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Sample records for bones of upper extremity

  1. Ergonomic task reduction prevents bone osteopenia in a rat model of upper extremity overuse.

    Science.gov (United States)

    Barbe, Mary F; Jain, Nisha X; Massicotte, Vicky S; Popoff, Steven N; Barr-Gillespie, Ann E

    2015-01-01

    We evaluated the effectiveness of ergonomic workload reduction of switching rats from a high repetition high force (HRHF) lever pulling task to a reduced force and reach rate task for preventing task-induced osteopenic changes in distal forelimb bones. Distal radius and ulna trabecular structure was examined in young adult rats performing one of three handle-pulling tasks for 12 wk: (1) HRHF, (2) low repetition low force (LRLF); or (3) HRHF for 4 wk and than LRLF thereafter (HRHF-to-LRLF). Results were compared to age-matched controls rats. Distal forelimb bones of 12-wk HRHF rats showed increased trabecular resorption and decreased volume, as control rats. HRHF-to-LRLF rats had similar trabecular bone quality as control rats; and decreased bone resorption (decreased trabecular bone volume and serum CTX1), increased bone formation (increased mineral apposition, bone formation rate, and serum osteocalcin), and decreased osteoclasts and inflammatory cytokines, than HRHF rats. Thus, an ergonomic intervention of HRHF-to-LRLF prevented loss of trabecular bone volume occurring with prolonged performance of a repetitive upper extremity task. These findings support the idea of reduced workload as an effective approach to management of work-related musculoskeletal disorders, and begin to define reach rate and load level boundaries for such interventions.

  2. Bone multicentric epithelioid hemangioendothelioma of the lower and upper extremities with pulmonary metastases: A case report

    Science.gov (United States)

    ZHANG, HUA; FU, YANBIAO; YE, ZHAOMING

    2015-01-01

    The present study reports a rare case of bone multicentric epithelioid hemangioendothelioma (EH) involving the upper and lower extremities simultaneously, with visceral involvement of the lung. Osteolytic lesions were first identified in the right distal femur and proximal tibia. Slight increased radionuclide uptake was observed in the right shoulder joint on bone scintigraphy, however, this was ignored, as no clinical symptoms were present. The patient was initially misdiagnosed with multifocal chondroblastoma, and an extra-articular curettage of lesions was performed in the proximal tibia and medial femoral condyle, which was filled with bone cement. The histopathological diagnosis was corrected post-operatively following immunohistochemical analysis, which indicated EH, and subsequently, an amputation of the right leg at thigh level was performed. In addition, multiple lytic lesions in the right shoulder joint and pulmonary metastases were identified on whole-body radiological examination. Radiotherapy was administered to the right shoulder joint, however, the patient refused chemotherapy or further surgery. At 15 months after the initial surgery, the patient currently remains alive. This case indicates that an improved understanding with regard to the clinical features of this disease may prevent misdiagnosis and improve EH treatment. PMID:26137035

  3. Current management of the mangled upper extremity.

    Science.gov (United States)

    Bumbasirevic, Marko; Stevanovic, Milan; Lesic, Aleksandar; Atkinson, Henry D E

    2012-11-01

    Mangled describes an injury caused by cutting, tearing, or crushing, which leads to the limb becoming unrecognizable; in essence, there are two treatment options for mangled upper extremities, amputation and salvage reconstruction. With advances in our understanding of human physiology and basic science, and with the development of new fixation devices, modern microsurgical techniques and the possibility of different types of bony and soft tissue reconstruction, the clinical and functional outcomes are often good, and certainly preferable to those of contemporary prosthetics. Early or even immediate (emergency) complete upper extremity reconstruction appears to give better results than delayed or late reconstruction and should be the treatment of choice where possible. Before any reconstruction is attempted, injuries to other organs must be excluded. Each step in the assessment and treatment of a mangled extremity is of utmost importance. These include radical tissue debridement, prophylactic antibiotics, copious irrigation with a lavage system, stable bone fixation, revascularization, nerve repair, and soft tissue coverage. Well-planned and early rehabilitation leads to a better functional outcome. Despite the use of scoring systems to help guide decisions and predict outcomes, the decision to reconstruct or to amputate still ultimately lies with the surgical judgment and experience of the treating surgeon.

  4. Replantation of upper extremity, hand and digits.

    Science.gov (United States)

    Bumbasirević, Marko Z; Vucković, Cedo D; Vucetić, Cedomir; Manojlović, Radovan; Andjelkovic, Sladjana Z; Palibrk, Tomislav D; Milutinović, Suzana M; Raspopović, Emilija Dubljanin

    2013-01-01

    Replantation is defined as reattachment of the part that has been completely amputated and there is no connection between the severed part and the patient. In Boston in 1962 Malt successfully replanted a completely amputated arm of a 12-year-old boy. Komatsu and Tamai reported the first successful replantation of an amputated digit by microvascular technique. There are no strict indications and contraindications for replantation. It's on surgeon to explain to the patient the chances of success of viability, expected function, length of operation, hospitalization and long rehabilitation protocol. Survival and useful function in replantation of upper extremity amputations is questionable. Success depends on microvascular anastomoses, but the final function is related with tendon, nerve, bone and joint repair.

  5. Intra-arterial Autologous Bone Marrow Cell Transplantation in a Patient with Upper-extremity Critical Limb Ischemia

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    Madaric, Juraj, E-mail: jurmad@hotmail.com [National Institute of Cardiovascular Diseases (NUSCH) and Slovak Medical University, Department of Cardiology and Angiology (Slovakia); Klepanec, Andrej [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia); Mistrik, Martin [Clinic of Hematology and Transfusiology, Faculty Hospital (Slovakia); Altaner, Cestmir [Slovak Academy of Science, Institute of Experimental Oncology (Slovakia); Vulev, Ivan [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia)

    2013-04-15

    Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

  6. Sex determination using discriminant analysis of upper and lower extremity bones: New approach using the volume and surface area of digital model.

    Science.gov (United States)

    Lee, U-Young; Kim, In-Beom; Kwak, Dai-Soon

    2015-08-01

    This study used 110 CT images taken from donated Korean cadavers to create 3-D models of the following upper and lower limb bones: the clavicle, scapula, humerus, radius, ulna, hip bone (os coxa), femur, patella (knee cap), tibia, talus, and calcaneus. In addition, the bone volume and surface area were calculated to determine sex differences using discriminant analysis. Significant sex differences were found in all bones with respect to volume and surface area (phip bone>tibia>humerus>scapula), although the order of surface area was different. The largest surface area in men was the femur and in women was the hip bone (psex determination (94%). When using the surface area of multiple bones, the maximum accuracy (99.4%) was achieved. The equation was as follows: (discriminant equation of surface area; femalesex determination.

  7. Current management of the mangled upper extremity

    OpenAIRE

    Bumbasirevic, Marko; Stevanovic, Milan; Lesic, Aleksandar; Atkinson, Henry D. E.

    2012-01-01

    Mangled describes an injury caused by cutting, tearing, or crushing, which leads to the limb becoming unrecognizable; in essence, there are two treatment options for mangled upper extremities, amputation and salvage reconstruction. With advances in our understanding of human physiology and basic science, and with the development of new fixation devices, modern microsurgical techniques and the possibility of different types of bony and soft tissue reconstruction, the clinical and functional ou...

  8. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    to the condition. Malignancy and therapeutic interventions are major risk factors for the secondary deep vein thrombosis in combination with the patient's characteristics, comorbidities and prior history of deep vein thrombosis. Complications: recurrent deep venous thrombosis, pulmonary embolism and Post......Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget-Schroetter syndrome) or secondary to an underlying cause. Primary and secondary UEDVT differs in long-term sequelae and mortality. This review...... will focus on the clinical presentation, risk factors, diagnosis, and treatment strategies of UEDVT. In the period from January to October 2012 an electronic literature search was performed in the PubMed/MEDLINE database, and 27 publications were included. Clinical presentation: swelling, pain and functional...

  9. Reliability of the mangled extremity severity score in combat-related upper and lower extremity injuries

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    Tolga Ege

    2015-01-01

    Full Text Available Background: Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS. However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the environmental circumstance. The purpose of the retrospective study was to evaluate the extent of extremity injuries due to ballistic missiles and to detect the reliability of mangled extremity severity score (MESS in both upper and lower extremities. Materials and Methods: Between 2004 and 2014, 139 Gustillo Anderson Type III open fractures of both the upper and lower extremities were enrolled in the study. Data for patient age, fire arm type, transporting time from the field to the hospital (and the method, injury severity scores, MESS scores, fracture types, amputation levels, bone fixation methods and postoperative infections and complications retrieved from the two level-2 trauma center's data base. Sensitivity, specificity, positive and negative predictive values of the MESS were calculated to detect the ability in deciding amputation in the mangled limb. Results: Amputation was performed in 39 extremities and limb salvage attempted in 100 extremities. The mean followup time was 14.6 months (range 6–32 months. In the amputated group, the mean MESS scores for upper and lower extremity were 8.8 (range 6–11 and 9.24 (range 6–11, respectively. In the limb salvage group, the mean MESS scores for upper and lower extremities were 5.29 (range 4–7 and 5.19 (range 3–8, respectively. Sensitivity of MESS in upper and lower extremities were calculated as 80% and 79.4% and positive predictive values detected as 55.55% and 83.3%, respectively. Specificity of MESS

  10. Current perspective of venous thrombosis in the upper extremity

    OpenAIRE

    Flinterman, L.E.; Meer, van der, D; Rosendaal, F.R.; Doggen, C. J. M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous thrombosis. In this review an overview of the different risk factors, possible treatments and the complications for patients with a venous thrombosis of the upper extremity is given

  11. Current perspective of venous thrombosis in the upper extremity

    NARCIS (Netherlands)

    Flinterman, L.E.; Meer, van der F.J.M.; Rosendaal, F.R.; Doggen, C.J.M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous

  12. Congenital monomelic muscular hypertrophy of the upper extremity.

    NARCIS (Netherlands)

    Gilhuis, H.J.; Zophel, O.T.; Lammens, M.M.Y.; Zwarts, M.J.

    2009-01-01

    Pathological muscular hypertrophy results from either muscular or neurogenic damage. Rarely, it is caused by a congenital malformation consisting of a unilateral muscular hyperplasia of the upper extremity. We report on a young woman with an enlargement of the right upper extremity. Electromyography

  13. [Gender determination based on osteometric characteristics of the upper and lower extremities by discriminant analysis].

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    Zviagin, V N; Sineva, I M

    2007-01-01

    The authors studied the osteological collection of the Chair of Antropology of the Moscow State University. The results of measurement of length of long tubular bones and articular parts of scapula and pelvis were statistically treated. The complex of discriminant models calculated by the Fisher's method is recommended for the sex identification. The diagnostic accuracy is 74 - 83.5% (separated bones) and 85.7 - 95.2% (complex of bones of upper and lower extremities).

  14. Characterisation and Outcomes of Upper Extremity Amputations

    Science.gov (United States)

    2014-06-01

    www.warms.vba.va.gov/bookc.html [accessed 01.10.10]. [14] Biddiss EA, Chau TT. Upper limb prosthesis use and abandonment: a survey of the last 25 years...combat injured patient. Foot Ankle Clin 2010;15(1):157–74. [22] Harvey ZT, Loomis GA, Mitsch S, Murphy IC, Griffin SC, Potter BK, et al. Advanced

  15. A Case Report on Upper Extremity Pain of Cardiac Origin

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    Turgay Altınbilek

    2016-08-01

    Full Text Available Upper extremity pain can originate from the musculoskeletal system, or be a reflection of problems originating from various organs. Therefore, it is highly important to perform a detailed clinical evaluation on patients during differential diagnosis. In this case report, we present a 61 year-old male patient who was admitted with pain in both upper extremities and the upper back that presumed to be of cardiac origin following our clinical evaluations. The patient was referred to the cardiology department, where he was diagnosed with coronary heart disease. The patient’s complaints of pain were fully resolved through the application of an intracoronary stent.

  16. Application of RFID technology-upper extremity rehabilitation training.

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    Chen, Chih-Chen; Chen, Yu-Luen; Chen, Shih-Ching

    2016-01-01

    [Purpose] Upper extremity rehabilitation after an injury is very important. This study proposes radio frequency identification (RFID) technology to improve and enhance the effectiveness of the upper extremity rehabilitation. [Subjects and Methods] People use their upper extremities to conduct daily activities. When recovering from injuries, many patients neglect the importance of rehabilitation, which results in degraded function. This study recorded the training process using the traditional rehabilitation hand gliding cart with a RFID reader, RFID tags in the panel, and a servo host computer. [Results] Clinical evidence, time taken to achieve a full score, counts of missing the specified spots, and Brunnstrom stage of aided recovery, the proximal part of the upper extremity show that the RFID-based upper extremity training significantly and reduce negative impacts of the disability in daily life and activities. [Conclusion] This study combined a hand-gliding cart with an RFID reader, and when patients moved the cart, the movement could be observed via the activated RFID tags. The training data was collected and quantified for a better understanding of the recovery status of the patients. Each of the participating patients made progress as expected.

  17. Nerve Injuries of the Upper Extremity

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    ... nerves do both of these things. Injury to nerves that carry motor signals causes some amount of weakness. Pain : This is frequently a symptom after nerve injury. The pain present after a nerve injury ...

  18. Radiographic assessment of congenital malformations of the upper extremity

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    Winfeld, Matthew J. [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, Musculoskeletal Division, Penn Medicine University City, Philadelphia, PA (United States); Otero, Hansel [Children' s National Medical Center, Department of Radiology, Washington, DC (United States)

    2016-09-15

    Congenital and developmental malformations of the upper extremity are uncommon and their diagnosis can challenge radiologists. Many complex classification systems exist, the latest of which accounts for the complex embryology and pathogenetic mechanisms that govern the formation of these anomalies. Using appropriate descriptors allows for more specific diagnosis and improved consultation with referring pediatricians and surgeons, helping to guide medical and surgical interventions and, if indicated, further investigation for associated abnormalities and underlying syndromes. We review the imaging characteristics of upper limb malformations to help pediatric radiologists better understand the classification and workup necessary in these cases. (orig.)

  19. Upper extremity amputations and prosthetics.

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    Ovadia, Steven A; Askari, Morad

    2015-02-01

    Upper extremity amputations are most frequently indicated by severe traumatic injuries. The location of the injury will determine the level of amputation. Preservation of extremity length is often a goal. The amputation site will have important implications on the functional status of the patient and options for prosthetic reconstruction. Advances in amputation techniques and prosthetic reconstructions promote improved quality of life. In this article, the authors review the principles of upper extremity amputation, including techniques, amputation sites, and prosthetic reconstructions.

  20. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

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    Tapar, Hakan; SÜREN, Mustafa; Kaya, Ziya; Arıcı, Semih; Karaman, Serkan; Kahveci, Mürsel

    2012-01-01

    Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to...

  1. Modelling and control of an upper extremity exoskeleton for rehabilitation

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    Taha, Zahari; Majeed, Anwar P. P. Abdul; Tze, Mohd Yashim Wong Paul; Abdo Hashem, Mohammed; Mohd Khairuddin, Ismail; Azraai Mohd Razman, Mohd

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton for rehabilitation. The Lagrangian formulation was employed to obtain the dynamic modelling of both the anthropometric based human upper limb as well as the exoskeleton that comprises of the upper arm and the forearm. A proportional-derivative (PD) architecture is employed to investigate its efficacy performing a joint task trajectory tracking in performing flexion/extension on the elbow joint as well as the forward adduction/abduction on the shoulder joint. An active force control (AFC) algorithm is also incorporated into the aforementioned controller to examine its effectiveness in compensating disturbances. It was found from the study that the AFC-PD performed well against the disturbances introduced into the system without compromising its tracking performances as compared to the conventional PD control architecture.

  2. The effect of upper extremity weight bearing on upper extremity function in children with hemiplegic type of cerebral palsy

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    P. Jayaraman

    2010-02-01

    Full Text Available The main objective of this study was to quantify the effects ofweight bearing on upper limb function in children with hemiplegic cerebralpalsy. This study also sought to monitor the change in spasticity immediatelyfollowing weight bearing exercises. A  quasi-experimental, one group pre-test,post-test design was used. Eleven children with hemiplegic type of cerebral palsyfrom a special school in KwaZulu Natal participated after fully informed consentof the caretaking guardian. The intervention consisted of a standardized programof weight bearing. The Melbourne A ssessment of Upper Extremity function wasused to quantify upper extremity function of reach, grasp and manipulation and the modified A shworth grading of spasticity was used to grade and monitor spasticity. The data was analysed using the Wilcoxon signed rank test.  A  significant decrease in spasticity during elbow extension (p= 0,004, wrist flexion (p=0,026 and extension (p=0,004was noted. Statistically significant improvement in function, reach (p=0, 00, grasp (p=0, 02 manipulation (p=0, 05and overall quality of function (p= 0,003 was also found. A n overall significant effect of weight bearing exercises onupper extremity function was noted providing evidence for practice.

  3. Electrodiagnosis of brachial plexopathies and proximal upper extremity neuropathies.

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    Simmons, Zachary

    2013-02-01

    This article describes the normal anatomy of the brachial plexus and its major terminal branches, as well as the major causes and clinical presentations of lesions of these structures. An approach to electrodiagnosis of brachial plexopathies and proximal upper extremity neuropathies is provided, with an emphasis on those nerve conduction studies and portions of the needle examination, which permit localization of lesions to specific trunks, cords, and terminal branches. The importance of specific sensory nerve conduction studies for differentiating plexopathies from radiculopathies and mononeuropathies is emphasized.

  4. Functional and Clinical Outcomes of Upper Extremity Amputation.

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    Fitzgibbons, Peter; Medvedev, Gleb

    2015-12-01

    Upper extremity amputation is an uncommon but often necessary procedure. It can be required as a result of trauma, infection, or malignancy. Amputation is a life-changing procedure. Careful planning for it must not only include the level of amputation and assurance of durable soft-tissue coverage of the amputation site, but it must also consider patients' goals and occupations, as well as social factors affecting amputees. The choice of prosthesis is an individual matter, but new technology permits lighter and more multifunctional prostheses. Targeted muscle reinnervation can be used to achieve improved myoelectric signaling and possibly decrease limb pain following amputation. Rehabilitation is crucial to achieving favorable results.

  5. Mangled extremity severity score: an accurate guide to treatment of the severely injured upper extremity.

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    Slauterbeck, J R; Britton, C; Moneim, M S; Clevenger, F W

    1994-08-01

    The mangled extremity severity score (MESS) is a scoring system that can be applied to mangled extremities and help one determine which mangled limbs will eventually come to amputation. The MESS is a graduated grading system based on skeletal and soft tissue injury, shock, ischemia, and age. The records of 37 patients having sustained 43 open fractures or mangled upper extremity injuries, seen and treated at the University of New Mexico's Regional Trauma Center between April 1987 and September 1990, have been reviewed. All nine extremity injuries with a MESS of greater than or equal to seven were amputated, and 34 of 34 with a MESS of less than seven were salvaged. Nine Grade IIIC and six mangled extremities were identified in our study. Five of these Grade IIIC and four of the mangled extremities with a MESS of greater than or equal to seven were amputated. All Grade IIIC or mangled extremities with a MESS of less than seven were salvaged. In conclusion, the MESS is an early and accurate predictor for identifying the extremities that may be best treated by amputation.

  6. [Upper extremity arterial diseases].

    Science.gov (United States)

    Becker, F

    2007-02-01

    Compared to lower limb arterial diseases, upper limb arterial diseases look rare, heterogeneous with various etiologies and a rather vague clinical picture, but with a negligible risk of amputation. Almost all types of arterial diseases can be present in the upper limb, but the anatomical and hemodynamic conditions particular to the upper limb often confuse the issue. Thus, atherosclerosis affects mainly the subclavian artery in its proximal segment where the potential of collateral pathway is high making the symptomatic forms not very frequent whereas the prevalence of subclavian artery stenosis or occlusion is relatively high. The clinical examination and the etiologies are discussed according to the clinical, anatomical and hemodynamic context.

  7. Complete 3D kinematics of upper extremity functional tasks.

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    van Andel, Carolien J; Wolterbeek, Nienke; Doorenbosch, Caroline A M; Veeger, DirkJan H E J; Harlaar, Jaap

    2008-01-01

    Upper extremity (UX) movement analysis by means of 3D kinematics has the potential to become an important clinical evaluation method. However, no standardized protocol for clinical application has yet been developed, that includes the whole upper limb. Standardization problems include the lack of a single representative function, the wide range of motion of joints and the complexity of the anatomical structures. A useful protocol would focus on the functional status of the arm and particularly the orientation of the hand. The aim of this work was to develop a standardized measurement method for unconstrained movement analysis of the UX that includes hand orientation, for a set of functional tasks for the UX and obtain normative values. Ten healthy subjects performed four representative activities of daily living (ADL). In addition, six standard active range of motion (ROM) tasks were executed. Joint angles of the wrist, elbow, shoulder and scapula were analyzed throughout each ADL task and minimum/maximum angles were determined from the ROM tasks. Characteristic trajectories were found for the ADL tasks, standard deviations were generally small and ROM results were consistent with the literature. The results of this study could form the normative basis for the development of a 'UX analysis report' equivalent to the 'gait analysis report' and would allow for future comparisons with pediatric and/or pathologic movement patterns.

  8. Automated assessment of upper extremity movement impairment due to stroke.

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    Erienne V Olesh

    Full Text Available Current diagnosis and treatment of movement impairment post-stroke is based on the subjective assessment of select movements by a trained clinical specialist. However, modern low-cost motion capture technology allows for the development of automated quantitative assessment of motor impairment. Such outcome measures are crucial for advancing post-stroke treatment methods. We sought to develop an automated method of measuring the quality of movement in clinically-relevant terms from low-cost motion capture. Unconstrained movements of upper extremity were performed by people with chronic hemiparesis and recorded by standard and low-cost motion capture systems. Quantitative scores derived from motion capture were compared to qualitative clinical scores produced by trained human raters. A strong linear relationship was found between qualitative scores and quantitative scores derived from both standard and low-cost motion capture. Performance of the automated scoring algorithm was matched by averaged qualitative scores of three human raters. We conclude that low-cost motion capture combined with an automated scoring algorithm is a feasible method to assess objectively upper-arm impairment post stroke. The application of this technology may not only reduce the cost of assessment of post-stroke movement impairment, but also promote the acceptance of objective impairment measures into routine medical practice.

  9. Automated assessment of upper extremity movement impairment due to stroke.

    Science.gov (United States)

    Olesh, Erienne V; Yakovenko, Sergiy; Gritsenko, Valeriya

    2014-01-01

    Current diagnosis and treatment of movement impairment post-stroke is based on the subjective assessment of select movements by a trained clinical specialist. However, modern low-cost motion capture technology allows for the development of automated quantitative assessment of motor impairment. Such outcome measures are crucial for advancing post-stroke treatment methods. We sought to develop an automated method of measuring the quality of movement in clinically-relevant terms from low-cost motion capture. Unconstrained movements of upper extremity were performed by people with chronic hemiparesis and recorded by standard and low-cost motion capture systems. Quantitative scores derived from motion capture were compared to qualitative clinical scores produced by trained human raters. A strong linear relationship was found between qualitative scores and quantitative scores derived from both standard and low-cost motion capture. Performance of the automated scoring algorithm was matched by averaged qualitative scores of three human raters. We conclude that low-cost motion capture combined with an automated scoring algorithm is a feasible method to assess objectively upper-arm impairment post stroke. The application of this technology may not only reduce the cost of assessment of post-stroke movement impairment, but also promote the acceptance of objective impairment measures into routine medical practice.

  10. ANAESTHESIA, POSTOPERATIVE ANALGESIA AND EARLY REHABILITATION FOR UPPER EXTREMITY BONE AND MAJOR JOINTS SURGERY

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    A. V. Kurnosov

    2011-01-01

    Full Text Available A new method was developed to perform prolonged brachial plexus block with almost 100% effectiveness. It was also shown in 44 patients to be 33 % safer for local complications and 11,3 % safer for general complications than common used supraclavicular Winnie block (42 patients in control group, received opiates and NSAID for post-operative analgesia. This new method of analgesia allows effective rehabilitation after elbow arthroplasty to be started on the first day after the surgery.

  11. Systematic review of the effectiveness of mirror therapy in upper extremity function

    NARCIS (Netherlands)

    Ezendam, Danielle; Bongers, Raoul M.; Jannink, Michiel J. A.

    2009-01-01

    Purpose. This review gives an overview of the current state of research regarding the effectiveness of mirror therapy in upper extremity function. Method. A systematic literature search was performed to identify studies concerning mirror therapy in upper extremity. The included journal articles were

  12. Technology improves upper extremity rehabilitation.

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    Kowalczewski, Jan; Prochazka, Arthur

    2011-01-01

    Stroke survivors with hemiparesis and spinal cord injury (SCI) survivors with tetraplegia find it difficult or impossible to perform many activities of daily life. There is growing evidence that intensive exercise therapy, especially when supplemented with functional electrical stimulation (FES), can improve upper extremity function, but delivering the treatment can be costly, particularly after recipients leave rehabilitation facilities. Recently, there has been a growing level of interest among researchers and healthcare policymakers to deliver upper extremity treatments to people in their homes using in-home teletherapy (IHT). The few studies that have been carried out so far have encountered a variety of logistical and technical problems, not least the difficulty of conducting properly controlled and blinded protocols that satisfy the requirements of high-level evidence-based research. In most cases, the equipment and communications technology were not designed for individuals with upper extremity disability. It is clear that exercise therapy combined with interventions such as FES, supervised over the Internet, will soon be adopted worldwide in one form or another. Therefore it is timely that researchers, clinicians, and healthcare planners interested in assessing IHT be aware of the pros and cons of the new technology and the factors involved in designing appropriate studies of it. It is crucial to understand the technical barriers, the role of telesupervisors, the motor improvements that participants can reasonably expect and the process of optimizing IHT-exercise therapy protocols to maximize the benefits of the emerging technology.

  13. A pilot study of myoelectrically controlled FES of upper extremity

    NARCIS (Netherlands)

    Thorsen, Rune; Spadone, Rafaella; Ferrarin, Maurizio

    2001-01-01

    Functional electrical stimulation (FES) of upper limbs can be used for the recovery of some hand functions on patients with CNS lesions. This study deals with the control of FES by means of myoelectrical activity detected from voluntarily activated paretic muscles. The specific aim of this paper is

  14. Motor Cortex Stimulation for the Treatment of Chronic Facial, Upper Extremity, and Throat Pain.

    Science.gov (United States)

    2016-08-29

    Trigeminal Neuralgia (Burchiel Type I); Trigeminal Neuralgia (Burchiel Type II); Trigeminal Neuropathic Pain; Trigeminal Deafferentation Pain; Complex Regional Pain Syndrome (Types I and II, Involving the Upper Extremity); Glossopharyngeal Neuralgia; Upper Extremity Pain Due to Deafferentation of the Cervical Spine; Central Pain Syndromes

  15. Analysis of upper-extremity performance in athletes and musicians.

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    An, K N; Bejjani, F J

    1990-08-01

    Injuries can result from direct or indirect trauma and overuse in sports and the performing arts. These injuries occur when the objective exceeds the physiologic tolerance. Biomechanics analysis enables the estimation of the capacities of the body as well as the loading environment encountered by the tendons, muscles, bones, and joints during various types of sports and musical activities.

  16. Longitudinal evaluation of upper extremity reachable workspace in ALS by Kinect sensor.

    Science.gov (United States)

    de Bie, Evan; Oskarsson, Bjorn; Joyce, Nanette C; Nicorici, Alina; Kurillo, Gregorij; Han, Jay J

    2017-02-01

    Our objective was to evaluate longitudinal changes in Microsoft Kinect measured upper extremity reachable workspace relative surface area (RSA) versus the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), ALSFRS-R upper extremity sub-scale and Forced Vital Capacity (FVC) in a cohort of patients diagnosed with amyotrophic lateral sclerosis (ALS). Ten patients diagnosed with ALS (ages 52-76 years, ALSFRS-R: 8-41 at entry) were tested using single 3D depth sensor, Microsoft Kinect, to measure reachable workspace RSA across five visits spanning one year. Changes in RSA, ALSFRS-R, ALSFRS-R upper extremity sub-scale, and FVC were assessed using a linear mixed model. Results showed that upper lateral quadrant RSA declined significantly in one year by approximately 19% (p <0.01) while all other quadrants and total RSA did not change significantly in this time-period. Simultaneously, ALSFRS-R upper extremity sub-scale worsened significantly by 25% (p <0.01). In conclusion, upper extremity reachable workspace RSA as a novel ALS outcome measure is capable of objectively quantifying declines in upper extremity ability over time in patients with ALS with more granularity than other common outcome measures. RSA may serve as a clinical endpoint for the evaluation of upper extremity targeted therapeutics.

  17. Advances in upper extremity prosthetics.

    Science.gov (United States)

    Zlotolow, Dan A; Kozin, Scott H

    2012-11-01

    Until recently, upper extremity prostheses had changed little since World War II. In 2006, the Defense Advanced Research Projects Agency responded to an increasing number of military amputees with the Revolutionizing Prosthetics program. The program has yielded several breakthroughs both in the engineering of new prosthetic arms and in the control of those arms. Direct brain-wave control of a limb with 22° of freedom may be within reach. In the meantime, advances such as individually powered digits have opened the door to multifunctional full and partial hand prostheses. Restoring sensation to the prosthetic limb remains a major challenge to full integration of the limb into a patient's self-image.

  18. Sleep Disturbance and Upper-Extremity Disability

    Directory of Open Access Journals (Sweden)

    Rinne Peters

    2016-01-01

    Full Text Available Background: Although upper-extremity disability correlates with psychosocial aspects of illness the association with sleep disturbance in upper extremity disability is less certain. To evaluate whether sleep disturbance is associated with upper-extremity disability among patients with upper extremity illness, accounting for sociodemographic, condition-related, and psychosocial factors. Methods: A cohort of 111 new or follow-up patients presenting to an urban academic hospital-based hand surgeon completed a sociodemographic survey and measures of sleep disturbance (PROMIS Sleep Disturbance, disability (PROMIS Upper-Extremity Physical Function, ineffective coping strategies (PROMIS Pain Interference, and depression (PROMIS Depression. Bivariate and multivariable linear regression modeling were performed. Results: Sleep disturbance correlated with disability (r=-0.38; P

  19. Reliability of the mangled extremity severity score in combat-related upper and lower extremity injuries

    OpenAIRE

    Tolga Ege; Aytekin Unlu; Huseyin Tas; Dogan Bek; Selim Turkan; Aytac Cetinkaya

    2015-01-01

    Background: Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS). However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the envi...

  20. Magnetic resonance angiographic assessment of upper extremity vessels prior to vascular access surgery: feasibility and accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Planken, Nils R. [Maastricht University Hospital, Department of Vascular Surgery, Maastricht (Netherlands); Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Tordoir, Jan H. [Maastricht University Hospital, Department of Vascular Surgery, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Duijm, Lucien E.; Bosch, Harrie C. van den [Catharina Hospital, Department of Radiology, Eindhoven (Netherlands); Sande, Frank M. van der; Kooman, Jeroen P. [Maastricht University Hospital, Department of Nephrology, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Haan, Michiel W. de; Leiner, Tim [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands)

    2008-01-15

    A contrast-enhanced magnetic resonance angiography (CE-MRA) protocol for selective imaging of the entire upper extremity arterial and venous tree in a single exam has been developed. Twenty-five end-stage renal disease (ESRD) patients underwent CE-MRA and duplex ultrasonography (DUS) of the upper extremity prior to hemodialysis vascular access creation. Accuracy of CE-MRA arterial and venous diameter measurements were compared with DUS and intraoperative (IO) diameter measurements, the standard of reference. Upper extremity vasculature depiction was feasible with CE-MRA. CE-MRA forearm and upper arm arterial diameters were 2.94 {+-} 0.67 mm and 4.05 {+-} 0.84 mm, respectively. DUS arterial diameters were 2.80 {+-} 0.48 mm and 4.38 {+-} 1.24 mm; IO diameters were 3.00 {+-} 0.35 mm and 3.55 {+-} 0.51 mm. Forearm arterial diameters were accurately determined with both techniques. Both techniques overestimated upper arm arterial diameters significantly. Venous diameters were accurately determined with CE-MRA but not with DUS (forearm: CE-MRA: 2.64 {+-} 0.61 mm; DUS: 2.50 {+-} 0.44 mm, and IO: 3.40 {+-} 0.22 mm; upper arm: CE-MRA: 4.09 {+-} 0.71 mm; DUS: 3.02 {+-} 1.65 mm, and IO: 4.30 {+-} 0.78 mm). CE-MRA enables selective imaging of upper extremity vasculature in patients requiring hemodialysis access. Forearm arterial diameters can be assessed accurately by CE-MRA. Both CE-MRA and DUS slightly overestimate upper arm arterial diameters. In comparison to DUS, CE-MRA enables a more accurate determination of upper extremity venous diameters. (orig.)

  1. Updating upper extremity temporary prosthesis: thermoplastics.

    Science.gov (United States)

    Fletchall, S; Tran, T; Ungaro, V; Hickerson, W

    1992-01-01

    Since 1989 amputees with upper-extremity burns have been fitted with a temporary prosthesis fabricated from low-temperature thermoplastic. Before 1989 conventional temporary prostheses were fabricated with plaster. The use of the thermoplastic material has produced a lightweight, cost-effective, modular system. No patients exhibited skin breakdown with the thermoplastic material. It appears that thermoplastics may be the next major breakthrough in terms of a design for a temporary upper-extremity prosthesis.

  2. EFFECT OF MIRROR THERAPY ON HEMIPARETIC UPPER EXTREMITY IN SUBACUTE STROKE PATIENTS

    Directory of Open Access Journals (Sweden)

    Roshini Rajappan

    2015-12-01

    Full Text Available Background: Stroke is one of the most common causes for chronic disability. Only 5 to 20% of stroke survivors attain complete functional recovery of their affected upper extremity. The primary objective of this study was to investigate the effect of mirror therapy on hemiparetic upper extremity motor recovery and functions in patients with subacute stroke. Methods: A total of 30 participants were selected for the study. They were randomly assigned to Mirror Therapy Group (MTG and Sham Mirror Therapy Group (SMTG with fifteen participants in each group. All the participants equally took part in conventional stroke rehabilitation program 5 days a week for 4 weeks. In addition to the conventional stroke rehabilitation program, MTG participated in 30 minutes of mirror therapy and SMTG received 30 minutes of sham mirror therapy for the affected hemiparetic upper limb. The participants were measured for upper extremity motor recovery and functions by Fugl-Meyer Assessment (FMA-UE and Upper Extremity Functional Index (UEFI scales respectively. Results: Wilcoxon signed ranks test and Mann Whitney U test were used to statistically analyze the data. Spearman correlational technique was used to analyze the relationship between upper limb functions and motor recovery of hand. Based on Wilcoxon signed ranks test, the results were highly significant (p<0.05. On the basis of Mann Whitney U test, Mirror therapy group showed high significance (p<0.05 than sham mirror therapy group. The Spearman’s rho value was 0.65 which indicated moderate to maximum positive correlation between the two variables and the alpha level was set at 0.01. Conclusion: This study concludes that incorporating mirror therapy in subacute stroke rehabilitation program improves the hemiparetic upper extremity motor recovery and its functions and also motor recovery of hand can directly influence the upper limb functions.

  3. Effect of Upper Extremity Robot-Assisted Exercise on Spasticity in Stroke Patients

    Science.gov (United States)

    2016-01-01

    Objective To determine the efficacy of a stretching and strengthening exercise program using an upper extremity robot, as compared with a conventional occupational therapy program for upper extremity spasticity in stroke patients. Methods Subjects were randomly divided into a robot-assisted therapy (RT) group and a conventional rehabilitation therapy (CT) group. RT group patients received RT and CT once daily for 30 minutes each, 5 days a week, for 2 weeks. RT was performed using an upper-extremity robot (Neuro-X; Apsun Inc., Seoul, Korea), and CT was administered by occupational therapists. CT group patients received CT alone twice daily for 30 minutes, 5 days a week, for 2 weeks. Modified Ashworth Scale (MAS) was used to measure the spasticity of upper extremity. Manual muscle tests (MMT), Manual Function Tests (MFT), Brunnstrom stage, and the Korean version of Modified Barthel Index (K-MBI) were used to measure the strength and function of upper extremity. All measurements were obtained before and after 2-week treatment. Results The RT and CT groups included 22 subjects each. After treatment, both groups showed significantly lower MAS scores and significant improvement in the MMT, MFT, Brunnstrom stage, and K-MBI scores. Treatment effects showed no significant differences between the two groups. Conclusion RT showed similar treatment benefits on spasticity, as compared to CT. The study results suggested that RT could be a useful method for continuous, repeatable, and relatively accurate range of motion exercise in stroke patients with spasticity. PMID:28119825

  4. A rare disease in an atypical location - Kimura's Disease of the upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Alan Cheuk Si; Lau, Vince Wing Hang [Queen Mary Hospital, Department of Radiology, Hong Kong (China); Au Yeung, Rex Kwok Him [University of Hong Kong, Department of Pathology, Li Ka Shing Faculty of Medicine, Hong Kong (China)

    2015-12-15

    Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment. (orig.)

  5. Upper extremity neuro-rehabilitation through the use of power mobility.

    Science.gov (United States)

    Damiao, John; Kean, Danielle

    2016-01-01

    Power mobility is typically used as an accommodative form of assistive technology allowing individuals with impaired ambulation to remain mobile. While research has focused on the cognitive development and social benefits of power mobility for individuals with developmental disabilities, research is lacking on using this technology to rehabilitate physical dysfunction. Recent technology, such as robot-mediated neuro-rehabilitation, is proving effective in upper extremity rehabilitation, but lacks the movement feedback of power mobility. This article presents a case study of a client with cerebral palsy who experienced severe neural impairment following a motor vehicle accident. As a previous power mobility user, the client identified returning to using power mobility with the affected upper extremity as a key functional goal. This case study describes the series of steps that returned the client to independent mobility and increased upper extremity function.

  6. Planning of surgical treatment of upper extremity in patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    V. V. Umnov

    2013-01-01

    Full Text Available The purpose - to devise the algorithm of patient examination with spastic hand to determine what the variant of surgical treatment is indicated. The variant of surgical treatment and it's results are depend on the cause of upper extremity deformation. Materials and methods. This study is based on a survey of children with cerebral palsy with lesions of the upper extremity. The main criterion for the selection of patients was the presence of the combined lesion of the upper extremity, where the cause of dysfunction hands are not only fixed contractures, but primary tonic. Was to survey 47 patients with spastic forms of cerebral palsy with the defeat of the upper limb, but the study group included only 26 of them in the ages of 7 to 18 years (average 12,1, as having the clinical picture both types of contractures. We have developed and applied a system of examinations, modeling expected outcome of selective neurotomy motor nerves of the upper limb, which allows to estimate the possible result of such treatment, and clearly differentiate tonic and fixed contracture. Results and conclusions. Based on the results of study we supposed that, using diagnostic blockade motor nerve at the period of planning surgical treatment help us to create temporary reversible model of selective neurotomy motor nerve branches and identify the type of contracture, degree of manifestation and functional perspective.

  7. Brief Assessment of Motor Function: Content Validity and Reliability of the Upper Extremity Gross Motor Scale

    Science.gov (United States)

    Cintas, Holly Lea; Parks, Rebecca; Don, Sarah; Gerber, Lynn

    2011-01-01

    Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five BAMF ordinal scales designed for quick documentation of gross, fine, and oral motor skill levels. Designed to be independent of age and…

  8. Postcontraction hyperemia after electrical stimulation: potential utility in rehabilitation of patients with upper extremity paralysis.

    Science.gov (United States)

    Shibata, Nobusuke; Matsunaga, Toshiki; Kudo, Daisuke; Sasaki, Kana; Mizutani, Takashi; Sato, Mineyoshi; Chida, Satoaki; Hatakeyama, Kazutoshi; Watanabe, Motoyuki; Shimada, Yoichi

    2016-01-01

    The purpose of this study was to compare postcontraction hyperemia after electrical stimulation between patients with upper extremity paralysis caused by upper motor neuron diseases and healthy controls. Thirteen healthy controls and eleven patients with upper extremity paralysis were enrolled. The blood flow in the basilic vein was measured by ultrasound before the electrical stimulation of the biceps brachii muscle and 30 s after the stimulation. The stimulation was performed at 10 mA and at a frequency of 70 Hz for 20 s. The mean blood flow in the healthy control group and in upper extremity paralysis group before the electrical stimulation was 60 ± 20 mL/min (mean ± SD) and 48 ± 25 mL/min, respectively. After the stimulation, blood flow in both groups increased to 117 ± 23 mL/min and 81 ± 41 mL/min, respectively. We show that it is possible to measure postcontraction hyperemia using an ultrasound system. In addition, blood flow in both groups increased after the electrical stimulation because of postcontraction hyperemia. These findings suggest that evaluating post contraction hyperemia in patients with upper extremity paralysis can assess rehabilitation effects.

