健康中老年人上肢负重状态下利手和非利手的三维运动学分析
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摘要
背景:上肢利手和非利手在执行日常生活中动作存在差异性。中老年人随着年龄增加,利手和非利手在日常生活活动任务执行和完成中同等重要,以往对上肢研究涉及肌力方面内容较多,而目前对关节动态特征及轨迹偏移影响作业活动的研究也逐步增加,三维运动检测和分析已作为上肢运动评估的可靠和有效标准。目的:利用三维运动学分析方法,收集健康中老年人双侧上肢持不同质量杯子下进行饮水动作的数据,探讨基于不同负重状态的利手和非利手上肢关节运动学是否存在差异性。方法:选取16名40-69岁右利手健康中老年人为实验对象,用Vicon Nexus采集双上肢不同质量水杯进行饮水动作的运动捕捉,通过pipeline数据建模和运动轨迹滤过后,用Matlab对采集数据进行动作周期的百分化处理;分析并比较利手和非利手持100 g、200 g和500 g质量的水杯时,肩、肘和腕关节三维平面上的角度和运动速度峰值。结果与结论:利手和非利手持重物肩、肘和腕关节,三维运动角度在肘关节差异最明显,100 g水平面(X轴)和矢状面(Z轴),200 g额状面(Y轴)和矢状面(Z轴),500 g三维面比较差异有显著性意义(P<0.05);三维运动角速度峰值在肩、肘和腕关节有差异,100 g(肩关节Px=0.01;肘关节Py=0.048,Pz=0.007),200 g(肘关节Py=0.033,Pz=0.005;腕关节Py=0.035),500 g(肘关节Py=0.027,Pz=0.006)比较差异有显著性意义(P<0.05)。同侧上肢持不同重物之间运动角度和角速度差异无显著性意义(P>0.05)。结果表明利手和非利手负重物进行饮水动作时在运动角度和角速度之间存在差异性,利手肘关节X轴运动角度大,非利手肘关节Z轴上角度大;角速度非利手在Y轴和Z轴变化大;持重物大小对双侧上肢运动无影响。
BACKGROUND: Differences exist between the action execution of the dominant hand and the nondominant hand during daily lives. With the increasing of the age, the dominant hand and the nondominant hand play an equally important role in the action execution and implementation during daily lives. Previous studies mainly focus on the muscle strength of upper limbs. However, studies on the influence of joint dynamic characteristics and trajectory deviation on the occupational activities have been increased gradually. The three-dimension motion capture and analysis have become the reliable and valid standard of the assessment of the upper limb movement. OBJECTIVE: By using the three-dimensional kinematic analyze method, to collect the data of the healthy elderly people using the upper limbs to drink water respectively with the cups of different weights and to investigate whether there is a difference between dominant and nondominant hands under different weight-bearing conditions based on upper limb kinematics METHODS: Sixteen right-handed elder people were chosen to be the experimental subjects. The upper limb motion of drinking water with different weight was captured by Vicon Nexus. By Data modeling and trajectory filtering with pipeline and data normalizing with the Matlab, the three-dimensional angle and peak value of the velocity of the should, elbow and wrist joint in the bilateral upper limbs were analyzed and compared when lifting the cups of 100, 200 and 500 g. RESULTS AND CONCLUSION: The most significant difference could be found in the three-dimensional movement angle of the elbow joint when holding the weights: there were significant differences in 100 g horizontal plane(X axis) and sagittal plane(Z axis), 200 g frontal plane(Y axis) and sagittal plane(Z axis), and 500 g three-dimensional plane(P < 0.05). Difference could be found in the peak value of three-dimension angular velocity in the shoulder, elbow and wrist joints: 100 g(shoulder joint Px=0.01; elbow joint Py=0.048, Pz=0.007), 200 g(elbow joint Py=0.033, Pz=0.005; wrist joint Py=0.035), 500 g(elbow joint Py=0.027, Pz=0.006) had significant differences(P < 0.05). There was no significant difference in the movement angle and angular velocity when holding different weights with the ipsilateral upper limb(P > 0.05). These results show that there is a difference in the movement angle and angular velocity between the dominant hand and the nondominant hand when drinking water. A great change of movement angle could be found in the X axis of the elbow joint in the dominant hand, and a great change of the movement angle could be found in the Z axis of the elbow joint in the nondominant hand. The angluar velocity in the Y axis has better changes than in the Z axis. The size of the weights has no effect on the movement of bilateral upper limbs.
