Trunk, head and pelvis interactions in healthy children when performing seated daily arm tasks

L H C Peeters,I Kingma,I J M De Groot,G S Faber,J H Van Dieën

doi:10.1007/s00221-018-5279-2

Abstract

Development of trunk and head supportive devices for children with neuromuscular disorders requires detailed information about pelvis, trunk and head movement in interaction with upper extremity movement, as these are crucial for daily activities when seated in a wheelchair. Twenty-five healthy subjects (6–20 years old) were included to obtain insight in the physiological interactions between these segments and to assess maturation effects. Subjects performed a maximum range of trunk and head movement tasks and several daily tasks, including forward and lateral reaching. Movements of the arms, head, pelvis, and sub-sections of the trunk were recorded with an optical motion capture system. The range of motion of each segment was calculated. Contributions of individual trunk segments to the range of trunk motion varied with movement direction and therefore with the task performed. Movement of pelvis and all trunk segments in the sagittal plane increased significantly with reaching height, distance and object weight when reaching forward and lateral. Trunk movement in reaching decreased with age. Head movement was opposite to trunk movement in the sagittal (> 50% of the subjects) and transverse planes (> 75% of the subjects) and was variable in the frontal plane in most tasks. Both trunk and head movement onsets were earlier compared to arm movement onset. These results provide insight in the role of the upper body in arm tasks in young subjects and can be used for the design of trunk and head supportive devices for children with neuromuscular disorders.

Highlights

Children with neuromuscular disorders (NMD) suffer from progressive muscle weakness
Each movement task was successfully completed by all subjects, with the exception of reaching laterally, 1.3 times arm length at eye level
The contribution was roughly equal among all segments, but in lateral bending the thoracic segments contributed more compared to the lumbar segments, and in trunk axial rotation the lower thoracic segment contributed most

Summary

Introduction

Children with neuromuscular disorders (NMD) suffer from progressive muscle weakness. They first lose the ability to walk, followed by a decrease in trunk and arm function. In addition to control of upper extremity movement, trunk and head control are necessary in accomplishing daily tasks. The interaction between trunk and arm movements is likely most pronounced when reaching to objects beyond arm length distance (Schneiberg et al 2002; Sveistrup et al 2008). In healthy children, trunk movement is seen when performing tasks within arm length distance (Schneiberg et al 2002; Coluccini et al 2007). Maturation affects the interactions between arm, trunk and head movements

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