BACKGROUND Upper limb associated reactions (ARs) are common in people with acquired brain injury (ABI). Despite this, there is no gold-standard outcome measure and no kinematic description of this movement disorder. The aim of this study was to determine the upper limb kinematic variables most frequently affected by ARs in people with ABI compared with a healthy cohort at matched walking speed intention. METHODS A convenience sample of 36 healthy control adults (HCs) and 42 people with ABI who had upper limb ARs during walking were recruited and underwent assessment of their self-selected walking speed using the criterion-reference three dimensional motion analysis (3DMA) at Epworth Hospital, Melbourne. Shoulder flexion, abduction and rotation, elbow flexion, forearm rotation and wrist flexion were assessed. The mean angle, standard deviation (SD), peak joint angles and total joint angle range of motion (ROM) were calculated for each axis across the gait cycle. On a group level, ANCOVA was used to assess the between-group differences for each upper limb kinematic outcome variable. To quantify abnormality prevalence on an individual participant level, the percentage of ABI participants that were outside of the 95% confidence interval of the HC sample for each variable were calculated. RESULTS There were significant between-group differences for all elbow and shoulder abduction outcome variables (p < 0.01), most shoulder flexion variables (except for shoulder extension peak), forearm rotation SD and ROM and for wrist flexion ROM. Elbow flexion and shoulder abduction were the axes most frequently affected by ARs. Despite the elbow being the most prevalently affected (38/42, 90%), a large proportion of participants had abnormality, defined as ±1.96 SD of the HC mean, present at the shoulder (32/42, 76%), forearm (20/42, 48%) and wrist joints (10/42, 24%). CONCLUSION This study provides valuable information on ARs, and highlights the need for clinical assessment of ARs to include all of the major joints of the upper limb. This may inform the development of a criterion-reference outcome measure or classification system specific to ARs.

中文翻译：

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患有后天性脑损伤的人在行走过程中与上肢相关的反应的性质和程度。

背景技术上肢相关反应（ARs）在获得性脑损伤（ABI）患者中很常见。尽管如此，仍没有金标准的结果量度，也没有运动障碍的运动学描述。这项研究的目的是确定在步行速度匹配的情况下，与健康队列相比，ABI患者最常受AR影响的上肢运动学变量。方法收集了36名健康对照成年人（HCs）和42名ABI患者在步行过程中出现上肢AR的便利样本，并在Epworth使用标准参考三维运动分析（3DMA）对其自我选择的步行速度进行了评估。墨尔本医院。评估肩膀的屈曲，外展和旋转，肘部的屈曲，前臂的旋转和腕部的屈曲。平均角度 计算整个步态周期中每个轴的标准偏差（SD），峰值关节角度和总关节角度运动范围（ROM）。在组水平上，ANCOVA用于评估每个上肢运动学结果变量的组间差异。为了量化单个参与者水平的异常患病率，计算了每个变量在HC样本的95％置信区间之外的ABI参与者的百分比。结果所有肘关节和肩关节外展结果变量（p <0.01），大多数肩部屈曲变量（除了肩部伸展峰），前臂旋转SD和ROM以及腕部屈曲ROM组之间存在显着差异。肘屈曲和肩外展是ARs最常影响的轴。尽管肘部受到的影响最为广泛（38/42，90％），但仍有很大一部分参与者出现在肩部（32/42，76％）的HC异常平均值为HC平均值的±1.96 SD（ 20 / 42，48％）和腕关节（10 / 42，24％）。结论这项研究提供了有关ARs的有价值的信息，并强调了对ARs进行临床评估以包括上肢所有主要关节的必要性。这可以为特定于AR的标准参考结果度量或分类系统的开发提供信息。并强调需要对AR进行临床评估以包括上肢的所有主要关节。这可以为特定于AR的标准参考结果度量或分类系统的开发提供信息。并强调需要对AR进行临床评估以包括上肢的所有主要关节。这可以为特定于AR的标准参考结果度量或分类系统的开发提供信息。