  9. Statin-induced focal myositis of the upper extremity. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, M., E-mail: wagner.radiologie@herzchirurgie.de [Department of Radiology, Herz- und Gefaessklinik GmbH, Salzburger Leite 1, D-97616 Bad Neustadt an der Saale (Germany); Muehldorfer-Fodor, M.; Prommersberger, K.J. [Department of Handsurgery, Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale (Germany); Schmitt, R. [Department of Radiology, Herz- und Gefaessklinik GmbH, Salzburger Leite 1, D-97616 Bad Neustadt an der Saale (Germany)

    2011-02-15

    Statins are widely used to lower increased cholesterol levels with the aim to prevent major cardiovascular events. However, they bare the risk of myotoxic side effects. We report on two patients with focal weakness and pain in the upper extremities. In both patients, abnormal MRI signal heights in the muscle groups involved were indicative of the final diagnosis of focal myositis during statin therapy.

  10. Solid variant of aneurysmal bone cist on the distal extremity of the radius in a child.

    Science.gov (United States)

    Ferreira, Adriano Jander; de Almeida Leitão, Sebastião; Rocha, Murilo Antônio; Nascimento, Valdênia das Graças; Lima, Giovanni Bessa Pereira; de Meneses, Antonio Carlos Oliveira

    2016-01-01

    The solid variant of aneurismal bone cysts (ABC) is considered rare. It occurs with greater frequency in pediatric patients and in the tibia, femur, pelvis and humerus. We present a case of a metaphyseal lytic lesion on the distal extremity of the radius in a child whose radiograph was requested after low-energy trauma. The hypothesis of a pathological bone fracture secondary to an aneurysmal bone cyst was suggested. After biopsy, the child underwent intralesional excision without bone grafting and the histopathological findings were compatible with the solid variant of aneurysmal bone cyst.

  11. Range of Motion of the Upper Extremity in a Healthy Pediatric Population: Introduction to Normative Data.

    Science.gov (United States)

    Da Paz, Stephanie Nunes; Stalder, Andreas; Berger, Steffen; Ziebarth, Kai

    2016-10-01

    Objective In the pediatric population traumatic injuries of the upper extremity are common. After therapy a decision has to be made if the mobility of the joint lies within a normal range. The purpose of this study was to give an introduction to normative data. We investigate if there is a significant difference in the range of motion (ROM) between male and female probands and furthermore, if an effect of the age can be detected. Methods We performed an institutional review board-approved study of healthy girls and boys aged between 2 and 16 years without any medical history of an upper extremity fracture. We investigated the active ROM of the elbow, wrist, metacarpophalangeal, and interphalangeal joints. Furthermore, age, handedness, weight, and height were recorded. A total of 171 adolescents with a mean age of 10.6 years were included and separated into four cohorts by age: 2 to 5, 6 to 10, 11 to 13, and 14 to 16 years. Results We found significant differences between the genders in the age group from 11 to 13 years for the flexion of the elbow, the pronation, the flexion of the interphalangeal joint of the thumb, as well as the flexion of the metacarpophalangeal joints of digitus II to V. Furthermore, a significant difference in the same joints except from the elbow flexion could be demonstrated between the genders. Conclusion Our study contributes normative data for upper extremity ROM in the pediatric population and presents a gender-related difference in certain joints. Clinical Relevance Normative data for the ROM of upper extremity joints in children is helpful for the evaluation of pediatric orthopedic patients and provides the framework for therapeutic resolution. Since a great number of traumatic injuries in children affect the upper extremity, this information may help the physician to estimate the impact of the injury and decide on the therapeutic management.

  12. THE METHOD OF TREATMENT OF PATIENTS WITH NONUNIONS AND GUNSHOT PSEUDOARTHROSIS OF LONG BONE OF EXTREMITIES

    Directory of Open Access Journals (Sweden)

    B. A. Akhmedov

    2010-01-01

    Full Text Available Developed by the authors the method of treatment for nonunions and pseudoarthrosis of extremities long bones is described. It consist in mini-invasive preparation of interfragmentary space and bone grafting with cancellous graft from the wing of ilium. Successful use this method in 23 patients with gunshot wounds of humeral, forearm, femur and shin bones allows to recommend it for wide application. Suggested method of surgical treatment can be used not only after gunshot wounds, but after long bones fractures of another genesis.

  13. Electrical stimulation of the upper extremity in stroke: cyclic versus EMG-triggered stimulation

    NARCIS (Netherlands)

    Kroon, de Joke R.; IJzerman, Maarten J.

    2008-01-01

    Objective: To compare the effect of cyclic and electromyography (EMG)-triggered electrical stimulation on motor impairment and function of the affected upper extremity in chronic stroke. Design: Randomized controlled trial. Setting: Outpatient clinic of a rehabilitation centre. Subjects and inte

  14. The clinical aspects of the upper extremity exoskeleton "EXAR" use

    Science.gov (United States)

    Vorobiev, A. A.; Krivonozhkina, P. S.; Andryushchenko, F. A.; Zasypkina, O. A.

    2015-11-01

    The article considers some of indications and contraindications for the use of the exoskeleton "EXAR". Our experience with the present construction use shows that the exoskeleton "EXAR" is able to make up the following lost or disturbed muscle functions:- an arm raise; a drawing of the arm aside from the trunk;- a bending of the arm in shoulder or elbow joints.

  15. Epithelioid sarcoma of the upper extremity with cerebral metastases.

    Directory of Open Access Journals (Sweden)

    Rege A

    1992-10-01

    Full Text Available A forty year old male patient presented with swollen, deformed right hand with multiple irregular ulcers. The axillary lymph nodes were enlarged, firm and tender. The biopsy of nodules present on the hand revealed areas of haemorrhage and necrosis. The histopathological examination confirmed the clinical diagnosis of epithelioid sarcoma. Following below-elbow amputation, patient failed to regain consciousness and expired. On autopsy, distant metastases were found in the regional lymph nodes, pleura, kidney and cerebrum.

  16. Endovascular stent placement in the treatment of upper extremity central venous obstruction in hemodialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Aytekin, Cueneyt E-mail: cuneytaytekin@hotmail.com; Boyvat, Fatih; Yagmurdur, Mahmut Can; Moray, Goekhan; Haberal, Mehmet

    2004-01-01

    Objective: To evaluate the efficacy of stent placement for treating upper extremity central venous obstruction in chronic hemodialysis patients. Methods and Material: Between January 1999 and October 2001, we inserted metallic stents into the upper extremity central veins of 14 patients with shunt dysfunction and/or arm swelling. The indications for stent placement were stenosis or occlusion of the central vein in the upper extremity used for dialysis. Six of the individuals were diagnosed with subclavian vein stenosis, and 5 with brachiocephalic vein stenosis. Of the remaining 3 patients, 2 had subclavian vein occlusion, and 1 had left brachiocephalic vein occlusion. Results: All the stent placement procedures were technically successful, and there were no major complications. Follow-up ranged from 2 weeks to 29 months. The 1-, 3-, 6- and 12-month primary stent patency rates were 92.8, 85.7, 50 and 14.3%, respectively. Repeat interventions, including percutaneous transluminal angioplasty and additional stent placement, were required in 9 patients. The 3-, 6-, 12-month, and 2-year assisted primary stent patency rates were 100, 88.8, 55.5 and 33.3%, respectively. Conclusion: Endovascular stent placement is an effective alternative to surgery in patients with shunt dysfunction due to obstruction of an upper extremity central vein. Repeated interventions are usually required to prolong stent patency.

  17. Upper extremities flexibility comparisons of collegiate "soft" martial art practitioners with other athletes.

    Science.gov (United States)

    Huang, C-C; Yang, Y-H; Chen, C-H; Chen, T-W; Lee, C-L; Wu, C-L; Chuang, S-H; Huang, M-H

    2008-03-01

    The aim of this study was to compare the flexibility of the upper extremities in collegiate students involved in Aikido (a kind of soft martial art attracting youth) training with those involved in other sports. Fifty freshmen with a similar frequency of exercise were divided into the Aikido group (n = 18), the upper-body sports group (n = 17), and the lower-body sports group (n = 15) according to the sports that they participated in. Eight classes of range of motion in upper extremities were taken for all subjects by the same clinicians. The Aikido group had significantly better flexibility than the upper-body sports group except for range of motion in shoulder flexion (p = 0.22), shoulder lateral rotation (p > 0.99), and wrist extension (p > 0.99). The Aikido group also had significantly better flexibility than the lower-body sports group (p martial arts had good upper extremities flexibility that might not result from regular exercise alone.

  18. The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress.

    Science.gov (United States)

    Slowik, Jonathan S; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R

    2016-06-14

    The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop or semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should consider using either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground.

  19. Effects of virtual reality-based bilateral upper-extremity training on brain activity in post-stroke patients.

    Science.gov (United States)

    Lee, Su-Hyun; Kim, Yu-Mi; Lee, Byoung-Hee

    2015-07-01

    [Purpose] This study investigated the therapeutic effects of virtual reality-based bilateral upper-extremity training on brain activity in patients with stroke. [Subjects and Methods] Eighteen chronic stroke patients were divided into two groups: the virtual reality-based bilateral upper-extremity training group (n = 10) and the bilateral upper-limb training group (n = 8). The virtual reality-based bilateral upper-extremity training group performed bilateral upper-extremity exercises in a virtual reality environment, while the bilateral upper-limb training group performed only bilateral upper-extremity exercise. All training was conducted 30 minutes per day, three times per week for six weeks, followed by brain activity evaluation. [Results] Electroencephalography showed significant increases in concentration in the frontopolar 2 and frontal 4 areas, and significant increases in brain activity in the frontopolar 1 and frontal 3 areas in the virtual reality-based bilateral upper-extremity training group. [Conclusion] Virtual reality-based bilateral upper-extremity training can improve the brain activity of stroke patients. Thus, virtual reality-based bilateral upper-extremity training is feasible and beneficial for improving brain activation in stroke patients.

  20. Aging contributes to inflammation in upper extremity tendons and declines in forelimb agility in a rat model of upper extremity overuse.

    Directory of Open Access Journals (Sweden)

    David M Kietrys

    Full Text Available We sought to determine if tendon inflammatory and histopathological responses increase in aged rats compared to young rats performing a voluntary upper extremity repetitive task, and if these changes are associated with motor declines. Ninety-six female Sprague-Dawley rats were used in the rat model of upper extremity overuse: 67 aged and 29 young adult rats. After a training period of 4 weeks, task rats performed a voluntary high repetition low force (HRLF handle-pulling task for 2 hrs/day, 3 days/wk for up to 12 weeks. Upper extremity motor function was assessed, as were inflammatory and histomorphological changes in flexor digitorum and supraspinatus tendons. The percentage of successful reaches improved in young adult HRLF rats, but not in aged HRLF rats. Forelimb agility decreased transiently in young adult HRLF rats, but persistently in aged HRLF rats. HRLF task performance for 12 weeks lead to increased IL-1beta and IL-6 in flexor digitorum tendons of aged HRLF rats, compared to aged normal control (NC as well as young adult HRLF rats. In contrast, TNF-alpha increased more in flexor digitorum tendons of young adult 12-week HRLF rats than in aged HRLF rats. Vascularity and collagen fibril organization were not affected by task performance in flexor digitorum tendons of either age group, although cellularity increased in both. By week 12 of HRLF task performance, vascularity and cellularity increased in the supraspinatus tendons of only aged rats. The increased cellularity was due to increased macrophages and connective tissue growth factor (CTGF-immunoreactive fibroblasts in the peritendon. In conclusion, aged rat tendons were overall more affected by the HRLF task than young adult tendons, particularly supraspinatus tendons. Greater inflammatory changes in aged HRLF rat tendons were observed, increases associated temporally with decreased forelimb agility and lack of improvement in task success.

  1. Aging contributes to inflammation in upper extremity tendons and declines in forelimb agility in a rat model of upper extremity overuse.

    Science.gov (United States)

    Kietrys, David M; Barr-Gillespie, Ann E; Amin, Mamta; Wade, Christine K; Popoff, Steve N; Barbe, Mary F

    2012-01-01

    We sought to determine if tendon inflammatory and histopathological responses increase in aged rats compared to young rats performing a voluntary upper extremity repetitive task, and if these changes are associated with motor declines. Ninety-six female Sprague-Dawley rats were used in the rat model of upper extremity overuse: 67 aged and 29 young adult rats. After a training period of 4 weeks, task rats performed a voluntary high repetition low force (HRLF) handle-pulling task for 2 hrs/day, 3 days/wk for up to 12 weeks. Upper extremity motor function was assessed, as were inflammatory and histomorphological changes in flexor digitorum and supraspinatus tendons. The percentage of successful reaches improved in young adult HRLF rats, but not in aged HRLF rats. Forelimb agility decreased transiently in young adult HRLF rats, but persistently in aged HRLF rats. HRLF task performance for 12 weeks lead to increased IL-1beta and IL-6 in flexor digitorum tendons of aged HRLF rats, compared to aged normal control (NC) as well as young adult HRLF rats. In contrast, TNF-alpha increased more in flexor digitorum tendons of young adult 12-week HRLF rats than in aged HRLF rats. Vascularity and collagen fibril organization were not affected by task performance in flexor digitorum tendons of either age group, although cellularity increased in both. By week 12 of HRLF task performance, vascularity and cellularity increased in the supraspinatus tendons of only aged rats. The increased cellularity was due to increased macrophages and connective tissue growth factor (CTGF)-immunoreactive fibroblasts in the peritendon. In conclusion, aged rat tendons were overall more affected by the HRLF task than young adult tendons, particularly supraspinatus tendons. Greater inflammatory changes in aged HRLF rat tendons were observed, increases associated temporally with decreased forelimb agility and lack of improvement in task success.

  2. The first results of the development and implementation of the upper extremity exoskeleton "EXAR"

    Science.gov (United States)

    Vorobiev, A. A.; Krivonozhkina, P. S.; Zasypkina, O. A.; Andrewshenko, F. A.

    2015-11-01

    This research considers the first results of the development and implementation of the upper extremity exoskeleton "EXAR". Made anatomical parameterization developed the device the testing of the apparatus have been conducted in accordance with the bioethics regulations with the girl I. Sh. at the age of 4 years suffering the artrogryposis. The parameters of the exoskeleton "EXAR" selected according to our methods allowed us to conduct its use in the period of 4 months. There have been no defects at all. By the analysis of the first results of the passive upper limb skeleton EXAR development we should consider them as positive and worthy of the widespread adoption in the remedial practice.

  3. Content Range and Precision of a Computer Adaptive Test of Upper Extremity Function for Children with Cerebral Palsy

    Science.gov (United States)

    Montpetit, Kathleen; Haley, Stephen; Bilodeau, Nathalie; Ni, Pengsheng; Tian, Feng; Gorton, George, III; Mulcahey, M. J.

    2011-01-01

    This article reports on the content range and measurement precision of an upper extremity (UE) computer adaptive testing (CAT) platform of physical function in children with cerebral palsy. Upper extremity items representing skills of all abilities were administered to 305 parents. These responses were compared with two traditional standardized…

  4. A COMPARISON OF UPPER-EXTREMITY REACTION FORCES BETWEEN THE YURCHENKO VAULT AND FLOOR EXERCISE

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    Matthew Kirk Seeley

    2005-06-01

    Full Text Available The purpose of this study was to examine reaction forces transmitted to the upper extremities of high-level gymnasts during the round-off phase of the Yurchenko vault. A secondary purpose of this study was to compare reaction forces during the Yurchenko vault to reaction forces observed in a tumbling pass during the floor exercise. Ten high-level, female gymnasts volunteered to participate. Conditions of the independent variable were the Yurchenko vault and floor exercise; dependent variables were peak vertical and peak anterior-posterior reaction forces. Each participant performed three trials of both conditions with the trail hand contacting a force platform. Vertical and anterior-posterior reaction forces, normalized to body weight, were greater (p < 0.05 during the round-off phase of the Yurchenko vault (2.38 than during the floor exercise round-off (2.15. Vertical reaction forces during the round-off phase of the Yurchenko vault and floor exercise round-off are similar to reaction forces transmitted to upper extremities during other gymnastic skills and ground reaction forces transmitted to lower extremities while running and walking at various speeds. Results of this study reveal a need for further research considering methods aimed at reducing reaction forces transmitted to the upper extremities during the Yurchenko vault and floor exercise.

  5. Diagnosis of occlusive lesions of upper extremity arteries in patients with thromboangiitis obliterans.

    Science.gov (United States)

    Pokrovskiĭ, A V; Kuntsevich, G I; Dan, V N; Chupin, A V; Kalinin, A A; Alekperov, R T; Makhmudova, L S

    2003-01-01

    The study accrued 84 patients suffering from thromboangiitis obliterans (TO) examined and treated at the A.V. Vishnevsky Institute of Surgery, RAMS, over the period 1988 to 2002. Based on the complaints on the part of the upper extremities the patients were distributed into four groups. Sixteen (19.1%) TO patients did not make any complaints on the part of the arms (degree I ischemia). Thirty-eight (45.2%) patients complained of numbness and paresthesia, chiefly of the tips of the fingers on both hands (degree II ischemia). Six (7.1%) persons complained of pains in the hands at physical exercise (decree III ischemia). Ulcers and necroses of the fingers were present in 24 (28.6%) patients (degree IV ischemia). The diagnostic procedures for arterial lesion of the upper extremities included laboratory investigations, duplex scanning of the great arteries, of the arteries of the hands, fingers and nail matrix, wide-field capillaroscopy, oxygen tension measurements, and angiography as well. Comparison of the clinical manifestations of arterial lesion of the upper extremities in TO patients to the data supplied by different research methods has revealed a direct correlation between the degree of ischemia and the pathomorphological as well as functional changes which increased as the ischemic syndrome was aggravated. As a result of the present work, there have been studied and systematized the criteria for the diagnosis of the degree of arterial lesion of the upper extremities in TO patients, based on the data, supplied by duplex scanning, capillaroscopy, measurements of transcutaneous oxygen tension and angiography. In addition, there has been studied the role of the humoral component of immunity in the delineation of inflammatory activity in patients with TO.

  6. Upper extremity cumulative trauma disorders in the makers of Maraş pounded ice cream

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    Betül Bakan

    2013-01-01

    Full Text Available Objective: Upper Extremity Cumulative Trauma Disorders(UE-CTD are among the major health problems affectingthe workers. The aim of this study was to investigateUE-CTD in the makers of Maras pounded ice cream(MMPICMethods: This study was conducted among 50 volunteerswho work as a MMPIC and 50 control in our downtownarea. During face-to-face conversion, the participantsfilled out a survey inquiring about age, duration ofwork (in years in job, daily working time, occupation withanother job, health history, and medication usage. Thesubjects were questioned regarding the musculoskeletalcomplaints within the last six months and upper bodyphysical examination was performed in all participants.Results: The study group was composed of males.The mean age of study group and control group were31.78±6.58 and 30.74±5.99 years (p=0.411, respectively.The mean duration of work in pounded ice creambusiness and the mean duration of work in control were11.64± 6.26 years and 10.68±5.48 years (p=0.417, respectively.The mean daily working time in the studygroup and in control group were 10.64±1.82 hours and11.12±1.62 hours (p= 0.168, respectively. Musculoskeletalcomplaints of the upper extremity were found in 52%of the study group, and 28% of the control group. Musculoskeletaldisease of upper extremity was found in 28% ofthe study group and in 12% of the control group. Upperextremity musculoskeletal system complaints and illnesswere difference statistically between the two groups (p=0.014; p= 0.046, respectively.Conclusion: UE-CTD was seen in the makers of poundedice cream and its prevalence was similar to the otherlaborers work in the areas needing repetitive arm andhand motion.Key words: Makers of Maras pounded ice cream, cumulativetrauma disorders, upper extremity problems

  7. Upper-extremity deep venous thrombosis: a review.

    Science.gov (United States)

    Mai, Cuc; Hunt, Daniel

    2011-05-01

    Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with similar adverse consequences and is becoming more common in patients with complex medical conditions requiring central venous catheters or wires. Although guidelines suggest that this disorder be managed using approaches similar to those for lower-extremity deep venous thrombosis, studies are refining the prognosis and management of upper-extremity deep venous thrombosis. Physicians should be familiar with the diagnostic and treatment considerations for this disease. This review will differentiate between primary and secondary upper-extremity deep venous thromboses; assess the risk factors and clinical sequelae associated with upper-extremity deep venous thrombosis, comparing these with lower-extremity deep venous thrombosis; and describe an approach to treatment and prevention of secondary upper-extremity deep venous thrombosis based on clinical evidence.

  8. The effects of music on pain perception of stroke patients during upper extremity joint exercises.

    Science.gov (United States)

    Kim, Soo Ji; Koh, Iljoo

    2005-01-01

    The purpose of this study was to determine the effects of music therapy on pain perception of stroke patients during upper extremity joint exercises. Ten stroke patients (1 male and 9 females) ranging in age from 61 to 73 participated in the study. Music conditions used in the study consisted of: (a) song, (b) karaoke accompaniment (same music to condition A except singers' voices), and (c) no music. Exercise movements in this study included hand, wrist, and shoulder joints. During the 8-week period music therapy sessions, subjects repeated 3 conditions according to the randomized orders and subjects rated their perceived pain on a scale immediately after each condition. The General Linear Model (GLM) Repeated Measures ANOVA revealed that there were no significant differences in pain rating across the three music conditions. However, positive affects and verbal responses, while performing upper extremity exercises with both music and karaoke accompaniment music, were observed using video observations.

  9. Correlation of crossed cerebellar diaschisis with motor impairment of the hemiplegic upper extremity in stroke patients

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Chun; Choi, In Sung; Heo, Young Jun; Min, Jeong Jun; Lee, Sam Gyu; Bom, Hee Seung [School of Medicine, Chonnam National University, Gwangju (Korea, Republic of)

    2004-07-01

    The aim of this study was to investigate the correlation between crossed cerebellar diaschisis (CCD) and motor evoked potentials (MEPs) and to study the relationship between CCD and the severity and prognosis of stroke. Twenty-eight patients with first-ever unilateral stroke underwent brain perfusion SPECT with Tc-99m ECD. The existence of CCD was evaluated by visual inspection on SPECT images. The central motor conduction times were obtained from Abductor pollicis brevis and Abductor hallucis by recording MEPs. The National Institutes of Health stroke scale, the motricity Index (MI), and the functional outcome scales were measured. Fifteen of 28 patients (53.6%) had CCD. The presence of CCD was significantly correlated with 'not evoked' MEPs in the upper extremity (p<0.01). The existence of CCD was not associated with locations (p>0.05) and volume of brain lesion (p>0.05). There was a significant correlation between the presence of CCD and lower MI score of upper extremity (p<0.05). The presence of CCD would indicate the damage on the descending motor pathways and be associated with the severe motor impairment of the upper extremity in stroke patients.

  10. Two-point discrimination of the upper extremities of healthy Koreans in their 20's.

    Science.gov (United States)

    Koo, Ja-Pung; Kim, Soon-Hee; An, Ho-Jung; Moon, Ok-Gon; Choi, Jung-Hyun; Yun, Young-Dae; Park, Joo-Hyun; Min, Kyoung-Ok

    2016-03-01

    [Purpose] The present study attempted to measure two-point discrimination in the upper extremities of healthy Koreans in their 20's. [Subjects and Methods] Using a three-point esthesiometer, we conducted an experiment with a group of 256 college students (128 male and 128 female), attending N University in Chonan, Republic of Korea. [Results] Females showed two-point discrimination at a shorter distance than males at the following points: (i) 5 cm above the elbow joint, the middle part, and 5 cm below the shoulder joint of the anterior upper arm; (ii) 5 cm above the elbow joint and 5 cm below the shoulder joint of the posterior upper arm; (iii) 5 cm above the front of the wrist joint of the forearm; 5 cm below the elbow joint, the palmar part of the distal interphalangeal joint of the thumb, the dorsal part of the distal interphalangeal joint of the middle and little fingers. It was also found that females showed greater two-point discrimination than males in distal regions rather than proximal regions. [Conclusion] The findings of this study will help establish normal values for two-point discrimination of upper extremities of young Koreans in their 20's.

  11. Axillary Brachial Plexus Blockage in Treatment of Upper Extremity Ischemic Disorder in Critically Ill Patient: A Report of Two Cases

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    İlkay Ceylan

    2015-08-01

    Full Text Available Arterial catheterization, vasoactive agents, autonomic dysfunction and septic embolus may cause ischemia at distal ends of upper extremity in critically ill patients. Axillary brachial plexus blockage is highly reliable intervention when appropriate technique is used. Sympathetic blockage occurs after administration of local anesthetic drug and can resolve the circulatory disorder of extremity. We aimed to present two cases with ischemia of upper distal extremity that resolves after axillary brachial plexus blockage.

  12. Axillary Brachial Plexus Blockage in Treatment of Upper Extremity Ischemic Disorder in Critically Ill Patient: A Report of Two Cases

    OpenAIRE

    İlkay Ceylan; Nermin Kelebek Girgin; Mehmet Ali Kopan; Alp Gurbet

    2015-01-01

    Arterial catheterization, vasoactive agents, autonomic dysfunction and septic embolus may cause ischemia at distal ends of upper extremity in critically ill patients. Axillary brachial plexus blockage is highly reliable intervention when appropriate technique is used. Sympathetic blockage occurs after administration of local anesthetic drug and can resolve the circulatory disorder of extremity. We aimed to present two cases with ischemia of upper distal extremity that resolves after axillary ...

  13. Upper extremity function and quality of life in patients with breast cancer related lymphedema

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    Bojinović-Rodić Dragana

    2016-01-01

    Full Text Available Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL. The aim of this study was to estimate health-related quality of life (HRQoL in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36. Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH. The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ± 12.2 than for physical one (42.2 ± 7.5. The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9 and Social Function (70.1 ± 23.1. The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1 and General Health (49.3 ± 20.1. Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p 0.05. Conclusions. Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

  14. Upper extremity biomechanical model for evaluation of pediatric joint demands during wheelchair mobility.

    Science.gov (United States)

    Paul, Alyssa J; Slavens, Brooke A; Graf, Adam; Krzak, Joseph; Vogel, Lawrence; Harris, Gerald F

    2012-01-01

    Current methods for evaluating upper extremity (UE) dynamics during pediatric wheelchair use are limited. We propose a new model to characterize UE joint kinematics and kinetics during pediatric wheelchair mobility. The bilateral model is comprised of the thorax, clavicle, scapula, upper arm, forearm, and hand segments. The modeled joints include: sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist. The model is complete and is currently undergoing pilot studies for clinical application. Results may provide considerable quantitative insight into pediatric UE joint dynamics to improve wheelchair prescription, training and long term care of children with orthopaedic disabilities.

  15. Effects of Increased Physiological Arousal on Upper Extremity Positional Awareness in Healthy Young Adults

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    Christopher Kovacs

    2010-01-01

    Full Text Available Problem statement: The purpose of this investigation was to examine the effects of increased physiological arousal on the ability to perceive upper extremity positional awareness in healthy young adults. Approach: Thirty-eight participants were pre- and post-tested for upper extremity positional awareness using a manual kinesthesiometer. Participants in the experimental group underwent a combination of the Stroop color-word task and timed arithmetic problems to produce a state of physiological arousal. Heart rate and blood pressure measurements were taken during data collection to assess levels of physiological arousal. Pre-and post-test absolute error scores for each participant were compared. Results: ANCOVA revealed a significant time effect (pConclusion: The results suggested positional awareness is altered under a state of elevated physiological arousal and that these results may have significant implications for individuals performing various types of motor skills.

  16. Upper extremity biomechanics of children with spinal cord injury during wheelchair mobility.

    Science.gov (United States)

    Schnorenberg, Alyssa J; Slavens, Brooke A; Graf, Adam; Krzak, Joseph; Vogel, Lawrence; Harris, Gerald F

    2014-01-01

    While much work is being done evaluating the upper extremity joint dynamics of adult manual wheelchair propulsion, limited work has examined the pediatric population of manual wheelchair users. Our group used a custom pediatric biomechanical model to characterize the upper extremity joint dynamics of 12 children and adolescents with spinal cord injury (SCI) during wheelchair propulsion. Results show that loading appears to agree with that of adult manual wheelchair users, with the highest loading primarily seen at the glenohumeral joint. This is concerning due to the increased time of wheelchair use in the pediatric population and the impact of this loading during developmental years. This research may assist clinicians with improved mobility assessment methods, wheelchair prescription, training, and long-term care of children with orthopaedic disabilities.

  17. Multidetector-row CT angiography of upper- and lower-extremity peripheral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Willmann, J.K.; Wildermuth, S. [Inst. of Diagnostic Radiology, Univ. Hospital Zurich, Zurich (Switzerland)

    2005-11-15

    With the introduction of multidetector-row CT (MDCT) technology indications for MDCT angiography have expanded to include assessment of the peripheral arteries of the upper and lower extremities. Combined with patient- and scanner-adjusted CT data acquisition and contrast medium application strategies, an accurate and reliable evaluation of the peripheral arteries of the upper and lower extremities is possible. MDCT angiography is cost-effective and accurate for detection of arterial stenosis and occlusion in patients with peripheral arterial disease (PAD). MDCT angiography allows postoperative assessment of peripheral arterial bypass grafts, including bypass graft stenosis and occlusion, as well as presence of aneurysms or arteriovenous fistulas. In addition, MDCT angiography is helpful in particular for visualization of arterial bypass grafts with a complicated extra-anatomical course. Furthermore, pre-operative peripheral vascular mapping can be performed by using MDCT angiography. Finally, due to the integration of MDCT scanners in many trauma centres, MDCT angiography is increasingly being used for assessment of traumatic arterial injuries. This article gives an overview of technical aspects of peripheral MDCT angiography, including scanning parameters, contrast medium application, image postprocessing and radiation exposure, and summarizes the most frequent acute and non-acute indications of MDCT angiography for assessment of the upper- and lower-extremity peripheral arteries. (orig.)

  18. Rehabilitation of the Upper Extremity after Stroke: Current Practice As a Guide for Curriculum

    OpenAIRE

    Mylene Schriner PhD, OTR/L; Janell Thome OTR/L; Monica Carrier OTR/L

    2014-01-01

    Stroke is the leading cause of disability in the United States and a top diagnosis for occupational therapy (OT) services among neurological conditions. Academic programs teach OT students neurological frames of reference (FORs) to provide a foundation for future practice. To meet accreditation standards, entry-level curricula must reflect current practice and evidence-based interventions. A survey of OT practitioners working in upper extremity stroke rehabilitation was conducted to investiga...

  19. Enzymatic debridement for the treatment of severely burned upper extremities – early single center experiences

    OpenAIRE

    Cordts, Tomke; Horter, Johannes; Vogelpohl, Julian; Kremer, Thomas; Kneser, Ulrich; Hernekamp, Jochen-Frederick

    2016-01-01

    Background Severe burns of hands and arms are complex and challenging injuries. The Standard of care (SOC) – necrosectomy with skin grafting – is often associated with poor functional or aesthetic outcome. Enzymatic debridement (ED) is considered one promising alternative but, until recently, results proved to be highly variable. Methods Between 04/2014 and 04/2015, 16 patients with deep partial- to full-thickness burns of the upper extremities underwent enzymatic debridement (ED) in our Burn...

  20. A case report of a patient with upper extremity symptoms: differentiating radicular and referred pain

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    Daub Clifford W

    2007-07-01

    Full Text Available Abstract Background Similar upper extremity symptoms can present with varied physiologic etiologies. However, due to the multifaceted nature of musculoskeletal conditions, a definitive diagnosis using physical examination and advanced testing is not always possible. This report discusses the diagnosis and case management of a patient with two episodes of similar upper extremity symptoms of different etiologies. Case Presentation On two separate occasions a forty-four year old female patient presented to a chiropractic office with a chief complaint of insidious right-sided upper extremity symptoms. During each episode she reported similar pain and parasthesias from her neck and shoulder to her lateral forearm and hand. During the first episode the patient was diagnosed with a cervical radiculopathy. Conservative treatment, including manual cervical traction, spinal manipulation and neuromobilization, was initiated and resolved the symptoms. Approximately eighteen months later the patient again experienced a severe acute flare-up of the upper extremity symptoms. Although the subjective complaint was similar, it was determined that the pain generator of this episode was an active trigger point of the infraspinatus muscle. A diagnosis of myofascial referred pain was made and a protocol of manual trigger point therapy and functional postural rehabilitative exercises improved the condition. Conclusion In this case a thorough physical evaluation was able to differentiate between radicular and referred pain. By accurately identifying the pain generating structures, the appropriate rehabilitative protocol was prescribed and led to a successful outcome for each condition. Conservative manual therapy and rehabilitative exercises may be an effective treatment for certain cases of cervical radiculopathy and myofascial referred pain.

  1. The Influence of Dynamic Orthosis Training on Upper Extremity Function after Stroke: A Pilot Study

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    Rodrigo Cappato de Araújo

    2014-01-01

    Full Text Available The goal of this study was to assess the use of a dynamic orthosis on upper extremity function in chronic stroke patients. A case series approach was utilized, with provision of a training program (3x/week, 50 minutes/session for 8 weeks and employment of a dynamic orthosis. Six volunteers with persistent hemiparesis due to a single, unilateral stroke performed task-oriented movements with the aid of a dynamic orthosis. Tests were administered before and after training. Functional capacity was assessed using the TEMPA (Test d'Évaluation des Membres Supérieurs de Personnes Âgées test. The Wilcoxon test was used for pre-training and post-training comparisons of TEMPA scores. The volunteers showed significant improvement of upper extremity function in the performance of a bilateral task (p = 0.01 and three unilateral tasks (p = 0.04. This pilot study suggests that the dynamic orthosis associated with the performance of functional tasks can have positive outcomes regarding the improvement of functional capacity of upper extremity.

  2. Biomechanical Model for Evaluation of Pediatric Upper Extremity Joint Dynamics during Wheelchair Mobility

    OpenAIRE

    2013-01-01

    Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair ...

  3. [Identification of male somatotype based on osteometric characteristics of the upper and lower extremities].

    Science.gov (United States)

    Zviagin, V N; Sineva, I M

    2009-01-01

    This osteologic study included examination of 101 skeletons from the collections of the Department of Anthropology, M. V. Lomonosov Moscow State University, and Peter the Great Museum of Anthropology and Ethnography (Sankt-Peterburg). The results were compared with the data obtained by examining materials excavated from grave sites of an Yoshkar-Ola cemetery and from the Isupovo necropole (Kostroma) to evaluate the possibility of identifying human somatotypes from bone remains. Multidimensional discriminative analysis demonstrated that the equation derived by comparing characteristic signs of all long tubular bones of the extremities was of highest diagnostic value for the purpose of the study. Diagnostic equations are proposed for the identification of individual somatotypes based on the analysis of skeletal remains for the use in practical forensic medical examination.

  4. Effect of mirror therapy on upper extremity motor function in stroke patients: a randomized controlled trial

    Science.gov (United States)

    Gurbuz, Nigar; Afsar, Sevgi Ikbali; Ayaş, Sehri; Cosar, Sacide Nur Saracgil

    2016-01-01

    [Purpose] This study aimed to evaluate the effectiveness of mirror therapy combined with a conventional rehabilitation program on upper extremity motor and functional recovery in stroke patients. [Subjects and Methods] Thirty-one hemiplegic patients were included. The patients were randomly assigned to a mirror (n=16) or conventional group (n=15). The patients in both groups underwent conventional therapy for 4 weeks (60–120 minutes/day, 5 days/week). The mirror group received mirror therapy, consisting of periodic flexion and extension movements of the wrist and fingers on the non-paralyzed side. The patients in the conventional group performed the same exercises against the non-reflecting face of the mirror. The patients were evaluated at the beginning and end of the treatment by a blinded assessor using the Brunnstrom stage, Fugl-Meyer Assessment (FMA) upper extremity score, and the Functional Independence Measure (FIM) self-care score. [Results] There was an improvement in Brunnstrom stage and the FIM self-care score in both groups, but the post-treatment FMA score was significantly higher in the mirror therapy group than in the conventional treatment group. [Conclusion] Mirror therapy in addition to a conventional rehabilitation program was found to provide additional benefit in motor recovery of the upper extremity in stroke patients. PMID:27799679

  5. Role of Anomalous States of Upper Tropospheric Circulation on Extremely Dry and Wet Summer Monsoon Events

    Science.gov (United States)

    Ahmad, S.; Koike, T.; Nishii, K.; Shrestha, M.

    2011-12-01

    Seasonal changes in wind pattern, monsoon, sometimes result in severe droughts and intense flooding in many parts of the world including South Asian countries like Pakistan. The livelihood of a vast population in Pakistan depends on agriculture and land use is strongly influenced by water-based ecosystems that depend on the monsoon rains. Furthermore, climate change studies undertaken so far reveal that action is essential in order to prevent long term damage to water cycle and thus of great concern to the community and stakeholders. Pakistan Summer Monsoon (PSM) is affected by both the disturbances from the tropical and the extratropical regions; however there is lack of understanding of physical mechanisms of PSM compared to other regional studies i.e. Indian Summer Monsoon (ISM) and South-East Asian Monsoon (SEAM). In our study, we applied heat and vorticity budgets, and wave train analysis to reveal the mechanisms of the extremely dry and wet PSM events associated with the anomalous upper tropospheric conditions. We found that the extremely dry (wet) PSM events were closely related with the anomalous cyclonic (anticyclonic) upper-tropospheric circulation around northwest of Pakistan, and mid-upper tropospheric cooling (warming) anomaly around Pakistan and to its north/northwest. We also found in addition to Rossby wave response due to the suppressed (enhanced) convective activities around monsoon regions, the midlatitude wave energy propagation emanating around cyclonic/anticyclonic anomaly around northwestern Atlantic, northeastern Atlantic, Europe or Mediterranean regions induced/reinforced/maintained the anomalous upper tropospheric cyclonic (anticyclonic) circulation around northwest of Pakistan during extremely dry (wet) PSM events. Therefore, devastating drought (flood) events over the PSM region resulting from weak (strong) convection anomalies are induced by both the tropical and extratropical processes.

  6. Kinematic Analysis of the Neck and Upper Extremities During Walking in Healthy Young Adults

    Institute of Scientific and Technical Information of China (English)

    Kwon Son; Junghong Park; Seonghun Park

    2011-01-01

    The objective of this paper is to quantify the local stabilities of the neck and upper extremities (right/left shoulders and right/left elbows), and investigate differences between linear and nonlinear measurements of the associated joint motions and differences in the local stability between the upper and lower extremities. This attempt involves the calculation of a nonlinear parameter, Lyapunov Exponent (LE), and a linear parameter, Range of Motion (ROM), during treadmill walking in conjunction with a large population of healthy subjects. Joint motions of subjects were captured using a three-dimensional motion-capture system. Then mathematical chaos theory and the Rosenstein algorithm were employed to calculate LE of joints as the extent of logarithmic divergence between the neighboring state-space trajectories of flexion-extension angles. LEs computed over twenty males and twenty females were 0.037±0.023 for the neck, 0.043±0.021 for the right shoulder, 0.045±0.030 for the left shoulder, 0.032±0.021 for the right elbow, and 0.034±0.026 for the left elbow. Although statistically significant difference in the ROM was observed between all pairs of the neck and upper extremity joints, differences in the LE between all pairs of the joints as well as between males and females were not statistically significant. Between the upper and lower extremities, LEs of the neck, shoulder, and elbow were significantly smaller than those of the hip (~0.064) and the knee (~0.062). These results indicate that a statistical difference in the local stability between the upper extremity joints is not significant. However, the different result between the ROM and LE gives a strong rationale for applying both linear and nonlinear tools together to the evaluation of joint movement. The LEs of the joints calculated from a large population of healthy subjects could provide normative values for the associated joints and can be used to evaluate the recovery progress of patients with

  7. Upper Extremity Injuries in Gymnasts.

    Science.gov (United States)

    Wolf, Megan R; Avery, Daniel; Wolf, Jennifer Moriatis

    2017-02-01

    Gymnastics is a unique sport, which loads the wrist and arms as weight-bearing extremities. Because of the load demands on the wrist in particular, stress fractures, physeal injury, and overuse syndromes may be observed. This spectrum of injury has been termed "gymnast's wrist," and incorporates such disorders as wrist capsulitis, ligamentous tears, triangular fibrocartilage complex tears, chondromalacia of the carpus, stress fractures, distal radius physeal arrest, and grip lock injury.

