Impact of impaired wrist motion on hand and upper-extremity performance

The effect of common wrist orthoses on the stiffness of wrist rotations

“…Second, our finding that orthoses within the same type are gener ally not significantly different from one another cor relates to the observation that similar wrist orthoses cause similar reductions in wrist range of motion because orthoses with similar stiffness will produce similar dis placements for a given torque input [24]. Similarly, our finding that type-V, type-D, and type-VD orthoses sig nificantly altered the stiffness of the wrist joint is in agreement with the common conclusion that wrist ortho ses reduce the maximal wrist range of motion [8,[25][26][27].…”

“…For example, increases in forearm muscle activity during tasks requiring manipulation indicate that wrist orthosis wearers sometimes "fight against the [orthosis] to achieve the necessary wrist angle or transfer these postural deviations to the elbow, shoulder, or even the torso," potentially doing more harm than good [4][5]. Wrist orthoses have been linked to increases in shoulder muscle activation [5][6][7] and to deviations in shoulder position [8][9][10]. Although orthoses users have been shown to acclimatize somewhat to orthoses, many of the previously cited studies expressed concern that wrist JRRD, Volume 53, Number 6, 2016 orthoses contribute to disorders of the kinematic chain (wrist, elbow, shoulder, trunk) [9,11].…”

Functional Task Kinematics of the Thumb Carpometacarpal Joint

“…Motion analysis grants the ability to objectively measure how subjects without arthritis perform these functions. Subsequently evaluating patients with functional limitations and comparing their motion with that of the control subjects allows us to understand why one subject is able to perform an activity, whereas the other is not [2]. Defining the carpometacarpal position and motion associated with functional activities known to cause symptoms and load the base of the thumb will augment current fundamental information of this complex joint [10].…”

“…Loss of thumb function imparts a 40% to 50% impairment to the upper extremity as a result of its central role in nearly all grasp and handling maneuvers [1]. The role of compensatory motion of adjacent and contiguous joints is well known in musculoskeletal impairment [2,3,16,20] but the interdependence has not been quantified in diseases and arthritis of the hand.…”

The use of kinematic and parametric information to highlight lack of movement and compensation in the upper extremities during activities of daily living

“…In these situations, quantifying each joint's angular limits and compensatory movements can help monitor the progresses of the affected side, select the most effective treatment and limit those abnormal movements that can lead to unnecessary stresses on articulations and fatigue. Several tools are available to obtain this kind of data and they can be broadly classified in those which use standalone tests, involving for example questionnaires or functional tests based on activities of daily living (ADLs) [6][7][8][9][10][11][12], and those which rely on motion capture [2,8,13,14]. Motion analysis can provide information on the action as it unfolds, complementing the data from standalone tests.…”