Wrist Circumduction Research Articles

Ulnar Extension Coupling in Functional Wrist Kinematics During Hand Activities of Daily Living

Wrist circumduction is increasingly used as a functional motion assessment for patients. Thus, increasing our understanding of its relation to the functional motion envelope is valuable. Previous studies have shown that the wrist is preferentially extended during hand activities of daily living (ADLs), with greater ulnar than radial deviation. The purpose of this study was to characterize the functional wrist motions of 22 modern ADLs in healthy subjects. We hypothesized that the subjects would perform ADLs predominantly in ulnar extension. Ten right-handed, healthy subjects performed flexion-extension, radioulnar deviation, maximal circumduction, and 22 modern ADLs. Angular wrist positions were obtained by tracking retroreflective markers on the hand and forearm. Angular motion data were analyzed with a custom program for peak/trough angles in flexion extension and radioulnar deviation, ellipse area of circumduction data, and ellipse area of combined motion data. The required ranges of motion for ADLs were from 46.6° ± 16.5° of flexion (stirring task) to 63.8° ± 14.2° of extension (combing) in flexion-extension and from 15.6° ± 8.9° of radial deviation (opening a jar) to 32.5° ± 8.3° of ulnar deviation (picking up smartphone) in radioulnar deviation. Ellipse area of combined motion data of the 22 ADLs were, on average, 58.2% ± 14.3% of the ellipse area of maximal circumduction. A motion data quadrantal analysis revealed that 54.9% of all ADL wrist motion occurred in ulnar extension. Among the average wrist positions for 22 ADLs, 16 were located in the ulnar extension quadrant. This study revealed a functional wrist motion envelope that was less than 60% of wrist maximal motion capacity on average. Our results also showed that the majority of ADLs are performed in ulnar extension of the wrist. Baseline values for healthy subjects performing 22 wrist ADLs can informfuture studies assessing dysfunction, postsurgical changes, and rehabilitation progress.

Biomechanical Effects of Radioscapholunate Fusion With Distal Scaphoidectomy and Triquetrum Excision on Dart-Throwing and Wrist Circumduction Motions

Distal scaphoid and triquetrum excisions can improve the range of wrist motion after radioscapholunate (RSL) fusion, but little is known about the kinematics of dart-throwing and global circumduction motions. We hypothesized that these excisions could increase the range of motion without causing midcarpal instability. Seven fresh-frozen cadaver upper extremities were mounted on a testing apparatus after isolation and preloading of the tendons of the flexor carpi radialis, flexor carpi ulnaris, extensor carpi radialis, and extensor carpi ulnaris. Sequential loadings of the flexor carpi ulnaris and extensor carpi radialis simulated active dart-throwing motion. Passive circumferential loading produced the wrist circumduction motion. We measured the range of wrist motions with an electromagnetic tracking system in 4 experiments: intact, simulated RSL fusion, RSL fusion with distal scaphoid excision, and RSL fusion with distal scaphoid and total triquetrum excisions. To evaluate midcarpal stability, we conducted passive mobility testing of the distal carpal row in the radial, volar, ulnar, and dorsal directions. Radioscapholunate fusion decreased the dart-throwing motion to a mean of 46% of the baseline value; distal scaphoid and triquetrum excisions increased the mean arc to 50% and 62%, respectively. Radioscapholunate fusion diminished the wrist circumduction to a mean of 43% of the baseline value, which increased to a mean of 58% and 74% after distal scaphoid and triquetrum excision, respectively. A significant increase in radial deviation was noted after distal scaphoid excision, and subsequent triquetrum excision significantly increased motion in the ulnar-palmar direction. Regarding midcarpal stability, dorsal translation significantly increased after distal scaphoid and triquetrum excisions. Distal scaphoid and triquetrum excision after RSL fusion improved both dart-throwing and circumduction motions, but dorsal midcarpal instability occurred. Subsequent carpal excisions may improve short-term outcome by increasing motions in a RSL-fused wrist; however, a potential risk of midcarpal instability should be considered.

