Capacity Assessment of Prosthetic Performance for the Upper Limb (CAPPFUL): Characterization of Normative Kinematics and Performance

Abstract

Background Evaluation of maladaptive compensatory movement is important to objectively identify the impact of prosthetic rehabilitative intervention on body mechanics. The Capacity Assessment of Prosthetic Performance for the Upper Limb (CAPPFUL) scores this type of compensation by comparing movements of the prosthesis user to movements of individuals with intact, sound upper limbs (ULs). However, expected movements of individuals with sound, intact ULs have not been studied for the set of tasks performed in the CAPPFUL. Objective To enhance the scoring approach for the maladaptive compensatory movement domain of the CAPPFUL by defining normative kinematic movement and characterizing variability and repeatability. Design Clinical measurement. Setting Laboratories at the U.S. Food and Drug Administration (FDA) and University of Texas‐Arlington. Participants Convenience sample of 20 participants with no upper limb (UL) disability or impairment. Interventions Not applicable. Main Outcome Measurements Kinematic trajectories, range of motion, maximum angle, and completion time were calculated. Repeatability and intersubject variability were assessed by calculating Pearsonʼs correlation coefficient (R), adjusted coefficient of multiple correlation (CMCadj), and max SD (SDmax) for nine joint angles at the elbow, shoulder, neck, and torso. Results For most joints evaluated, repeatability was lower (R < 0.8) for CAPPFUL 3‐Zip vest, CAPPFUL 7‐Cut w/ knife, and CAPPFUL 8‐Squeeze water, implying inconsistent approaches within a subject from trial to trial for a given task. For most tasks, the joint angle SDmax across all participants was <20°. The approach for completing CAPPFUL 1 ‐ Weights in crate and CAPPFUL 4 ‐ Pick up dice was generally similar across participants (CMCadj >0.4). For other tasks, however, different approaches across participants at the torso and shoulder joint can be seen. Conclusion(s) This work established the expected movements of individuals with sound, intact ULs for tasks performed in the CAPPFUL that can be used to inform consistent, standardized scoring of the maladaptive compensatory movement domain.

Limb loading enhances skill transfer between augmented and physical reality tasks during limb loss rehabilitation

“…Another limitation of this study is that general motor performance was characterized by only a single outcome measure: the PHAM. An extension of this work should include multiple functional outcome measures to better understand how limb loading enhances motor performance more generally [52,64,65].…”

Biomechanical Analysis of Body Movements of Myoelectric Prosthesis Users During Standardized Clinical Tests

“…The trend of compensatory movements depends on task types and available prosthesis functions [18] and thus we have decided to capture a whole range of activities by relying on three difference clinical assessments. The study of compensatory movements has been of interest across various research disciplines due to numerous reasons [26,27,28,29,30,32,35,36,38,39,40,41,42]. However, no previous research has provided such detailed analysis of myoelectric prosthesis users.…”

“…We have specifically targeted the below-elbow myoelectric prosthesis users, in contrast to other studies that recruited body-powered prosthesis users [27,29,36] or stroke survivors [26,30,35]. Moreover, we have decided to focus on strictly objective clinical assessments [28,32,41], thus eliminating the need for subjective scoring provided by a trained evaluator. Finally, even though some previous studies have indeed recruited a similar study population and have used some of the tests investigated in this study [38,39,40,42], we have uniquely performed all of them together and in full, alongside a gender matched control group, allowing for a truly extensive analysis and insights.…”

Comparison of Motion Analysis Systems in Tracking Upper Body Movement of Myoelectric Bypass Prosthesis Users

“…With the motivation to determine the limitations of the motion analysis systems, tasks were selected from the outcome measures that would elicit a wide range of movements representative of those performed during activities of daily living. These outcome measures have also been used in previous kinematic studies [57,58,63] and most are validated in the upper limb prosthesis user population [62,64].…”