The role of the scapulo-thoracic and gleno-humeral joints in upper-limb motion in children with hemiplegic cerebral palsy

Brochard, Sylvain; Lempereur, Mathieu; Mao, Linda; Rémy-Néris, Olivier

doi:10.1016/j.clinbiomech.2012.04.001

Cited by 20 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Also during more functional tasks, such as hand-to-mouth and hand-to-head, deviant UL kinematics have been reported [3–6,8,9]. Furthermore, children with uCP have longer movement durations, less straight hand trajectories and lower maximum velocities when executing UL tasks compared to their typically developing peers [3,5,6,8,10].…”

Section: Introductionmentioning

confidence: 99%

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

et al. 2017

View full text Add to dashboard Cite

IntroductionThe clinical application of upper limb (UL) three-dimensional movement analysis (3DMA) in children with unilateral cerebral palsy (uCP) remains challenging, despite its benefits compared to conventional clinical scales. Moreover, knowledge on UL movement pathology and how this relates to clinical parameters remains scarce. Therefore, we investigated UL kinematics across different manual ability classification system (MACS) levels and explored the relation between clinical and kinematic parameters in children with uCP.Patients and methodsFifty children (MACS: I = 15, II = 26, III = 9) underwent an UL evaluation of sensorimotor impairments (grip force, muscle strength, muscle tone, two-point discrimination, stereognosis), bimanual performance (Assisting Hand Assessment, AHA), unimanual capacity (Melbourne Assessment 2, MA2) and UL-3DMA during hand-to-head, hand-to-mouth and reach-to-grasp tasks. Global parameters (Arm Profile Score (APS), duration, (timing of) maximum velocity, trajectory straightness) and joint specific parameters (angles at task endpoint, ROM and Arm Variable Scores (AVS)) were extracted. The APS and AVS refer respectively to the total amount of movement pathology and movement deviations of wrist, elbow, shoulder, scapula and trunk.ResultsLonger movement durations and increased APS were found with higher MACS-levels (p<0.001). Increased APS was also associated with more severe sensorimotor impairments (r = -0.30-(-0.73)) and with lower AHA and MA2-scores (r = -0.50-(-0.86)). For the joint specific parameters, stronger movement deviations distally were significantly associated with increased muscle weakness (r = -0.32-(-0.74)) and muscle tone (r = 0.33-(-0.61)); proximal movement deviations correlated only with muscle weakness (r = -0.35–0.59). Regression analysis exposed grip force as the most important predictor for the variability in APS (p<0.002).ConclusionWe found increased movement pathology with increasing MACS-levels and demonstrated the adverse impact of especially muscle weakness. The lower correlations suggest that 3DMA provides additional information regarding UL motor function, particularly for the proximal joints. Integrating both methods seems clinically meaningful to obtain a comprehensive representation of all aspects of a child’s UL functioning.

show abstract

Section: Introductionmentioning

confidence: 99%

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Indeed, during arm elevation in healthy subjects, there is significant motion of the scapula relative to the thorax with a mean 2° decrease in protraction, 39° increase in upward rotation and 21° increase in posterior tilt (Ludewig et al, 2009). Moreover abnormal 3D shoulder kinematic patterns have been found in frozen shoulder (Fayad et al, 2008a), hemiplegia (Meskers et al, 2005), impingement syndrome (McClure et al, 2006), children with cerebral palsy (Brochard et al, 2012) and obstetrical plexus palsy (Duff et al, 2007). This highlights the importance of 3D dynamic analysis to improve understanding of shoulder movement both in the biomechanical field and the clinical environment.…”

Section: Introductionmentioning

confidence: 99%

Validity and reliability of 3D marker based scapular motion analysis: A systematic review

