Nives Klopcar and Jadran Lenarcic

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Arm Reachable Working Space as Evaluation Tool

• Nives Klopcar and Jadran Lenarcic

Jožef Stefan Institute, Department of Automatics,
Biocybernetics and Robotics Jamova 39,
Ljubljana, Slovenia
Institute of the Republic of Slovenia for
Rehabilitation, Linhartova 51, Ljubljana, Slovenia
5th International Shoulder Complex Conference,
Portugal, 27 28 August, 2004
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1. Introduction
The intention is to create a computer assistant
tool for a graphical and numerical presentation
of ROM measurements with the arm
reachableworkspace.
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2.1 Shoulder ROM measurement
(a) elevation through flexion and retroflexion
in sagittal plane (b) elevation through
abduction and adduction in frontal plane (c)
ext./int. rotation

• passive ROM
• frozen shoulder patient
• during therapy

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2.2 Upper extremity model
rW Red Rpr T . rSG RA RF RR . ( rGE REF .
rEW )
Red Rot(y, jed) Rpr Rot(z, jpr) T Trans (x,
dSG/do) RA Rot(y, jA) RF Rot(x, jF) RR Rot(z,
jR) REF Rot(x, jEF)
rSG ( dSG, 0, 0)T rGE (0, 0, - dH)T rEW (0,
0, - dF)T
dSG(H), dH(H), dF(H) H...subject height
D. A. Winter, Biomechanics and Motor Control of
Human Movement, A Wiley-Interscience Publication,
University of Waterloo, Canada, 1990.
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2.3 Computer assistant tool

• adduction/abduction jAm, jAM
• retroflexion/flexion jFm jA/3, jFM - jA/6
• ext./int. rotation jRm7jA/9 - jF/9
  2jAjF/810,
• jRM 4jA/9 5jF/9
  5jAjF /810
• shoulder girdle position (shoulder rhythm,
• length changes, angular motion range )
• flexion (- 60) in extension (90) of healthy
  elbow jEF

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2.4 Wrist points calculation

• adduction/abduction jAm, jAM
• retroflexion/flexion jFm jA/3, jFM - jA/6
• ext./int. rotation jRm7jA/9 - jF/9
  2jAjF/810,
• jRM 4jA/9 5jF/9
  5jAjF /810
• shoulder girdle position (shoulder rhythm,
• length changes, angular motion range )
• flexion (- 60) in extension (90) of healthy
  elbow jEF

rW Red Rpr T . rSG RA RF RR . ( rGE REF .
rEW )
BODY VOLUME IS AN OBSTACLE
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3. Results

• Arms workspace presents an area within reach of
  the wrist.

right shoulder PASSIVE
flexion 170
retroflexion 60
abduction 170
adduction 10
ext. rotation 90
int. rotation 60
height 170 cm
V 615,7dm3 55,7dm3
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Comparison of involved arm reachable workspace
volume
Passive measurement left (involved) arm V1 95.2 dm3 V2 154.7 dm3 V3 160.5 dm3 V4 231.2 dm3 V5 313.6 dm3 V6 335.4 dm3
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Comparison of involved and uninvolved arm
reachable workspace volume
Passive measurement left (involved) arm Functioning Deficit V1 95.2 dm3 15.5 84.5 V2 154.7 dm3 25.1 74.9 V3 160.5 dm3 26.1 73.9 V4 231.2 dm3 37.6 62.4 V5 313.6 dm3 50.9 49.1 V6 335.4 dm3 54.5 45.5 right (uninvolved) arm Vh 615.7dm3
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Comparison of involved arm reachable workspace
Passive measurement left (involved) arm V1 95.2 dm3 V2 154.7dm3 V3 160.5dm3 V4 231.2dm3 V5 313.6dm3 V6 335.4dm3 right (uninvolved) arm Vh 615.7dm3
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Comparison of involved and uninvolved arm
reachable workspace
Passive measurement left (involved) arm V1 95.2 dm3 V2 154.7dm3 V3 160.5dm3 V4 231.2dm3 V5 313.6dm3 V6 335.4dm3 right (uninvolved) arm Vh 615.7dm3
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Comparison of involved and uninvolved arm
reachable workspace
Passive measurement left (involved) arm V1 95.2 dm3 V2 154.7dm3 V3 160.5dm3 V4 231.2dm3 V5 313.6dm3 V6 335.4dm3 right (uninvolved) arm Vh 615.7dm3
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Involved and uninvolvedarm reachable workspace
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Arm reachable workspace advantages

• mathematical criterion
• volume
• shape
• evaluation
• objective comparison
• to motivate the patient
• easily understandable

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Conclusions

• enables a new expression of the shoulder and arm
  disability based on standard ROM measurements
• documents qualitatively and quantitatively
• compares treatment objectively
• is easily understood by patients and
  professionals engaged in the evaluation of the
  patients disability
• provides standard computer documentation
  benefits

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