Validity and reliability of inertial measurement units used to measure motion of the lumbar spine: A systematic review of individuals with and without low back pain

Low back pain (LBP) is a leading cause of disability, resulting in aberrant movement. This movement is difficult to measure accurately in clinical practice and gold standard methods, such as optoelectronic systems involve the use of expensive laboratory equipment. Inertial measurement units (IMU) offer an alternative method of quantifying movement that is accessible in most environments. However, there is no consensus around the validity and reliability of IMUs for quantifying lumbar spine movements compared with gold standard measures. The aim of this systematic review was to establish concurrent validity and repeated measures reliability of using IMUs for the measurement of lumbar spine movements in individuals with and without LBP. A systematic search of electronic databases, incorporating PRISMA guidelines was completed, limited to the English language. 503 studies were identified where 15 studies met the inclusion criteria. Overall, 305 individuals were included, and 109 of these individuals had LBP. Weighted synthesis of the results demonstrated root mean squared differences of <2.4° compared to the gold standard and intraclass correlations >0.84 for lumbar spine movements. IMUs offer clinicians and researchers valid and reliable measurement of motion in the lumbar spine, comparable to laboratory methods, such as optoelectronic motion capture for individuals with and without LBP.