Three-Dimensional Biomechanical Model of Wrist Dynamics during Tasks of Daily Living

119 Pages·2016·4.15 MB·English

Marquete University
THREE-DIMESIONAL BIOMECHANICAL MODEL OF WRIST DYNAMICS
DURING TASKS OF DAILY LIVING

by
Patrick Roscher, B.A.

A Thesis submitted to the Faculty for the Graduate School,
Marquette University,
in Partial Fulfillment of Requirements for
the Degree of Master of Biomedical Engineering

Milwaukee, Wisconsin
December 2012
ABSTRACT
THREE-DIMESIONAL BIOMECHANICAL MODEL OF WRIST DYNAMICS
DURING TASKS OF DAILY LIVING

Patrick Roscher, B.A.
Marquette University, 2012

An understanding of wrist dynamics during functional movements is required to
better diagnose and treat wrist injury and disease. Currently, there is a lack of upper
extremity (UE) models that combine both the motions and resulting forces that occur in
the wrist during daily activities. The purpose of this study is to create a three-dimensional
(3D) model of the upper extremity that describes kinematics and wrist kinetics during
functional activities. A model of this type could benefit clinical diagnosis, treatment, and
follow-up care of orthopaedic and neurological disorders of the wrist.
The created dynamic wrist model was used to test ten normal subjects during
seven tasks (flexion/extension, radial/ulnar deviation, pronation/supination, hammering,
jar opening, door-opening, and isometric pushing). Primary and secondary wrist motions
were described for each task, as well as tri-axial forces and moments at the wrist for jar
opening, door-opening, and isometric push tasks. These data were stratified by gender to
demonstrate the model’s capacity to compare populations. Data were analyzed and
showed that there were very few significant differences between male and female
populations. This model demonstrates potential for clinical use for pre- and post-
treatment assessment and initial wrist function baseline assessment.
i

AKNOWLEDGEMENTS

Patrick Roscher, B.A.

I would like to express my sincere gratitude for all of the support and guidance to
my advisor, Dr. Gerald Harris and my committee members, Jessica Fritz, Dr. Roger
Daley, and Dr. Jason Long. Thanks to their help and support I was able to complete my
graduate school education. I am grateful to my parents, Michael and Margaret, family and
friends for their love and support. I owe a special thanks to Ashley Swanson for her
encouragement and patience. I would like to thank Dr. Doug Fisher and Dr. Philip
Vogelwede for their assistance and expertise. Finally I would like to thank the
Orthopaedic and Rehabilitation Engineering Center (OREC) for its financial support as
well as everyone involved at OREC for all of the help and memories.
ii

TABLE OF CONTENTS
ACKNOWLEDGMENTS……………………………………………………………i
LIST OF TABLES………………………………………………………..…………..iv
LIST OF FIGURES……………………………….……………………………….….v
CHAPTER
1.INTRODUCTION……………………………………………………………….…1
1.1Overview and Objective…………………………………………………..1
1.2 Clinical Significance and Applications…………...……………………...2
1.3 Wrist Kinesiology………………………………..………………………5
1.4 Kinematics………………………...……………………………………..12
1.5 Kinetics…………………………….…………………………………….15
1.6 Skin Movement Correction……………….……………………………..17
1.7 Existing Upper Extremity and Wrist Models……………………………19
METHODS………………………………………………………………….……….24
2.1 Standardized Functional Assessments………………………...…………24
2.2 Kinematic Model…………………………………………..……………26
2.2.1 Joint Centers…………………………………………..……….27
2.2.2 Segment Coordinate Systems……………………….…………31
2.3 Kinetic Model………………………………………..…………………..33
2.4 Subject Population…………………………………….…………………38
2.5 Experimental Procedure…………………………………………………38
2.6 Data Collection and Analysis……………………………………………44
3. RESULTS ………………………………………………….……………………..45
3.1 Standardized Functional Assessments……………………….…………..45
3.2 Kinematic Tasks…………………………………………………………46
iii

