{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:15:34Z","timestamp":1792790134611,"version":"4.5.0"},"reference-count":23,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of California, Irvine","id":[{"id":"https:\/\/ror.org\/04gyf1771","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/04gyf1771","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Age-related declines in upper-extremity mobility remain a challenge to assess in older adults. This study examined whether a sensor-based motion analysis of reachable workspace (RWS), quantified using relative surface area (RSA), could track longitudinal upper-extremity mobility changes in a cohort of community-dwelling older adults receiving the Spencer Technique, an established therapeutic intervention for the shoulder. Fifteen community-dwelling older adults \u226565 years with shoulder mobility limitations identified by reduced goniometric ROM received the Spencer Technique twice weekly for two weeks. Outcomes including RSA, shoulder flexion and abduction via goniometry, Apley scratch test, DASH and upper extremity NeuroQoL were assessed at baseline, weekly, post-therapy, and 1-month follow-up. Total RSA significantly increased from baseline to post-therapy and 1-month follow-up in both dominant and nondominant upper extremities and remained significant after Holm correction (adjusted p \u2264 0.030). Bilateral shoulder flexion and abduction along with Apley scratch tests demonstrated parallel improvements. DASH scores did not demonstrate significant change, whereas NeuroQoL UE scores increased significantly at 1-month follow-up after Holm correction (adjusted p = 0.031). Total RSA demonstrated responsiveness to longitudinal changes in upper-extremity reachability following the Spencer Technique that parallel changes observed with standard clinical assessments. These findings support the utility of sensor-based RWS as a quantitative measure for tracking longitudinal upper-extremity mobility over time in older adults.<\/jats:p>","DOI":"10.3390\/s26196305","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:06:47Z","timestamp":1791274007000},"page":"6305","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sensor-Based Reachable Workspace Assessment for Tracking Upper-Extremity Mobility Changes over Time Following the Spencer Technique in Older Adults"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4638-3855","authenticated-orcid":false,"given":"Vicky","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of California at Irvine School of Medicine, Irvine, CA 92868, USA"},{"name":"Department of Rehabilitation Services, Irvine Medical Center, University of California, Orange, CA 92868, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4513-4750","authenticated-orcid":false,"given":"Andria","family":"Farrens","sequence":"additional","affiliation":[{"name":"Research Institute at Children Hospital Orange County (CHOC), Orange, CA 92868, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of California at Irvine School of Medicine, Irvine, CA 92868, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Addy","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of California at Irvine School of Medicine, Irvine, CA 92868, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of California at Irvine School of Medicine, Irvine, CA 92868, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Perez-Ibarra","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of California at Irvine School of Medicine, Irvine, CA 92868, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Thai","sequence":"additional","affiliation":[{"name":"Veterans Affairs Hospital in Long Beach (VALB), Long Beach, CA 90822, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Koh","sequence":"additional","affiliation":[{"name":"MemorialCare Rehabilitation Institute, MemorialCare Long Beach Medical Center, Long Beach, CA 90806, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5618-0942","authenticated-orcid":false,"given":"Jay J.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of California at Irvine School of Medicine, Irvine, CA 92868, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"ref_1","unstructured":"U.S. Census Bureau (2026, September 22). Disability Characteristics: 2022 American Community Survey 1-Year Estimates, Table S1810, Available online: https:\/\/data.census.gov\/table\/ACSST1Y2022.S1810."},{"key":"ref_2","unstructured":"Vincent, G.K., and Velkoff, V.A. (2026, September 22). The Next Four Decades: The Older Population in the United States: 2010 to 2050, Available online: https:\/\/www.census.gov\/library\/publications\/2010\/demo\/p25-1138.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"743843","DOI":"10.1155\/2013\/743843","article-title":"Flexibility of older adults aged 55\u201386 years and the influence of physical activity","volume":"2013","author":"Stathokostas","year":"2013","journal-title":"J. Aging Res."},{"key":"ref_4","first-page":"377","article-title":"The impact of ageing on fibrillar collagens","volume":"Volume 113","author":"Gupta","year":"2026","journal-title":"Fibrous Proteins: Structures and Mechanisms"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1519\/JPT.0b013e3182abe7d6","article-title":"Shoulder symptoms and function in geriatric patients","volume":"37","author":"Burner","year":"2014","journal-title":"J. Geriatr. Phys. