1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

O-25
3D KINEMATICS OF UPPER EXTREMITY TASKS
van Andel, Carolien, PhD 1,2,3 , Wolterbeek, Nienke 1,2,3 , MSc, Doorenbosch, Caroline, PhD 1,3 ,
Harlaar, Jaap, PhD 1,2,3 , Veeger, DirkJan, PhD 2,3,4
1 Dept. of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The
Netherlands
2 Faculty of Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
3 MOVE institute for human movement research
4 Man Machine Systems, Delft University of Technology, The Netherlands
Summary/conclusions
This study presents a measurement method for the 3D kinematics of the Upper Extremity
(UX). Also a series of standardised UX tasks and their kinematic ranges are presented. These
results are the basis for a ‘UX analysis report’ compared to the ‘gait analysis report’.
Introduction
Though the kinematics of the UX have been studied before [1], these studies did not include
sets of standard functional movements of the UX that included the correct hand orientation.
Since hand orientation is a major determinant in the usefulness of upper limb motion, this is a
serious drawback. The purpose of this study was firstly to define a measurement method based
on current state of the art that includes hand orientation. Secondly, to define a set of functional
tasks for the UX and establish the stereotype execution of the tasks (norm values) as well the
amount of normal variation.
Statement of clinical significance
The development of gait analysis has been extremely useful in the treatment of lower extremity
dysfunctions. Likewise, analysis of UX functions by means of 3D kinematics has the potential
to become an important tool in clinical decision making and therapeutic evaluation of patients
with UX disorders.
Methods
Movements of the UX were measured using stereophotogrammatic recording of active LEDmarkers
using an Optotrak (Northern Digital) system. Small clusters of 3 markers were placed
on the hand, upper arm, acromion (to represent the scapula [2]) and trunk. Also, a cuff with 6
markers was placed just proximal of the styloids of the wrist. Local anatomical coordinate
systems and joint rotations were defined according to the ISB standardization proposal [3]. The
proximal landmark for the humerus was determined using a helical axis approximation. The
orientation of the humerus was defined with respect to the thorax. Axial rotation of the
humerus was determined using the orientation of the forearm. Zero angles were defined by
alignment of the anatomical coordinate systems.
Ten healthy adults (age 23-42) performed 6 simple whole ROM tasks (wrist palmar - dorsal
flexion, pronation - supination, elbow flexion - extension, endo - exorotation with 90 o humerus
abduction, anteflexion - retroflexion, abduction - adduction). Additionally they performed four
functional tasks (drinking, combing hair, move hand to back pocket, move hand to contra
lateral shoulder). All tasks were performed three times and recorded at a sample rate of 50 Hz.
For the ROM tasks the subjects started in the anatomical position and were asked actively
move to a maximum joint angle in that plane. The four functional tasks were selected after
consultation with the clinical staff. To promote standard performance, subjects were asked to
copy the movements made by the instructor who stood in front of them. From the ROM tasks
the following maximum angles were selected for further analysis: wrist palmar and dorsal
flexion, pronation, elbow flexion, humeral endo- and exorotation, humeral elevation and
scapula laterorotation. The same angles were derived for the functional tasks, from the starting
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