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Kinematic and kinetic assessment of upper limb movements in patients with writer's cramp.

Delrobaei M, Rahimi F, Jackman ME, Atashzar SF, Shahbazi M, Patel R, Jog M - J Neuroeng Rehabil (2016)

Bottom Line: A multi-sensor system was used to record finger and wrist forces along with deviation angles at the wrist, elbow and shoulder while 9 patients with writer's cramp performed a series of standardized tasks on surfaces inclined at different angles.Third, cluster analyses using these features showed a clear separation of patients into two severity classes.The results demonstrate that using a set of standardized tasks and objective measures, individual profiles for arm movements and applied forces associated with writer's cramp can be generated.

View Article: PubMed Central - PubMed

Affiliation: K. N. Toosi University of Technology, Faculty of Electrical and Computer Engineering, Tehran, 19697, Iran. delrobaei@kntu.ac.ir.

ABSTRACT

Background: The assessment and treatment of writer's cramp is complicated due to the variations in the forces and angles of involved joints. Additionally, in some cases compensatory movements for cramp relief further complicates assessment. Currently these variables are subjectively measured with clinical scales and visual assessments. This subjectivity makes it difficult to successfully administer interventions such as Botulinum toxin injection or orthotics resulting in poor efficacy and significant side effects.

Method: A multi-sensor system was used to record finger and wrist forces along with deviation angles at the wrist, elbow and shoulder while 9 patients with writer's cramp performed a series of standardized tasks on surfaces inclined at different angles. Clinical, kinetic, and kinematic information regarding cramping was collected.

Results: First, four tasks appeared to best predict cramp occurrence. Second, unique biomechanical profiles emerged for patients regarding force, angles and cramp severity. Third, cluster analyses using these features showed a clear separation of patients into two severity classes. Finally, a relationship between severity and kinetic-kinematic information suggested that primary cramping versus compensatory movements could be potentially inferred.

Conclusions: The results demonstrate that using a set of standardized tasks and objective measures, individual profiles for arm movements and applied forces associated with writer's cramp can be generated. The clinician can then accurately target the biomechanics specifically, whether it is with injection or other rehabilitative measures, fulfilling an important unmet need in the treatment of writer's cramp.

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Related in: MedlinePlus

The dendrograms visualizing the hierarchy of clusters based on a applied forces, b joint angles, and c self-reported cramp severities from the 9 writer’s cramp patients
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Fig6: The dendrograms visualizing the hierarchy of clusters based on a applied forces, b joint angles, and c self-reported cramp severities from the 9 writer’s cramp patients

Mentions: In order to group the patients, clustering analysis was performed. Patients were grouped based on the applied forces, joint angles, and self-reported cramp severities. The hierarchy of clusters is visualized by dendrograms in Fig. 6, using the data from the nine patients. Since not all patients were able to complete the tasks on TNH and TPT surfaces, the analysis was performed based on the data collected on the FLT and the TDH surfaces. The vertical axis on each dendrogram plot gives the multivariate distance between two patients or clusters of patients presented along the horizontal axis. The possible clusters are shown with different colors and multivariate distance is calculated using the Euclidean method.Fig. 6


Kinematic and kinetic assessment of upper limb movements in patients with writer's cramp.

Delrobaei M, Rahimi F, Jackman ME, Atashzar SF, Shahbazi M, Patel R, Jog M - J Neuroeng Rehabil (2016)

The dendrograms visualizing the hierarchy of clusters based on a applied forces, b joint angles, and c self-reported cramp severities from the 9 writer’s cramp patients
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4759959&req=5

Fig6: The dendrograms visualizing the hierarchy of clusters based on a applied forces, b joint angles, and c self-reported cramp severities from the 9 writer’s cramp patients
Mentions: In order to group the patients, clustering analysis was performed. Patients were grouped based on the applied forces, joint angles, and self-reported cramp severities. The hierarchy of clusters is visualized by dendrograms in Fig. 6, using the data from the nine patients. Since not all patients were able to complete the tasks on TNH and TPT surfaces, the analysis was performed based on the data collected on the FLT and the TDH surfaces. The vertical axis on each dendrogram plot gives the multivariate distance between two patients or clusters of patients presented along the horizontal axis. The possible clusters are shown with different colors and multivariate distance is calculated using the Euclidean method.Fig. 6

Bottom Line: A multi-sensor system was used to record finger and wrist forces along with deviation angles at the wrist, elbow and shoulder while 9 patients with writer's cramp performed a series of standardized tasks on surfaces inclined at different angles.Third, cluster analyses using these features showed a clear separation of patients into two severity classes.The results demonstrate that using a set of standardized tasks and objective measures, individual profiles for arm movements and applied forces associated with writer's cramp can be generated.

View Article: PubMed Central - PubMed

Affiliation: K. N. Toosi University of Technology, Faculty of Electrical and Computer Engineering, Tehran, 19697, Iran. delrobaei@kntu.ac.ir.

ABSTRACT

Background: The assessment and treatment of writer's cramp is complicated due to the variations in the forces and angles of involved joints. Additionally, in some cases compensatory movements for cramp relief further complicates assessment. Currently these variables are subjectively measured with clinical scales and visual assessments. This subjectivity makes it difficult to successfully administer interventions such as Botulinum toxin injection or orthotics resulting in poor efficacy and significant side effects.

Method: A multi-sensor system was used to record finger and wrist forces along with deviation angles at the wrist, elbow and shoulder while 9 patients with writer's cramp performed a series of standardized tasks on surfaces inclined at different angles. Clinical, kinetic, and kinematic information regarding cramping was collected.

Results: First, four tasks appeared to best predict cramp occurrence. Second, unique biomechanical profiles emerged for patients regarding force, angles and cramp severity. Third, cluster analyses using these features showed a clear separation of patients into two severity classes. Finally, a relationship between severity and kinetic-kinematic information suggested that primary cramping versus compensatory movements could be potentially inferred.

Conclusions: The results demonstrate that using a set of standardized tasks and objective measures, individual profiles for arm movements and applied forces associated with writer's cramp can be generated. The clinician can then accurately target the biomechanics specifically, whether it is with injection or other rehabilitative measures, fulfilling an important unmet need in the treatment of writer's cramp.

Show MeSH
Related in: MedlinePlus