3.2.1 Wrist Flexion and Extension…………….…………………….46
3.2.2 Wrist Radial/Ulnar Deviation………………………………….50
3.2.3 Pronation/Supination…………………………………………..52
3.2.4 Hammer………………………………………………………..55
3.3 Kinetic Tasks………………...…………………………………………..58
3.3.1 Jar-Opening Task………………………………………………59
3.3.2 Door-Opening Task……………………………………………62
3.3.3 Isometric Push Task……………………………………………65
3.4 Significant Differences ………………………………………………….68
4. DISCUSSION……………………………………………………………………..70
5. CONCLUSION…………………………………………..………………………..76
5.1 Summary………………………………………………...……………….76
5.2 Future Directions………………………………………..……………….77
5.3 Concluding Remarks……………………………………...……………...78
6. BIBLEOGRAPHY………………………………………………………..……….79
APPENDICES…………………………………………………………………..……83
Appendix A: Functional Assessment Materials…………………..………….83
Appendix B: Source Code...…………………………………………...……..86
Appendix C: Complete Statistical Analysis Results..…………………..……99
iv

LIST OF TABLES
2.1 Jebsen Functional Hand Test Activities…………………………………..…….25
2.2 Marker Names, Locations, and Segment Affiliation …………………..………28
3.1 DASH and Jebsen Functional Hand Test Results ……………………...………46
3.2 Kinematic Tasks’ Results Summary ………………………………...…………49
3.3 Dynamic Tasks’ Kinematic Results Summary ………………………..……….59
3.4 Dynamic Tasks’ Kinetic Results Summary …………………………..………..59
4.1 Power Analysis …………………………………………………………………75
v

LIST OF FIGURES
1.1 Carpal Bones ……………………………………………………...…………….7
1.2 Extensors of the Wrist ……………………………………………..……………9
1.3 Flexors of the Wrist ………………………………………………..……………10
1.4 Pronators and Supinator of the Wrist ……………………………….………….12
2.1 Dynamometer Coordinate System in Reference to the Body…………………..27
2.2 Upper Extremity Marker Placement and Coordinate Systems ……...………….28
2.3 The Flexion and Extension Task…………….………………………….……….39
2.4 The Radial and Ulnar Deviation Task…………………………………..……….40
2.5 The Pronation and Supination Task………………………………….………….40
2.6 The Hammering Task………………………………………………..….……….41
2.7 The Jar-Opening Task…………………………………………………..……….42
2.8 The Door-Opening Task…………………………………………………………42
2.9 The Isometric Push Task………………………………………………….……..44
3.1 The Flexion and Extension Results………………………………………...……48
3.2 The Flexion and Extension Males vs. Females Comparison …………………...49
3.3 The Radial and Ulnar Deviation Results………………………………...………51
3.4 The Radial and Ulnar Deviation Males vs. Females Comparison ……………..52
3.5 The Pronation and Supination Results…………………………….……………..54
3.6 The Pronation and Supination Males vs. Females Comparison ………………...55
3.7 The Hammering Results…………………………………………………………57
3.8 The Hammering Males vs. Females Comparison ………………………………58
3.9 The Jar-Opening Results……………………………………………..………….61
3.10 The Jar-Opening Force Comparison …………………………………………..62
3.11 The Door-Opening Results……………………………………………..….…..64
vi

3.12 The Door-Opening Force Comparison ………………………………………….65
3.13 The Isometric Push Results……………………………………………..……….67
3.14 The Isometric Push Force Comparison …………………………………………68
3.15 Significant Differences in Males vs. Females …………………………………..69
1

1. INTRODUCTION
1.1 OVERVIEW AND OBJECTIVE
Three-dimensional (3D) analysis of upper extremity (UE) motion is a relatively
under developed area of motion analysis. Historically, lower body motion analysis has
been better developed than upper body modeling (Rau 2000). For this reason, it is not
surprising that there is a current need for UE models that define joint kinematics and
kinetics for activities of daily living (ADLs). The understanding and quantification of
wrist motion during functional movements is required for better diagnosis and treatment
of wrist pathologies. Currently there is a lack of UE models that combine both quantified
motions and resulting forces that occur during ADLs. This quantification is important for
accurate assessment and tracking of disability and rehabilitation. The first objective of
this study is to create a 3D model to quantify the motion of the right UE that includes the
resulting forces seen in the wrist during selected ADLs. A model of this type could
benefit clinical diagnosis and treatment of orthopaedic and neurological disorders of the
wrist (Schmidt 1999). The second objective is to demonstrate the ability of the model to
compare the wrist function of two populations. In this study, wrist function of normal
male and female populations will be compared. It is hypothesized that there will be no
significant difference in wrist function between male and female populations. Current
functional assessments of the wrist that are commonly used clinically include self-
reported disability scores, such as the Disability of the Arm, Shoulder and Hand (DASH)
measure, or simple quantification of function, such as the Jebsen Hand Function Test
(JHFT). These assessments may be insensitive to small differences in disability and are