Article

Rehabilitation of patients with joint affecting diseases makes an
appeal to available compensating motions. Objective information about
compensatory motions is required for clinical decision-making. Our objective was
to quantify resulting shoulder and arm motions from limited elbow mobility during
activities of daily living in healthy controls and patients. METHODS: Ten
hemophilia patients with reduced elbow motion and ten controls volunteered in a
kinematic motion analysis of thorax, shoulder, arm and wrist during 5
experimental activities of daily living. In controls, the elbow range of motion
was limited by an elbow brace with variable flexion and extension stops. The
elbow angle of patients was not intervened. Outcome variables were minimal
required elbow range of motion for successful activity of daily living completion
and concurring compensatory motions. FINDINGS: An elbow flexion and extension
domain was identified separated by a 97 degrees to 110 degrees interval in which
none of the observed tasks could be fulfilled. A minimal average elbow flexion
angle of 86 degrees and an additional range of motion of 36 degrees were required
to finish all tasks successfully. Predominant significant compensatory motion was
found in the glenohumeral joint and wrist. INTERPRETATION: Two functional elbow
flexion domains exist, separated by a transition domain of 36 degrees . Treatment
should be focussed to bridge both domains. Limiting treatments, e.g. arthrodesis
of the elbow joint within this transition range, especially in a cosmetic 90
degrees , leads to severe disability. Limited joint range of motion requires
increased compensatory motions in other joints.
CI - Copyright (c) 2011 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS