scholarly journals Three-Dimensional Assessment of Upper Limb Proprioception via a Wearable Exoskeleton

2021 ◽  
Vol 11 (6) ◽  
pp. 2615
Author(s):  
Elisa Galofaro ◽  
Erika D’Antonio ◽  
Fabrizio Patané ◽  
Maura Casadio ◽  
Lorenzo Masia
Keyword(s):  
Neurological Diseases ◽  
Scientific Evidence ◽  
Three Dimensional ◽  
Sensory Information ◽  
Elbow Flexion ◽  
Muscle Spindles ◽  
Shoulder Abduction ◽  
Anatomical Location ◽  
Preferred Direction ◽  
Flexion Extension

Proprioception—the sense of body segment’s position and movement—plays a crucial role in human motor control, integrating the sensory information necessary for the correct execution of daily life activities. Despite scientific evidence recognizes that several neurological diseases hamper proprioceptive encoding with consequent inability to correctly perform movements, proprioceptive assessment in clinical settings is still limited to standard scales. Literature on physiology of upper limb’s proprioception is mainly focused on experimental approaches involving planar setups, while the present work provides a novel paradigm for assessing proprioception during single—and multi-joint matching tasks in a three-dimensional workspace. To such extent, a six-degrees of freedom exoskeleton, ALEx-RS (Arm Light Exoskeleton Rehab Station), was used to evaluate 18 healthy subjects’ abilities in matching proprioceptive targets during combined single and multi-joint arm’s movements: shoulder abduction/adduction, shoulder flexion/extension, and elbow flexion/extension. Results provided evidence that proprioceptive abilities depend on the number of joints simultaneously involved in the task and on their anatomical location, since muscle spindles work along their preferred direction, modulating the streaming of sensory information accordingly. These findings suggest solutions for clinical sensorimotor evaluation after neurological disease, where assessing proprioceptive deficits can improve the recovery path and complement the rehabilitation outcomes.

Clinical findings in C5-C6 and C5-C7 root palsies with brachial plexus traction lesions

2012 ◽  
Vol 38 (3) ◽  
pp. 237-241 ◽  
Author(s):  
J. A. Bertelli ◽  
M. F. Ghizoni
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Elbow Flexion ◽  
Clinical Findings ◽  
Hand Strength ◽  
Shoulder Abduction ◽  
Finger Extension ◽  
Root Injury ◽  
Flexion Extension

Stretch injuries of the C5-C7 roots of the brachial plexus traditionally have been associated with palsies of shoulder abduction/external rotation, elbow flexion/extension, and wrist, thumb, and finger extension. Based on current myotome maps we hypothesized that, as far as motion is concerned, palsies involving C5-C6 and C5-C7 root injuries should be similar. In 38 patients with upper-type palsies of the brachial plexus, we examined for correlations between clinical findings and root injury level, as documented by CT tomomyeloscan. Contrary to commonly held beliefs, C5-C7 root injuries were not associated with loss of extension of the elbow, wrist, thumb, or fingers, but residual hand strength was much lower with C5-C7 vs C5-C6 lesions.

Kinematics and Laxity of Ulnohumeral Joint Under Valgus-Varus Stress

1998 ◽  
Vol 02 (01) ◽  
pp. 45-54 ◽  
Author(s):  
Shinji Tanaka ◽  
Kai-Nan An ◽  
Bernard F. Morrey
Keyword(s):  
Elbow Joint ◽  
Three Dimensional ◽  
Elbow Flexion ◽  
Axial Rotation ◽  
Joint Laxity ◽  
Treatment Modalities ◽  
Trochlear Groove ◽  
Flexion Extension ◽  
Varus Stress ◽  
Baseline Information

Three-dimensional kinematics of the ulnohumeral joint under simulated active elbow joint flexion-extension was obtained by using an electromagnetic tacking device. The joint motion was analyzed based on Eulerian angle description. In order to minimize the effect of "downstream cross-talk" on calculation of the three Eulerian angles, an optimal axis to best represent flexion-extension of the elbow joint was established. This axis, on average, is close to the line joining the centers of the capitellum and the trochlear groove. Furthermore, joint laxity under valgus-varus stress was also examined. With the weight of the forearm as the stress, maximums of 7.6° valgus-varus laxity and 5.3° axial rotation laxity were observed within a range of elbow flexion. The results of this study provide useful baseline information on joint laxity for the evaluation of elbow joints with implant replacements and other surgical treatment modalities.

scholarly journals Measures of Interjoint Coordination Post-stroke Across Different Upper Limb Movement Tasks

