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Rene Ferdinands
07-18-2000, 05:40 PM
Dear Biomch-L subscribers,

I apologise for my delayed presentation of the summary of replies, as I
have been overseas for the last month. I thank everyone for taking the time
to help with this problem, especially Daniel Magnusson from the Department
of Biomedical Engineering at the Lerner Research Institute.
It is evident that the kinematic/kinetic modelling of shoulder motion is a
complex problem that still needs much attention.

If anyone has more ideas on the subject, then your comments would be most
welcome. I am particularly interested in methods that determine the centre
of rotation of the glenohumeral joint. Presently, I am aware of two such
methods.

The other problem is how to account for shoulder retraction/protraction and
shoulder elevation/depression in a rigid-body kinetic model (inverse &
forward solution) of the trunk-arm-hand complex. Any ideas how this can be
done?

Thank you.

Rene Ferdinands
University of Waikato
Dept of Physics & Electronic Engineering
Private Bag 3105
Hamilton 2001
New Zealand

Phone: (+64 7) 838 4026
Fax: (+64 7) 838 4219
email: redf1@waikato.ac.nz
--------------------------------------


ORIGINAL MESSAGE
**********************
Rene Ferdinands wrote:
>
> Hello,
>
> I am performing a 3D motion analysis of bowling in cricket. I am having
> difficulty in deciding how to place markers around the shoulder to estimate
> the 3D position of the glenohumeral joint.
>
> I know there are methods that specify various bony landmarks on the
> scapula. However, in a dynamic activity such as bowling the scapula moves
> significantly under the skin. Instead, I need to develop a skin-based
> method to do this job. Any information on this subject would be greatly
> appreciated.
>
> Regards
>
> Rene Ferdinands
> University of Waikato
> Dept of Physics & Electronic Engineering
> Private Bag 3105
> Hamilton 2001
> New Zealand
>
> Phone: (+64 7) 838 4026
> Fax: (+64 7) 838 4219
> email: redf1@waikato.ac.nz
> --------------------------------------



Hi Rene,

I have also looked at measuring the motions of the shoulder (was working on a
method to describe just what you are trying to figure out, had limited
success). As you can imagine that is not an easy task. The shoulder defies
standard motion analysis techniques for exactly the reason that you mention,
the great movement of the scapula under the surface of the skin. The only way
that anyone has "accurately" measured the shoulder is by either:

(a) doing a series of static positions along the path of action (ie. the
various positions that the thrower/bowler would be going through) see numerous
articles by Veeger, van der Helm, Pronk, and others in the Dutch shoulder
group, or
(b) actually drilling in bone pins into the acromial process of the scapula.
See articles by Koh and Grabiner (1998?) and recent work done by Karduna et
al.

(If you want the exact references for all of the above people please let me
know, they are too many to list at the moment.)

As you can imagine both of these methods have their detractors. The ideal way
would be to look at the position of the scapula as if it were in an MR
scanner.
However, here again you are limitied to static positions (Look at Graichen et
al, 2000; Journal of Biomechanics, 33, pgs 609-613).

Personally, I have experimented with using a motion analysis system to detect
the surface deformation of the skin over the scapula, with limited success
(was
only a semester long directed study course, so the project has been on hold
for
a while now, as I focus on my thesis research (also on the shoulder)). If you
are curious about exactly what I did, please contact me.

Since it is difficult to do this there are several approaches that you could
possibly take, in addition to the ones mentioned above:

1) Consider looking at the shoulder joint like a ball and socket joint that
has
a stationary position on the torso (Problem: Is the motion you measure
going to
be sufficiently accurate?)

2) Consider doing a series of static positions that could be strung together
"cinematically" to show the relative positions the shoulder through the range
of motion. (Problem: Static position of the scapula may be different than what
actually occurs in real life since the shoulder is required to stabilize the
arm in the stationary position until that position is quantified. Also
consider
the difficulty of keeping the arm/shoulder stationary while in an awkward
position without external stabilization. (Very difficult!) )

3) Consider finding a willing subject to have pins drilled into the acromial
process. (Problem: Pins may interefere with the range of motion of the
subject,
and may not accurately reflect the movement of the "whole" scapula, just the
movement at the acromial process. ie. Can't see how much the inferior angle of
the scapula moves from just the acromial process movement.)

4) Consider using fluoroscopy to measure the movement (cine-fluoroscopy)
(Problems: Inherently inaccurate since you are looking at a 2-D image of a 3-d
object. Also consider the amount of radiation exposure)

5) Consider creating a cadaveric model that can be used to mimic the movement
of the bowler/pitcher (Problems: Difficulty in determining the exact forces
that all of the individual muscles use when actually doing the task. More
problems are present but are not important to discuss unless you are
interested
in doing this.)

