Kinematic Asymmetries in the Wrist and Elbow During Axillary Crutch Use
Bibliographic record
Abstract
INTRODUCTION Axillary crutches are frequently prescribed in North America to enable patients to ambulate safely through the support of the upper extremities. However, crutch use may result in abnormal upper extremity forces and movement patterns, potentially resulting in discomfort or injury. This study evaluated three gait asymmetry measurement approaches to quantify asymmetries in joint angles during crutch-assisted swing-through gait (STG). METHODS Fifteen healthy adult males (ages 23 – 34 years) performed 10 trials of STG (1.40±0.07ms-1), landing on the left leg. Joint kinematics were recorded using a 10-camera optical tracking system (Motion Analysis, USA; 240Hz). Bilateral joint angles of the elbow and wrist were computed using Visual3D (C-Motion, USA) and normalized to 100% of the gait cycle. Asymmetry was quantified using Matlab (MathWorks, USA) at each percentage of the gait cycle using the symmetry index (SI)1, the normalized symmetry index2, and the symmetry angle3. RESULTS Asymmetry varied throughout the gait cycle, and values varied between the different methods. The symmetry index showed areas of artificial inflation of the calculated value due to the required use of a reference value (Figure 1). The normalized symmetry index did not have the same artificial inflations but still required the use of a reference value. The symmetry angle required no reference value. When the indices for a particular joint doing a specific motion were graphed generally all indices resulted in similarly shaped graphs. Peak asymmetry for radial-ulnar deviation of the wrist occurred at ~85% of the gait cycle, and peak asymmetry for flexion-extension of the elbow occurring at ~60% of the gait cycle. CONCLUSIONS Axillary crutch use results in asymmetries at the elbow and wrist. These asymmetries vary throughout the gait cycle. In clinical practice, more injuries are seen on the side of the landing leg and the side of hand dominance. ACKNOWLEDGEMENTS The authors would like to thank the Cumming School of Medicine & Alberta Health Services Clinical Research Fund Pre-Seed Grant (#18-1202) and Natural Science and Engineering Research Council of Canada Undergraduate Student Research Award for supporting this investigation. REFERENCES Robinson R, Herzog W, Nigg B. Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry. J Manip Physiol Ther. 1987;10:172–6. Queen R, Dickerson L, Ranganathan S, Schmitt D. A novel method for measuring asymmetry in kinematic and kinetic variables: the normalized symmetry index. J Biomech. 20AD;99. Zifchock RA, Davis I, Higginson J, Royer T. The symmetry angle: a novel, robust method of quantifying asymmetry. Gait Posture. 2008;27(4):622-627.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".