BACKGROUND: Differences exist between the action execution of the dominant hand and the nondominant hand during daily lives. With the increasing of the age, the dominant hand and the nondominant hand play an equally important role in the action execution and implementation during daily lives. Previous studies mainly focus on the muscle strength of upper limbs. However, studies on the influence of joint dynamic characteristics and trajectory deviation on the occupational activities have been increased gradually. The three-dimension motion capture and analysis have become the reliable and valid standard of the assessment of the upper limb movement. OBJECTIVE: By using the three-dimensional kinematic analyze method, to collect the data of the healthy elderly people using the upper limbs to drink water respectively with the cups of different weights and to investigate whether there is a difference between dominant and nondominant hands under different weight-bearing conditions based on upper limb kinematics METHODS: Sixteen right-handed elder people were chosen to be the experimental subjects. The upper limb motion of drinking water with different weight was captured by Vicon Nexus. By Data modeling and trajectory filtering with pipeline and data normalizing with the Matlab, the three-dimensional angle and peak value of the velocity of the should, elbow and wrist joint in the bilateral upper limbs were analyzed and compared when lifting the cups of 100, 200 and 500 g. RESULTS AND CONCLUSION: The most significant difference could be found in the three-dimensional movement angle of the elbow joint when holding the weights: there were significant differences in 100 g horizontal plane(X axis) and sagittal plane(Z axis), 200 g frontal plane(Y axis) and sagittal plane(Z axis), and 500 g three-dimensional plane(P < 0.05). Difference could be found in the peak value of three-dimension angular velocity in the shoulder, elbow and wrist joints: 100 g(shoulder joint Px=0.01; elbow joint Py=0.048, Pz=0.007), 200 g(elbow joint Py=0.033, Pz=0.005; wrist joint Py=0.035), 500 g(elbow joint Py=0.027, Pz=0.006) had significant differences(P < 0.05). There was no significant difference in the movement angle and angular velocity when holding different weights with the ipsilateral upper limb(P > 0.05). These results show that there is a difference in the movement angle and angular velocity between the dominant hand and the nondominant hand when drinking water. A great change of movement angle could be found in the X axis of the elbow joint in the dominant hand, and a great change of the movement angle could be found in the Z axis of the elbow joint in the nondominant hand. The angluar velocity in the Y axis has better changes than in the Z axis. The size of the weights has no effect on the movement of bilateral upper limbs.
引文
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[11]Taub E,Uswatte G.Constraint-induced movement therapy:bridging from the primate laboratory to the stroke rehabilitation laboratory.J Rehabil Med.2003;(41 Suppl):34-40.
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[18]Chen W,Xiong C,Huang X,et al.Kinematic analysis and dexterity evaluation of upper extremity in activities of daily living.Gait Posture.2010;32(4):475-481.
[19]Aizawa J,Masuda T,Koyama T,et al.Three-dimensional motion of the upper extremity joints during various activities of daily living.J Biomech.2010;43(15):2915-2922.
[20]Mackey AH,Walt SE,Lobb GA,et al.Reliability of upper and lower limb three-dimensional kinematics in children with hemiplegia.Gait Posture.2005;22(1):1-9.
[21]de los Reyes-Guzmán A,Dimbwadyo-Terrer I,TrincadoAlonso F,et al.Quantitative assessment based on kinematic measures of functional impairments during upper extremity movements:A review.Clin Biomech.2014;29(7):719-727.
[22]Molina Rueda F,Rivas Montero FM,Pérez de Heredia Torres M,et al.Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease:a pilot study.Neurologia.2012;27(6):343-347.
[23]Slavens BA,Harris GF.The biomechanics of upper extremity kinematic and kinetic modeling:applications to rehabilitation engineering.Crit Rev Biomed Eng.2008;36(2-3):93-125.