2021 ◽  
Vol 8 ◽  
Author(s):  
Anne Schwarz ◽  
Janne M. Veerbeek ◽  
Jeremia P. O. Held ◽  
Jaap H. Buurke ◽  
Andreas R. Luft
Keyword(s):  
Upper Limb ◽  
Elbow Flexion ◽  
Shoulder Abduction ◽  
Kinematic Parameters ◽  
Limb Function ◽  
Interjoint Coordination ◽  
Upper Limb Function ◽  
Shoulder Flexion ◽  
Flexion Extension ◽  
Median Slope

Background: Deficits in interjoint coordination, such as the inability to move out of synergy, are frequent symptoms in stroke subjects with upper limb impairments that hinder them from regaining normal motor function. Kinematic measurements allow a fine-grained assessment of movement pathologies, thereby complementing clinical scales, like the Fugl–Meyer Motor Assessment of the Upper Extremity (FMMA-UE). The study goal was to investigate the effects of the performed task, the tested arm, the dominant affected hand, upper limb function, and age on spatiotemporal parameters of the elbow, shoulder, and trunk. The construct validity of the metrics was examined by relating them with each other, the FMMA-UE, and its arm section.Methods: This is a cross-sectional observational study including chronic stroke patients with mild to moderate upper limb motor impairment. Kinematic measurements were taken using a wearable sensor suit while performing four movements with both upper limbs: (1) isolated shoulder flexion, (2) pointing, (3) reach-to-grasp a glass, and (4) key insertion. The kinematic parameters included the joint ranges of shoulder abduction/adduction, shoulder flexion/extension, and elbow flexion/extension; trunk displacement; shoulder–elbow correlation coefficient; median slope; and curve efficiency. The effects of the task and tested arm on the metrics were investigated using a mixed-model analysis. The validity of metrics compared to clinically measured interjoint coordination (FMMA-UE) was done by correlation analysis.Results: Twenty-six subjects were included in the analysis. The movement task and tested arm showed significant effects (p < 0.05) on all kinematic parameters. Hand dominance resulted in significant effects on shoulder flexion/extension and curve efficiency. The level of upper limb function showed influences on curve efficiency and the factor age on median slope. Relations with the FMMA-UE revealed the strongest and significant correlation for curve efficiency (r = 0.75), followed by shoulder flexion/extension (r = 0.68), elbow flexion/extension (r = 0.53), and shoulder abduction/adduction (r = 0.49). Curve efficiency additionally correlated significantly with the arm subsection, focusing on synergistic control (r = 0.59).Conclusion: The kinematic parameters of the upper limb after stroke were influenced largely by the task. These results underpin the necessity to assess different relevant functional movements close to real-world conditions rather than relying solely on clinical measures.Study Registration: clinicaltrials.gov, identifier NCT03135093 and BASEC-ID 2016-02075.

scholarly journals Measuring Upper Limb Kinematics of Forehand and Backhand Topspin Drives with IMU Sensors in Wheelchair and Able-Bodied Table Tennis Players

Sensors ◽  
2021 ◽  
Vol 21 (24) ◽  
pp. 8303
Author(s):  
Jia-Wen Yam ◽  
Jing-Wen Pan ◽  
Pui-Wah Kong
Keyword(s):  
Upper Limb ◽  
Wrist Joint ◽  
Elbow Flexion ◽  
Measurement Unit ◽  
Shoulder Abduction ◽  
Table Tennis ◽  
Tennis Players ◽  
Movement Strategies ◽  
Flexion Extension ◽  
Limb Kinematics

To better understand the biomechanics of para-table tennis players, this study compared the shoulder, elbow, and wrist joint kinematics among able-bodied (AB) and wheelchair players in different classifications. Nineteen participants (AB, n = 9; classification 1 (C1), n = 3; C2, n = 3; C3, n = 4) executed 10 forehand and backhand topspin drives. Shoulder abduction/adduction, elbow flexion/extension, wrist extension/flexion, respective range of motion (ROM), and joint patterns were obtained using inertial measurement unit (IMU) sensors. The results showed clear differences in upper limb kinematics between the able-bodied and wheelchair players, especially in the elbow and wrist. For the para-players, noticeable variations in techniques were also observed among the different disability classes. In conclusion, wheelchair players likely adopted distinct movement strategies compared to AB to compensate for their physical impairments and functional limitations. Hence, traditional table tennis programs targeting skills and techniques for able-bodied players are unsuitable for para-players. Future work can investigate how best to customize training programs and to optimize movement strategies for para-players with varied types and degrees of impairment.

scholarly journals Comparison of modelling and tracking methods for analysing elbow and forearm kinematics