Biomechanical function requirements of the wrist. Circumduction versus flexion/abduction range of motion

The biomechanical function of the wrist is widely assessed by measuring the range of motion (RoM) in two separate orthogonal planes: flexion–extension (FE) and radioulnar deviation (RUD). However, the two motions are coupled. The aim of this study is to compare wrist circumduction with FE and RUD RoM in terms of representativeness of the kinematic requirements for performing activities of daily living (ADL). To this end, the wrist motion of healthy participants was measured while performing maximum RoM in FE and in RUD, circumduction, and thirty-two representative ADL. Active and functional RoM (ARoM and FRoM) were computed in each plane, the evolving circumduction curves were adjusted to ellipses, and intensity maps representing the frequency of the coupling angles in ADL were plotted, both per ADL and globally for both hands. Ellipses representing different percentages of coupling angles in ADL were also plotted. Wrist circumduction fits the coupling angles measured in ADL better than ARoM or FRoM. As a novelty, quantitative data for both circumduction and the coupling angles required in ADL are provided, shedding light on the real biomechanical function requirements of the wrist. Results might be used to quantify mobility reduction and its impact on the performance of ADL, globally and per ADL, to enhance rehabilitation strategies, as well as in clinical decision-making, robotics, and prostheses.

Development of wearable rehabilitation device using parallel link mechanism: rehabilitation of compound motion combining palmar/dorsi flexion and radial/ulnar deviation

In recent years, the total number of physical therapists is increasing in Japan. However, it is not sufficient to nurse of patients requiring long-term care. In order to cope with the shortage of manpower, it is desirable to develop the rehabilitation equipment. This paper describes the development of a wearable wrist rehabilitation training device using the parallel link mechanism. It is possible to train the translational and rotational motion of the wrist joint by the adoption of parallel links. Training of the translational motion of the wrist joint has not been discussed in existing methods. Therefore, compared to existing methods, this method can be expected to reduce the burden on the wrist joint. And it is possible to move about 60% of the wrist joint movable range of motion. This device performs repetitive training to prevent contracture of the wearer’s joints. In experiments, assumed wrist circumduction motion was trained to the six subjects. The correlation coefficient between the target trajectory and the training result was obtained and evaluated whether correct operation was trained. The validity of the proposed method was demonstrated.

Electrogoniometer measurement and directional analysis of wrist angles and movements during the Sollerman hand function test

Study DesignClinical measurement. IntroductionTo investigate the characteristics of wrist motion (area, axis, and location) during activities of daily living (ADL) using electrogoniometry. MethodsA sample of 83 normal volunteers performed the Sollerman hand function test (SHFT) with a flexible biaxial electrogoniometer applied to their wrists. This technique is accurate and reliable and has been used before for assessment of wrist circumduction in normal volunteers. A software package was used to overlay an ellipse of best fit around the 2-dimensional trace of the electrogoniometer mathematically computing the area, location, and axis angle of the ellipse. ResultsMost ADL could be completed within 20% of the total area of circumduction (3686°° ± 1575°°) of a normal wrist. An oblique plane in radial extension and ulnar flexion (dart-throwing motion plane) was used for rotation (−14° ± 32°) and power grip tasks (−29° ± 25°) during ADL; however, precision tasks (4° ± 28°), like writing, were performed more often in the flexion extension plane. In the dominant hand, only 2 power tasks were located in flexion region (cutting play dough [ulnar] and pouring carton [radial]), precision tasks were located centrally, and rotation and other power tasks were located in extension region. DiscussionThis study has identified that wrist motion during the ADL requires varying degrees of movement in oblique planes. Using electrogoniometry, we could visualize the area, location, and plane of motion during ADL. This could assist future researchers to compare procedures leading to loss of motion in specific quadrants of wrist motion and its impact on patient's ability in performing particular ADL. It could guide hand therapists to specifically focus on retraining the ADL that may be affected when wrist range of motion is lost after injury. Level of EvidenceDiagnostic level III.

Principal components of wrist circumduction from electromagnetic surgical tracking.

