Quantifying the Nature And Extent of Upper-Limb Associated Reactions During Walking in People With Acquired Brain Injury

Abstract

Research Objectives To use criterion-reference three-dimensional motion analysis (3DMA) during walking to; 1.Define upper-limb associated reaction (AR) kinematics 2.Devise composite score outcome measures to quantify Ars. Design Cross-sectional observational study. Setting A major brain injury rehabilitation centre. Participants Forty-two participants with an ABI and hemiplegic upper-limb AR during walking and 36 healthy controls (HCs). Interventions N/A. Main Outcome Measures Participants underwent 3DMA upper-limb assessment at self-selected and fast walking speeds. The mean, standard deviation (SD), peak and total joint range of motion (ROM) were calculated for each axis across the gait cycle. The AR kinematics were evaluated according to between-group differences (analysis of covariance) and individually with calculation of the percentage of ABI participants classified as abnormal (i.e., ±1.96 SD of the HC mean). Composite score outcome measures were devised and evaluated for validity (Pearson's r correlation), test-retest reliability (intra-class correlation coefficient (ICC)) and responsiveness (Cohen's d effect size (ES), % change scores). Results Significant between-group differences existed for all elbow and shoulder abduction outcome variables (p 0.81). Conclusions All upper-limb joints may be implicated in ARs and therefore all warrant inclusion in clinical assessment. Composite scores were able to comprehensively assess the whole upper-limb AR, accurately classifies abnormality, and quantify severity with very strong clinimetrics. Author(s) Disclosures There are no disclosures or conflicts of interest for this abstract. To use criterion-reference three-dimensional motion analysis (3DMA) during walking to; 1.Define upper-limb associated reaction (AR) kinematics 2.Devise composite score outcome measures to quantify Ars. Cross-sectional observational study. A major brain injury rehabilitation centre. Forty-two participants with an ABI and hemiplegic upper-limb AR during walking and 36 healthy controls (HCs). N/A. Participants underwent 3DMA upper-limb assessment at self-selected and fast walking speeds. The mean, standard deviation (SD), peak and total joint range of motion (ROM) were calculated for each axis across the gait cycle. The AR kinematics were evaluated according to between-group differences (analysis of covariance) and individually with calculation of the percentage of ABI participants classified as abnormal (i.e., ±1.96 SD of the HC mean). Composite score outcome measures were devised and evaluated for validity (Pearson's r correlation), test-retest reliability (intra-class correlation coefficient (ICC)) and responsiveness (Cohen's d effect size (ES), % change scores). Significant between-group differences existed for all elbow and shoulder abduction outcome variables (p 0.81). All upper-limb joints may be implicated in ARs and therefore all warrant inclusion in clinical assessment. Composite scores were able to comprehensively assess the whole upper-limb AR, accurately classifies abnormality, and quantify severity with very strong clinimetrics.