  8. The Role of Imaging in Patient Selection, Preoperative Planning, and Postoperative Monitoring in Human Upper Extremity Allotransplantation

    Science.gov (United States)

    Roth, Eira S.; Buck, David G.; Gorantla, Vijay S.; Losee, Joseph E.; Foust, Daniel E.; Britton, Cynthia A.

    2014-01-01

    Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution's experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from 2008 to 2011 on individuals undergoing upper extremity transplantation. This demonstrated that, of the 19 patients initially considered, 5 patients with a mean age of 37 underwent transplantation. Reports were correlated clinically to delineate which preoperative factors lead to patient selection versus disqualification and what concerns dictated postoperative imaging. Findings were subdivided into musculoskeletal and vascular imaging criterion. Results. Within the screening phase, musculoskeletal exclusion criterion included severe shoulder arthropathy, poor native bone integrity, and marked muscular atrophy. Vascular exclusion criterion included loss of sufficient arterial or venous supply and significant distortion of the native vascular architecture. Postoperative imaging was used to document healing and hardware integrity. Postsurgical angiography and ultrasound were used to monitor for endothelial proliferation or thrombosis as signs of rejection and vascular complication. Conclusion. Multimodality imaging is an integral component of vascular composite allotransplantation surgical planning and surveillance to maximize returning form and functionality while minimizing possible complications. PMID:24800056

  9. The Role of Imaging in Patient Selection, Preoperative Planning, and Postoperative Monitoring in Human Upper Extremity Allotransplantation

    Directory of Open Access Journals (Sweden)

    Eira S. Roth

    2014-01-01

    Full Text Available Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution’s experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from 2008 to 2011 on individuals undergoing upper extremity transplantation. This demonstrated that, of the 19 patients initially considered, 5 patients with a mean age of 37 underwent transplantation. Reports were correlated clinically to delineate which preoperative factors lead to patient selection versus disqualification and what concerns dictated postoperative imaging. Findings were subdivided into musculoskeletal and vascular imaging criterion. Results. Within the screening phase, musculoskeletal exclusion criterion included severe shoulder arthropathy, poor native bone integrity, and marked muscular atrophy. Vascular exclusion criterion included loss of sufficient arterial or venous supply and significant distortion of the native vascular architecture. Postoperative imaging was used to document healing and hardware integrity. Postsurgical angiography and ultrasound were used to monitor for endothelial proliferation or thrombosis as signs of rejection and vascular complication. Conclusion. Multimodality imaging is an integral component of vascular composite allotransplantation surgical planning and surveillance to maximize returning form and functionality while minimizing possible complications.

  10. The role of imaging in patient selection, preoperative planning, and postoperative monitoring in human upper extremity allotransplantation.

    Science.gov (United States)

    Roth, Eira S; Buck, David G; Gorantla, Vijay S; Losee, Joseph E; Foust, Daniel E; Britton, Cynthia A

    2014-01-01

    Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution's experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from 2008 to 2011 on individuals undergoing upper extremity transplantation. This demonstrated that, of the 19 patients initially considered, 5 patients with a mean age of 37 underwent transplantation. Reports were correlated clinically to delineate which preoperative factors lead to patient selection versus disqualification and what concerns dictated postoperative imaging. Findings were subdivided into musculoskeletal and vascular imaging criterion. Results. Within the screening phase, musculoskeletal exclusion criterion included severe shoulder arthropathy, poor native bone integrity, and marked muscular atrophy. Vascular exclusion criterion included loss of sufficient arterial or venous supply and significant distortion of the native vascular architecture. Postoperative imaging was used to document healing and hardware integrity. Postsurgical angiography and ultrasound were used to monitor for endothelial proliferation or thrombosis as signs of rejection and vascular complication. Conclusion. Multimodality imaging is an integral component of vascular composite allotransplantation surgical planning and surveillance to maximize returning form and functionality while minimizing possible complications.

  11. The validity of the mangled extremity severity score in the assessment of upper limb injuries.

    Science.gov (United States)

    Togawa, S; Yamami, N; Nakayama, H; Mano, Y; Ikegami, K; Ozeki, S

    2005-11-01

    The Mangled Extremity Severity Score (MESS) may be used to decide whether to perform amputation in patients with injuries involving a limb. A score of 7 points or higher indicates the need for amputation. We have treated three patients with a MESS of 7 points or higher, in two of which the injured limb was salvaged. This scoring system was originally devised to assess injuries to the lower limb. However, a MESS of 7 points as a justification for amputation does not appear appropriate when assessing injuries to the major vessels in the upper limb.

  12. Upper extremity rehabilitation of stroke: Facilitation of corticospinal excitability using virtual mirror paradigm

    Directory of Open Access Journals (Sweden)

    Kang Youn

    2012-10-01

    Full Text Available Abstract Background Several experimental studies in stroke patients suggest that mirror therapy and various virtual reality programs facilitate motor rehabilitation. However, the underlying mechanisms for these therapeutic effects have not been previously described. Objectives We attempted to delineate the changes in corticospinal excitability when individuals were asked to exercise their upper extremity using a real mirror and virtual mirror. Moreover, we attempted to delineate the role of visual modulation within the virtual environment that affected corticospinal excitability in healthy subjects and stroke patients. Methods A total of 18 healthy subjects and 18 hemiplegic patients were enrolled into the study. Motor evoked potential (MEPs from transcranial magnetic stimulation were recorded in the flexor carpi radialis of the non-dominant or affected upper extremity using three different conditions: (A relaxation; (B real mirror; and (C virtual mirror. Moreover, we compared the MEPs from the virtual mirror paradigm using continuous visual feedback or intermittent visual feedback. Results The rates of amplitude increment and latency decrement of MEPs in both groups were higher during the virtual mirror task than during the real mirror. In healthy subjects and stroke patients, the virtual mirror task with intermittent visual feedback significantly facilitated corticospinal excitability of MEPs compared with continuous visual feedback. Conclusion Corticospinal excitability was facilitated to a greater extent in the virtual mirror paradigm than in the real mirror and in intermittent visual feedback than in the continuous visual feedback, in both groups. This provides neurophysiological evidence supporting the application of the virtual mirror paradigm using various visual modulation technologies to upper extremity rehabilitation in stroke patients.

  13. International spinal cord injury upper extremity basic data set

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Bryden, A; Curt, A;

    2014-01-01

    OBJECTIVE: To develop an International Spinal Cord Injury (SCI) Upper Extremity Basic Data Set as part of the International SCI Data Sets, which facilitates consistent collection and reporting of basic upper extremity findings in the SCI population. SETTING: International. METHODS: A first draft.......iscos.org.uk). CONCLUSION: The International SCI Upper Extremity Basic Data Set will facilitate consistent collection and reporting of basic upper extremity findings in the SCI population....... of a SCI Upper Extremity Data Set was developed by an international working group. This was reviewed by many different organisations, societies and individuals over several months. A final version was created. VARIABLES: The final version of the International SCI Upper Extremity Data Set contains variables...

  14. Soft Tissue Coverage of the Hand and Upper Extremity: The Reconstructive Elevator.

    Science.gov (United States)

    Miller, Erin Anne; Friedrich, Jeffrey

    2016-07-01

    Soft tissue reconstruction of the upper extremity is a complex topic because every defect has multiple potential solutions. Whereas the often-cited reconstructive ladder advised selection of the simplest reconstruction of the defect, the newer concept of the reconstructive elevator allows freedom to choose a more complex reconstruction to account for specialized function and aesthetic outcome. An algorithm for assessment of the defect is presented and demonstrated in this review, using 6 case examples to highlight key concepts. Representative flaps are presented and a discussion of functional and aesthetic outcomes is undertaken to provide a framework for achieving the patient's and surgeon's goals of reconstruction.

  15. Treatment of upper extremity reflex sympathetic dystrophy with joint stiffness using sympatholytic Bier blocks and manipulation.

    Science.gov (United States)

    Duncan, K H; Lewis, R C; Racz, G; Nordyke, M D

    1988-06-01

    Twenty patients with reflex sympathetic dystrophy involving the upper extremity with associated joint stiffness were treated by manipulation under Bier blocks composed of lidocaine, methylprednisolone, and reserpine or guanethidine. Depending on the patients' response, repeat blocks were performed at 48- to 72-hour intervals. Range of motion in the affected joints (primarily the hand and wrist) improved from a pre-block mean of 46% to 81% of normal following the blocks. Patients also reported an 80% mean improvement in their pain. The treatment of advanced reflex sympathetic dystrophy using joint manipulation under sympatholytic Bier blocks appears to be a safe and effective method of treatment.

  16. Subcutaneous emphysema of the upper extremity following penetrating blackthorn injury to the wrist.

    LENUS (Irish Health Repository)

    Tiong, W H C

    2009-02-01

    SUMMARY: Noninfective subcutaneous emphysema of the upper extremity, albeit rare, has to be borne in mind when treating patients with subcutaneous emphysema. The misdiagnosis of this condition as its serious infective counterpart often leads to unnecessary aggressive treatment. Noninfective subcutaneous emphysema often accompanies a patient who has no systemic symptoms of illness. Unfortunately, the distinction is not always easy especially when history of injury suggests involvement of an infective or reactive element. Penetrating blackthorn injury is common, especially in rural communities, and often occurs from farming or gardening activities. Blackthorn penetration can cause numerous tissue reactions once embedded under the skin and they are often contaminated with soil. Here we present, for the first time, a case where penetrating blackthorn injury to the wrist resulted in noninfective subcutaneous emphysema involving the whole upper limb and neck, and its subsequent management.

  17. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Garg Arun

    2012-06-01

    Full Text Available Abstract Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A

  18. Quantitative Assessment of ADL: A Pilot Study of Upper Extremity Reaching Tasks

    Directory of Open Access Journals (Sweden)

    Saiyi Li

    2015-01-01

    Full Text Available Effective telerehabilitation technologies enable patients with certain physiological disabilities to engage in rehabilitative exercises for performing Activities of Daily Living (ADLs. Therefore, training and assessment scenarios for the performance of ADLs are vital for the promotion for telerehabilitation. In this paper we investigate quantitatively and automatically assessing patient’s kinematic ability to perform functional upper extremity reaching tasks. The shape of the movement trajectory and the instantaneous acceleration of kinematically crucial body parts, such as wrists, are used to compute the approximate entropy of the motions to represent stability (smoothness in addition to the duration of the activity. Computer simulations were conducted to illustrate the consistency, sensitivity and robustness of the proposed method. A preliminary experiment with kinematic data captured from healthy subjects mimicking a reaching task with dyskinesia showed a high degree of correlation (Cohen’s kappa 0.85 with p<0.05 between a human observer and the proposed automatic classification tool in terms of assigning the datasets to various levels to represent the subjects’ kinematic abilities to perform reaching tasks. This study supported the use of Microsoft Kinect to quantitatively evaluate the ability of individuals with involuntary movements to perform an upper extremity reaching task.

  19. A Reappraisal of the Purported Gastric Pellet with Pterosaurian Bones from the Upper Triassic of Italy.

    Science.gov (United States)

    Holgado, Borja; Dalla Vecchia, Fabio Marco; Fortuny, Josep; Bernardini, Federico; Tuniz, Claudio

    2015-01-01

    A small accumulation of bones from the Norian (Upper Triassic) of the Seazza Brook Valley (Carnic Prealps, Northern Italy) was originally (1989) identified as a gastric pellet made of pterosaur skeletal elements. The specimen has been reported in literature as one of the very few cases of gastric ejecta containing pterosaur bones since then. However, the detailed analysis of the bones preserved in the pellet, their study by X-ray microCT, and the comparison with those of basal pterosaurs do not support a referral to the Pterosauria. Comparison with the osteology of a large sample of Middle-Late Triassic reptiles shows some affinity with the protorosaurians, mainly with Langobardisaurus pandolfii that was found in the same formation as the pellet. However, differences with this species suggest that the bones belong to a similar but distinct taxon. The interpretation as a gastric pellet is confirmed.

  20. A Reappraisal of the Purported Gastric Pellet with Pterosaurian Bones from the Upper Triassic of Italy

    Science.gov (United States)

    Holgado, Borja; Dalla Vecchia, Fabio Marco; Fortuny, Josep; Bernardini, Federico; Tuniz, Claudio

    2015-01-01

    A small accumulation of bones from the Norian (Upper Triassic) of the Seazza Brook Valley (Carnic Prealps, Northern Italy) was originally (1989) identified as a gastric pellet made of pterosaur skeletal elements. The specimen has been reported in literature as one of the very few cases of gastric ejecta containing pterosaur bones since then. However, the detailed analysis of the bones preserved in the pellet, their study by X-ray microCT, and the comparison with those of basal pterosaurs do not support a referral to the Pterosauria. Comparison with the osteology of a large sample of Middle-Late Triassic reptiles shows some affinity with the protorosaurians, mainly with Langobardisaurus pandolfii that was found in the same formation as the pellet. However, differences with this species suggest that the bones belong to a similar but distinct taxon. The interpretation as a gastric pellet is confirmed. PMID:26560101

  1. [Hemiplegia and cerebral palsy - multidisciplinary treatment of the spastic upper extremity].

    Science.gov (United States)

    Haefeli, Mathias; Calcagni, Maurizio

    2014-09-17

    Spastic hemiplegia and cerebral palsy often lead to typical deformities of the upper extremity. Muscle- and joint-contractures may be painful and aesthetically unappealing and may interfere with function and hygiene. Within the first weeks after the cerebral incidence the vital threat is dominating and the exact amount of neurologic impairment is not assessable. During this period, conservative treatment should counteract the development of contractures. After spontaneous neurologic recovery, surgical options should be taken into account. When choosing surgical procedures, factors as volitional motor control, sensibility and cognition must be taken into account besides the morphologic changes. This is best achieved in a multidisciplinary setting of neurologists, rehabilitation specialists, physiotherapists and surgeons.

  2. Probability modeling of high flow extremes in Yingluoxia watershed, the upper reaches of Heihe River basin

    Science.gov (United States)

    Li, Zhanling; Li, Zhanjie; Li, Chengcheng

    2014-05-01

    Probability modeling of hydrological extremes is one of the major research areas in hydrological science. Most basins in humid and semi-humid south and east of China are concerned for probability modeling analysis of high flow extremes. While, for the inland river basin which occupies about 35% of the country area, there is a limited presence of such studies partly due to the limited data availability and a relatively low mean annual flow. The objective of this study is to carry out probability modeling of high flow extremes in the upper reach of Heihe River basin, the second largest inland river basin in China, by using the peak over threshold (POT) method and Generalized Pareto Distribution (GPD), in which the selection of threshold and inherent assumptions for POT series are elaborated in details. For comparison, other widely used probability distributions including generalized extreme value (GEV), Lognormal, Log-logistic and Gamma are employed as well. Maximum likelihood estimate is used for parameter estimations. Daily flow data at Yingluoxia station from 1978 to 2008 are used. Results show that, synthesizing the approaches of mean excess plot, stability features of model parameters, return level plot and the inherent independence assumption of POT series, an optimum threshold of 340m3/s is finally determined for high flow extremes in Yingluoxia watershed. The resulting POT series is proved to be stationary and independent based on Mann-Kendall test, Pettitt test and autocorrelation test. In terms of Kolmogorov-Smirnov test, Anderson-Darling test and several graphical diagnostics such as quantile and cumulative density function plots, GPD provides the best fit to high flow extremes in the study area. The estimated high flows for long return periods demonstrate that, as the return period increasing, the return level estimates are probably more uncertain. The frequency of high flow extremes exhibits a very slight but not significant decreasing trend from 1978 to

  3. Upper extremity thrombosis in Behçet’s disease

    Directory of Open Access Journals (Sweden)

    Adem Küçük

    2013-09-01

    Full Text Available Behçet’s disease (BD is a systemic disease characterizedby oral aphthosis, genital ulcers, ocular lesions andalso gastrointestinal, musculoskeletal, neurological andvessel involvements may develop. Venous manifestationsare more common than arterial involvement. Venousinvolvement often occurs in the veins of lower extremity.Upper extremity venous involvement is rare. In this paperwe report a case of BH presenting with upper extremitysuperficial vein thrombosis.Key words: Behçet’s disease, upper extremity, superficialvein thrombosis

  4. A comparison of ultrasound-guided supraclavicular and infraclavicular blocks for upper extremity surgery

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Z J; Frederiksen, B S; Rasmussen, H;

    2009-01-01

    BACKGROUND: Ultrasound (US)-guided supraclavicular or infraclavicular blocks are commonly used for upper extremity surgery. The aims of this randomized study were to compare the block performance and onset times, effectiveness, incidence of adverse events and patient's acceptance of US-guided...... times, surgical effectiveness, adverse events and patient's acceptance were recorded. RESULTS: Significantly more patients in the I group were ready for surgery 20 and 30 min after the block. The mean block performance time was 5.7 min in the S group and 5.0 min in the I group (NS). Block effectiveness...

  5. Predictors of upper extremity discomfort: a longitudinal study of industrial and clerical workers.

    Science.gov (United States)

    Werner, Robert A; Franzblau, Alfred; Gell, Nancy; Ulin, Sheryl S; Armstrong, Thomas J

    2005-03-01

    Upper extremity discomfort associated with work activity is common with a prevalence of over 50% in many settings. This study followed a cohort of 501 active workers for an average of 5.4 years. Cases were defined as workers who were asymptomatic or had a low discomfort score of 1 or 2 at baseline testing and went on to report a discomfort score of 4 or above on a 10-point visual analog scale. This change is considered clinically significant. Controls had a low baseline discomfort score and continued to have a low discomfort rating throughout the study. The risk factors found to have the highest predictive value for identifying a person who is likely to develop a significant upper extremity discomfort rating included age over 40, a BMI over 28, a complaint of baseline discomfort, the severity of the baseline discomfort rating and a job that had a high hand activity level (based upon hand repetition and force). The risk profile identified both ergonomic and personal health factors as risks and both factors may be amenable to prevention strategies.

  6. Quality of Life Following Amputation or Limb Preservation in Patients with Lower Extremity Bone Sarcoma

    Directory of Open Access Journals (Sweden)

    Gary E Mason

    2013-08-01

    Full Text Available PURPOSE: Although functional differences have been described between patients with lower extremity bone sarcoma with amputation and limb preservation surgery, differences have not clearly been shown between the two groups related to quality of life. The aim of the study was to determine if there is a difference in overall quality of life in lower extremity bone sarcoma survivors related to whether they had an amputation or a limb preservation procedure. PATIENTS AND METHODS: Eighty-two long-term survivors of lower extremity bone sarcoma were studied to make a comparison of the overall quality of life, pain assessment and psychological evaluations in limb preservation and amputation patients. Forty-eight patients with limb preservation and thirty-four patients with amputations were enrolled in the study. Validated psychometric measures including the Quality of Life Questionnaire, the Minnesota Multiphasic Personality Inventory and visual analog scales were utilized.RESULTS: The overall quality of life of patients with limb preservation was significantly higher than patients with amputation (p-value < 0.01. Significant differences were noted in the categories of material well being, job satisfiers and occupational relations. CONCLUSION: The overall quality of life of patients with limb preservation appears to be better than for those patients with amputation based on the quality of life questionnaire in patients surviving lower extremity bone sarcoma. Further analysis needs to verify the results and focus on the categories that significantly affect the overall quality of life.

  7. Upper and lower extremity proprioceptive inputs modulate EMG activity of the trapezius.

    Science.gov (United States)

    Tataroglu, Cengiz; Kuçuk, Fatma Kursad; Ozkul, Ayca

    2011-02-01

    Axial muscles like the trapezius have different reflexive and functional properties. The aim of this study was to analyze the long latency reflexes obtained from the trapezius by the electrical stimulation of upper and lower extremity peripheral nerves. Thirty-one healthy volunteers were included in the study. Surface EMG activity of both trapezius muscles was recorded and averaged after electrical stimulation of the median and peroneal mixed nerves. The recordings were performed during supine and erect posture in nine subjects to evaluate of the effect of postural differences on reflex response. Reflex recordings were also performed in six subjects from some other muscles together with the trapezius by the stimulation of the peroneal nerve. Reflex responses including three components were recorded from the trapezius muscle (unilateral or bilateral) by electrical stimulation of the peroneal nerve. The most stable of them was the second component (23/31) which had a latency of 72.6 ± 7.9 ms for the ipsilateral, and 74.2 ± 8.5 ms for the contralateral trapezius (15/31). For median stimulation, the first component recorded at 32.0 ± 6.7 ms was the most stable (25/31). The second component was more frequently recorded on the contralateral side (14/31). Erect posture increased the amplitude of these components. Upper and lower extremity proprioceptive inputs modulate the EMG activity of the trapezius. This modulation probably related with postural adjustments.

  8. Rehabilitation of the Upper Extremity after Stroke: Current Practice As a Guide for Curriculum

    Directory of Open Access Journals (Sweden)

    Mylene Schriner PhD, OTR/L

    2014-01-01

    Full Text Available Stroke is the leading cause of disability in the United States and a top diagnosis for occupational therapy (OT services among neurological conditions. Academic programs teach OT students neurological frames of reference (FORs to provide a foundation for future practice. To meet accreditation standards, entry-level curricula must reflect current practice and evidence-based interventions. A survey of OT practitioners working in upper extremity stroke rehabilitation was conducted to investigate current clinical practice in a variety of treatment settings. Survey questions probed the use of motor rehabilitation techniques exclusive to one of six neurological FORs: Brunnstrom, Constraint-induced Movement Therapy, Neurodevelopmental Treatment, Proprioceptive Neuromuscular Facilitation, Rood, and Task-Oriented. Responses from 167 OT professionals indicated interventions representing all six FORs are currently being utilized in stroke rehabilitation. Techniques from the Task-Oriented and Neurodevelopmental Treatment approaches were used most frequently; however, the Rood–based techniques were used much less than interventions from the other FORs. No single neurological approach was found to dominate practice regardless of the number of years of experience in stroke rehabilitation or years since graduation from an entry-level program. A majority of participants appear to employ techniques from multiple approaches frequently, suggesting contemporary OT practice in upper extremity stroke rehabilitation is eclectic in nature.

  9. Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review

    Directory of Open Access Journals (Sweden)

    Veiersted Kaj Bo

    2010-04-01

    Full Text Available Abstract Background This review examines the evidence for an association between computer work and neck and upper extremity disorders (except carpal tunnel syndrome. Methods A systematic critical review of studies of computer work and musculoskeletal disorders verified by a physical examination was performed. Results A total of 22 studies (26 articles fulfilled the inclusion criteria. Results show limited evidence for a causal relationship between computer work per se, computer mouse and keyboard time related to a diagnosis of wrist tendonitis, and for an association between computer mouse time and forearm disorders. Limited evidence was also found for a causal relationship between computer work per se and computer mouse time related to tension neck syndrome, but the evidence for keyboard time was insufficient. Insufficient evidence was found for an association between other musculoskeletal diagnoses of the neck and upper extremities, including shoulder tendonitis and epicondylitis, and any aspect of computer work. Conclusions There is limited epidemiological evidence for an association between aspects of computer work and some of the clinical diagnoses studied. None of the evidence was considered as moderate or strong and there is a need for more and better documentation.

  10. Upper Extremity Freezing and Dyscoordination in Parkinson’s Disease: Effects of Amplitude and Cadence Manipulations

    Directory of Open Access Journals (Sweden)

    April J. Williams

    2013-01-01

    Full Text Available Purpose. Motor freezing, the inability to produce effective movement, is associated with decreasing amplitude, hastening of movement, and poor coordination. We investigated how manipulations of movement amplitude and cadence affect upper extremity (UE coordination as measured by the phase coordination index (PCI—only previously measured in gait—and freezing of the upper extremity (FO-UE in people with Parkinson's disease (PD who experience freezing of gait (PD + FOG, do not experience FOG (PD-FOG, and healthy controls. Methods. Twenty-seven participants with PD and 18 healthy older adults made alternating bimanual movements between targets under four conditions: Baseline; Fast; Small; SmallFast. Kinematic data were recorded and analyzed for PCI and FO-UE events. PCI and FO-UE were compared across groups and conditions. Correlations between UE PCI, gait PCI, FO-UE, and Freezing of Gait Questionnaire (FOG-Q were determined. Results. PD + FOG had poorer coordination than healthy old during SmallFast. UE coordination correlated with number of FO-UE episodes in two conditions and FOG-Q score in one. No differences existed between PD−/+FOG in coordination or number of FO-UE episodes. Conclusions. Dyscoordination and FO-UE can be elicited by manipulating cadence and amplitude of an alternating bimanual task. It remains unclear whether FO-UE and FOG share common mechanisms.

  11. Adaptive Control of a Wearable Exoskeleton for Upper-Extremity Neurorehabilitation

    Directory of Open Access Journals (Sweden)

    Sivakumar Balasubramanian

    2012-01-01

    Full Text Available The paper describes the implementation and testing of two adaptive controllers developed for a wearable, underactuated upper extremity therapy robot – RUPERT (Robotic Upper Extremity Repetitive Trainer. The controllers developed in this study were used to implement two adaptive robotic therapy modes – the adaptive co-operative mode and the adaptive active-assist mode – that are based on two different approaches for providing robotic assistance for task practice. The adaptive active-assist mode completes therapy tasks when a subject is unable to do so voluntarily. This robotic therapy mode is a novel implementation of the idea of an active-assist therapy mode; it utilizes the measure of a subject’s motor ability, along with their real-time movement kinematics to initiate robotic assistance at the appropriate time during a movement trial. The adaptive co-operative mode, on the other hand, is based on the idea of enabling task completion instead of completing the task for the subject. Both these therapy modes were designed to adapt to a stroke subject's motor ability, and thus encourage voluntary participation from the stroke subject. The two controllers were tested on three stroke subjects practicing robot-assisted reaching movements. The results from this testing demonstrate that an underactuated wearable exoskeleton, such as RUPERT, can be used for administering robot-assisted therapy, in a manner that encourages voluntary participation from the subject undergoing therapy.

  12. Accuracy and consequences of 3D-fluoroscopy in upper and lower extremity fracture treatment: A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Beerekamp, M.S.H., E-mail: m.s.beerekamp@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Sulkers, George S.I., E-mail: georgesulkers@gmail.com [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Ubbink, Dirk T., E-mail: D.Ubbink@amc.nl [Department of Quality and Process Innovation, Academic Medical Center, Amsterdam (Netherlands); Maas, Mario, E-mail: M.Maas@amc.nl [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Schep, Niels W.L., E-mail: N.W.Schep@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Goslings, J. Carel, E-mail: J.C.Goslings@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands)

    2012-12-15

    Objectives: The aim of this systematic review was to compare the diagnostic accuracy, subjective image quality and clinical consequences of 3D-fluoroscopy with standard imaging modalities (2D-fluoroscopy, X-ray or CT) during reduction and fixation of intra-articular upper and lower extremity fractures. Methods: A systematic literature search was performed in MEDLINE, EMBASE and the Cochrane library. In total 673 articles were identified (up to March 2012). The 19 included studies described patients/cadavers with intra-articular upper/lower extremity fractures and compared 3D-fluoroscopy to standard imaging. The study was performed in accordance with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) guidelines. Diagnostic accuracy was defined by the quality of fracture reduction or implant position and, if possible, expressed as sensitivity and specificity; subjective image quality was determined by the quality of depiction of bone or implants; clinical consequences were defined as corrections in reduction or implant position following 3D-fluoroscopy. Results: Ten cadaver- and nine clinical studies were included. A meta-analysis was not possible, because studies used different scoring protocols to express diagnostic accuracy and reported incomplete data. Based on the individual studies, diagnostic accuracy of 3D-fluoroscopy was better than 2D-fluoroscopy and X-ray, but similar to CT-scanning. Subjective image quality of 3D-fluoroscopy was inferior compared to all other imaging modalities. In 11–40% of the operations additional corrections were performed after 3D-fluoroscopy, while the necessity for these corrections were not recognized based on 2D-fluoroscopic images. Conclusions: Although subjective image quality is rated inferior compared to other imaging modalities, intra-operative use of 3D-fluoroscopy is a helpful diagnostic tool for improving the quality of reduction and implant position in intra-articular fractures.

  13. Clinicopathological features and treatment of extremity bone metastasis in patients with endometrial carcinoma: a case report and review

    Institute of Scientific and Technical Information of China (English)

    JIANG Guo-qing; GAO Yu-nong; GAO Min; ZHENG Hong; YAN Xin; WANG Wen; AN Na; CAO Kun

    2011-01-01

    Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.

  14. Upper extremity disorders in performing artists.

    Science.gov (United States)

    Rozmaryn, L M

    1993-03-01

    Studies in the past decade have shown that a significant proportion of instrumentalists report musculoskeletal problems severely affecting their musical performance. Musicians endure daily intensive use of their upper extremities, frequently placing them in bizarre positions. Their training schedules are rigorous and long term Predisposing factors to, and treatment for, overuse syndromes, tendinitis, and tendon trauma commonly encountered by musical performers are discussed at length. Nerve entrapment has also surfaced as a major problem in musicians, and the means of evaluation and treatment and the role of surgery are put forth. Techniques for studying and analyzing the difficulties faced by instrumentalists are summarized.

  15. Poststroke upper extremity rehabilitation: a review of robotic systems and clinical results.

    Science.gov (United States)

    Brewer, Bambi R; McDowell, Sharon K; Worthen-Chaudhari, Lise C

    2007-01-01

    Although the use of robotic devices to address neuromuscular rehabilitative goals represents a promising technological advance in medical care, the large number of systems being developed and varying levels of clinical study of the devices make it difficult to follow and interpret the results in this new field. This article is a review of the current state-of-the-art in robotic applications in poststroke therapy for the upper extremity, written specifically to help clinicians determine the differences between various systems. We concentrate primarily on systems that have been tested clinically. Robotic systems are grouped by rehabilitation application (e.g., gross motor movement, bilateral training, etc.), and, where possible, the neurorehabilitation strategies employed by each system are described. We close with a discussion of the benefits and concerns of using robotics in rehabilitation and an indication of challenges that must be addressed for therapeutic robots to be applied practically in the clinic.

  16. Injury to the upper extremity caused by extravasation of contrast medium: a true emergency.

    Science.gov (United States)

    Fallscheer, Philipp; Kammer, Erich; Roeren, Thomas; Meuli-Simmen, Claudia

    2007-01-01

    This retrospective clinical study, over a period of four years, includes 16 patients who had extravasation of iopromidum 623 mg (Ultravist 300) in the upper extremity during computed tomography (CT). Although conservative management is sufficient in most cases, seven patients were operated on. The mean time between extravasation and operation was 155 minutes. The most complicated postoperative course occurred when the operation was delayed 300 minutes after extravasation. When patients were treated early, there was no permanent postoperative impairment. Extravasation of contrast is an increasing cause of potential complications in the forearm as a result of the use of power injectors in CT. Immediate assessment by an experienced plastic surgeon followed by either conservative treatment or quick intervention if necessary may avoid serious damage.

  17. Occupational performance, pain, and global quality of life in women with upper extremity fractures

    DEFF Research Database (Denmark)

    Dekkers, Merete Klindt; Nielsen, Tove Lise

    2010-01-01

    To examine pain, occupational performance problems, and quality of life (QoL) and possible associations between these variables, 41 elderly women with acute pain due to a fracture of the upper extremity were assessed with COPM, DASH, validated questions on pain, and a global question on Qo......L. The participants reported 802 performance problems: 38% within self-care, 52% within productivity, and 10% within leisure. Strength demanding bilateral activities in cleaning, hygiene, and cooking were most frequently reported. The median COPM performance and satisfaction scores were 2.8 and 3.4; the mean DASH...... score was 44.27. Pain frequency and intensity as well as QoL correlated moderately with the number of performance problems on the COPM. QoL was in general not very reduced and correlated only negligibly with pain. The DASH score correlated moderately with the total number of performance problems...

  18. Assessment of upper extremity function in multiple sclerosis: review and opinion.

    Science.gov (United States)

    Kraft, George H; Amtmann, Dagmar; Bennett, Susan E; Finlayson, Marcia; Sutliff, Matthew H; Tullman, Mark; Sidovar, Matthew; Rabinowicz, Adrian L

    2014-09-01

    Upper extremity (UE) dysfunction may be present in up to ~80% of individuals with multiple sclerosis (MS), although its importance may be under-recognized relative to walking impairment, which is the hallmark symptom of MS. Upper extremity dysfunction affects independence and can impact the ability to use walking aids. Under-recognition of UE dysfunction may result in part from limited availability of performance-based and patient self-report measures that are validated for use in MS and that can be readily incorporated into clinical practice for screening and regularly scheduled assessments. In addition to the 9-Hole Peg Test, which is part of the Multiple Sclerosis Functional Composite, there are several performance-based measures that are generally used in the rehabilitation setting. These measures include the Box and Block Test, the Action Research Arm Test, the Test d'Evaluation de la performance des Membres Supérieurs des Personnes Agées, and the Jebsen-Taylor Test of Hand Function. Several of these measures were developed for use in stroke, although in contrast to stroke, which is characterized by unilateral dysfunction, UE impairment in MS is generally bilateral, and should be assessed as such. Similarly, patient-reported UE measures are available, including Disabilities of the Arm, Shoulder, and Hand (DASH) and its shorter version, QuickDASH, the Manual Ability Measure, and ABILHAND, although none has been psychometrically validated for MS. Recently, item response theory was used to develop a Neuro-QOL (Quality of Life) UE measure and a Patient-Reported Outcomes Measurement Information System UE measure; neither of these have demonstrated sensitivity to change, limiting their use for longitudinal assessment. Consequently, although work is still needed to develop and validate performance-based and patient-reported measures of UE function that are suitable for use in daily MS clinical practice, currently available UE measures can be recommended for

  19. Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility.

    Science.gov (United States)

    Schnorenberg, Alyssa J; Slavens, Brooke A; Wang, Mei; Vogel, Lawrence C; Smith, Peter A; Harris, Gerald F

    2014-01-03

    Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood.

  20. Assessing upper extremity motor function in practice of virtual activities of daily living.

    Science.gov (United States)

    Adams, Richard J; Lichter, Matthew D; Krepkovich, Eileen T; Ellington, Allison; White, Marga; Diamond, Paul T

    2015-03-01

    A study was conducted to investigate the criterion validity of measures of upper extremity (UE) motor function derived during practice of virtual activities of daily living (ADLs). Fourteen hemiparetic stroke patients employed a Virtual Occupational Therapy Assistant (VOTA), consisting of a high-fidelity virtual world and a Kinect™ sensor, in four sessions of approximately one hour in duration. An unscented Kalman Filter-based human motion tracking algorithm estimated UE joint kinematics in real-time during performance of virtual ADL activities, enabling both animation of the user's avatar and automated generation of metrics related to speed and smoothness of motion. These metrics, aggregated over discrete sub-task elements during performance of virtual ADLs, were compared to scores from an established assessment of UE motor performance, the Wolf Motor Function Test (WMFT). Spearman's rank correlation analysis indicates a moderate correlation between VOTA-derived metrics and the time-based WMFT assessments, supporting the criterion validity of VOTA measures as a means of tracking patient progress during an UE rehabilitation program that includes practice of virtual ADLs.

  1. MR Imaging of the cervical cord in juvenile amyotrophy of distal upper extremity.

    Science.gov (United States)

    Biondi, A; Dormont, D; Weitzner, I; Bouche, P; Chaine, P; Bories, J

    1989-01-01

    We report the MR studies of the cervical cord in seven patients presenting juvenile muscular atrophy of distal upper extremity. This illness, also known as monomelic amyotrophy or benign focal amyotrophy, is distinct from the other motor neuron diseases. Seen in young males, it is characterized by muscular atrophy of the hand, and usually of the forearm, most often unilateral. The underlying process, of unknown origin, affects the anterior horn cells in the lower cervical cord. The gradual onset of purely motor disturbances may mimic early amyotrophic lateral sclerosis. This latter diagnosis may be excluded because of clinical stabilization and lack of pyramidal tract involvement. In our series, five MR studies were positive. In three cases we were able to demonstrate focal and unilateral atrophy in the lower cervical cord limited to the anterior horn region. Morphologic MR findings correlated with clinical and electromyographic features. In two other cases the MR-clinical correlation was more complex. No pathologic MR signal was detected on either T1- or T2-weighted images. Although the diagnosis of monomelic muscular atrophy is based on neurologic and neurophysiologic data, MR provides confirmatory evidence as well as useful information contributing to an understanding of this disease.

  2. SENSITIVITY OF COMPUTER ESTHESIOMETRY ON DISTAL PARTS OF THE UPPER EXTREMITIES AT PATIENTS WITH HEREDITARY NEUROPATHY CHARCOT-MARIE-TOOTH

    Directory of Open Access Journals (Sweden)

    NATALIA SHNAYDER

    2011-11-01

    Full Text Available The purpose: to define the diagnostic importance of computer esthesiometry for use in diagnostics of hereditary neuropathy with primary defeat of myelin sheath of peripheral nerves of the upper extremities. Materials and methods: 47 individuals in a condition of relative health (control group from 21 to 50 years, comparable group % 40 patients from 6 to 81 years, with hereditary neuropathy Charcot%Marie%Tooth (CMT. Vibrating sensitivity was investigated by means of computer vibrometer “Vibrotester MBN” VТ%02%1 (MBN, RF in a wide strip of frequencies of vibration (8, 16, 32, 64, 125, 250, 500 Hz. Statistical data processing of research was lead by means of programs STATISTICA v. 7.0 (StatSoft, USA. Results and discussion: We compared received corridors vibrating sensitivity on the upper extremities for healthy volunteers with those at patients with CMT. Statistically significant increase of vibration sensitivity thresholds in a wide range of vibration frequencies on upper extremities and at patients with CMT versus healthy volunteers is shown. Computer esthesiometry method demonstrates high sensitivity in diagnostics of hereditary neuropathy with primary damage of myelin sheath of peripheral nerves of upper extremities on an example of CMT.

  3. Reliability of the Quality of Upper Extremity Skills Test for Children with Cerebral Palsy Aged 2 to 12 Years

    Science.gov (United States)

    Thorley, Megan; Lannin, Natasha; Cusick, Anne; Novak, Iona; Boyd, Roslyn

    2012-01-01

    Aim: To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 2-12 years. Method: Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total,…

  4. High-fidelity numerical modeling of the Upper Mississippi River under extreme flood condition

    Science.gov (United States)

    Khosronejad, Ali; Le, Trung; DeWall, Petra; Bartelt, Nicole; Woldeamlak, Solomon; Yang, Xiaolei; Sotiropoulos, Fotis

    2016-12-01

    We present data-driven numerical simulations of extreme flooding in a large-scale river coupling coherent-structure resolving hydrodynamics with bed morphodynamics under live-bed conditions. The study area is a ∼ 3.2 km long and ∼ 300 m wide reach of the Upper Mississippi River, near Minneapolis MN, which contains several natural islands and man-made hydraulic structures. We employ the large-eddy simulation (LES) and bed-morphodynamic modules of the Virtual Flow Simulator (VFS-Rivers) model, a recently developed in-house code, to investigate the flow and bed evolution of the river during a 100-year flood event. The coupling of the two modules is carried out via a fluid-structure interaction approach using a nested domain approach to enhance the resolution of bridge scour predictions. We integrate data from airborne Light Detection and Ranging (LiDAR), sub-aqueous sonar apparatus on-board a boat and in-situ laser scanners to construct a digital elevation model of the river bathymetry and surrounding flood plain, including islands and bridge piers. A field campaign under base-flow condition is also carried out to collect mean flow measurements via Acoustic Doppler Current Profiler (ADCP) to validate the hydrodynamic module of the VFS-Rivers model. Our simulation results for the bed evolution of the river under the 100-year flood reveal complex sediment transport dynamics near the bridge piers consisting of both scour and refilling events due to the continuous passage of sand dunes. We find that the scour depth near the bridge piers can reach to a maximum of ∼ 9 m. The data-driven simulation strategy we present in this work exemplifies a practical simulation-based-engineering-approach to investigate the resilience of infrastructures to extreme flood events in intricate field-scale riverine systems.

