Membre supérieur (anatomie humaine)

Résumé

Chez l'homme et chez les bipèdes, les membres supérieurs (ou bras dans le langage courant) sont les deux membres reliés au tronc par le biais des épaules. Le membre supérieur est en relation directe avec la portion inférieure latérale du cou. Il est relié au tronc grâce à de nombreux muscles et grâce à l’articulation sternoclaviculaire. En se basant sur la répartition des articulations et sur la structure osseuse du membre supérieur, on peut alors le diviser en 4 parties : l’épaule, Le bras, l’avant-bras et la main. L’épaule relie le membre supérieur au tronc. Le bras est compris entre l’épaule et le coude, l’avant-bras entre le coude et le poignet et la main suit le prolongement du poignet. Terminologie Dans le langage courant le terme "bras" désigne le membre supérieur dans son ensemble comprenant l'épaule, l'aisselle, le bras (du point de vue anatomique), l'avant-bras et la main. En anatomie, on distingue également la partie libre du membre supérieur, également appel

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The shoulder provides mobility to the upper limb and is thus necessary for lots of activities. Consequently injuries in the shoulder joint affect the patient in his daily life. The study of shoulder pathologies is however difficult : each patient has his individual anatomy and his own lifestyle which have an impact on his shoulder biomechanical pattern. This is why patient specific shoulder models are necessary to explore precise and specific features of the patient’s shoulder joint. The goal of this project was to analyse the impact of individual anatomy on the shoulder muscle coordination. To do this, we built two patient specific musculoskeletal models. The first one was based on MRI scans of a male volunteer, the second one on MRI scans of a female volunteer. We observed both models to predict similar muscle force patterns and joint reaction forces. However, the models predicted variations in muscle force intensity, that were related to the anatomic changes.

2015

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The challenge in virtual human modeling is to achieve the representation of the main human characteristics with as much realism as possible. Such achievements would allow the simulation and/or analysis of many virtual situations involving humans. Simulation is especially useful to derive information from the models so as to predict and/or reproduce the behaviors that would be observed in real situations. Computer methods in visualization and simulation have thus great potential for advances in medicine. The processes of strength generation and motion coordination are some of these phenomena for which there is still much remaining to be understood. The human shoulder is also probably the articulation of the human body which deserves more than any other to be named "terra incognita". Investigations towards the biomechanical modeling and simulation of the human upper limb are therefore presented in this study. It includes thorough investigation into the musculoskeletal anatomy and biomechanics of the human upper limb, into the biomechanical constitutive modeling of muscles and soft tissues, and into the nonlinear continuum mechanics and numerical methods, especially the incremental finite element methods, necessary for their simulation. On this basis, a 3-D biomechanical musculoskeletal human upper limb model has been designed using the Visible Human Data provided by the U.S. National Library of Medicine, and applied to the dynamic musculoskeletal simulation of the human upper limb. This research has been achieved in the context of the EU ESPRIT Project CHARM, whose objective has been to develop a comprehensive human animation resource database and a set of software tools allowing the modeling of the human complex musculoskeletal system and the simulation of its dynamics, including the finite element simulation of soft tissue deformation and muscular contraction. An investigation towards the application of this knowledge for the realistic modeling and animation of the upper limb in computer animation is then presented. The anatomical and biomechanical modeling of the scapulo-thoracic constraint and the shoulder joint sinus cones are proposed and applied to the realistic animation, using inverse kinematics, of a virtual skeleton and an anatomic musculoskeletal body model.

EPFL1999

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Evaluation of the effects of the Arm Light Exoskeleton on movement execution and muscle activities: a pilot study on healthy subjects

Massimo Bergamasco, Martina Coscia, Silvestro Micera, Elvira Pirondini

Background: Exoskeletons for lower and upper extremities have been introduced in neurorehabilitation because they can guide the patient's limb following its anatomy, covering many degrees of freedom and most of its natural workspace, and allowing the control of the articular joints. The aims of this study were to evaluate the possible use of a novel exoskeleton, the Arm Light Exoskeleton (ALEx), for robot-aided neurorehabilitation and to investigate the effects of some rehabilitative strategies adopted in robot-assisted training. Methods: We studied movement execution and muscle activities of 16 upper limb muscles in six healthy subjects, focusing on end-effector and joint kinematics, muscle synergies, and spinal maps. The subjects performed three dimensional point-to-point reaching movements, without and with the exoskeleton in different assistive modalities and control strategies. Results: The results showed that ALEx supported the upper limb in all modalities and control strategies: it reduced the muscular activity of the shoulder's abductors and it increased the activity of the elbow flexors. The different assistive modalities favored kinematics and muscle coordination similar to natural movements, but the muscle activity during the movements assisted by the exoskeleton was reduced with respect to the movements actively performed by the subjects. Moreover, natural trajectories recorded from the movements actively performed by the subjects seemed to promote an activity of muscles and spinal circuitries more similar to the natural one. Conclusions: The preliminary analysis on healthy subjects supported the use of ALEx for post-stroke upper limb robotic assisted rehabilitation, and it provided clues on the effects of different rehabilitative strategies on movement and muscle coordination.

Biomed Central Ltd2016

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