Kinematic analysis of the upper limb during anatomical and functional movements in healthy children

Abstract

Impairments of upper limb function can negatively impact an individual s ability to carry out everyday tasks. Children with cerebral palsy can have limitations of upper limb movement due to physiological and structural changes in their body. Current treatment regimes for children with upper limb involvement of cerebral palsy are assessed using a variety of qualitative assessment tools. These measures rely on subjective input from the assessor, and can be insensitive to significant functional improvements.

Research methods in upper limb motion analysis are developing towards use as clinical tools. To date, there is a paucity of knowledge on the quantitative measures of range of motion (ROM) and function of upper limbs in healthy children. There is also lack of agreement on repeatable functional tasks of the upper limb for 3D measurement. The identification of a repeatable task in healthy children would facilitate the use of upper limb 3D motion analysis to guide clinical practice and improve patient outcomes.

This thesis aims to describe upper limb joint range of movement in each degree of freedom and present normative three dimensional kinematic data of upper limb movement in healthy children during a repeatable upper limb functional task. This will provide a basis for comparison to children with movement disorders for future research and clinical practice.

The UNSW kinematic upper limb model was found to successfully measure three dimensional upper limb anatomical and functional movements in healthy children. Normative kinematic data are reported for anatomical movements and two functional tasks.

The results of the studies undertaken showed that differences in dominant and non-dominant limbs were present during anatomical and functional movements. Joint angles measured were found to be repeatable in healthy children. The results suggest that methods used were reliable for investigating upper limb kinematics. Functional movement time-series data were found to be repeatable for the group with the exception of wrist flexion/extension during the hand to mouth movement for both the dominant and non-dominant limbs.

These findings improve current knowledge on upper limb kinematics in healthy children. This knowledge can assist the investigation of movement disorders in children to facilitate clinical decision making.