Deanna H. Gates, Lisa Smurr Walters, Jeffrey Cowley, Jason M. Wilken, Linda Resnik; Range of Motion Requirements for Upper-Limb Activities of Daily Living. Am J Occup Ther 2015;70(1):7001350010. https://doi.org/10.5014/ajot.2016.015487
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© 2020 American Occupational Therapy Association
OBJECTIVE. We quantified the range of motion (ROM) required for eight upper-extremity activities of daily living (ADLs) in healthy participants.
METHOD. Fifteen right-handed participants completed several bimanual and unilateral basic ADLs while joint kinematics were monitored using a motion capture system. Peak motions of the pelvis, trunk, shoulder, elbow, and wrist were quantified for each task.
RESULTS. To complete all activities tested, participants needed a minimum ROM of −65°/0°/105° for humeral plane angle (horizontal abduction–adduction), 0°–108° for humeral elevation, −55°/0°/79° for humeral rotation, 0°–121° for elbow flexion, −53°/0°/13° for forearm rotation, −40°/0°/38° for wrist flexion–extension, and −28°/0°/38° for wrist ulnar–radial deviation. Peak trunk ROM was 23° lean, 32° axial rotation, and 59° flexion–extension.
CONCLUSION. Full upper-limb kinematics were calculated for several ADLs. This methodology can be used in future studies as a basis for developing normative databases of upper-extremity motions and evaluating pathology in populations.
Box off shelf (n = 9 fixed; n = 15 high): Participants stood an arm’s length from a tall shelving unit and were asked to move a shoe box from a higher shelf (fixed = 1.48 m vertical height; high = head height) to a lower shelf (0.96 m).
Can off shelf (n = 9 fixed; n = 15 high): Participants moved a commercially available full 15.5-oz (439-g) can from a high shelf to a low shelf with one arm.
Deodorant (n = 14): Participants reached toward a stick of deodorant that was placed on a 0.96-m-high shelf at the midline. They removed the lid from the deodorant, simulated swiping it three times on their contralateral axilla, then replaced the cap and set the deodorant back on the shelf.
Drinking from a cup (n = 9): Participants reached with one hand toward an empty paper cup that was placed on a 0.96-m-high shelf at the midline. They lifted the cup to or near their mouth, simulated drinking, and placed the cup back on the shelf.
Hand to back pocket (n = 9): Participants reached with one hand and simulated grasping an object in their back pocket on the ipsilateral side. They then extended the arm to simulate handing the object to another person. The task ended when the arm returned to the resting position.
Perineal care (n = 5): Participants began in a seated position on a 16-in. (40.6-cm) foldable commode chair with hands placed on their thighs. A commercially available weighted toilet tissue stand (53 cm tall) was placed 6 in. (15.2 cm) behind the front leg of the folding commode and 6 in. lateral to the commode on the side opposite the hand being tested. When instructed to begin, participants removed a few squares of toilet paper from the roll, simulated wiping from front to back, dropped the toilet paper into the toilet seat opening, and returned their hands to their thighs.
Donning and zipping pants (n = 15): Participants were instructed to don a pair of large elastic-waist pants to their knees, sit, and place their hands on their thighs. When instructed to begin, participants grasped the sides of the pants with both hands, stood, and pulled the pants up to their waist. They then zipped the pants and returned their hands to their side.
Box off ground (n = 15): Participants were instructed to squat down, keeping their back straight, and grasp the handles on both sides of a box placed on the ground. They then placed the box on a standard-height table (0.76 m). The box was 45 cm long, 29 cm wide, and 23 cm tall; weighed 20 lb (9.1 kg); and had handle holes on the sides.
Occupational therapists can set treatment goals based on the motion used to complete specific tasks.
The patterns of motion can be used to identify activities that may be more difficult for patients with specific joint impairments, allowing training in compensatory approaches.
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