Clinical Biomechanics 19 (2004) 248–254

www.elsevier.com/locate/clinbiomech

Marker placement to describe the wrist movements during

activities of daily living in cyclical tasks
a,*
Alessio Murgia , Peter J. Kyberd a, Paul H. Chappell b, Colin M. Light b

a
School of Systems Engineering, Department of Cybernetics, University of Reading, Whiteknights, Reading RG6 6AY, UK
b
Department of Electronics and Computer Science, University of Southampton, Southampton, UK
Received 17 July 2003; accepted 26 November 2003

Abstract
Objective. To describe the wrist kinematics during movement through free range of motion and activities of daily living using a
cyclical task.
Design. The wrist angles were initially calculated in a calibration trial and then in two selected activities of daily living (jar
opening and carton pouring).
Background. Existing studies which describe the wrist movement do not address the specific application of daily activities.
Moreover, the data presented from subject to subject may differ simply because of the non-cyclical nature of the upper limbs
movements.
Methods. The coordinates of external markers attached to bone references on the forearm and dorsal side of the hand were
obtained using an optical motion capture system. The wrist angles were derived from free motion trials and successively calculated in
four healthy subjects for two specific cyclical daily activities (opening a jar and pouring from a carton).
Results. The free motions trial highlighted the interaction between the wrist angles. Both the jar opening and the carton pouring
activity showed a repetitive pattern for the three angles within the cycle length. In the jar-opening task, the standard deviation for
the whole population was 10.8
for flexion–extension, 5.3
for radial-ulnar deviation and 10.4
for pronation–supination. In the
carton-pouring task, the standard deviation for the whole population was 16.0
for flexion–extension, 3.4
for radial-ulnar deviation
and 10.7
for pronation–supination.
Conclusion. Wrist kinematics in healthy subjects can be successfully described by the rotations about the axes of marker-defined
coordinates systems during free range of motion and daily activities using cyclical tasks.

Relevance
This study explores the kinematics of the wrist during free motion and daily activities. The technique can be used by the clinician
to describe the upper limbs joint angles from a functional perspective.
 2003 Elsevier Ltd. All rights reserved.

Keywords: Upper limbs kinematics; Wrist angles; Euler angles; Activities of daily living

1. Introduction ment of the wrist and elbow during in vitro tests. The
invasive nature of the measurements, requiring bone
A complete description of the wrist kinematics is implanted markers and Roentgen photogrammetry,
particularly useful when observing the wrist when it makes it impossible to validate and difficult to apply the
performs daily activities rather than the use of range of models to real conditions.
motion (RoM) tests. The reason is that RoM does not The advances in motion capture systems and the use
always correlate well with the subject’s real hand func- of external markers coupled to larger capture volumes
tion (Light et al., 1999; Fowler and Nicol, 2001). and higher resolution make possible the measurement of
The kinematical models presented by Youm et al. representative activities, while at the same time reducing
(1978), Chao and Morrey (1978) described the move- the subject’s inconvenience and the invasiveness of the
tests. The approach to the study of upper kinematics
*
Corresponding author. using an optical motion capture system proposed by
E-mail address: [email protected] (A. Murgia). Light (2000a) and Rau et al. (2000) shows the importance
0268-0033/$ - see front matter  2003 Elsevier Ltd. All rights reserved.
doi:10.1016/j.clinbiomech.2003.11.012
 A. Murgia et al. / Clinical Biomechanics 19 (2004) 248–254 249

of cyclical actions in the study of upper limbs movements The hemispherical geometry, where the marker’s
in order to effectively compare kinematic parameters in centre is in contact with the skin, reduced the amount of
different subjects, and circumvent the complexity repre- angular error between the marker-to-marker centre
sented by the non-cyclical nature of these movements. direction and the real axis of the bone, as opposed to the
Finally, the validation of a coordinate system derived case where spherical markers are used. The small
from external markers is still object of debate due to the amount of space on the dorsal side of the hand and the
variations caused by skin movements. Several models desire to reduce measurements uncertainties led to the
destined to be used in such systems to describe the wrist selection of the hemispherical geometry, whereas marker
movements have been proposed although none ad- visibility led to the choice of 14 mm diameter markers on
dresses the specific application to activities of daily liv- the elbow.
ing (ADLs). A four cameras motion capture system (Vicon 512 ,
Small et al. (1996) used bone references to attach Vicon Motion Systems, Oxford) was used to capture the
external markers to the skin. The results derived from an spatial coordinates of the markers.
optical motion capture system for different hand pos- The capability of the system to describe the wrist
tures were cross-validated using radiography and good angles was assessed by asking a member of the selected
correlation was found between the two sets of data. group to perform a sequence of RUDEV, FE and PS
Schmidt et al. (1999) suggested an external marker movements (free motion trials). Results from RUDEV
configuration used in combination with an optical mo- were cross-validated using a polar graph (5
resolution),
tion capture system to describe the movements of the whereas a goniometer (1
resolution) was used to mea-
wrist joint based on the Euler angles. The markers were sure FE angles. During radial-ulnar deviation the sub-
used in arrays rather than being separately attached to ject was asked to cycle between a neutral position (0

