presentation_workspace by wuyunyi

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									Arm Reachable Working Space
     as Evaluation Tool
            Nives Klopčar and Jadran Lenarčič
             Jožef Stefan Institute, Department of Automatics,
             Biocybernetics and Robotics Jamova 39, Ljubljana,
             Slovenia
             Institute of the Republic of Slovenia for
             Rehabilitation, Linhartova 51, Ljubljana, Slovenia

5th International Shoulder Complex Conference, Portugal, 27 – 28 August, 2004
                          1. Introduction




The intention is to create a computer assistant tool for a graphical and numerical
presentation of ROM measurements with the arm reachableworkspace.
2.1 Shoulder ROM measurement

                    (a) elevation through
                    flexion and retroflexion
                    in sagittal plane
                    (b) elevation through
                    abduction and adduction
                    in frontal plane
                    (c) ext./int. rotation


                    • passive ROM
                    • frozen shoulder patient
                    • during therapy
2.2 Upper extremity model
         rW = Red Rpr T . rSG + RA RF RR . ( rGE + REF . rEW )


         Red =Rot(y, jed)                       rSG= (± dSG, 0, 0)T
         Rpr = Rot(z, jpr)                      rGE = (0, 0, - dH)T
         T = Trans (x, dSG/do)                  rEW = (0, 0, - dF)T
         RA =Rot(y, jA)
         RF =Rot(x, jF)
                                                dSG(H), dH(H), dF(H)
         RR =Rot(z, jR)
                                                H...subject height
         REF =Rot(x, jEF)

         D. A. Winter, Biomechanics and Motor Control of Human Movement, A
         Wiley-Interscience Publication, University of Waterloo, Canada, 1990.
2.3 Computer assistant tool




• adduction/abduction [jAm, jAM ]
• retroflexion/flexion [jFm + jA/3, jFM - jA/6]
• ext./int. rotation [jRm+7jA/9 - jF/9 + 2jAjF/810°,
                    jRM + 4jA/9 – 5jF/9 + 5jAjF /810°]
      • shoulder girdle position (shoulder rhythm,
        length changes, angular motion range )
• flexion (- 60°) in extension (90°) of healthy elbow jEF
2.4 Wrist points calculation
        • adduction/abduction [jAm, jAM ]
        • retroflexion/flexion [jFm + jA/3, jFM - jA/6]
        • ext./int. rotation [jRm+7jA/9 - jF/9 + 2jAjF/810°,
                            jRM + 4jA/9 – 5jF/9 + 5jAjF /810°]
              • shoulder girdle position (shoulder rhythm,
                length changes, angular motion range )
        • flexion (- 60°) in extension (90°) of healthy elbow jEF

            rW = Red Rpr T . rSG + RA RF RR . ( rGE + REF . rEW )


                 BODY VOLUME IS AN OBSTACLE
                            3. Results
Arm’s workspace presents an area within reach of the wrist.



 right shoulder   PASSIVE
 flexion           170°
 retroflexion       60°
 abduction         170°
 adduction          10°
 ext. rotation      90°
 int. rotation      60°
 height           170 cm


                                 V = 615,7dm3 ± 55,7dm3
          Comparison of involved arm
          reachable workspace volume
Passive measurement:

left (involved) arm:
V1 = 95.2 dm3
V2 = 154.7 dm3
V3 = 160.5 dm3
V4 = 231.2 dm3
V5 = 313.6 dm3
V6 = 335.4 dm3
      Comparison of involved and
  uninvolved arm reachable workspace
                volume
Passive measurement:

left (involved) arm:      Functioning:   Deficit:
V1 = 95.2 dm3              15.5%         84.5%
V2 = 154.7 dm3             25.1%         74.9%
V3 = 160.5 dm3             26.1%         73.9%
V4 = 231.2 dm3             37.6%         62.4%
V5 = 313.6 dm3             50.9%         49.1%
V6 = 335.4 dm3             54.5%         45.5%
right (uninvolved) arm:
Vh = 615.7dm3
          Comparison of involved arm
             reachable workspace
Passive measurement:

left (involved) arm:
V1 = 95.2 dm3
V2 = 154.7dm3
V3 = 160.5dm3
V4 = 231.2dm3
V5 = 313.6dm3
V6 = 335.4dm3
right (uninvolved) arm:
Vh = 615.7dm3
      Comparison of involved and
  uninvolved arm reachable workspace
Passive measurement:

left (involved) arm:
V1 = 95.2 dm3
V2 = 154.7dm3
V3 = 160.5dm3
V4 = 231.2dm3
V5 = 313.6dm3
V6 = 335.4dm3
right (uninvolved) arm:
Vh = 615.7dm3
      Comparison of involved and
  uninvolved arm reachable workspace
Passive measurement:

left (involved) arm:
V1 = 95.2 dm3
V2 = 154.7dm3
V3 = 160.5dm3
V4 = 231.2dm3
V5 = 313.6dm3
V6 = 335.4dm3
right (uninvolved) arm:
Vh = 615.7dm3
Involved and uninvolved
arm reachable workspace
Arm reachable workspace advantages
                     mathematical criterion:
                         – volume
                         – shape
                     • evaluation
                     • objective comparison
                     • to motivate the patient
                     • easily understandable
                Conclusions
• enables a new expression of the shoulder and arm
disability based on standard ROM measurements
• documents qualitatively and quantitatively
• compares treatment objectively
• is easily understood by patients and professionals
engaged in the evaluation of the patient`s disability
• provides standard computer documentation benefits

								
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