The nature and extent of upper limb associated reactions during walking in people with acquired brain injury

Michelle B Kahn; Ross Clark; Gavin Williams; Kelly Bower; Megan A Banky; John Olver; Benjamin Mentiplay

doi:10.1186/s12984-019-0637-2

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The nature and extent of upper limb associated reactions during walking in people with acquired brain injury

Journal article

Open access

Peer reviewed

The nature and extent of upper limb associated reactions during walking in people with acquired brain injury

Michelle B Kahn, Ross Clark, Gavin Williams, Kelly Bower, Megan A Banky, John Olver and Benjamin Mentiplay

Journal of NeuroEngineering and Rehabilitation, Vol.16(1), 160

2019

DOI: https://doi.org/10.1186/s12984-019-0637-2

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Abstract

acquired brain injury

associated reactions

kinematics

three-dimensional motion analysis

upper limb

Background: Upper limb associated reactions (ARs) are common in people with acquired brain injury (ABI). Despite this, there is no gold-standard outcome measure and no kinematic description of this movement disorder. The aim of this study was to determine the upper limb kinematic variables most frequently affected by ARs in people with ABI compared with a healthy cohort at matched walking speed intention. Methods: A convenience sample of 36 healthy control adults (HCs) and 42 people with ABI who had upper limb ARs during walking were recruited and underwent assessment of their self-selected walking speed using the criterion-reference three dimensional motion analysis (3DMA) at Epworth Hospital, Melbourne. Shoulder flexion, abduction and rotation, elbow flexion, forearm rotation and wrist flexion were assessed. The mean angle, standard deviation (SD), peak joint angles and total joint angle range of motion (ROM) were calculated for each axis across the gait cycle. On a group level, ANCOVA was used to assess the between-group differences for each upper limb kinematic outcome variable. To quantify abnormality prevalence on an individual participant level, the percentage of ABI participants that were outside of the 95% confidence interval of the HC sample for each variable were calculated. Results: There were significant between-group differences for all elbow and shoulder abduction outcome variables (p < 0.01), most shoulder flexion variables (except for shoulder extension peak), forearm rotation SD and ROM and for wrist flexion ROM. Elbow flexion and shoulder abduction were the axes most frequently affected by ARs. Despite the elbow being the most prevalently affected (38/42, 90%), a large proportion of participants had abnormality, defined as ±1.96 SD of the HC mean, present at the shoulder (32/42, 76%), forearm (20/42, 48%) and wrist joints (10/42, 24%). Conclusion: This study provides valuable information on ARs, and highlights the need for clinical assessment of ARs to include all of the major joints of the upper limb. This may inform the development of a criterion-reference outcome measure or classification system specific to ARs.

Details

Title: The nature and extent of upper limb associated reactions during walking in people with acquired brain injury
Authors: Michelle B Kahn (Author) - University of the Sunshine Coast - School of Health & Sports Sciences
Ross Clark (Author) - University of the Sunshine Coast - School of Health & Sports Sciences
Gavin Williams (Author) - University of Melbourne
Kelly Bower (Author) - University of Melbourne
Megan A Banky (Author) - University of the Sunshine Coast - School of Health & Sports Sciences
John Olver (Author) - Epworth Monash Rehabilitation Unit (EMReM)
Benjamin Mentiplay (Author) - La Trobe University
Publication details: Journal of NeuroEngineering and Rehabilitation, Vol.16(1), 160; 10
Publisher: BioMed Central Ltd.
Date published: 2019
DOI: 10.1186/s12984-019-0637-2
ISSN: 1743-0003
Copyright note: Copyright © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy; School of Health - Public Health
Language: English
Record Identifier: 99450979702621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Engineering, Biomedical; Neurosciences; Rehabilitation

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