An electromagnetic (EM) surgical tracking system was used for a functionally calibrated kinematic analysis of wrist motion. Circumduction motions were tested for differences in subject gender and for differences in the sense of the circumduction as clockwise or counter-clockwise motion. Twenty subjects were instrumented for EM tracking. Flexion-extension motion was used to identify the functional axis. Subjects performed unconstrained wrist circumduction in a clockwise and counter-clockwise sense. Data were decomposed into orthogonal flexion-extension motions and radial-ulnar deviation motions. PCA was used to concisely represent motions. Nonparametric Wilcoxon tests were used to distinguish the groups. Flexion-extension motions were projected onto a direction axis with a root-mean-square error of [Formula: see text]. Using the first three principal components, there was no statistically significant difference in gender (all [Formula: see text]). For motion sense, radial-ulnar deviation distinguished the sense of circumduction in the first principal component ([Formula: see text]) and in the third principal component ([Formula: see text]); flexion-extension distinguished the sense in the second principal component ([Formula: see text]). The clockwise sense of circumduction could be distinguished by a multifactorial combination of components; there were no gender differences in this small population. These data constitute a baseline for normal wrist circumduction. The multifactorial PCA findings suggest that a higher-dimensional method, such as manifold analysis, may be a more concise way of representing circumduction in human joints.

Relation Between the Upper Extremity Synergistic Movement Components and Its Implication for Motor Recovery in Poststroke Hemiparesis

Background: Synergy is a functional linkage of muscles during voluntary motor action. In poststroke hemiparesis, synergistic movements get disorganized in the form of stereotyped behaviors. Furthermore, there is a linkage between the movement components of the synergies, which should be understood for focused motor rehabilitation. Objective: To find the relationship between the synergistic motor behavior and recovery of the individual movement in chronic poststroke hemiparetic subjects. Method: A prospective, cross-sectional, observational study was conducted at an outpatient occupational therapy unit of a rehabilitation institute. A convenience sample of 30 chronic poststroke hemiparetic subjects (25 male and 5 female; 16 left sided and 14 right sided) was assessed using the Fugl-Meyer assessment (FMA) and Brunnstrom recovery stages of arm (BRS-A) and hand (BRS-H). Results: The mean poststroke duration of the subjects was 40.9 months. There were significantly higher scores (P < .001) for BRS-A (4.13 ± 1.07) and FMA upper arm (29.03 ± 4.31) as compared to BRS-H (2.47 ± 1.45) and FMA wrist and hand (11.50 ± 5.88), respectively. Very high correlation (r = 0.9 to 1.0; P < .05) was found between the 2 components of FMA (wrist circumduction and spherical grasp). Moderate (r = 0.5 to 0.69; P < .05) to high (r = 0.7 to 0.89; P < .05) correlation was found between many components of FMA (flexor synergy, extensor synergy, movement combining synergies, movement out of synergy, upper arm, and wrist-hand components). Conclusion: Many upper extremity movement components of the paretic side were related to one another. The components may be used for motor rehabilitation in order of their strength of association. The concept of synergistic linkage may be applied for motor training of the upper limb at a particular stage of the recovery.

Relation Between the Upper Extremity Synergistic Movement Components and Its Implication for Motor Recovery in Poststroke Hemiparesis

Background: Synergy is a functional linkage of muscles during voluntary motor action. In poststroke hemiparesis, synergistic movements get disorganized in the form of stereotyped behaviors. Furthermore, there is a linkage between the movement components of the synergies, which should be understood for focused motor rehabilitation. Objective: To find the relationship between the synergistic motor behavior and recovery of the individual movement in chronic poststroke hemiparetic subjects. Method: A prospective, cross-sectional, observational study was conducted at an outpatient occupational therapy unit of a rehabilitation institute. A convenience sample of 30 chronic poststroke hemiparetic subjects (25 male and 5 female; 16 left sided and 14 right sided) was assessed using the Fugl-Meyer assessment (FMA) and Brunnstrom recovery stages of arm (BRS-A) and hand (BRS-H). Results: The mean poststroke duration of the subjects was 40.9 months. There were significantly higher scores (P < .001) for BRS-A (4.13 ± 1.07) and FMA upper arm (29.03 ± 4.31) as compared to BRS-H (2.47 ± 1.45) and FMA wrist and hand (11.50 ± 5.88), respectively. Very high correlation (r = 0.9 to 1.0; P < .05) was found between the 2 components of FMA (wrist circumduction and spherical grasp). Moderate (r = 0.5 to 0.69; P < .05) to high (r = 0.7 to 0.89; P < .05) correlation was found between many components of FMA (flexor synergy, extensor synergy, movement combining synergies, movement out of synergy, upper arm, and wrist-hand components). Conclusion: Many upper extremity movement components of the paretic side were related to one another. The components may be used for motor rehabilitation in order of their strength of association. The concept of synergistic linkage may be applied for motor training of the upper limb at a particular stage of the recovery.

