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Research Papers

Spatial Dependency of Glenohumeral Joint Stability During Dynamic Unimanual and Bimanual Pushing and Pulling

[+] Author and Article Information
Daniel C. McFarland

Department of Mechanical and Aerospace
Engineering,
North Carolina State University,
911 Oval Drive,
Raleigh, NC 27606
e-mail: dcmcfarl@ncsu.edu

Emily M. McCain

Department of Mechanical and Aerospace
Engineering,
North Carolina State University,
911 Oval Drive,
Raleigh, NC 27606
e-mail: emmccain@ncsu.edu

Michael N. Poppo

Department of Mechanical and Aerospace
Engineering,
North Carolina State University,
911 Oval Drive,
Raleigh, NC 27606
e-mail: mnpoppo@ncsu.edu

Katherine R. Saul

Department of Mechanical and Aerospace
Engineering,
North Carolina State University,
911 Oval Drive,
Raleigh, NC 27606
e-mail: ksaul@ncsu.edu

1Corresponding author.

Manuscript received July 31, 2018; final manuscript received February 18, 2019; published online March 25, 2019. Assoc. Editor: Steven D. Abramowitch.

J Biomech Eng 141(5), 051006 (Mar 25, 2019) (7 pages) Paper No: BIO-18-1349; doi: 10.1115/1.4043035 History: Received July 31, 2018; Revised February 18, 2019

Degenerative wear to the glenoid from repetitive loading can reduce effective concavity depth and lead to future instability. Workspace design should consider glenohumeral stability to prevent initial wear. While glenohumeral stability has been previously explored for activities of daily living including push–pull tasks, whether stability is spatially dependent is unexplored. We simulated bimanual and unimanual push–pull tasks to four horizontal targets (planes of elevation: 0 deg, 45 deg, 90 deg, and 135 deg) at 90 deg thoracohumeral elevation and three elevation targets (thoracohumeral elevations: 20 deg, 90 deg, 170 deg) at 90 deg plane of elevation. The 45 deg horizontal target was most stable regardless of exertion type and would be the ideal target placement when considering stability. This target is likely more stable because the applied load acts perpendicular to the glenoid, limiting shear force production. The 135 deg horizontal target was particularly unstable for unimanual pushing (143% less stable than the 45 deg target), and the applied force for this task acts parallel to the glenoid, likely creating shear forces or limiting compressive forces. Pushing was less stable than pulling (all targets except sagittal 170 deg for both task types and horizontal 45 deg for bimanual) (p < 0.01), which is consistent with prior reports. For example, unimanual pushing at the 90 deg horizontal target was 197% less stable than unimanual pulling. There were limited stability benefits to task placement for pushing, and larger stability benefits may be seen from converting tasks from push to pull rather than optimizing task layout. There was no difference in stability between bimanual and unimanual tasks, suggesting no stability benefit to bimanual operation.

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Figures

Grahic Jump Location
Fig. 1

Task targets. Unimanual and bimanual push and pull simulations were performed for four horizontal targets defined by the plane of elevation angle achieved at the target (0 deg, 45 deg, 90 deg, and 135 deg) at thoracohumeral elevation of 90 deg and three sagittal targets defined by the thoracohumeral elevation angle achieved at the target (20 deg, 90 deg, 170 deg) at plane of elevation of 90 deg, for a total of six independent task targets. Bimanual tasks to the lateral 0 deg horizontal target were not simulated due to the extremely restricted handle motion and joint rotations observed.

Grahic Jump Location
Fig. 2

Upper limb marker set. Retro-reflective motion capture markers (gray spheres) were placed on anatomical locations. Only the right side (denoted by R.) and neutral markers are labeled in the figure; left markers are mirrored from right side. Markers include the seventh cervical vertebra (C7), the most ventral aspect of the sternoclavicular joint (SC), xiphoid process (XP), the most lateral aspect of the acromial angle (AA), a biceps cluster of three markers (BC), the lateral epicondyle of the humerus (LE), the medial epicondyle of the humerus (ME), a forearm cluster of three markers (FC), the styloid process of the radius (RS), the styloid process of the ulna (US), the second metacarpophalangeal joint (2MP), and the fifth metacarpophalangeal joint (5MP).

Grahic Jump Location
Fig. 3

Unimanual task direction by task target interaction. In general, pushing was less stable than pulling, and had a different spatial dependency from pulling. Unimanual pushing was less stable than unimanual pulling (indicated by *) (p < 0.001) at all task targets except the most elevated: sagittal 170 deg (p = 0.0503). For pushing, targets with different capital letters are significantly different. For pulling, targets with different lowercase letters are significantly different. Error bars represent 95% confidence interval for adjusted means.

Grahic Jump Location
Fig. 4

Bimanual task direction by task target interaction. For bimanual tasks when considering only the dominant shoulder, pushing, in general, was again less stable than pulling, but both bimanual task types had similar response to spatial location of tasks. Bimanual pushing was significantly less stable than bimanual pulling at all targets (indicated by *) (p < 0.01) except for horizontal 45 deg (p = 0.3059) and sagittal 170 deg (p = 0.1947). For pushing, targets with different capital letters are significantly different. For pulling, targets with different lowercase letters are significantly different. Error bars represent 95% confidence interval for adjusted means.

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