Assessing the Accuracy and Reliability of the Monitored Augmented Rehabilitation System for Measuring Shoulder and Elbow Range of Motion.

Accurate range of motion (ROM) assessment is essential for evaluating musculoskeletal function and guiding rehabilitation, particularly in pediatric populations. Traditional methods, such as optical motion capture and handheld goniometry, are often limited by cost, accessibility, and inter-rater variability. This study evaluated the feasibility and accuracy of the Microsoft Azure Kinect-powered Monitored Augmented Rehabilitation System (MARS) compared to Kinovea. Sixty-five pediatric participants (ages 5-18) performed standardized shoulder and elbow movements in the frontal and sagittal planes. ROM data were recorded using MARS and compared to Kinovea. Measurement reliability was evaluated using intraclass correlation coefficients (ICC3k), and accuracy was evaluated using root mean squared error (RMSE) analysis. MARS demonstrated excellent reliability with an average ICC3k of 0.993 and met the predefined accuracy threshold (RMSE ≤ 8°) for most movements, with the exception of sagittal elbow flexion. These findings suggest that MARS is a reliable, accurate, and cost-effective alternative for clinical ROM assessment, offering a markerless solution that enhances measurement precision and accessibility in pediatric rehabilitation. Future studies should enhance accuracy in sagittal plane movements and further validate MARS against gold-standard systems.