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Effect of elbow flexion contractures on the ability of people with C5 and C6 tetraplegia to lift
Author(s) -
Harvey Lisa,
Crosbie Jack
Publication year - 2001
Publication title -
physiotherapy research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 49
eISSN - 1471-2865
pISSN - 1358-2267
DOI - 10.1002/pri.216
Subject(s) - tetraplegia , physical medicine and rehabilitation , muscle contracture , elbow , lift (data mining) , medicine , physical therapy , elbow flexion , rehabilitation , anatomy , computer science , spinal cord injury , spinal cord , psychiatry , data mining
Abstract Background and Purpose It is commonly assumed that minor elbow flexion contractures prevent people with C5–C6 tetraplegia and paralysis of the triceps brachii muscles from bearing full body weight through their upper limbs. The aim of the present study was to determine the effect of simulated bilateral elbow flexion contractures on the ability of these individuals to bear weight through their upper limbs and to determine whether full passive elbow extension is truly critical for lifting body weight. Method A biomechanical study was performed. Body weight lifted was measured under conditions that simulated bilateral elbow flexion contractures. Five people with motor complete C6 tetraplegia and one person with motor complete C5 tetraplegia, all with bilateral paralysis of the triceps brachii muscles, were recruited to the study. Subjects were fitted with bilateral elbow splints that restricted elbow extension but did not restrain elbow flexion nor prevent the elbow from collapsing, and were seated on an instrumented platform that measured vertical forces under the buttocks. Subjects pushed down through their hands and lifted under five different conditions, namely: with no elbow splints; with bilateral elbow splints adjusted to restrict elbow extension by 5–10°; by 15–20°; by 25–30° and with bilateral elbow splints adjusted to allow unrestricted movement of the elbow joint. Maximal weight lifted from under the buttocks, for each condition, was expressed in relation to weight under the buttocks during unsupported sitting (that is, ‘seated body weight’). Results Subjects lifted progessively less weight from under their buttocks as passive elbow restriction was progressively restricted. However, one subject lifted all his seated body weight when elbow extension was restricted by 5–10° and another lifted all his seated body weight when elbow extension was restricted by 5–10° and 15–20°. Conclusions Minor elbow flexion contractures will not alone prevent people with tetraplegia and paralysis of the triceps brachii muscles from lifting. Full passive elbow extension is not critical for the performance of this task. Copyright © 2001 Whurr Publishers Ltd.