  5. The utility of onion extract gel containing topical allantoin and heparin after surgical treatment of upper extremity burn scars

    Directory of Open Access Journals (Sweden)

    Mehmet Ihsan Okur

    2014-12-01

    Conclusion: Although no significant difference was obtained with Contractubex gel treatment in this study, cosmetic and functional success can be achieved through excision of the scar and use of medium thickness skin graft in patients with upper extremity hypertrophic burn scarring that is resistant to conservative treatments. [Hand Microsurg 2014; 3(3.000: 74-79

  6. Muscle activation patterns of the upper and lower extremity during the windmill softball pitch.

    Science.gov (United States)

    Oliver, Gretchen D; Plummer, Hillary A; Keeley, David W

    2011-06-01

    Fast-pitch softball has become an increasingly popular sport for female athletes. There has been little research examining the windmill softball pitch in the literature. The purpose of this study was to describe the muscle activation patterns of 3 upper extremity muscles (biceps, triceps, and rhomboids [scapular stabilizers]) and 2 lower extremity muscles (gluteus maximus and medius) during the 5 phases of the windmill softball pitch. Data describing muscle activation were collected on 7 postpubescent softball pitchers (age 17.7 ± 2.6 years; height 169 ± 5.4 cm; mass 69.1 ± 5.4 kg). Surface electromyographic data were collected using a Myopac Jr 10-channel amplifier (RUN Technologies Scientific Systems, Laguna Hills, CA, USA) synchronized with The MotionMonitor™ motion capture system (Innovative Sports Training Inc, Chicago IL, USA) and presented as a percent of maximum voluntary isometric contraction. Gluteus maximus activity reached (196.3% maximum voluntary isometric contraction [MVIC]), whereas gluteus medius activity was consistent during the single leg support of phase 3 (101.2% MVIC). Biceps brachii activity was greatest during phase 4 of the pitching motion. Triceps brachii activation was consistently >150% MVIC throughout the entire pitching motion, whereas the scapular stabilizers were most active during phase 2 (170.1% MVIC). The results of this study indicate the extent to which muscles are activated during the windmill softball pitch, and this knowledge can lead to the development of proper preventative and rehabilitative muscle strengthening programs. In addition, clinicians will be able to incorporate strengthening exercises that mimic the timing of maximal muscle activation most used during the windmill pitching phases.

  7. Outcomes of Botulinum Toxin Type A Injection Followed by Rehabilitation in Cases of Cerebral Palsy With Upper Extremity Involvement.

    Science.gov (United States)

    Karaca, Burcu; Ünlü, Ece; Köse, Gülşen; Gönen, Emel; Çakcı, Aytül

    2016-03-01

    We evaluated the efficiency of botulinum toxin type A injection followed by a rehabilitation program including individual therapy, group therapy, and occupational therapy in cases of cerebral palsy with upper extremity involvement. A total of 29 injections were performed on 25 patients, and the patients were placed on rehabilitation program. At 3-month and 6-month assessments, there was a significant improvement in lateral grip strength, 9 Hole Peg test, Upper Limb Physician's Rating Scale and pediatric functional independence measure total scores. There were significant decreases in active range of motion in elbow extension, supination, and wrist extension, and Modified Ashworth Scale in elbow flexion, elbow pronation, and wrist flexion at 6-week, 3-month, and 6-month assessments. Combination of group therapy with traditional therapy methods after injection is effective in cases of cerebral palsy with upper extremity involvement.

  8. Frequency of Painful Shoulder Limitation of Motion after Long Casting of Upper Extremity

    Directory of Open Access Journals (Sweden)

    A.R. Yavarikia

    2004-01-01

    Full Text Available The aim of this study was determination of frequency of painful reduced shoulder motion after long casting of upper extremity and its relation with age , sex and education . The present work was a descriptive analytic prospective study and included 388 patients who referred to Mobasher hospital of Hamadan during 2001. The selected patients in recurrent referring to orthopedic department were classified to 10 age groups and were examined by researcher in 1 , 1.5 and 3 months after treatment and data was collected in check list. The primary data were analyzed with 2 & Anova by employing EPI 6. Out of 388 studied patients 73.5% after 3 months had no mobility limitation and 26.5% had some limitation. There was significant statistical difference in limitation of abduction shoulder joint movement after 1 , 1.5 and 3 months after treatment among 10 different age groups (P<0.05. Mobility limitation of internal rotation after 3 months in 74 cases (19.1%(P=0.0001. Final mobility limitation in 59.5% of female patients and 40.5% of male patients(P=0.001. Mobility limitation in 54.1% of illiterate people , 24.5% under high school diploma and 21.4% high school diploma and higher. Painful limitation of motion in 50-80 year aged is most frequent, then early mobility and physiotherapy in this age range is indicated. There is significant relation between sex and frozen shoulder and it is more common in females also in illiterate people.

  9. Acute Bouts of Assisted Cycling Improves Cognitive and Upper Extremity Movement Functions in Adolescents with Down Syndrome

    Science.gov (United States)

    Ringenbach, Shannon D. R; Albert, Andrew R.; Chen, Chih-Chia; Alberts, Jay L.

    2014-01-01

    The aim of this study was to examine the effectiveness of 2 modes of exercise on cognitive and upper extremity movement functioning in adolescents with Down syndrome (DS). Nine participants randomly completed 3 interventions over 3 consecutive weeks. The interventions were: (a) voluntary cycling (VC), in which participants cycled at their…

  10. Validity and intra- and interobserver reliability of an indirect volume measurements in patients with upper extremity lymphedema

    NARCIS (Netherlands)

    Meijer, R.S.; Rietman, J.S.; Geertzen, J.H.B.; Bosmans, J.C.; Dijkstra, P.U.

    2004-01-01

    We investigated a method of indirect volume measurement that utilized surface measurements and a simplified formula derived from the formula for a frustum (Sitzia's method) to determine limb volumes in patients with breast cancer-related lymphedema of the upper extremity. Repeated measurements of up

  11. Upper extremity neurodynamic tests: range of motion asymmetry may not indicate impairment.

    Science.gov (United States)

    Covill, Laura G; Petersen, Shannon M

    2012-10-01

    Upper extremity (UE) neurodynamic tests are used to examine neural tissue in patients with neuro-musculoskeletal disorders. Although comparisons between involved and uninvolved limbs are made clinically, minimal data exist reflecting the normal variation between sides. The purpose of this study was to determine if within-subject differences exist between limbs in the UE component of neurodynamic tests of the median, radial, and ulnar nerves. Sixty-one healthy subjects were examined. Difference between limbs for the median nerve-biased test was significant (right=16.4° ± 11.4°, left=20.1° ± 13.7°; p=0.045). There was no significant difference between limbs for the radial or ulnar nerve-biased tests. Correlation between limbs was poor for all tests (median r(2) =0.14; radial r(2) =0.20; ulnar r(2) =0.13). Lower-bound scores were calculated to determine the amount of difference needed to consider asymmetry beyond measurement error; the scores for each neurodynamic test were as follows: median 27°, radial 20°, and ulnar 21°. The results of this study show that between-limb values have low correlation and that it may be normal for an individual to have range of motion differences between limbs with neurodynamic tests.

  12. New biomechanical model for clinical evaluation of the upper extremity motion in subjects with neurological disorders: an application case

    NARCIS (Netherlands)

    Lobo-Prat, Joan; Font-Llagunes, Josep M.; Gómez-Pérez, Cristina; Medina-Casanovas, Josep; Angulo-Barroso, Rosa M.

    2014-01-01

    Cervical spinal cord injury and acquired brain injury commonly imply a reduction in the upper extremity function which complicates, or even constrains, the performance of basic activities of daily living. Neurological rehabilitation in specialised hospitals is a common treatment for patients with ne

  13. Stimulus-response characteristics of motor evoked potentials and silent periods in proximal and distal upper-extremity muscles.

    NARCIS (Netherlands)

    Kuijk, A.A. van; Anker, L.C.; Pasman, J.W.; Hendriks, J.C.M.; Elswijk, G.A.F. van; Geurts, A.C.H.

    2009-01-01

    OBJECTIVE: To compare stimulus-response characteristics of both motor evoked potentials (MEP) and silent periods (SP) induced by transcranial magnetic stimulation (TMS) in proximal and distal upper-extremity muscles. METHODS: Stimulus-response curves of MEPs and SPs were obtained from the biceps bra

  14. ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries

    DEFF Research Database (Denmark)

    Beitzel, Knut; Mazzocca, Augustus D; Bak, Klaus;

    2014-01-01

    the coracoclavicular and AC ligaments. The ISAKOS Upper Extremity Committee has provided a more specific classification of shoulder pathologies to enhance the knowledge on and clinical approach to these injuries. We suggest the addition of grade IIIA and grade IIIB injuries to a modified Rockwood classification. Grade...

  15. To Constrain or Not to Constrain, and Other Stories of Intensive Upper Extremity Training for Children with Unilateral Cerebral Palsy

    Science.gov (United States)

    Gordon, Andrew M.

    2011-01-01

    Impaired hand function is among the most functionally disabling symptoms of unilateral cerebral palsy. Evidence-based treatment approaches are generally lacking. However, recent approaches providing intensive upper extremity training appear promising. In this review, we first describe two such approaches, constraint-induced movement therapy (CIMT)…

  16. Does Training of the Nondominant Upper Extremity Reduce the Surgeon's Muscular Strain During Laparoscopy?: Results From a Randomized Controlled Trial

    NARCIS (Netherlands)

    Nieboer, T.E.; Massa, M.; Weinans, M.J.; Vierhout, M.E.; Kluivers, K.B.; Stegeman, D.F.

    2013-01-01

    Introduction. In laparoscopy, suboptimal ergonomics frequently lead to morbidity for surgeons. Physical complaints are more commonly reported on the dominant upper extremity. This may be the consequence of challenging laparoscopic tasks being easier to perform with the dominant side. The authors hyp

  17. Metastatic tumours in upper maxillary bone of esophageal adenocarcinoma. A case report.

    Science.gov (United States)

    Sánchez-Jiménez, Juan; Acebal-Blanco, Faustino; Arévalo-Arévalo, Rafael E; Molina-Martínez, Manuel

    2005-01-01

    Metastases in the oral cavity are rare lesions which represent approximately 1% of all malignant neoplasms in the oral cavity. Oral metastases are located in the mandible 80-90% on average, the maxilla location being rarer. Metastases in mouth soft tissue are also rare, and within these it is on the gums where they more frequently occur. Primary tumours which metastasize to mouth are most commonly: lung, breast and kidney. Oral cavity metastases appear as a result of distant disease spreading and show wrong prognosis, with short survival. Here we present a clinical case of a patient diagnosed with esophagus adenocarcinoma which presented metastasis in upper-left maxillary bone.

  18. Maturational Sequence of Growth in Upper Extremity Dimensions among Garhwali and Jaunsari Rajput Females of Dehradun, Uttarakhand

    Directory of Open Access Journals (Sweden)

    Archana Kharyal

    2012-05-01

    Full Text Available The present study attempts to evaluate the progression of maturation in the three sub-segments (upper arm, forearm and hand length of the upper extremity among pre-adolescent and adolescent females of a tribal group and a non tribal group sharing common environment. A total of 1319 females (664 Garhwali and 655 Jaunsari Rajput in the age range of 8 to 18 years have been measured for upper arm length, forearm length, hand length and stature, following standard techniques recommended by Weiner and Lourie (1969. Analysis of data clearly reveals the existence of both cephalo- caudal and caudo- cephalic directions of maturation. The existence of multiple gradients is also observed at different age groups within the sub-segments of upper extremity in both the populations. At 16 years, the upper arm length and at 17 years the forearm length among the Garhwali females have attained complete maturation, while in Jaunsari females the forearm length and hand length achieve complete maturation at 17 years.

  19. Ergotamine-induced upper extremity ischemia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk; Lee, Gun [Bundang CHA General Hospital, Pochon (China); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-06-15

    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  20. Acute deep venous thrombosis of the upper extremity as demonstrated by scintigraphy with {sup 99m}Tc-apcitide

    Energy Technology Data Exchange (ETDEWEB)

    Dunzinger, A.; Piswanger-Soelkner, J.; Lipp, R. [Medical Univ. Graz (Austria). Div. of Nuclear Medicine; Hafner, F.; Brodmann, M. [Medical Univ. Graz (Austria). Div. of Angiology

    2008-07-01

    With an incidence of 0.7% inhabitants per year, acute deep venous thrombosis (DVT) is a common occurrence (20). Its incidence in the upper extremities, however, is not as precisely known; the literature reports that 1% to 10% of all DVT cases involve the upper limbs. Acute DVT of upper limb is mainly iatro-genic following interventions like implantation of pacemakers or central venous catheters, and is more likely to occur in obese patients or those with malignant diseases. Life-threatening pulmonary embolism (PE) may occur if acute DVT remains undetected. The presented case report demonstrates the feasibility of {sup 9}9mTc-apcitide scintigraphy for diagnosis of acute DVT of the upper limb and exclusion of PE in a single examination.

  1. Investigation of the effects of mirror therapy on the upper extremity functions of stroke patients using the manual function test

    OpenAIRE

    Kim, Hwanhee; Shim, Jemyung

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 ...

  2. Testing the concurrent validity of a naturalistic upper extremity reaching task.

    Science.gov (United States)

    Schaefer, S Y; Hengge, C R

    2016-01-01

    Point-to-point reaching has been widely used to study upper extremity motor control. We have been developing a naturalistic reaching task that adds tool manipulation and object transport to this established paradigm. The purpose of this study was to determine the concurrent validity of a naturalistic reaching task in a sample of healthy adults. This task was compared to the criterion measure of standard point-to-point reaching. Twenty-eight adults performed unconstrained out-and-back movements in three different directions relative to constant start location along midline using their nondominant arm. In the naturalistic task, participants manipulated a tool to transport objects sequentially between physical targets anchored to the planar workspace. In the standard task, participants moved a digital cursor sequentially between virtual targets, veridical to the planar workspace. In both tasks, the primary measure of performance was trial time, which indicated the time to complete 15 reaches (five cycles of three reaches/target). Two other comparator tasks were also designed to test concurrent validity when components of the naturalistic task were added to the standard task. Spearman's rank correlation coefficients indicated minimal relationship between the naturalistic and standard tasks due to differences in progressive task difficulty. Accounting for this yielded a moderate linear relationship, indicating concurrent validity. The comparator tasks were also related to both the standard and naturalistic task. Thus, the principles of motor control and learning that have been established by the wealth of point-to-point reaching studies can still be applied to the naturalistic task to a certain extent.

  3. Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients

    Directory of Open Access Journals (Sweden)

    Michael Blaivas

    2012-01-01

    Full Text Available Background-Aim. Upper extremity deep vein thrombosis (UEDVT is an increasingly recognized problem in the critically ill. We sought to identify the prevalence of and risk factors for UEDVT, and to characterize sonographically detected thrombi in the critical care setting. Patients and Methods. Three hundred and twenty patients receiving a subclavian or internal jugular central venous catheter (CVC were included. When an UEDVT was detected, therapeutic anticoagulation was started. Additionally, a standardized ultrasound scan was performed to detect the extent of the thrombus. Images were interpreted offline by two independent readers. Results. Thirty-six (11.25% patients had UEDVT and a complete scan was performed. One (2.7% of these patients died, and 2 had pulmonary embolism (5.5%. Risk factors associated with UEDVT were presence of CVC [(odds ratio (OR 2.716, P=0.007], malignancy (OR 1.483, P=0.036, total parenteral nutrition (OR 1.399, P=0.035, hypercoagulable state (OR 1.284, P=0.045, and obesity (OR 1.191, P=0.049. Eight thrombi were chronic, and 28 were acute. We describe a new sonographic sign which characterized acute thrombosis: a double hyperechoic line at the interface between the thrombus and the venous wall; but its clinical significance remains to be defined. Conclusion. Presence of CVC was a strong predictor for the development of UEDVT in a cohort of critical care patients; however, the rate of subsequent PE and related mortality was low.

  4. An accelerometry-based methodology for assessment of real-world bilateral upper extremity activity.

    Directory of Open Access Journals (Sweden)

    Ryan R Bailey

    Full Text Available The use of both upper extremities (UE is necessary for the completion of many everyday tasks. Few clinical assessments measure the abilities of the UEs to work together; rather, they assess unilateral function and compare it between affected and unaffected UEs. Furthermore, clinical assessments are unable to measure function that occurs in the real-world, outside the clinic. This study examines the validity of an innovative approach to assess real-world bilateral UE activity using accelerometry.Seventy-four neurologically intact adults completed ten tasks (donning/doffing shoes, grooming, stacking boxes, cutting playdough, folding towels, writing, unilateral sorting, bilateral sorting, unilateral typing, and bilateral typing while wearing accelerometers on both wrists. Two variables, the Bilateral Magnitude and Magnitude Ratio, were derived from accelerometry data to distinguish between high- and low-intensity tasks, and between bilateral and unilateral tasks. Estimated energy expenditure and time spent in simultaneous UE activity for each task were also calculated.The Bilateral Magnitude distinguished between high- and low-intensity tasks, and the Magnitude Ratio distinguished between unilateral and bilateral UE tasks. The Bilateral Magnitude was strongly correlated with estimated energy expenditure (ρ = 0.74, p<0.02, and the Magnitude Ratio was strongly correlated with time spent in simultaneous UE activity (ρ = 0.93, p<0.01 across tasks.These results demonstrate face validity and construct validity of this methodology to quantify bilateral UE activity during the performance of everyday tasks performed in a laboratory setting, and can now be used to assess bilateral UE activity in real-world environments.

  5. Functional Latissimus Dorsi Transfer for Upper-Extremity Reconstruction: A Case Report and Review of the Literature

    Science.gov (United States)

    Therattil, Paul J.; Russo, Gerardo; Lee, Edward S.

    2017-01-01

    Objective: The latissimus dorsi flap is a workhorse for plastic surgeons, being used for many years for soft-tissue coverage of the upper extremity as well as for functional reconstruction to restore motion to the elbow and shoulder. The authors present a case of functional latissimus dorsi transfer for restoration of elbow flexion and review the literature on technique and outcomes. Methods: A literature review was performed using MEDLINE and the Cochrane Collaboration Library for primary research articles on functional latissimus dorsi flap transfer. Data related to surgical techniques and outcomes were extracted. Results: The literature search yielded 13 relevant studies, with a total of 52 patients who received pedicled, functional latissimus dorsi flaps for upper-extremity reconstruction. The most common etiology requiring reconstruction was closed brachial plexus injury (n = 13). After flap transfer, 98% of patients were able to flex the elbow against gravity and 82.3% were able to flex against resistance. In the presented case, a 77-year-old man underwent resection of myxofibrosarcoma of the upper arm with elbow prosthesis placement and functional latissimus dorsi transfer. The patient was able to actively flex against gravity at 3-month follow-up. Conclusions: A review of the literature shows that nearly all patients undergoing functional latissimus dorsi transfer for upper-extremity reconstruction regain at least motion against gravity whereas a large proportion regain motion against resistance. Considerations when planning for functional latissimus dorsi transfer include patient positioning, appropriate tensioning of the muscle, safe inset, polarity, management of other affected upper-extremity joints, and educating patients on the expected outcomes. PMID:28293330

  6. Upper extremity function: What's posture got to do with it?

    Science.gov (United States)

    Harbourne, Regina; Kamm, Kathi

    2015-01-01

    This perspective paper reviews the linkage between developing postural control and upper extremity function. We suggest updated principles for guiding clinical practice, based on current views from motor learning, motor development, and motor control research. Using three clinical examples, we illustrate principles focusing on the use of variability, the importance of errors in learning movement, task specific exploration and practice, and the critical timing necessary to build skill of the upper extremity in a variety of postures. These principles differ from historic approaches in therapeutic exercise, which treated posture as a separate system and a precursor for extremity skill building. We maintain that current movement science supports the tight interaction of posture and upper extremity function through developmental time and in real time, such that one system cannot be considered separate from the other. Specific suggestions for clinical practice flow from the guiding principles outlined in this paper.

  7. Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular auto-grafts. Methods: From January 2001 to December 2005. large bone defects in 19 patients (11 men and 8 women, aged 6 to 35 years) were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm (mean 17. 6 cm), length of vascularized free fibular was 15 to 29 cm (mean 19. 2 cm), length of massive bone allografts was 11 to 24 cm (mean 17. 1 cm). Location of massive bone defects was in humerus(n = 1), in femur(n = 9) and in tibia(n = 9), respectively. Results: After 9 to 69 months (mean 38. 2 months) follow-up, wounds of donor and recipient sites were healed in Ⅰ stage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2. 5 months, post-operatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion: The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular au-tograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.

  8. Two-point discrimination of the upper extremities of healthy Koreans in their 20’s

    Science.gov (United States)

    Koo, Ja-Pung; Kim, Soon-Hee; An, Ho-Jung; Moon, Ok-Gon; Choi, Jung-Hyun; Yun, Young-Dae; Park, Joo-Hyun; Min, Kyoung-Ok

    2016-01-01

    [Purpose] The present study attempted to measure two-point discrimination in the upper extremities of healthy Koreans in their 20’s. [Subjects and Methods] Using a three-point esthesiometer, we conducted an experiment with a group of 256 college students (128 male and 128 female), attending N University in Chonan, Republic of Korea. [Results] Females showed two-point discrimination at a shorter distance than males at the following points: (i) 5 cm above the elbow joint, the middle part, and 5 cm below the shoulder joint of the anterior upper arm; (ii) 5 cm above the elbow joint and 5 cm below the shoulder joint of the posterior upper arm; (iii) 5 cm above the front of the wrist joint of the forearm; 5 cm below the elbow joint, the palmar part of the distal interphalangeal joint of the thumb, the dorsal part of the distal interphalangeal joint of the middle and little fingers. It was also found that females showed greater two-point discrimination than males in distal regions rather than proximal regions. [Conclusion] The findings of this study will help establish normal values for two-point discrimination of upper extremities of young Koreans in their 20’s. PMID:27134375

  9. Role and significance of dual-energy X-ray absorptiometry in measurement of bone mineral density in children with upper extremity fractures%双能X线吸收法检测儿童上肢骨折的骨密度及其意义

    Institute of Scientific and Technical Information of China (English)

    韦溦; 杨星华; 刘洋; 韦继刚; 陈辉; 郭元

    2014-01-01

    Objective To measure the bone mineral density in children with dual-energy X-ray absorptiometry and examine the relevance of bone mineral density with the risk of pediatric upper limb fracture.Methods A total of 864 children (8-14 years of age) admitted into our hospital in 2009 were involved in the study.The bone mass density (Z score) at the left radius was measured using dual-energy X-ray absorptiometry.Children were grouped according to their Z score and age to observe correlations of Z value and age with the incidence of fractures.Results Thirty-three children were lost to follow-up.For the other 831 children,the mean duration of follow-up was 2 years.Z sore was ≤-2 in 66 children and >-2 in 765 children.There was significant difference in fracture incidence between children with Z score of ≤-2 and >-2 (27.27% vs 5.49%,P <0.01).Furthermore,fracture incidence in children at age group of 8-10 years and 11-14 years revealed significant difference (10.83% vs 5.03%,P < 0.01).Conclusions Bone mineral density is closely related to upper limb fracture in children and increases with aging.Early application of dual-energy X-ray absorptiometry to detect the bone density is an effective primary measure for prevention of fractures in children.%目的 探讨双能X线吸收法检测儿童上肢骨折的骨密度及其意义. 方法 选取2009年1-12月体检的8~14岁儿童864例,采用双能X线骨密度测试仪检测左桡骨骨密度Z值,根据Z值大小进行分组观察Z值与骨折的关系;根据年龄分组观察年龄与骨折的关系. 结果 864例患者中获得2年随访831例,失随访33例.Z值结果显示,Z值≤-2者66例,Z值>-2者765例.Z值≤-2组儿童骨折发生率为27.27%,Z值>-2组骨折发生率为5.49%,两组比较差异有统计学意义(P<0.01);8~10岁组儿童骨折发生率为10.83%,11 ~ 14岁组骨折发生率为5.03%,两组比较差异有统计学意义(P<0.01). 结论 骨密度与儿童上肢骨

  10. Vascular injuries of the upper extremity Lesões vasculares de membros superiores

    Directory of Open Access Journals (Sweden)

    Raafat Shalabi

    2006-12-01

    Full Text Available OBJECTIVE: This study analyzes the causes of injuries, presentations, surgical approaches, outcome and complications of vascular trauma of the upper limbs, in spite of limited hospital resources. METHODS: A 5-year retrospective analysis. From 01/01/2001 to 31/12/2005, 165 patients were operated for vascular injuries at King Fahd Hospital, Medina, Saudi Arabia. Of all peripheral vascular trauma patients (115, upper limb trauma was present in 58. Diagnosis was made by physical examination and hand-held Doppler alone or in combination with Doppler scan/angiography. Primary vascular repair was performed whenever possible; otherwise, the interposition vein graft was used. Fasciotomy was considered when required. Patients with unsalvageable lower extremity injury requiring primary amputation were excluded from the study. RESULTS: Fifty patients were male (86% and eight were female (14%, aged between 2.5-55 years (mean 23 years. Mean duration of presentation was 8 h after the injury. The most common etiological factor was road traffic accidents, accounting for 50.5% in the blunt trauma group and 33% among all penetrating and stab wound injuries. Incidence of concomitant orthopedic injuries was very high in our study (51%. The brachial artery was the most affected (51%. Interposition vein grafts were used in 53% of the cases. Limb salvage rate was 100%. CONCLUSION: Patients who suffer vascular injuries of the upper extremities should be transferred to vascular surgery centers as soon as possible. Decisive management of peripheral vascular trauma will maximize patient survival and limb salvage. Priorities must be established in the management of associated injuries, and delay must be avoided when ischemic changes are present.OBJETIVO: Este estudo analisa as causas de lesões, apresentação, abordagens cirúrgicas, desfechos e complicações do trauma vascular de membros superiores, apesar de recursos hospitalares limitados. MÉTODOS: An

  11. Motor And Sensory Effects Of Ipsilesional Upper Extremity Hypothermia And Contralesional Sensory Training For Chronic Stroke Patients

    OpenAIRE

    Lima, de, M.; Nubia Maria; Menegatti; Karina Candido; Yu; Erica; Sacomoto; Natalia Yumi; Oberg; Telma Dagmar; Honorato; Donizeti Cesar

    2016-01-01

    As hypothermia by immersion can reduce the sensory nerve conduction velocity, this study hypothesized that the reduction of sensory input to the ipsilesional upper extremity (UE) using cryotherapy would reduce the inhibitory activity of the contralesional hemisphere in chronic stroke subjects. Objective: In this study, hypothermia was applied by immersing the ipsilesional UE in association with sensory training of the contralesional UE of stroke patients to assess the immediate (e.g. sensorim...

  12. Effects of interactive metronome training on postural stability and upper extremity function in Parkinson’s disease: a case study

    Science.gov (United States)

    Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

    2017-01-01

    [Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson’s disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson’s disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient’s static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson’s disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson’s disease. PMID:28210066

  13. Vascular injuries after minor blunt upper extremity trauma: pitfalls in the recognition and diagnosis of potential "near miss" injuries

    Directory of Open Access Journals (Sweden)

    Bravman Jonathan T

    2008-11-01

    Full Text Available Abstract Background Low energy trauma to the upper extremity is rarely associated with a significant vascular injury. Due to the low incidence, a high level of suspicion combined with appropriate diagnostic algorithms are mandatory for early recognition and timely management of these potentially detrimental injuries. Methods Review of the pertinent literature, supported by the presentation of two representative "near miss" case examples. Results A major diagnostic pitfall is represented by the insidious presentation of significant upper extremity arterial injuries with intact pulses and normal capillary refill distal to the injury site, due to collateral perfusion. Thus, severe vascular injuries may easily be missed or neglected at the upper extremity, leading to a long-term adverse outcome with the potential need for a surgical amputation. Conclusion The present review article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating or high-velocity trauma mechanism.

  14. ACUTE EFFECTS OF STATIC STRETCHING, DYNAMIC EXERCISES, AND HIGH VOLUME UPPER EXTREMITY PLYOMETRIC ACTIVITY ON TENNIS SERVE PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Ertugrul Gelen

    2012-12-01

    Full Text Available The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg performed 4 different warm-up (WU routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice (TRAD; traditional WU and static stretching (TRSS; traditional WU and dynamic exercise (TRDE; and traditional WU and high volume upper extremity plyometric activity (TRPLYP. Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p 0.05. ICCs for ball speed showed strong reliability (0.82 to 0.93 for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players.

  15. Deep vein thrombosis of upper extremities due to reactive thrombocytosis in septic patients

    Directory of Open Access Journals (Sweden)

    Shakti Bedanta Mishra

    2014-01-01

    Full Text Available Deep venous thrombosis (DVT is not an uncommon condition in the intensive care unit (ICU, and having high morbidity and mortality. Upper limb DVT also is increasingly being recognized as a clinical entity. The presence of the indwelling catheter in neck veins is a risk for developing venous thrombus, which may be further aggravated by presence of thrombocytosis. In ICU patients with sepsis, reactive thrombocytosis has been found during the recovery phase. Here, we are presenting two cases, having thrombocytosis and central venous catheter who developed upper limb DVT.

  16. Movement characteristics of upper extremity prostheses during basic goal-directed tasks

    NARCIS (Netherlands)

    Bouwsema, Hanneke; van der Sluis, Corry K.; Bongers, Raoul M.

    2010-01-01

    Background: After an upper limb amputation a prosthesis is often used to restore the functionality. However, the frequency of prostheses use is generally low. Movement kinematics of prostheses use might suggest origins of this low use. The aim of this study was to reveal movement patterns of prosthe

  17. Bilateral macrodystrophia lipomatosa of the upper extremities with syndactyly and multiple lipomas

    NARCIS (Netherlands)

    van der Meer, Saskia; Nicolai, Jean-Philippe A.; Schut, Simone M.; Meek, Marcel F.

    2011-01-01

    Macrodystrophia lipomatosa is a rare disease that causes congenital local gigantism of part of an extremity, which is characterised by an increase in all mesenchymal elements, particularly fibroadipose tissue. This is the first report to our knowledge of a case of histologically confirmed bilateral

  18. Satisfaction with upper extremity surgery in individuals with tetraplegia

    DEFF Research Database (Denmark)

    Gregersen, Hanne; Lybæk, Mille; Lauge Johannesen, Inger

    2015-01-01

    OBJECTIVE: To supplement the scant information available regarding the satisfaction of patients with tetraplegia following upper extremity reconstructive surgery for such individuals with spinal cord injury (SCI). STUDY DESIGN: Retrospective study with questionnaire follow-up. SETTING: The Danish...... questions (P satisfaction with upper extremity surgery is high. It can have a positive impact on life in general, ability to perform ADL, as well as supplying an increased level of independence....... to strongly disagree regarding satisfaction. Forty patients completed the questionnaire. RESULTS: Median time from first surgery was 13 years (2-36). Sixty-five percent of the sample had a C5-C6 SCI, with 64% experiencing complete injury. Initially, 76% of the sample expressed general satisfaction with life......OBJECTIVE: To supplement the scant information available regarding the satisfaction of patients with tetraplegia following upper extremity reconstructive surgery for such individuals with spinal cord injury (SCI). STUDY DESIGN: Retrospective study with questionnaire follow-up. SETTING: The Danish...

  19. Simulated bone remodeling around two types of osseointegrated implants for direct fixation of upper-leg prostheses

    NARCIS (Netherlands)

    Tomaszewski, P.K.; Verdonschot, N.; Bulstra, S.K.; Rietman, J.S.; Verkerke, G.J.

    2012-01-01

    Direct attachment of an upper leg prosthesis to the skeletal system by a percutaneous implant is an alternative solution to the traditional socket fixation. In this study, we investigated long-term periprosthetic bone changes around two types of fixation implants using two different initial conditio

  20. Magnetic resonance imaging of peripheral nerve tumours in the upper extremity

    DEFF Research Database (Denmark)

    Nilsson, Jessica; Sandberg, Kristina; Søe Nielsen, Niels;

    2009-01-01

    extremity. Medical records of 19 patients (20 MRI examinations) with 29 histopathologically verified benign nerve tumours were examined retrospectively. In 12/20 cases MRI suggested a correct diagnosis of the type of nerve tumour. An additional 3/20 cases had an uncertain diagnosis, but nerve relations...

  1. Upper extremity sensorimotor control among collegiate football players.

    Science.gov (United States)

    Laudner, Kevin G

    2012-03-01

    Injuries stemming from shoulder instability are very common among athletes participating in contact sports, such as football. Previous research has shown that increased laxity negatively affects the function of the sensorimotor system potentially leading to a pathological cycle of shoulder dysfunction. Currently, there are no data detailing such effects among football players. Therefore, the purpose of this study was to examine the differences in upper extremity sensorimotor control among football players compared with that of a control group. Forty-five collegiate football players and 70 male control subjects with no previous experience in contact sports participated. All the subjects had no recent history of upper extremity injury. Each subject performed three 30-second upper extremity balance trials on each arm. The balance trials were conducted in a single-arm push-up position with the test arm in the center of a force platform and the subjects' feet on a labile device. The trials were averaged, and the differences in radial area deviation between groups were analyzed using separate 1-way analyses of variance (p football players showed significantly more radial area deviation of the dominant (0.41 ± 1.23 cm2, p = 0.02) and nondominant arms (0.47 ± 1.63 cm2, p = 0.03) when compared with the control group. These results suggest that football players may have decreased sensorimotor control of the upper extremity compared with individuals with no contact sport experience. The decreased upper extremity sensorimotor control among the football players may be because of the frequent impacts accumulated during football participation. Football players may benefit from exercises that target the sensorimotor system. These findings may also be beneficial in the evaluation and treatment of various upper extremity injuries among football players.

  2. Sensory reinnervation of free flaps in reconstruction of the breast and the upper and lower extremities

    Institute of Scientific and Technical Information of China (English)

    Nektarios Sinis; Androniki Lamia; Helml Gudrun; Thomas Schoeller; Frank Werdin

    2012-01-01

    There is long-standing debate about sensate versus non-sensate free microvascular flaps among microsurgeons.The principle of connecting not only the vascular supply,but also sensitive nerves,in free tissue transfer is attractive.However,increased operating time and partial spontaneous innervation led to the common decision to restrict microsurgical tissue transfer to the vascular anastomosis and to leave the nerves "untreated".Nevertheless,in special cases such as breast reconstruction or extremity reconstruction,the question about sensory nerve coaptation of the flaps remains open.We present our experience with free microvascular tissue transfer for breast and extremity reconstruction and compare the data with previous literature and conclude that most free flap surgeries do not benefit from nerve coaptation.

  3. Upper Extremity Sports Injury: Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, R.; Dekker, R.; Dijkstra, P.U.; ten Duis, H.J.; van der Sluis, C.K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  4. Upper Extremity Sports Injury : Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U.; ten Duis, Hendrik J.; van der Sluis, Corry K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  5. The Flail and Pulseless Upper Limb: an Extreme Case of Traumatic Scapulo-thoracic Dissociation

    Directory of Open Access Journals (Sweden)

    Maria SW

    2015-07-01

    Full Text Available Scapulo-thoracic dissociation is an infrequent injury resulting from high energy trauma which is often associated with severe neurological and vascular injuries which may be unrecognised at the time of presentation. A 24 year-old female presented with bilateral rib fractures, pneumothorax, liver and kidney injuries following a road traffic accident. She also sustained fractures of her right scapula, odontoid, right transverse processes of the thoracic and lumbar vertebrae and a closed fracture of her right femur. Her right upper limb was later noted to be flail and pulseless, due to complete right brachial plexus injury, scapula-thoracic dissociation and subclavian artery avulsion. We managed the upper limb injuries non-operatively, and focused on resuscitation of the patient. Early exploration of the complete brachial plexus injury was not undertaken in spite of the possible associated poor functional outcome as there was no life-threatening indication.

  6. Motor relearning program and Bobath method improve motor function of the upper extremities in patients with stroke

    Institute of Scientific and Technical Information of China (English)

    Jinjing Liu; Fengsheng Li; Guihua Liu

    2006-01-01

    BACKGROUND: In the natural evolution of cerebrovascular disease, unconscious use of affected extremity during drug treatment and daily life can improve the function of affected upper extremity partially, but it is very slow and alsc accompanied by the formation of abnormal mode. Therefore, functional training should be emphasized in recovering the motor function of extremity.OBJECTIVE: To observe the effects of combination of motor relearning program and Bobath method on motor function of upper extremity of patients with stroke.DESIGN: Comparison of therapeutic effects taking stroke patients as observation subjects.SETTING: Department of Neurology, General Hospital of Beijing Jingmei Group.PARTICIPANTS: Totally 120 stroke patients, including 60 males and 60 females, averaged (59±3) years, who hospitalized in the Department of Neurology, General Hospital of Beijing Jingmei Group between January 2005 and June 2006 were recruited. The involved patients met the following criteria: Stroke attack within 2 weeks;diagnosis criteria of cerebral hemorrhage or infarction made in the 4th National Cerebrovascular Disease Conference; confirmed by skull CT or MRI; Informed consents of therapeutic regimen were obtained. The patients were assigned into 2 groups according to their wills: rehabilitation group and control group, with 30 males and 30 females in each group. Patients in rehabilitation group averaged (59±2)years old, and those in the control group averaged (58±2)years old.METHODS: ① Patients in two groups received routine treatment in the Department of Neurology. When the vital signs of patients in the rehabilitation group were stable, individualized treatment was conducted by combined application of motor relearning program and Bobath method. Meanwhile, training of activity of daily living was performed according to the disease condition changes of patients at different phases, including the nursing and instruction of body posture, the maintenance of good extremity

  7. Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies.

    Science.gov (United States)

    Noorkõiv, Marika; Rodgers, Helen; Price, Christopher I

    2014-10-09

    The aim of this review was to identify and summarise publications, which have reported clinical applications of upper limb accelerometry for stroke within free-living environments and make recommendations for future studies. Data was searched from MEDLINE, Scopus, IEEExplore and Compendex databases. The final search was 31st October 2013. Any study was included which reported clinical assessments in parallel with accelerometry in a free-living hospital or home setting. Study quality is reflected by participant numbers, methodological approach, technical details of the equipment used, blinding of clinical measures, whether safety and compliance data was collected. First author screened articles for inclusion and inclusion of full text articles and data extraction was confirmed by the third author. Out of 1375 initial abstracts, 8 articles were included. All participants were stroke patients. Accelerometers were worn for either 24 hours or 3 days. Data were collected as summed acceleration counts over a specified time or as the duration of active/inactive periods. Activity in both arms was reported by all studies and the ratio of impaired to unimpaired arm activity was calculated in six studies. The correlation between clinical assessments and accelerometry was tested in five studies and significant correlations were found. The efficacy of a rehabilitation intervention was assessed using accelerometry by three studies: in two studies both accelerometry and clinical test scores detected a post-treatment difference but in one study accelerometry data did not change despite clinical test scores showing motor and functional improvements. Further research is needed to understand the additional value of accelerometry as a measure of upper limb use and function in a clinical context. A simple and easily interpretable accelerometry approach is required.

  8. Upper extremity hemodynamics and sensation with backpack loads.

    Science.gov (United States)

    Kim, Sae Hoon; Neuschwander, Timothy B; Macias, Brandon R; Bachman, Larry; Hargens, Alan R

    2014-05-01

    Heavy backpacks are often used in extreme environments, for example by military during combat, therefore completion of tasks quickly and efficiently is of operational relevance. The purpose of this study was to quantify hemodynamic parameters (brachial artery Doppler and microvascular flow by photoplethysmography; tissue oxygenation by near-infrared spectroscopy; arterial oxygen saturation by pulse oximeter) and sensation in upper extremities and hands (Semmes-Weinstein monofilament test and 2-point discrimination test) while wearing a loaded backpack (12 kg) in healthy adults for 10 min. All values were compared to baseline before wearing a backpack. Moderate weight loaded backpack loads significantly decreased upper extremity sensation as well as all macrovascular and microvascular hemodynamic values. Decreased macrovascular and microvascular hemodynamics may produce neurological dysfunction and consequently, probably affect fine motor control of the hands.

  9. Rehabilitation of motor function after stroke: a multiple systematic review focused on techniques to stimulate upper extremity recovery

    Directory of Open Access Journals (Sweden)

    Samar M Hatem

    2016-09-01

    Full Text Available Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients’ mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed.At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation.

