Range of Motion Requirements for Upper-Limb Activities of Daily Living.

OBJECTIVE: We quantified the range of motion (ROM) required for eight upper-extremity activities of daily living (ADLs) in healthy participants. METHOD: Fifteen right-handed participants completed several bimanual and unilateral basic ADLs while joint kinematics were monitored using a motion capture system. Peak motions of the pelvis, trunk, shoulder, elbow, and wrist were quantified for each task. RESULTS: To complete all activities tested, participants needed a minimum ROM of -65°/0°/105° for humeral plane angle (horizontal abduction-adduction), 0°-108° for humeral elevation, -55°/0°/79° for humeral rotation, 0°-121° for elbow flexion, -53°/0°/13° for forearm rotation, -40°/0°/38° for wrist flexion-extension, and -28°/0°/38° for wrist ulnar-radial deviation. Peak trunk ROM was 23° lean, 32° axial rotation, and 59° flexion-extension. CONCLUSION: Full upper-limb kinematics were calculated for several ADLs. This methodology can be used in future studies as a basis for developing normative databases of upper-extremity motions and evaluating pathology in populations.

Development and evaluation of the activities measure for upper limb amputees.

OBJECTIVES: (1) To develop a measure of activities for adults with upper limb amputation: the Activities Measure for Upper Limb Amputees (AM-ULA); and (2) to conduct initial psychometric evaluation of the measure. DESIGN: This was a cohort study where the prototype measure was administered twice within 1 week. Tests were videotaped and graded by 2 independent raters. Interrater reliability, test-retest reliability, internal consistency, and minimal detectable change were estimated. Known group validity was examined using analyses of variance comparing scores of transradial, transhumeral, and shoulder level amputees. Convergent validity was examined by correlating AM-ULA scores with dexterity tests and self-reported function. SETTING: Hospital outpatient. PARTICIPANTS: Subjects (N=52) with upper limb amputation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: Intraclass correlation coefficients (ICCs) for test-retest reliability were .88 to .91. ICCs for interrater reliability were .84 to .89. Cronbach alphas were .89 to .91. The minimal detectable change at the 90% confidence interval was 3.7 points. Subjects with more distal levels of limb loss had better scores than those with more proximal levels (P<.01). The AM-ULA was moderately correlated with most dexterity tests and self-reported function. CONCLUSIONS: The AM-ULA is a new measure of activity performance for adults with upper limb amputation that considers task completion, speed, movement quality, skillfulness of prosthetic use, and independence in its rating system. It has good interrater reliability, test-retest reliability, and demonstrated known group validity.

A narrative review: current upper limb prosthetic options and design.

Purpose: This review was conducted to provide an overview of current literature as it relates to upper limb difference, available componentry, and prosthetic options and design. Emerging technologies combined with an increased awareness of the limb difference community have contributed to recent advancements in upper extremity prosthetics.Methods: A search of five major clinical databases utilizing keywords relating to upper limb prostheses, componenty and limb difference levels resulted in over 1200 articles. These articles were subjected to inclusion and exclusion criteria in order to identify current peer reviewed research relevant to this topic.Results: Fifty-five applicable articles and sources of standards were reviewed based on the inclusion and exclusion criteria, presenting five general options for prosthetic intervention. This information was assimilated and categorized in this article, which provides an overview of the aforementioned options.Conclusion: While a noteworthy amount of research focuses on technological advancements, the five options for prosthetic intervention are inherently represented in the current literature. For individuals with upper limb difference, as well as their care team, successful rehabilitation hinges on awareness of new components, the functional efficacy of these components, and the evolved techniques used in prosthetic design and fabrication. It is noted that the rapid evolution of upper limb prosthetics consistently outpaces research and publication of information.Implications for rehabilitationTo provide an overview of prosthetic design considerations and options to help create a more informed rehabilitation team, leading to improved outcomes in prescription and management of upper limb prosthetics.To bring awareness of current research in the field of upper limb prosthetics in order to provoke further exploration of the efficacy of prosthetic options and design considerations.