{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T07:59:07Z","timestamp":1776931147681,"version":"3.51.2"},"reference-count":23,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004040","name":"KU Leuven (BOF\/IOF)","doi-asserted-by":"publisher","award":["3M210654"],"award-info":[{"award-number":["3M210654"]}],"id":[{"id":"10.13039\/501100004040","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>(1) Background: Being able to objectively assess upper limb (UL) dysfunction in breast cancer survivors (BCS) is an emerging issue. This study aims to determine the accuracy of a pre-trained lab-based machine learning model (MLM) to distinguish functional from non-functional arm movements in a home situation in BCS. (2) Methods: Participants performed four daily life activities while wearing two wrist accelerometers and being video recorded. To define UL functioning, video data were annotated and accelerometer data were analyzed using a counts threshold method and an MLM. Prediction accuracy, recall, sensitivity, f1-score, \u2018total minutes functional activity\u2019 and \u2018percentage functionally active\u2019 were considered. (3) Results: Despite a good MLM accuracy (0.77\u20130.90), recall, and specificity, the f1-score was poor. An overestimation of the \u2018total minutes functional activity\u2019 and \u2018percentage functionally active\u2019 was found by the MLM. Between the video-annotated data and the functional activity determined by the MLM, the mean differences were 0.14% and 0.10% for the left and right side, respectively. For the video-annotated data versus the counts threshold method, the mean differences were 0.27% and 0.24%, respectively. (4) Conclusions: An MLM is a better alternative than the counts threshold method for distinguishing functional from non-functional arm movements. However, the abovementioned wrist accelerometer-based assessment methods overestimate UL functional activity.<\/jats:p>","DOI":"10.3390\/s23136100","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:53:16Z","timestamp":1688345596000},"page":"6100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Assessing Upper Limb Function in Breast Cancer Survivors Using Wearable Sensors and Machine Learning in a Free-Living Environment"],"prefix":"10.3390","volume":"23","author":[{"given":"Nieke","family":"Vets","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, B-3000 Leuven, Belgium"},{"name":"CarEdOn Research Group, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An","family":"De Groef","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, B-3000 Leuven, Belgium"},{"name":"CarEdOn Research Group, B-3000 Leuven, Belgium"},{"name":"MOVANT Research Group, Department of Rehabilitation Sciences, University of Antwerp, B-2000 Antwerp, Belgium"},{"name":"Pain in Motion International Research Group, B-1000 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaat","family":"Verbeelen","sequence":"additional","affiliation":[{"name":"CarEdOn Research Group, B-3000 Leuven, Belgium"},{"name":"MOVANT Research Group, Department of Rehabilitation Sciences, University of Antwerp, B-2000 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8117-7080","authenticated-orcid":false,"given":"Nele","family":"Devoogdt","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, B-3000 Leuven, Belgium"},{"name":"CarEdOn Research Group, B-3000 Leuven, Belgium"},{"name":"Center for Lymphoedema, Department of Vascular Surgery, Department of Physical Medicine and Rehabilitation, UZ Leuven\u2014University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Smeets","sequence":"additional","affiliation":[{"name":"KU Leuven, Department of Oncology, B-3000 Leuven, Belgium"},{"name":"Surgical Oncology, UZ Leuven\u2014University Hospitals Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-0106","authenticated-orcid":false,"given":"Dieter","family":"Van Assche","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1370-2090","authenticated-orcid":false,"given":"Liesbet","family":"De Baets","sequence":"additional","affiliation":[{"name":"Pain in Motion International Research Group, B-1000 Brussels, Belgium"},{"name":"Pain in Motion (PAIN) Research Group, Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, B-1000 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9218-7604","authenticated-orcid":false,"given":"Jill","family":"Emmerzaal","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, B-3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,2]]},"reference":[{"key":"ref_1","first-page":"1038","article-title":"Development of the Quickdash: Comparison of Three Item-Reduction Approaches","volume":"87","author":"Beaton","year":"2005","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.gaitpost.2017.06.025","article-title":"Shoulder assessment according to the international classification of functioning by means of inertial sensor technologies: A systematic review","volume":"57","author":"Matheve","year":"2017","journal-title":"Gait Posture"},{"key":"ref_3","first-page":"1176","article-title":"The Association between Upper Limb Function and Variables at the Different Domains of the International Classification of Functioning, Disability and Health in Women after Breast Cancer Surgery: A Systematic Review","volume":"44","author":"Dams","year":"2020","journal-title":"Disabil. