Original article

einstein. 2008; 6(3):282-6

Kinematic movement analysis of change from quadrupedalism to bipedalism

Análise cinemática do movimento das trocas posturais de quadrupedia para bipedestaçãoPaulo Roberto Garcia Lucareli1, Juliana Tais Estevam2, Mário Oliveira Lima3, Juliane Gomes de Almeida4,

Fernanda Púpio Silva Lima5, Ligia Maria Presumido Braccialli6, Rafaela Okano Gimenes7

aBStractObjective: To assess the joint’s kinematics of the trunk, hip, knee and ankle in the sagittal plane during the postures changes from quadrupedalism to bipedalism. Methods: Twelve volunteers participated in this study: six female and six males, aged 20 to 28 years. All volunteers performed three movements, starting with the right and other with the left. All were submitted to two-dimensional computerized movement analysis. results: After statistical analysis, no statistically significant difference was found inter and intravolunteers in the two groups tested. conclusions: After examining the kinematic angle, it was possible to see that there is no single pattern of movement during the postures’ changes from quadrupedalism to bipedalism in healthy young adults. There were strategies for development and execution of the movement that showed some resemblance variability intravolunteers. However, intervolunteers there were no similarity between two groups, which enabled us to distinguish specific strategies to accomplish the tasks.

Keywords: Posture; Biomechanics; Joints; Rehabilitation

reSUMOObjetivo: Avaliar a cinemática angular das articulações do tronco, quadril, joelho e tornozelo no plano sagital durante as trocas posturais de quadrupedia para a bipedestação. Métodos: Doze voluntários participaram do estudo: seis do sexo feminino e seis do masculino, com idade entre 20 e 28 anos. Os participantes realizaram seis repetições, três iniciadas com o lado direito e as outras três com o esquerdo. Todos foram submetidos à análise computadorizada do movimento por meio

de cinemetria bi-dimensional. resultados: Após a análise estatística não foi encontrada diferença estatisticamente significativa inter e intravoluntários nos dois grupos testados. conclusões: Após análise da cinemática angular foi possível constatar que não há um único padrão de movimento para realizar a troca postural de quadrupedia para ortostase em adultos jovens sadios. Houve estratégias de elaboração e execução de movimento que mostraram semelhança e pouca variabilidade intravoluntários. Porém, intervoluntários houve semelhança entre os grupos, o que possibilitou uma distinção das estratégias específicas para a realização da tarefa.

Descritores: Postura; Biomecânica; Articulações; Reabilitação

intrODUctiOn

Knowing normal neuropsychomotor development, the physical therapist is able to propose an appropriate treatment for children and adults with neurological dysfunctions. This enables the therapist to train motor performance in executing a series of important actions for daily routine(1), allowing postural changes and the freedom to carry out motor tasks in the most independent way as possible.

The introduction of new methods of investigation of motor development through movement analysis and a greater interest in childhood methods practiced in other cultural environments resulted in the interpretation of motor control, over the last 10 years, in which the task

Study carried out at Hospital Israelita Albert Eisntein – HIAE, São Paulo (SP), Brazil1 PhD student from Faculdade de Medicina da Universidade de São Paulo – USP, São Paulo (SP), Brasil; Adjunct Professor at Centro Universitário São Camilo and Universidade Paulista – UNIP, São Paulo

(SP), Brazil; Physiotherapist of the Hospital Israelita Albert Einstein – HIAE, São Paulo (SP), Brazil. 2 Specialist from Universidade Paulista – UNIP, São Paulo (SP), Brazil. 3 PhD from Universidade do Vale do Paraíba – UNIVAP, São José dos Campos (SP), Brazil.4 Master’s degree from Universidade Paulista – UNIP, São Paulo (SP), Brazil.5 Master’s degree from Universidade do Vale do Paraíba – UNIVAP, São José dos Campos (SP), Brazil.6 PhD from Universidade Estadual Paulista “Júlio de Mesquita Filho” – UNESP, Marília (SP), Brazil.7 Master’s degree from Centro Universitário São Camilo, São Paulo (SP), Brazil.

Corresponding author: Paulo Roberto Garcia Lucareli – Rua Jair Moraes, 55 – apto. 111B – Santana – CEP 02033-060 – São Paulo (SP), Brasil – Tel.: 11 3539-2659 – e-mail: plucareli@hotmail.com

Received on Feb 15, 2008 – Accepted on Aug 18, 2008

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Kinematic movement analysis of change from quadrupedalism to bipedalism 283

and the environment are extremely significant factors in their acquisition.

