Technology, design, innovation just over 3 cm
Created to make available at the professional athlete or amateur Wiva® is a small inertial sensor (35x37x15mm) that uses wireless Bluetooth connection “4 low energy”.
Inside there are a IMU 9 axes sensor, an altimeter and optionally a powerful GPS.
choose where place your Wiva® device and get in track!
Since in the field of functional evaluation it is often not possible to directly measure a quantity because this is inaccessible or because the test is too expensive, then we fall back on an indirect measure of the quantity periodically investigated.
Tests performed with the Wiva Science system respect the three fundamental characteristics to be considered scientific:
- A test should be VALID: the degree of the agreement between the measure and “true” value of the phenomenon must be high. The validity assessment requires a standard measurement system of reference.
- A test should be REPRODUCIBLE: reproducibility is the ability of an entire experiment or study to be reproduced, either by the researcher or by someone else working independently
- A test should be REPEATABLE: repeatability is the variation in measurements taken by a single person or instrument on the same item and under the same conditions. A less-than-perfect test–retest reliability causes test–retest variability. Such variability can be caused by, for example, intra-individual variability and intra-observer variability. A measurement may be said to be repeatable when this variation is smaller than some agreed limit.
From these considerations was born Wiva Science system you chose and you are going to use.
Osteokinematics refers to the gross movement of the shafts of bones rather than the movement of joint surfaces. The movements of the shafts of bones are usually described in terms of the rotary or angular motion produced, as if the movement occurs around a fixed axis of motion. Goniometry measures the angles created by the rotary motion of the shafts of the bones. Some translatory shifting of the axis of motion usually occurs during movement; however, most clinicians find the description of osteokinematic movement in terms of just rotary motion to be sufficiently accurate and use goniometry to measure osteokinematic movements.
- PLANES AND AXES
Osteokinematic motions are classically described as taking place in one of the three cardinal planes of the body (sagittal, frontal, transverse) around three corresponding axes (medial-lateral, anterior-posterior, vertical). The three planes lie at right angles to one another, whereas the three axes lie at right angles both to one another and to their corresponding planes. The sagittal plane proceeds from the anterior to the posterior aspect of the body. The median sagittal plane divides the body into right and left halves. The motions of flexion and extension occur in the sagittal plane. The axis around which the motions of flexion and extension occur may be envisioned as a line that is perpendicular to the sagittal plane and proceeds from one side of the body to the other. This axis is called a medial–lateral axis. All motions in the sagittal plane take place around a medial–lateral axis. The frontal plane proceeds from one side of the body to the other and divides the body into front and back halves. The motions that occur in the frontal plane are abduction and adduction. The axis around which the motions of abduction and adduction take place is an anterior–posterior axis. This axis lies at right angles to the frontal plane and proceeds from the anterior to the posterior aspect of the body. Therefore, the anterior–posterior axis lies in the sagittal plane. The transverse plane is horizontal and divides the body into upper and lower portions. The motion of rotation occurs in the transverse plane around a vertical axis. The vertical axis lies at right angles to the transverse plane and proceeds in a cranial to caudal direction. 6
RANGE OF MOTION
Range of motion (ROM) is the arc of motion that occurs at a joint or a series of joints. The starting position for measuring all ROM, except rotations in the transverse plane, is anatomical position.
- ACTIVE RANGE OF MOTION
Active range of motion (AROM) is the arc of motion attained by a subject during unassisted voluntary joint motion. Having a subject perform active ROM provides the examiner with information about the subject’s willingness to move, coordination, muscle strength, and joint ROM. If pain occurs during active ROM, it may be due to contracting or stretching of “contractile” tissues, such as muscles, tendons, and their attachments to bone. Pain may also be due to stretching or pinching of noncontractile (inert) tissues, such as ligaments, joint capsules, bursa, fascia, and skin. Testing active ROM is a good screening technique to help focus a physical examination. If a subject can complete active ROM easily and painlessly, further testing of that motion is probably not needed. If, however, active ROM is limited, painful, or awkward, the physical examination should include additional testing to clarify the problem.
- PASSIVE RANGE OF MOTION
Passive range of motion (PROM) is the arc of motion attained by an examiner without assistance from the subject. The subject remains relaxed and plays no active role in producing the motion. Normally passive ROM is slightly greater than active ROM because each joint has a small amount of available motion that is not under voluntary control. The additional passive ROM that is available at the end of the normal active ROM is due to the stretch of tissues surrounding the joint and the reduced bulk of relaxed compared to contracting muscles. This additional passive ROM helps to protect joint structures because it allows the joint to absorb extrinsic forces. Testing passive ROM provides the examiner with information about the integrity of the joint surfaces and the extensibility of the joint capsule and associated ligaments, muscles, fascia, and skin. To focus on these issues, passive ROM rather than active ROM should be tested in goniometry. Unlike active ROM, passive ROM does not depend on the subject’s muscle strength and coordination. Comparisons between passive ROMs and active ROMs provide information about the amount of motion permitted by the associated joint structures (passive ROM) relative to the subject’s ability to produce motion at a joint (active ROM). In cases of impairment such as muscle weakness, passive ROMs and active ROMs may vary considerably. If pain occurs during passive ROM, it is often due to moving, stretching, or pinching of noncontractile (inert) structures. Pain occurring at the end of passive ROM may be due to stretching of contractile structures as well as noncontractile structures. 7
Pain during passive ROM is not due to active shortening (contracting) of contractile tissues. By comparing which motions (active versus passive) cause pain and noting the location of the pain, the examiner can begin to determine which injured tissues are involved.
