title: Analysis of tetraplegic reaching in their 3D workspace following posterior deltoid-triceps tendon transfer.
abstract: METHODS
  Cross-sectional study.
  
  
  OBJECTIVE
  To quantify three-dimensional (3D) reachable workspace in different groups of tetraplegic participants and to assess their reaching performance within this workspace.
  
  
  METHODS
  Northwest Regional Spinal Injuries Centre, UK.
  
  
  METHODS
  The 3D reachable workspace of three groups of tetraplegics (NON-OP, operated group (OP) and tetraplegic control group (CON(Tetraplegic)) with varying levels of triceps function together with a healthy control group (CON(Healthy))) was defined by reaching to five target positions (anterior, medial, lateral, superior and inferior) located on the periphery of their workspace. Joint angles and inter-joint co-ordination were analysed after a 3D reconstruction of the thorax, humerus and forearm. The performance related variables of movement time, peak velocity, time-to-peak velocity and curvature index were also examined.
  
  
  RESULTS
  The reachable volumes covered were consistent with the level of triceps function as CON(Healthy) covered a significantly greater volume than the tetraplegic groups and in turn the OP covered a larger workspace volume than NON-OP. The reduced workspace of tetraplegics was identified as being due to restrictions in workspace above shoulder height and across the body. Co-ordination data identified some differences in movement patterns but when reaching to targets on the workspace there were no significant differences between the OP and NON-OP groups.
  
  
  CONCLUSIONS
  This study provided a detailed assessment of reachable workspace and target reaching. Tetraplegic participants found the superior and medial parts of the workspace were the most challenging directions. Standardised biomechanical analysis of tetraplegic upper-limb function is required for objective assessment.
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, Merseyside, UK. m.a.robinson@ljmu.ac.uk
authors.forename: M A
authors.initials: MA
authors.lastname: Robinson
authors.forename: G J
authors.initials: GJ
authors.lastname: Barton
authors.forename: A
authors.initials: A
authors.lastname: Lees
authors.forename: P
authors.initials: P
authors.lastname: Sett
mesh_terms: D000328:Adult; D001132:Arm / Q000503:physiopathology / Q000601:surgery; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011782:Quadriplegia / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D012785:Shoulder Joint / Q000502:physiology; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000601:surgery; D013709:Tendon Transfer / Q000379:methods / Q000534:rehabilitation*; D055815:Young Adult