***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Body-worn inertial sensors have enabled motion capture outside of the laboratory setting . In this work , an inertial measurement unit was attached to the upper arm to track and discriminate between shoulder motion gestures in order to help prevent shoulder over-use injuries in athletics through real-time preventative feedback . We present a detection and classification approach that can be used to count the number of times certain motion gestures occur . The application presented involves tracking baseball throws and volleyball serves , which are common overhead movements that can lead to shoulder and elbow overuse injuries . Eleven subjects are recruited to collect training , testing , and r and omized validation data , which include throws , serves , and seven other exercises that serve as a large null class of similar movements , which is analogous to a realistic usage scenario and requires a robust estimator BACKGROUND Variable definitions of outcome ( Constant score , Simple Shoulder Test [ SST ] ) have been used to assess outcome after shoulder treatment , although none has been accepted as the universal st and ard . Physicians lack an objective method to reliably assess the activity of their patients in dynamic conditions . Our purpose was to clinical ly vali date the shoulder kinematic scores given by a portable movement analysis device , using the activities of daily living described in the SST as a reference . The secondary objective was to determine whether this device could be used to document the effectiveness of shoulder treatments ( for glenohumeral osteoarthritis and rotator cuff disease ) and detect early failures . METHODS A clinical trial including 34 patients and a control group of 31 subjects over an observation period of 1 year was set up . Evaluations were made at baseline and 3 , 6 , and 12 months after surgery by 2 independent observers . Miniature sensors ( 3-dimensional gyroscopes and accelerometers ) allowed kinematic scores to be computed . They were compared with the regular outcome scores : SST ; Disabilities of the Arm , Shoulder and H and ; American Shoulder and Elbow Surgeons ; and Constant . RESULTS Good to excellent correlations ( 0.61 - 0.80 ) were found between kinematics and clinical scores . Significant differences were found at each follow-up in comparison with the baseline status for all the kinematic scores ( P < .015 ) . The kinematic scores were able to point out abnormal patient outcomes at the first postoperative follow-up . CONCLUSION Kinematic scores add information to the regular outcome tools . They offer an effective way to measure the functional performance of patients with shoulder pathology and have the potential to detect early treatment failures Clinical practice involves measuring quantities for a variety of purpose s , such as aiding diagnosis , predicting future patient outcomes , and serving as endpoints in studies or r and omized trials . Measurements are almost always prone to various sorts of errors , which cause the measured value to differ from the true value ; accordingly , studies investigating measurement error frequently appear in this and other journals . The importance of measurement error depends upon the context in which the measurements in question are to be used . For example , a certain degree of measurement error may be acceptable if measurements are to be used as an outcome in a comparative study such as a clinical trial , but the same measurement errors may be unacceptably large to make measurements usable in individual patient management , such as screening or risk prediction . In the past 20 years many papers have been published advocating how studies of measurement error should be analyzed , with a paper by Bl and and Altman1 being one of the most cited and well known examples . There has been much controversy concerning the choice of parameter to be estimated and reported , and consequently confusion surrounding the meaning and interpretation of results from studies investigating measurement error . In this paper we first distinguish between the general concepts of agreement and reliability to aid research ers in considering which are relevant for their particular application . We then review the statistical methods that can be used to investigate and quantify agreement and reliability , dealing separately with the different types of measurement error study , while emphasizing the largely common techniques that should be used for data analysis . We reiterate that the judgment of whether agreement or reliability are acceptable must be related to the clinical application , and can not be proven by a statistical test . We highlight the fact that reliability depends on the population in which measurements are made , and not just on the measurement errors of the measurement method . We discuss the advantages of method comparison studies making at least two measurements with each measurement method on each subject . A key advantage is that the cause of a correlation between paired differences and means in the so-called Bl and –Altman plot can be determined , in contrast to when only a single measurement is made with each method . Throughout the paper , we try to emphasize that calculated values of agreement and reliability from measurement error studies are estimates of parameters , and as such we should report such estimates with CIs to indicate the uncertainty with which they have been estimated . We restrict our attention to measurements of a continuous quantity ; alternative methods are required for categorical data 2 Background The B-B Score is a straightforward kinematic shoulder function score including only two movements ( h and to the Back + lift h and 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 Magneto-Inertial Measurement Unit sensors ( MIMU ) display high potential for the quantitative evaluation of upper limb kinematics , as they allow monitoring ambulatory measurements . The sensor-to-segment calibration step , consisting