Summary

The manipulation ability of the hand is essential for the development of activities of daily living (ADL), as reflected by the WHO that establishes the ability to carry out ADL as the main factor to classify the degree of disability. But this capacity is compromised by different pathologies or injuries, whose incidence is increasing in a population with an increasing life expectancy. The kinematics of the hand plays an important role in this ability, but the methods currently used for the functional assessment do not contemplate the kinematic analysis of the hand during the performance of ADL. Some methods of functional evaluation contemplate the capacity to perform these activities, but in a qualitative (and subjective) way through questionnaires. The evaluation of the kinematics in the assessment of the functionality is usually reduced to measuring the maximum ranges of mobility of the joints.

The project is based on the results obtained by the research team in a previous research project in which the healthy hand kinematics was experimentally characterized in a representative set of ADL, selected from the International Classification of Functioning, Disability and Health (ICF), of the WHO. This characterization was carried out at different levels: (i) The functional mobility ranges were obtained (those necessary to carry out the selected ADLs); (ii) The patterns of kinematic coordination (synergies) used by the healthy hand to develop the ADLs were identified, and it was quantified how the healthy hand uses each of these synergies to carry out each activity; (iii) The relevance for the personal autonomy of the different types of grasp used in ADL was quantified.

The purpose of this project is to develop tools for clinical use, based on the kinematic characterization of the hand, that are easy to apply and that provide a more objective quantification of the functional alterations during the performance of ADL. The specific objectives can be summarized as follows: 1) To search for kinematic parameters as indicators of loss of functionality through the experimental kinematic characterization of pathological hands using dimensional reduction techniques. 2) To improve the current functional kinematics assessment tools and / or to propose new tools based on the identified kinematic parameters, and on the results of relevance of the grasps for personal autonomy, and functional mobility ranges. These tools would be useful for the assessment of disability, for the establishment of rehabilitative strategies and even as an aid to select clinical criteria of surgical intervention.