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  • wrist extension summary

    A week ago I sent a message about measuring torque for wrist
    extension and flexion, and methods of measurement via transducer or
    EMG. Here is a summary of responses and many thanks to those who did
    reply !!! I'll try reply back (but have exams at the moment).


    ---------------------------------------------------------------------------
    Date sent: Fri, 14 Jun 1996 00:39:01 -0700 (PDT)
    From: kelvin@sfu.ca (Kelvin E. Jones)
    Subject: Re: Wrist Extension
    To: Timothy B F Woodfield

    I've recently been reading a bunch of wrist biomechanics literature and
    could pass on a number of references. As far as the joint rotations goes,
    you can get a good model of flexion-extension about a single axis of
    rotation (Sommer H.J. and Miller N.R, J Biomech Eng 102:311-317, 1980;
    Brumbaugh R.B. et al., J Biomech Eng 104:176-181, 1982; Horii E. et al., J
    Hand Surg 18A:83-90, 1993). Many of the biomechanical references that I've
    been reading came from a great paper on estimation of muscle force from EMG
    in the wrist by T.S. Buchanan et al., J Biomech 26:547-560, 1993. This group
    also has another paper coming out in J Biomech on isometric moments
    generated by wrist muscles (Delp, S.L., Grierson, A.E., and Buchanan, T.S. J
    Biomech, in press).

    Kelvin Edward Jones, Postdoctoral Fellow
    Dept of Physiology, University of Goteborg
    Medicinaregatan 11, 413 90 Goteborg, Sweden
    tel: +46 31 773 35 02, fax: +46 31 773 35 12, email: kelvin@sfu.ca
    Home Page: http://www.sfu.ca/~kelvin
    ------------------------------------------------------------------------------

    Date sent: Fri, 14 Jun 1996 10:02:10 -0500
    From: anne@www.ortho.lsumc.edu (Anne Hollister, MD)
    Subject: Re: Wrist Extension
    To: Timothy B F Woodfield

    The Greenleaf Medical Co, Palo Alto, Ca has a very simple glove which uses
    strain guages to measure wrist position. The device can be coupled with
    EMG recorders if necessary, and has been used in evaluation and treatment
    of rehab patients with paralysis and in ergonomic evaluation in the
    workplace. Ed Klinenberg did his PhD dissertation at UC Berkeley using the
    device in the workplace.

    The engineer is Stuart Rothenberg.
    Address 3145 Porter Drive, Building A202
    Palo Alto, California 94304
    (415) 843-3640

    Anne Hollister, MD
    LSUMC-S / Orthopaedic Surgery
    1501 Kings Hwy.
    Shreveport, LA 71130-3932
    email: anne@www.ortho.lsumc.edu

    ---------------------------------------------------------------------------------

    Date sent: Fri, 14 Jun 1996 14:12:29 -0500 (EST)
    From: "Robert Streb [Health Technology]"
    Subject: Re: Wrist Extension
    To: WOODFITB@cad.canterbury.ac.nz
    Organization: SUNY Stony Brook
    Priority: normal

    In response to your questions about wrist flex and ext. When
    measuring those motions in the clinic the triquetrum is the generally
    accepted center where the axis is placed. There are rather complex
    and accurate dynamometers that will measure torque at the major
    joints. The reliability of these test has been in my experience
    good (the literature supports this). If I am reading your note
    correctly you are building a separate machine for these
    motions. My point is it may be accurate enough to use the
    triquetrum and the axis of motion. By the way there is some debate
    as to the axis of motion, some texts do not agree with the ones you
    have paraphrased.