6) Utilize a computer model. The shoulder model constructed by van der Helm is
one of the most complete, and accurate ones available. Also some modelling of
the shoulder has been done by a graduate student of Marcus Pandy. Also see the
work of Udupa's group who have done MRI reconstructed cinematic sequences
(series of static positions strung together.) Again, I don't have the
references immediately handy, but if you want I will dig them up.

I wish you good luck in your efforts and am very curious to see the responses
that you get to your question. Please email me a summary when you can.

Please feel free to contact me at the following:

Daniel Magnusson B.Sc.
Research Assistant
Department of Biomedical Engineering (ND-20)
Lerner Research Institute
Cleveland Clinic Foundation
9620 Carnegie Avenue
Cleveland, Ohio
44195
USA

Telephone: (216) 445-0747
Fax: (216) 444-9198
email: magnusd@bme.ri.ccf.org

Good luck!
-Dan

************************************************** ****************************
Rene,

If you are using a magnetic tracking device, such as those by Ascension
Technologies (e.g. Flock of Birds), you may want to look at a
dissertation by Kevin McQuade at the University of Iowa in the USA. The
title is "The scapulohumeral rhythm: a three-dimensional kinematic
analysis of the effects of load and fatigue during evaluation of the arm
in the scapular plane".

There is also a thesis at the University of Iowa by PM Ludewig titled
"The effect of head position on scapular rotation and muscle activity
during humeral elevation"

You can also want to get in touch with Andrew Kardua, Ph.D. at Hannaman
University in Philadelphia, Pennsylvania in the USA. I believe this
hospital has merged with Drexel University, also in Philadelphia. You
may have to search under both to find out how to contact him. He has a
method for measuring scapular position, also with magnetic tracking
devices.

I hope this is some help,

Timothy Lutz
North Carolina State University

************************************************** **************************
Hi Rene,

I have been watching your cricket progress with interest, especially
as I see you are one of the very few NZers on the membership list of
ISBS

Your latest question, shoulder markers, got a wry smile from me in
the first instance. In the second I wonder whether you might:

1 set up a group of markers and compute a position

2.set up a triangulation method using say C3 and L1 and head of
humerus. or maybe even four positions with iliac crest added to the
other three.

Why don't you ask Jim Hay at Unisport?

In the meantime I'll continue to think on it.

From: "Doug McClymont"
Organization: Christchurch Collge of Education
************************************************** **********
Hi Rene,

We did some 3D motion capture on bowling in cricket last year. At the
time we were not concerned with the shoulder and therefore only used
one marker on the acromion process. However the marker was often
occluded on the bowling arm side as the arm came over prior to
ball release.This occlusion may be another concern when specifying a
marker placement to find the 3D position of the glenohumeral joint.

I am sorry I could not assist with any ideas. I would be interested
in the answers to this question.

Regards

Dudley Tabakin
University of Cape Town
Motion analysis Laboratory
Sports Science Institute of South Africa
Boundary Rd
Newlands
Cape Town
South Africa

Tel: +27 21 686-7330 ext.257
email: dudley@sports.uct.ac.za
************************************************** ***********
Hi Rene,

I read your message on Biomch-l.
Doorenbosch et al., 1999
Gait and Posture 1999 Vol. 10, No 1, pp54-55.

This is an abstract presented at ESMAC'99. They work out the centre of
rotation of the glenohumeral joint.

I hope this helps.

Gabor
************************************************** ********************
Hello Rene,

I am actually in the process of completing my Masters thesis. My research
examines the amount of glenohumeral translation present in the shoulder in
vivo using MRI, specifically in a paraplegic population.

For your interest, there is a meeting of the International Shoulder Group in
Newcastle(-upon-Tyne), England in September 4 - 5 2000.

The kinematic analyses that look at javelin and baseball pitching tend to
use fine wire and surface EMG (and examine the muscle activation patterns)
as their main focus (Pink; Perry; Jobe, to name a few authors). Those that
do use motion analysis (can't think of who might have done these offhand)
tend to use the assumption that the shoulder joint is a ball and socket in a
stationary position on the torso.

The most "successful" technique to date is the use of the bone pins, but
like I mentioned in the previous email, there are problems with this
technique as well, especially if you want to look at bowling/pitching.

Here are a list of the references that I have. It is not a complete list but
should give you a good start. Should give you some other authors to start
from if you want to look at the fuction of the glenohumeral joint. The
authors I would recommend for you are references #
11,13,14,16,19,22,24,25,26,28,30,36-41.

For the work from Karduna you will have to contact him directly since I do
not have any of his papers handy (saw his work at some conferences).

Hopefully this helps you.

Curious to hear what other responses you have gotten.

Best of luck.

