Measurement and Description of Three-Dimensional Shoulder Range of Motion With Degrees of Freedom Interactions

Abstract

The shoulder is the most mobile joint of the human body due to bony constraint scarcity and soft tissue function unlocking several degrees of freedom (DOF). Clinical evaluation of the shoulder range of motion (RoM) is often limited to a few monoplanar measurements where each DOF varies independently. The main objective of this study was to provide a method and its experimental approach to assess shoulder 3D RoM with DOF interactions. Sixteen participants performed four series of active arm movements with maximal amplitude consisting in (1) elevations with fixed arm axial rotations (elevation series), (2) axial rotations at different elevations (rotation series), both in five planes of elevation, (3) free arm movements with the instruction to fill the largest volume in space while varying hand orientation (random series), and (4) a combination of elevation and rotation series (overall series). A motion analysis system combined with an upper limb kinematic model was used to estimate the 3D joint kinematics. Thoracohumeral Euler angles with correction were chosen to represent rotations. The angle-time-histories were treated altogether to analyze their 3D interaction. Then, all 3D angular poses were included into a nonconvex hull representing the RoM space accounting for DOF interactions. The effect of series of movements (n = 4) on RoM volumes was tested with a one-way repeated-measures ANOVA followed by Bonferroni posthoc analysis. A normalized 3D RoM space was defined by including 3D poses common to a maximal number of participants into a hull of average volume. A significant effect of the series of movements (p < 0.001) on the volumes of thoracohumeral RoM was found. The overall series measured the largest RoM with an average volume of 3.46 ± 0.89 million cubic degrees. The main difference between the series of movements was due to axial rotation. A normalized RoM hull with average volume was found by encompassing arm poses common to more than 50% of the participants. In general, the results confirmed and characterized the complex 3D interaction of shoulder RoM between the DOF. The combination of elevation and rotation series (overall series) is recommended to fully evaluate shoulder RoM. The normalized 3D RoM hull is expected to provide a reliable reference to evaluate shoulder function in clinical research and for defining physiologic continuous limits in 3D shoulder computer simulation models.

Glenohumeral translations during range-of-motion movements, activities of daily living, and sports activities in healthy participants

“…However, the radiation imposed by fluoroscopy limits the acquisition for each participant to about 30-s annually (Bey et al, 2008). Consequently, only dynamic arm flexion, scaption, abduction, and external rotation (Bey et al, 2008;Bishop et al, 2009;Giphart et al, 2013;Matsuki et al, 2012;Nishinaka et al, 2008) have been assessed to date, which represents a small fraction of the shoulder range-of-motion (ROM) comparatively to the total shoulder ROM (Haering et al, 2014;Veeger and van der Helm, 2007). In 2014, a method based on intracortical pins has permitted the measurement of glenohumeral translations during dynamic tasks with less than 0.15 mm error for one hour (Dal Maso et al, 2014).…”

Assessment of the glenohumeral joint's active and passive axial rotational range

“…Furthermore, the range of motion should be assessed at multiple report the axial range of motion of the GHJ, showing that the range is dependent on the 58 elevation angle 17,37 , elevation plane 17,29,37 and form of motion (active and passive rotations) 29 . 59 However, these previous studies have not provided a comprehensive description of the 60 Axial rotations of the Glenohumeral joint 5 normal range of axial rotation of the GHJ during active and passive motion when the 61 humerus is positioned at multiple elevation angles and elevation planes.…”

“…Subjects were seated during the protocol to allow the thorax to be restrained and humero- that could be achieved in the three elevation planes was 130° 17 .…”

Invariant spatial parametrization of human thoracohumeral kinematics: A feasibility study

“…The human shoulder is the joint complex with the highest range of motion (ROM) in the human body due to lack of bony constraints [9]. The dynamic nature of the surrounding musculature and the flexibility of ligaments impart kinematic and dynamic redundancy, facilitating necessary positioning of the human forearm and palm [12].…”

“…However, these representations introduces geometric singularities in the arm-reachable workspace [8], resulting in ambiguity. Note that the three-angle system is reliable only if independent motions occur in cardinal planes [9]; otherwise, for non-cardinal plane motions, they serve as a crude approximation.…”