    ----------------------------------------------------------------------------
    Date sent: Fri, 14 Jun 1996 15:03:58 +0800
    From: iallison@info.curtin.edu.au (Garry Allison)
    Subject: Re: Wrist Extension
    To: Timothy B F Woodfield

    Regarding EMG amplitude normalisation there is no clear cut answer. The
    most common method used is the Maximal Isometric effort and this has
    obvious advantages in interpretation of the data.... however.... recently
    we have addressed similar issues to find:
    i. MVIC is not as reliable as submaximal isometric contractions and they
    not logistically possible in many clinical populations. (Last year at the
    biomech Conference MVIC was recommended with the caveat that the individual
    provided a reliable performance)
    ii. Using isometric to normalise for other muscle actions particularly
    within the SSC model may have limitations.
    iii. Using the coefficient of variation of grouped data to justify the
    validity of a normalisation technique can cause problems since you may be
    removing a proportion of the biological difference. (aside- from the
    experience of our most recent work in individuals with chronic low back
    pain, the issue of the independence of the amplitude normalisation
    technique from the testing task needs to be carefully scrutinised before
    interpretation of the data analyses). Indeed using MVIC in one of our
    experiments increased the variance in the data.
    iv. By manipulating the variance in a population you may/will see a change
    in the statistical power of your analysis. The difficulty lies in the
    paradox between statitically significantly difference and the clinically
    significant difference in the EMG signal amplitude.


    Ref.(to others pending).
    Allison, GT, Marshall, RN & Singer KP (1993) EMG signal Amplitude
    Normalization Technique in Stretch-Shortening Cycle Movements. 3(4) 236 -
    244.

    The strength factor is difficult and really depends on how you want to use
    your data. Using your case in C5-6 individuals then the influence of
    'strength' on function is often a non linear association and commonly
    demonstarted by a threshold effect. Make sure your assessment is sensitive
    enough for the full range.

    Hope this helps in some way.

    Sorry Tim the Journal reference was "Journal of Electromyography and
    Kinesiology"

    Garry T Allison PhD. Lecturer,
    School of Physiotherapy, email:iallison@info.curtin.edu.au
    Curtin University of Technology, Tel. +61 9 351 3648
    Selby Street, Shenton Park, Fax. +61 9 351 3636
    Western Australia 6008
    http://www.curtin.edu.au/curtin/dept/physio/pt/staff/allison/

    ================================================== =======================

    Date sent: Tue, 18 Jun 1996 02:03:05 +1200
    From: kwa0913@acs.tamu.edu (Khaled Al-Eisawi)
    Subject: RE: Wrist Extension
    To: woodfitb@cad.canterbury.ac.nz


    I read the note you posted on the Biomch-L. My masters thesis, which I
    completed in May 1994 at Texas A&M University, was about wrist strength
    limitations to manual exertion capability. I have a paper that is in review
    at this time. Part of my experimental work was measuring wrist flexion and
    wrist radial deviation strength at different wrist angle. I used the radial
    styloid as an estimate for the center of rotation for the flexion tests.
    For the radial deviation tests, I used the palpable groove between the
    capitate and the lunate bone. A copy of the thesis is available through
    interlibrary loan from Texas A&M University. The thesis title is:
    "Evaluation of wrist strength limitations in two-dimensioanl biomechanical
    modeling". Please feel free to contact me if I can be of further
    assistance. Good luck with your work.

    Khaled W. Al-Eisawi
    Research Assistant
    Safety Engineering Program
    Texas A&M University
    College Station, TX 77843-3133
    USA
    Phone: (409) 845-3545
    Fax: (409) 845-6443
    Email: eisawi@tamu.edu

    ------------------------------------------------------------------------------------

    Date sent: Fri, 21 Jun 1996 13:27:57 -0700 (PDT)
    From: Jeffrey Kumer
    Subject: Re: Wrist Extension
    To: Timothy B F Woodfield

    Tim,
    Unfortunately, there are no good methods to keep EMG readings
    consistent between subjects. Each subjects will have differing skin
    resistance and electrode placement on the muscle belly depending on how
    the muscle has been developed. One way to compare between subjects that
    I am doing in my thesis is to collect Maximal Voluntary Contractions of
    each muscle that you are measuring with EMG. Then, you can normalize the
    amount of voltage to that maximal voluntary contraction and get a
    percentage of the electrical impulses being recorded by the electrodes.
    You may want to look into the details of this method and do pilot work to
    see if this is really going to work for you.
    Good Luck!!!

