An instrumented wheel system for three-dimensional kinetic analysis of upper extremity during wheelchair propulsion has been designed and validated. This system allows the direct measurements of three-dimensional dynamic forces and moments on the handrim during wheelchair propulsion in a laboratory setting as well as in the field. Static loading tests showed a high linearity and little drift (coefficient of determination, r2 > 0.999). Under dynamic loading, the instrumented wheel provided the well-matched measurement forces and moments with the predicted values from the inverse dynamic method using video-based kinematic data (correlation coefficient, ρ > 0.97). The three-dimensional handrim forces and moments during wheelchair propulsion by a non-disabled subject were demonstrated.
Lumbrical Muscle Incursion into the Carpal Tunnel During Finger Flexion
Carpal tunnel syndrome is one of the many so-called cumulative trauma disorders thought by some to be related to the performance of repetitive tasks in the work-place. The cause of this disorder is unknown. We have observed lumbrical muscle incursion into the carpal tunnel during finger flexion. This study was conducted to determine the amount of this incursion in normal wrists. Five cadaver upper limbs were analyzed radiographically with radiopaque markers on the flexor retinaculum and the lumbrical muscle origins in four finger positions: full extension, 50% flexion, 75% flexion, and 100% finger flexion. The lumbrical muscle origins were an average of 7.8 mm distal to the carpal tunnel in full finger extension. They moved an average of 14 mm into the carpal tunnel with 50% finger flexion, 25.5 mm with 75% flexion, and 30 mm with 100% flexion. Abnormal lumbrical muscles have been cited as a possible cause of carpal tunnel syndrome. These findings suggest that lumbrical muscle incursion during finger flexion is a normal occurrence and is a possible cause of work-related carpal tunnel syndrome.