Affiliations: [a] School of Physiotherapy, Faculty of Allied Health Professions, AIMST University, Semeling Campus, Bedong, Kedah, Malaysia | [b] Centre for Artificial Intelligence and Robotics (CAIRO UTM), School of Electrical Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Skudai, Johor Darul Takzim, Malaysia | [c] Bharathiar University, Coimbatore, India
Correspondence:
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Corresponding author: Jagannathan Madhanagopal, School of Physiotherapy, Faculty of Allied Health Professions, AIMST University, Semeling Campus, Bedong, Kedah, 08100, Malaysia. Tel.: +60 44298000; Ext: 6114; Fax: +60 44298009; E-mail: [email protected].
Abstract: BACKGROUND: Force Monitoring Devices (FMDs) reported in the literature to monitor applied force during Joint Mobilization Technique (JMT) possess complex design/bulky which alters the execution of treatment, has poor accuracy and is unable to feel the resistance provided by soft tissues limits its usage in the clinical settings. OBJECTIVES: This study aims to develop a highly accurate, portable FMD and to demonstrate real-time monitoring of force applied by health professionals during JMT without altering its execution. METHODS: The FMD was constructed using the FlexiForce sensor, potential divider, ATmega 328 microcontroller, custom-written software, and liquid crystal display. The calibration, accuracy, and cyclic repeatability of the FMD were tested from 0 to 90 N applied load with a gold standard universal testing machine. For practical demonstration, the FMD was tested for monitoring applied force by a physiotherapist while performing Maitland’s grade I to IV over the 6th cervical vertebra among 30 healthy subjects. RESULTS: The obtained Bland-Altman plot limits agreement for accuracy, and cyclic repeatability was -1.57 N to 1.22 N, and -1.26 N to 1.26 N, respectively with standard deviation and standard error of the mean values of 3.77% and 0.73% and 2.15% and 0.23%, respectively. The test-retest reliability of the FMD tested by the same researcher at an interval of one week showed an excellent intra-class correlation coefficient of r= 1.00. The obtained force readings for grade I to IV among 30 subjects ranged from 10.33 N to 45.24 N. CONCLUSIONS: Appreciable performance of the developed FMD suggested that it may be useful to monitor force applied by clinicians during JMT among neck pain subjects and is a useful educational tool for academicians to teach mobilization skills.
Keywords: Force monitoring device, joint mobilization, neck pain, accuracy, reliability