    Jeff Kumer
    University of California, Davis
    Exercise Science Department
    (916) 752 - 3893
    jlkumer@ucdavis.edu

    -------------------------------------------------------------------------------

    Date sent: Fri, 14 Jun 1996 08:45:40 -0600
    From: tzipple@uomhs.edu
    Subject: Wrist Extension -Reply
    To: WOODFITB@cad.canterbury.ac.nz

    Dear Tim,
    This is just an idea, but could you develop a device
    that measures flexion and extension seperately (ie.
    measure strength of flexion from neutral to full flexion
    and extension strength from neutral to full extension)?
    If this device allows movement of the wrist and
    forearm (slide up or down) for the appropriate axis of
    rotation you could measure flexion strength and
    extension strength seperately. Or could you develop a
    device with two seperate rotation axes (one for flexion
    and one for extension) where one axis could be
    locked while you measure the appropriate motion?
    I applaud you for your efforts. Calculating torque
    from distance of center of rotation to grip is a difficult
    task considering the changes in instantaneous axis of
    rotation throughout the motion of the wrist. As with
    many measurements made from joint centers in the
    human body, there is seldom a best-fit.
    I did my master's thesis on developing a method for
    analyzing 3-D human wrist motion using a joint
    coordination system at Michigan State University in
    1989. I am interested in your developments and would
    like to here back from you.

    J. Tim Zipple PT, MS, OCS, OMPT
    University of Osteopathic Medicine and Health Sci.
    3200 Grand Ave.
    Des Moines, IA, 50312
    E-mail: tzipple@uomhs.edu

    -----------------------------------------------------------------------

    Date sent: Mon, 17 Jun 1996 16:50:26 -0300 (BST)
    From: Tim Adlam
    Subject: Wrist Measurements
    To: woodfitb@cad.canterbury.ac.nz

    Tim,
    I'm designing a dynamic wrist fixator and am an M.Sc. (Biomedical
    Engineering) student at Surrey University in England.

    To answer one of your questions,YES, there is a single centre of rotation
    in a wrist. This is highly convenient for you and I.

    It's just proximal to the proximal head of the capitate.
    For references see trhe following as an excellent start. There aren't
    many more worth looking at that I've found.

    >Jackson et al. Determination of wrist kinematics using a magnetic
    >tracking device. Medical Engineering and Physics. v16, p123-, March 1994
    This one is very good. Excellent work and all the transformation matrices
    are shown. GET IT!

    >Youm et al. Kinematics of the wrist. An experimental study of
    >radial-ulnar deviation and flexion-extension. Journal of Bone and Joint
    >Surgery (American Volume). v60A, n4, p423-431, June 1978.
    You'll like this one. It seems to be the first good work on the subject.
    GET THIS TOO.

    >de Lange et al. Kinematic behaviour of the human wrist joint: a
    >roentgen-stereophotogrammetric analysis, Journal of Orthopaedic Research.
    >v3, n1, 1985
    This one is good as well.

    Hope this helps.

    I'm very interested in any information you have on wrist loadings re.
    fixator stresses. I've had difficulty getting anything. Can you help?

    The fixator is a frame attached externally across the joint via bone
    screws in the radius and second metacarpal.

    Can you help?

    Thanks,
    Tim Adlam.


    ==============================================

    -=\ Tim Adlam
    \ BioMedical Engineering
    || Surrey University
    || Guildford
    || SURREY
    || GU2 5XH
    |\ \--/
    \ \| |
    \ / email: mem1ta@surrey.ac.uk
    --- tel: (UK) 01483 568 394
    (Int.) +44 1483 568 394

    ==============================================

    Date sent: Mon, 17 Jun 1996 10:28:20 -0500
    From: delp@casbah.acns.nwu.edu (Scott Delp)
    Subject: Your biomech/l post: wrist strength
    To: woodfitb@cad.canterbury.ac.nz

    Tim,

    I would be happy to send you a pre-print of our paper entitled: Maximum
    isometric moments generated by the wrist muscles in flexion-extension and
    radial-ulnar deviation. This paper addresses some of the issues you raised
    in your email and will be published in the Journal of Biomechanics in the
    next couple months. Please send me your physical mail address if you are
    interested.

    Scott Delp
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