Quantifying forearm and wrist joint power during unconstrained movements in healthy individuals

Background Wrist movement-related injuries account for a large number of repetitive motion injuries. Remarkably little, if any, empirical data exist to quantify the impact of neuromuscular disorders affecting the wrist or to validate the effectiveness of rehabilitation training programs on wrist functions. The aim of this project was to develop a biomechanical model for quantifying wrist and forearm kinetics during unconstrained movements, to assess its reliability and to determine its sensitivity. Methods Twenty healthy subjects with no history of upper arm and wrist pain volunteered for the experiment. To evaluate the reliability of the data, we quantified their forearm and wrist kinetics on two different days (minimum and maximum number of days between experimental sessions were 1 and 4 days respectively). To measure forearm and wrist kinetics, an apparatus was built to offer rotational inertia during forearm and wrist movements. An inertial measurement unit was located near the top of the device measuring its angular position along the frontal and sagittal planes. We used a mathematical model to infer forearm and wrist torque. Thereafter, we calculated the product of torque and angular velocity to determine forearm and wrist power. Results Results revealed that for 75% of the power and torque measurements the ICC was greater than 0.75 (range: 0.77 – 0.83). Torque and power measurements for adduction movements, however, were less reliable (i.e., ICC of 0.60 and 0.47, respectively) across testing sessions. The biomechanical model was robust to small measurement errors, and the power peaks between the first and second testing session were not different indicating that there was no systematic bias (i.e., motor performance improvement) between testing sessions. Conclusions The biomechanical model can be used to assess the effectiveness of rehabilitation programs, document the progression of athletes or conduct research-oriented testing of maximum forearm and wrist kinetic capacities. Nonetheless, caution should be taken when assessing forearm and wrist power adduction movements. Future studies should aim at defining a set of normative values, for various age groups, for forearm and wrist joint torque and power in healthy individuals.