Flores Diana Castillo, Laurendeau Simon, Teasdale Normand, Simoneau Martin
Faculté de médecine, Département de kinésiologie, Université Laval, Quebec City, Canada.
J Neuroeng Rehabil. 2014 Nov 17;11:157. doi: 10.1186/1743-0003-11-157.
Wrist movement-related injuries account for a large number of repetitive motion injuries. Remarkably little, if any, empirical data exist to quantify the impact of neuromuscular disorders affecting the wrist or to validate the effectiveness of rehabilitation training programs on wrist functions. The aim of this project was to develop a biomechanical model for quantifying wrist and forearm kinetics during unconstrained movements, to assess its reliability and to determine its sensitivity.
Twenty healthy subjects with no history of upper arm and wrist pain volunteered for the experiment. To evaluate the reliability of the data, we quantified their forearm and wrist kinetics on two different days (minimum and maximum number of days between experimental sessions were 1 and 4 days respectively). To measure forearm and wrist kinetics, an apparatus was built to offer rotational inertia during forearm and wrist movements. An inertial measurement unit was located near the top of the device measuring its angular position along the frontal and sagittal planes. We used a mathematical model to infer forearm and wrist torque. Thereafter, we calculated the product of torque and angular velocity to determine forearm and wrist power.
Results revealed that for 75% of the power and torque measurements the ICC was greater than 0.75 (range: 0.77 - 0.83). Torque and power measurements for adduction movements, however, were less reliable (i.e., ICC of 0.60 and 0.47, respectively) across testing sessions. The biomechanical model was robust to small measurement errors, and the power peaks between the first and second testing session were not different indicating that there was no systematic bias (i.e., motor performance improvement) between testing sessions.
The biomechanical model can be used to assess the effectiveness of rehabilitation programs, document the progression of athletes or conduct research-oriented testing of maximum forearm and wrist kinetic capacities. Nonetheless, caution should be taken when assessing forearm and wrist power adduction movements. Future studies should aim at defining a set of normative values, for various age groups, for forearm and wrist joint torque and power in healthy individuals.
与腕部运动相关的损伤占大量重复性运动损伤的比例。令人惊讶的是，几乎没有（如果有的话）实证数据来量化影响腕部的神经肌肉疾病的影响，或验证康复训练计划对腕部功能的有效性。本项目的目的是开发一种生物力学模型，用于量化无约束运动期间的腕部和前臂动力学，评估其可靠性并确定其敏感性。
20名无上臂和腕部疼痛病史的健康受试者自愿参加实验。为了评估数据的可靠性，我们在两天内对他们的前臂和腕部动力学进行了量化（实验 sessions 之间的最小和最大天数分别为1天和4天）。为了测量前臂和腕部动力学，构建了一种装置，在前臂和腕部运动期间提供转动惯量。一个惯性测量单元位于设备顶部附近，测量其沿额面和矢状面的角位置。我们使用数学模型来推断前臂和腕部扭矩。此后，我们计算扭矩和角速度的乘积来确定前臂和腕部功率。
结果显示，在75%的功率和扭矩测量中，组内相关系数（ICC）大于0.75（范围：0.77 - 0.83）。然而，内收运动的扭矩和功率测量在不同测试 session 之间不太可靠（即ICC分别为0.60和0.47）。生物力学模型对小测量误差具有鲁棒性，第一次和第二次测试 session 之间的功率峰值没有差异，表明测试 session 之间没有系统偏差（即运动表现改善）。
生物力学模型可用于评估康复计划的有效性，记录运动员的进展或进行针对最大前臂和腕部动力能力的研究性测试。尽管如此，在评估前臂和腕部内收运动功率时应谨慎。未来的研究应旨在为健康个体的前臂和腕关节扭矩及功率定义一组针对不同年龄组的标准值。
