Motion analysis of the glenohumeral joint during activities of daily living

The shoulder complex has a larger range of motion (ROM) than any other joint complex in the human body, leaving it prone to numerous injuries. Objective kinematic analysis could yield useful functional insights that may assist clinical practice. Non-invasive optoelectronic motion analysis techniques have been used to assess the shoulders of five healthy subjects performing ROM tasks and 10 functional tasks of daily living. The four most demanding tasks – touching the side and back of the head, brushing the opposite side of the head, lifting an object to shoulder height and lifting an object to head height, required 78%, 60%, 61% and 71%, respectively, of the glenohumeral elevation necessary for full abduction in the scapular plane for the 10 shoulders. This has implications for clinical practice where maximum arm elevation is commonly used to determine a patient's ability to return to work and other everyday activities.     

Load along the tibial shaft during activities of daily living

External load at the tibia during activities of daily living provides baseline measures for the improvement of the design of the bone–implant interface for relevant internal and external prostheses. A motion analysis system was used together with an established protocol with skin markers to estimate three-dimensional forces and moments acting on ten equidistant points along the tibial shaft. Twenty young and able-bodied volunteers were analysed while performing three repetitions of the following tasks: level walking at three different speeds, in a straight-line and with sudden changes of direction to the right and to the left, stair ascending and descending, squatting, rising from a chair and sitting down. Moment and force patterns were normalised to the percentage of body weight per height and body weight, respectively, and then averaged over all subjects for each point, about the three tibial anatomical axes, and for each task. Load patterns were found to be consistent over subjects, but different among the anatomical axes, tasks and points. Generally, moments were higher in the medio/lateral axis and influenced by walking speed. In all five walking tasks and in ascending stairs with alternating feet, the more proximal the point was the smaller the mean moment was. For the remaining tasks the opposite trend was observed. The overall largest value was observed in the medio/lateral direction at the ankle centre in level walking at high speed (9.1% body weight * height on average), nearly three times larger than that of the anterior/posterior axis (2.9) during level walking with a sidestep turn. The present results should be of value also for in-vitro mechanical tests and finite element models.     

Prediction of ground reaction forces and moments during various activities of daily living

Inverse dynamics based simulations on musculoskeletal models is a commonly used method for the analysis of human movement. Due to inaccuracies in the kinematic and force plate data, and a mismatch between the model and the subject, the equations of motion are violated when solving the inverse dynamics problem. As a result, dynamic inconsistency will exist and lead to residual forces and moments. In this study, we present and evaluate a computational method to perform inverse dynamics-based simulations without force plates, which both improves the dynamic consistency as well as removes the model?s dependency on measured external forces. Using the equations of motion and a scaled musculoskeletal model, the ground reaction forces and moments (GRF&Ms) are derived from three-dimensional full-body motion. The method entails a dynamic contact model and optimization techniques to solve the indeterminacy problem during a double contact phase and, in contrast to previously proposed techniques, does not require training or empirical data. The method was applied to nine healthy subjects performing several Activities of Daily Living (ADLs) and evaluated with simultaneously measured force plate data. Except for the transverse ground reaction moment, no significant differences (P>0.05) were found between the mean predicted and measured GRF&Ms for almost all ADLs. The mean residual forces and moments, however, were significantly reduced (P>0.05) in almost all ADLs using our method compared to conventional inverse dynamic simulations. Hence, the proposed method may be used instead of raw force plate data in human movement analysis using inverse dynamics.     

Oral temperatures of the elderly in nursing homes in summer and winter in relation to activities of daily living

 This study was conducted to clarify the seasonal difference in body temperature in summer and winter, and to document the thermal environment of the elderly living in nursing homes. The subjects were 57 healthy elderly people aged ≥63 years living in two nursing homes in Japan. One of the homes was characterized by subjects with low levels of activities of daily living (ADL). Oral temperatures were measured in the morning and afternoon, with simultaneous recording of ambient temperature and relative humidity. Oral temperatures in summer were higher than in winter, with statistically significant differences (P<0.05) of 0.25 (SD 0.61) °C in the morning and 0.24 (SD 0.50) °C in the afternoon. Differences between oral temperatures in summer and winter tended to be greater in subjects with low ADL scores, even when their room temperature was well-controlled. In conclusion, the oral temperatures of the elderly are lower in winter than summer, particularly in physically inactive people. It appears that those with low levels of ADL are more vulnerable to large changes in ambient temperature. Received: 28 March 1996 / Accepted: 12 November 1996