  10. Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity Recovery

    Science.gov (United States)

    Hatem, Samar M.; Saussez, Geoffroy; della Faille, Margaux; Prist, Vincent; Zhang, Xue; Dispa, Delphine; Bleyenheuft, Yannick

    2016-01-01

    Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients' mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training, and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed. At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning, and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation. PMID:27679565

  11. Effect of upper extremity proprioceptive neuromuscular facilitation combined with elastic resistance bands on respiratory muscle strength: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Guilherme P. T. Areas

    2013-12-01

    Full Text Available BACKGROUND: Elastic resistance bands (ERB combined with proprioceptive neuromuscular facilitation (PNF are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle strength warrant further investigation. OBJECTIVES: The assessment of the effects of PNF combined with ERB on respiratory muscle strength. METHOD: Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10 or the control group (CG, n=10. Maximal expiratory pressure (MEP and inspiratory pressure (MIP were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. RESULTS: PNF combined with ERB showed significant increases in MIP and MEP (p<0.05. In addition, there were significant differences between the TG and CG regarding ∆MIP (p=0.01 and ∆MEP (p=0.04. CONCLUSIONS: PNF combined with ERB can have a positive impact on respiratory muscle strength. These results may be useful with respect to cardiopulmonary chronic diseases that are associated with reduced respiratory muscle strength.

  12. A hybrid joint based controller for an upper extremity exoskeleton

    Science.gov (United States)

    Mohd Khairuddin, Ismail; Taha, Zahari; Majeed, Anwar P. P. Abdul; Hakeem Deboucha, Abdel; Azraai Mohd Razman, Mohd; Aziz Jaafar, Abdul; Mohamed, Zulkifli

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton. The Euler-Lagrange formulation was used in deriving the dynamic modelling of both the human upper limb as well as the exoskeleton that consists of the upper arm and the forearm. The human model is based on anthropometrical measurements of the upper limb. The proportional-derivative (PD) computed torque control (CTC) architecture is employed in this study to investigate its efficacy performing joint-space control objectives specifically in rehabilitating the elbow and shoulder joints along the sagittal plane. An active force control (AFC) algorithm is also incorporated into the PD-CTC to investigate the effectiveness of this hybrid system in compensating disturbances. It was found that the AFC- PD-CTC performs well against the disturbances introduced into the system whilst achieving acceptable trajectory tracking as compared to the conventional PD-CTC control architecture.

  13. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients.

    Science.gov (United States)

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-12-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients.

  14. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients

    Science.gov (United States)

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients. PMID:28174433

  15. Reinforced Feedback in Virtual Environment for Rehabilitation of Upper Extremity Dysfunction after Stroke: Preliminary Data from a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Paweł Kiper

    2014-01-01

    Full Text Available Objectives. To study whether the reinforced feedback in virtual environment (RFVE is more effective than traditional rehabilitation (TR for the treatment of upper limb motor function after stroke, regardless of stroke etiology (i.e., ischemic, hemorrhagic. Design. Randomized controlled trial. Participants. Forty-four patients affected by stroke. Intervention. The patients were randomized into two groups: RFVE (N=23 and TR (N=21, and stratified according to stroke etiology. The RFVE treatment consisted of multidirectional exercises providing augmented feedback provided by virtual reality, while in the TR treatment the same exercises were provided without augmented feedbacks. Outcome Measures. Fugl-Meyer upper extremity scale (F-M UE, Functional Independence Measure scale (FIM, and kinematics parameters (speed, time, and peak. Results. The F-M UE (P=0.030, FIM (P=0.021, time (P=0.008, and peak (P=0.018, were significantly higher in the RFVE group after treatment, but not speed (P=0.140. The patients affected by hemorrhagic stroke significantly improved FIM (P=0.031, time (P=0.011, and peak (P=0.020 after treatment, whereas the patients affected by ischemic stroke improved significantly only speed (P=0.005 when treated by RFVE. Conclusion. These results indicated that some poststroke patients may benefit from RFVE program for the recovery of upper limb motor function. This trial is registered with NCT01955291.

  16. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 1

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2015-01-01

    Full Text Available Rheumatic diseases of juxta-articular soft tissues (RDJAST (tendinitis, tenosynovitis, bursitis, etc. are one of the most common causes of disability and one the most common reasons for seeking medical advice. To manage patients with RDJAST is an important part of practising rheumatologists’ work. But unfortunately, the issues of diagnosis and therapy of this pathology have been relatively rarely discussed on the pages of Russian medical journals and at the scientific congresses and conferences of rheumatologists in recent years. This review is to refresh physicians’interest in this problem. Part 1 of this review briefly considers the general issues relating to the epidemiology, pathogenesis, and diagnosis of RDJAST of the upper extremity, such as rotator cuff tendinitis, lateral and medial epicondylitis, stenosing flexor tenosynovitis, de Quervain’s syndrome, and carpal tunnel syndrome.

  17. Bone histology of the stegosaur Kentrosaurus aethiopicus (Ornithischia: Thyreophora) from the Upper Jurassic of Tanzania.

    Science.gov (United States)

    Redelstorff, Ragna; Hübner, Tom R; Chinsamy, Anusuya; Sander, P Martin

    2013-06-01

    Using bone histology, a slow growth rate, uncommon for most dinosaurs, has been interpreted for the highly derived stegosaur Stegosaurus (Ornithischia: Thyreophora) and the basal thyreophoran Scutellosaurus. In this study, we examine whether this slow growth rate also occurs in the more basal stegosaur Kentrosaurus from the Tendaguru beds of Tanzania. The bone histology of six femora of Kentrosaurus representing an ontogenetic series from subadult to adult was studied, as well as one scapula. The primary bone is mainly highly vascularized fibro-lamellar bone with some reticular organization of the vascular canals. In addition to LAGs and annuli, distinctive shifts in the pattern of vascularization occur, which have been interpreted as potential growth marks. The variation in the development of growth marks may reflect annual climatic fluctuations. The overall bone depositional rate, and hence growth rate in Kentrosaurus appears to be higher than in Stegosaurus and Scutellosaurus. Considering that Stegosaurus is the larger-sized of the two stegosaurs, this would be contrary to an earlier supposition that small-bodied dinosaurs have slower growth rates than larger ones. Our finding of rapid rates of bone deposition in Kentrosaurus suggests that slow growth rates previously reported in Scutellosaurus and Stegosaurus are not a phylogenetic characteristic of the Thyreophora. Thus, slow growth rates are not plesiomorphic for the Thyreophora. We propose that the slow growth rates documented in the highly derived Stegosaurus could have been secondarily derived or alternatively that Kentrosaurus is the exception having increased growth rates.

  18. Magnetic resonance imaging in a juvenile type of distal and segmental muscular atrophy of the upper extremities

    Energy Technology Data Exchange (ETDEWEB)

    Hasuo, K. [Dept. of Radiology, Faculty of Medicine, Kyushu Univ., Fukuoka (Japan); Uchino, A. [Dept. of Radiology, Faculty of Medicine, Kyushu Univ., Fukuoka (Japan); Matsumoto, S. [Dept. of Radiology, Faculty of Medicine, Kyushu Univ., Fukuoka (Japan); Yoshida, K. [Dept. of Radiology, Faculty of Medicine, Kyushu Univ., Fukuoka (Japan); Kira, J. [Dept. of Neurology, Faculty of Medicine, Kyushu Univ., Fukuoka (Japan); Masuda, K. [Dept. of Radiology, Faculty of Medicine, Kyushu Univ., Fukuoka (Japan)

    1994-04-01

    Eight patients with a juvenile type of distal and segmental muscular atrophy of the upper extremities (DSMA), a type of cervical flexion myelopathy, were evaluated using MR imaging. In the neutral position there was no spinal cord compression, but in flexion the spinal cord was displaced anteriorly and was compressed by the posterior surfaces or margins of the vertebrae and/or any herniated disks in all cases. In flexion, compression of the cord was exaggerated in seven patients by the anterior displacement of the posterior margin of the thecal sac, which was accompanied by dilated posterior internal vertebral veins. In patients suspected of having DSMA, MR images made in flexion are regarded essential for verifying the diagnosis. (orig.)

  19. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller;

    2008-01-01

    and carpal bones. MagneVu and CR detected 100% and 89%, respectively, of large erosions (OMERACT-RAMRIS-score > 1 on Artoscan) in MCP-joints, and 69% and 15.8% of large erosions in wrists. CONCLUSIONS: Both E-MRI units detected more erosions than CR, particularly due to a higher sensitivity in metacarpal...... heads and carpal bones. The MagneVu detected fewer erosions than the Artoscan, due to a lower average image quality and a smaller proportion of bones being visualized....

  20. Bilateral upper-extremity deep vein thrombosis following central cord syndrome

    OpenAIRE

    Onmez, Hilal; Cingoz, Havva Turac; Kucuksen, Sami; Anliacık, Emel; Yaşar, Ozan; Yilmaz, Halim; Salli, Ali

    2013-01-01

    Deep vein thrombosis (DVT) is a common complication following spinal cord injury (SCI). Although DVT of the upper extremity is much less common than DVT of the lower extremities, the risk of pulmonary embolism following upper-extremity DVT should not be disregarded.

  1. Clinical effect of radiation synovectomy of the upper extremity joints: a randomised, double-blind, placebo-controlled study

    Energy Technology Data Exchange (ETDEWEB)

    Zant, F.M. van der; Boer, R.O. [Hospital Medical Center Alkmaar, Department of Nuclear Medicine, Alkmaar (Netherlands); Jahangier, Z.N.; Jacobs, J.W.G. [University Medical Center, Department of Rheumatology and Clinical Immunology, Utrecht (Netherlands); Moolenburgh, J.D.; Swen, W.A.A. [Hospital Medical Center Alkmaar, Department of Rheumatology, Alkmaar (Netherlands)

    2007-02-15

    To compare the clinical efficacy of radiosynoviorthesis (RSO) with intra-articular radionuclide plus glucocorticoid (GC) injection (group A) with that of placebo plus GC injection (group B) for the treatment of persistent synovitis in joints of the upper extremity. At baseline and at 6 and 12 months after intra-articular injection, six clinical parameters were scored. Changes in clinical values over time were summed to provide a change composite index (CCI), ranging from 0 (no effect) to 12 (maximal effect). A CCI {>=}6 was considered to indicate successful treatment. Differences in response rate and CCI between groups A and B were examined. Regression analyses were performed to explore whether baseline variables could predict therapeutic effect. Sixty-eight joints in 44 patients were treated. Six months after intra-articular injection, response rates (CCI {>=}6) were 69% (25/36) in group A and 29% (9/31) in group B (p=0.001). The mean CCIs {+-} standard deviation at 6 months were 6.7{+-}3.2 for group A and 3.3{+-}3.8 for group B (p=0.001). At 12 months the response rates were 69% (25/36) in group A and 32% (8/25) in group B (p=0.004). The mean CCIs at 12 months were 6.8{+-}3.3 for group A and 4.2{+-}4.7 for group B (p= 0.046). None of the baseline variables predicted the therapeutic effect. RSO (radionuclide plus GC) of upper extremity joints with immobilisation for 72 h shows a significantly better response rate than placebo plus GC in patients with persistent synovitis after at least one failed outpatient intra-articular GC injection. (orig.)

  2. Ectopic major transplantation for salvage of upper and lower extremity amputations

    Directory of Open Access Journals (Sweden)

    Nazerani Shahram

    2013-12-01

    Full Text Available 【Abstract】Objective: Ectopic tissue transplanta- tion is not a new idea. Godina and his colleagues pioneered this method in the 1980s. This method is a last resort method of preserving an amputated body part, which consists of banking the amputated segment in an ectopic area and re- turning it to its native place at a later date. In this article we present our experience with this demanding procedure. Methods: Debridement was the mainstay of this procedure. The stump and amputated part are carefully de- brided and the stump was either closed primarily or covered by a flap. The amputated part was transplanted to one of several banking sites in the body and at a later date it will be transferred to its native site in an elective setting. Results: Seven patients meeting the set criteria for ectopic transplantation were enrolled in this study. The over- all success rate was about 70%, lower than expected but these are cases of severe crush injury. Although the func- tional recovery of these patients are very low, all of the successful cases except one could find a job as a janitor or light manual worker. No patient could return to his previous job. Conclusion: Ectopic transplantation of body parts is an accepted method of treatment of severely crushed ex- tremity or finger injuries. In our country an amputee has very little chance of finding a job instead a disabled person can. In addition in Iran cultures amputation is seen as pu- nishment of either the God or the society, so it is not well accepted and many patients persist on saving the limb even with no functional recovery. None of our successful cases could return to his previous occupation but almost all of them could find a job as janitors or light manual workers. Key words: Replantation; Transplantation; Extremities; Amputation, traumatic

  3. Ectopic major transplantation for salvage of upper and lower extremity amputations

    Institute of Scientific and Technical Information of China (English)

    Shahram Nazerani; Hamed Vaseghi; Saied Hesami; Tina Nazerani

    2013-01-01

    Objective:Ectopic tissue transplantation is not a new idea.Godina and his colleagues pioneered this method in the 1980s.This method is a last resort method of preserving an amputated body part,which consists of banking the amputated segment in an ectopic area and returning it to its native place at a later date.In this article we present our experience with this demanding procedure.Methods:Debridement was the mainstay of this procedure.The stump and amputated part are carefully debrided and the stump was either closed primarily or covered by a flap.The amputated part was transplanted to one of several banking sites in the body and at a later date it will be transferred to its native site in an elective setting.Results:Seven patients meeting the set criteria for ectopic transplantation were enrolled in this study.The overall success rate was about 70%,lower than expected but these are cases of severe crush injury.Although the functional recovery of these patients are very low,all of the successful cases except one could find a job as a janitor or light manual worker.No patient could return to his previous job.Conclusion:Ectopic transplantation of body parts is an accepted method of treatment of severely crushed extremity or finger injuries.In our country an amputee has very little chance of finding a job instead a disabled person can.In addition in Iran cultures amputation is seen as punishment of either the God or the society,so it is not well accepted and many patients persist on saving the limb even with no functional recovery.None of our successful cases could return to his previous occupation but almost all of them could find a job as janitors or light manual workers.

  4. Upper extremity constraint-induced movement therapy in infantile hemiplegia

    Directory of Open Access Journals (Sweden)

    Selvam Ramachandran

    2011-01-01

    Full Text Available Infantile hemiplegia is one of the clinical forms of cerebral palsy that refers to impaired motor function of one half of the body owing to contralateral brain damage due to prenatal, perinatal and postnatal causes amongst which vascular lesion is the most common causative factor. We report here the effects of constraint-induced movement therapy in a five-year-old female child with infantile hemiplegia on improvement of upper extremity motor skills.

  5. Effect of horizontal position of the computer keyboard on upper extremity posture and muscular load during computer work.

    Science.gov (United States)

    Kotani, K; Barrero, L H; Lee, D L; Dennerlein, J T

    2007-09-01

    The distance of the keyboard from the edge of a work surface has been associated with hand and arm pain; however, the variation in postural and muscular effects with the horizontal position have not been explicitly explored in previous studies. It was hypothesized that the wrist approaches more of a neutral posture as the keyboard distance from the edge of table increases. In a laboratory setting, 20 adults completed computer tasks using four workstation configurations: with the keyboard at the edge of the work surface (NEAR), 8 cm from the edge and 15 cm from the edge, the latter condition also with a pad that raised the work surface proximal to the keyboard (FWP). Electrogoniometers and an electromagnetic motion analysis system measured wrist and upper arm postures and surface electromyography measured muscle activity of two forearm and two shoulder muscles. Wrist ulnar deviation decreased by 50% (4 degrees ) as the keyboard position moved away from the user. Without a pad, wrist extension increased by 20% (4 degrees ) as the keyboard moved away but when the pad was added, wrist extension did not differ from that in the NEAR configuration. Median values of wrist extensor muscle activity decreased by 4% maximum voluntary contraction for the farthest position with a pad (FWP). The upper arm followed suit: flexion increased while abduction and internal rotation decreased as the keyboard was positioned further away from the edge of the table. In order to achieve neutral postures of the upper extremity, the keyboard position in the horizontal plane has an important role and needs to be considered within the context of workstation designs and interventions.

  6. Neuromusculoskeletal disorders in the neck and upper extremities among drivers of all-terrain vehicles – a case series

    Directory of Open Access Journals (Sweden)

    Nilsson Tohr

    2004-01-01

    Full Text Available Abstract Background The purpose of this study was to investigate whether professional drivers of all-terrain vehicles (ATVs with neck pain have a different array of neuromusculoskeletal disorders in the neck and upper extremities than a referent group with neck pain from the general population. It is hypothesized that exposure to shock-type vibration and unfavorable working postures in ATVs have the capacity to cause peripheral nervous lesions. Methods This study was based on a case series analyzed according to a case-case comparison design. The study population consisted of 60 male subjects, including professional drivers of forest machines (n = 15, snowmobiles (n = 15, snowgroomers (n = 15 and referents from the general population (n = 15 all of whom had reported neck pain in a questionnaire and underwent an extensive physical examination of the neck and upper extremities. Based on symptom history, symptoms and signs, and in some cases chemical, electroneurographical and radiological findings, subjects were classified as having a nociceptive or neuropathic disorder or a mix of these types. Results The occurrence of asymmetrical and focal neuropathies (peripheral nervous lesion, pure or in a mix with a nociceptive disorder was common among cases in the ATV driver groups (47%–79%. This contrasted with the referents that were less often classified as having asymmetrical and focal neuropathy (27%, but instead had more nociceptive disorders. The difference was most pronounced among drivers of snowgroomers, while drivers of forest machines were more frequently classified as having a nociceptive disorder originating in the muscles. Conclusion This study found a high prevalence of assymetrical and focal neuropathies among drivers with pain in the neck, operating various ATVs. It seems as if exposure to shock-type whole-body vibration (WBV and appurtenant unfavorable postures in ATVs may be associated to peripheral nervous lesions.

  7. An extremely sensitive species-specific ARMs PCR test for the presence of tiger bone DNA.

    Science.gov (United States)

    Wetton, Jon H; Tsang, Carol S F; Roney, Chris A; Spriggs, Adrian C

    2004-02-10

    The survival of the tiger (Panthera tigris) is seriously threatened by poaching to provide raw materials for Traditional Chinese Medicines (TCMs). Most highly prized are the tiger's bones, which are used in combination with other animal and plant derivatives in pills and plasters for the treatment of rheumatism and other ailments. Hundreds of patent remedies have been produced which claim to contain tiger bone, but proof of its presence is needed, if legislation prohibiting the trade in endangered species is to be enforced. A highly sensitive tiger-specific real-time PCR assay has been developed to address this problem. Using primers specific to the tiger mitochondrial cytochrome b gene, successful amplification has been reliably achieved from blood, hair and bone as well as from a range of TCMs spiked with 0.5% tiger bone. Although capable of detecting fewer than 10 substrate molecules, the seven varieties of TCM pills and plasters tested showed no detectable trace of tiger DNA before spiking. Furthermore, sequencing several "tiger bone" fragments seized from TCM shops has shown that they actually originated from cattle and pigs. The potential effects of traditional bone preparation methods, evidence that much lower concentrations are used than alleged on TCM packaging, and substitution of bones from other species all suggest a low likelihood of detecting tiger DNA in patent medicines. Despite this, the basic methods have been thoroughly proven and can be readily applied to derivatives from other CITES protected species providing a rapid and highly sensitive forensic test for species of origin. Potential applications to the monitoring of wild populations are demonstrated by the successful identification of shed hairs and faecal samples.

  8. A pilot study evaluating use of a computer-assisted neurorehabilitation platform for upper-extremity stroke assessment

    Directory of Open Access Journals (Sweden)

    Feng Xin

    2009-05-01

    Full Text Available Abstract Background There is a need to develop cost-effective, sensitive stroke assessment instruments. One approach is examining kinematic measures derived from goal-directed tasks, which can potentially be sensitive to the subtle changes in the stroke rehabilitation process. This paper presents the findings from a pilot study that uses a computer-assisted neurorehabilitation platform, interfaced with a conventional force-reflecting joystick, to examine the assessment capability of the system by various types of goal-directed tasks. Methods Both stroke subjects with hemiparesis and able-bodied subjects used the force-reflecting joystick to complete a suite of goal-directed tasks under various task settings. Kinematic metrics, developed for specific types of goal-directed tasks, were used to assess various aspects of upper-extremity motor performance across subjects. Results A number of metrics based on kinematic performance were able to differentiate subjects with different impairment levels, with metrics associated with accuracy, steadiness and speed consistency showing the best capability. Significant differences were also shown on these metrics between various force field settings. Conclusion The results support the potential of using UniTherapy software with a conventional joystick system as an upper-extremity assessment instrument. We demonstrated the ability of using various types of goal-directed tasks to distinguish between subjects with different impairment levels. In addition, we were able to show that different force fields have a significant effect on the performance across subjects with different impairment levels in the trajectory tracking task. These results provide motivation for studies with a larger sample size that can more completely span the impairment space, and can use insights presented here to refine considerations of various task settings so as to generalize and extend our conclusions.

  9. Our experience on brachial plexus blockade in upper extremity surgery

    Directory of Open Access Journals (Sweden)

    Ömer Uslukaya

    2012-03-01

    Full Text Available Objective: Peripheral nerve blocks are usually used either alone or along with general anesthesia for postoperative analgesia. We also aimed to present the results and experiences.Materials and methods: This retrospective study was conducted to scan the files of patients who underwent orthopedic upper extremity surgery with peripheral nerve block between September 2009 and October 2010. After ethics committee approval was obtained, 114 patients who were ASA physical status I-III, aged 18-70, performed upper extremity surgery in the Orthopedics and Traumatology Clinic were included to study. Patients’ demographic data, clinical diagnoses, premedication status, peripheral block type, local anesthetic dose, stimuplex needle types, hemodynamic parameters at the during surgery, the first postoperative analgesic requirements, complications and patient satisfaction were recorded.Results: Demographic data were similar to each other. Brachial plexus block was commonly performed for the forearm surgery. Infraclavicular block was performed the most frequently to patients. As the classical methods in the supine position were preferred in 98.2% of patients, Stimuplex A needle (B. Braun, Melsungen AG, Germany have been used for blockage in 80.7% of patients. Also, in 54.4% of patients, 30 ml of local anesthetic solution composed of bupivacaine + prilocaine was used for blockade. Blocks applied to patients had provided adequate anesthesia.Conclusion: Since the brachial plexus blockade guided peripheral nerve stimulator for upper extremity surgery provide adequate depth of anesthesia and analgesia, it may be a good alternative to general anesthesia because of unwanted side effects

  10. On the assessment of coordination between upper extremities: towards a common language between rehabilitation engineers, clinicians and neuroscientists.

    Science.gov (United States)

    Shirota, Camila; Jansa, Jelka; Diaz, Javier; Balasubramanian, Sivakumar; Mazzoleni, Stefano; Borghese, N Alberto; Melendez-Calderon, Alejandro

    2016-09-08

    Well-developed coordination of the upper extremities is critical for function in everyday life. Interlimb coordination is an intuitive, yet subjective concept that refers to spatio-temporal relationships between kinematic, kinetic and physiological variables of two or more limbs executing a motor task with a common goal. While both the clinical and neuroscience communities agree on the relevance of assessing and quantifying interlimb coordination, rehabilitation engineers struggle to translate the knowledge and needs of clinicians and neuroscientists into technological devices for the impaired. The use of ambiguous definitions in the scientific literature, and lack of common agreement on what should be measured, present large barriers to advancements in this area. Here, we present the different definitions and approaches to assess and quantify interlimb coordination in the clinic, in motor control studies, and by state-of-the-art robotic devices. We then propose a taxonomy of interlimb activities and give recommendations for future neuroscience-based robotic- and sensor-based assessments of upper limb function that are applicable to the everyday clinical practice. We believe this is the first step towards our long-term goal of unifying different fields and help the generation of more consistent and effective tools for neurorehabilitation.

  11. The effect of visual field condition on kinetic in upper extremities and e.m.g in lower extremities while performing reaching in normal adults

    Science.gov (United States)

    Park, Hyekang; Kang, Youngeun; Yoo, Minah; Lee, Bomjin; Yang, Jeongok; Lee, Joongsook; Han, Dongwook; Oh, Taeyoung

    2017-01-01

    [Purpose] The aims of this study was to investigate mean velocity and angle of shoulder joint, activation of tibialis anterior and gastrocnemius according to both eyes, dominant eye and non-dominant eye condition during reaching task in normal adults. [Subjects and Methods] Our research recruited 24 participants (male 11, female 13) in Silla University. Participants were performed reaching out movement by conditions of both eye, dominants eye, non-dominants eye. The target was placed at 45 degree diagonal direction and distance far away 130% of their arm length. Kinetic analysis of the upper extremities was investigated by QUALISYS 3-dimensional motion analysis system. Muscle activation were measured by EMG during reaching tasks. The collected data were statistically processed using the SPSS for win version 20.0. [Results] There was a significant difference of shoulder joint velocity of flexion, abduction and internal rotation according to visual field condition during reaching tasks. There was no significant difference of shoulder joint angle and muscle activation according to visual field conditions during reaching tasks. [Conclusion] In conclusion, visual field has an influence on shoulder joint velocity. Therefore, the visual field may be to play an important role in reach performance. PMID:28210047

  12. Upper Extremity Injured Workers Stratified by Current Work Status: An Examination of Health Characteristics, Work Limitations and Work Instability

    Directory of Open Access Journals (Sweden)

    H Grant

    2010-06-01

    Full Text Available Background: Upper extremity injured workers are an under-studied population. A descriptive comparison of workers with shoulder, elbow and hand injuries reporting to a Canadian Workplace Safety and Insurance Board (WSIB clinic was undertaken.Objective: To determine if differences existed between injury groups stratified by current work status.Methods: All WSIB claimants reporting to our upper extremity clinic between 2003 and 2008 were approached to participate in this descriptive study. 314 working and 146 non-working WSIB claimants completed the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH; Short Form health survey (SF36; Worker’s Limitations Questionnaire and the Work Instability Scale. Various parametric and non-parametric analyses were used to assess significant differences between groups on demographic, work and health related variables.Results: Hand, followed by the shoulder and elbow were the most common site of injury. Most non-workers listed their current injury as the reason for being off work, and attempted to return to work once since their injury occurrence. Non-workers and a subset of workers at high risk for work loss showed significantly worse mental functioning. Workers identified physical demands as the most frequent injury-related on the job limitation. 60% of current workers were listed as low risk for work loss on the Work Instability Scale.Conclusions: Poorer mental functioning, being female and sustaining a shoulder injury were risk factors for work instability. Our cohort of injured non-workers were unable to return to work due to their current injury, reinforcing the need to advocate for modified duties, shorter hours and a work environment where stress and injury recurrence is reduced. Future studies examining pre-injury depression as a risk factor for prolonged work absences are warranted.

  13. Potential compensation of hydrological extremes in headwaters: case study of upper Vltava River basin, Šumava Mts., Czechia

    Science.gov (United States)

    Kocum, Jan; Janský, Bohumír.; Česák, Julius

    2010-05-01

    Increasing frequency of catastrophic flash floods and extreme droughts in recent years results in an urgent need of solving of flood protection questions and measures leading to discharge increase in dry periods. Flattening of discharge call for the use of untraditional practices as a suitable complement to classical engineering methods. These measures could be represented by gradual increase of river catchment retention capacity in headstream areas. Very favorable conditions for this research solution are concentrated to the upper part of Otava River basin (Vltava River left tributary, Šumava Mts., southwestern Czechia) representing the core zone of a number of extreme floods in Central Europe and the area with high peat land proportion. A number of automatic ultrasound and hydrostatic pressure water level gauges, climatic stations and precipitation gauges and utilization of modern equipment and methods were used in chosen experimental catchments to assess the landscape retention potential and to find out rainfall-runoff relations in this area. Successively, the detailed analysis of peat land hydrological function was carried out. The peat bogs influence on runoff conditions were assessed by thorough comparison of runoff regimes in subcatchments with different peat land proportion. The peat bog influence on hydrological process can be considered also with respect to its affecting of water quality. Therefore, hydrological monitoring was completed by ion, carbon (TOC) and oxygen isotopes balance observing within periods of high or low discharges in order to precise runoff phases separation by means of anion deficiency. Pedological survey of different soil types and textures was carried out to precise the estimation of its water capacity. Detailed analyses of extreme runoff ascending and descending phases and minimum discharges in profiles closing several subcatchments with different physical-geographic conditions show higher peak flow frequency and their shorter

  14. Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: a peripheral quantitative computed tomography study of the upper arms of male tennis players.

    Science.gov (United States)

    Haapasalo, H; Kontulainen, S; Sievänen, H; Kannus, P; Järvinen, M; Vuori, I

    2000-09-01

    due to a change in volumetric bone density. These upper arm results may not be generalized to the entire skeleton, but the finding may give new insight into conventional dual-energy X-ray absorptiometry (DXA)-based bone density measurements when interpreting the effects of exercise on bone.

  15. Detection of rheumatoid arthritis bone erosions by two different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer-Jensen, A.; Vestergaard, A.; Dohn, U.M.;

    2008-01-01

    was particularly more sensitive than CR for metacarpal heads and carpal bones. MagneVu MRI and CR detected 100% and 89%, respectively, of large erosions (Outcome Measures in Rheumatoid Arthritis Clinical Trials-Rheumatoid Arthritis MRI Scoring System (OMERACT-RAMRIS) score >1 on Artoscan) in MCP joints and 69......% and 15.8% of large erosions in wrists. Conclusions: Both E-MRI units detected more erosions than CR, in particular due to a higher sensitivity in metacarpal heads and carpal bones. The MagneVu unit detected fewer erosions than the Artoscan unit due to a lower average image quality and a smaller...

  16. Neuromodulation of the cervical spinal cord in the treatment of chronic intractable neck and upper extremity pain: a case series and review of the literature.

    Science.gov (United States)

    Vallejo, Ricardo; Kramer, Jeffery; Benyamin, Ramsin

    2007-03-01

    Electrical spinal neuromodulation in the form of spinal cord stimulation is currently used for treating chronic painful conditions such as complex regional pain syndrome, diabetic neuropathy, postherpetic neuralgia, peripheral ischemia, low back pain, and other conditions refractory to more conservative treatments. To date, there are very few published reports documenting the use of spinal cord stimulation in the treatment of head/neck and upper limb pain. This paper reports a case series of 5 consecutive patients outlining the use of spinal cord stimulation to treat upper extremity pain. All subjects had previously undergone cervical fusion surgery to treat chronic neck and upper limb pain. Patients were referred following failure of the surgery to manage their painful conditions. Spinal cord stimulators were placed in the cervical epidural space through a thoracic needle placement. Stimulation parameters were adjusted to capture as much of the painful area(s) as possible. In total, 4 out of 5 patients moved to implantation. In all cases, patients reported significant (70-90%) reductions in pain, including axial neck pain and upper extremity pain. Interestingly, 2 patients with associated headache and lower extremity pain obtained relief after paresthesia-steering reportedly covered those areas. Moreover, 2 patients reported that cervical spinal cord stimulation significantly improved axial low back pain. Patients continue to report excellent pain relief up to 9 months following implantation. This case series documents the successful treatment of neck and upper extremity pain following unsuccessful cervical spine fusion surgery. Given this initial success, prospective, controlled studies are warranted to more adequately assess the long term utility and cost effectiveness of electrical neuromodulation treatment of chronic neck and upper extremity pain.

  17. Lymphatic Filariasis Disseminating to the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Catherine Maldjian

    2014-01-01

    Full Text Available Lymphatic filariasis is the most common cause of acquired lymphedema worldwide (Szuba and Rockson, 1998. It is endemic to tropical and subtropical regions, and its effects are devastating. With over 100 million infected persons, it ranks second only to leprosy as the leading cause of permanent and long-term disability. Wuchereria bancrofti is the etiologic agent in 90% of cases. There is a dearth of published MRI findings with pathologically proven active infections, making this entity even more of a diagnostic dilemma. Imaging may provide the first clue that one is dealing with a parasite and may facilitate proper treatment and containment of this disease. This is the first report of pathologic correlation with MRI findings in the extremity in active filariasis. The magnetic resonance images demonstrate an enhancing, infiltrative, mass-like appearance with partial encasement of vasculature that has not been previously described in filariasis. Low signal strands in T2-hyperintense dilated lymphatic channels are seen and may depict live adult worms. We hypothesize that the low signal strands correspond to the collagen rich acellular cuticle. This, in combination with the surrounding hyperintense T2 signal, corresponding to a dilated lymphatic channel, may provide more specific MRI findings for active nematodal infection, which can prompt early biopsy, pathological correlation, and diagnosis.

  18. Investigation of the effects of mirror therapy on the upper extremity functions of stroke patients using the manual function test.

    Science.gov (United States)

    Kim, Hwanhee; Shim, Jemyung

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 items), grasp and pinch (2 items), and manipulation (2 items). The experiment was conducted with the subjects sitting in a chair. The mirror was vertically placed in the sagittal plane on the desk. The paretic hand was placed behind the mirror, and the non-paretic hand was placed in front of the mirror so that it was reflected in the mirror. In this position, the subjects completed activities repetitively according to the mirror therapy program over the course of four weeks. [Results] There were significant increases in the grasp-and-pinch score and manipulation score. [Conclusion] In conclusion, the grasp-and-pinch and manipulation functions were improved through mirror therapy.

  19. Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study

    OpenAIRE

    Kim, Yong Wook; Yoon, Seo Yeon; Park, Yongbum; Chang, Won Hyuk; Lee, Sang Chul

    2016-01-01

    Purpose To compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only. Materials and Methods Twenty patients with upper extremity paresthesia who met the criteria were recruited to participate in this single-blind, crossover study. Fourteen of 20 patients were female. The average age was 45.0±10.5 years and duration of symptom was 12.2±8.7 months. Each participant completed one injection an...

  20. Lower extremity lipedema, upper extremity lipodystrophy and severe calcinosis complicating juvenile dermatomyositis.

    Science.gov (United States)

    Pavlov-Dolijanovic, Slavica R; Vujasinovic Stupar, Nada Z; Gavrilov, Nikola; Seric, Srdjan

    2014-11-01

    Juvenile dermatomyositis (JDM) is a rare but complex and potentially life-threatening autoimmune disease of childhood. Significant proportions of patients have residual weakness, muscle atrophy, joint contractures, and calcinosis. Recently, new clinical findings, such as lipodystrophy accompanied with increased fat deposition in certain areas, have been reported. So far, it is not known whether the redistribution of body fat may be the type of lipedema of lower extremity. We describe a 39-year-old woman who was diagnosed with JDM at the age of 7. Later she developed symmetrical lipodystrophy of upper extremities and symmetrical lipedema of lower extremities (making 2 and 58.3 % of total body fat mass, respectively), with multiple calcified nodules in the subcutaneous tissues. These nodules gradually increased in size despite therapy. Capillaroscopy findings showed scleroderma-like abnormalities. ANA and anti-U1RNP antibodies were positive. Similar cases with simultaneous occurrence of the lipedema of lower extremities, lipodystrophy of upper extremities, and severe calcinosis complicating JDM have not been published so far. We showed that the calcinosis and lipodystrophy were associated with short duration of active disease. Also, we display case that raises the question whether it is possible overlapping autoimmune diseases revealed during follow-up.

  1. Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Zimmerli Lukas

    2012-02-01

    Full Text Available Abstract Background The motivation of patients during robot-assisted rehabilitation after neurological disorders that lead to impairments of motor functions is of great importance. Due to the increasing number of patients, increasing medical costs and limited therapeutic resources, clinicians in the future may want patients to practice their movements at home or with reduced supervision during their stay in the clinic. Since people only engage in an activity and are motivated to practice if the outcome matches the effort at which they perform, an augmented feedback application for rehabilitation should take the cognitive and physical deficits of patients into account and incorporate a mechanism that is capable of balancing i.e. adjusting the difficulty of an exercise in an augmented feedback application to the patient's capabilities. Methods We propose a computational mechanism based on Fitts' Law that balances i.e. adjusts the difficulty of an exercise for upper-extremity rehabilitation. The proposed mechanism was implemented into an augmented feedback application consisting of three difficulty conditions (easy, balanced, hard. The task of the exercise was to reach random targets on the screen from a starting point within a specified time window. The available time was decreased with increasing condition difficulty. Ten subacute stroke patients were recruited to validate the mechanism through a study. Cognitive and motor functions of patients were assessed using the upper extremity section of the Fugl-Meyer Assessment, the modified Ashworth scale as well as the Addenbrookes cognitive examination-revised. Handedness of patients was obtained using the Edinburgh handedness inventory. Patients' performance during the execution of the exercises was measured twice, once for the paretic and once for the non-paretic arm. Results were compared using a two-way ANOVA. Post hoc analysis was performed using a Tukey HSD with a significance level of p Results

  2. Nosology of juvenile muscular atrophy of distal upper extremity: from monomelic amyotrophy to Hirayama disease--Indian perspective.

    Science.gov (United States)

    Hassan, Kaukab Maqbool; Sahni, Hirdesh

    2013-01-01

    Since its original description by Keizo Hirayama in 1959, "juvenile muscular atrophy of the unilateral upper extremity" has been described under many nomenclatures from the east. Hirayama disease (HD), also interchangeably referred to as monomelic amyotrophy, has been more frequently recognised in the west only in the last two decades. HD presents in adolescence and young adulthood with insidious onset unilateral or bilateral asymmetric atrophy of hand and forearm with sparing of brachioradialis giving the characteristic appearance of oblique amyotrophy. Symmetrically bilateral disease has also been recognized. Believed to be a cervical flexion myelopathy, HD differs from motor neuron diseases because of its nonprogressive course and pathologic findings of chronic microcirculatory changes in the lower cervical cord. Electromyography shows features of acute and/or chronic denervation in C7, C8, and T1 myotomes in clinically affected limb and sometimes also in clinically unaffected contralateral limb. Dynamic forward displacement of dura in flexion causes asymmetric flattening of lower cervical cord. While dynamic contrast magnetic resonance imaging is diagnostic, routine study has high predictive value. There is a need to lump all the nomenclatures under the rubric of HD as prognosis in this condition is benign and prompt diagnosis is important to institute early collar therapy.

  3. Evaluating the Impact of Player Experience in the Design of a Serious Game for Upper Extremity Stroke Rehabilitation.

    Science.gov (United States)

    Cordeiro d'Ornellas, Marcos; Cargnin, Diego João; Cervi Prado, Ana Lúcia

    2015-01-01

    Video games have become a major entertainment industry and one of the most popular leisure forms, ranging from laboratory experiments to a mainstream cultural medium. Indeed, current games are multimodal and multidimensional products, relying on sophisticated features including not only a narrative-driven story but also impressive graphics and detailed settings. All of these elements helped to create a seamless and appealing product that have resulted in a growing number of players and in the number of game genres. Although video games have been used in education, simulation, and training, another application that exploits serious gaming is the exploration of player experience in the context of game research. Recent advances in the natural user interfaces and player experience have brought new perspectives on the in-game assessment of serious games. This paper evaluates the impact of player experience in the design of a serious game for upper extremity stroke rehabilitation. The game combines biofeedback and mirror neurons both in single and multiplayer mode. Results have shown that the game is a feasible solution to integrate serious games into the physical therapy routine.

  4. The analysis of lead, cadmium, zinc, copper and nickel content in human bones from the upper Silesian industrial district.

    Science.gov (United States)

    Baranowska, I; Czernicki, K; Aleksandrowicz, R

    1995-01-10

    The concentration of lead, cadmium, zinc, copper and nickel in autopsy samples of bones from adults living in the Upper Silesian industrial district (Poland)--an ecological disaster region--was determined by atomic absorption spectrometry (flame and flameless GF AAS). Lead concentrations ranged from 20 micrograms/g to 200 micrograms/g bone wet weight, cadmium from 0.4 microgram/g to 1.5 micrograms/g bone wet weight. About one-fourth of the bones examined from Silesia, contained lead in the range from 100 micrograms/g to 200 micrograms/g. The were no significant differences in zinc, copper and nickel concentration between the control groups. The samples were mineralized in a microwave digestion system. To avoid anomalous results caused by the influence of the matrix Ca3 (PO4)2--the procedure of lead determination was carried out at a temperature of 2000 degrees C, the cadmium determination at a temperature of about 1200 degrees C.

  5. Preoperative and postoperative evaluation of somatosensorial evoked potentials of upper extremities in cervical intervertebral disc herniation.