[24]Magermans DJ,Chadwick EK,Veeger HE,van der Helm FC.Requirements for upper extremity motions during activities of daily living.Clin Biomech.2005;20(6):591-599.
[25]Van Hoof T,Vangestel C,Shacklock M,et al.Asymmetry of the ULNT1 elbow extension range-of-motion in a healthy population:consequences for clinical practice and research.Phys Ther Sport.2012;13(3):141-149.
[26]Cooper JE,Shwedyk E,Quanbury AO,et al.Elbow joint restriction:effect on functional upper limb motion during performance of three feeding activities.Arch Phys Med Rehabil.1993;74(8):805-809.
[27]Werner FW,An KN.Biomechanics of the elbow and forearm.Hand Clin..1994:10(3):357-373.
[28]Earles DR,Judge JO,Gunnarsson OT.Velocity training induces power-specific adaptations in highly functioning older adults.Arch Phys Med Rehabil.2001;82(7):872-878.
[29]Henwood TR,Taaffe DR.Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training.Gerontology.2005;51:108-115.
[30]Bottaro M,Machado SN,Noqueira W,et al.Effect of high versus low-velocity resistance training on muscular fitness and functional performance in older men.Eur J Appl Physiol.2007;99(3):257-264.
[31]Sainburg RL.Evidence for a dynamic-dominance hypothesis of handedness.Exp Brain Res.2002;142(2):241-258.
[32]Katz RT,Rymer WZ.Spastic hypertonia:mechanisms and measurement.Arch Phys Med Rehabil.1989;70(2):144-55.
[33]Gottlieb GL,Song Q,Hong DA,et al.Coordinating two degrees of freedom during human arm movement:load and speed invariance of relative joint torques.J Neurophysiol.1996;76(5):3196-206.
[34]Kee D,Na S,Chung MK.Effect of external load at varying hand positions on perceived discomfort.Int J Occup Saf Erqon.2013;19(3):397-408.
[35]Glenn JM,Gray M,Binns A.The effects of loaded and unloaded high-velocity resistance training on functional fitness among community-dwelling older adults.Age Ageing.2015;7(11):1-6.
[2]Bagesteiro LB,Sainburg RL.Handedness:dominant arm advantages in control of limb dynamics.J Neurophysiol.2002;88(5):2408-21.
[3]Coley B,Jolles BM,Farron A,et al.Estimating dominant upper-limb segments during daily activity.Gait Posture.2008;27(3):368-375.
[4]Chew JZ,Gandevia SC,Fitzpatrick RC.Postural control at the human wrist.J Physiol.2008;586(5):1265-1275.
[5]Sainburg RL,Kalakanis D.Differences in control of limb dynamics during dominant and nondominant arm reaching.J Neurophysiol.2000;83(5):2661-2675.
[6]de Niet M,Bussmann JB,Ribbers GM,et al.The stroke upper-limb activity monitor:Its sensitivity to measure hemiplegic upper-limb activity during daily life.Arch Phys Med Rehabil.2007;88(9):1121-1126.
[7]Vega-Gonzalez A,Granat MH.Continuous monitoring of upper-limb activity in a free-living environment.Arch Phys Med Rehabil.2005;86(3):541-548.
[8]Mozaz MJ,Crucian GP,Heilman KM.Age-related changes in arm-hand postural knowledge.Cogn Neuropsychol.2009;26(8):675-684.
[9]Kalisch T,Wilimzig C,Kleibel N,et al.Age-related attenuation of dominant hand superiority.Plo S One.2006;1:e90.
[10]Kilbreath SL,Heard RC.Frequency of hand use in healthy older persons.Aust J Physiother.2005;51(2):119-122.
[11]Taub E,Uswatte G.Constraint-induced movement therapy:bridging from the primate laboratory to the stroke rehabilitation laboratory.J Rehabil Med.2003;(41 Suppl):34-40.
[12]Butler EE,Ladd AL,Louie SA,et al.Three-dimensional kinematics of the upper limb during a Reach and Grasp Cycle for children.Gait Posture.2010;32(1):72-77.
[13]Mc Ginley JL,Baker R,Wolfe R,et al.The reliability of three–dimensional kinematic gait measurements:a systematic review.Gait Posture.2009;29(3):360-369.