specific bone references. The model was tested on rota- RUDEV) and a deviated angle, with the hand palm and
tions about the three individual axes of the wrist. the forearm in contact with the bench to reduce un-
Compensation in the pronation–supination rotation was wanted natural movements of the joint (FE and PS).
proposed to override the alteration due to the skin The cycle was repeated using two different angles for
movements. both radial (10
, 20
) and ulnar deviation (15
, 30
).
The model presented in these pages describes the Flexion and extension were both performed with the
kinematics of the wrist using the sequence of Euler an- wrist statically flexed at 40
and then extended at 50
.
gles: flexion–extension (FE), radial-ulnar deviation In the PS free movements, the subject pronated the
(RUDEV) and pronation–supination (PS). The model wrist and forearm cyclically between three positions:
was tested on free range of motion movements of the hand palm facing the bench, hand palm at 45
circa and
wrist and successively used to describe the joint angles hand palm perpendicular to the bench.
during two selected daily activities. A population of four subjects with healthy hand
function and dominant right hand, average age 31.5 (SD
6.6) years, was successively tested on two selected ADLs.
2. Methods Each subject was asked to repeat the action four times.
The dominant hand function of each individual was
2.1. Experimental method assessed using the ÔSouthampton Hand Assessment
Procedure’ functional hand test (SHAP, University of
Passive hemispherical retroreflective markers 6 mm in Southampton, 2000).
diameter were attached to the subject’s skin of the wrist The test was chosen for the repeatability of its tasks
and dorsal side of the dominant hand. Spherical mark- and for its standardized protocol, which introduce cyclic
ers 14 mm in diameter were used for the elbow’s skin movements in the assessment of upper limbs function.
surface. The markers were attached to anatomical The test consists of a series of six activities involving
landmarks found by palpation as indicated in Fig. 1. basic shapes manipulation followed by 14 activities of
daily living. The subject begins the experiment by
pressing a timer before starting each action and pressing
it down a second time after completing the task. The
objects are placed on the board on pre-fixed marks,
therefore their position relative to the subject’s does not
change between successive trials. Instructions on how to
perform the action are read to the subject at the begin-
ning of each trial. The test score is calculated on the
basis of the time spent to perform each single activity.
Each action, including pressing a timer before starting
Fig. 1. Wrist and elbow coordinate systems. and after finishing the task, is completed using the hand
250 A. Murgia et al. / Clinical Biomechanics 19 (2004) 248–254

under assessment. The final overall score is split into the axis pointing from the proximal end of the middle finger
six fundamental grips: spherical, tripod, power, lateral, metacarpophalangeal (MCP) joint to the wrist capitate
tip and extension. centre. The y-axis resulted from the cross product of the
The potential applications of the coordinate system vector pointing from the wrist capitate centre to the
to describe the movements of the wrist during different distal end of the index finger MCP joint and
x. The z-
activities were assessed on two selected activities of the axis was derived as the cross product of x and y. The two
SHAP test. coordinate systems are shown in Fig. 1.
The jar-opening task consisted in pressing the timer As a result, when the forearm was fully pronated and
on the bench before starting the task, picking up a jam- the wrist in a neutral position the magnitude of the three
jar with the non-dominant hand and undoing the lid (70 angles was 0
for flexion, 0
for radial deviation and 0