Many factors probably contribute to this type of motor strategy used to determine the transfer from a supine to a vertical position. Traditionally, maturing of the nervous system, more specifically neck-body and body-body verticalization reactions are considered significant factors that affect the appearance of a mature strategy, from the point of view of development, in transferal of a supine to a vertical position(2).

Vanderlinden and Wilhelm(3) used kinematics to assess the linear and angular dislocation of the hip, knee, and ankle in knee, half-kneel, and orthostatic postures, and electromyography to quantify the activity of the gastrocnemius, tibialis anterior, rectus femoris, and biceps femoris muscles of ten healthy children aged between five and seven years.

However, until today there are no other studies describing measurements of postural changes initiating in rolling over and extending to orthostatism in healthy adults. There are only studies that evaluate linear and angular dislocation of segments and muscular activities in other situations, such as rising (from sitting to standing position) and walking(4-5).

OBJectiVeTo evaluate angular kinematics of the trunk, hip, knee, and ankle on the saggital plane during posture changes from quadrupedalism to orthostasis.

MetHODS Twelve volunteers were selected in the city of São Paulo: six female and six male aged between 20 and 28 years (± 25.6 years), weighing between 50 and 90 kg (± 73.8 kg), and height of 1.50 to 1.90 m (± 1.76).

Data were collected in the division of neurological physical therapy of the Institution, after being approved by the Research Ethics Committee (195/06).

The criteria used to include volunteers were: absence of rheumatic, orthopedic, or neurological diseases; ambulatory community members; no need for walking aids; no prior surgical orthopedic procedure; willingness to participate voluntarily in the study by signing the informed consent form.

collection proceduresThe volunteers were submitted to a medical history and evaluation of anthropometric measurements (height and weight). They were also familiarized with the procedures to be carried out and instructed as to the sequence of activities proposed.

All participants used bathing suits, which allowed placement of reflective markers for analysis.

Nine selected anatomical points were adopted as reference points for affixing markers that reflect infrared light to the “Kavideo” movement analysis system: head of the fifth metatarsal, lateral malleolus, lateral femoral condyle, greater trochanter of the femur, anterosuperior iliac spine, posterior superior iliac spine, acromium, lateral epicondyle of the humerus and mid point between the styloid process of the radius and the ulna. Markers were composed of plastic spheres covered with material that reflects light, and they were used to estimate the position of segments and joints and to calculate kinematics in elbow, shoulder, trunk, hip, knee, and ankle joints.

The task given to each volunteer was to move from the quadrupedal position to bipedal position on a previously marked area on the floor that measured 2 m2.

The volunteers were instructed to carry out the movement at a comfortable auto-selected velocity, totalizing in six repetitions; the first three repetitions were done with the right side of their bodies and the other three, with the left side.

Using two Sony® DV TRV120 cameras, the images were collected and transported to the movement analysis program that utilized the anatomical reference points to create segments and joints.

The program was capable of identifying each point individually on the two cameras because, during data collection, we used an infrared emission device produced by the camera that reflected off the markers affixed to each volunteer to facilitate identification by the program’s automatic tracking system.

Whenever the markers were occluded, the reconstruction was based on images from the second camera. The extraction of angular values was done automatically. So that it can be done, the program uses rotation matrixes called DLTs, calculated by the program itself.

The data were expressed on graphics of the angular position of each joint relative to time, producing six graphics for each joint of each volunteer, three graphics for the right side and three for the left. Using the six cycles, an intervolunteer analysis was carried out with the intention of detecting measuring reproducibility of each movement.

Possible differences among the volunteers, according to previously defined variables, were analyzed by Kruskal-Wallis non-parametric tests for independent samples, and completed, whenever necessary, by multiple determination tests. The mean and standard deviation were not calculated, since using the non-parametric test, the variables analyzed do not have a normal distribution, and their calculation is meaningless.

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284 Lucareli PRG, Estevam JT, Lima MO, Almeida JG, Lima FPS, Braccialli LMP, Gimenes RO

The rejection level for the null hypothesis was fixed at a value lower than or equal to 0.05 (5%).

reSUltSAfter analysis of movement patterns of the volunteers individually and as a whole, we verified that the data was agglutinated into two distinct groups, called Group A (six volunteers) and Group B (six volunteers).

