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Technical Brief

Measurement and Description of Three-Dimensional Shoulder Range of Motion With Degrees of Freedom Interactions

[+] Author and Article Information
Diane Haering

Laboratory of Simulation and Movement Modeling,
Department of Kinesiology,
Université de Montréal,
1700 rue Jacques Tétreault,
Laval, QC H7N 0B6, Canada
e-mail: diane.haering@umontreal.ca

Maxime Raison

ÉcolePolytechnique de Montréal and Centre de
Réadaptation Marie Enfant – Sainte-Justine UHC,
Research & Engineering Chair
Applied in Pediatrics (RECAP),
5200 rue Bélanger, office GR-123,
Montreal, QC H1T 1C9, Canada
e-mail: maxime.raison@polymtl.ca

Mickael Begon

Laboratory of Simulation and Movement Modeling,
Department of Kinesiology,
Université de Montréal,
1700 rue Jacques Tétreault,
Laval, QC H7N 0B6, Canada
e-mail: mickael.begon@umontreal.ca

1Corresponding author.

Manuscript received October 29, 2013; final manuscript received May 2, 2014; accepted manuscript posted May 14, 2014; published online June 3, 2014. Assoc. Editor: Zong-Ming Li.

J Biomech Eng 136(8), 084502 (Jun 03, 2014) (6 pages) Paper No: BIO-13-1511; doi: 10.1115/1.4027665 History: Received October 29, 2013; Revised May 02, 2014; Accepted May 14, 2014

The shoulder is the most mobile joint of the human body due to bony constraint scarcity and soft tissue function unlocking several degrees of freedom (DOF). Clinical evaluation of the shoulder range of motion (RoM) is often limited to a few monoplanar measurements where each DOF varies independently. The main objective of this study was to provide a method and its experimental approach to assess shoulder 3D RoM with DOF interactions. Sixteen participants performed four series of active arm movements with maximal amplitude consisting in (1) elevations with fixed arm axial rotations (elevation series), (2) axial rotations at different elevations (rotation series), both in five planes of elevation, (3) free arm movements with the instruction to fill the largest volume in space while varying hand orientation (random series), and (4) a combination of elevation and rotation series (overall series). A motion analysis system combined with an upper limb kinematic model was used to estimate the 3D joint kinematics. Thoracohumeral Euler angles with correction were chosen to represent rotations. The angle-time-histories were treated altogether to analyze their 3D interaction. Then, all 3D angular poses were included into a nonconvex hull representing the RoM space accounting for DOF interactions. The effect of series of movements (n = 4) on RoM volumes was tested with a one-way repeated-measures ANOVA followed by Bonferroni posthoc analysis. A normalized 3D RoM space was defined by including 3D poses common to a maximal number of participants into a hull of average volume. A significant effect of the series of movements (p < 0.001) on the volumes of thoracohumeral RoM was found. The overall series measured the largest RoM with an average volume of 3.46 ± 0.89 million cubic degrees. The main difference between the series of movements was due to axial rotation. A normalized RoM hull with average volume was found by encompassing arm poses common to more than 50% of the participants. In general, the results confirmed and characterized the complex 3D interaction of shoulder RoM between the DOF. The combination of elevation and rotation series (overall series) is recommended to fully evaluate shoulder RoM. The normalized 3D RoM hull is expected to provide a reliable reference to evaluate shoulder function in clinical research and for defining physiologic continuous limits in 3D shoulder computer simulation models.

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Figures

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Fig. 3

Boxplots representing the effects of movement series on maximal shoulder RoM volume with paired t-test. The series showing significant differences with each other are mentioned after one (p < 0.05) or two (p < 0.01) asterisks. The red crosses represent outliers.

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Fig. 4

Slices of average RoM volume for all series compared to the literature data. Subplots indicate the 2D rotation–elevation interaction every 45 deg of plane of elevation.

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Fig. 2

Example of hull construction for the first series of movements (elevations). (a) Poses during evolution of the movement defined by 3D angles. (b) and (c) Tetrahedra and nonconvex hull that encompasses all the poses, respectively.

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Fig. 1

Description of arm movement series relatively to the thorax with the arm reference frame and the corresponding axes of rotation. (a) “Elevation” series. (b) “Rotation” series. The seven vertical planes of elevation are seen from above. The maximal external, neutral, and maximal internal rotations of the arm are represented during elevation. “Plateau” indicates that elevation is stopped at 30 deg, 60 deg, 90 deg, 120 deg, 150 deg, and maximal elevation, while a maximal external–internal rotation is performed. Notes: For clarity, the arm is represented with extended elbow during internal–external rotations; however, in the reality, the elbow was bent at about 90 deg. The addition sign indicates that each combination of the right hand side is performed in all seven vertical planes of elevation.

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Fig. 5

(a) Individual and (b) average thoracohumeral RoM volumes, represented by 3D angle (ψ)–angle (θ)–angle (φ) hulls. Notes: The upper and lower boxes represent the thoracohumeral RoM from Klopčar's model [6] and Barnes's data [13], respectively. Vertical lines and planes indicate planes in which characteristic anatomical movement are realized.

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