of establishing the relation between MIMU sensors and human segments , plays an important role in the global accuracy of joint angles . The aim of this study was to compare sensor-to-segment calibrations for the MIMU-based estimation of wrist , elbow , and shoulder joint angles , by examining trueness ( “ close to the reference ” ) and precision ( reproducibility ) validity criteria . Ten subjects performed five sessions with three different operators . Three classes of calibrations were studied : segment axes equal to technical MIMU axes ( TECH ) , segment axes generated during a static pose ( STATIC ) , and those generated during functional movements ( FUNCT ) . The calibrations were compared during the maximal uniaxial movements of each joint , plus an extra multi-joint movement . Generally , joint angles presented good trueness and very good precision in the range 5 ° –10 ° . Only small discrepancy between calibrations was highlighted , with the exception of a few cases . The very good overall accuracy ( trueness and precision ) of MIMU-based joint angle data seems to be more dependent on the level of rigor of the experimental procedure ( operator training ) than on the choice of calibration itself BACKGROUND The objective measurement of dominant/nondominant arm use proportion in daily life may provide relevant information on healthy and pathologic arm behavior . This prospect i ve case-control study explored the potential of such measurements as indicators of upper limb functional recovery after rotator cuff surgery . METHODS Data on dominant/nondominant arm usage were acquired with body-worn sensors for 7 hours . The postsurgical arm usage of 21 patients was collected at 3 , 6 , and 12 months after rotator cuff surgery  in the sitting , walking , and st and ing postures and compared with a reference established with 41 healthy subjects . The results were calculated for the dominant and nondominant surgical side subgroups at all stages . The correlations with clinical scores were calculated . RESULTS Healthy right-h and ed and left-h and ed dominant arm usage was 60.2 % ( ±6.3 % ) and 53.4 % ( ±6.6 % ) , respectively . Differences in use of the dominant side were significant between the right- and left-h and ed subgroups for sitting ( P = .014 ) and st and ing ( P = .009 ) but not for walking ( P = .328 ) . The patient group showed a significant underuse of 10.7 % ( ±8.9 % ) at 3 months after surgery ( P < .001 ) . The patients recovered normal arm usage within 12 months , regardless of surgical side . The arm underuse measurement was weakly related to function and pain scores . CONCLUSION This study provided new information on arm recovery after rotator cuff surgery using an innovative measurement method . It highlighted that objective arm underuse measurement is a valuable indicator of upper limb postsurgical outcome that captures a complementary feature to clinical scores Knowledge of three-dimensional scapular movements is essential to underst and post-stroke shoulder pain . The goal of the present work is to determine the feasibility and the within and between session reliability of a movement protocol for three-dimensional scapular movement analysis in stroke patients with mild to moderate impairment , using an optoelectronic measurement system . Scapular kinematics of 10 stroke patients and 10 healthy controls was recorded on two occasions during active anteflexion and abduction from 0 ° to 60 ° and from 0 ° to 120 ° . All tasks were executed unilaterally and bilaterally . The protocol ’s feasibility was first assessed , followed by within and between session reliability of scapular total range of motion ( ROM ) , joint angles at start position and of angular waveforms . Additionally , measurement errors were calculated for all parameters . Results indicated that the protocol was generally feasible for this group of patients and assessors . Within session reliability was very good for all tasks . Between sessions , scapular angles at start position were measured reliably for most tasks , while scapular ROM was more reliable during the 120 ° tasks . In general , scapular angles showed higher reliability during anteflexion compared to abduction , especially for protraction . Scapular lateral rotations result ed in smallest measurement errors . This study indicates that scapular kinematics can be measured reliably and with precision within one measurement session . In case of multiple test sessions , further method ological optimization is required for this protocol to be suitable for clinical decision-making and evaluation of treatment efficacy The purpose of this study was to examine the psychometric properties of the American Shoulder and Elbow Surgeons St and ardized Shoulder Assessment Form ( ASES ) , patient self-report section . Patients with shoulder dysfunction ( n = 63 ) completed the ASES , The University of Pennsylvania Shoulder Score , and the  Short Form-36  during the initial evaluation , 24 to 72 hours after the initial visit , and after 3 to 4 weeks of physical therapy . The test-retest reliability ( intraclass correlation coefficient[1-way r and om-effects ] , 0.84 ; 95 % CI lower limit , 0.75 ) and internal consistency ( Cronbach alpha , 0.86 ) values were acceptable . The st and ard error of the measure was 6.7 ASES points ( 90 % CI , 11.0 ) . Construct and discriminant validity was demonstrated . Responsiveness was demonstrated with a st and ardized response mean of 1.5 and an effect size of 1.4 . The minimal detectable change was 9.7 ASES points ( 90 % CI , 16 ) , and the minimal clinical ly important difference was 6.4 ASES points . The results indicate that the ASES is a reliable , valid , and responsive outcome tool OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a check 
    Output:
    
Most available IMU- research regarding the shoulder is clinical ly less relevant , given the widely reported humerothoracic kinematics which do not add to clinical -decision-making , and the absence of protocol s assessing the complete upper limb chain .