After statistical analysis, no statistically significant (ns) intervolunteer and intravolunteer difference was found (ns) in both groups tested and divided in Group A, with intervolunteer analysis with p = 0.3 (ns) and intravolunteer analysis with p = 0.2 (ns), and Group B, with intervolunteer analysis with p = 0.5 (ns) and intravolunteer analysis with p = 0.1 (ns).

It is possible to visualize an example of each group in Figure 1. The graphics of angular kinematics of each segment during the task are shown in Figure 2.

DiScUSSiOnPhysical therapists and healthcare professionals frequently use posture changes such as quadrupedalism, kneel, and half-knee to help in movement dysfunctions and reach an orthostatic posture. Very little is known about how children and adults activate the muscles of the lower extremities to move the joints during postural changes(6).

Based on the results of this study, it can be affirmed that the task given to each volunteer was carried out in a different manner. Six participants performed a standard movement defined as Pattern A, and the other six performed a movement pattern denominated B. As a result, we obtained two distinct movement patterns. Each segment was compared by performing the task in two situations: support and balance.

Studies were found, in medical literature, that analyzed children(6-7), young adults(8), and adults compared to young adults(9) with performance of the task rising from a supine to a bipedal position.

Movement strategies to change from supine to bipedal position in children aged between four and seven years and in young adults aged between 20 and 35 years showed that, although there is a slight tendency towards age-specific strategies, in supine to vertical movement there is also a great variation among volunteers of the same age bracket. These discoveries seem not to support the traditional supposition that a single mature pattern of movement from the supine to vertical position appears after the age of five years(2).

There are three most common strategies reported by these authors in assuming the vertical position. For analysis of these strategies, it was necessary to divide

Group A Group BFigure 1. Postural change from quadrupedalism to bipedalism of an individual from Group A and another from Group B

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Kinematic movement analysis of change from quadrupedalism to bipedalism 285

Figure 2. Angular kinematic graphics of each segment during the task of moving from quadruped to biped posture

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286 Lucareli PRG, Estevam JT, Lima MO, Almeida JG, Lima FPS, Braccialli LMP, Gimenes RO

the body into three components: upper extremities, lower extremities, and the axial region, that includes the head and trunk. The researches conducted in young adults suggest that the most common patterns involve symmetrical movements of the trunk and extremities and a symmetrical squatting in order to reach the vertical position. However, only 25% of the volunteers studied used this strategy(9).

After performing electromyographic and cinematographic analysis of the hip, knee, and ankle joints in five to seven years-old children, the authors found a great variation and variability of movements performed and of muscle activity involved in the change of posture from quadrupedalism to bipedalism. These results corroborate our results that also show that there is no established pattern of movement, but rather a possible pattern of movement strategy(5).

cOnclUSiOnSAfter analysis of angular kinematics, it was possible to determine that there is no single pattern of movement for changing posture from a quadrupedal to orthostatic position in the healthy young adults evaluated.

There were strategies of intention and execution of movements that showed similarities and little

intravolunteer variability, but intervolunteers there was resemblance between the two groups evaluated (A and B) making it possible to distinguish specific manners of carrying out the task.

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4. Lucareli PRG, Greve JMA. Alteration of the load-response mechanism of the knee joint during hemiparetic gait following stroke analyzed by 3-dimensional kinematic. Clinics. 2006;61(4):295-300.

5. Mathiyakom W, Mcnitt-Gray Jl, Wilcox R. Lower extremity control and dynamics during backward angular impulse generation in forward translating tasks. J Biomech. 2006;39(6):990-1000.

6. Abitbol M. Quadrupedalism and acquisition of bipedalism in human children. Gait Posture. 1993;1(4):189-95.

7. VanSant AF. Age differences in movement patterns used by children to rise from a supine position to erect stance. Phys Ther. 1988;68(9):1330-9.

8. VanSant AF. Rising from a supine position to erect stance. Description of adult movement and a developmental hypothesis. Phys Ther. 1988;68(2):185-92.

9. Marsala G, VanSant AF. Age-related differences in movement patterns used by toddlers to rise from a supine position to erect stance. Phys Ther. 1998;78(2):149-59.