2019 ◽  
Vol 233 (11) ◽  
pp. 1113-1121 ◽  
Author(s):  
Wei Wang ◽  
Dongmei Wang ◽  
Mariska Wesseling ◽  
Bin Xue ◽  
Feiyue Li
Keyword(s):  
Three Dimensional ◽  
Optimal Estimation ◽  
Elbow Flexion ◽  
Coordinate Systems ◽  
Kinematic Data ◽  
Measurement Protocol ◽  
Flexion Extension ◽  
Good Consistency ◽  
Optical Motion ◽  
Optical Motion Capture

This study aimed to find an optimal measurement protocol of elbow and forearm kinematics using different modelling and tracking methods. Kinematic data of elbow flexion/extension and forearm pronation/supination was acquired using optical motion capture from 12 healthy male volunteers. Segment coordinate systems for humerus, forearm, radius, ulna, and hand were defined. Different tracking methods, using anatomical markers or rigid or point maker clusters, were used to compute the three-dimensional rotations. Marker placement errors were assessed to evaluate the rigid body assumption. Multiple comparisons demonstrated statistical differences between tracking methods: compared to using only anatomical markers, tracking using clusters reduced the estimated range of pronation/supination by 14.9%–43.2%, while it estimated increased flexion/extension by 5.3%–9.1%. The study suggests using only anatomical markers exerts the optimal estimation of elbow and forearm kinematics. Modelling using the coordinate systems of the humerus and forearm and of the humerus and ulna, respectively, demonstrated good consistency with literature and are correspondingly regarded as the most appropriate approach for measuring pronation/supination and flexion/extension. The results are valuable in establishing a measurement protocol for analysing elbow and forearm kinematics, avoiding confusions and misinterpretations in communicating results from different methodologies.

Influence of the Sampling Rate on the Measurements of the Upper Limb Movements

2014 ◽  
Vol 601 ◽  
pp. 163-166 ◽  
Author(s):  
Mirela Toth-Taşcău ◽  
Dan Ioan Stoia ◽  
Flavia Bălănean
Keyword(s):  
Upper Limb ◽  
Sampling Rate ◽  
Elbow Flexion ◽  
Measuring System ◽  
Shoulder Abduction ◽  
Limb Movements ◽  
Flexion Extension ◽  
Upper Limb Movements ◽  
Left And Right

The main objective of the study consists in determination of the most appropriate sampling rate of the measurements in instrumented kinematic analysis of the upper limb movements. The measuring system involved in the study is Zebris CMS-HS Measuring System, whose configuration was defined by ultrasound markers attached to specific body sites. The sampling rate interval was set from 10 to 25 Hz, according to the system’s range of frequencies. The kinematic parameters which have been analyzed are shoulder and elbow flexion-extension and shoulder abduction-adduction. A comparative kinematical analysis of the angle variations of flexion-extension and abduction-adduction in shoulder joint and flexion-extension in elbow joint was performed for both left and right upper limbs at each sampling rate.

FLUOROSCOPIC ANALYSIS FOR THE ESTIMATION OF IN VIVO ELBOW KINEMATICS: INFLUENCE OF 3D MODEL

2012 ◽  
Vol 12 (03) ◽  
pp. 1250046 ◽  
Author(s):  
LUCA TERSI ◽  
SILVIA FANTOZZI ◽  
RITA STAGNI ◽  
ANGELO CAPPELLO
Keyword(s):  
Cost Function ◽  
Three Dimensional ◽  
Elbow Flexion ◽  
Estimation Algorithm ◽  
Healthy Male Subject ◽  
Distance Map ◽  
3D Fluoroscopy ◽  
Flexion Extension ◽  
Single Bone

The reliable knowledge that model-based three-dimensional (3D) fluoroscopy can provide about in vivo joints kinematics is essential to diagnose orthopedic pathologies, develop new prosthesis, and evaluate clinical procedures. To exploit 3D fluoroscopy for the analysis of elbow kinematics, its use was evaluated considering a single model for the forearm or two different models for the ulna and radius. Active elbow flexion-extension and prono-supination motor tasks of a healthy male subject were acquired by means of fluoroscopy. The 3D bone models were automatically aligned to the relevant projections. The pose estimation algorithm sought the tangency condition of the projection rays with the model surface, minimizing a cost function and exploiting an adaptive distance map. Five iterative guided alignments were performed to avoid the final convergence to a local minimum. The results highlighted the critical alignment of the ulna/radius model, particularly when prono-supination is performed. From the physiological motion patterns and given the values of the cost function, 3D fluoroscopy was proven to be applicable to the analysis of the elbow kinematics when single bone models for the ulna and radius are used.

