Minimum measured-input models for the assessment of motor ability

The problem of assessing the physical functional limitation of a given individual and establishing the relationship between impairment/s and disability using a biomechanical approach is addressed. This endeavour was pursued with reference to the locomotor system and in order to address the following specific clinical issues: prognosis, eligibility for health services, measure of the outcome of a therapy, and therapeutic programming. A thorough biomechanical analysis of selected motor tasks would be effective but awkward to apply for subject-specific evaluation in clinical practice by reason of the complexity of both instrumentation and experimental protocols. In addition, as illustrated in the paper, the adequacy of the accuracy with which this type of analysis provides relevant information may be argued. Therefore, different methods were devised in the attempt to join objectivity with field applicability. These entailed the measurement of a minimum number of biomechanical variables during the execution of the selected motor task and these quantities were acquired using a, low cost experimental apparatus least perceivable to the test subject, that is a dynamometric plate. However, since data thus obtained do not necessarily lend themselves to straightforward interpretation in terms of function assessment, models of the musculo-skeletal system that embodied the invariant aspects of both the modelled system and the specific motor task were devised. Using such "minimum measured-input models", physiology-related, and thus easier to interpret, information was obtained. Two different sets of mathematical models are presented: one deals with the lowest level of detail and normally aims at assessing a global physical performance score, the other discloses joint function and segmental mechanics and therefore contributes to establishing 4 relationship between impairment and disability. The validation of these models, carried out in the laboratory, has shown that they possess a potential for application in clinical practice. (C) 2002 Elsevier Science Ltd. All rights reserved.