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Original article| Volume 93, ISSUE 11, P2029-2034, November 2012

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Characterization of Compensatory Trunk Movements During Prosthetic Upper Limb Reaching Tasks

  • Anthony J. Metzger
    Affiliations
    Center for Applied Biomechanics and Rehabilitation Research, National Rehabilitation Hospital, Washington, DC

    Department of Biomedical Engineering, The Catholic University of America, Washington, DC
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  • Alexander W. Dromerick
    Affiliations
    Neuroscience Research Center, National Rehabilitation Hospital, Washington, DC

    Department of Rehabilitation Medicine and Neurology, Georgetown University School of Medicine, Washington, DC

    Washington DC Veterans Affairs Medical Center, Washington, DC
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  • Rahsaan J. Holley
    Affiliations
    Washington DC Veterans Affairs Medical Center, Washington, DC
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  • Peter S. Lum
    Correspondence
    Correspondence to Peter S. Lum, PhD, The Catholic University of America, Pangborn Hall, Room 131, 620 Michigan Ave, NE, Washington, DC 20064, Reprints are not available from the author
    Affiliations
    Center for Applied Biomechanics and Rehabilitation Research, National Rehabilitation Hospital, Washington, DC

    Department of Biomedical Engineering, The Catholic University of America, Washington, DC

    Washington DC Veterans Affairs Medical Center, Washington, DC
    Search for articles by this author
Published:March 26, 2012DOI:https://doi.org/10.1016/j.apmr.2012.03.011

      Abstract

      Metzger AJ, Dromerick AW, Holley RJ, Lum PS. Characterization of compensatory trunk movements during prosthetic upper limb reaching tasks.

      Objective

      To characterize the compensatory movements of the trunk during functional reaching tasks performed by upper limb prosthesis users.

      Design

      Survey.

      Setting

      Clinical laboratory at a national rehabilitation hospital.

      Participants

      Transhumeral and transradial prosthesis users (n=10) and uninjured control subjects (n=10).

      Interventions

      Not applicable.

      Main Outcome Measures

      Three-dimensional motion analysis data were collected during simulated reaching tasks, such as donning a cap, placing a nut, and sorting clothes. The metrics were range of motion of the trunk in the 3 anatomical directions and elbow and shoulder path distance.

      Results

      Prosthesis users had significantly larger truncal movements than controls during all 3 reaching tasks in all 3 directions (P≤.03). Shoulder path distance in persons with amputation was larger than in controls in all 3 tasks (P<.01). Elbow path distance in persons with amputation was larger than in controls in the nut and clothes tasks (P≤.02). The subgroup of transradial prosthesis users displayed these abnormal movements despite the presence of an intact elbow.

      Conclusions

      The altered physiologic structure of the arm caused the individuals to develop a different motor control strategy than an intact arm. Functional limitations, such as the loss of distal degrees of freedom, required persons with amputation to use trunk displacement in place of arm/hand movement. These compensatory movements during reaching tasks may be a cause of prosthesis rejection and, in some cases, may be resolved with proper rehabilitative training. Analysis of compensatory trunk movements may also provide a useful endpoint for evaluating new prosthesis designs.

      Key Words

      List of Abbreviations:

      ADLs (activities of daily living), AP (anterior-posterior), DOF (degree of freedom), ML (medial-lateral), ROM (range of motion), V (vertical)
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