-Dan

Daniel Magnusson B.Sc.
Research Assistant
Department of Biomedical Engineering
Lerner Research Institute
9620 Carnegie Avenue (ND-20)
Cleveland Clinic Foundation
Cleveland, Ohio, USA 44195

Tel:(216)445-0747
Fax:(216)444-9198
Email: magnusd@bme.ri.ccf.org



References
1. Bassett, RW, Browne, AO and An, KN. Glenohumeral muscle force and moment
mechanics in a position of shoulder instability. Journal of Biomechanics
23(5): 405-415, 1990.

2. Bayley JC, Cochran TP, Sledge CB: The weight bearing shoulder: The
impingement syndrome in paraplegics. Journal of Bone and Joint Surgery
69-a:676-678, 1987

3. Burnham RS, May L, Nelson E, Steadward RD, Reid DC: Shoulder pain in
wheelchair athletes: The role of muscle imbalance. American Journal of
Sports Medicine 21: 238-242, 1993

4. Burnham RS, Steadward RD: Upper extremity peripheral nerve entrapments:
Prevalence, location and risk factors. Archives of Physical Medicine and
Rehabilitation 75:519-524, 1994

5. Codman, EA. The shoulder: rupture of the supraspinatus tendon and other
lesions in or about the subacromial bursa, special ed. New York: Classics
of Surgery Library, repr.1991, c. 1934.

6. Enoka, RM. Simple joint system operation in: Neuromechanical basis of
kinesiology. Champaign: Human Kinetics Books. p. 133, 1988.

7. Flatow EL, Soslowsky LJ, Ticker JB, Pawluk RJ, Hepler M, Ark J, Mow VC,
Bigliani LU: Excursion of the rotator cuff under the acromion: Patterns of
subacromial contact. American Journal of Sports Medicine 22:779-788, 1994

8. Frank, C.B. and Shrive, N.B. Ligament in: Biomechanics of the
musculoskeletal system: Nigg and Herzog (Eds.), John Wiley and Sons: New
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9. Gellman H, Waters RL, Sie IH: Late complications of the weight-bearing
upper extremity in the paraplegic patient. Clinical Orthopaedics and Related
Research 233:132-135, 1988

10. Gibb, TD, Sidles, JA, Harryman, DT, McQuade, KJ and Masten III, FA. The
effect of capsular venting on glenohumeral laxity. Clinical Orthopaedics and
Related Research 268: 120-127, 1991.

11. Happee, R and Van der Helm, FCT. The control of shoulder muscles during
goal directed movements, an inverse dynamic analysis. Journal of
Biomechanics 28: 1179-1191, 1995.

12. Harryman DT, Sidles JA, Harris SL, Matsen FA: Laxity of the normal
glenohumeral joint: A qualitative in-vivo assessment. Journal of Shoulder
and Elbow Surgery 1: 66-76, 1992.

13. Högfors C, Peterson B, Sigholm G and Herberts P: Biomechanical model of
the human shoulder joint - II. The shoulder rhythm. Journal of Biomechanics
24 (8): 699-709, 1991

14. Inman VT, Saunders M, Abbot LC: Observations on the function of the
shoulder joint. Journal of Bone and Joint Surgery 26:1-30, 1944.

15. Itoi E, Motzkin NE, Morrey BF, An KN: Contribution of axial arm rotation
to humeral head translation. American Journal of Sports Medicine 22:499-503,
1994

16. Kronberg M, Broström LA, Németh G: Differences in shoulder muscle
activity between patients with generealized joint laxity and normal
controls. Clinical Orthopaedics and Related Research 269:181-192, 1991.

17. Kronberg M, Larsson P, Broström LA: Characterisation of Human deltoid
muscle in patients with impingement syndrome. Orthopaedic Research
15:727-733, 1997

18. Lippit S, Matsen F: Mechanisms of glenohumeral stability. Clinical
Orthopaedics and Related Research 291:20-28, 1993.

19. Maffet, MW, Jobe, FW, Pink, MM, Brault, J and Mathiyakom, W. Shoulder
muscle firing patterns during the windmill softball pitch. American Journal
of Sports Medicine 25: 369-374, 1997.

20. Neer CS II: Impingement lesions. Clinical Orthopaedics and Related
Research 173:70-77, 1983

21. Nigg BM: Inertial properties of the human or animal body In:
Biomechanics of the musculo-skeletal system. Nigg & Herzog (Eds.) John Wiley
and Sons, Toronto, 1994

22. Otis, JC, Jiang, CC, Wickiewicz, TL, Peterson, MGE, Warren, RF and
Santner, TJ. Changes in the moment arms of the rotator cuff and deltoid
muscles with abduction and rotation. Journal of Bone and Joint Surgery 76:
667- 676, 1994.