The term hypomobility refers to a decrease in passive ROM that is substantially less than normal values for that joint, given the subject’s age and gender. The end-feel occurs early in the ROM and may be different in quality from what is expected. The limitation in passive ROM may be due to a variety of causes including abnormalities of the joint surfaces; passive shortening of joint capsules, ligaments, muscles, fascia, and skin; and inflammation of these structures. Hypomobility has been associated with many orthopedic conditions such as osteoarthritis, rheumatoid arthritis, adhesive capsulitis, and spinal disorders. Decreased ROM is a common consequence of immobilization after fractures and scar development after burns. Neurological conditions such as stroke, head trauma, cerebral palsy, and complex regional pain syndrome can also result in hypomobility owing to loss of voluntary movement, increased muscle tone, immobilization, and pain. In addition, metabolic conditions such as diabetes have been associated with limited joint motion.
The term hypermobility refers to an increase in passive ROM that exceeds normal values for that joint, given the subject’s age and gender. Hypermobility is due to the laxity of soft tissue structures such as ligaments, capsules, and muscles that normally prevent excessive motion at a joint. In some instances the hypermobility may be due to abnormalities of the joint surfaces. A frequent cause of hypermobility is trauma to a joint. Hypermobility also occurs in serious hereditary disorders of connective tissue such as Ehlers-Danlos syndrome, Marfan syndrome, rheumatic diseases, and osteogenesis imperfecta. One of the typical physical abnormalities of Down syndrome is hypermobility. In this instance generalized hypotonia is thought to be an important contributing factor to the hypermobility.8
FACTOS AFFECTING RANGE OF MOTION
ROM varies among individuals and is influenced by factors such as age, gender, and whether the motion is performed actively or passively. A fairly extensive amount of research on the effects of age and gender on ROM has been conducted for the upper and lower extremities as well as the spine. Other factors relating to subject characteristics such as body mass index (BMI), occupational activities, and recreational activities may affect ROM, but have not been as extensively researched as age and gender. In addition, factors relating to the testing process, such as the testing position, type of instrument employed, experience of the examiner, and even time of day have been identified as affecting ROM measurements. Ideally, to determine whether a ROM is impaired, the value of the ROM of the joint under consideration should be compared with ROM values from people of the same age and gender and from studies that used the same method of measurement. Often such comparisons are not possible because age-related and gender-related norms have not been established for all groups. In such situations the ROM of the joint should be compared with the same joint of the individual’s contralateral extremity, providing that the contralateral extremity is not impaired or used selectively in athletic or occupational activities. Most studies have found little difference between the ROM of the right and left extremities. A few studies have found slightly less ROM in some joints of the upper extremity on the dominant or right side as compared with the contralateral side, which Allender and coworkers attribute to increased exposure to stress.
A wide range of age groups have found that older adult groups have somewhat less ROM of the extremities than younger adult groups. These agerelated changes in the ROM of older adults also are joint and motion specific and may affect males and females differently.
The effects of gender on the ROM of the extremities and spine also appear to be joint and motion specific. If gender differences in the amount of ROM are found, females are more often reported to have slightly greater ROM than males. In general, gender differences appear to be more prevalent in adults than in young children.9
Goniometry refers to the measurement of angles, in particular the measurement of angles created at human joints by the bones of the body. Traditionally, the examiner obtains these measurements by placing the parts of the measuring instrument, called a goniometer, along the bones immediately proximal and distal to the joint being evaluated. Goniometry may be used to determine both a particular joint position and the total amount of motion available at a joint.
The performance of active joint motions by the subject during the examination allows the examiner to screen for abnormal movements and gain information about the subject’s willingness to move. If abnormal active motions are found, the examiner performs passive joint motions in an attempt to determine reasons for joint limitation. Performing passive joint motions enables the examiner to assess the tissue that is limiting the motion, detect pain, and make an estimate of the amount of motion. Goniometry is used to measure and document the amount of active and passive joint motion as well as abnormal fixed joint positions. Resisted isometric muscle contractions, joint integrity and mobility tests, and special tests for specific body regions are used in conjunction with goniometry to help identify the injured anatomical structures. Tests to assess muscle performance and neurological function are often included. Diagnostic imaging procedures and laboratory tests may be required.
Goniometric data used in conjunction with other information can provide a basis for the following:
- Determining the presence or absence of impairment.
- Establishing a diagnosis.
- Developing a prognosis, treatment goals, and plan of care.
- Evaluating progress or lack of progress toward rehabilitative goals.
- Modifying treatment.
- Motivating the subject.
- Researching the effectiveness of therapeutic techniques or regimens (for example, measuring outcomes following exercises, medications, and surgical procedures).
- Fabricating orthoses and adaptive equipment.
With the Wiva Science device it is possible to measure the joint motion in a easy way and quickly, without the need of specific skills or competency in device positioning as required by the measure tecnique with the goniometer but with an comparable accuracy. The automatic registration of the angular measurements avoids the reading of the measuring instrument and the recording of the measurement by means of manual transcription, necessary in the traditional technique.