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Quantitative characterisation of upper limb motion allows the evaluation of the effect of pathology on functional task performance, potentially directing rehabilitation strategies. Movement patterns of the distal upper limb in healthy adults during functional tasks have not been extensively characterised. During five loaded functional tasks (drinking from a glass, pouring from a kettle, turning a handle, lifting a bag to a shelf, turning a key) the movement patterns were characterised using three-dimensional motion analysis with a minimal marker set in 16 healthy adults (10 M,6F, 27 (IQR:25-43)years). Joint angles reported include flexion/extension at the elbow and wrist, forearm supination/pronation and digits 2-5 metacarpophalangeal (MCP) joint flexion/extension. Additionally for the thumb the angle between the metacarpal of the thumb and the 2nd digit (Thumb base), the thumb MCP (Thumb MCP) and interphalangeal (Thumb IP) joint angles are presented. Durations of activities performed at self-selected comfortable speeds (3.36 (IQR:3.07,3.66)s turning a key to 6.20 (IQR:5.44,6.38)s drinking from a glass) are reported. The maximum joint angles used (median of participants' maxima) were 141° of elbow flexion, 116° forearm supination, 36° wrist extension, 56° Thumb base, 14° Thumb MCP flexion, 18° Thumb IP flexion, 85° MCP2-5 flexion. The tasks of drinking from a glass, lifting a bag to a shelf and turning a key appeared to have the least variation in performance, suggesting that these activities are better suited to be selected as standardized tasks for assessing the impact of pathology on movement than pouring from a kettle and turning a handle. [ABSTRACT FROM AUTHOR]

Assessments of upper limb performance should require participants to perform tasks that challenge the limits of their ability. In order to select appropriate tasks, it is important to know which joints are used to perform the movement and how reliably those movements can be measured. The purpose of this work was to quantify the reliability of upper limb and trunk joint angles in healthy adults during common activities of daily living (ADLs). Nineteen participants performed six ADLs with the right arm (applying deodorant, turning a doorknob, answering a desk telephone, placing a pushpin in a bulletin board, wiping a plate with a towel, and pouring water from a pitcher) during two separate sessions. Within- and between-session reliability was quantified using intraclass correlation coefficients (ICCs) and minimum detectable change values (MDCs). Reliability was generally better within-session than between-session. The ICCs exceeded 0.75 for 88% of the joint angles and exceeded 0.90 for 32% of the angles. All MDCs were less than 25° and 61% were also less than 10°. The MDCs represented a larger percent of the average angles for the trunk (61%) and wrist (62%) compared to the shoulder (18%) and elbow (26%). Although these results show that most angles can be measured reliably for these six ADLs, reliability varied considerably between joints. It is therefore important to select tasks for assessing of upper limb performance based on which specific joints need to be evaluated. [ABSTRACT FROM AUTHOR]

Impaired arm swing is a common motor symptom of Parkinson's disease (PD), and correlates with other gait impairments and increased risk of falls. Studies suggest that arm swing is not merely a passive consequence of trunk rotation during walking, but an active component of gait. Thus, techniques to enhance arm swing may improve gait characteristics. There is currently no portable device to measure arm swing and deliver immediate cues for larger movement. Here we test report pilot testing of such a device, ArmSense (patented), using a crossover repeated-measures design. Twelve people with PD walked in a video-recorded gym space at self-selected comfortable and fast speeds. After baseline, cues were given either visually using taped targets on the floor to increase step length or through vibrations at the wrist using ArmSense to increase arm swing amplitude. Uncued walking then followed, to assess retention. Subjects successfully reached cueing targets on >95% of steps. At a comfortable pace, step length increased during both visual cueing and ArmSense cueing. However, we observed increased medial-lateral trunk sway with visual cueing, possibly suggesting decreased gait stability. In contrast, no statistically significant changes in trunk sway were observed with ArmSense cues compared to baseline walking. At a fast pace, changes in gait parameters were less systematic. Even though ArmSense cues only specified changes in arm swing amplitude, we observed changes in multiple gait parameters, reflecting the active role arm swing plays in gait and suggesting a new therapeutic path to improve mobility in people with PD. [ABSTRACT FROM AUTHOR]

Obesity reduces the efficiency of postural and movement control mechanisms. However, the effects of obesity on a functional motor task and postural control in standing and seated position have not been closely quantified among children. The aim of this study is to examine the effects of obesity on the execution of aiming tasks performed in standing and seated conditions in children. Twelve healthy weight children and eleven obese children aged between 8 and 11 years pointed to a target in standing and seated position. The difficulty of the aiming task was varied by using 2 target sizes (1.0 cm and 5.0 cm width; pointing to the smaller target size needs a more precise movement and constitutes a more difficult task). Hand movement time (MT) and its phases were measured to quantify the aiming task. Mean speed of the center of pressure displacement (COP speed) was calculated to assess postural stability during the movement. Obese children had significantly higher MTs compared to healthy-weight children in seated and standing conditions explained by greater durations of deceleration phase when aiming. Concerning the COP speed during the movement, obese children showed significantly higher values when standing compared to healthy-weight children. This was also observed in the seated position. In conclusion, obesity adds a postural constraint during an aiming task in both seated and standing conditions and requires obese children to take more time to correct their movements due to a greater postural instability of the body when pointing to a target with the upper-limb. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this study was to characterize normal temporal–spatial patterns during the Reach & Grasp Cycle and to identify upper limb motor deficits in children with cerebral palsy (CP). The Reach & Grasp Cycle encompasses six sequential tasks: reach, grasp cylinder, transport to self (T 1), transport back to table (T 2), release cylinder, and return to initial position. Three-dimensional motion data were recorded from 25 typically developing children (11 males, 14 females; ages 5–18 years) and 12 children with hemiplegic CP (2 males, 10 females; ages 5–17 years). Within-day and between-day coefficients of variation for the control group ranged from 0 to 0.19, indicating good repeatability of all parameters. The mean duration of the Cycle for children with CP was nearly twice as long as controls, 9.5±4.3s versus 5.1±1.2s (U =37.0, P =.002), partly due to prolonged grasp and release durations. Peak hand velocity occurred at approximately 40% of each phase and was greater during the transport (T 1, T 2) than non-transport phases (reach, return) in controls (P <.001). Index of curvature was lower during transport versus non-transport phases for all children. Children with CP demonstrated an increased index of curvature during reach (U =46.0, P =.0074) and an increased total number of movement units (U =16.5, P <.0001) compared to controls, indicating less efficient and less smooth movements. Total duration of the Reach & Grasp Cycle (rho=.957, P <.0001), index of curvature during reach and T 1 (rho=.873, P =.0002 and rho=.778, P =.0028), and total number of movement units (rho=.907, P <.0001) correlated strongly with MACS score. The consistent normative data and the substantial differences between children with CP and controls reflect utility of the Reach & Grasp Cycle for quantitative evaluation of upper limb motor deficits. [Copyright &y& Elsevier]