Vanezis Athanasios, Robinson Mark A, Darras Nikolaos
Gait & Motion Analysis Center, ELEPAP - Rehabilitation for the Disabled, Kononos 16, Pagrati, 11634 Athens, Greece.
School of Sport and Exercise Sciences Tom Reilly Building, Byrom Street Campus, Liverpool, L3 3AF, UK.
Gait Posture. 2015 Feb;41(2):431-9. doi: 10.1016/j.gaitpost.2014.11.007. Epub 2014 Dec 4.
Upper limb (UL) kinematic assessment protocols are becoming integrated into clinical practice due to their development over the last few years. We propose the ELEPAP UL protocol, a contemporary UL kinematic protocol that can be applied to different pathological conditions. This model is based on ISB modeling recommendations, uses functional joint definitions, and models three joints of the shoulder girdle. The specific aim of this study was to determine the within and between session reliability of the ELEPAP UL model. Ten healthy subjects (mean age: 13.6±4.3 years) performed four reach-to-grasp and five functional tasks, which included a novel throwing task to assess a wide spectrum of motor skills. Three trials of every task in two different sessions were analyzed. The reliability of angular waveforms was evaluated by measurement error (σ) and coefficient of multiple correlation (CMC). Spatiotemporal parameters were assessed by standard error of measurement (SEM). Generally joint kinematics presented low σw and σb errors (<100). A selection of angular waveforms errors was presented to inspect error fluctuation in different phases, which was found to be related to the demands of the different movements. CMCw and CMCb values (>0.60) were found, demonstrating good to excellent reliability especially in joints with larger ranges of motion. The throwing task proved equally reliable, enhancing the universal application of the protocol. Compared to the literature, this study demonstrated higher reliability of the thorax, scapula and wrist joints. This was attributed to the highly standardized procedure and the implementation of recent methodological advancements. In conclusion, ELEPAP protocol was proved a reliable tool to analyze UL kinematics.
由于上肢（UL）运动学评估方案在过去几年的发展，它们正逐渐融入临床实践。我们提出了ELEPAP UL方案，这是一种可应用于不同病理状况的当代UL运动学方案。该模型基于国际生物力学学会（ISB）的建模建议，使用功能性关节定义，并对肩胛带的三个关节进行建模。本研究的具体目的是确定ELEPAP UL模型在不同测试时段内以及不同测试时段之间的可靠性。十名健康受试者（平均年龄：13.6±4.3岁）完成了四项伸手抓握任务和五项功能性任务，其中包括一项新颖的投掷任务，以评估广泛的运动技能。对两个不同测试时段中每个任务的三次试验进行了分析。通过测量误差（σ）和多重相关系数（CMC）评估角度波形的可靠性。通过测量标准误差（SEM）评估时空参数。一般来说，关节运动学的σw和σb误差较低（<100）。展示了一系列角度波形误差，以检查不同阶段的误差波动，发现其与不同运动的需求有关。发现CMCw和CMCb值（>0.60），表明可靠性良好至优秀，尤其是在运动范围较大的关节中。投掷任务同样可靠，增强了该方案的普遍适用性。与文献相比，本研究表明胸部、肩胛骨和腕关节的可靠性更高。这归因于高度标准化的程序和近期方法学进展的实施。总之，ELEPAP方案被证明是分析上肢运动学的可靠工具。
