腕关节屈伸与桡尺偏斜之间的耦合。

Coupling between wrist flexion-extension and radial-ulnar deviation.

作者信息

Li Zong-Ming, Kuxhaus Laurel, Fisk Jesse A, Christophel Thomas H

机构信息

Hand Research Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, E1641 Biomedical Science Tower, 210 Lothrop Street, Pittsburgh, PA 15213, USA.

出版信息

Clin Biomech (Bristol). 2005 Feb;20(2):177-83. doi: 10.1016/j.clinbiomech.2004.10.002.

DOI:10.1016/j.clinbiomech.2004.10.002

PMID:15621323

Abstract

BACKGROUND

Conventional wrist joint goniometry evaluates range of motion in isolated directions. The coupling between wrist flexion-extension and radial-ulnar deviation was investigated.

METHODS

Ten healthy young male subjects performed wrist flexion-extension, radial-ulnar deviation, and circumduction motions. Flexion-extension and radial-ulnar deviation angles were computed from the coordinates of surface markers attached to the forearm and hand. A motion analysis system recorded marker motion.

FINDINGS

During radial-ulnar deviation, the amount of accompanying flexion-extension movement was linearly related to the amount of radial-ulnar deviation. The secondary (flexion-extension) range of motion (48.3 degrees) was about 75% of the primary (radial-ulnar deviation) range of motion (55.1 degrees). During the flexion-extension task, the coupling was less linear. The motion range in radial-ulnar deviation (21.2 degrees) was about 20% of the primary (flexion-extension) range of motion (108.3 degrees). The radial-ulnar deviation and flexion-extension motions combined extension with radial deviation, and flexion with ulnar deviation. The convex hull of the flexion-extension and radial-ulnar deviation angles during circumduction was "egg-shaped" and asymmetric with respect to the anatomically defined flexion-extension and radial-ulnar deviation axes. Wrist position in one direction strongly influenced the range of motion in the other. Maximum range of motion in flexion-extension occurred with the wrist near the neutral radial-ulnar deviation position, and vice versa. Wrist deviation from neutral position in one direction diminished wrist range of motion in the other.

INTERPRETATION

Wrist movements in flexion-extension and radial-ulnar deviation are coupled. Maximal wrist range of motion is near the neutral position. To account for the naturally coupled wrist motion in work station design and rehabilitation, the wrist should be placed at a neutral position.

摘要

背景

传统的腕关节测角法评估的是孤立方向上的运动范围。本研究对腕关节屈伸与桡尺偏斜之间的耦合关系进行了调查。

方法

10名健康年轻男性受试者进行腕关节屈伸、桡尺偏斜和环转运动。根据附着在前臂和手部的表面标记的坐标计算屈伸和桡尺偏斜角度。一个运动分析系统记录标记的运动。

结果

在桡尺偏斜过程中，伴随的屈伸运动量与桡尺偏斜量呈线性相关。次要（屈伸）运动范围（48.3度）约为主要（桡尺偏斜）运动范围（55.1度）的75%。在屈伸任务中，耦合关系的线性程度较低。桡尺偏斜的运动范围（21.2度）约为主要（屈伸）运动范围（108.3度）的20%。桡尺偏斜和屈伸运动表现为伸展与桡侧偏斜相结合，屈曲与尺侧偏斜相结合。环转过程中屈伸和桡尺偏斜角度的凸包呈“蛋形”，相对于解剖学定义的屈伸和桡尺偏斜轴不对称。一个方向上的腕关节位置强烈影响另一个方向上的运动范围。屈伸运动的最大运动范围出现在腕关节接近桡尺偏斜中立位置时，反之亦然。腕关节在一个方向上偏离中立位置会减小另一个方向上的腕关节运动范围。