mm diameter) with the dominant hand. The lid and the for forearm pronation.
jar were then returned on the board on appropriate The rotation order used was FE, a about the Z-axis,
marked positions (Fig. 2). The jar closing torque was followed by RUDEV, b about the Y -axis and PS, c
fixed beforehand at 5 Nm, being this value suggested as about the X -axis. This sequence of rotation already
the average operating range for healthy subjects proposed by Small et al. (1992) to describe the MCP
(Department of Trade and Industry, 1999). The lid was joint and applied in that occasion to calibration exper-
completely unscrewed after a 45
turn. iments had the advantage of avoiding that the solution
The carton-pouring task consisted in pressing the of the rotation matrix degenerates (gimbal lock) since
timer before starting the task, picking up a carton (90 the radial-ulnar deviation, 2nd angle of the rotation
cm · 60 cm · 195 cm) filled with 200 ml of water with the sequence, did not exceed 90
.
dominant hand using an extension grip, pouring its The rotation matrix describing this sequence is
content into a jug, returning the carton back on the therefore defined as (Craig, 1989) (s ¼ sin, c ¼ cos):
appropriate marked area on the desk and stopping the 2 3
cacb casbsc
sacc casbcc þ sasc
timer (Light, 2000b).
R ¼ 4 sacb sasbsc þ cacc sasbcc
casc 5: ð1Þ

sb cbsc cbcc
2.2. Mathematical model
Given i, j, k the unit vectors of the distal coordinate
In order to describe the wrist movements, two system and I, J , K those of the proximal coordinate
Cartesian coordinate systems were defined on the basis system, the rotation matrix can also be reformulated as
of the 3D coordinates of the markers, under the the dot product of the unit vectors of the two systems:
assumption of rigid body kinematics. The ‘‘forearm’’ 2 3
iI jI kI
embedded coordinate system was defined as having the
R ¼ 4 i  J j  J k  J 5: ð2Þ
X -axis pointing from the mid-point between the radial
iK jK kK
and the ulnar styloid process and the mid-point between
the lateral epycondyles. The Y -axis was defined as the The proximal coordinate system can be linked to the
cross product of the vector pointing from the mid-point distal coordinate system through the expression:
between lateral and medial epycondyle to the lateral 2 3 2 3
I i
epycondyle (for the right arm) and X . The Z-axis was 4 J 5 ¼ R4 j 5: ð3Þ
defined as the cross product of X and Y . The wrist-
K k
embedded coordinate system was defined as having its x-
By comparing Eqs. (1) and (2) it is possible to obtain
the three rotations a, b, c.
The results were filtered using a third order Butter-
worth filter with a cutoff frequency of 10 Hz, appro-
priately chosen to deliver a signal distortion to noise
ratio equal to one (Winter, 1990).
The cyclical nature of the ADL tasks allowed the
collected angle data to be fit in a cycle, which was as-
sumed to start (0%) the moment the timer was pressed
the first time and to end (100%) when the timer was
pressed again after completing the action. In the free
motion trials no time was taken.
The standard deviation was calculated on each sub-
ject for each percentage point of the cycle and then
Fig. 2. Top view of the jar opening experiment, SHAP. Hand assessed: averaged between the cycles and then between the sub-
right. jects to express the variability within different subjects.
 A. Murgia et al. / Clinical Biomechanics 19 (2004) 248–254 251

The standard deviation over the whole population was Data from the FE trials also show that a certain
then calculated as the root square of the difference be- amount of RUDEV and PS accompanied wrist FE.
tween the total angle variance and the within-subject In the PS motions it is evident the step marking the
variance divided by the number of subjects (4). intermediate position between ‘‘hand palm facing
down’’ and ‘‘hand palm perpendicular to the desk’’, at
45
.
3. Results The average wrist angles form the ADLs trials ±1
point-by-point standard deviation, are shown in Fig. 4
Wrist angles from the free motion trials are illustrated against the cycle percentage. Data for each subject are
in Fig. 3a–d for UDEV, RDEV, flexion, extension and illustrated in Figs. 5 and 6 for jar-opening and carton-
PS, respectively. pouring, respectively.
The subject initially was asked to perform cyclical As Fig. 4-left shows, the wrist was initially flexed to
radial (by 10
and 20
) and then ulnar deviation (by 15
pick up the jar and then extended when the lid was
and 30
) back and to a neutral position. This trial was undone. This corresponded to about 50% of the cycle.
followed by static wrist flexion by 40
and then exten- The wrist was flexed again when the lid was put back on
sion by 50
. the table (60%), and then one more time (80%) before
Data from Fig. 3a and b show a nearly constant FE stopping the timer. The data in Fig. 4-left also show a
and PS during RUDEV movements as both wrist and wrist ulnar deviation at about 30% of the cycle by 15

forearm were constantly restrained in their movement when the jar was reached and a radial deviation (45%)
by the desk’s surface. However, it is evident that both by 20
to maximise the opening torque.
FE and PS are not zero while RUDEV occurs (cross- The forearm was initially pronated to reach the jar
talk). (30%), then supinated when the lid was undone (50%)