Assessment of Velocity, Range, and Smoothness of Wrist Circumduction Using Flexible Electrogoniometry

To quantify the range, velocity, and smoothness of wrist circumduction, to explore the oblique functional plane of wrist circumduction, and to establish the reproducibility and reliability of these measures. Forty healthy subjects with a mean age of 43 years and without a history of wrist pathology or pain participated in this study. We used a flexible electrogoniometer with a twin-axis sensor to measure the relative angles between the 2 end blocks while the subject performed maximum excursion of flexion-extension, radioulnar deviation, and circumduction of the wrist held in a standardized, fully pronated position. A software package was used to further analyze the characteristics of the circumduction curve or oval such as the mean area (designated as degree-degree or oo) shape, size, rate, smoothness, and orientation. The mean area of circumduction (4729 [degree-degree]) and circumference (265°) of the circumduction curve indicated the total range of circumduction. The velocity of circumduction (mean 179°/s) and the time (1.6 second) taken to complete 1 cycle of circumduction were similar in both hands. The 4 quadrants for the velocity of circumduction showed that the velocity was faster in the radioulnar deviation quadrants compared with flexion and extension. Quadrant analysis showed the smoothness was greater in the radioulnar deviation quadrants than in the flexion and extension quadrants. The oblique planes of the circumduction curves of all the normal wrists lie in ulnopalmar and radiodorsal direction with a mean angle of 28° to the vertical flexion and extension plane. This technique was accurate and reliable in measuring the velocity, range, and smoothness of wrist circumduction.

Cerebral activations related to ballistic, stepwise interrupted and gradually modulated movements in Parkinson patients.

Patients with Parkinson’s disease (PD) experience impaired initiation and inhibition of movements such as difficulty to start/stop walking. At single-joint level this is accompanied by reduced inhibition of antagonist muscle activity. While normal basal ganglia (BG) contributions to motor control include selecting appropriate muscles by inhibiting others, it is unclear how PD-related changes in BG function cause impaired movement initiation and inhibition at single-joint level. To further elucidate these changes we studied 4 right-hand movement tasks with fMRI, by dissociating activations related to abrupt movement initiation, inhibition and gradual movement modulation. Initiation and inhibition were inferred from ballistic and stepwise interrupted movement, respectively, while smooth wrist circumduction enabled the assessment of gradually modulated movement. Task-related activations were compared between PD patients (N = 12) and healthy subjects (N = 18). In healthy subjects, movement initiation was characterized by antero-ventral striatum, substantia nigra (SN) and premotor activations while inhibition was dominated by subthalamic nucleus (STN) and pallidal activations, in line with the known role of these areas in simple movement. Gradual movement mainly involved antero-dorsal putamen and pallidum. Compared to healthy subjects, patients showed reduced striatal/SN and increased pallidal activation for initiation, whereas for inhibition STN activation was reduced and striatal-thalamo-cortical activation increased. For gradual movement patients showed reduced pallidal and increased thalamo-cortical activation. We conclude that PD-related changes during movement initiation fit the (rather static) model of alterations in direct and indirect BG pathways. Reduced STN activation and regional cortical increased activation in PD during inhibition and gradual movement modulation are better explained by a dynamic model that also takes into account enhanced responsiveness to external stimuli in this disease and the effects of hyper-fluctuating cortical inputs to the striatum and STN in particular.

Impairment of Gradual Muscle Adjustment during Wrist Circumduction in Parkinson's Disease

Purposeful movements are attained by gradually adjusted activity of opposite muscles, or synergists. This requires a motor system that adequately modulates initiation and inhibition of movement and selectively activates the appropriate muscles. In patients with Parkinson's disease (PD) initiation and inhibition of movements are impaired which may manifest itself in e.g. difficulty to start and stop walking. At single-joint level, impaired movement initiation is further accompanied by insufficient inhibition of antagonist muscle activity. As the motor symptoms in PD primarily result from cerebral dysfunction, quantitative investigation of gradually adjusted muscle activity during execution of purposeful movement is a first step to gain more insight in the link between impaired modulation of initiation and inhibition at the levels of (i) cerebrally coded task performance and (ii) final execution by the musculoskeletal system. To that end, the present study investigated changes in gradual adjustment of muscle synergists using a manipulandum that enabled standardized smooth movement by continuous wrist circumduction. Differences between PD patients (N = 15, off-medication) and healthy subjects (N = 16) concerning the relation between muscle activity and movement performance in these groups were assessed using kinematic and electromyographic (EMG) recordings. The variability in the extent to which a particular muscle was active during wrist circumduction – defined as muscle activity differentiation - was quantified by EMG. We demonstrated that more differentiated muscle activity indeed correlated positively with improved movement performance, i.e. higher movement speed and increased smoothness of movement. Additionally, patients employed a less differentiated muscle activity pattern than healthy subjects. These specific changes during wrist circumduction imply that patients have a decreased ability to gradually adjust muscles causing a decline in movement performance. We propose that less differentiated muscle use in PD patients reflects impaired control of modulated initiation and inhibition due to decreased ability to selectively and jointly activate muscles.

