Albers, F. (Friederike) (2020) Preliminary observations of elbow joint loading during activities of daily living. thesis, Human Movement Sciences.
Full text available on request.Abstract
Background. Total elbow arthroplasty (TEA) survival rates are low. Aseptic loosening is the major reason for revision, possibly caused by mechanical overloading. Currently, the recommendations given by clinicians to patients following TEA are not based on former research but entirely on historical records. The general recommendation is to avoid repeatedly lifting a load greater than 1 kg. Lifting anything greater than 5 kg is strongly discouraged (Gramstad et al., 2005). Research is required that investigates the impact of such given instruction. Objectives. To determine strenuous elbow joint moments due to elbow flexion and extension in a healthy elbow joint during activities of daily living (ADLs). To test if the current clinical advice given to patients following TEA generally impacts task performance. The report offers preliminary guidelines since COVID-19 prevented further measurements. Design. A 55-year-old right-handed female, with no history of pathologies that would affect upper extremity function, performed a series of eight ADLs. She was asked to perform the tasks without and with the instruction to limit loads on the elbow to 1 kg. This instruction was the same received by TEA patients to safeguard the life of the prosthesis. Methods. Motion capture data was acquired for the upper limb and trunk. An inverse kinematic and dynamic analysis was subsequently carried out to calculate the moments acting on the elbow joint during ADLs. The difference between the task performance was derived from the peak moments acting on the joint as well as power generation and absorption. ‘Power plane‘ graphs gave insight into the link between angular velocity and torque production during the elbow flexion and extension. Results. The most strenuous tasks identified were rising from a chair (9.60 Nm, -18.03 to 30.05 W) and lifting a 1 kg object to shoulder height (6.66 Nm, -13.25 to 20.60 W). No ADL exceeded the current clinical advice of 1 kg threshold if interpreted as 10 Nm internal load-bearing. Results have shown that the moments acting on the elbow joint were not impacted by task instruction. Concerning power generated and absorbed on the elbow joint, task instruction impacted task performance during sitting down on a chair, while no other tasks appeared to be affected by the instruction. Conclusions. A ranking of tasks into strenuousness for the elbow joint has been established based on moments, angular velocities and power. The task instruction, as given in the form of the current clinical advice, solely impacted the moments acting on the elbow joint in one ADL. Since, however, the power generation and absorption were impacted by task instruction, it is worth including this aspect into the analysis in future research. To avoid confusion in the patient population the current clinical advice should address the posture and a generally slower movement speed. Keywords: Total elbow arthroplasty, ADLs, Upper extremity, Inverse dynamics, Eccentric contractions
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Murgia, dr. A. and Vegter, dr. R.J.K. |
| Faculty: | Medical Sciences |
| Date Deposited: | 16 May 2022 08:06 |
| Last Modified: | 16 May 2022 08:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3331 |
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