title: An upper extremity inverse dynamics model for pediatric Lofstrand crutch-assisted gait.
abstract: The objective of this study was to develop an instrumented Lofstrand crutch system, which quantifies three-dimensional (3-D) upper extremity (UE) kinematics and kinetics using an inverse dynamics model. The model describes the dynamics of the shoulders, elbows, wrists, and crutches and is compliant with the International Society of Biomechanics (ISB) recommended standards. A custom designed Lofstrand crutch system with four, six-degree-of-freedom force transducers was implemented with the inverse dynamics model to obtain triaxial UE joint reaction forces and moments. The crutch system was validated statically and dynamically for accuracy of computing joint reaction forces and moments during gait. The root mean square (RMS) error of the system ranged from 0.84 to 5.20%. The system was demonstrated in children with diplegic cerebral palsy (CP), incomplete spinal cord injury (SCI), and type I osteogenesis imperfecta (OI). The greatest joint reaction forces were observed in the posterior direction of the wrist, while shoulder flexion moments were the greatest joint reaction moments. The subject with CP showed the highest forces and the subject with SCI demonstrated the highest moments. Dynamic quantification may help to elucidate UE joint demands in regard to pain and pathology in long-term assistive device users.
authors.affiliation: Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201-0413, USA. slavens@uwm.edu
authors.forename: Brooke A
authors.initials: BA
authors.lastname: Slavens
authors.forename: Neha
authors.initials: N
authors.lastname: Bhagchandani
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.forename: Peter A
authors.initials: PA
authors.lastname: Smith
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Harris
mesh_terms: D001132:Arm / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000502:physiology*; D002547:Cerebral Palsy / Q000503:physiopathology; D002648:Child; D003446:Crutches; D005684:Gait / Q000502:physiology*; D006801:Humans; D007596:Joints / Q000502:physiology; D007700:Kinetics; D008954:Models, Biological; D009068:Movement / Q000502:physiology; D010013:Osteogenesis Imperfecta / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000503:physiopathology