    Science.gov (United States)

    Umur, Ahmet Sukru; Selcuki, Mehmet; Selcuki, Deniz; Temiz, Cuneyt; Akbasak, Aytac

    2013-01-01

    This study aims to determine the dysfunction caused by existing pathological condition in structures involved in the transfer of sensory functions of the neural system in cervical disc herniation, and to establish whether or not the level and degree of this anatomical damage can be anticipated by SEP (Somatosensorial Evoked Potentials). We compared the obtained SEP values for statistical significance using the Friedman Variation Analysis. In parameters with statistical significance, the Wilcoxon Signed Rank test was used to identify when significant improvements occurred. The study found that the statistical data of the latency of the N14 wave originating from the dorsal column nuclei of the medulla spinalis and dorsal column gray matter improved (p < 0.05) in the postoperative period compared with the preoperative values. Using the Wilcoxon Signed Rank test, we studied postoperative months separately in regard to the difference in the latency of the N14 wave, and found the statistically significant improvement to be marked particularly in months 3 and 6 postoperatively (p < 0.05). In conclusion, we suggest that SEP is a useful tool to check the functional condition of the dorsal spinal column. The benefit of the SEP utilization is the ability to determine the severity of the pathological condition preoperatively and follow the patient's functional postoperative improvement.

  6. Critical review of the impact of core stability on upper extremity athletic injury and performance

    OpenAIRE

    2015-01-01

    BACKGROUND: Programs designed to prevent or rehabilitate athletic injuries or improve athletic performance frequently focus on core stability. This approach is based upon the theory that poor core stability increases the risk of poor performance and/or injury. Despite the widespread use of core stability training amongst athletes, the question of whether or not sufficient evidence exists to support this practice remains to be answered. OBJECTIVES: 1) Open a dialogue on the definition and comp...

  7. Upper extremity deep vein thrombosis in a military patient.

    Science.gov (United States)

    Bullock, Charlotte; Johnston, A McD

    2016-08-01

    We describe the case of a 23-year-old serviceman on overseas deployment who presented with a painful, swollen arm. Investigations showed an upper extremity deep vein thrombosis (UEDVT) of the right arm with an associated asymptomatic pulmonary embolism, which was treated with warfarin anticoagulation. Further investigation identified positional obstruction at the thoracic outlet, and the patient was diagnosed with Paget-Schroetter syndrome. He underwent elective resection of the first rib, and has now returned to normal duties. After review of the literature on UEDVT, it is suggested that in this military patient, the occurrence of an anatomical variant put him at risk of upper limb venous thrombosis, which was probably potentiated by the occupational factor of carrying a rifle. The external compression of the subclavian vein from the rifle butt and hypertrophied muscles, in addition to the anatomical variation, caused repetitive microtrauma of the vessel intima, which precipitated venous thrombosis.

  8. Kinesiology Taping reduces lymphedema of the upper extremity in women after breast cancer treatment: a pilot study

    Directory of Open Access Journals (Sweden)

    Iwona Malicka

    2014-09-01

    Full Text Available Introduction : Secondary lymphedema affects approximately 40% of women treated for breast cancer and is recognized as a major problem associated with the therapy of malignant tumors. Consequently, new therapeutic methods are constantly being sought to effectively eliminate the condition. One of the new forms of edema management, especially in the initial stages of edematous development, is Kinesiology Taping (KT. Aim of the study : The aim of the study was to assess the effects of KT applications on the extent of lymphedema of the upper extremity in women post cancer treatment. Material and methods: The study group consisted of 28 women after axillary lymphadenectomy due to breast cancer. All the patients were diagnosed with grade I secondary lymphedema. Kinesiology Taping was applied to a total of 14 randomly selected women. The remaining 14 patients constituted a control group. The extent of lymphedema was measured using a centimeter tape and Limb Volumes Professional 5.0 software. Results : A significant reduction in the extent of lymphedema (p = 0.0009 was achieved in the KT group between baseline and post-treatment assessments. No such reduction, however, was found in the control group (p = 0.36. Conclusions : Kinesiology Taping applications are an effective method of early-stage edema management. Kinesiology Taping may be a safe new therapeutic option in patients who are contraindicated for the use of other methods.

  9. An Upper Limit on the Ratio Between the Extreme Ultraviolet and the Bolometric Luminosities of Stars Hosting Habitable Planets

    Indian Academy of Sciences (India)

    Sujan Sengupta

    2016-06-01

    A large number of terrestrial planets in the classical habitable zone of stars of different spectral types have already been discovered and many are expected to be discovered in the near future. However, owing to the lack of knowledge on the atmospheric properties, the ambient environment of such planets are unknown. It is known that sufficient amount of Extreme Ultraviolet (EUV) radiation from the star can drive hydrodynamic outflow of hydrogen that may drag heavier species from the atmosphere of the planet. If the rate of mass loss is sufficiently high, then substantial amount of volatiles would escape causing the planet to become uninhabitable. Considering energy-limited hydrodynamical mass loss with an escape rate that causes oxygen to escape alongwith hydrogen, an upper limit for the ratio between the EUV and the bolometric luminosities of stars which constrains the habitability of planets around them is presented here. Application of the limit to planet-hosting stars with known EUV luminosities implies that many M-type of stars should not have habitable planets around them.

  10. "RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY"

    Directory of Open Access Journals (Sweden)

    M. Pourmahabadian

    2005-08-01

    Full Text Available The strain index (SI is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is safe or hazardous, quantification of the risks, and assistance in the initial design of a job or in the redesign of a job. The aim of this study was to assess and analyze risk of developing DUE disorders in different jobs as well as hazard classification in an assembling electronic industry through SI method. Also, DUE disorders prevalence, work-related absenteeism and turnover extracted from SI results were compared and assessed by those obtained by Nordic musculoskeletal questionnaire (NMQ. The findings of this study showed that more than 50% of investigated jobs are categorized as "hazardous" and there is a significant difference between SI mean in hazardous and safe jobs (P < 0.0001. In addition, significant difference was found between prevalence of DUE disorders in "safe" and "hazardous" jobs (P < 0.049. But, no significant difference (P = 0.3 was obtained between mean absenteeism in "safe" and hazardous jobs. Also, no significant difference statistically was found between turnover in "safe" and hazardous jobs (X2 = 0.133, P = 1 and high prevalence of DUE disorders is due to low turnover rate of workers.

  11. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, H.J.; Reekers, J.A. [Academic Medical Centre, Amsterdam (Netherlands). Dept. of Radiology; Beek, E.J. van [Royal Hallamshire Hospital, Sheffield (United Kingdom). Unit of Academic Radiology

    2004-02-01

    To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Consecutive in- and outpatients who were referred for imaging of suspected DVTUE in a large teaching hospital during the period April 2001 to October 2002 were eligible for inclusion. All patients were scheduled to undergo contrast venography with the intention to perform additional MR venography. Both time-of-flight and gadolinium-enhanced 3D MR venography were scheduled. All MR imaging were interpreted independently by consensus of two experienced radiologists, who were blinded for contrast venography outcome. Patients were managed based on contrast venography only. A total of 44 patients were eligible for inclusion. Thirteen patients were excluded (5 refused consent, 2 inability to gain venous access, 2 renal failure, 4 logistic reasons). Contrast venography was performed in 31 patients, and demonstrated DVTUE in 11 patients. MR imaging was not feasible in 10 patients (4 unable to lie flat, 3 claustrophobia, 1 too large for MR scanner, 1 osteosynthesis of shoulder, 1 pacemaker). The sensitivity and specificity of TOF MRV versus Gadolinium 3D MRV was 71% and 89% versus 50% and 80%, respectively. A high number of patients were unable to undergo MR venography in this setting. Contrast-enhanced MRV did not improve diagnostic accuracy. The clinical utility of MR venography in the setting of suspected DVTUE seems disappointing.

  12. Cutting balloon angioplasty for in-stent restenosis of the aortic coarctation in a young boy presenting with systemic hypertension of the upper extremities.

    Science.gov (United States)

    Lee, Meng-Luen

    2013-12-01

    An 8.25-year-old boy was incidentally found to have systemic hypertension of the upper extremities. Blood pressures of the upper extremities were 142-150/86-98 mmHg, and those of the lower extremities 110-116/60-66 mmHg. Doppler echocardiography showed in-stent restenosis of the aortic coarctation. Traditional high-pressure balloon angioplasty failed to dilate this inveterate in-stent restenosis. Instead, a cutting balloon angioplasty was performed. The lumen was dilated from 4.80 mm to 7.89 mm. The pressure gradient dropped from 32 mmHg to 9 mmHg. Blood pressures of the upper extremities were 112-116/76-78 mmHg, and those of the lower extremities 100-104/70-72 mmHg. This paper highlights that a cutting balloon angioplasty can serve as a juste milieu to relieve in-stent restenosis of the aortic coarctation when traditional high-pressure balloon angioplasty is debatable.

  13. Effects of functional electrical therapy on upper extremity functional motor recovery in patients after stroke: Our experience and future directions

    Directory of Open Access Journals (Sweden)

    Plavšić Aleksandra

    2011-01-01

    Full Text Available Introduction. New neurorehabilitation together with conventional techniques provide methods and technologies for maximizing what is preserved from the sensory motor system after cerebrovascular insult. The rehabilitation technique named functional electrical therapy was investigated in more than 60 patients in acute, subacute and chronic phase after cerebrovascular insult. The functional sensory information generated by functional electrical therapy was hypothesized to result in the intensive functional brain training of the activities performed. Functional Electrical Therapy. Functional electrical therapy is a combination of functional exercise and electrical therapy. The functional electrical therapy protocol comprises voluntary movement of the paretic arm in synchrony with the electrically assisted hand functions in order to perform typical daily activities. The daily treatment of 30 minutes lasts three weeks. The outcome measures include several tests for the evaluation of arm/hand functionality: upper extremity function test, drawing test, modified Aschworth scale, motor activity log and passive range of movement. Results of Functional Electrical Therapy Studies. Results from our several clinical studies showed that functional electrical therapy, if applied in acute and subacute stroke patients, leads to faster and greater improvement of functioning of the hemiplegic arm/hand compared to the control group. The outcomes were significantly superior at all times after the treatment for the higher functioning group. Discussion. Additional well-planned clinical studies are needed to determine the adequate dose of treatment (timing, duration, intensity with functional electrical therapy regarding the patient’s status. A combination with other techniques should be further investigated.

  14. Wireless wearable range-of-motion sensor system for upper and lower extremity joints: a validation study

    Science.gov (United States)

    Kumar, Yogaprakash; Yen, Shih-Cheng; Lee, Wangwei; Gao, Fan; Zhao, Ziyi; Li, Jingze; Hon, Benjamin; Tian-Ma Xu, Tim; Cheong, Angela; Koh, Karen; Ng, Yee-Sien; Chew, Effie; Koh, Gerald

    2015-01-01

    Range-of-motion (ROM) assessment is a critical assessment tool during the rehabilitation process. The conventional approach uses the goniometer which remains the most reliable instrument but it is usually time-consuming and subject to both intra- and inter-therapist measurement errors. An automated wireless wearable sensor system for the measurement of ROM has previously been developed by the current authors. Presented is the correlation and accuracy of the automated wireless wearable sensor system against a goniometer in measuring ROM in the major joints of upper (UEs) and lower extremities (LEs) in 19 healthy subjects and 20 newly disabled inpatients through intra (same) subject comparison of ROM assessments between the sensor system against goniometer measurements by physical therapists. In healthy subjects, ROM measurements using the new sensor system were highly correlated with goniometry, with 95% of differences < 20° and 10° for most movements in major joints of UE and LE, respectively. Among inpatients undergoing rehabilitation, ROM measurements using the new sensor system were also highly correlated with goniometry, with 95% of the differences being < 20° and 25° for most movements in the major joints of UE and LE, respectively. PMID:26609398

  15. 3D stereophotogrammetry in upper-extremity lymphedema: An accurate diagnostic method

    NARCIS (Netherlands)

    Hameeteman, M.; Verhulst, A.C.; Vreeken, R.D.; Maal, T.J.; Ulrich, D.J.

    2016-01-01

    BACKGROUND: Upper-extremity lymphedema is a frequent complication in patients treated for breast cancer. Current diagnostic methods for the upper-extremity volume measurements are cumbersome or time consuming. The purpose of this study was to assess the validity and reliability of three-dimensional

  16. Effectiveness of a feedback signal in a computer mouse on upper extremity musculoskeletal symptoms: a randomised controlled trial with an 8-month follow-up

    NARCIS (Netherlands)

    E.M. Meijer; J.K. Sluiter; M.H.W. Frings-Dresen

    2009-01-01

    OBJECTIVES: To study the effectiveness of using a computer mouse with a feedback signal for upper extremity musculoskeletal symptoms in office workers. METHODS: A randomised controlled trial with 8 months of follow-up was carried out. The intervention consisted of a computer mouse with a feedback si

  17. Helping hands: caring for the upper extremity transplant patient.

    Science.gov (United States)

    Lovasik, Darlene; Foust, Daniel E; Losee, Joseph E; Lee, W P Andrew; Brandacher, Gerald; Gorantla, Vijay S

    2011-09-01

    Caring for upper extremity transplant recipients can offer challenges and opportunities to nursing staff in combining new patient procedures, new technologies, and complex patient care needs including unique physical care, monitoring and observation, rehabilitation expectations, and psychiatric/psychosocial support. Medical professionals continue to be apprehensive about the risks of immunosuppressive therapy and the possibility of acute and chronic rejection. The sustained development and research into reliable, reduced-dose immunosuppression or immunomodulatory strategies could expand the life-enhancing benefits of reconstructive transplantation.

  18. Hydatid disease of scapula and upper third of humerus treated by en bloc excision and fibular bone grafting

    Directory of Open Access Journals (Sweden)

    Chari P

    2007-01-01

    Full Text Available 35-year-old male patient presented with gradually increasing painful swelling of the right shoulder, which was incised and drained and wound persisted as a discharging sinus on the anterolateral aspect of the deltoid region with seropurulent discharge. A clinical diagnosis of tuberculosis of the shoulder was made. Plain skiagram of the right shoulder revealed multicystic lesion involving the entire scapula and upper third of the humerus with loss of joint space and pathological fracture at the junction of upper one-third and lower two-thirds of the humerus. A clinico-radiological diagnosis of hydatid disease was made. In view of the extensive involvement of the scapula with stiff shoulder and an active sinus, a two-stage surgical procedure was performed. Stage 1 consisted of en bloc excision of the scapula, upper half of the humerus and lateral end of the clavicle. Stage II surgery, consisting of fibular bone grafting. Tablet albendazole (400 mg, thrice daily was given as systemic scolicidal agent. This case is reported in view of it′s rarity and to highlight the management.

  19. Optimal Dimensional Synthesis of a Symmetrical Five-Bar Planar Upper-Extremity Neuromotor Device

    Institute of Scientific and Technical Information of China (English)

    GAO Jianshe; LI Mingxiang; ALLISON Garry; CUI Lei

    2015-01-01

    Individuals with hemiplegia suffer from impaired arm movements that appear as a marked change in arm stiffness. A quantitative measure of arm stiffness would characterize rehabilitation therapy effectively, while little mechanism is designed to implement the function. A symmetrical five-bar linkage consisting of two revolute joints and three prismatic joints is presented. Inverse kinematics and forward kinematics are obtained first. Then inverse singularities and direct singularities of the mechanism are gained. The global stiffness index is defined based on the results of kinematics analysis. Finally, optimal dimensional synthesis of the mechanism in terms of maximum stiffness is conducted by genetic algorithms. The calculation results show that with the length of both the two linkage a=830 mm, the interacting angle of the two guides 2δ=4.48 radian, and the maximum range of displacement of the two carriers dmax=940 mm, the mechanism achieves highest rigidity and its workspace is singularity-free, which covers the human left and right arm range of motion. The proposed novel mechanism featuring high rigidity and a singularity-free workspace can provide rehabilitation training, also solve the problem of quantitative measure of arm stiffness.

  20. Prevalence and risk factors of upper extremity cumulative trauma disorder in dental hygienists.

    Science.gov (United States)

    Shenkar, O; Mann, J; Shevach, A; Ever-Hadani, P; Weiss, P L

    1998-01-01

    Cumulative trauma disorder (CTD) refers to a number of conditions arising from overuse of joints or soft tissues. The common risk factors that contribute to the development of these disorders are related to personal and occupational variables. Job analysis of the tasks performed by the dental hygienist have shown that this occupation is particularly at risk. The objectives of this study were to determine the prevalence of CTD symptoms amongst dental hygienists in Israel and to identify which are the factors that are related to CTD. A questionnaire including items concerning demographic data, employment history, professional occupational information, use of instrumentation, and CTD symptomatology was mailed to all 530 registered dental hygienists. Two hundred forty-six hygienists (46%) returned the questionnaire; 63% of the respondents were classified as CTD 'sufferers', Age, year of graduation, hours worked per week, and frequency of changing instruments were found to be significantly related to CTD symptoms. Hygienists at high risk included those aged 50 years or more (Odds ratio, OR = 6), those who graduated before 1986 (OR = 3), those who work more than 34 h per week (OR = 2.5) and those who change two or fewer instruments per patient (OR = 2). The major recommendation resulting from this study is to make dental hygienists aware that they work in a high-risk profession. It is hoped that increased awareness of the risk will spur the hygienist to make appropriate work practice, administrative, and engineering modifications and to seek treatment at the first indication of CTD symptoms.

  1. Design and development of an upper extremity motion capture system for a rehabilitation robot.

    Science.gov (United States)

    Nanda, Pooja; Smith, Alan; Gebregiorgis, Adey; Brown, Edward E

    2009-01-01

    Human robot interaction is a new and rapidly growing field and its application in the realm of rehabilitation and physical care is a major focus area of research worldwide. This paper discusses the development and implementation of a wireless motion capture system for the human arm which can be used for physical therapy or real-time control of a robotic arm, among many other potential applications. The system is comprised of a mechanical brace with rotary potentiometers inserted at the different joints to capture position data. It also contains surface electrodes which acquire electromyographic signals through the CleveMed BioRadio device. The brace interfaces with a software subsystem which displays real time data signals. The software includes a 3D arm model which imitates the actual movement of a subject's arm under testing. This project began as part of the Rochester Institute of Technology's Undergraduate Multidisciplinary Senior Design curriculum and has been integrated into the overall research objectives of the Biomechatronic Learning Laboratory.

  2. Computational investigation of two interventions for neck and upper extremity pain in office workers

    DEFF Research Database (Denmark)

    Rasmussen, J.; De Zee, M.

    2010-01-01

    This paper reports on novel results derived from a computer model of a typical office work place. We demonstrate how the detailed albeit very small muscle loads can be analyzed and how the effect of two interventions can be assessed using the model. The investigations reveal that both interventions...... reduce the muscle loads, but a wrist cushion is the more effective intervention type for the vast majority of the muscles. It is concluded that the method can offer useful assistance for design and prescription of efficient interventions for particular ergonomic problems typical for office workers...

  3. Usability Evaluation of Notebook Computers and Cellular Telephones Among Users with Visual and Upper Extremity Disabilities

    OpenAIRE

    Mooney, Aaron Michael

    2002-01-01

    Information appliances such as notebook computers and cellular telephones are becoming integral to the lives of many. These devices facilitate a variety of communication tasks, and are used for employment, education, and entertainment. Those with disabilities, however, have limited access to these devices, due in part to product designs that do not consider their special needs. A usability evaluation can help identify the needs and difficulties those with disabilities have when using a pro...

  4. The Acute Effects of Upper Extremity Stretching on Throwing Velocity in Baseball Throwers

    Directory of Open Access Journals (Sweden)

    Michael Williams

    2013-01-01

    Full Text Available Purpose. To examine the effects of static and proprioceptive neuromuscular facilitation (PNF stretching of the shoulder internal rotators on throwing velocity. Subjects. 27 male throwers (mean age = 25.1 years old, SD = 2.4 with adequate knowledge of demonstrable throwing mechanics. Study Design. Randomized crossover trial with repeated measures. Methods. Subjects warmed up, threw 10 pitches at their maximum velocity, were randomly assigned to 1 of 3 stretching protocols (static, PNF, or no stretch, and then repeated their 10 pitches. Velocities were recorded after each pitch and average and peak velocities were recorded after each session. Results. Data were analyzed using a repeated measures ANOVA. No significant interaction between stretching and throwing velocity was observed. Main effects for time were not statistically significant. Main effects for the stretching groups were statistically significant. Discussion. Results suggest that stretching of the shoulder internal rotators did not significantly affect throwing velocity immediately after stretching. This may be due to the complexity of the throwing task. Conclusions. Stretching may be included in a thrower's warm-up without any effects on throwing velocity. Further research should be performed using a population with more throwing experience and skill.

  5. The Acute Effects of Upper Extremity Stretching on Throwing Velocity in Baseball Throwers.

    Science.gov (United States)

    Williams, Michael; Harveson, Lanisa; Melton, Jason; Delobel, Ashley; Puentedura, Emilio J

    2013-01-01

    Purpose. To examine the effects of static and proprioceptive neuromuscular facilitation (PNF) stretching of the shoulder internal rotators on throwing velocity. Subjects. 27 male throwers (mean age = 25.1 years old, SD = 2.4) with adequate knowledge of demonstrable throwing mechanics. Study Design. Randomized crossover trial with repeated measures. Methods. Subjects warmed up, threw 10 pitches at their maximum velocity, were randomly assigned to 1 of 3 stretching protocols (static, PNF, or no stretch), and then repeated their 10 pitches. Velocities were recorded after each pitch and average and peak velocities were recorded after each session. Results. Data were analyzed using a 3 × 2 repeated measures ANOVA. No significant interaction between stretching and throwing velocity was observed. Main effects for time were not statistically significant. Main effects for the stretching groups were statistically significant. Discussion. Results suggest that stretching of the shoulder internal rotators did not significantly affect throwing velocity immediately after stretching. This may be due to the complexity of the throwing task. Conclusions. Stretching may be included in a thrower's warm-up without any effects on throwing velocity. Further research should be performed using a population with more throwing experience and skill.

  6. The effects of upper extremity task training with symmetric abdominal muscle contraction on trunk stability and balance in chronic stroke patients.

    Science.gov (United States)

    Lee, Je-Hyeok; Choi, Jong-Duk

    2017-03-01

    [Purpose] The purpose of this study is to examine the effects of upper extremity task training employing the bracing method on the trunk control and balance of stroke patients. [Subjects and Methods] The subjects were 46 stroke patients whose strokes had occurred six months or more prior to the study. The subjects were divided into two groups. One group underwent upper extremity task training with symmetric abdominal muscle contraction (bracing) applied. The other group simply underwent upper extremity task training, without bracing. [Results] The experimental group's Trunk Impairment Scale (TIS) significantly increased after the intervention, whereas the control group did not see any significant difference. There was significant improvement in balance after the intervention in both the experimental group and the control group. According to the between-group comparisons, the improvements in the experimental group were significantly greater in the control group, except in the Postural Assessment Scale (PASS). [Conclusion] Based on the results of this study, upper extremity task exercises with symmetric abdominal muscle contraction, conducted as part of adult hemiplegic patients' trunk stabilization exercises, can be applied to a diverse range of hemiplegic patients and implemented as an exercise program after discharge from hospital.

  7. Impact of Climate Change on Hydrologic Extremes in the Upper Basin of the Yellow River Basin of China

    Directory of Open Access Journals (Sweden)

    Jun Wang

    2016-01-01

    Full Text Available To reveal the revolution law of hydrologic extremes in the next 50 years and analyze the impact of climate change on hydrologic extremes, the following main works were carried on: firstly, the long duration (15 d, 30 d, and 60 d rainfall extremes according to observed time-series and forecast time-series by dynamical climate model product (BCC-CSM-1.1 were deduced, respectively, on the basis that the quantitative estimation of the impact of climate change on rainfall extremes was conducted; secondly, the SWAT model was used to deduce design flood with the input of design rainfall for the next 50 years. On this basis, quantitative estimation of the impact of climate change on long duration flood volume extremes was conducted. It indicates that (1 the value of long duration rainfall extremes for given probabilities (1%, 2%, 5%, and 10% of the Tangnaihai basin will rise with slight increasing rate from 1% to 6% in the next 50 years and (2 long duration flood volume extremes of given probabilities of the Tangnaihai basin will rise with slight increasing rate from 1% to 6% in the next 50 years. The conclusions may provide technical supports for basin level planning of flood control and hydropower production.

  8. Workstyle Intervention for the Prevention of Work-Related Upper Extremity Problems: A Randomized Controlled Trial

    Science.gov (United States)

    2005-01-01

    increased sensitization of the response system (Melzack, 1999). This theory is supported by recent evidence from animal models that showed neuroplastic ...appetite at all [ ] I crave food all the time 19. Concentration Difficulty [ ] I can concentrate as well as ever [ ] I can’t

  9. Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap

    Directory of Open Access Journals (Sweden)

    Kyeong Tae Lee

    2012-03-01

    Full Text Available Lymphedema is a common complication after mastectomy in breast cancer patients. Manytreatment options are available, but no treatment results in a complete cure. We report acase of lymphedema that occurred after modified radical mastectomy in a breast cancerpatient who showed objective improvement after delayed breast reconstruction with anlatissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer hadundergone modified radical mastectomy with axillary lymph node dissection and postoperativeradiotherapy 12 years previously. Four years after surgery, lymphedema developed andincreased in aggravation despite conservative treatment. Eight years after the first operation,the patient underwent delayed breast reconstruction using the extended latissimus dorsimyocutaneous flap method. After reconstruction, the patient’s lymphedema symptomsshowed dramatic improvement by subjective measures including tissue softness and feeling oflightness, and by objective measures of about 7 mL per a week, resulting in near normal rangesof volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayedbreast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful topatients with lymphedema after mastectomy. This may be a good option for patients who areworried about the possibility of the occurrence or aggravation of secondary lymphedema.

  10. Rehabilitation outcome of upper extremity skilled performance in persons with cervical spinal cord injuries

    NARCIS (Netherlands)

    Spooren, Annemie I.F.; Janssen-Potten, Yvonne J.M.; Snoek, Govert J.; IJzerman, Maarten J.; Kerckhofs, Eric; Seelen, Henk A.M.

    2010-01-01

    Objective: To investigate changes in arm hand skilled performance during and after active rehabilitation in (sub)groups of subjects with cervical spinal cord injuries. Design: Longitudinal multi-centre cohort study. Patients: Persons with cervical spinal cord injuries during (n?=?57) and after (n?=

  11. Incidence of Upper Extremity Nerve Entrapments In Veterans With Major Limb Amputations

    Science.gov (United States)

    2009-03-01

    epicondyle and above- elbow stimulation was performed with the elbow flexed to 90 degrees at a distance of 4cm proximal to medial epicondyle (6, 8, 11...deep tendon reflexes, strength testing, sensory testing with pinprick and light touch, Tinel’s test at the elbow and wrist, and Phalen’s test. All...subjects had ulnar entrapment neuropathy across the elbow (22/38 affected limbs, 6 subjects with unilateral and 8 subjects with bilateral findings

  12. Optimum interpulse interval for transcranial electrical train stimulation to elicit motor evoked potentials of maximal amplitude in both upper and lower extremity target muscles

    NARCIS (Netherlands)

    van Hal, C.; Hoebink, E.; Polak, H. E.; Racz, I.; de Kleuver, M.; Journee, H. L.

    2013-01-01

    Objective: The aim of this study was to determine the optimum interpulse interval (OIPI) for transcranial electrical train stimulation to elicit muscle motor evoked potentials (TES-MEP) with maximal amplitude in upper and lower extremities during intra-operative spinal cord monitoring. Methods: Intr

  13. Cost-effectiveness of multidisciplinary treatment in sick-listed patients with upper extremity musculoskeletal disorders: a randomized, controlled trial with one-year follow up

    NARCIS (Netherlands)

    Meijer, E.M.; Sluiter, J.K.; Heyma, A.; Sadiraj, K.; Frings-Dresen, M.H.W.

    2006-01-01

    Objective: To determine the effectiveness and cost-effectiveness of a return-to-work outpatient multidisciplinary treatment programme for sick-listed workers with non-specific upper extremity musculoskeletal complaints. Methods: A randomized controlled trial with a 1-year follow-up was carried out.

  14. Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke.

    Science.gov (United States)

    Jeong, Hee-Won; Chon, Seung-Chul

    2015-11-01

    [Purpose] This research demonstrated a forced intensive strength technique as a novel treatment for muscle power and function in the affected upper extremity muscle to determine the clinical feasibility with respect to upper extremity performance in a stroke hemiparesis. [Subject and Methods] The subject was a patient with chronic stroke who was dependent on others for performing the functional activities of his affected upper extremity. The technique incorporates a comprehensive approach of forced, intensive, and strength-inducing activities to enhance morphological changes associated with motor learning of the upper extremity. The forced intensive strength technique consisted of a 6-week course of sessions lasting 60 minutes per day, five times a week. [Results] After the 6-week intervention, the difference between relaxation and contraction of the affected extensor carpi radialis muscle increased from 0.28 to 0.63 cm(2), and that of the affected triceps brachii muscle increased from 0.30 to 0.90 cm(2). The results of clinical tests including the modified Ashworth scale (MAS; from 1+ to 1), muscle strength (from 15 to 32 kg), the manual function test (MFT; scores of 16/32 to 27/32 score), the Fugl-Meyer assessment (FMA; scores of 29/66 to 49/66 score), and the Jebsen-Taylor hand function test (JTHFT; from 38/60 to 19/60 sec) were improved. [Conclusion] Our results suggest that the forced intensive strength technique may have a beneficial effect on the muscle size of the upper extremity and motor function in patients with chronic stroke.

  15. Is There Any Association between PEEP and Upper Extremity DVT?

    Directory of Open Access Journals (Sweden)

    Farah Al-Saffar

    2015-01-01

    Full Text Available Background. We hypothesized that positive end-exploratory pressure (PEEP may promote venous stasis in the upper extremities and predispose to upper extremity deep vein thrombosis (UEDVT. Methods. We performed a retrospective case control study of medical intensive care unit patients who required mechanical ventilation (MV for >72 hours and underwent duplex ultrasound of their upper veins for suspected DVT between January 2011 and December 2013. Results. UEDVT was found in 32 (28.5% of 112 patients. Nineteen (67.8% had a central venous catheter on the same side. The mean ± SD duration of MV was 13.2±9.5 days. Average PEEP was 7.13±2.97 cm H2O. Average PEEP was ≥10 cm H2O in 23 (20.5% patients. Congestive heart failure (CHF significantly increased the odds of UEDVT (OR 4.53, 95% CI 1.13–18.11; P=0.03 whereas longer duration of MV (≥13 vs. <13 days significantly reduced it (OR 0.29, 95% CI 0.11–0.8; P=0.02. Morbid obesity showed a trend towards significance (OR 3.82, 95% CI 0.95–15.4; P=0.06. Neither PEEP nor any of the other analyzed predictors was associated with UEDVT. Conclusions. There is no association between PEEP and UEDVT. CHF may predispose to UEDVT whereas the risk of UEDVT declines with longer duration of MV.

  16. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 2. Drug and non-drug treatments

    OpenAIRE

    Andrei Evgenyevich Karateev; D. E. Karateev; Yu. A. Ermakova

    2015-01-01

    The treatment of rheumatic diseases of juxta-articular soft tissues (RDJAST) of the upper extremity (rotator cuff tendinitis, epicondylitis, de Quervain’s syndrome, trigger finger, carpal tunnel syndrome) entails a combination of drug and nondrug therapies. The basic agents that have been proven to be efficacious in this pathology are nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticosteroids (GCs). The paper considers the largest and known studies that are an evidence base for th...

  17. Aggressive intramuscular hemangiomas in the upper extremity

    Science.gov (United States)

    Lu, Hui; Chen, Qiang; Yang, Hu; Shen, Hui

    2017-01-01

    Abstract Introduction: Intramuscular hemangioma (IMH) is a rare congenital soft tissue tumor. Here, we report a case of IMH patient who had undergone several surgeries and other treatments that were all ineffective before he visited us. Clinical Findings: This IMH patient was a 16-yearold male who was born with a tumor of unknown size in his right hand and forearm. On physical examination, the tumor and skin flap complex was seen with a size of 14 cm_12 cm in his right hand, and the multiple postoperative scars were shown on his right hand and forearm. The patient was not able to raise his right shoulder, and the ranges of motion of his right elbow, wrist, and finger were almost zero degrees. Interventions: Considering that the tumor had been surgically excised for several times and the multiple recurrences had affected adversely his daily life, an amputation of his right hand, forearm, and the part of his right arm was performed. Diagnoses: The pathological examination confirmed the diagnosis of IMH. Outcomes: After the amputation surgery, the patient gained a functional recovery and the tumor did not recur during the 2 years after the surgery. Conclusion: A treatment of choice should be personalized according to an IMH patient's overall situation. For an IMH patient like our case with a history of multiple tumor recurrences, we suggest that an amputation surgery should be performed as early as possible to avoid the repeated, but ineffective surgical excisions and the unnecessary sufferings. PMID:28099360

  18. Upper extremity neuromotor dysfunction caused by local vibration

    Directory of Open Access Journals (Sweden)

    O. A. Shavlovskaya

    2015-01-01

    Full Text Available Vibration disease (VD (pneumatic hammer disease is a leader among occupational diseases. The prolonged use of vibrating tools is a high occupational health risk. The clinical picture of VD caused by local vibration includes sensorineural and upper extremity locomotor impairments that are polymorphic, polysyndromic, and not always specific. The International List of Occupational Diseases (2010 defines VD using the terms «vibration-induced white finger» (VWF and «hand-arm vibration syndrome» (HAVS. VWF as a manifestation of secondary Raynaud’s syndrome is the most noticeable vascular injury in HAVS. According to the recommendations of the International Labor Organization (2011 and the order of the Ministry of Health of Russia (2012, the clinical manifestations of local vibration include upper extremity polyneuropathy, secondary Raynaud’s phenomenon, and carpal tunnel syndrome (CTS. The paper considers approaches to differentially diagnosing CTS and HAVS, primary and secondary Raynaud’s syndrome, as well as clinical, laboratory, and electrodiagnostic studies. Prolonged exposure to vibration may affect the large myelinated (Ab fibers responsible for tactile touch, pressure, and vibration. Patients with VWF are frequently found to have hyperresponsiveness of the sympathetic nervous system, which affects digital vascular tone and appears as lower fingertip skin temperature. The paper discusses some possible mechanisms for the pathogenesis of vibration neuropathy (e.g. demyelinationof peripheral nerve fiber, as well as the involvement of plasma endothelin-1 in vascular response to cold as one of the components of the pathogenesis of vascular disorders. The central nervous system (cortical reorganization, plasticity phenomenon is believed to be implicated in the development and maintenance of vibration neuropathy.

  19. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

    Science.gov (United States)

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-03-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement.

  20. A Comparative Analysis of Speed Profile Models for Ankle Pointing Movements: Evidence that Lower and Upper Extremity Discrete Movements are controlled by a Single Invariant Strategy

    Directory of Open Access Journals (Sweden)

    Konstantinos eMichmizos

    2014-11-01

    Full Text Available Little is known about whether our knowledge of how the central nervous system controls the upper extremities, can generalize, and to what extent to the lower limbs. Our continuous efforts to design the ideal adaptive robotic therapy for the lower limbs of stroke patients and children with cerebral palsy highlighted the importance of analyzing and modeling the kinematics of the lower limbs, in general, and those of the ankle joints, in particular. We recruited 15 young healthy adults that performed in total 1,386 visually-evoked, visually-guided and target-directed discrete pointing movements with their ankle in dorsal–plantar and inversion–eversion directions. Using a nonlinear, least-squares error-minimization procedure, we estimated the parameters for 19 models which were initially designed to capture the dynamics of upper limb movements of various complexity. We validated our models based on their ability to reconstruct the experimental data. Our results suggest a remarkable similarity between the top performing models that described the speed profiles of ankle pointing movements and the ones previously found for the upper extremities both during arm reaching and wrist pointing movements. Among the top performers were the support-bounded lognormal and the beta models that have a neurophysiological basis and have been successfully used in upper extremity studies with normal subjects and patients. Our findings suggest that the same model can be applied to different human hardware, perhaps revealing a key invariant in human motor control. These findings have a great potential to enhance our rehabilitation efforts in any population with lower extremity deficits by, for example, assessing the level of motor impairment and improvement as well as informing the design of control algorithms for therapeutic ankle robots.

  1. Mirror therapy combined with biofeedback functional electrical stimulation for motor recovery of upper extremities after stroke: a pilot randomized controlled trial.

    Science.gov (United States)

    Kim, Jung Hee; Lee, Byoung-Hee

    2015-06-01

    The objective of this study was to evaluate the effects of mirror therapy in combination with biofeedback functional electrical stimulation (BF-FES) on motor recovery of the upper extremities after stroke. Twenty-nine patients who suffered a stroke > 6 months prior participated in this study and were randomly allocated to three groups. The BF-FES + mirror therapy and FES + mirror therapy groups practiced training for 5 × 30 min sessions over a 4-week period. The control group received a conventional physical therapy program. The following clinical tools were used to assess motor recovery of the upper extremities: electrical muscle tester, electrogoniometer, dual-inclinometer, electrodynamometer, the Box and Block Test (BBT) and Jabsen Taylor Hand Function Test (JHFT), the Functional Independence Measure, the Modified Ashworth Scale, and the Stroke Specific Quality of Life (SSQOL) assessment. The BF-FES + mirror therapy group showed significant improvement in wrist extension as revealed by the Manual Muscle Test and Range of Motion (p therapy group showed significant improvement in the BBT, JTHT, and SSQOL compared with the FES + mirror therapy group and control group (p therapy induced motor recovery and improved quality of life. These results suggest that mirror therapy, in combination with BF-FES, is feasible and effective for motor recovery of the upper extremities after stroke.

  2. Upper Extremity Kinematics and Muscle Activation Patterns in Subjects With Facioscapulohumeral Dystrophy

    NARCIS (Netherlands)

    Bergsma, Arjen; Murgia, Alessio; Cup, Edith H.; Verstegen, Paul P.; Meijer, Kenneth; de Groot, Imelda J.

    2014-01-01

    Objective: To compare the kinematics and muscle activity of subjects with facioscapulohumeral dystrophy (FSHD) and healthy control subjects during the performance of standardized upper extremity tasks. Design: Exploratory case-control study. Setting: A movement laboratory. Participants: Subjects (N=

  3. Refining 14C dating of bone >30,000 BP : establishing an accurate chronology for the Middle to Upper Palaeolithic transition in France.

    NARCIS (Netherlands)

    Talamo, Sahra

    2012-01-01

    This thesis aims to improve the chronology of the transition from the Middle to Upper Palaeolithic in France through the radiocarbon dating of bone collagen samples. This requires accurate calibration of the radiocarbon time scale for this time interval, reliable extraction of collagen from prehisto

  4. Three-dimensional evaluation of upper anterior alveolar bone dehiscence after incisor retraction and intrusion in adult patients with bimaxillary protrusion malocclusion

    Institute of Scientific and Technical Information of China (English)

    Qing-yuan GUO; Shi-jie ZHANG; Hong LIU; Chun-ling WANG; Fu-lan WEI; Tao LV; Na-na WANG; Dong-xu LIU

    2011-01-01

    Objective: The purpose of this study was to evaluate three-dimensional (3D) dehiscence of upper anterior alveolar bone during incisor retraction and intrusion in adult patients with maximum anchorage.Methods: Twenty adult patients with bimaxillary dentoalveolar protrusion had the four first premolars extracted.Miniscrews were placed to provide maximum anchorage for upper incisor retraction and intrusion.A computed tomography (CT) scan was performed after placement of the miniscrews and treatment.The 3D reconstructions of pre- and post-CT data were used to assess the dehiscence of upper anterior alveolar bone.Results: The amounts of upper incisor retraction at the edge and apex were (7.64±1.68) and (3.91±2.10) mm,respectively,and (1.34±0.74) mm of upper central incisor intrusion.Upper alveolar bone height losses at labial alveolar ridge crest (LAC) and palatal alveolar ridge crest (PAC) were 0.543 and 2.612 mm,respectively,and the percentages were (6.49±3.54)% and (27.42±9.77)%,respectively.The shape deformations of LAC-labial cortex bending point (LBP) and PAC-palatal cortex bending point (PBP) were (15.37±5.20)° and (6.43±3.27)°,respectively.Conclusions: Thus,for adult patients with bimaxillary protrusion,mechanobiological response of anterior alveolus should be taken into account during incisor retraction and intrusion.Pursuit of maximum anchorage might lead to upper anterior alveolar bone loss.

