Donders Institute for Brain, Cognition and Behaviour
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Thesis defense Laura Peeters (Donders series 391)

23 October 2019
Promotor: prof. dr. A. Geurts, prof.dr. J. van Dieën (Vrije Universiteit Amsterdam)
Co-promotors: dr. I. de Groot, dr. I. Kingma (Vrije Universiteit Amsterdam)
The trunk in neuromuscular disorders: A neglected part of the chain
Performing daily activities independently is becoming more difficult over time for patients with neuromuscular disorders, due to progressive muscle weakness. The trunk plays an indispensable role during seated activities as part of the kinematic chain and by providing a stable base. This thesis provides more insight in trunk function and the interaction between trunk, upper extremity and head movements when performing seated daily tasks in patients with neuromuscular disorders. Maximum muscle strength and range of motion were measured in 25 healthy children, 17 boys with Duchenne muscular dystrophy and 17 people with spinal muscular atrophy. Afterwards they performed several daily tasks, like reaching (and placing), drinking and displacement of a diner plate. 3D upper body movements and muscle activity were recorded simultaneously. Results showed that the contribution of individual trunk segments to the range of motion varied with movement direction and therefore also with the task performed. Boys with Duchenne muscular dystrophy showed increased trunk movement when performing tasks, while people with spinal muscular atrophy showed similar trunk movement compared to healthy controls. However, the muscle activity was greatly increased in both groups and the maximum muscle strength was decreased. Clinicians should take the increased load on trunk muscles into account when assessing function and interventions are needed to reduce the muscle load, like development of dynamic assistive devices. However, the (compensatory) trunk movements should not be restricted because this will likely lead to limitations in accomplishing daily tasks independently.