Assessment of the Spastic Upper Limb with Computational Motion Analysis

Karakostas, Tasos; Watters, Kelsey; King, Erik

doi:10.1016/j.hcl.2018.06.002

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…Motion laboratories can additionally examine kinematics. 17 Imaging and electrodiagnostics, although supplementary, cannot substitute for a comprehensive physical examination.…”

Section: General Assessmentmentioning

confidence: 99%

The Spastic Upper Extremity in Children: Multilevel Surgical Decision-making

Chaudhry

Bhardwaj

Venkatramani

et al. 2021

J Am Acad Orthop Surg

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Multilevel surgery for upper extremity spasticity is the current surgical standard. While the literature details surgical techniques and outcomes, a comprehensive guide to surgical planning is lacking. Patients commonly present with posturing into shoulder internal rotation, elbow flexion, forearm pronation, wrist flexion with ulnar deviation, finger flexion, and thumb adduction, although variations exist. Multiple surgical options exist for each segment; therefore, repeated examinations for contracture, pathologic laxity, and out of phase activity are necessary to optimize the surgical plan. To avoid decreasing function, one must carefully balance the benefits of contracture release and tendon transfers with their weakening effects. In certain cases, stability from joint fusion outweighs the loss of motion. Failure to recognize dynamic posturing, grasp and release requirements, or hand intrinsic spasticity can worsen function and cause new deformities. Surgical indications are formulated for individual deformity patterns and severity along with personal/family goals. General comprehension, voluntary control, and sensation, although not modifiable, influence decision making and are prognostic indicators. Functional improvement is unlikely without preexisting voluntary control, but appearance and visual feedback may be improved by repositioning nonetheless. Appropriate interventions and management of expectations will optimize limb appearance and function while avoiding unexpected sequelae.

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“…Motion laboratories can additionally examine kinematics. 17 Imaging and electrodiagnostics, although supplementary, cannot substitute for a comprehensive physical examination.…”

Section: General Assessmentmentioning

confidence: 99%

The Spastic Upper Extremity in Children: Multilevel Surgical Decision-making

Chaudhry

Bhardwaj

Venkatramani

et al. 2021

J Am Acad Orthop Surg

View full text Add to dashboard Cite

show abstract

“…After an upper motor neuron injury, heterotopic ossification, which can markedly impede motion, is often present within the elbow and is rarely present within the shoulder 2,13,14 . Concomitant with central nervous system trauma, fractures of the upper extremities also may have occurred, thus contributing to abnormal alignment and limited 16 . The dEMG analysis can be extremely beneficial for determining whether volitional motor activation is present within a specific muscle and for identifying whether an inability to perform full active motion is due to motor weakness or to dyssynergy [2][3][4] .…”

Section: Imaging Studiesmentioning

confidence: 99%

Surgical Management of the Spastic Forearm, Wrist, and Hand: Evidence-Based Treatment Recommendations

Rhee

2019

JBJS Rev

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The surgical approach for the patient with a spastic upper limb must be individualized and goal-focused.» An injury to the central nervous system can lead to spinal reflex hyperexcitability with exaggerated muscle activation in response to quick stretch stimuli (i.e., spasticity).» Surgical treatment options are dependent on the potential for function in the spastic upper limb.» If volitional motor control is present, spastic motor units can be lengthened or released while preserving function. » In the absence of volitional motor control, spastic muscles can be divided, released, or denervated with selective neurectomies.

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“…This type of measurement is relevant for a better understanding of any risks or deficiencies involving specific parts of the human body. It contributes to clinical decision-making concerning the need and type of surgery, drug administration, and even the assessment of treatment efficacy [ 3 ]. In clinical settings, a post-stroke recovery analysis is a recommended application [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Upper Limb Movement Measurement Systems for Cerebral Palsy: A Systematic Literature Review

Francisco-Martínez¹,

Prado-Olivarez²,

Padilla-Medina³

et al. 2021

Sensors

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Quantifying the quality of upper limb movements is fundamental to the therapeutic process of patients with cerebral palsy (CP). Several clinical methods are currently available to assess the upper limb range of motion (ROM) in children with CP. This paper focuses on identifying and describing available techniques for the quantitative assessment of the upper limb active range of motion (AROM) and kinematics in children with CP. Following the screening and exclusion of articles that did not meet the selection criteria, we analyzed 14 studies involving objective upper extremity assessments of the AROM and kinematics using optoelectronic devices, wearable sensors, and low-cost Kinect sensors in children with CP aged 4–18 years. An increase in the motor function of the upper extremity and an improvement in most of the daily tasks reviewed were reported. In the population of this study, the potential of wearable sensors and the Kinect sensor natural user interface as complementary devices for the quantitative evaluation of the upper extremity was evident. The Kinect sensor is a clinical assessment tool with a unique markerless motion capture system. Few authors had described the kinematic models and algorithms used to estimate their kinematic analysis in detail. However, the kinematic models in these studies varied from 4 to 10 segments. In addition, few authors had followed the joint assessment recommendations proposed by the International Society of Biomechanics (ISB). This review showed that three-dimensional analysis systems were used primarily for monitoring and evaluating spatiotemporal variables and kinematic parameters of upper limb movements. The results indicated that optoelectronic devices were the most commonly used systems. The joint assessment recommendations proposed by the ISB should be used because they are approved standards for human kinematic assessments. This review was registered in the PROSPERO database (CRD42021257211).

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Assessment of the Spastic Upper Limb with Computational Motion Analysis

Cited by 4 publications

References 22 publications

The Spastic Upper Extremity in Children: Multilevel Surgical Decision-making

The Spastic Upper Extremity in Children: Multilevel Surgical Decision-making

Surgical Management of the Spastic Forearm, Wrist, and Hand: Evidence-Based Treatment Recommendations

Upper Limb Movement Measurement Systems for Cerebral Palsy: A Systematic Literature Review

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