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Normative Data for an Instrumental Assessment of the Upper-Limb Functionality.

ABSTRACT: Upper-limb movement analysis is important to monitor objectively rehabilitation interventions, contributing to improving the overall treatments outcomes. Simple, fast, easy-to-use, and applicable methods are required to allow routinely functional evaluation of patients with different pathologies and clinical conditions. This paper describes the Reaching and Hand-to-Mouth Evaluation Method, a fast procedure to assess the upper-limb motor control and functional ability, providing a set of normative data from 42 healthy subjects of different ages, evaluated for both the dominant and the nondominant limb motor performance. Sixteen of them were reevaluated after two weeks to perform test-retest reliability analysis. Data were clustered into three subgroups of different ages to test the method sensitivity to motor control differences. Experimental data show notable test-retest reliability in all tasks. Data from older and younger subjects show significant differences in the measures related to the ability for coordination thus showing the high sensitivity of the method to motor control differences. The presented method, provided with control data from healthy subjects, appears to be a suitable and reliable tool for the upper-limb functional assessment in the clinical environment.

SUBMITTER: Caimmi M

PROVIDER: S-EPMC4619839 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Normative Data for an Instrumental Assessment of the Upper-Limb Functionality.

Caimmi Marco M Guanziroli Eleonora E Malosio Matteo M Pedrocchi Nicola N Vicentini Federico F Molinari Tosatti Lorenzo L Molteni Franco F

BioMed research international 20151011

Upper-limb movement analysis is important to monitor objectively rehabilitation interventions, contributing to improving the overall treatments outcomes. Simple, fast, easy-to-use, and applicable methods are required to allow routinely functional evaluation of patients with different pathologies and clinical conditions. This paper describes the Reaching and Hand-to-Mouth Evaluation Method, a fast procedure to assess the upper-limb motor control and functional ability, providing a set of normativ ...[more]

PMID: 26539500

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Project description:BackgroundDexterous hand function is crucial for completing activities of daily living (ADLs), which typically require precise hand-object interactions. Kinematic analyses of hand trajectory, hand velocity, and grip aperture provide valuable mechanistic insights into task performance, but there is a need for standardized tasks representative of ADLs that are amenable to motion capture and show consistent performance in non-disabled individuals. Our objective was to develop two standardized functional upper limb tasks and to quantitatively characterize the kinematics of normative hand movement.MethodsTwenty non-disabled participants were recruited to perform two tasks: the Pasta Box Task and Cup Transfer Task. A 12-camera motion capture system was used to collect kinematic data from which hand movement and grip aperture measures were calculated. Measures reported for reach-grasp and transport-release segments were hand distance travelled, hand trajectory variability, movement time, peak and percent-to-peak hand velocity, number of movement units, peak and percent-to-peak grip aperture, and percent-to-peak hand deceleration. A between-session repeatability analysis was conducted on 10 participants.ResultsMovement times were longer for transport-release compared to reach-grasp for every movement. Hand and grip aperture measures had low variability, with 55 out of 63 measures showing good repeatability (ICC > 0.75). Cross-body movements in the Pasta Box Task had longer movement times and reduced percent-to-peak hand velocity values. The Cup Transfer Task showed decoupling of peak grip aperture and peak hand deceleration for all movements. Movements requiring the clearing of an obstacle while transporting an object displayed a double velocity peak and typically a longer deceleration phase.DiscussionNormative hand kinematics for two standardized functional tasks challenging various aspects of hand-object interactions important for ADLs showed excellent repeatability. The consistency in normative task performance across a variety of task demands shows promise as a potential outcome assessment for populations with upper limb impairment.

Project description:PurposeTo determine the range of the Pediatric Outcomes Collection Instrument (PODCI) scores for children with a wide variety of congenital upper limb differences and to examine the scoring effect of the patient's surgical history, family history, severity of involvement, and syndromic associations.MethodsWe reviewed the PODCI scores for 109 patients, aged 2-18 years, treated for nontraumatic upper extremity conditions. Charts were reviewed for sex, age, extent of limb involvement, laterality, family history, surgical history, and syndrome association. All patients were classified based on the Oberg, Manske, Tonkin classification with general categories of malformation, deformation, or dysplasia.ResultsOf 109 patients, 80 (73%) had a malformation, 12 (11%) had a deformation, and 17 (16%) had a dysplasia. The cohort as a whole had a happiness PODCI score that was similar to the normal population, yet a lower (worse) PODCI score for upper extremity and global function. Patients with a dysplasia had a higher upper extremity function scores than those with malformations or deformations, but they had similar happiness and global function scores. Complete upper limb involvement and lower extremity involvement statistically lowered the PODCI score within our study cohort, whereas a positive family history and syndromic association increased PODCI scores.ConclusionsThis study showed that there was a similar level of perceived happiness between children/adolescents with congenital upper extremity conditions compared with the normal pediatric population based on PODCI scores. In contrast, the perceived upper extremity and global function was significantly decreased in patients with congenital differences compared with normal individuals. This investigation also revealed that the extent of upper extremity involvement, lower extremity involvement, family history, and syndromic association may affect PODCI scores as independent variables and should be taken into consideration in studies of upper extremity congenital anomalies.Type of study/level of evidencePrognostic IV.

Project description:The number of smartphone users globally is rapidly increasing. This study aimed to assess the level of ergonomic risk to smartphone users, and to evaluate the correlation between any self-reported musculoskeletal disorders and the level of ergonomic risk. Thirty participants completed a questionnaire, tailored specifically for smartphone users, to determine any musculoskeletal disorders. Participants were given a seated smartphone texting task and their postures were video recorded during the task. The video scenarios were evaluated by three independent researchers to determine the level of ergonomic risk using the Rapid Upper Limb Assessment (RULA) tool. RULA is an observation-based screening tool which has been widely used to assess the postural risk of IT device users. However, it has not yet been specifically utilized with smartphone users. The RULA tool scores identified ergonomics risks from using smartphones to text. Most smartphone users had a total RULA Grand Score of 6 for both sides (left side: 80.00%, right side: 90.00%), indicating the need for further investigation and changes (Action Level 3). Notably, no participants had acceptable RULA Grand Scores of 1 or 2. The correlation between musculoskeletal disorders and the ergonomic risk among smartphone users was determined using the Chi-Square test and Fisher's exact test; p<0.05 was considered statistically significant. There was a significant correlation between right RULA Grand Score and neck musculoskeletal disorder (χ2 = 9.424 at p value = 0.009) and right RULA Grand Score and upper back musculoskeletal disorder (χ2 = 31.717 at p value <0.001). RULA Score B (combination of neck, trunk and leg postures) and RULA Score D (combination of Score B, muscle use and force scores for group B) were also significantly correlated with neck musculoskeletal disorders (χ2 = 19.286 at p value<0.001 and χ2 = 9.310 at p value = 0.002 respectively). The RULA results identified the high ergonomics risk of smartphone users, this resulted from two key risk factors: posture and muscle use. The neck, trunk and leg postures had a combined effect on neck musculoskeletal disorders. Future investigations should consider these factors when designing ergonomic interventions for smartphone users.

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Normative Data for an Instrumental Assessment of the Upper-Limb Functionality.

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Normative Data for an Instrumental Assessment of the Upper-Limb Functionality.

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