Conservative Treatment of an Acute Traumatic Extensor Carpi Ulnaris Tendon Subluxation in a Collegiate Basketball Player: A Case Report

To present the case of an acute traumatic extensor carpi ulnaris (ECU) subluxation in a National Collegiate Athletic Association Division II female basketball player. The ECU tendon is stabilized in the ulnar groove by a subsheath located inferior to the extensor retinaculum. The subsheath can be injured with forced supination, ulnar deviation, and wrist flexion, resulting in the ECU tendon subluxing in the palmar and ulnar directions during wrist circumduction. Several methods of intervention exist, but controversy remains on how to best treat this condition. Distal ulnar fracture, ulnar collateral ligament sprain, triangular fibrocartilage complex lesion, lunotriquetral instability, distal radioulnar joint injury, pisotriquetral joint injury, ECU tendinopathy or subluxation. The wrist was placed in a short-arm cast in slight extension and radial deviation for 4 weeks. At that time, the patient was still able to actively sublux the ECU tendon, so a long-arm cast was applied with the wrist in slight extension, radial deviation, and pronation for an additional 4 weeks. The ECU tendon was then found to be stable. She wore a rigid wrist brace for 3 more weeks while she pursued rehabilitation. At the final follow-up appointment, the ECU tendon remained stable, and the wrist was asymptomatic. Subluxations of the ECU are rare. If the patient does not improve with conservative measures, surgical intervention is warranted to repair the sixth dorsal compartment. A long-arm cast with the elbow flexed to 90° and the wrist in approximately 30° of extension, radial deviation, and pronation was appropriate treatment for this type of injury.

Wrist Circumduction Reduced by Finger Constraints

Assessment of wrist motion is important in diagnosing and treating motion impairment after injuries to the wrist. Little is known of how finger posture influences the movement of the wrist. The aim of this study was to investigate the effect of finger constraints on the maximum circumduction movement of the wrist. Fifteen male right-handed subjects performed maximal circumferential wrist movements under 4 finger conditions: unconstrained fingers, holding a large cylinder (50 mm diameter), holding a small cylinder (25 mm diameter), and closed fist position. The wrist motion was captured by a surface marker-based motion analysis system. To quantify wrist motion capability, we constructed the maximal boundaries of wrist motion (circumduction envelope) from angular plots in flexion-extension (FE) and radial-ulnar deviation (RUD). The ranges of motion in FE and RUD and the envelope area were calculated. Finger constraints significantly reduced motion ranges in flexion and ulnar deviation, but not in extension and radial deviation. In comparison to the unconstrained finger condition, the motion ranges in flexion decreased by 13%, 16%, and 27% for the large cylinder, small cylinder, and fist conditions, respectively. The range of ulnar deviation was reduced by 10% for the large and small cylinder conditions and by 11% for the fist condition. The overall mobility in FE and RUD, as quantified by the area of circumduction envelope, decreased by 15%, 15%, and 23% for the large cylinder, small cylinder, and fist conditions, respectively. Wrist mobility is facilitated by the synergistic motion of finger joints. Constraining fingers in static flexion posture reduces wrist flexion and ulnar deviation without decreasing extension and radial deviation. A clinical implication is that wrist motion should be assessed under standardized finger joint configuration.

