Simulated activities of daily living do not replicate functional upper limb movement or reduce movement variability

Abstract

Kinematic assessments of the upper limb during activities of daily living (ADLs) are used as an objective measure of upper limb function. The implementation of ADLs varies between studies; whilst some make use of props and define a functional target, others use simplified tasks to simulate the movements in ADLs. Simulated tasks have been used as an attempt to reduce the large movement variability associated with the upper limb. However, it is not known whether simulated tasks replicate the movements required to complete ADLs or reduce movement variability. The aim of this study is to evaluate the use of simulated tasks in upper limb assessments in comparison to functional movements. Therefore answering the following questions: Do simulated tasks replicate the movements required of the upper limb to perform functional activities? Do simulated tasks reduce intra- and inter-subject movement variability? Fourteen participants were asked to perform five functional tasks (eat, wash, retrieve from shelf, comb and perineal care) using two approaches: a functional and a simulated approach. Joint rotations were measured using an optoelectronic system. Differences in movement and movement variability between functional and simulated tasks were evaluated for the thorax, shoulder, elbow/forearm and wrist rotations. Simulated tasks did not accurately replicate the movements required for ADLs and there were minimal differences in movement variability between the two approaches. The study recommends the use of functional tasks with props for future assessments of the upper limb.

Influence of Purposeful Activities on Upper Extremity Motor Performance: A Systematic Review

“…Conversely, no difference in performance duration was found by Morton et al (1992). The study by Taylor et al (2018) was the only study that evaluated joint range of motion. Greater arcs of shoulder and wrist motion were required to perform functional activities than simulated tasks, for most of the activities evaluated.…”

“…Characteristics of the studies and main results are presented in Table 4. The purposeful activities used in the studies included: personal care (Taylor et al, 2018); writing (Ross & Nelson, 2000;Wu et al, 1994); eating (Hall & Nelson, 1998); using chopsticks (Ma et al, 1999;Rice et al, 2009); reaching for candy (Sackaloo et al, 2015), a mug (Holubar & Rice, 2006;Rice et al, 2009), a bell (Lin et al, 1998;Morton et al, 1992) or a magazine (Rice & Renock, 2006); meal preparation tasks (e.g., slicing vegetables or making cookies) (Fasoli et al, 2002;Hoppe et al, 2008;Miller & Nelson, 1987;Rice et al, 1999;Wu et al, 1998); woodwork or handcrafts (Bakshi et al, 1991); and board or computer games, throwing darts or ping-pong (Kehoe & Rice, 2016;King, 1993;Steinbeck, 1986;Wagner et al, 1995).…”

“…The activity in Morton's study did not relate to any purposeful end goal, lacked meaning and was performed in an artificial research environment, and these factors may have accounted for the lack of perseverance observed in both groups. The study by Taylor et al (2018) was the only study to evaluate range of motion during the performance of functional tasks. Those authors showed that participants used greater arcs, and therefore higher overall volume of motion, when performing tasks in a naturalistic manner rather than as simulated motions.…”

Evaluating the efficacy of singular spectrum transformation in detecting working posture changes in a time series

“…The maximum and minimum calculated joint angles were recorded for each task type under each experimental condition; the anatomical position and natural posture the participants maintained at the beginning of the experiment were excluded from the calculation. The actual range of motion (ROM) for each experimental condition was defined as the difference between the maximum and minimum joint angle, as described in a previous study (Taylor, 2018). Then, the inter-participant mean and standard deviation (SD) for the maximum, minimum, and actual ROM of each joint angle were calculated for each experimental condition.…”

“…The relationship between the movement variability and the anomaly score will be discussed on the basis of the above results. Taylor et al (2018) investigated the movement variability of upper limbs in activities of daily living and reported that the minimum movement variability occurred in the wrist joint angle. However, the movement variability of the elbow flexion angle was smallest when considering the relative value of the range of motion of the joint.…”