  5. Perfusion Assessment with the SPY System after Arterial Venous Reversal for Upper Extremity Ischemia

    Directory of Open Access Journals (Sweden)

    Darrell Brooks, MD

    2014-07-01

    Conclusions: AVR effectively reestablished blood flow in patients with terminal upper extremity ischemia. ICG angiography with SPY technology revealed that, in most cases, kinetic curves, timing, and patterns of perfusion gradually normalized over several PODs.

  6. Nosology of Juvenile Muscular Atrophy of Distal Upper Extremity: From Monomelic Amyotrophy to Hirayama Disease—Indian Perspective

    OpenAIRE

    Kaukab Maqbool Hassan; Hirdesh Sahni

    2013-01-01

    Since its original description by Keizo Hirayama in 1959, “juvenile muscular atrophy of the unilateral upper extremity” has been described under many nomenclatures from the east. Hirayama disease (HD), also interchangeably referred to as monomelic amyotrophy, has been more frequently recognised in the west only in the last two decades. HD presents in adolescence and young adulthood with insidious onset unilateral or bilateral asymmetric atrophy of hand and forearm with sparing of brachioradia...

  7. To compare the effectiveness of constraint induced movement therapy versus motor relearning programme to improve motor function of hemiplegic upper extremity after stroke

    Science.gov (United States)

    Batool, Sana; Soomro, Nabila; Amjad, Fareeha; Fauz, Rabia

    2015-01-01

    Objective: To compare the effectiveness of constraint induced movement therapy versus motor relearning programme to improve motor function of hemiplegic upper extremity after stroke. Method: A sample of 42 patients was recruited from the Physiotherapy Department of IPM&R and Neurology OPD of Civil Hospital Karachi through non probability purposive sampling technique. Twenty one patients were placed to each experimental and control groups. Experimental group was treated with Constraint Induced Movement Therapy (CIMT) and control group was treated with motor relearning programme (MRP) for three consecutive weeks. Pre and post treatment measurements were determined by upper arm section of Motor Assessment Scale (MAS) and Self Care item of Functional Independence Measure (FIM) Scale. Results: Intra group analysis showed statistically significant results (p-value<0.05) in all items of MAS in both groups. However, advanced hand activities item of MAS in MRP group showed insignificant result (p-value=0.059). Self-care items of FIM Scale also showed significant result (p-value< 0.05) in both groups except dressing upper body item (p-value=0.059) in CIMT group and grooming and dressing upper body items (p-value=0.059 & 0.063) in MRP group showed insignificant p-values. Conclusion: CIMT group showed more significant improvement in motor function and self-care performance of hemiplegic upper extremity as compared to MRP group in patients with sub-acute stroke assessed by the MAS and FIM scales. Thus CIMT is proved to be more statistically significant and clinically effective intervention in comparison to motor relearning programme among the patients aged between 35-60 years. Further studies are needed to evaluate CIMT effects in acute and chronic post stroke population. PMID:26649007

  8. Life in an extreme environment: phytoplankton blooms in the upper Scheldt estuary

    OpenAIRE

    Muylaert, K.; Kromkamp, J.

    2002-01-01

    Being extremely turbid environments characterised by short residence times and rapid changes in salinity, the upper reaches of estuaries comprise an extreme environment for phytoplankton to live and grow in. Nevertheless, in many estuaries including the Schelde estuary, these reaches often support dense phytoplankton populations. In the past, these phytoplankton blooms in the upper reaches of estuaries have often been found difficult to explain. In this presentation, we will describe the exte...

  9. The results of bone deformity correction using a spider frame with web-based software for lower extremity long bone deformities

    Directory of Open Access Journals (Sweden)

    Tekin Ali Çağrı

    2016-01-01

    Full Text Available Aim: To present the functional and radiological results and evaluate the effectiveness of a computer-assisted external fixator (spider frame in patients with lower extremity shortness and deformity. Materials and methods: The study comprised 17 patients (14 male, 3 female who were treated for lower extremity long bone deformity and shortness between 2012 and 2015 using a spider frame. The procedure’s level of difficulty was determined preoperatively using the Paley Scale. Postoperatively, the results for the patients who underwent tibial operations were evaluated using the Paley criteria modified by ASAMI, and the results for the patients who underwent femoral operations were evaluated according to the Paley scoring system. The evaluations were made by calculating the External Fixator and Distraction indexes. Results: The mean age of the patients was 24.58 years (range, 5–51 years. The spider frame was applied to the femur in 10 patients and to the tibia in seven. The mean follow-up period was 15 months (range, 6–31 months from the operation day, and the mean amount of lengthening was 3.0 cm (range, 1–6 cm. The mean duration of fixator application was 202.7 days (range, 104–300 days. The mean External Fixator Index was 98 days/cm (range, 42–265 days/cm. The mean Distraction Index was 10.49 days/cm (range, 10–14 days/cm. Conclusion: The computer-assisted external fixator system (spider frame achieves single-stage correction in cases of both deformity and shortness. The system can be applied easily, and because of its high-tech software, it offers the possibility of postoperative treatment of the deformity.

  10. Recapitulating flesh with silicon and steel: advancements in upper extremity robotic prosthetics.

    Science.gov (United States)

    Lee, Brian; Attenello, Frank J; Liu, Charles Y; McLoughlin, Michael P; Apuzzo, Michael L J

    2014-01-01

    With the loss of function of an upper extremity because of stroke or spinal cord injury or a physical loss from amputation, an individual's life is forever changed, and activities that were once routine become a magnitude more difficult. Much research and effort have been put into developing advanced robotic prostheses to restore upper extremity function. For patients with upper extremity amputations, previously crude prostheses have evolved to become exceptionally functional. Because the upper extremities can perform a wide variety of activities, several types of upper extremity prostheses are available ranging from passive cosmetic limbs to externally powered robotic limbs. In addition, new developments in brain-machine interface are poised to revolutionize how patients can control these advanced prostheses using their thoughts alone. For patients with spinal cord injury or stroke, functional electrical stimulation promises to provide the most sophisticated prosthetic limbs possible by reanimating paralyzed arms of these patients. Advances in technology and robotics continue to help patients recover vital function. This article examines the latest neurorestorative technologies for patients who have either undergone amputation or lost the use of their upper extremities secondary to stroke or spinal cord injury.

  11. The structure of long tubular bones fractures of lower extremity by the data of the regional bureau of forensic-medical examination

    Directory of Open Access Journals (Sweden)

    Savka I.H.

    2013-10-01

    Full Text Available The main purpose of the research is carrying out forensic-medical analysis of cases from expert’s practice with fractures of the long bones based on the findings of the Regional Bureau of Forensic-Medical Examination over 2009-2012 years period. The research has been carried out using methods of statistical and comparative analysis. Their distribution by gender, age, localization, character and type of external influence, the conditions of their occurrence and participation of other persons has been outlined. Fractures of lower extremity bones make up from 15,8 to 22,5% of all the cases of mechanical trauma with lethal outcomes. Therewith male persons suffer more often from injury of the left extremity at different day time and season. The principal mechanism of their origin is injury resulting from road accidents in the countryside with the participation of other persons.

  12. Common Factors and Outcome in Late Upper Extremity Amputations After Military Injury

    Science.gov (United States)

    2014-04-01

    are no quality studies that attempt to define an upper extremity limb salvage in a consistent way such as the Lower Extremity Assessment Project study...their prosthetic arm frequently despite all of them receiving multiple prostheses. This percentage is lower than the 76% found in a previous study that...following limb - threatening lower limb trauma: lessons learned from the Lower Extremity Assessment Project (LEAP). J Am Acad Orthop Surg. 2006;14:S205

  13. A clinical prediction score for upper extremity deep venous thrombosis.

    Science.gov (United States)

    Constans, Joel; Salmi, Louis-Rachid; Sevestre-Pietri, Marie-Antoinette; Perusat, Sophie; Nguon, Monika; Degeilh, Maryse; Labarere, Jose; Gattolliat, Olivier; Boulon, Carine; Laroche, Jean-Pierre; Le Roux, Philippe; Pichot, Olivier; Quéré, Isabelle; Conri, Claude; Bosson, Jean-Luc

    2008-01-01

    It was the objective of this study to design a clinical prediction score for the diagnosis of upper extremity deep venous thrombosis (UEDVT). A score was built by multivariate logistic regression in a sample of patients hospitalized for suspicion of UEDVT (derivation sample). It was validated in a second sample in the same university hospital, then in a sample from the multicenter OPTIMEV study that included both outpatients and inpatients. In these three samples, UEDVT diagnosis was objectively confirmed by ultrasound. The derivation sample included 140 patients among whom 50 had confirmed UEDVT, the validation sample included 103 patients among whom 46 had UEDVT, and the OPTIMEV sample included 214 patients among whom 65 had UEDVT. The clinical score identified a combination of four items (venous material, localized pain, unilateral pitting edema and other diagnosis as plausible). One point was attributed to each item (positive for the first 3 and negative for the other diagnosis). A score of -1 or 0 characterized low probability patients, a score of 1 identified intermediate probability patients, and a score of 2 or 3 identified patients with high probability. Low probability score identified a prevalence of UEDVT of 12, 9 and 13%, respectively, in the derivation, validation and OPTIMEV samples. High probability score identified a prevalence of UEDVT of 70, 64 and 69% respectively. In conclusion we propose a simple score to calculate clinical probability of UEDVT. This score might be a useful test in clinical trials as well as in clinical practice.

  14. The clinical effect of the expandable intramedullary nailing in fractures of upper and lower extremities%可膨胀髓内钉治疗四肢长骨骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    喻鑫罡; 夏荣刚; 陈旸; 李晓林; 曾炳芳

    2011-01-01

    Objective To assess the efficacy of the expandable intramedullary nailing for fractures of upper and lower extremities.Methods 45 cases ( included 52 extremities )of long bone fractures involved upper and lower extremities were treated by using expandable intramedullary nails.5 cases received inferior vena cava filter because of deep vein thrombosis before the operation.Results Operative timing was from 30 to 140 minutes ( average 70 ±6.2 minutes ).All cases were followed up for 12 to 34 months( average 18.6 ± 1.2 months ).The healing time ranged from 10 to 28 weeks ( average 11.9 ± 1.3 weeks ).3 cases were healed by plate fixation and bone graft because of bone non-union.2 cases showed delay-union because intramedullary nails expanded noneffectively.7 cases were transfered to inter-locking medullary nailings because of bone non-union.The general healing rate was 80.7%.Conclusions Fractures involved of upper and lower extremities can be treated by expandable intramedullary nailing, with the characteristic of less invasive, few complications and ease of application, and elastic and axial fixation accelerated fracture healing, especially in polytraumas and multi-fractures.%目的 探讨可膨胀髓内钉治疗四肢长骨骨折的疗效.方法 采用可膨胀髓内钉治疗四肢长骨骨折45例(52侧),其中5例术前出现下肢深静脉血栓者安装静脉滤器后手术.结果 手术时间30~140(70±6.2) min.45例均获随访,时间12~34(18.6±1.2)个月.骨折愈合时间10~28(11.9±1.3)周.3例出现骨不连后更换钢板植骨固定后愈合,2例髓内钉膨胀失败延迟愈合,7例出现骨不连更换交锁钉植骨固定后愈合.骨折总愈合率达80.7%.结论 可膨胀髓内钉治疗四肢长骨骨折具有手术创伤小、操作简单、并发症少的特点,且轴向弹性固定加速骨折的愈合时间,适用多发骨折患者的治疗.

  15. A comparative ergonomic study of work-related upper extremity musculo skeletal disorder among the unskilled and skilled surgical blacksmiths in West Bengal, India

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    Tirthankar Ghosh

    2011-01-01

    Full Text Available Objective: The main aim of the study was to determine the nature and extent of work-related upper extremity musculoskeletal disorders (MSDs and physiological stress among the blacksmiths involved in surgical instrument industry. Materials and Methods: In the present investigation, 50 male blacksmiths of each skilled and unskilled groups of the forging section had been selected. For the symptom survey, a questionnaire on discomfort symptoms was performed. Repetitiveness of work and hand grip strength of both the groups were measured. Results: It was revealed that upper limb MSD was a major problem among both group of blacksmith, primarily involving the hand, wrist, fingers, and shoulder. From this study it was found that 66% (33 skilled and 80% (40 unskilled blacksmith workers are feeling discomfort. The most commonly affected regions among the skilled and unskilled blacksmith workers were lower back (skilled 65% and unskilled 80%, neck (skilled 60% and unskilled 80%, and hand (skilled 50% and unskilled.

  16. Successful Recovery and Transplantation of 11 Organs Including Face, Bilateral Upper Extremities, and Thoracic and Abdominal Organs From a Single Deceased Organ Donor.

    Science.gov (United States)

    Tullius, Stefan G; Pomahac, Bohdan; Kim, Heung Bae; Carty, Matthew J; Talbot, Simon G; Nelson, Helen M; Delmonico, Francis L

    2016-10-01

    We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor.

  17. A Study on Extremely Dry and Wet Summer Monsoon in Pakistan by Focusing on the Anomalous States of the Upper Troposphere

    Science.gov (United States)

    Ahmad, S.; Koike, T.; Nishii, K.

    2012-04-01

    Seasonally-changes in wind pattern, monsoon, sometimes results in severe droughts and intense flooding in many parts of the world including South Asian countries like Pakistan. The livelihood of a vast population in Pakistan depends on agriculture and land use is strongly influenced by water-based ecosystems that depend on the monsoon rains. Furthermore, climate change studies undertaken so far reveal that action is essential in order to prevent long term damage to water cycle and thus of great concern to the community and stakeholders. Pakistan Summer Monsoon (PSM) is generally affected by both the disturbances from the tropical and the extratropical regions; however there is lack of understanding of physical mechanisms of PSM compared to other regional studies i.e. Indian Summer Monsoon (ISM) and South-East Asian Monsoon (SEAM). In our study, we applied heat and vorticity budgets and wave train analysis to reveal the mechanisms of the extremely dry and wet PSM events associated with the anomalous upper tropospheric circulation. We found that the extremely dry (wet) PSM events are closely related with the strengthening(weakening) of the upper-tropospheric central Asian high. We also found that in addition to Rossby-wave (Matsuno-Gill) type atmospheric response, the Rossby wave train along the Asian Jet originating from northwestern Europe or North Atlantic Ocean strengthened(weakened) the upper-tropospheric central Asian high. Therefore strong convection anomalies resulting in severe flooding (drought) events over the PSM region are induced by both the tropical and extratropical processes. Key Words: Pakistan, Extremes Monsoon Events, Physical Processes, Heat Budget, Vorticity, Wave Train

  18. Self-reported musculoskeletal disorders of the distal upper extremities and the neck in German veterinarians: a cross-sectional study.

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    Agnessa Kozak

    Full Text Available BACKGROUND: Veterinary work is a physically demanding profession and entails the risk of injuries and diseases of the musculoskeletal system, particularly in the upper body. The prevalence of musculoskeletal disorders (MSD, the consequences and work-related accidents in German veterinarians were investigated. Work-related and individual factors associated with MSD of upper extremities and the neck were analyzed. METHODS: In 2011, a self-reporting Standardized Nordic Questionnaire was mailed to registered veterinarians in seven federal medical associations in Germany. A total of 3174 (38.4% veterinarians responded. Logistic regression analysis was used to determine the association between risk factors and MSD-related impairment of daily activities. RESULTS: MSD in the neck (66.6% and shoulder (60.5% were more prevalent than in the hand (34.5% or elbow (24.5%. Normal activities were affected in 28.7% (neck, 29.5% (shoulder, 19.4% (hand and 14% (elbow of the respondents. MSD in the upper body occurred significantly more often in large animal practitioners. Accidents that resulted in MSD were most frequently reported in the hand/wrist (14.3% or in the shoulder (10.8%. The majority of all accidents in the distal upper extremities were caused by animals than by other factors (19% vs. 9.2%. For each area of the body, a specific set of individual and work-related factors contributed significantly to severe MSD: Older age, gender, previous injuries, BMI, practice type, veterinary procedures such as dentistry, rectal procedures and obstetric procedures as well as high demands and personal burnout. CONCLUSION: From the perspective of occupational health and safety, it seems to be necessary to improve accident prevention and to optimize the ergonomics of specific tasks. Our data suggest the need for target group-specific preventive measures that also focus on the psychological factors at work.

  19. The influence of the Extreme Ultraviolet spectral energy distribution on the structure and composition of the upper atmosphere of exoplanets

    CERN Document Server

    Guo, J H

    2015-01-01

    By varying the profiles of stellar extreme ultraviolet (EUV) spectral energy distribution (SED), we tested the influences of stellar EUV SEDs on the physical and chemical properties of the escaping atmosphere. We apply our model to study four exoplanets, HD\\,189733b, HD\\,209458b, GJ \\,436b, and Kepler-11b. We found that the total mass loss rates of an exoplanet, which are determined mainly by the integrated fluxes, are moderately affected by the profiles of the EUV SED, but the composition and species distributions in the atmosphere can be dramatically modified by the different profiles of the EUV SED. For exoplanets with a high hydrodynamic escape parameter ($\\lambda$), the amount of atomic hydrogen produced by photoionization at different altitudes can vary by one to two orders of magnitude with the variation of stellar EUV SEDs. The effect of photoionization of H is prominent when the EUV SED is dominated by the low-energy spectral region (400-900${\\AA}$), which pushes the transition of H/H$^{+}$ to low al...

  20. Quantification of radiation exposure in the operating theatre during management of common fractures of the upper extremity in children.

    Science.gov (United States)

    Maempel, J F; Stone, O D; Murray, A W

    2016-09-01

    Introduction Surgical procedures to manage trauma to the wrist, forearm and elbow in children are very common. Image intensifiers are used routinely, yet studies/guidelines that quantify expected radiation exposure in such procedures are lacking. Methods Information on demographics, injury type, surgeon grade and dose area product (DAP) of radiation exposure per procedure was collected prospectively for 248 patients undergoing manipulation/fixation of injuries to the elbow, forearm or wrist at a paediatric hospital over 1 year. Results DAP exposure (in cGycm(2)) differed significantly across different procedures (pexposure than grade-2 fixation (1.95cGycm(2)) (p=0.048). Fractures of the wrist or forearm necessitating metalwork fixation resulted in higher exposure than those requiring manipulation only (both pexposures for common procedures utilised in the management of paediatric upper limb trauma were quantified. These findings will be useful to surgeons auditing their practice and quantifying radiation-associated risks to patients. Our data may serve as a basis for implementing protocols designed to improve patient safety.

  1. THE INFLUENCE OF THE EXTREME ULTRAVIOLET SPECTRAL ENERGY DISTRIBUTION ON THE STRUCTURE AND COMPOSITION OF THE UPPER ATMOSPHERE OF EXOPLANETS

    Energy Technology Data Exchange (ETDEWEB)

    Guo, J. H. [Yunnan Observatories, Chinese Academy of Sciences, P.O. Box 110, Kunming 650011 (China); Ben-Jaffel, Lotfi, E-mail: guojh@ynao.ac.cn, E-mail: bjaffel@iap.fr [Sorbonne Universités, UPMC Univ. Paris 6 et CNRS, UMR 7095, Institut Astrophysique de Paris, F-75014 Paris (France)

    2016-02-20

    By varying the profiles of stellar extreme ultraviolet (EUV) spectral energy distributions (SEDs), we tested the influences of stellar EUV SEDs on the physical and chemical properties of an escaping atmosphere. We apply our model to study four exoplanets: HD 189733b, HD 209458b, GJ 436b, and Kepler-11b. We find that the total mass loss rates of an exoplanet, which are determined mainly by the integrated fluxes, are moderately affected by the profiles of the EUV SED, but the composition and species distributions in the atmosphere can be dramatically modified by the different profiles of the EUV SED. For exoplanets with a high hydrodynamic escape parameter (λ), the amount of atomic hydrogen produced by photoionization at different altitudes can vary by one to two orders of magnitude with the variation of stellar EUV SEDs. The effect of photoionization of H is prominent when the EUV SED is dominated by the low-energy spectral region (400–900 Å), which pushes the transition of H/H{sup +} to low altitudes. In contrast, the transition of H/H{sup +} moves to higher altitudes when most photons are concentrated in the high-energy spectral region (50–400 Å). For exoplanets with a low λ, the lower temperatures of the atmosphere make many chemical reactions so important that photoionization alone can no longer determine the composition of the escaping atmosphere. For HD 189733b, it is possible to explain the time variability of Lyα between 2010 and 2011 by a change in the EUV SED of the host K-type star, yet invoking only thermal H i in the atmosphere.

  2. Nosology of Juvenile Muscular Atrophy of Distal Upper Extremity: From Monomelic Amyotrophy to Hirayama Disease—Indian Perspective

    Science.gov (United States)

    Hassan, Kaukab Maqbool; Sahni, Hirdesh

    2013-01-01

    Since its original description by Keizo Hirayama in 1959, “juvenile muscular atrophy of the unilateral upper extremity” has been described under many nomenclatures from the east. Hirayama disease (HD), also interchangeably referred to as monomelic amyotrophy, has been more frequently recognised in the west only in the last two decades. HD presents in adolescence and young adulthood with insidious onset unilateral or bilateral asymmetric atrophy of hand and forearm with sparing of brachioradialis giving the characteristic appearance of oblique amyotrophy. Symmetrically bilateral disease has also been recognized. Believed to be a cervical flexion myelopathy, HD differs from motor neuron diseases because of its nonprogressive course and pathologic findings of chronic microcirculatory changes in the lower cervical cord. Electromyography shows features of acute and/or chronic denervation in C7, C8, and T1 myotomes in clinically affected limb and sometimes also in clinically unaffected contralateral limb. Dynamic forward displacement of dura in flexion causes asymmetric flattening of lower cervical cord. While dynamic contrast magnetic resonance imaging is diagnostic, routine study has high predictive value. There is a need to lump all the nomenclatures under the rubric of HD as prognosis in this condition is benign and prompt diagnosis is important to institute early collar therapy. PMID:24063005

  3. Nosology of Juvenile Muscular Atrophy of Distal Upper Extremity: From Monomelic Amyotrophy to Hirayama Disease—Indian Perspective

    Directory of Open Access Journals (Sweden)

    Kaukab Maqbool Hassan

    2013-01-01

    Full Text Available Since its original description by Keizo Hirayama in 1959, “juvenile muscular atrophy of the unilateral upper extremity” has been described under many nomenclatures from the east. Hirayama disease (HD, also interchangeably referred to as monomelic amyotrophy, has been more frequently recognised in the west only in the last two decades. HD presents in adolescence and young adulthood with insidious onset unilateral or bilateral asymmetric atrophy of hand and forearm with sparing of brachioradialis giving the characteristic appearance of oblique amyotrophy. Symmetrically bilateral disease has also been recognized. Believed to be a cervical flexion myelopathy, HD differs from motor neuron diseases because of its nonprogressive course and pathologic findings of chronic microcirculatory changes in the lower cervical cord. Electromyography shows features of acute and/or chronic denervation in C7, C8, and T1 myotomes in clinically affected limb and sometimes also in clinically unaffected contralateral limb. Dynamic forward displacement of dura in flexion causes asymmetric flattening of lower cervical cord. While dynamic contrast magnetic resonance imaging is diagnostic, routine study has high predictive value. There is a need to lump all the nomenclatures under the rubric of HD as prognosis in this condition is benign and prompt diagnosis is important to institute early collar therapy.

  4. Assessment of image quality in soft tissue and bone visualization tasks for a dedicated extremity cone-beam CT system

    Energy Technology Data Exchange (ETDEWEB)

    Demehri, S. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Johns Hopkins Outpatient Center, JHOC 5168, Musculoskeletal Radiology, Baltimore, MD (United States); Muhit, A.; Zbijewski, W.; Stayman, J.W. [Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States); Yorkston, J.; Packard, N.; Senn, R.; Yang, D.; Foos, D. [Carestream Health, Rochester, NY (United States); Thawait, G.K.; Fayad, L.M.; Chhabra, A.; Carrino, J.A. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Siewerdsen, J.H. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States)

    2015-06-01

    To assess visualization tasks using cone-beam CT (CBCT) compared to multi-detector CT (MDCT) for musculoskeletal extremity imaging. Ten cadaveric hands and ten knees were examined using a dedicated CBCT prototype and a clinical multi-detector CT using nominal protocols (80kVp-108mAs for CBCT; 120kVp- 300mAs for MDCT). Soft tissue and bone visualization tasks were assessed by four radiologists using five-point satisfaction (for CBCT and MDCT individually) and five-point preference (side-by-side CBCT versus MDCT image quality comparison) rating tests. Ratings were analyzed using Kruskal-Wallis and Wilcoxon signed-rank tests, and observer agreement was assessed using the Kappa-statistic. Knee CBCT images were rated ''excellent'' or ''good'' (median scores 5 and 4) for ''bone'' and ''soft tissue'' visualization tasks. Hand CBCT images were rated ''excellent'' or ''adequate'' (median scores 5 and 3) for ''bone'' and ''soft tissue'' visualization tasks. Preference tests rated CBCT equivalent or superior to MDCT for bone visualization and favoured the MDCT for soft tissue visualization tasks. Intraobserver agreement for CBCT satisfaction tests was fair to almost perfect (κ ∝ 0.26-0.92), and interobserver agreement was fair to moderate (κ ∝ 0.27-0.54). CBCT provided excellent image quality for bone visualization and adequate image quality for soft tissue visualization tasks. (orig.)

  5. [Application of the discriminant analysis for the assessment of human somatotype using the long bones of extremities].

    Science.gov (United States)

    Grigor'eva, M A

    2004-01-01

    Measurements were made on the basis of the osteological collection of the chair for anthropology, Moscow State University (70 cases), and on the basis of a series of skeletons (10 cases) from among burial places of the Novospassk Monastery (males aged above 18-20). Eleven sizes of Martin program (length, diaphysis circumference and epiphysis width) were fixed onto the humerus, radial, femoral and shin bones. Simultaneously, the development of the osseous relief elements in the above bones (a total of 18 signs in each skeleton) was evaluated by Fedosova program. The data was processed by SPSS. Discriminative analysis was used as a basis to work out a diagnostic model that can be used to determine a somatotype by the humerus, radial and femoral bones. The classification accuracy is 75%. The method should be applied in those cases, when the appropriate bones are available. If the available combination of bones is different from the above, the routine method is recommended for use, i.e. determination of a somatotype by the skeleton massiveness.

  6. The Association of Upper Extremity Deep Vein Thrombosis and Homozygosity for the MTHFR 1298A-C Mutation in a Young Women with Membranoproliferative Glomerulonephritis

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    İsmail YILDIZ

    2014-05-01

    Full Text Available Nephrotic syndrome increases the tendency to thromboembolic complications in both adults and children. Changes in the plasma concentrations of many proteins concerned with regulation of clotting and fibrinolytic systems, hyperviscosity, dehydration, corticosteroid and diuretic therapy may also contribute to thromboembolism. In addition, some of the genetic disorders also increase tendency to thromboembolic events. One of these disorders is methylene tetrahydrofolate reductase (MTHFR A1298C mutation, which may cause hyperhomocysteinemia and thrombotic events when the folate level is low. A 26-year-old female was admitted to hospital with upper extremity deep vein thrombosis and nephrotic range proteinuria. On her renal biopsy, membranoproliferative glomerulonephritis (MPGN was found. The other causes of thrombosis were excluded and homozygosity for the MTHFR A1298C mutation was determined. The levels of homocysteine and folic acid were normal. We report a first case of MPGN together with homozygosity for MTHFR 1298C mutation in adult nephrotic syndrome, complicated with unusual upper extremity venous thrombosis.

  7. Assessing upper extremity capacity as a potential indicator of needs related to household activities for rehabilitation services in people with myotonic dystrophy type 1.

    Science.gov (United States)

    Raymond, Kateri; Auger, Louis-Pierre; Cormier, Marie-France; Vachon, Christine; St-Onge, Sabrina; Mathieu, Jean; Noreau, Luc; Gagnon, Cynthia

    2015-06-01

    This study aimed to assess upper extremity capacity as a potential indicator of needs related to household activities for rehabilitation services in people with myotonic dystrophy type 1 (DM1). A cross-sectional study was set in an outpatient neuromuscular clinic where 200 adults with a confirmed diagnosis of DM1 (121 women; mean age: 47 y) were selected from the registry of a neuromuscular clinic to participate. Housing-related activities were assessed using the "housing" section of the Assessment of Life Habits Questionnaire (LIFE-H). The upper extremity assessment included grip strength (Jamar dynamometer), lateral pinch strength (pinch gauge), gross dexterity (Box and Block Test) and fine dexterity (Purdue Pegboard Test). Correlations with the LIFE-H item "housing" were stronger for grip and lateral strength (r = 0.62; 0.61). When difficulties were present in "housing", the cut-off score associated with lateral pinch strength was 4.8 kg (sensitivity: 75.6%; specificity: 79.2%). Grip strength presented cut-off scores that clinically differed by gender. In conclusion, potential indicator of needs related to household activities for rehabilitation services with valid assessment tools were developed for people with DM1 who experience difficulties in housing-related activities. These criteria will assist health professionals in their attempt to refer DM1 patients to rehabilitation services at the appropriate time.

  8. Nerve conduction studies in upper extremities: skin temperature corrections.

    Science.gov (United States)

    Halar, E M; DeLisa, J A; Soine, T L

    1983-09-01

    The relationship of skin to near nerve (NN) temperature and to nerve conduction velocity (NCV) and distal latency (DL) was studied in 34 normal adult subjects before and after cooling both upper extremities. Median and ulnar motor and sensory NCV, DL, and NN temperature were determined at ambient temperature (mean X skin temp = 33 C) and after cooling, at approximately 26, 28, and 30 C of forearm skin temperature. Skin temperatures on the volar side of the forearm, wrist, palm, and fingers and NN temperature at the forearm, midpalm, and thenar or hypothenar eminence were compared with respective NCV and DL. Results showed a significant linear correlation between skin temperature and NN temperature at corresponding sites (r2 range, 0.4-0.84; p less than 0.005). Furthermore, both skin and NN temperatures correlated significantly with respective NCV and DL. Midline wrist skin temperature showed the best correlation to NCV and DL. Median motor and sensory NCV were altered 1.5 and 1.4m/sec/C degree and their DL 0.2 msec/C degree of wrist skin temperature change, respectively. Ulnar motor and sensory NCV were changed 2.1 and 1.6m/sec/C degree respectively, and 0.2 msec/C degree wrist temperature for motor and sensory DL. Average ambient skin temperature at the wrist (33 C) was used as a standard skin temperature in the temperature correction formula: NCV or DL(temp corrected) = CF(Tst degree - Tm degree) + obtained NCV or DL, where Tst = 33 C for wrist, Tm = the measured skin temperature, and CF = correction factor of tested nerve. Use of temperature correction formula for NCV and DL is suggested in patients with changed wrist skin temperature outside 29.6-36.4C temperature range.

  9. CT analysis of the upper end of the femur: the asterisk sign and ischaemic bone necrosis of the femoral head.

    Science.gov (United States)

    Dihlmann, W

    1982-01-01

    In computed tomography (CT) of the head of the femur, a star-shaped structure can be seen which we refer to as the asterisk or asterisk sign. The asterisk is formed by thickened weight-bearing bone trabeculae. It can be shown by CT that the asterisk exhibits a characteristic change in ischaemic bone necrosis of the femoral head, even when the disease is in an early stage. CT of the hip joint is therefore an important examination for early diagnosis of ischaemic disease of the femoral head.

  10. A comparative study of the effects of daily minodronate and weekly alendronate on upper gastrointestinal symptoms, bone resorption, and back pain in postmenopausal osteoporosis patients.

    Science.gov (United States)

    Yoshioka, Toru; Okimoto, Nobukazu; Okamoto, Ken; Sakai, Akinori

    2013-03-01

    The purpose of the present study was to precisely compare both the efficacy and abdominal symptom-related quality of life after treatment with daily minodronate and weekly alendronate in patients with primary postmenopausal osteoporosis. The efficacy of the two drugs was assessed based on improvements in a bone turnover marker, back pain, and gastrointestinal symptoms that impair quality of life, which was assessed using the Izumo scale questionnaire. In the minodronate group, there were no significant changes during the treatment period in the specific scores for heartburn, epigastralgia and epigastric fullness, whereas all of the scores were significantly elevated at some time point after drug administration in the alendronate group. Urinary N-telopeptide of type I collagen (uNTX), a bone resorption marker, and bone-specific alkaline phosphatase, a bone formation marker, significantly decreased in both groups, but decreases in uNTX in the minodronate group was observed significantly earlier compared with those in the alendronate group. The back pain scores, which were obtained using a visual analog scale, were significantly reduced in both groups. However, analgesic effects were detected earlier in the minodronate group. In conclusion, compared with weekly alendronate, daily minodronate improved bone turnover and back pain more promptly without causing upper gastrointestinal symptoms.

  11. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 2. Drug and non-drug treatments

    Directory of Open Access Journals (Sweden)

    Andrei Evgenyevich Karateev

    2015-01-01

    Full Text Available The treatment of rheumatic diseases of juxta-articular soft tissues (RDJAST of the upper extremity (rotator cuff tendinitis, epicondylitis, de Quervain’s syndrome, trigger finger, carpal tunnel syndrome entails a combination of drug and nondrug therapies. The basic agents that have been proven to be efficacious in this pathology are nonsteroidal anti-inflammatory drugs (NSAIDs and glucocorticosteroids (GCs. The paper considers the largest and known studies that are an evidence base for the expediency of using agents, such NSAIDs, local administration of GCs, hyaluronic acid, and plateletrich plasma, as well as different non-drug treatments, in RDJAST. The latter (physiotherapy, exercises, and rehabilitation programs should be regarded as a necessary component of the therapeutic process in patients with RDJAST-associated chronic pain. Preservation of obvious pain and impaired function despite medical therapy should be regarded as an indication for surgical treatment.

  12. High-intensity, unilateral resistance training of a non-paretic muscle group increases active range of motion in a severely paretic upper extremity muscle group after stroke.

    Directory of Open Access Journals (Sweden)

    M. A. Urbin

    2015-05-01

    Full Text Available Limited rehabilitation strategies are available for movement restoration when paresis is too severe following stroke. Previous research has shown that high-intensity resistance training of one muscle group enhances strength of the homologous, contralateral muscle group in neurologically-intact adults. How this cross education phenomenon might be exploited to moderate severe weakness in an upper extremity muscle group after stroke is not well understood. The primary aim of this study was to examine adaptations in force-generating capacity of severely paretic wrist extensors resulting from high-intensity, dynamic contractions of the non-paretic wrist extensors. A secondary, exploratory aim was to probe neural adaptations in a subset of participants from each sample using a single-pulse, transcranial magnetic stimulation protocol. Separate samples of neurologically-intact controls (n=7 and individuals > 4 months post stroke (n=6 underwent 16 sessions of training. Following training, one-repetition maximum of the untrained wrist extensors in the control group and active range of motion of the untrained, paretic wrist extensors in the stroke group were significantly increased. No changes in corticospinal excitability, intracortical inhibition or interhemispheric inhibition were observed in control participants. Both stroke participants who underwent TMS testing, however, exhibited increased voluntary muscle activation following the intervention. In addition, motor-evoked potentials that were unobtainable prior to the intervention were readily elicited afterwards in a stroke participant. Results of this study demonstrate that high-intensity resistance training of a non-paretic upper extremity muscle group can enhance voluntary muscle activation and force-generating capacity of a severely paretic muscle group after stroke. There is also preliminary evidence that corticospinal adaptations may accompany these gains.

  13. Rescue procedures in the major trauma of upper extremities – The role of the polish medical air rescue in the therapeutic process

    Directory of Open Access Journals (Sweden)

    Robert Gałązkowski

    2014-12-01

    Full Text Available Background: Due to the growing use of various types of industrial and agricultural machinery, occupational accidents are among the most serious ones and quite frequently result in the permanent posttraumatic disability of the injured person. In Poland, a replantation service has been operating since 2010. Each day, one out of six centres provides emergency replantation service accepting amputation calls from across the country. Patients qualified for replantation often need to be transported from places located even several hundred kilometres from the target hospital. Material and Methods: The analysis covered 174 Helicopter Emergency Medical Service (HEMS missions and 112 interhospital transports. The data were obtained as a result of a retrospective analysis of the air and medical documentation of 23 460 missions carried out by the Polish Medical Air Rescue (Samodzielny Publiczny Zakład Opieki Zdrowotnej Lotnicze Pogotowie Ratunkowe – SP ZOZ LPR aircrafts in the years 2011–2013. Results: In the period under study, the Polish Medical Air Rescue helicopters dressed 135 patients with upper extremity amputations at the scene and transported them to hospitals as part of HEMS missions. At the same time, SP ZOZ LPR aircrafts made 102 interhospital transports. Ninety patients were qualified for treatment in replantation service centres. The average air transport time was 76 min, while the total transport time was 172.3 min. With transport exceeding 300 km, the average time advantage over the ground transport was approximately 1.5 h. Conclusions: In justified cases, the use of helicopters and airplanes is an optimal method of transporting patients with the major trauma to upper extremities. Med. Pr. 2014;65(6:765–776

  14. The Psychometric Properties of a Modified Sit-to-Stand Test With Use of the Upper Extremities in Institutionalized Older Adults.

    Science.gov (United States)

    Le Berre, Melanie; Apap, David; Babcock, Jade; Bray, Sarah; Gareau, Esther; Chassé, Kathleen; Lévesque, Nicole; Robbins, Shawn M

    2016-08-01

    Current sit-to-stand protocols do not permit use of upper extremities, limiting the protocols' utility for institutionalized older adults with diminished physical function. The objective of this study was to modify a 30-s sit-to-stand protocol to allow for arm use and to examine test-retest reliability and convergent validity; 54 institutionalized older adult men (age = 91 ± 3 year) performed the 30-s sit-to-stand twice within a span of 3 to 7 days. Results suggest good test-retest reliability (intraclass correlation coefficient = .84) and convergent validity with the Timed Up and Go Test (r = -.62). This modified 30-s sit-to-stand can be used to assess physical function performance in institutionalized older adults and will ensure that individuals with lower physical function capacity can complete the test, thus eliminating the floor effect demonstrated with other sit-to-stand protocols.

  15. [Modification of bone quality by extreme physical stress. Bone density measurements in high-performance athletes using dual-energy x-ray absorptiometry].

    Science.gov (United States)

    Sabo, D; Reiter, A; Pfeil, J; Güssbacher, A; Niethard, F U

    1996-01-01

    The treatment of osteoporosis is still controversial. Rehabilitation programs which stress strengthening exercises as well as impact loading activities increase the bone mass. On the other side activity level early in life has not been proven to correlate with increased bone mineral content later in life. Little is known on the influence of high performance sports on the bone density especially in athletes with high demands on weight bearing of the spine. In (n = 40) internationally top ranked high performance athletes of different disciplines (n = 28 weight-lifters, n = 6 sports-boxers and n = 6 bicycle-racers) bone density measurements of the lumbar spine and the left hip were performed. The measurements were carried out by dual-photonabsorptiometry (DEXA; QDR 2000, Siemens) and evaluated by an interactive software-programme (Hologic Inc.). The results were compared to the measurements of 21 age-matched male control individuals. In the high performance weight lifters there was an increase of bone density compared to the control individuals of 23% in the Ward's triangle (p boxers had an increase up to 17% (lumbar spine), 9% (hip) and 7% (Wards' triangle). In the third athletes group (Tour de France-bikers) BMD was decreased 10% in the lumbar spine, 14% in the hip and 17% in the Wards' triangle. Our results show that training programs stressing axial loads of the skeletal system may lead to an increase of BMD in the spine and the hip of young individuals. Other authors findings, that the BMD of endurance athletes may decrease, is confirmed. Nevertheless the bikers BMD-loss of 10 to 17% was surprisingly high.

  16. Tooth-marked small theropod bone: an extremely rare trace

    DEFF Research Database (Denmark)

    Jacobsen, Aase Roland

    2001-01-01

    Tooth-marked dinosaur bones provide insight into feeding behaviours and biting strategies of theropod dinosaurs. The majority of theropod tooth marks reported to date have been found on herbivorous dinosaur bones, although some tyrannosaurid bones with tooth marks have also been reported. In 1988...

  17. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function

    Directory of Open Access Journals (Sweden)

    Charmayne Mary Lee Hughes

    2015-03-01

    Full Text Available The world’s population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research.

  18. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function.

    Science.gov (United States)

    Hughes, Charmayne Mary Lee; Tommasino, Paolo; Budhota, Aamani; Campolo, Domenico

    2015-01-01

    The world's population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review, we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research.

  19. Task design, psycho-social work climate and upper extremity pain disorders--effects of an organisational redesign on manual repetitive assembly jobs.