Changes in Patterns of Scaphoid and Lunate Motion During Functional Arcs of Wrist Motion Induced by Ligament Division

To determine the in vitro motion of the scaphoid and lunate during wrist circumduction and wrist dart-throw motions and to see how these motions change after the ligamentous stabilizers of the scaphoid and lunate are sectioned in a manner simulating scapholunate instability. Twenty-one fresh-frozen cadaver forearms were moved through a dart-throw motion and a circumduction motion using a wrist joint simulator. Scaphoid and lunate motion were measured with the wrist ligaments intact and after sectioning of the scapholunate interosseous ligament, the scaphotrapezium ligament, and the radioscaphocapitate ligament. In the intact wrist the scaphoid and lunate moved more during circumduction than during the dart-throw motion. With ligamentous sectioning the scaphoid flexed more and the lunate extended more during both the circumduction and dart-throw motions. During the circumduction motion both before and after sectioning the global motion of the scaphoid was greater than that of the lunate. After sectioning the scaphoid motion increased and the lunate motion decreased. The scaphoid and lunate motions were observed to change remarkably after ligamentous sectioning. The observed changes in carpal motion correlate with the clinical observation that after ligamentous injury arthritic changes occur in the radioscaphoid joint and not in the radiolunate joint. Analysis of the injured wrist in positions that combine flexion-extension and radial-ulnar deviation may allow noninvasive diagnosis of specific wrist ligament injuries.

Analysis of helical axes, pivot and envelope in active wrist circumduction

Objective. To study active wrist circumduction and planar moves, in terms of anatomical angles and envelope and of finite helical axes and mean pivot point. Design. We measured the position of the “mean pivot point” and its mean distance to the axes as anatomical angles in an in vivo full range movement. Background. The mean pivot point has been used in in vitro and roentgen stereophotogrammetric studies of wrist kinematics. However, the distribution of “3D centers of rotation” has never been presented in a non-invasive in vivo study. Methods. A light 6 degrees of freedom electrogoniometer was built and employed in vivo to measure circumduction, flexion–extension and radioulnar deviation on both wrists of twenty one volunteers. Results. Results were in general agreement with previously published ranges of wrist planar motion. The circumduction envelope proved to be a relevant representation of active wrist motion. The “mean pivot point” displayed a relative dispersion in localization of this point. Conclusion. The pivot results suggest that the wrist acts as a universal joint but with a non fixed location in the capitate head. The major axis of wrist envelope was not skew. Relevance The envelope and the precise knowledge of the helical axis pivot and its mean distance to the axes could give precious information on wrist functionality and stability after surgical or conservative treatment.

Ranges of dynamic motion of the wrist in healthy young and middle-aged men

The difference in the range of dynamic motion of the wrist between young and middle-aged men was studied. To analyse wrist function easily, a new quantitative evaluation technique for wrist circumduction using a biaxial flexible electrogoniometer was introduced. A phase plane was made from two-channel signals of the electrogoniometer, and the 'ROM (range of motion) Index' for wrist circumduction was defined. Twelve healthy young men (age 19-31 years) and twelve healthy middle-aged men (age 45-63 years) were studied. Under forearm fixed conditions, there was no difference of the ROM Index between the two age groups. A significant decrease of the ROM Index in the middle-aged group was found in the non-dominant wrists without forearm fixation. The four quadrantal analysis of wrist circumduction clarified that this difference appeared especially in the radiodorsal direction. These results suggest that in the middle-aged men, the motor function involving the radiocarpal and midcarpal joints does not decrease, but that for the proximal and distal radioulnar joints in the non-dominant side drops.

Dynamic analysis of wrist circumduction: a new application of the biaxial flexible electrogoniometer

A new technique for quantifying wrist circumduction was developed and evaluated using a biaxial flexible electrogoniometer. The reliability and validity of the electrogoniometer for the measurement of wrist motion were first tested, and then the device was applied clinically. The reliability tests demonstrated sufficient accuracy of the device. Also, validity of the measurement was recognized because the tests simulating wrist circumduction and cineradiography revealed that it could accurately detect the angle between the long axis of the forearm and the third metacarpal bone. Lissajous's figure was made from the two channel signals of the electrogoniometer, and the Range of Motion index for wrist circumduction was newly defined from this figure. This index represents the dynamic range of motion of wrist circumduction. Ten healthy men (ages 19–31 years) and three patients with wrist disorders were studied. In the patients, Lissajous's figures and Range of Motion indexes were markedly different from the healthy. In addition to this study, preliminary data on the ‘velocity-angle loci’ of healthy men during wrist circumduction were obtained for further detailed analysis.