Fig. 3. Wrist angles from the free movements trials on one subject: (a) UDEV between 0
and 15
and then between 0
and 30
; (b) RDEV between 0

and 10
and then between 0
and 20
; (c) flexion at 40
; (d) extension at 50
; (e) PS between hand palm facing the bench (0
), at an intermediate
position and hand palm perpendicular to the bench (90
). Tested hand: right. Dominant hand: right. In this case the beginning and end of the cycle
have arbitrarily chosen.
252 A. Murgia et al. / Clinical Biomechanics 19 (2004) 248–254

Fig. 4. Left: Wrist angles from 16 trials on four subjects. Tested hand: right. Dominant hand: right. Event: opening a jar closed at 5 Nm torque.
Event sequence: (a) jar reached, (b) jar opened, (c) jar put back on the table. Right: wrist angles from 16 trials on four subjects. Tested hand: right.
Dominant hand: right. Event: pouring from a carton into a jug 200 ml of water.

Fig. 5. Wrist angles from 16 trials on four subjects. Tested hand: right. Dominant hand: right. Event: jar opening.

and finally pronated again when the lid was put back on In the carton-pouring ADL, the wrist was supinated,
the table. after pressing the timer, to grasp the lateral side of the
The pooled standard deviation within any subject was carton (7%), afterwards the wrist was gradually pro-
5.4
for FE, 3.7
for RUDEV and 6.8
for PS. The nated for the length of time it took to empty the carton
pooled standard deviation over the whole popula- fully. After the carton was emptied, it was returned to
tion was 10.8
for FE, 5.3
for RUDEV and 10.4
for the desk in a vertical position with supination of the
PS. wrist (93%).
 A. Murgia et al. / Clinical Biomechanics 19 (2004) 248–254 253

Fig. 6. Wrist angles from 16 trials on four subjects. Tested hand: right. Dominant hand: right. Event: pouring from a carton into a jug 200 ml of
water.

Table 1 position, and the real joint axes (Piazza and Cavanagh,
Individual subject SD for each ADL 2000) and to natural joint movement association be-
Jar-opening Carton-pouring tween the different axes of the joint.
FE RU PS FE RU PS The use of Euler angles to describe the wrist move-
DEV DEV ments is effective if the coordinate systems are chosen so
Subject 1 4.5 3.9 5.4 4.2 6.3 6.0 that the rotation about the second axis of the Euler se-
Subject 2 4.3 3.7 8.0 22.7 10.3 27.2 quence is less than 90
. This procedure avoids that the
Subject 3 5.6 3.6 7.9 5.9 5.5 7.9
solution of the rotation matrix, within the rigid body
Subject 4 6.8 3.1 5.5 8.2 5.6 4.9
kinematics assumption, degenerates.
The validity of the proposed coordinate systems and
the rotation order assumption was tested on calibration
The pooled standard deviation within any subject was movements first and applied on a selected ADL there-
12.6
for FE, 7.2
for RUDEV and 14.7
for PS. The after.
pooled standard deviation over the whole population The use of activities of daily living to investigate
was 16.0
for FE, 3.4
for RUDEV and 10.7
for PS. upper limbs kinematics provides a more detailed and
In addition, the pooled standard deviation of each real picture of the subject’s capabilities. In this type of
subject for the two ADLs is shown in Table 1. tasks functionality is predominant over range of motion
and the results are especially useful when the results can
be compared for different subjects.
4. Discussion In order to achieve this objective, the activity needs to
be cyclical, more explicitly it should have a common
The free movements trials suggested the presence of starting and finishing point and a common sequence of
cross-talk between the different wrist angles. This could events, dictated by a protocol to be followed. The results
be both due to misalignment between the axes of the from ADLs suggested that an angle pattern for the wrist
chosen coordinate system, as derived by the markers’ angles emerges if these criteria are met.
254 A. Murgia et al. / Clinical Biomechanics 19 (2004) 248–254

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