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s11136-011-9958-8","article-title":"Neuro-QOL: Quality of life item banks for adults with neurological disorders: Item development and calibrations based upon clinical and general population testing","volume":"21","author":"Gershon","year":"2012","journal-title":"Qual. Life Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1002\/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L","article-title":"Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm, Shoulder and Hand)","volume":"29","author":"Hudak","year":"1996","journal-title":"Am. J. Ind. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3233\/THC-130764","article-title":"Evaluation of upper extremity reachable workspace using Kinect camera","volume":"21","author":"Kurillo","year":"2013","journal-title":"Technol. Health Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e29575","DOI":"10.1097\/MD.0000000000029575","article-title":"Sensor acquired reachable workspace in the elderly population: A cross-sectional observational study","volume":"101","author":"Chan","year":"2022","journal-title":"Medicine"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Han, J.J., Kurillo, G., Abresch, R.T., Nicorici, A., and Bajcsy, R. (2013). Validity, reliability, and sensitivity of a 3D vision sensor-based upper extremity reachable workspace evaluation in neuromuscular diseases. PLoS Curr., 5.","DOI":"10.1371\/currents.md.f63ae7dde63caa718fa0770217c5a0e6"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1080\/21678421.2016.1241278","article-title":"Longitudinal evaluation of upper extremity reachable workspace in ALS by Kinect sensor","volume":"18","author":"Oskarsson","year":"2017","journal-title":"Amyotroph. Lateral Scler. Front. Degener."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Chan, V., Lee, S.A., Lee, J.M., and Han, J.J. (2024). Sensor-acquired reachable workspace (RWS) correlates with activities of daily living (ADL) function in stroke as measured by Functional Independence Measure (FIM) self-care. Sensors, 24.","DOI":"10.20944\/preprints202409.1794.v2"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Han, J.J., Hayward, L.J., Adams, C., and Perez-Ibarra, J. (Muscle Nerve, 2026). Reachable workspace as a clinical outcome for upper extremity function: A narrative review, Muscle Nerve, Online ahead of print.","DOI":"10.1002\/mus.70190"},{"key":"ref_14","unstructured":"Bharbhari, K.S., and Hungund, A. (2025). Effect of Niel-Asher Technique vs Spencer Technique for pain, range of motion and functional disability in frozen shoulder: A randomized clinical trial. Altern. Ther. Health Med., AT11794. Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/41411137\/."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1080\/09593985.2026.2615392","article-title":"Effectiveness of the Spencer technique on pain, disability and range of motion in patients with frozen shoulder: A systematic review and meta-analysis with meta-regression of randomized controlled trials","volume":"42","author":"Tsai","year":"2026","journal-title":"Physiother. Theory Pract."},{"key":"ref_16","first-page":"101","article-title":"Shoulder range of motion of healthy elderly people: A normative study","volume":"13","author":"Desrosiers","year":"1995","journal-title":"Phys. Occup. Ther. Geriatr."},{"key":"ref_17","first-page":"387","article-title":"Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: A randomized, controlled trial","volume":"102","author":"Knebl","year":"2002","journal-title":"J. Am. Osteopath. Assoc."},{"key":"ref_18","unstructured":"Norkin, C.C., and White, D.J. (2009). Measurement of Joint Motion: A Guide to Goniometry, F.A. Davis Company. [4th ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/S0003-9993(98)90038-7","article-title":"Goniometric assessment of shoulder range of motion: Comparison of testing in supine and sitting positions","volume":"79","author":"Sabari","year":"1998","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4085\/1062-6050-498-16","article-title":"Potential mediators of load-related decreases in movement quality in young, healthy adults","volume":"54","author":"Glass","year":"2019","journal-title":"J. Athl. Train."},{"key":"ref_21","first-page":"65","article-title":"A simple sequentially rejective multiple test procedure","volume":"6","author":"Holm","year":"1979","journal-title":"Scand. J. Stat."},{"key":"ref_22","unstructured":"Magee, D.J. (2021). Orthopedic Physical Assessment, Elsevier. [7th ed.]."},{"key":"ref_23","first-page":"3079","article-title":"The painful shoulder: Part I. Clinical evaluation","volume":"61","author":"Woodward","year":"2000","journal-title":"Am. Fam. Physician"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/19\/6305\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:12:32Z","timestamp":1791432752000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/19\/6305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":23,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["s26196305"],"URL":"https:\/\/doi.org\/10.3390\/s26196305","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]}}}