Movement preferences of the wrist and forearm during activities of daily living

An Analysis of Wrist Motions During Daily Activities From a Directional Perspective: The Significance of Directions Beyond the Dart-Throwing Motion

BACKGROUND

Previous studies on Activities of Daily Living (ADL) suggest that the wrist demonstrates different ranges of motion and frequencies in various directions. However, the specific directional characteristics of wrist activities remain unexplored. This study aims to investigate the directional characteristics of wrist motions during ADL with optical motion capture technology.

METHOD

This is a basic science study. Twenty-six right-handed subjects executed 22 ADLs, with angular wrist positions tracked via retroreflective markers on the dominant limb. The Cartesian coordinate system formed by wrist flexion-extension and radial-ulnar deviation angles was transformed into a polar coordinate system, enabling the directional analysis and the calculation of the directional range of motion (ROM). The directional distribution of trajectory points was analyzed using the Rayleigh test and visualized. The values and trends of directional RoM in 72 directions for both aggregated and individual ADLs were examined. The peaks of ROMs across ADLs were clustered using K-means to identify key directions. Differences in gender and age were analyzed with a two-way ANOVA.

RESULT

The trajectories exhibited a strong directional preference across all ADLs (p < 0.01). In the majority of ADLs, the trajectories favored the ulnar extension direction (19/22) and were distributed along the radial flexion-ulnar extension plane (12/22). ROM was calculated for each of the 72 directions in each ADL. The aggregated ADL analysis provided the directional functional ROM (fROM). Three types of ADLs were identified, each with 1, 2, and 3 peaks in their directional ROM, respectively. Three key directions were identified as clusters of peak ROMs in the ADLs. Comparisons across gender and age groups revealed varying preferences for directional ROM in each group.

CONCLUSION

This study identified three key wrist motion directions essential for daily functions, highlighting the critical role of ulnar extension. Additionally, it demonstrated variations in directional wrist motion preferences across different genders and age groups.

Design of Novel Human Wrist Prostheses Based on Parallel Architectures: Dimensional Synthesis and Kinetostatics

The human wrist affects the ability to efficiently perform many manipulation tasks. Despite this, most upper-limb prostheses are focused on the hand's mobility, which makes users compensate for the lost wrist mobility with complex manipulation strategies relying on the mobility of other body parts. In this context, research on wrist prostheses is still open to new contributions, even though a number of such prostheses are already present in the literature and on the market. In particular, the potential uses of parallel mechanisms in wrist prosthesis design have not been fully explored yet. In this work, after recalling the mobility characteristics of human wrists and reviewing the literature both on wrist prostheses and parallel mechanisms, a number of parallel architectures employable in a wrist prosthesis are selected. Then, with reference to the design requirements of this prosthesis type, the dimensional synthesis and kinetostatic analysis of the selected architectures are addressed. The results of this work are new wrist prosthesis architectures together with the analysis of their kinetostatic performances. These findings complete the first step of a research project aimed at developing new concepts for mechatronic wrists.

Sex differences in wrist strength: a systematic review

Sex differences in strength have been attributed to differences in body anthropometrics and composition; these factors are often ignored when generating workplace guidelines. These differences directly impact the upper extremity, leaving female workers exposed to injury risk. The wide range of tools and techniques for measuring upper extremity strength presents a challenge to ergonomists and work task designers; collating outcomes to provide a clear outlook of differences between males and females is essential and the purpose of this work. Four online databases were searched (PROSPERO ID: CRD42022339023) with a focus on articles assessing sex differences in wrist strength. A total of 2,378 articles were screened for relevancy; 25 full-text articles were included in this systematic review. Articles examined movement pairs (ulnar/radial deviation, pronation/supination, and flexion/extension), as well as contraction types (isometric and isokinetic) to observe sex differences in wrist strength. Across all articles, females produced ∼60-65% of male flexion/extension strength, ∼55-60% pronation/supination strength, and ∼60-70% ulnar/radial deviation strength. Overall, females presented lower strength-producing abilities than males, but when considering strength relative to body mass, male-female differences were less pronounced and occasionally females surpassed male strength metrics; typically, this occurred during flexion/extension, particularly in isokinetic contractions. This review has identified a scarcity of articles examining ulnar/radial deviation, pronation/supination, as well as isokinetic contractions; these are needed to supplement workplace exposure guidelines.

Clinical measurement of functional dart thrower's motion in patients with unilateral wrist conditions undergoing nonoperative or postoperative hand therapy

STUDY DESIGN

Cross-sectional and descriptive study BACKGROUND: Functional dart thrower's motion (F-DTM) is an obliquely oriented wrist motion that occurs in activities such as throwing and drinking from a cup. There is limited data on clinical measurement of F-DTM.

PURPOSE OF THE STUDY

The purpose of this study was to 1) describe and establish reference scores for F-DTM measurement for nonoperative and postoperative wrist patients 2) compare F-DTM between the affected and nonaffected sides and 3) determine F-DTM score agreement across three consecutive trials.

METHODS

Two certified hand therapists evaluated F-DTM in consecutive adult patients with a unilateral wrist condition undergoing nonoperative or postoperative therapy. Three trials of goniometer measurements for radial extension (RE) and ulnar flexion (UF) were assessed on the nonaffected and affected wrists. A total arc F-DTM was computed. Mean, 95% confidence intervals (CI), and Cohen's d effect size described side-to-side differences in RE, UF, and total arc F-DTM. Agreement in scores across trials was assessed with an intraclass correlation coefficient (ICC).

RESULTS

Thirty-one nonoperative (mean ± SD age = 40.0 ± 13.9 years, 74% female, 94% right hand dominant) and 44 postoperative patients (mean ± SD age = 44.9 ± 14.9 years, 66% female, 84% right hand dominant) were enrolled. The average side-to-side difference, in degrees, in the nonoperative group was -6.4 (95% CI: -9.4 to -3.4, Cohen's d = 0.8) for RE, -10.4 (-16.7 to -4.0, d = 0.6) for UF, and -16.8 (-24.3 to -9.2, d = 0.8) for total arc F-DTM. The average side-to-side difference in the postoperative group was -33.6 (-38.8 to -28.3, d = 1.9) for RE, -34.7 (-40.6 to -28.7, d = 1.8) for UF, and -68.2 (-77.9 to -58.5, d = 2.1) for total arc F-DTM. The range of ICCs for F-DTM measurements was 0.82-0.96.

CONCLUSIONS

Goniometer measurement of F-DTM is a clinically feasible method to quantify functional motion loss in an injured wrist population, particularly patients with postoperatively managed wrist conditions.