{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T20:05:40Z","timestamp":1769025940893,"version":"3.49.0"},"reference-count":58,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ontario Early Researcher Award","award":["ER17-13-007"],"award-info":[{"award-number":["ER17-13-007"]}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["RGPIN-2014-05560"],"award-info":[{"award-number":["RGPIN-2014-05560"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>An objective method to detect muscle fatigue-related kinematic changes may reduce workplace injuries. However, heterogeneous responses to muscle fatigue suggest that subject-specific analyses are necessary. The objectives of this study were to: (1) determine if wearable inertial measurement units (IMUs) could be used in conjunction with a spine motion composite index (SMCI) to quantify subject-specific changes in spine kinematics during a repetitive spine flexion-extension (FE) task; and (2) determine if the SMCI was correlated with measures of global trunk muscle fatigue. Spine kinematics were measured using wearable IMUs in 10 healthy adults during a baseline set followed by 10 sets of 50 spine FE repetitions. After each set, two fatigue measures were collected: perceived level of fatigue using a visual analogue scale (VAS), and maximal lift strength. SMCIs incorporating 10 kinematic variables from 2 IMUs (pelvis and T8 vertebrae) were calculated and used to quantify subject-specific changes in movement. A main effect of set was observed (F (1.7, 15.32) = 10.42, p = 0.002), where the SMCI became significantly greater than set 1 starting at set 4. Significant correlations were observed between the SMCI and both fatigue VAS and maximal lift strength at the individual and study level. These findings support the use of wearable IMUs to detect subject-specific changes in spine motion associated with muscle fatigue.<\/jats:p>","DOI":"10.3390\/s20092646","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T03:10:38Z","timestamp":1588821038000},"page":"2646","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A Subject-Specific Approach to Detect Fatigue-Related Changes in Spine Motion Using Wearable Sensors"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-5822","authenticated-orcid":false,"given":"Victor C.H.","family":"Chan","sequence":"first","affiliation":[{"name":"School of Human Kinetics, University of Ottawa, 200 Lees Avenue, Ottawa, ON K1S 5L5, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8427-3959","authenticated-orcid":false,"given":"Shawn M.","family":"Beaudette","sequence":"additional","affiliation":[{"name":"School of Human Kinetics, University of Ottawa, 200 Lees Avenue, Ottawa, ON K1S 5L5, Canada"},{"name":"Department of Kinesiology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada"}]},{"given":"Kenneth B.","family":"Smale","sequence":"additional","affiliation":[{"name":"School of Human Kinetics, University of Ottawa, 200 Lees Avenue, Ottawa, ON K1S 5L5, Canada"}]},{"given":"Kristen H.E.","family":"Beange","sequence":"additional","affiliation":[{"name":"School of Human Kinetics, University of Ottawa, 200 Lees Avenue, Ottawa, ON K1S 5L5, Canada"},{"name":"Department of Systems and Computer Engineering, Carleton University, 1125 Colonel by Drive, Ottawa, ON K1S 5B6, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7502-8065","authenticated-orcid":false,"given":"Ryan B.","family":"Graham","sequence":"additional","affiliation":[{"name":"School of Human Kinetics, University of Ottawa, 200 Lees Avenue, Ottawa, ON K1S 5L5, Canada"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0165-0270(97)02251-6","article-title":"Measurement of human muscle fatigue","volume":"74","year":"1997","journal-title":"J. Neurosci. Methods"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00421-010-1480-0","article-title":"Muscle fatigue: From observations in humans to underlying mechanisms studied in intact single muscle fibres","volume":"110","author":"Place","year":"2010","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.humov.2017.10.015","article-title":"Inter-joint coordination changes during and after muscle fatigue","volume":"56","author":"Cowley","year":"2017","journal-title":"Hum. Mov. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Cowley, J.C., and Gates, D.H. (2017). Proximal and distal muscle fatigue differentially affect movement coordination. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172835"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.humov.2017.06.007","article-title":"Local dynamic stability of the spine and its coordinated lower joints during repetitive Lifting: Effects of fatigue and chronic low back pain","volume":"54","author":"Asgari","year":"2017","journal-title":"Hum. Mov. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S0003-6870(03)00039-5","article-title":"Short-duration fatigue alters neuromuscular coordination of trunk musculature: Implications for injury","volume":"34","author":"Gorelick","year":"2003","journal-title":"Appl. Ergon."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S1047-9651(18)30135-9","article-title":"Muscle fatigue and muscle injury","volume":"11","author":"Dugan","year":"2000","journal-title":"Phys. Med. Rehabil. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.autcon.2017.07.007","article-title":"Biomechanical analysis of risk factors for work-related musculoskeletal disorders during repetitive lifting task in construction workers","volume":"83","author":"Li","year":"2017","journal-title":"Autom. Constr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1111\/jan.13952","article-title":"The relationship between work-related musculoskeletal disorders, chronic occupational fatigue, and work organization: A multi-hospital cross-sectional study","volume":"75","author":"Younan","year":"2019","journal-title":"J. Adv. Nurs."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5633\/amm.2017.0403","article-title":"The influence of working conditions, health status and characteristics of workers on the occurrence of workplace injuries","volume":"56","year":"2017","journal-title":"Acta Med. Median."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1114\/1.284","article-title":"Fatigue-related loading imbalance on the shank in running: A possible factor in stress fractures","volume":"28","author":"Mizrahi","year":"2000","journal-title":"Ann. Biomed. Eng."},{"key":"ref_12","first-page":"467","article-title":"Prevalence of low back pain in health care workers and comparison with other occupational categories in Iran: A systematic review","volume":"41","author":"Mehrdad","year":"2016","journal-title":"Iran. J. Med. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1080\/00140139.2017.1361552","article-title":"Prevalence of work-related musculoskeletal and non-musculoskeletal injuries in health care workers: The implications for work disability management","volume":"61","author":"Oranye","year":"2018","journal-title":"Ergonomics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/S0140-6736(16)31460-X","article-title":"Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990\u20132015: A systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"Kassebaum","year":"2016","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1547-5069.1999.tb00420.x","article-title":"Defining and Measuring Fatigue","volume":"31","author":"Aaronson","year":"1999","journal-title":"Image J. Nurs. Scholarsh."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jpain.2018.07.009","article-title":"Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review","volume":"20","author":"Chiarotto","year":"2019","journal-title":"J. Pain"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zemkov\u00e1, E., Po\u00f3r, O., and Pecho, J. (2019). Peak Rate of Force Development and Isometric Maximum Strength of Back Muscles Are Associated With Power Performance During Load-Lifting Tasks. Am. J. Mens. Health, 13.","DOI":"10.1177\/1557988319828622"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.jelekin.2012.02.019","article-title":"Electromyographic models to assess muscle fatigue","volume":"22","author":"Malanda","year":"2012","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/j.gaitpost.2013.11.020","article-title":"Differential effects of fatigue on movement variability","volume":"39","author":"Cortes","year":"2014","journal-title":"Gait Posture"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.1016\/j.jbiomech.2016.08.032","article-title":"(Jaap. Continuous three dimensional analysis of running mechanics during a marathon by means of inertial magnetic measurement units to objectify changes in running mechanics","volume":"49","author":"Reenalda","year":"2016","journal-title":"J. Biomech."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1123\/jab.2018-0453","article-title":"New considerations for wearable technology data: Changes in running biomechanics during a marathon","volume":"35","author":"Clermont","year":"2019","journal-title":"J. Appl. Biomech."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Kobsar, D., and Ferber, R. (2018). Wearable sensor data to track subject-specific movement patterns related to clinical outcomes using a machine learning approach. Sensors, 18.","DOI":"10.3390\/s18092828"},{"key":"ref_23","unstructured":"Saisana, M., and Tarantola, S. (2002). State-of-the-Art Report on Current Methodologies and Practices for Composite Indicator Development, Joint Research Centre, European Commission."