In Vivo Determination of the Direction of Rotation and Moment-Angle Relationship of Individual Elbow Muscles

1998 ◽  
Vol 120 (5) ◽  
pp. 625-633 ◽  
Author(s):  
L. Zhang ◽  
J. Butler ◽  
T. Nishida ◽  
G. Nuber ◽  
H. Huang ◽  
...  
Keyword(s):  
Muscle Activation ◽  
Dimensional Space ◽  
Three Dimensional ◽  
Elbow Flexion ◽  
Joint Movement ◽  
Flexion Extension ◽  
Relationship Of ◽  
Three Dimensional Space

The direction of rotation (DOR) of individual elbow muscles, defined as the direction in which a muscle rotates the forearm relative to the upper arm in three-dimensional space, was studied in vivo as a function of elbow flexion and forearm rotation. Electrical stimulation was used to activate an individual muscle selectively, and the resultant flexion-extension, supination-pronation, and varus-valgus moments were used to determine the DOR. Furthermore, multi-axis moment-angle relationships of individual muscles were determined by stimulating the muscle at a constant submaximal level across different joint positions, which was assumed to result in a constant level of muscle activation. The muscles generate significant moments about axes other than flexion-extension, which is potentially important for actively controlling joint movement and maintaining stability about all axes. Both the muscle DOR and the multi axis moments vary with the joint position systematically. Variations of the DOR and moment-angle relationship across muscle twitches of different amplitudes in a subject were small, while there were considerable variations between subjects.

Proximal cueing to reduce elbow extension levels in suspect spin bowlers: A case study

2018 ◽  
Vol 13 (5) ◽  
pp. 643-648 ◽  
Author(s):  
Kane J Middleton ◽  
Denny JM Wells ◽  
Daryl H Foster ◽  
Jacqueline A Alderson
Keyword(s):  
Elbow Joint ◽  
Three Dimensional ◽  
Statistical Parametric Mapping ◽  
Elbow Flexion ◽  
Joint Kinematics ◽  
Hand Position ◽  
Elbow Extension ◽  
Waveform Data ◽  
Flexion Extension

Cricket bowlers must be able to deliver the ball with less than 15° of elbow extension or face suspension. The aim of this case study was to report the findings of a technique remediation programme on the elbow joint kinematics of an international cricket bowler. The bowler underwent a three-dimensional bowling analysis to measure his elbow joint kinematics before and after a technique remediation programme. The bowler was required to bowl six deliveries of each of his off-break, quicker and doosra variations. The remediation programme focussed on modifying the bowler’s run-up, shoulder alignment and ball/hand position at back foot impact. Elbow joint waveform data were analysed using statistical parametric mapping tests and coefficient of multiple determination. Elbow flexion–extension angles at discrete events were compared pre- and post-remediation using paired-sample t-tests. Results showed that the remediation programme was effective in reducing the amount of elbow flexion, particularly in the first 60% of the delivery cycle. Elbow extension range was significantly lower post-remediation for the off-break and quicker deliveries. It was concluded that basic short-term technique remediation can be effective in reducing elbow extension range.

scholarly journals Evolution of forelimb musculoskeletal function across the fish-to-tetrapod transition

2021 ◽  
Vol 7 (4) ◽  
pp. eabd7457
Author(s):  
J. L. Molnar ◽  
J. R. Hutchinson ◽  
R. Diogo ◽  
J. A. Clack ◽  
S. E. Pierce
Keyword(s):  
Three Dimensional ◽  
Elbow Flexion ◽  
Selective Pressures ◽  
Musculoskeletal Models ◽  
Weight Support ◽  
Flexion Extension ◽  
Terrestrial Environments ◽  
Axis Rotation ◽  
Musculoskeletal Function ◽  
Restricted Mobility

One of the most intriguing questions in vertebrate evolution is how tetrapods gained the ability to walk on land. Although many hypotheses have been proposed, few have been rigorously tested using the fossil record. Here, we build three-dimensional musculoskeletal models of the pectoral appendage in Eusthenopteron, Acanthostega, and Pederpes and quantitatively examine changes in forelimb function across the fin-to-limb transition. Through comparison with extant fishes and tetrapods, we show that early tetrapods share a suite of characters including restricted mobility in humerus long-axis rotation, increased muscular leverage for humeral retraction, but not depression/adduction, and increased mobility in elbow flexion-extension. We infer that the earliest steps in tetrapod forelimb evolution were related to limb-substrate interactions, whereas specializations for weight support appeared later. Together, these results suggest that competing selective pressures for aquatic and terrestrial environments produced a unique, ancestral “early tetrapod” forelimb locomotor mode unlike that of any extant animal.

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