title: Postures and repetitive movements during use of a long cane by individuals with visual impairment.
abstract: METHODS
  Descriptive.
  
  
  OBJECTIVE
  To describe upper body postures and movements that occur when an individual with visual impairment uses a cane to explore the environment while walking.
  
  
  BACKGROUND
  Previous research revealed self-reported neuromusculoskeletal problems related to cane use in individuals with visual impairments. No research, however, is available correlating neuromusculoskeletal problems with specific strategies of cane use or describing what movements and postures actually occur during cane use.
  
  
  METHODS
  Twenty-eight individuals with visual impairment who had been walking independently with a long cane for >1 year were videotaped walking with their canes. Subjects included 16 men and 12 women with a mean age of 39.8 +/- 15.2. Postures and movements of the head and neck, trunk, and each upper extremity body segment were analyzed using videotape.
  
  
  RESULTS
  Thirty-nine categories of postures or repetitive joint movements were observed. Half of the subjects lacked intersegmental movement of the head, trunk, and shoulder girdles during walking. The repetitive movements used to manipulate the cane occurred at the forearm or wrist. Intrasubject variability of postures and movements was low.
  
  
  CONCLUSIONS
  A variety of sustained postures and repetitive movements occur among individuals using long canes. Each individual displays minimal variability in cane manipulation strategy when walking in an uncomplicated environment. Cane manipulation is accomplished by repetitive movements of wrist flexion/extension, wrist ulnar/radial deviation, or forearm pronation/supination. The remainder of the upper body maintains sustained postures, and more than half of long cane users lack the normal intersegmental movement that typically occurs in the neck, trunk, and shoulder girdle during walking. Further research is needed to determine whether particular cane manipulation strategies or sustained postures during cane use increase the risk of musculoskeletal pain syndromes.
authors.affiliation: Department of Physical Therapy, College of Health Professions, Thomas Jefferson University, Philadelphia, PA 19107, USA. Julie.Mount@mail.tju.edu
authors.forename: J
authors.initials: J
authors.lastname: Mount
authors.forename: P D
authors.initials: PD
authors.lastname: Howard
authors.forename: A L
authors.initials: AL
authors.lastname: Dalla Palu
authors.forename: A
authors.initials: A
authors.lastname: Grafstrom
authors.forename: D M
authors.initials: DM
authors.lastname: Pinto
authors.forename: S L
authors.initials: SL
authors.lastname: Rudy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001132:Arm / Q000502:physiology; D001766:Blindness / Q000534:rehabilitation*; D002183:Canes; D012090:Cumulative Trauma Disorders / Q000453:epidemiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D005684:Gait / Q000502:physiology; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D009333:Neck / Q000502:physiology; D011187:Posture / Q000502:physiology*