Diane Haering

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

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.

Mechanical risk of rotator cuff repair failure during passive movements: A simulation-based study.

BACKGROUND Despite improvements in rotator cuff surgery techniques, re-tear rate remains above 20% and increases with tear severity. Mechanical stresses to failure of repaired tendons have been reported. While optimal immobilization postures were proposed to minimize this stress, post-operative rehabilitation protocols have never been assessed with respect to these values. Purpose was to use musculoskeletal simulation to predict when the stress in repaired tendons exceeds safety limits during passive movements. Hence, guidelines could be provided towards safer post-operative exercises. METHODS Sixteen healthy participants volunteered in passive three-dimensional shoulder range-of-motion and passive rehabilitation exercises assessment. Stress in all rotator cuff tendons was predicted during each movement by means of a musculoskeletal model using simulations with different type and size of tears. Safety stress thresholds were defined based on repaired tendon loads to failure reported in the literature and used to discriminate safe from unsafe ranges-of-motion. FINDINGS Increased tear size and multiple tendons tear decreased safe range-of-motion. Mostly, glenohumeral elevations below 38°, above 65°, or performed with the arm held in internal rotation cause excessive stresses in most types and sizes of injury during abduction, scaption or flexion. Larger safe amplitudes of elevation are found in scapular plane for supraspinatus alone, supraspinatus plus infraspinatus, and supraspinatus plus subscapularis tears. INTERPRETATION This study reinforces that passive early rehabilitation exercises could contribute to re-tear due to excessive stresses. Recommendations arising from this study, for instance to keep the arm externally rotated during elevation in case of supraspinatus or supraspinatus plus infraspinatus tear, could help prevent re-tear.

Local versus global optimal sports techniques in a group of athletes.

Various optimization algorithms have been used to achieve optimal control of sports movements. Nevertheless, no local or global optimization algorithm could be the most effective for solving all optimal control problems. This study aims at comparing local and global optimal solutions in a multistart gradient-based optimization by considering actual repetitive performances of a group of athletes performing a transition move on the uneven bars. Twenty-four trials by eight national-level female gymnasts were recorded using a motion capture system, and then multistart sequential quadratic programming optimizations were performed to obtain global optimal, local optimal and suboptimal solutions. The multistart approach combined with a gradient-based algorithm did not often find the local solution to be the best and proposed several other solutions including global optimal and suboptimal techniques. The qualitative change between actual and optimal techniques provided three directions for training: to increase hip flexion–abduction, to transfer leg and arm angular momentum to the trunk and to straighten hand path to the bar.

Identification of the contribution of contact and aerial biomechanical parameters in acrobatic performance

Introduction Teaching acrobatic skills with a minimal amount of repetition is a major challenge for coaches. Biomechanical, statistical or computer simulation tools can help them identify the most determinant factors of performance. Release parameters, change in moment of inertia and segmental momentum transfers were identified in the prediction of acrobatics success. The purpose of the present study was to evaluate the relative contribution of these parameters in performance throughout expertise or optimisation based improvements. The counter movement forward in flight (CMFIF) was chosen for its intrinsic dichotomy between the accessibility of its attempt and complexity of its mastery. Methods Three repetitions of the CMFIF performed by eight novice and eight advanced female gymnasts were recorded using a motion capture system. Optimal aerial techniques that maximise rotation potential at regrasp were also computed. A 14-segment-multibody-model defined through the Rigid Body Dynamics Library was used to compute recorded and optimal kinematics, and biomechanical parameters. A stepwise multiple linear regression was used to determine the relative contribution of these parameters in novice recorded, novice optimised, advanced recorded and advanced optimised trials. Finally, fixed effects of expertise and optimisation were tested through a mixed-effects analysis. Results and discussion Variation in release state only contributed to performances in novice recorded trials. Moment of inertia contribution to performance increased from novice recorded, to novice optimised, advanced recorded, and advanced optimised trials. Contribution to performance of momentum transfer to the trunk during the flight prevailed in all recorded trials. Although optimisation decreased transfer contribution, momentum transfer to the arms appeared. Conclusion Findings suggest that novices should be coached on both contact and aerial technique. Inversely, mainly improved aerial technique helped advanced gymnasts increase their performance. For both, reduction of the moment of inertia should be focused on. The method proposed in this article could be generalized to any aerial skill learning investigation.

Which mathematical model best fit the maximal isometric torque-angle relationship of the elbow?

In biomechanics, modelling musculoskeletal behaviour opens large perspectives for injury prevention enabling non-invasive internal forces prediction. Current muscle models rely on isometric force-l...

Kinematic model and elbow flexion interaction on shoulder range of motion.

D. Haering*, M. Raison, A. Arndt and M. Begon Department of Kinesiology Laboratory of Simulation & Movement Modelling, Université de Montréal, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada; École Polytechnique de Montréal and Centre de Réadaptation Marie Enfant Sainte-Justine, Montreal, Quebec, Canada; Department of Orthopedic Surgery, Karolinska University Hospital/Huddinge, Stockholm, Sweden