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1002\/art.24396","article-title":"Measuring shoulder function: A systematic review of four questionnaires","volume":"61","author":"Roy","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/10255840008908000","article-title":"Musculoskeletal Model of the Upper Limb Based on the Visible Human Male Dataset","volume":"4","author":"Garner","year":"2001","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1001\/jamaoncol.2016.4851","article-title":"A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (Ichom) Initiative","volume":"3","author":"Ong","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.apmr.2013.09.016","article-title":"Validation of QuickDASH Outcome Measure in Breast Cancer Survivors for Upper Extremity Disability","volume":"95","author":"LeBlanc","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5307","DOI":"10.1007\/s00520-020-05365-5","article-title":"A quantitative comparison of arm activity between survivors of breast cancer and healthy controls: Use of accelerometry","volume":"28","author":"Fisher","year":"2020","journal-title":"Support. Care Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1177\/1545968320962483","article-title":"Improving Accelerometry-Based Measurement of Functional Use of the Upper Extremity After Stroke: Machine Learning versus Counts Threshold Method","volume":"34","author":"Lum","year":"2020","journal-title":"Neurorehabilit. Neural Repair"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1037\/a0017501","article-title":"A behavioral observation system for quantifying arm activity in daily life after stroke","volume":"54","author":"Uswatte","year":"2009","journal-title":"Rehabil. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1161\/01.STR.31.3.662","article-title":"Objective measurement of functional upper-extremity movement using accelerometer recordings transformed with a threshold filter","volume":"31","author":"Uswatte","year":"2000","journal-title":"Stroke"},{"key":"ref_12","first-page":"55673","article-title":"A Method for Quantifying Upper Limb Performance in Daily Life Using Accelerometers","volume":"122","author":"Lang","year":"2017","journal-title":"J. Vis. Exp."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"952757","DOI":"10.3389\/fphys.2022.952757","article-title":"Classification of functional and non-functional arm use by inertial measurement units in individuals with upper limb impairment after stroke","volume":"13","author":"Pohl","year":"2022","journal-title":"Front. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"667509","DOI":"10.3389\/fnhum.2021.667509","article-title":"A Framework for Sensor-Based Assessment of Upper-Limb Functioning in Hemiparesis","volume":"15","author":"David","year":"2021","journal-title":"Front. Hum. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1186\/s13073-021-00968-x","article-title":"Deep Learning in Cancer Diagnosis, Prognosis and Treatment Selection","volume":"13","author":"Tran","year":"2021","journal-title":"Genome Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"857","DOI":"10.3389\/fneur.2019.00857","article-title":"A Taxonomy of Functional Upper Extremity Motion","volume":"10","author":"Schambra","year":"2019","journal-title":"Front. Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"11958","DOI":"10.1038\/s41598-022-16003-x","article-title":"Quantification of acceleration as activity counts in ActiGraph wearable","volume":"12","author":"Neishabouri","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"James, G., Witten, D., Hastie, T., Tibshirani, R., and Taylor, J. (2021). An Introduction to Statistical Learning, Springer. [2nd ed.].","DOI":"10.1007\/978-1-0716-1418-1"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"James, G., Witten, D., Hastie, T., and Tibshirani, R. (2013). An Introduction to Statistical Learning: With Applications in R, Springer. Springer Texts in Statistics.","DOI":"10.1007\/978-1-4614-7138-7"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"747e","DOI":"10.1097\/PRS.0000000000009522","article-title":"Effect of Breast Reconstruction on Kinematics and Performance during Upper Limb\u2013Focused Functional Tasks","volume":"150","author":"Lang","year":"2022","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.clinbiomech.2019.10.001","article-title":"Impingement pain affects kinematics of breast cancer survivors in work-related functional tasks","volume":"70","author":"Lang","year":"2019","journal-title":"Clin. Biomech."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.apmr.2015.01.006","article-title":"Effectiveness of Postoperative Physical Therapy for Upper-Limb Impairments After Breast Cancer Treatment: A Systematic Review","volume":"96","author":"Dieltjens","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Olsson M\u00f6ller, U., Beck, I., Ryd\u00e9n, L., and Malmstr\u00f6m, M. (2019). A comprehensive approach to rehabilitation interventions following breast cancer treatment\u2014A systematic review of systematic reviews. 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