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Robertson, D.G.E., Caldwell, G.E., Hamill, J., Kamen, G., and Whittlesey, S.N. (2014). Dynamical Systems Analysis of Coordination. Research Methods in Biomechanics, Human Kinetics.","DOI":"10.5040\/9781492595809"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.clinbiomech.2010.11.012","article-title":"Low back pain status affects pelvis-trunk coordination and variability during walking and running","volume":"26","author":"Seay","year":"2011","journal-title":"Clin. Biomech."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.gaitpost.2008.10.053","article-title":"Trunk control during standing reach: A dynamical system analysis of movement strategies in patients with mechanical low back pain","volume":"29","author":"Silfies","year":"2009","journal-title":"Gait Posture"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0268-0033(00)00080-2","article-title":"Disorders in trunk rotation during walking in patients with low back pain: A dynamical systems approach","volume":"16","author":"Selles","year":"2001","journal-title":"Clin. Biomech."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.spinee.2019.02.002","article-title":"Discriminating spatiotemporal movement strategies during spine flexion-extension in healthy individuals","volume":"19","author":"Beaudette","year":"2019","journal-title":"Spine J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.2519\/jospt.1997.25.1.3","article-title":"The Effect of Fatigue on Multijoint Kinematics, Coordination, and Postural Stability During a Repetitive Lifting Test","volume":"25","author":"Sparto","year":"1997","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1080\/00140139.2015.1005173","article-title":"The influence of lumbar extensor muscle fatigue on lumbar\u2013pelvic coordination during weightlifting","volume":"58","author":"Hu","year":"2015","journal-title":"Ergonomics"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"109356","DOI":"10.1016\/j.jbiomech.2019.109356","article-title":"Concurrent validity of a wearable IMU for objective assessments of functional movement quality and control of the lumbar spine","volume":"97","author":"Beange","year":"2019","journal-title":"J. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1093\/ajcn\/36.5.936","article-title":"A short questionnaire for the measurement of habitual physical activity in epidemiological studies","volume":"36","author":"Baecke","year":"1982","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_33","unstructured":"Roetenberg, D., Luinge, H., and Slycke, P. (2013). Xsens MVN: Full 6DOF Human Motion Tracking Using Miniature Inertial Sensors. XSens Technol., 1\u20139."},{"key":"ref_34","unstructured":"Schepers, M., Giuberti, M., and Bellusci, G. (2018). Xsens MVN: Consistent Tracking of Human Motion Using Inertial Sensing. Xsens Technol. B.V., 1\u20138."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"N63","DOI":"10.1088\/0967-3334\/34\/8\/N63","article-title":"Concurrent validation of Xsens MVN measurement of lower limb joint angular kinematics","volume":"34","author":"Zhang","year":"2013","journal-title":"Physiol. Meas."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s11517-016-1537-2","article-title":"Validation of inertial measurement units with an optoelectronic system for whole-body motion analysis","volume":"55","author":"Mecheri","year":"2017","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/j.jbiomech.2014.01.033","article-title":"Comparing the local dynamic stability of trunk movements between varsity athletes with and without non-specific low back pain","volume":"47","author":"Graham","year":"2014","journal-title":"J. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"E271","DOI":"10.1097\/01.brs.0000216445.28943.d1","article-title":"Stability of dynamic trunk movement","volume":"31","author":"Granata","year":"2006","journal-title":"Spine (Phila. Pa. 1976)."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.jbiomech.2015.01.036","article-title":"Sensor positioning and experimental constraints influence estimates of local dynamic stability during repetitive spine movements","volume":"48","author":"Howarth","year":"2015","journal-title":"J. Biomech."},{"key":"ref_40","first-page":"415","article-title":"Development of new protocols and analysis procedures for the assessment of LBP by surface EMG techniques","volume":"34","author":"Oddsson","year":"1997","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_41","unstructured":"Winter, D.A. (2010). Three-Dimensional Kinematics and Kinetics. Biomechanics and Motor Control of Human Movement, John Wiley & Sons, Inc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.humov.2011.06.009","article-title":"Local dynamic stability of trunk movements during the repetitive lifting of loads","volume":"31","author":"Graham","year":"2012","journal-title":"Hum. Mov. