. (C) 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.