Upper limb kinematics: Development and reliability of a clinical protocol for children

Abstract

This study proposed a child-friendly measurement procedure for the three-dimensional analysis of upper limb movements, based on a comprehensive movement protocol. Within and between session reliability was tested in a group of 10 typically developing children (TDC) (mean age 10.3±3.2 years). The movement protocol was constructed for children with hemiplegic cerebral palsy (HCP) and contained three reach tasks (forwards, upwards, sideways), three reach-to-grasp tasks (with objects requiring different hand orientations) and three gross motor tasks. Upper limb kinematics were calculated following the ISB-guidelines. Reliability of movement duration/speed and endpoint joint angles was assessed with the intraclass correlation coefficient; similarity of the waveforms with the coefficient of multiple correlation; measurement errors were also calculated. Reliability coefficients were generally high for movement duration/speed and most kinematic parameters. Endpoint angles for scapular tilting, shoulder elevation plane and elevation, elbow flexion-extension and wrist ulnar-radial deviation showed highest reliability. Angular waveforms were best repeated for scapular medio-lateral rotation and pro-retraction, shoulder elevation plane and elevation, and elbow flexion-extension. Results also seemed task-dependent. This study indicated that the proposed procedure could be used reliably to quantify upper limb movements in TDC. However, to compose proper age-related standards for the different tasks, larger study samples are needed. This will also help with a well-founded task-selection depending on the joints of interest. Finally, further research will need to establish the reliability in children with HCP.

The Arm Profile Score: A new summary index to assess upper limb movement pathology

“…All assessments were performed by one trained physiotherapist, at the clinical motion analysis laboratory (University Hospital Pellenberg, Belgium), using a standardized protocol for the UL-3DMA [6,7] and the clinical evaluation [14].…”

“…UL-3DMA [6,7] Data were collected with the Vicon MX-system (Oxford Metrics Group, UK) and filtered using spline-interpolation [15]. Kinematics were calculated following the ISB-recommendations [5].…”

“…Given the variety of UL functions, a comprehensive set of tasks was selected to represent clinically relevant activities for children with HCP. The procedure was proven reliable in typically developing children (TDC) [6] and children with HCP [7]. To establish its true value as a clinical tool, a next step is to further expand our understanding of the information obtained from this 3DMA.…”

Difference in Movement Magnitude According to the Type of Compression Therapy Used on Healthy Subjects

“…This increased movement is compensation for movement restriction of the elbow and wrist. Upper extremity movement is systematic, so in order to overcome one joint constriction, another joint's, movement must be increased 14,15) .…”

Does the use of global optimisation improve kinematic repeatability of the spine during running gait?

“…During each laboratory visit kinematic data was collected for the foot, shank, thigh, pelvis, lumbar spine and thoracic spine whilst subjects ran at a speed of 5.6 m s −1 . A thoracic coordinate system was defined following ISB recommendations [3] and tracked with a rigid plate mounted on the sternum. The coordinate system for the pelvis was defined and tracked using the ASIS and PSIS markers and the lumbar spine segment was defined using the pelvic coordinate system and tracked using an arrangement of markers on the low back.…”