IMU-Based Analysis of Postural Transitions: A Systematic Review

Background: Postural transitions (PTs) are crucial for daily independence, but their assessment often relies on subjective observational scales. Inertial measurement units (IMUs) offer quantitative assessment, yet a comprehensive synthesis of methodological approaches for IMU-based PT assessment is lacking. This systematic review maps the methodological landscape of IMU-based PT studies. Methods: A PCC-based search queried PubMed, Scopus, and Web of Science for IMU-based PT assessment in adults. Methodological quality was appraised using design- and purpose-appropriate established tools. Results: From 30,181 records, 35 studies were included, with heterogeneous study designs, purposes (e.g., detection, segmentation, validation), and analytical methods (e.g., threshold-based approach, model-based approach, deep learning method). Sit-to-stand was the most frequently assessed PT. Methodological appraisal indicated an intermediate robustness, with most studies showing moderate concerns. Sensor configurations, acquisition protocols, signal processing, segmentation, and outcome definitions varied substantially, and IMU-derived PT outcomes lacked standardization. Conclusion: IMUs offer significant potential for objective postural-transition assessment in rehabilitation, yet methodological heterogeneity and underrepresented tasks like bed mobility limit progress. Future research must prioritize standardized, validated, and clinically interpretable metrics to address reporting inconsistencies and establish a unified framework essential for widespread clinical adoption.