Physical demand and compensatory movements in Functional Capacity Evaluation tests in one-handed individuals.

One-handedness due to peripheral pathology can be caused by several conditions,
such as Upper Limb Reduction Deficiency (ULRD), Upper Limb Amputations (ULA)
and Brachial Plexus Injuries (BPI). Overuse and compensatory movements of the
sound limb when performing daily and work related tasks might result in
musculoskeletal complaints in this population. Musculoskeletal complaints are
an important cause of disability and sick leave and possibly cause extra
difficulty for individuals with ULRD, ULA or BPI to participate in society.
Current international research shows higher rates of musculoskeletal complaints
in people with ULA, compared to the general population. In order to diminish
the rate of musculoskeletal complaints in this population good assessment of
functional and work capacity is necessary. Current Functional Capacity
Evaluations (FCEs) are frequently used in rehabilitation medicine, but are
developed for use in two-handed people. We wish to develop an FCE which can be
used to assess functional capacity in one-handed individuals, based on physical
demand and compensatory movements. In this study we examine physical demand
when executing FCE tests by measuring muscle tension in the back, neck and
shoulder, joint movements of the shoulder, elbow and wrist and heart rate.
Furthermore, we wish to describe compensatory movements.

The main objective of our research is to develop an FCE for use in one-handed
individuals. The main objective of this part of the study is to gain
descriptive data on muscle tension of the back, neck and shoulder, joint
movements of the shoulder, elbow and wrist, heart rate and compensatory
movements in order to develop this FCE.

This is an observational study.
We selected five Functional Capacity Evaluation (FCE) tests. Participants will
have to perform each test two to four times, depending on the group they're in.

The five tests are:
- Overhead lifting
- Overhead working
- Repetitive reaching
- Hand grip strength
- Finger dexterity

During the tests the following measurements are performed:
- Muscle tension of the muscles of the back, neck and shoulders (using surface
electromyography (SEMG))
- Joint movements of the shoulders, elbows and wrists (using Xsens, a motion
analysis system)
- Heart rate (using a heart rate monitor)
Furthermore, videos are made, in order to analyse compensatory movements.

Each group has to perform the test 2 to 4 times:
Participants with ULRD or ULA:
- With the unaffected hand and a prosthesis on the affected side
- With the unaffected hand, without prosthesis on the affected side, but with
the stump
- With the unaffected hand, but without prosthesis and stump (e.g. one-handed)

Participants with BPI:
- Two-handed, if they have any rest-function of the affected limb
- One-handed

Controls;
- Two-handed
- With a cast on the non-dominant hand, which mimics a below elbow prosthesis
(with grasp function)
- With a cast on the non-dominant hand, which mimics an above elbow prosthesis
- One-handed (non-dominant hand is placed in a sling)

The order of the rounds and the tests in each round will be randomly decided.

Individuals participating to the study will have to come to the clinic once,
for two hours, to perform FCE tests. FCEs are a safe and much used method to
assess capacity. None of the performed measurements are invasive or
pain-causing measurements. Participants might feel a bit of muscle soreness the
next day. We believe that the overall burden for participants is minimal and
the risks are negligible.