A biomechanical analysis of upper extremity kinetics in children with cerebral palsy using anterior and posterior walkers

Konop, Katherine A.; Strifling, Kelly M.B.; Wang, Mei; Cao, Kevin; Schwab, Jeffrey P.; Eastwood, Daniel; Jackson, Scott; Ackman, Jeffrey D.; Harris, Gerald F.

doi:10.1016/j.gaitpost.2009.06.012

Cited by 22 publications

(17 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Complete results from the 10 participants have been reported previously 13,16 and are shown in Figures 3e5. There were no statistically significant differences between walker types (anterior and posterior) or sides (right and left, or dominant and nondominant).…”

Section: Standard Anterior and Posterior Walkermentioning

confidence: 68%

“…13,16 The model complied with International Society of Biomechanics (ISB) standards 26 and computed three-dimensional Euler joint rotations comparing distal segments to proximal segments in a sagittalcoronal-transverse rotation sequence. The kinetic portion of the model used an inverse dynamics approach, similar to Vaughan et al in 1992 27 to determine the JRFs and JRMs at each UE joint.…”

Section: Discussionmentioning

confidence: 99%

“…16 Kinetic data were compared between walker types and sides using a Wilcoxon signed rank test with BenjaminiHochberg threshold values. 13 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Upper Extremity Joint Dynamics During Walker Assisted Gait: A Quantitative Approach Towards Rehabilitative Intervention

Konop¹,

Strifling²,

Krzak

et al. 2011

Journal of Experimental & Clinical Medicine

Self Cite

View full text Add to dashboard Cite

Background: Many children with spastic diplegic cerebral palsy (CP) use anterior or posterior walkers to aid ambulation. Prolonged use may lead to upper extremity (UE) pathology later in life, including arthritis and joint contractures. Purpose: This study analyzes the dynamics (kinematics and kinetics) of the shoulder (glenohumeral), elbow, and wrist joints during anterior and posterior walker use. It also examines the dynamic effects of adjusting handle height and grip rotation. Methods: Ten children with CP underwent motion analysis with upper and lower extremity marker sets and six-degree-of-freedom instrumented walker handles, while using both anterior and posterior walkers. One child underwent the same analysis, with added trials for wrist derotation (adjusted axial grip rotation) and wrist plus elbow derotation (adjusted handle height). A validated kinematic and kinetic model was applied to calculate UE joint angles, joint reaction forces (JRFs), and joint reaction moments (JRMs). Results: Surprisingly, no statistically significant differences in UE angles, JRFs, or JRMs were observed between anterior and posterior walkers. Wrist derotation, however, decreased the flexion JRM seen at the wrist, and elbow derotation decreased the flexion JRM seen at the elbow. Conclusion: Anterior and posterior walkers produce similar UE motion and peak loading values. Wrist and elbow joint derotation alters the dynamic effects experienced by the UEs. UE motion analysis during aided gait can be useful for optimizing UE loading conditions to limit pathology later in life.

show abstract

Section: Standard Anterior and Posterior Walkermentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Upper Extremity Joint Dynamics During Walker Assisted Gait: A Quantitative Approach Towards Rehabilitative Intervention

Konop¹,

Strifling²,

Krzak

et al. 2011

Journal of Experimental & Clinical Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the current work, the specimens were constrained in the loading plane only. This less constrained configuration was chosen to better approximate humeral load conditions during assistive device-aided upper extremity motion as demonstrated in previous studies [23,24,25]. Although the out-of-plane rotation was not constrained, no rotation accessed by following the link in the citation at the bottom of the page.…”

Section: Discussionmentioning

confidence: 99%

Mechanical characterization of fourth generation composite humerus

Grover

Albert

Wang

et al. 2011

Proc Inst Mech Eng H

View full text Add to dashboard Cite

Abstract:Mechanical data on upper extremity surrogate bones, supporting use as biomechanical tools, is limited. The objective of this study was to characterize the structural behavior of the fourth generation composite humerus under simulated physiologic bending, specifically, stiffness, rigidity, and middiaphysial surface strains. Three humeri were tested in four-point bending, in anatomically defined anteroposterior(AP) and mediolateral(ML) planes. Stiffness and rigidity were derived using load-displacement data. Principal strains were determined at the anterior, posterior, medial and lateral surfaces in the humeral mid-diaphysial transverse plane of one specimen using stacked rosettes. Linear structural behavior was observed within test range. Average stiffness and rigidity were greater in the ML (918+18 N/mm; 98.4+1.9 Nm 2 ) than the AP plane (833+16 N/mm; 89.3+1.6 Nm 2 ), with little interspecimen variability. The ML/AP rigidity ratio was 1.1. Surface principal strains were similar at the anterior (5.41 /N) and posterior (5.43 /N) gauges for AP bending, and comparatively less for ML bending, i.e., 5.1 and 4.5 /N, at the medial and lateral gauges, respectively. The study provides novel strain and stiffness data for the fourth generation composite humerus, and adds to published construct rigidity data. Results support use of this composite bone as a tool for modeling and experimentation.

show abstract

“…1,2 However, few studies have been conducted to examine the UE kinetics during wheelchair mobility. 3,4 In 2000, 90% of wheelchair users (1.5 million people) in the United States (US) were manual wheelchair users (MWU), requiring the use of their upper body to maneuver the wheelchair as well as to perform other activities of daily living.…”

Section: Introductionmentioning

confidence: 99%

Upper extremity biomechanical model for evaluation of pediatric joint demands during wheelchair mobility

Paul

Slavens

Graf

et al. 2012

2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

View full text Add to dashboard Cite

Current methods for evaluating upper extremity (UE) dynamics during pediatric wheelchair use are limited. We propose a new model to characterize UE joint kinematics and kinetics during pediatric wheelchair mobility. The bilateral model is comprised of the thorax, clavicle, scapula, upper arm, forearm, and hand segments. The modeled joints include: sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist. The model is complete and is currently undergoing pilot studies for

show abstract

A biomechanical analysis of upper extremity kinetics in children with cerebral palsy using anterior and posterior walkers

Cited by 22 publications

References 22 publications

Upper Extremity Joint Dynamics During Walker Assisted Gait: A Quantitative Approach Towards Rehabilitative Intervention

Upper Extremity Joint Dynamics During Walker Assisted Gait: A Quantitative Approach Towards Rehabilitative Intervention

Mechanical characterization of fourth generation composite humerus

Upper extremity biomechanical model for evaluation of pediatric joint demands during wheelchair mobility

Contact Info

Product

Resources

About