Validating the Monitored Augmented Rehabilitation System (MARS) for Pediatric Shoulder and Elbow Range of Motion Assessment

Research Objectives: To assess the validity of the Monitored Augmented Rehabilitation System (MARS) device to measure shoulder and elbow range of motion (ROM).

Design: Criterion standard.

Setting: Sports medicine research laboratory.

Participants: Physically active children were recruited as a volunteer sample.

Interventions: A validation study was conducted to assess the agreement between the MARS technology for ROM measurement and a clinically validated kinematic analysis software platform. Participants executed specific upper body movements while commercially available motion-sensor cameras captured ROM data in frontal and sagittal planes. Validity was assessed using frontal plane abduction (SH-ABD) and sagittal plane flexion (SH-FLX), while elbow flexion (EL-FLX) ROM was assessed in both frontal and sagittal planes.

Main Outcome Measures: The root mean square error (RMSE) served as the primary metric to evaluation deviations of the new technology’s measurements from the criterion standard.

Results: A total of 2,770 measurements were taken for 37 participants (11.2 ± 3.0 years) for shoulder and elbow movements. The average RMSE for all upper body measures was 6.09 ± 13.8°. Specific RMSE values for each movement were as follows: SH-ABD 3.95 ± 7.3°, frontal plane EL-FLX 5.69 ± 15.6°, SH-FLX 8.94 ± 16.0°, and sagittal plane EL-FLX 9.26 ± 16.6°.

Conclusions: Our findings demonstrate that the MARS device is a valid tool for measuring shoulder ROM in pediatric patients, with shoulder measurements aligning well with established standards. However, elbow measures resulted in a higher RMSE when compared to the typical standard error of measurement (SEM) ranges establish in the literature. The promising validity of the MARS device suggests its potential to enhance orthopaedic assessment practices in the growing telehealth market, particularly for geographically isolated populations or patients who might struggle to access in-person assessments. As telehealth communication gains prominence, the MARS device offers potential for shaping the future direction of orthopedic evaluation.

Author(s) Disclosures: Dr. Sarah Rebstock - As stated previously. Disclosures do not impact presented material.