Lempereur

Brochard

Leboeuf

et al. 2014

Journal of Biomechanics

Self Cite

121

View full text Add to dashboard Cite

Methods based on cutaneous markers are the most popular for the recording of three dimensional scapular motion analysis. Numerous methods have been evaluated, each showing different levels of accuracy and reliability. The aim of this review was to report the metrological properties of 3D scapular kinematic measurements using cutaneous markers and to make recommendations based on metrological evidence. A database search was conducted using relevant keywords and inclusion/exclusion criteria in 5 databases. 19 articles were included and assessed using a quality score. Concurrent validity and reliability were analyzed for each method. Six different methods are reported in the literature, each based on different marker locations and post collection computations. The acromion marker cluster (AMC) method coupled with a calibration of the scapula with the arm at rest is the most studied method. Below 90-100° of humeral elevation, this method is accurate to about 5° during arm flexion and 7° during arm abduction compared to palpation (average of the 3 scapular rotation errors). Good to excellent within-session reliability and moderate to excellent between-session reliability have been reported. The AMC method can be improved using different or multiple calibrations. Other methods using different marker locations or more markers on the scapula blade have been described but are less accurate than AMC methods. Based on current metrological evidence we would recommend (1) the use of an AMC located at the junction of the scapular spine and the acromion, (2) the use of a single calibration at rest if the task does not reach 90° of humeral elevation, (3) the use of a second calibration (at 90° or 120° of humeral elevation), or multiple calibrations above 90° of humeral elevation.

show abstract

“…As such, congenital conditions (e.g., brachial plexus palsy (Kozin et al, 2010) and cerebral palsy (Abel et al, 2003; Brochard et al, 2012)) can cause muscle imbalances and skeletal deformities, resulting in functional losses in both the pediatric and adult populations. Sports related injuries, which have been viewed as primarily adult issues, are now becoming prominent in pediatric populations as participation in high-level competitive sports is occurring at earlier ages (Davis, 2010; Emery, 2006).…”

Section: Introductionmentioning

confidence: 99%

In vivo pediatric shoulder muscle volumes and their relationship to 3D strength

Im¹,

Alter²,

Brochard³

et al. 2014

Journal of Biomechanics

Self Cite

View full text Add to dashboard Cite

In the pediatric shoulder, injury and pathology can disrupt the muscle force balance, resulting in severe functional losses. As little data exists pertaining to in vivo pediatric shoulder muscle function, musculoskeletal data are crucially needed to advance the treatment of pediatric shoulder pathology/injury. Therefore, the purpose of this study was to develop a pediatric database of in vivo volumes for the major shoulder muscles and correlate these volumes to maximum isometric flexion/extension, internal/external rotation, and abduction/adduction joint moments. A methodology was developed to derive 3D shoulder muscle volumes and to divide the deltoid into sub-units with unique torque producing capabilities, based on segmentation of three-dimensional magnetic resonance images. Eleven typically developing children/adolescents (4F/7M, 12.0±3.2years, 150.8±16.7cm, 49.2±16.4kg) participated. Correlation and regression analyses were used to evaluate the relationship between volume and maximum, voluntary, isometric joint torques. The deltoid demonstrated the largest (30.4 ±1.2%) and the supraspinatus the smallest (4.8 ± 0.5%) percent of the total summed volume of all six muscles evaluated. The anterior and posterior deltoid sections were 43.4±3.9% and 56.6±3.9% of the total deltoid volume. The percent volumes were highly consistent across subjects. Individual muscle volumes demonstrated moderate-high correlations with torque values (0.70–0.94, p<0.001). This study presents a comprehensive database documenting normative pediatric shoulder muscle volume. Using these data a clear relationship between shoulder volume and the torques they produce was established in all three rotational degrees-of-freedom. This study furthers the understanding of shoulder muscle function and serves as a foundation for evaluating shoulder injury/pathology in the pediatric/adolescent population.

show abstract

The role of the scapulo-thoracic and gleno-humeral joints in upper-limb motion in children with hemiplegic cerebral palsy

Cited by 20 publications

References 29 publications

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

Clinical assessment and three-dimensional movement analysis: An integrated approach for upper limb evaluation in children with unilateral cerebral palsy

Validity and reliability of 3D marker based scapular motion analysis: A systematic review

In vivo pediatric shoulder muscle volumes and their relationship to 3D strength

Contact Info

Product

Resources

About