[Range of motion of shoulder and elbow in activities of daily life in 3D motion analysis]

Abstract

Aim: Three-dimensional motion analysis of the lower limb has been an approved method of diagnosis and therapy planning for several years. In this study we observed the range of motion of the shoulder and elbow in 10 activities of daily life (ADL) with a marker-based biomechanical model for the upper extremity. With this database we hope to improve the evaluation of different handicaps of the upper limb.

Method: The used biomechanical model is based on 14 infrared light-reflecting markers. The ranges of motion in ADL for shoulder and elbow were measured in a standardised case setting in seven test persons with a mean age of 25 years (SD 15 years). The 10 observed ADL were eating with a spoon, combing hair, genital hygiene, using a telephone, typing on a keyboard, drinking from a glass, turning a key, turning a page, pouring water in a glass and drawing.

Results: For the ten explored ADL, the test persons needed a range of motion in the shoulder of 91 - 0 - 9 degrees (total 100 degrees) flexion/extension, 112 - 23 - 0 degrees (total 89 degrees) abduction/adduction, and 91 - 0 - 114 degrees (total 205 degrees) external/internal rotation. Most of the ADL were performed in external rotation and, excluding the motion genital hygiene, the test persons only needed an internal rotation of 10 degrees. Maximal shoulder flexion was used with opening a door, the minimum was reached with genital hygiene. The maximum angles of abduction and rotation were reached with combing hair and the minimum values were reached with genital hygiene. To perform the ADL, an elbow extension/flexion of 0 - 36 - 146 degrees (total 110 degrees), and 55 - 0 - 72 degrees (total 127 degrees) pro-/supination was needed. Maximal pronation was reached with "pour from a pitcher". Maximal supination was present with genital hygiene.

Conclusions: The decisive benefit of 3D motion analysis is the exact capturing of complex and dynamic movements at any time. Therefore, not only static joint positions can be recorded, but also the dynamic course of a movement can be traced. By using our model on every day movements, we were able to collect data that can serve as the basis for the desired range of motion of the upper extremities in patients.