Author(s): TIROSH, O., MARSHALL, C., GANDERTON, C., PRANATA, A., O’DONNELL, J., TAKLA, A., TRAN, P., WICKRAMASINGHE, N., EL-ANSARY, D., Institution: RMIT UNIVERSITY, Country: AUSTRALIA, Abstract-ID: 129

INTRODUCTION:
Squat performance is used as a clinical recovery assessment in common hip musculoskeletal conditions, such as Femoroacetabular Impingement (FAI) Syndrome. Objective quality of squat performance is measured by medio/lateral and anterior/posterior sway of the performer using accelerometers or force plates, but unfortunately, they are expensive and do not support remote tele home-based assessment, something that is in high demand following COVID-19. To address this, we developed targeted technology of a nexus cloud software bundle with smartphone motion sensors and App allowing clinicians to remotely and objectively measure squat from their clinic using web browser connecting to the patient smartphone at home, while sharing and monitoring progression in a linkage databank cloud interface. The aim of the study was to assess the technology to remotely measure squat performance of FAI patients pre surgery, and 6 weeks, 3 months, and 6 months following surgery.
METHODS:
Three continues double leg squats were measured using the smartphone on 8 FAI patients at each of the testing assessments: pre-surgery, and 6 weeks, 3 months, and 6 months following surgery. At the beginning of each assessment, the examiner remotely connected from their clinic using their web browser to the participant at home smartphone. During assessment the smartphone was inserted in a pouch strapped around the patient waist, positioned at their lower back. During the assessment, voice communication between the examiner and participant was via Zoom, allowing the examiner to instruct the patient when to start performing the squat while capturing the smartphone motion sensor data. Smartphone motion sensor signals were processed to calculate the approximate entropy (apen) with lower values indicating that the movement is more regular, repetitive, and predictable. Repeated ANOVA was performed to explore significant changes in apen before and after surgery.
RESULTS:
All participants’ squat performances were successfully measured remotely using the smartphone. Significant greater medial/lateral and anterior/posterior apen values were shown only after 6 months post-surgery (medio/lateral: 0.37, 0.44, 0.45, and 0.47; anterior/posterior 0.37, 0.42, 0.44, and 0.46, for pre-, 6wks, 3 months, and 6 months, respectively, p < 0.05). However, following 6 months participant squat did not reach healthy controls apen values (0.49 and 0.52 for medio/later and anterior/posterior, respectively).
CONCLUSION:
The results from this study showed the successful use of smartphone motion sensors to remotely measure and monitor squat performance in FAI patients before and after surgery. Only after 6 months of surgery postural control, indicated by apen, was significantly more complex with optimal movement variability compared to pre-surgery, and closer to healthy controls. The reported method and technology represent a new mode of care allowing clinicians to remot