3D upper limb kinematics of people with stroke during different types of elevation tasks

Abstract

Background and Purpose: Upper limb dysfunctions are common after stroke and are often related to factors, including hemiparesis or hemiplegia. To induce optimal function of the upper limb, normal shoulder and scapulothoracic kinematics are essential. The objective of this study is to assess how scapular movement in stroke patients without shoulder pain are influenced by commonly prescribed range of motion exercises: active, active-arm-assisted, and active-scapula-assisted. Methods: Thirteen stroke patients, without shoulder pain, were included in the study. Threedimensional kinematics of the trunk, shoulder girdle and elbow, were determined from infra-red markers attached to the sternum, acromion and on the upper arm during active, active-arm-assisted and active-scapula-assisted arm elevation (45° and 120°). Results: During active arm elevation more protraction of the scapula (p=0.001) and more pronation of the elbow (p=0.003) was found at a joint angle of 45° during 120° arm elevation. Concerning the active-arm-assisted elevation, more internal rotation at the trunk and more protraction of the scapula was seen at a joint angle of 45° (P=0.008). Active-scapula-assisted elevation was accompanied by a decreased amount of protraction and a greater amount of posterior tilting of the scapula (p=0.001), and an increased pronation of the elbow (p=0.003). Discussion and Conclusions: Active-assisted range of motion exercises create more optimal shoulder and scapulothoracic kinematics compared to active range of motion