Effects of Limited Wrist Motion and Forearm Rotation on Scapular Kinematics and Muscle Activity During Spoon-Feeding in Healthy Young Adults.

Background

Wrist-forearm orthoses used during self-feeding may alter scapular and shoulder mechanics and increase proximal load, but this has not been quantified.

Methods

Seventeen right-hand-dominant young adults performed a spoon-feeding task under free and restricted conditions. A thermoplastic wrist-forearm orthosis positioned the wrist at approximately 30° dorsiflexion at rest and was intended to constrain wrist motion during the task without rigidly immobilizing forearm pronation-supination. Three-dimensional kinematics (scapula, shoulder, trunk, and distal joints) were recorded using inertial sensors, and surface electromyography was obtained from the upper trapezius, middle deltoid, and biceps brachii. Maximum joint angles and mean %MVC over the feeding cycle were compared between conditions (α = 0.05).

Results

The restriction condition resulted in a more anteriorly tilted and downwardly rotated scapular posture, greater shoulder abduction and external rotation, and increased thoracic flexion, whereas maximum distal joint angles did not differ, suggesting a functional distal constraint rather than rigid immobilization. Middle deltoid and biceps brachii activities increased significantly, with a nonsignificant trend toward higher upper trapezius activation.

Conclusions

In healthy young adults, limited wrist motion and forearm rotation during spoon-feeding were associated with altered proximal coordination, including scapular, shoulder/trunk, and proximal muscle changes.