Movement preferences of the wrist and forearm during activities of daily living

Will Anderton MS; Scott Tew MS; Spencer Ferguson BS; Joshua Hernandez MD; Steven K Charles PhD

doi:10.1016/j.jht.2022.07.003

Movement preferences of the wrist and forearm during activities of daily living

J Hand Ther. 2023 Jul-Sep;36(3):580-592. doi: 10.1016/j.jht.2022.07.003. Epub 2022 Sep 18.

Authors

Will Anderton MS¹, Scott Tew MS¹, Spencer Ferguson BS¹, Joshua Hernandez MD², Steven K Charles PhD³

Affiliations

¹ Mechanical Engineering, Brigham Young University, Provo, UT, USA.
² Neuroscience, Brigham Young University, Provo, UT, USA.
³ Mechanical Engineering, Brigham Young University, Provo, UT, USA; Neuroscience, Brigham Young University, Provo, UT, USA. Electronic address: skcharles@byu.edu.

PMID: 36127238
DOI: 10.1016/j.jht.2022.07.003

Abstract

Background: During activities of daily living, the main degrees of freedom of the forearm and wrist-forearm pronation-supination (PS), wrist flexion-extension (FE), and wrist radial-ulnar deviation (RUD)-combine seamlessly to allow the hand to engage with and manipulate objects in our environment. Yet the combined behavior of these three degrees of freedom is relatively unknown.

Purpose: To provide a characterization of natural forearm and wrist kinematics (joint configuration, movement direction, and speed) during activities of daily living.

Study design: This is a descriptive cross-sectional study.

Methods: Ten healthy subjects performed 24 activities of daily living chosen to represent a wide variety of activities, while we measured their PS, FE, and RUD angles using electromagnetic motion capture. The orientation of the forearm and wrist was represented in the three-dimensional "configuration space" spanned by PS, FE, and RUD. From the time course of forearm and wrist orientation in configuration space, we extracted three-dimensional distributions of joint configuration, movement direction, and speed.

Results: Most joint configurations were focused in a relatively small area: subjects spent roughly 50% of the time in the central 20% of their functional range of motion. Some movement directions were significantly more common than others (p < 0.001); in particular, the direction of the dart-thrower's motion (DTM) was about three times more common than motion perpendicular to it. Most movements were slow: the likelihood of moving at increasing speeds dropped off exponentially. Interestingly, the most common high-speed motion combined the DTM with a twist from pronation to supination. As this motion allows one to pick up an object in front of one's body and bring it to the head, it is essential for self-care. Thus, although many activities of daily living follow the DTM without significant forearm rotation, the greatest importance of the DTM may lie in its combination with forearm rotation.

Conclusions: Despite the wide variety of activities, we found evidence of preferred movement behavior, and this behavior showed significant coupling between the wrist and forearm.

Keywords: Activities of daily living; Flexion-extension; Forearm; Pronation-supination; Radial-ulnar deviation; Wrist.