The Future of Clinical Active Shoulder Range of Motion Assessment, Best Practice, and Its Challenges: Narrative...

Optimising outcomes after shoulder interventions requires objective shoulder range of motion (ROM) assessments. This narrative review examines video-based pose technologies and markerless motion capture, focusing on their clinical application for shoulder ROM assessment. Camera pose-based methods offer objective ROM measurements, though the accuracy varies due to the differences in gold standards, anatomical definitions, and deep learning techniques. Despite some biases, the studies report a high consistency, emphasising that methods should not be used interchangeably if they do not agree with each other. Smartphone cameras perform well in capturing 2D planar movements but struggle with that of rotational movements and forward flexion, particularly when thoracic compensations are involved. Proper camera positioning, orientation, and distance are key, highlighting the importance of standardised protocols in mobile phone-based ROM evaluations. Although 3D motion capture, per the International Society of Biomechanics recommendations, remains the gold standard, advancements in LiDAR/depth sensing, smartphone cameras, and deep learning show promise for reliable ROM assessments in clinical settings.