[14]Manca M,Leardini A,Cavazza S,et al.Repeatability of a new protocol for gait analysis in adult subjects.Gait Posture.2010;32(2):282-284.
[15]van Andel CJ,Wolterbeek N,Doorenbosch CA,et al.Complete 3D kinematics of upper extremity functional tasks.Gait Posture.2008;27(1):120-127.
[16]Petuskey K,Bagley A,Abdala E,et al.Upper extremity kinematics during functional activities:Three-dimensional studies in a normal pediatric population.Gait Posture.2007;25(4):573-579.
[17]Butler EE,Rose J.The Pediatric Upper Limb Motion Index and a temporal-spatial logistic regression:Quantitative analysis of upper limb movement disorders during the Reach&Grasp Cycle.J Biomech.2012;45(6):945-951.
[18]Chen W,Xiong C,Huang X,et al.Kinematic analysis and dexterity evaluation of upper extremity in activities of daily living.Gait Posture.2010;32(4):475-481.
[19]Aizawa J,Masuda T,Koyama T,et al.Three-dimensional motion of the upper extremity joints during various activities of daily living.J Biomech.2010;43(15):2915-2922.
[20]Mackey AH,Walt SE,Lobb GA,et al.Reliability of upper and lower limb three-dimensional kinematics in children with hemiplegia.Gait Posture.2005;22(1):1-9.
[21]de los Reyes-Guzmán A,Dimbwadyo-Terrer I,TrincadoAlonso F,et al.Quantitative assessment based on kinematic measures of functional impairments during upper extremity movements:A review.Clin Biomech.2014;29(7):719-727.
[22]Molina Rueda F,Rivas Montero FM,Pérez de Heredia Torres M,et al.Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease:a pilot study.Neurologia.2012;27(6):343-347.
[23]Slavens BA,Harris GF.The biomechanics of upper extremity kinematic and kinetic modeling:applications to rehabilitation engineering.Crit Rev Biomed Eng.2008;36(2-3):93-125.
[24]Magermans DJ,Chadwick EK,Veeger HE,van der Helm FC.Requirements for upper extremity motions during activities of daily living.Clin Biomech.2005;20(6):591-599.
[25]Van Hoof T,Vangestel C,Shacklock M,et al.Asymmetry of the ULNT1 elbow extension range-of-motion in a healthy population:consequences for clinical practice and research.Phys Ther Sport.2012;13(3):141-149.
[26]Cooper JE,Shwedyk E,Quanbury AO,et al.Elbow joint restriction:effect on functional upper limb motion during performance of three feeding activities.Arch Phys Med Rehabil.1993;74(8):805-809.
[27]Werner FW,An KN.Biomechanics of the elbow and forearm.Hand Clin..1994:10(3):357-373.
[28]Earles DR,Judge JO,Gunnarsson OT.Velocity training induces power-specific adaptations in highly functioning older adults.Arch Phys Med Rehabil.2001;82(7):872-878.
[29]Henwood TR,Taaffe DR.Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training.Gerontology.2005;51:108-115.
[30]Bottaro M,Machado SN,Noqueira W,et al.Effect of high versus low-velocity resistance training on muscular fitness and functional performance in older men.Eur J Appl Physiol.2007;99(3):257-264.
[31]Sainburg RL.Evidence for a dynamic-dominance hypothesis of handedness.Exp Brain Res.2002;142(2):241-258.
[32]Katz RT,Rymer WZ.Spastic hypertonia:mechanisms and measurement.Arch Phys Med Rehabil.1989;70(2):144-55.
[33]Gottlieb GL,Song Q,Hong DA,et al.Coordinating two degrees of freedom during human arm movement:load and speed invariance of relative joint torques.J Neurophysiol.1996;76(5):3196-206.
[34]Kee D,Na S,Chung MK.Effect of external load at varying hand positions on perceived discomfort.Int J Occup Saf Erqon.2013;19(3):397-408.
[35]Glenn JM,Gray M,Binns A.The effects of loaded and unloaded high-velocity resistance training on functional fitness among community-dwelling older adults.Age Ageing.2015;7(11):1-6.