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1080\/00140139508925111","article-title":"Biomechanical risk factors for occupationally related low back disorders","volume":"38","author":"Marras","year":"1995","journal-title":"Ergonomics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/hfm.20170","article-title":"Progressive Fatigue Effects on Manual Lifting Factors","volume":"19","author":"Banks","year":"2009","journal-title":"Hum. Factors Ergon. Manuf."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1080\/0014013031000151659","article-title":"Postural and trunk muscle response to sudden release during stoop lifting tasks before and after fatigue of the trunk erector muscles","volume":"47","author":"Chow","year":"2004","journal-title":"Ergonomics"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0021-9290(02)00341-X","article-title":"Limitations in the use and interpretation of continuous relative phase","volume":"36","author":"Peters","year":"2003","journal-title":"J. Biomech."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.clinbiomech.2014.03.008","article-title":"On the use of continuous relative phase: Review of current approaches and outline for a new standard","volume":"29","author":"Lamb","year":"2014","journal-title":"Clin. Biomech."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jshs.2016.01.011","article-title":"A history of low back pain affects pelvis and trunk coordination during a sustained manual materials handling task","volume":"5","author":"Seay","year":"2016","journal-title":"J. Sport Heal. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/1758-2555-4-45","article-title":"Coordinative variability and overuse injury","volume":"4","author":"Hamill","year":"2012","journal-title":"Sports Med. Arthrosc. Rehabil. Ther. Technol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"151","DOI":"10.32614\/RJ-2014-031","article-title":"MVN: An R package for assessing multivariate normality","volume":"6","author":"Korkmaz","year":"2014","journal-title":"R J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3389\/fpsyg.2017.00456","article-title":"Repeated measures correlation","volume":"8","author":"Bakdash","year":"2017","journal-title":"Front. Psychol."},{"key":"ref_52","first-page":"19","article-title":"Statistical power analysis for the behavioral sciences: Jacob Cohen","volume":"84","author":"Cohen","year":"1988","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_53","unstructured":"Graham, R.B., and Josan, G.P.K. (2017, January 23\u201327). Development of a novel wearable system for the clinical assessment of movement quality and control in low back pain. Proceedings of the XXVI Congress of the International Society of Biomechanics, Brisbane, Australia."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1080\/00140130802030722","article-title":"Fatigue influences the dynamic stability of the torso","volume":"51","author":"Granata","year":"2008","journal-title":"Ergonomics"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.humov.2015.09.006","article-title":"Muscle fatigue as an investigative tool in motor control: A review with new insights on internal models and posture-movement coordination","volume":"44","author":"Monjo","year":"2015","journal-title":"Hum. Mov. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jelekin.2018.11.001","article-title":"Differential effects of muscle fatigue on dynamic spine stability: Implications for injury risk","volume":"43","author":"Larson","year":"2018","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1109\/TNSRE.2013.2291327","article-title":"Human movement analysis as a measure for fatigue: A hidden markov-based approach","volume":"22","author":"Karg","year":"2014","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_58","unstructured":"Hall, M.A. (2000). Correlation-Based Feature Selection for Discrete and Numeric Class Machine Learning, University of Waikato."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/9\/2646\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:32:44Z","timestamp":1760362364000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/9\/2646"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,6]]},"references-count":58,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["s20092646"],"URL":"https:\/\/doi.org\/10.3390\/s20092646","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,6]]}}}