23. Payne LZ, Deng X, Craig EV, Torzilli PA, Warren RF: The combined dynamic
and static contributions to subacromial impingement: A biomechanical
analysis. American Journal of Sports Medicine 25(6): 801-808, 1997

24. Pearl ML, Perry J, Torbum L, Gordon LH: An electromyographic analysis of
the shoulder during cones and planes of arm motion. Clinical Orthopaedics
and Related Research 284:116-127, 1992

25. Pink, M, Perry, J, Browne, A, Scovazzo, ML and Kerrigan, J. The normal
shoulder during freestyle swimming: An electromyographic and cinematographic
analysis of twelve muscles. American Journal of Sports Medicine 19(6):
569-576, 1991.

26. Poppen NK, Walker PS: Forces at the glenohumeral joint in abduction.
Clinical Orthopaedics and Related Research 135:165-170,1978

27. Powers, CM, Newsam, CJ, Gronley, JK, Fontaine, CA, Perry, J. Isometric
Shoulder Torque in Subjects with spinal cord injury. Archives of Physical
Medicine and Rehabilitation 75: 761-765, 1994.

28. Reyes, ML, Gronley, JK, Newsam, CJ, Mulroy, SJ, Perry, J.
Electromyographic analysis of shoulder muscles of men with low-level
paraplegia during a weight relief raise. Archives of Physical Medicine and
Rehabilitation 76: 433-439, 1995

29. Rodgers MM, Gayle GW, Figoni SF, Kobayashi M, Lieh J and Glaser RM:
Biomechanics of wheelchair propulsion during fatigue. Archives of Physical
Medicine and Rehabilitation 75: 85-93, 1994

30. Ruwe PA, Pink M, Jobe FW, Perry J, Scovazzo ML: The normal and painful
shoulders during the breaststroke: Electromyographic and cinematographic
analysis of twelve muscles. American Journal of Sports Medicine 22:7 89-796,
1994

31. Sie IH, Waters RL, Adkins RH, Gellman H: Upper extremity pain in the
post-rehabilitation, spinal cord injured patient. Archives of Physical
Medicine and Rehabilitation 73:44-48, 1992

32. Silfverskiold J & Waters RL: Shoulder pain and functional disability in
spinal cord injury patients. Clinical Orthopaedics and Related Research
272:141-145, 1991

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Harper Collins College Publishers, New York, 1996.

34. van de Graaff KM: Human Anatomy. Wm C. Brown Publishers, Iowa (4th ed),
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Related Physical Therapy 25:364-379, 1997

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Reliability testing and muscle force study. Journal of Biomechanics
28:489-499, 1995

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three-dimensional scapular movement. Clinical Biomechanics and Related
Research 8: 269-273, 1993

40. Pronk G.: Three-dimensional determination of the position of the
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deGroot et al.), pp. 1070-1076. Champaign, IL, Human Kinetics. (1988).

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Shoulder Group Delft University of Technology August 26-27, 1997

************************************************** *************************
Hello Rene,

I must apologize for the long delay in this reply but I have just been
extreamly busy with a new baby and all.

Anyways, in response to your question:

First, you say you want to track the "glenohumeral joint". This means you
want to know the position of BOTH the scapula and the humerus. Is this
correct? Or, are you only interested in the position of the humeral head?

If it is the first, then this is a difficult problem which I have not found
an adaquate solution in the literature. The bigger problem is tracking the
motion of the scapula. As you say, there are a number of techniques which
use palpation of bony landmarks.
e.g.
Barnett et al. 1999, The measurement of three dimensional scapulohumeral
kinematics - a study of reliability
Lukasiewicz et al. 1999, Comparison of 3-dimensional scapular position and
orientation between subjects with and without shoulder impingement.

In terms of a a dynamic method, there are few studies using a dynamic
approach. McQuade in 1998 (J Orthop Sports Phys Ther 1998 Aug;28(2):74-80)
use skin markers so you may want to check this reference. In the 1999
meeting of the ORS, Karduna has an article using skin markers compared to
bone pins directly inserted into the scapula. Unfortunatly, I have not seen
Karduna publish the study yet so...Karduna also has a website I've seen
before so you may want to do a search for it.

My study into using skin markers to track scapula motion is not yet
complete. However, it appears that the region around the scapular spine is
the best place to start (perhaps this is obvious but...)

If you are just interested in the humerus, then I think it is a much simpler
problem since it becomes similar to a gait analysis problem.

hope this helps a bit
good luck
anthony

Orthopaedic Engineering Research
The University of British Columbia & Vancouver Hospital



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Rene Ferdinands
University of Waikato
Dept of Physics & Electronic Engineering
Private Bag 3105
Hamilton 2001
New Zealand

Phone: (+64 7) 838 4026
Fax: (+64 7) 838 4219
email: redf1@waikato.ac.nz
--------------------------------------

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