    Science.gov (United States)

    Christmansson, M; Fridén, J; Sollerman, C

    1999-10-01

    A company redesign was carried out to improve production efficiency and minimise the prevalence of work-related musculoskeletal disorders and sick leave. The redesign was evaluated on the basis of studies of assembly workers before (17 workers) and after (12 workers) the redesign. The redesign resulted in more varied, less repetitive, and more autonomous assembly jobs. The psycho-social work climate was both improved and impaired. A medical examination showed that eight of 17 workers before and nine of 12 workers after the redesign suffered from upper extremity pain disorders. Neither the production goals nor the goals of the redesign were fulfilled. Our conclusion was that the increased task variation and impaired psycho-social work climate, combined with a lack of skill and competence, actually increased the physical stress, risk for disorders and difficulties in fulfilling the production goals.

  20. Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized Autograft and a Vascularized Fibula

    Directory of Open Access Journals (Sweden)

    Koichi Ogura

    2015-01-01

    Full Text Available Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autograft and a vascularized fibula graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years undergoing reconstruction using a devitalized autograft (pasteurization (n=6, deep freezing (n=5 and a vascularized fibula graft composite for lower extremity malignant bone tumors (femur (n=10, tibia (n=1. Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autograft, 1 frozen autograft and 1 fracture and 1 implant failure (both in pasteurized autografts. Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autograft, our novel method involving a combination of a frozen autograft with a vascularized fibula graft and rigid fixation with a locking plate may offer better outcomes than previously reported allografts or devitalized autografts.

  1. Cross-arm replantation for traumatic bilateral upper extremity amputations: a case report.

    Science.gov (United States)

    Liang, Kailu; Zhong, Gang; Yin, Jiahui; Xiang, Zhou; Cen, Shiqiang; Huang, Fuguo

    2011-02-01

    A 40-year-old woman had her right extremity avulsed at the proximal upper arm level and the wrist and hand of her left extremity irretrievably injured in a traffic accident. The right distal forearm was surgically amputated and replanted onto the stump of the left distal forearm. New strategy for nerve repair was applied and the function recovery of the cross-replanted hand was favorable. We thought that cross-extremity replantation was indicated when the patient suffered from bilateral total or subtotal amputation at different levels and orthotopic replantation was impossible.

  2. Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females.

    Science.gov (United States)

    Wu, Hui Ying; Tu, Jui Hung; Hsu, Chin Hsing; Tsao, Te Hung

    2016-01-01

    The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period.

  3. A piano training program to improve manual dexterity and upper extremity function in chronic stroke survivors

    Directory of Open Access Journals (Sweden)

    Myriam eVilleneuve

    2014-08-01

    Full Text Available Objective: Music-supported therapy was shown to induce improvements in motor skills in stroke survivors. Whether all stroke individuals respond similarly to the intervention and whether gains can be maintained over time remain unknown. We estimated the immediate and retention effects of a piano training program on upper extremity function in persons with chronic stroke. Methods: Thirteen stroke participants engaged in a 3-week piano training comprising of supervised sessions (9 x 60min and home practice. Fine and gross manual dexterity, movement coordination and functional use of the upper extremity were assessed at baseline, pre-intervention, post-intervention and at a 3-week follow-up. Results: Significant improvements were observed for all outcomes at post-intervention and follow-up, compared to pre-intervention scores. Larger magnitudes of change in manual dexterity and functional use of the upper extremity were associated with higher initial levels of motor recovery. Conclusions: Piano training can result in sustainable improvements in upper extremity function in chronic stroke survivors. Individuals with a higher initial level of motor recovery at baseline appear to benefit the most from this intervention.

  4. An intelligent active force control algorithm to control an upper extremity exoskeleton for motor recovery

    Science.gov (United States)

    Hasbullah Mohd Isa, Wan; Taha, Zahari; Mohd Khairuddin, Ismail; Majeed, Anwar P. P. Abdul; Fikri Muhammad, Khairul; Abdo Hashem, Mohammed; Mahmud, Jamaluddin; Mohamed, Zulkifli

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton by means of an intelligent active force control (AFC) mechanism. The Newton-Euler formulation was used in deriving the dynamic modelling of both the anthropometry based human upper extremity as well as the exoskeleton that consists of the upper arm and the forearm. A proportional-derivative (PD) architecture is employed in this study to investigate its efficacy performing joint-space control objectives. An intelligent AFC algorithm is also incorporated into the PD to investigate the effectiveness of this hybrid system in compensating disturbances. The Mamdani Fuzzy based rule is employed to approximate the estimated inertial properties of the system to ensure the AFC loop responds efficiently. It is found that the IAFC-PD performed well against the disturbances introduced into the system as compared to the conventional PD control architecture in performing the desired trajectory tracking.

  5. Upper Extremity Artificial Limb Control as an Issue Related to Movement and Mobility in Daily Living

    Science.gov (United States)

    Wallace, Steve; Anderson, David I.; Trujillo, Michael; Weeks, Douglas L.

    2005-01-01

    The 1992 NIH Research Planning Conference on Prosthetic and Orthotic Research for the 21st Century (Childress, 1992) recognized that the field of prosthetics lacks theoretical understanding and empirical studies on learning to control an upper-extremity prosthesis. We have addressed this problem using a novel approach in which persons without…

  6. 双侧上肢训练在脑卒中患者康复中的应用%Preliminary application of bilateral upper extremities training in rehabilitation of stroke patients

    Institute of Scientific and Technical Information of China (English)

    郑雅丹; 胡昔权; 李奎; 陈颖蓓; 解东风

    2011-01-01

    目的:初步观察双侧上肢训练对上肢功能中度到重度残损的恢复期脑卒中患者的疗效.方法:48例上肢功能中度到重度残损的恢复期脑卒中患者随机分为双侧训练组(n=24)、对照组(n=24),前者接受双侧(患侧、健侧)上肢同向、节律运动的重复练习,后者接受常规上肢训练,即以患侧上肢为主的单侧训练.两组患者上肢训练的时间均为1h/d,5d/周,持续4周,其余康复治疗如运动疗法和日常生活活动训练等两组均相同.两组患者分别于治疗前、治疗后予以FMA上肢部分(FMA-UE)、MAS上肢部分和MBI评定.结果:两组患者治疗后FMA-UE、FMA上肢的近端部分(FMA-PUE)和远端部分(FMA-DUE)、MAS-UE及MBI的评分均较治疗前提高,治疗前、后各量表的评分差异具有显著性(P<0.05=;与对照组相比,双侧训练组患者FMA-UE、FMA-PUE的评分提高幅度更大(P<0.05).结论:对于上肢功能中度到重度残损的恢复期脑卒中患者,采用双侧上肢训练可以更好地改善其患侧上肢,尤其是上肢近端的运动功能.%Objective: To observe the effect of bilateral upper extremities training on upper extremities function of stroke patient in convalescent phase with moderate to severe upper extremity impairment.Method: Forty-eight subjects participated in the randomized, single-blind training study. Subjects in the bilateral training group (n=24) practiced bilateral upper extremities(affected and unaffected sides) symmetrical thythmic repetitive activities, and the control group (n=24) performed conventional upper extremities training, mainly affected upper extremity unilateral training. The program of upper extremities training for both groups were 1h per day, 5d per week for 4 weeks. Physical therapy and training of activities of daily living were the same in both groups.Fugl-Meyer assessment of upper extremity (FMA-UE), motor assessment scale of upper extremity (MAS-UE) and modified Barthel index

  7. Feasibility of the adaptive and automatic presentation of tasks (ADAPT system for rehabilitation of upper extremity function post-stroke

    Directory of Open Access Journals (Sweden)

    Choi Younggeun

    2011-08-01

    Full Text Available Abstract Background Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task. Methods Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6 practiced four functional tasks (selected out of six in a pre-test with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task. Results No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT. Conclusions ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. Our encouraging results establish the feasibility of ADAPT; its

  8. Ulnar nerve excursion and strain at the elbow and wrist associated with upper extremity motion.

    Science.gov (United States)

    Wright, T W; Glowczewskie, F; Cowin, D; Wheeler, D L

    2001-07-01

    Significant excursion of the ulnar nerve is required for unimpeded upper extremity motion. This study evaluated the excursion necessary to accommodate common motions of daily living and associated strain on the ulnar nerve. The 2 most common sites of nerve entrapment, the cubital tunnel and the entrance of Guyon's canal, were studied. Five fresh-frozen, thawed transthoracic cadaver specimens (10 arms) were dissected and the nerve was exposed at the elbow and wrist only enough to be marked with a microsuture. Excursion was measured with a laser mounted on a Vernier caliper fixed to the bone and aligned in the direction of nerve motion. A Microstrain (Burlington, VT) DVRT strain device was applied to the nerve at both the elbow and wrist. Nerve excursion associated with motion of the shoulder, elbow, wrist, and fingers (measured by goniometer) was measured at the wrist and elbow. An average of 4.9 mm ulnar nerve excursion was required at the elbow to accommodate shoulder motion from 30 degrees to 110 degrees of abduction, and 5.1 mm was needed for elbow motion from 10 degrees to 90 degrees. When the wrist was moved from 60 degrees of extension to 65 degrees of flexion, 13.6 mm excursion of the ulnar nerve was required at the wrist. When all the motions of the wrist, fingers, elbow, and shoulder were combined, 21.9 mm of ulnar nerve excursion was required at the elbow and 23.2 mm at the wrist. Ulnar nerve strain of 15% or greater was experienced at the elbow with elbow flexion and at the wrist with wrist extension and radial deviation. Any factor that limits excursion at these sites could result in repetitive traction of the nerve and possibly play a role in the pathophysiology of cubital tunnel syndrome or ulnar neuropathy at Guyon's canal.

  9. Dating and context of three middle stone age sites with bone points in the Upper Semliki Valley, Zaire.

    Science.gov (United States)

    Brooks, A S; Helgren, D M; Cramer, J S; Franklin, A; Hornyak, W; Keating, J M; Klein, R G; Rink, W J; Schwarcz, H; Smith, J N

    1995-04-28

    The extent to which the earliest anatomically modern humans in Africa exhibited behavioral and cognitive traits typical of Homo sapiens sapiens is controversial. In eastern Zaire, archaeological sites with bone points have yielded dates older than 89(-15)+22 thousand years ago by several techniques. These include electron spin resonance, thermoluminescence, optically stimulated luminescence, uranium series, and amino acid racemization. Faunal and stratigraphic data are consistent with this age.

  10. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 1

    OpenAIRE

    A E Karateev; D. E. Karateev; E. S. Orlova; Yu. A. Ermakova

    2015-01-01

    Rheumatic diseases of juxta-articular soft tissues (RDJAST) (tendinitis, tenosynovitis, bursitis, etc.) are one of the most common causes of disability and one the most common reasons for seeking medical advice. To manage patients with RDJAST is an important part of practising rheumatologists’ work. But unfortunately, the issues of diagnosis and therapy of this pathology have been relatively rarely discussed on the pages of Russian medical journals and at the scientific congresses and confere...

  11. Free style perforator based propeller flaps: Simple solutions for upper extremity reconstruction!

    Directory of Open Access Journals (Sweden)

    Nikhil Panse

    2014-01-01

    Full Text Available Background: The introduction of perforator flaps by Koshima et al. was met with much animosity in the plastic surgery fraternity. The safety concerns of these flaps following the intentional twist of the perforators have prevented widespread adoption of this technique. Use of perforator based propeller flaps in the lower extremity is gradually on the rise, but their use in upper extremity reconstruction is infrequently reported, especially in the Indian subcontinent. Materials and Methods: We present a retrospective series of 63 free style perforator flaps used for soft tissue reconstruction of the upper extremity from November 2008 to June 2013. Flaps were performed by a single surgeon for various locations and indications over the upper extremity. Patient demographics, surgical indication, defect features, complications and clinical outcome are evaluated and presented as an uncontrolled case series. Results: 63 free style perforator based propeller flaps were used for soft tissue reconstruction of 62 patients for the upper extremity from November 2008 to June 2013. Of the 63 flaps, 31 flaps were performed for trauma, 30 for post burn sequel, and two for post snake bite defects. We encountered flap necrosis in 8 flaps, of which there was complete necrosis in 4 flaps, and partial necrosis in four flaps. Of these 8 flaps, 7 needed a secondary procedure, and one healed secondarily. Although we had a failure rate of 12-13%, most of our failures were in the early part of the series indicative of a learning curve associated with the flap. Conclusion: Free style perforator based propeller flaps are a reliable option for coverage of small to moderate sized defects. Level of Evidence: Therapeutic IV.

  12. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy

    Science.gov (United States)

    Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

    2016-01-01

    Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8–17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy. PMID:27338485

  13. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy.

    Science.gov (United States)

    Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

    2016-06-07

    Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8-17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy.

  14. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Marisa Sevick

    2016-06-01

    Full Text Available Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1 tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8–17 years with mild to moderate limitations to upper limb function; and (2 determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy.

  15. On the use of upper extremity proximal nerve action potentials in the localization of focal nerve lesions producing axonotmesis.

    Science.gov (United States)

    White, J C

    1997-09-01

    Ulnar, median, and radial proximal nerve action potentials (PNAPs) were recorded from the axilla and supraclavicularly, with stimulation of the nerves at the elbow or the radial groove, in 30 control subjects for each nerve. In addition to routine nerve conduction studies, wrist to elbow median nerve action potentials were recorded proximal to the lesion in 76 patients with carpal tunnel syndrome of varying degrees of severity to determine the effect that the distal lesion might have on more proximal nerve conduction. Utilizing this information, PNAPs, standard nerve conduction studies, and needle electrode examinations were carried out in patients with focal elbow area nerve or brachial plexus lesions producing axonotmesis. PNAPs confirmed the site of the lesions producing axonotmesis when localization was possible with standard nerve conduction and/or needle electrode studies and were the sole means by which localization of the lesions producing only sensory axonotmesis was accomplished.

  16. Finger muscle attachments for an OpenSim upper-extremity model.

    Directory of Open Access Journals (Sweden)

    Jong Hwa Lee

    Full Text Available We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms. Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic finger muscles. Therefore, it was necessary to scale and translate muscle attachments from one experimental or model environment to another while preserving mechanical function. We used a two-step process. First, we estimated muscle function by calculating moment arms for all intrinsic and extrinsic muscles using the partial velocity method. Second, optimization using Simulated Annealing and Hooke-Jeeves algorithms found muscle-tendon paths that minimized root mean square (RMS differences between experimental and modeled moment arms. The partial velocity method resulted in variance accounted for (VAF between measured and calculated moment arms of 75.5% on average (range from 48.5% to 99.5% for intrinsic and extrinsic index finger muscles where measured data were available. RMS error between experimental and optimized values was within one standard deviation (S.D of measured moment arm (mean RMS error = 1.5 mm < measured S.D = 2.5 mm. Validation of both steps of the technique allowed for estimation of muscle attachment points for muscles whose moment arms have not been measured. Differences between modeled and experimentally measured muscle attachments, averaged over all finger joints, were less than 4.9 mm (within 7.1% of the average length of the muscle-tendon paths. The resulting non-proprietary musculoskeletal model of the human fingers could be useful for many applications, including better understanding of complex multi-touch and gestural movements.

  17. Extreme erosion response after wildfire in the Upper Ovens, south-east Australia: Assessment of catchment scale connectivity by an intensive field survey

    Science.gov (United States)

    Box, Walter; Keestra, Saskia; Nyman, Petter; Langhans, Christoph; Sheridan, Gary

    2015-04-01

    South-eastern Australia is generally regarded as one of the world's most fire-prone environments because of its high temperatures, low rainfall and flammable native Eucalyptus forests. Modifications to the landscape by fire can lead to significant changes to erosion rates and hydrological processes. Debris flows in particular have been recognised as a process which increases in frequency as a result of fire. This study used a debris flow event in the east Upper Ovens occurred on the 28th of February 2013 as a case study for analysing sediment transport processes and connectivity of sediment sources and sinks. Source areas were identified using a 15 cm resolution areal imagery and a logistic regression model was made based on fire severity, aridity index and slope to predict locations of source areas. Deposits were measured by making cross-sections using a combination of a differential GPS and a total station. In total 77 cross-sections were made in a 14.1 km2 sub-catchment and distributed based on channel gradient and width. A more detailed estimation was obtained by making more cross-sections where the volume per area is higher. Particle size distribution between sources and sink areas were obtained by combination of field assessment, photography imagery analyses and sieve and laser diffraction. Sediment was locally eroded, transported and deposited depending on factors such as longitude gradient, stream power and the composition of bed and bank material. The role of headwaters as sediment sinks changed dramatically as a result of the extreme erosion event in the wildfire affected areas. Disconnected headwaters became connected to low order streams due to debris flow processes in the contributing catchment. However this redistribution of sediment from headwaters to the drainage network was confined to upper reaches of the Ovens. Below this upper part of the catchment the event resulted in redistribution of sediment already existing in the channel through a

  18. 儿童双骨肢体单骨骨折对关节的影响%Influence on Joints Due to Fracture of Single Bone on Double Bone Extremities in Children

    Institute of Scientific and Technical Information of China (English)

    俞志涛; 王承武; 范源

    1997-01-01

    Objective:To observe the overgrowth after the fracture of a single bone in double bone extremities in children.Methods:179 cases of forearm fracture and 123 of lower leg fracture (excluding Monteggia fracture,Galeazzi fracture or physeal injuries)were reviewed.The time of follow-up was 5~8 years(mean 7.5 years).Comparative assessments of bilateral extremities on X-ray examination included length of ulna and radius,radioulnar angle,anteversion of the radius,radiocapitular line,position of the capitellium,length of the tibia and fibula,and anteroposteriorproject of the ankle.Ranges of motion of the wrist,elbow,forearm and ankle were examined.Results:Overgrowth of affected bones With 2~4 mm in length were found only in 4 cases of forearm fracture and in 7 cases of lower leg fracture.Conclusions:In most cases of fracture of singlebone on double bone extremities,overgrowth of affected bone has been rarely observed.%目的:为了观察儿童双骨肢体单骨骨折后的过度生长.方法:对前臂单骨骨折179例(不包括孟氏骨折、盖氏骨折及骨骺损伤),小腿单骨骨折123例(不包括骨骺损伤),进行了5~6年的随访,平均7.5年.对比测量了双侧X线片中的尺、桡骨长度、胫腓骨长度、桡尺角、桡骨内倾角、桡骨头线、肱骨小头的位置以及踝关节正位片,并对腕、肘关节、踝关节活动进行了对比.结果:前臂有4例,小腿有7例较对侧长2~4 mm.前臂、腕、肘关节及踝关节活动无异常.结论:前臂是双骨均衡支撑肢体,小腿虽以胫骨负重为主,但单骨骨折后另一骨同样可起支撑作用,因此均不会出现明显的过度生长.

  19. Dual-energy imaging of bone marrow edema on a dedicated multi-source cone-beam CT system for the extremities

    Science.gov (United States)

    Zbijewski, W.; Sisniega, A.; Stayman, J. W.; Thawait, G.; Packard, N.; Yorkston, J.; Demehri, S.; Fritz, J.; Siewerdsen, J. H.

    2015-03-01

    Purpose: Arthritis and bone trauma are often accompanied by bone marrow edema (BME). BME is challenging to detect in CT due to the overlaying trabecular structure but can be visualized using dual-energy (DE) techniques to discriminate water and fat. We investigate the feasibility of DE imaging of BME on a dedicated flat-panel detector (FPD) extremities cone-beam CT (CBCT) with a unique x-ray tube with three longitudinally mounted sources. Methods: Simulations involved a digital BME knee phantom imaged with a 60 kVp low-energy beam (LE) and 105 kVp high-energy beam (HE) (+0.25 mm Ag filter). Experiments were also performed on a test-bench with a Varian 4030CB FPD using the same beam energies as the simulation study. A three-source configuration was implemented with x-ray sources distributed along the longitudinal axis and DE CBCT acquisition in which the superior and inferior sources operate at HE (and collect half of the projection angles each) and the central source operates at LE. Three-source DE CBCT was compared to a double-scan, single-source orbit. Experiments were performed with a wrist phantom containing a 50 mg/ml densitometry insert submerged in alcohol (simulating fat) with drilled trabeculae down to ~1 mm to emulate the trabecular matrix. Reconstruction-based three-material decomposition of fat, soft tissue, and bone was performed. Results: For a low-dose scan (36 mAs in the HE and LE data), DE CBCT achieved combined accuracy of ~0.80 for a pattern of BME spherical lesions ranging 2.5 - 10 mm diameter in the knee phantom. The accuracy increased to ~0.90 for a 360 mAs scan. Excellent DE discrimination of the base materials was achieved in the experiments. Approximately 80% of the alcohol (fat) voxels in the trabecular phantom was properly identified both for single and 3-source acquisitions, indicating the ability to detect edemous tissue (water-equivalent plastic in the body of the densitometry insert) from the fat inside the trabecular matrix

  20. The direct and indirect effects of the negative affectivity trait on self reported physical function among patients with upper extremity conditions.

    Science.gov (United States)

    Talaei-Khoei, Mojtaba; Mohamadi, Amin; Mellema, Jos J; Tourjee, Stephen M; Ring, David; Vranceanu, Ana-Maria

    2016-12-30

    Negative affectivity is a personality trait that predisposes people to psychological distress and low life satisfaction. Negative affectivity may also affect pain intensity and physical function in patients with musculoskeletal conditions. We explored the association of negative affectivity to pain intensity and self-reported physical function, and tested whether pain intensity mediates the effect of negative affectivity on physical function. In a cross-sectional study, 102 patients with upper extremity musculoskeletal conditions presenting to an orthopedic surgeon completed self-report measures of negative affectivity, pain intensity, and physical function in addition to demographic and injury information. We used the Preacher and Hayes' bootstrapping approach to quantify the indirect effect of negative affectivity on physical function through pain intensity. Negative affectivity correlated with greater pain intensity and lower self-reported physical function significantly. Also, pain intensity mediated the association of negative affectivity with physical function. The indirect effect accounted for one-third of the total effect. To conclude, negative affectivity is associated with decreased engagement in daily life activities both directly, but also indirectly through increased pain intensity. Treatments targeting negative affectivity may be more economical and efficient for alleviation of pain and limitations associated with musculoskeletal illness than those addressing coping strategies or psychological distress.

  1. [Relationship between inertial features of the upper extremity and simple reaction time in boys and girls aged 17-18].

    Science.gov (United States)

    Gutnik, B I; Pankova, N B; Karganov, M Iu; Nash, D

    2014-01-01

    The latent period of visual sensor-motor reaction depends, in part, on the sensory and integrative processes in the brain, but is also influenced by the rate of the muscle contraction. There is no clear evidence in the literature whether the rotational inertia of segments of limbs has any direct effect on the reaction time. The aim of our study was to identify this relationship. The study involved 566 right handed students aged 16-17 of both genders beginning their post puberty period. Reaction time was measured during experimental adduction of the forearm and hand, using a special rotating handle and lever connected to a computer that recorded the reaction time (+/- 1 ms). Calculations of the rotational inertia were carried out using regression models by Zatsiorsky and other authors. Each gender group was divided into three subgroups: with high, medium and low values of rotational inertia. It was found that individuals with high values of rotational inertia of forearm and wrist demonstrated significantly longer reaction times. This pattern was apparent in both gender groups. Although males illustrated greater values of rotational inertia than females they demonstrated relatively shorter reaction times. This contradiction can be explained by greater muscle power of young men. We recommend taking into account the amount of rotational inertia of the responsive segment in all kinds of research which require measurement of reaction time.

  2. The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

    DEFF Research Database (Denmark)

    Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels;

    2016-01-01

    To elucidate the mechanisms underlying the differences in adaptation of arm and leg muscles to sprint training, over a period of 11 days 16 untrained men performed six sessions of 4-6 × 30-s all-out sprints (SIT) with the legs and arms, separately, with a 1-h interval of recovery. Limb-specific VO2...

  3. Modeling and Design of a Spring-loaded, Cable-driven, Wearable Exoskeleton for the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Lelai Zhou

    2015-07-01

    Full Text Available An approach to the design of wearable exoskeletons on the basis of simulation of the exoskeleton and a human body model is proposed in this paper. The new approach, addressing the problem of physical human-exoskeleton interactions, models and simulates the mechanics of both the exoskeleton and the human body, which allows designers to effectively analyze and evaluate an exoskeleton design for their function in concert with the human body. A simulation platform is developed by integrating a biomechanical model of the human body and the exoskeleton. With the proposed approach, an exoskeleton is designed for assisting patients with neuromuscular injuries. Results of the analysis and optimization are included.

  4. Modeling and Design of a Spring-loaded, Cable-driven, Wearable Exoskeleton for the Upper Extremity

    OpenAIRE

    Lelai Zhou; Shaoping Bai; Michael Skipper Andersen; John Rasmussen

    2015-01-01

    An approach to the design of wearable exoskeletons on the basis of simulation of the exoskeleton and a human body model is proposed in this paper. The new approach, addressing the problem of physical human-exoskeleton interactions, models and simulates the mechanics of both the exoskeleton and the human body, which allows designers to effectively analyze and evaluate an exoskeleton design for their function in concert with the human body. A simulation platform is developed by integrating a bi...

  5. Design of a Passive Exoskeleton for the Upper Extremity through Co-simulation with a Biomechanical Human Arm Model

    DEFF Research Database (Denmark)

    2013-01-01

    An approach of designing exoskeletons on the basis of simulation of the exoskeleton and a human body model is proposed in this paper. The new approach, addressing the problem of physical human-exoskeleton interactions, models and simulates the mechanics for both the exoskeleton and the human body......, which allows designers to analyze and evaluate an exoskeleton for its functioning, effectively. A simulation platform is developed by integrating a biomechanical model of human body and the exoskeleton. With the proposed approach, two types of exoskeletons with gravity compensating capability...

  6. Early Electrodiagnostic Features of Upper Extremity Sensory Nerves Can Differentiate Axonal Guillain-Barré Syndrome from Acute Inflammatory Demyelinating Polyneuropathy

    Science.gov (United States)

    Koo, Yong Seo; Shin, Ha Young; Kim, Jong Kuk; Nam, Tai-Seung; Shin, Kyong Jin; Bae, Jong-Seok; Suh, Bum Chun; Oh, Jeeyoung; Yoon, Byeol-A

    2016-01-01

    Background and Purpose Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. Methods We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. Results The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. Conclusions Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients. PMID:27819421

  7. Amputations of Upper and Lower Extremities, Active and Reserve Components, U.S. Armed Forces, 2000-2011

    Science.gov (United States)

    2012-06-01

    bilateral amputations reported here remain unclear. Th e current case defi nition was repeat- edly refi ned to optimize the sensitivity of the case ...6,144 incident cases of traumatic amputations among 5,694 service members. Over one-third of these service members (n=2,037) had major amputations ...calendar years 2005 through 2011. For surveillance purposes, a case of traumatic amputation was defi ned as an individual with: 1) a hospitalization

  8. The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

    DEFF Research Database (Denmark)

    Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels;

    2016-01-01

    , reducing the O2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple...

  9. The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

    Science.gov (United States)

    Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels; Larsen, Filip J.; Schiffer, Tomas A.; Willis, Sarah J.; Gelabert-Rebato, Miriam; Perez-Valera, Mario; Boushel, Robert; Calbet, Jose A. L.; Holmberg, Hans-Christer

    2016-01-01

    To elucidate the mechanisms underlying the differences in adaptation of arm and leg muscles to sprint training, over a period of 11 days 16 untrained men performed six sessions of 4–6 × 30-s all-out sprints (SIT) with the legs and arms, separately, with a 1-h interval of recovery. Limb-specific VO2peak, sprint performance (two 30-s Wingate tests with 4-min recovery), muscle efficiency and time-trial performance (TT, 5-min all-out) were assessed and biopsies from the m. vastus lateralis and m. triceps brachii taken before and after training. VO2peak and Wmax increased 3–11% after training, with a more pronounced change in the arms (P < 0.05). Gross efficiency improved for the arms (+8.8%, P < 0.05), but not the legs (−0.6%). Wingate peak and mean power outputs improved similarly for the arms and legs, as did TT performance. After training, VO2 during the two Wingate tests was increased by 52 and 6% for the arms and legs, respectively (P < 0.001). In the case of the arms, VO2 was higher during the first than second Wingate test (64 vs. 44%, P < 0.05). During the TT, relative exercise intensity, HR, VO2, VCO2, VE, and Vt were all lower during arm-cranking than leg-pedaling, and oxidation of fat was minimal, remaining so after training. Despite the higher relative intensity, fat oxidation was 70% greater during leg-pedaling (P = 0.017). The aerobic energy contribution in the legs was larger than for the arms during the Wingate tests, although VO2 for the arms was enhanced more by training, reducing the O2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple regression analysis demonstrated that the variables that predict TT performance differ for the arms and legs. The primary mechanism of adaptation to SIT by both the arms and legs

  10. Effects of modified constraint-induced movement therapy and functional bimanual training on upper extremity function and daily activities in a patient with incomplete spinal cord injury: a case study.

    Science.gov (United States)

    Kim, Yeon-Ju; Kim, Jin-Kyung; Park, So-Yeon

    2015-12-01

    [Purpose] In this study, we examined effects of modified constraint-induced movement therapy (m-CIMT) and functional bimanual training, when applied to a patient with incomplete spinal cord injury, on upper extremity function and daily activities. [Subject and Methods] One patient, diagnosed with C4 incomplete spinal cord injury, underwent physical therapy with constraint-induced movement therapy for 3 hours and task-oriented bimanual training for 1 hour, per day. This combined 4-hour session was performed five times a week, for 3 weeks, totaling 15 sessions. Upper extremity function was measured using the Manual Function Test (MFT) and Box & Block Test (BBT). Additionally, Spinal Cord Independence Measure Version III (SCIM-III) and Short Form 36 Health Survey (SF-36) were used to assess functional outcomes. [Results] Mobility of the hand and overall function of upper extremities were enhanced following intervention. Moreover, the subject's quality of life and ability to carry out daily activities also improved. [Conclusion] Modified constraint-induced movement therapy and bimanual training was effective in enhancing upper extremity function and performance of daily routines in a patient with incomplete spinal cord injury. Further studies, recruiting multiple subjects, should focus on m-CIMT using diverse methods, performed during the course of daily activities.

  11. Upper Extremity Muscle Activation during Bodyblade Exercises Following Six Weeks of Intervention Focusing on the Lumbopelvic-Hip Complex

    Directory of Open Access Journals (Sweden)

    Gretchen D. Oliver

    2015-08-01

    Full Text Available The current study examined the effects of a six-week lumbopelvic-hip complex (LPHC strengthening program on muscle activation when performing the shoulder dump exercise. The shoulder dump is a total body exercise that includes overhead arm movements. A pre-post test with a control group was implemented. Twenty-seven graduate students (23.5 ± 1.34 yr; 174.4 ± 11.0 cm; 76.6 ± 16.9 kg participated. Participants were randomly assigned to a control or intervention group where the intervention group performed LPHC exercises. Two-way analysis of variance (ANOVA revealed a significant increase in muscle activation of the serratus anterior from pre- and post-LPHC intervention, (t = 6.5, p < 0.001. As presented by these data, incorporation of LPHC exercises may assist in facilitating greater activation in some of the scapula-stabilizing musculature that has traditionally been rehabilitated in prone or side-lying positions. It is, therefore, suggested that LPHC exercises be incorporated in a regular shoulder rehabilitation program.

  12. [Case of anti VGKC-complex antibody associated disorder presenting with severe pain and fasciculations predominant in unilateral upper extremity].

    Science.gov (United States)

    Hara, Kenju; Watanabe, Osamu; Shibano, Ken; Ishiguro, Hideaki

    2012-01-01

    A 21-year-old man complained of severe pain and muscle twitching localized in his right arm. Neurological examination showed muscle fasciculations in his right forearm but no myokymia or myotonia. Needle electromyography revealed fibrillation potentials in his biceps brachii muscle and extensor carpi radialis muscle at rest but no myokymic discharges. His serum anti-voltage-gated potassium channel (VGKC)-complex antibody level was significantly high (194.2pM; controls VGKC-complex antibody associated disorder.

  13. Game Analysis, Validation, and Potential Application of EyeToy Play and Play 2 to Upper-Extremity Rehabilitation

    Directory of Open Access Journals (Sweden)

    Yu-ping Chen

    2014-01-01

    Full Text Available Objective. To describe and analyze the potential use of games in the commercially available EyeToy Play and EyeToy Play 2 on required/targeted training skills and feedback provided for clinical application. Methods. A summary table including all games was created. Two movement experts naïve to the software validated required/targeted training skills and feedback for 10 randomly selected games. Ten healthy school-aged children played to further validate the required/targeted training skills. Results. All but two (muscular and cardiovascular endurance had excellent agreement in required/targeted training skills, and there was 100% agreement on feedback. Children’s performance in required/targeted training skills (number of unilateral reaches and bilateral reaches, speed, muscular endurance, and cardiovascular endurance significantly differed between games (P<.05. Conclusion. EyeToy Play games could be used to train children’s arm function. However, a careful evaluation of the games is needed since performance might not be consistent between players and therapists’ interpretation.

  14. Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos Upper-extremity deep vein thrombosis: a retrospective cohort study of 52 cases

    Directory of Open Access Journals (Sweden)

    Ricardo de Alvarenga Yoshida

    2005-09-01

    Full Text Available OBJETIVO: Rever os fatores predisponentes e a evolução em série de casos de trombose venosa profunda dos membros superiores de nossa instituição. MÉTODOS: Cinqüenta e dois pacientes consecutivos, com trombose venosa profunda dos membros superiores (29 homens e 23 mulheres, idade média de 52,3 anos, documentados por mapeamento dúplex (71,1%, flebografia (11,1% ou clinicamente (15,6%, foram incluídos no presente estudo. RESULTADOS: As manifestações clínicas foram: dor no antebraço (24 casos - 46,1%, dor no braço (27 casos - 51,9%, edema do membro superior (45 casos - 86,5%, dor à compressão do membro superior (36 casos - 70,2% e dor à movimentação do mesmo (32 casos - 61,7%. Os principais fatores de risco foram: punção ou acesso venoso (20 casos - 39,1% e câncer (16 casos - 32,6%. As veias envolvidas foram: umeral (n = 18, axilar (n = 27, subclávia (n = 15 e jugular (n = 11. A embolia pulmonar estava inicialmente presente em quatro casos (7,6%. O tratamento inicial foi feito com heparina não-fracionada intravenosa (64,3%, subcutânea (16,7%, ou heparina de baixo peso molecular (17,1%, seguido de varfarina. Doze pacientes morreram antes da alta, em função de causas não relacionadas à embolia pulmonar. Foram acompanhados os 40 pacientes restantes por período de 3 meses a 10 anos, sendo que dois morreram de causas não relacionadas à embolia pulmonar, um paciente desenvolveu seqüelas pós-trombóticas, como edema residual e limitações aos movimentos, e seis ficaram com discretos sintomas residuais (edema e dor. CONCLUSÕES: A trombose venosa profunda dos membros superiores foi mais freqüente em pacientes submetidos a acessos venosos e com neoplasia em atividade. Comparando com dados da literatura, a evolução dos pacientes sob tratamento exclusivo com anticoagulantes foi, no mínimo, similar a outros tratamentos propostos.OBJECTIVE: To review the predisposing factors and the evolution of upper-extremity deep vein

  15. Myocutaneous Mucormycosis in a Diabetic Burnt Patient Led to Upper Extremity Amputation; A Case Report

    Directory of Open Access Journals (Sweden)

    Mehdi Ayaz

    2017-01-01

    Full Text Available Mucormycosis is a rare opportunistic fungal infection that can implicate cranial sinuses, brain, lungs, gastrointestinal tract and skin. Although it can occur in patients with competent and incompetent immunity such as patients with diabetes mellitus, lymphoma, leukemia and burns, but it has an aggressive, malignant and lethal course in patients with incompetent immunity. To enforce the importance of burn in patients with underlaying diseases such as diabetes, we are going to report a rare case of diabetic burnt patient complicated by right upper extremity myocutaneous mucormycosis. We selected this case to emphasis the importance of underlying disease (diabetes mellitus with cutaneous burn, aggressive treatment of fungal infection in these patients and referring such case to burn center to prevent catastrophic results. A 50-year-old woman was introduced to us after several days of medical and surgical care of right upper extremity and trunk split-thickness burn. Due to gross muscle necrosis of right upper extremity and poor general condition of the patient, she was taken to the operating room that led to right upper extremity amputation and several times of aggressive debridement to save her life. Pathologic report was indicative of mucormycosis. We can conclude from this case that: 1 Burn, even partially thickness and with little body surface area, should be referred to burn center for better care 2 No response to usual medical treatment should make us more sensitive to consider the unusual causes of infection such as fungi 3 Suspected dead tissues should be excised aggressively especially if suspiciousness to wound sepsis and fungal infection is present especially in an immunocompromised patient.

  16. Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews.

    Directory of Open Access Journals (Sweden)

    Johan H Andersen

    Full Text Available BACKGROUND: To summarize systematic reviews that 1 assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS or upper extremity musculoskeletal disorders (UEMSDs, or 2 reported on intervention studies among computer users/or office workers. METHODOLOGY/PRINCIPAL FINDINGS: PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. CONCLUSIONS/SIGNIFICANCE: Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.

  17. Reduction of pain-related fear and increased function and participation in work-related upper extremity pain (WRUEP): effects of exposure in vivo.

    Science.gov (United States)

    de Jong, Jeroen R; Vlaeyen, Johan W S; van Eijsden, Marjon; Loo, Christoph; Onghena, Patrick

    2012-10-01

    There is increasing evidence that pain-related fear influences the development and maintenance of pain disability, presumably mediated through the fear-related avoidance of valued activities. Individually tailored graded exposure in vivo (GEXP) has been demonstrated to reduce pain-related fear and increase functional abilities in patients with chronic low back pain, neck pain, and complex regional pain syndrome. The current study aimed to test whether these effects generalize towards patients with work-related upper extremity pain. A sequential replicated and randomized single-case experimental phase design with multiple measurements was used. Within each participant, GEXP was compared to a no-treatment baseline period and a no-treatment 6-month follow-up period. Eight patients who reported a high level of pain-related fear were included in the study. Daily changes in pain catastrophizing, pain-related fear, and pain intensity were assessed using a diary, and subjected to randomization tests. Before the start of the baseline period, just after GEXP, and at 6-month follow-up, clinically relevant changes of pain catastrophizing, pain-related fear, perceived harmfulness of physical activity, pain disability, and participation/autonomy were verified. When GEXP was introduced, levels of pain catastrophizing and pain-related fear decreased significantly. Clinically relevant improvements were observed for pain disability, perceived participation, and autonomy. These favourable changes were maintained until 6-month follow-up. The findings of the current study underscore the external validity of a cognitive-behavioural GEXP treatment for patients with chronic pain reporting increased pain-related fear.

  18. Occupational Radiation Exposure to the Extremities of Medical Staff during Hysterosalpingography and Radionuclide Bone Scan Procedures in Several Nigerian Hospitals

    Directory of Open Access Journals (Sweden)

    Nnamdi Norbert Jibiri

    2016-10-01

    Full Text Available Objective: The practice of regular dose measurement helps to ascertain the level of occupational dose delivered to the staff involved in diagnostic procedures. This study was carried out to evaluate the dose exposed to the hands of radiologists and a radiologic technologist carrying out HSG and radionuclide bone scan examinations in several hospitals in Nigeria. Methods: Radiation doses exposed to the hands of radiologists and a technician carrying out hysterosalpingography (HSG and bone scan procedures were measured using calibrated thermo-luminescent dosimeters. Five radiologists and a radiologic technologist were included in the study for dose measurement. Results: The study indicates that each radiologist carried out approximately 2 examinations per week with the mean dose ranging between 0.49-0.62 mSv per week, resulting in an annual dose of 191 mSv. Similarly, the occupational dose delivered to both the left and right hands of a radiologic technologist administering 99mTc-methylene diphosphonate (MDP without cannula and with cannula were 10.68 (720.2 and 13.82 (556.4 mSv per week (and per annum, respectively. It was determined that the left hand of the personnel received higher doses than their right hand. Conclusion: The estimated annual dose during HSG is far below the annual dose limit for deterministic effects, however, it is greater than 10% of the applicable annual dose limit. Hence, routine monitoring is required to ensure adequate protection of the personnel. The total annual dose received during the bone scan exceeds the annual dose limit for both hands, and the dose to either left or right hand is greater than the dose limit of 500 mSv/yr. The radiologists monitored are not expected to incur any deterministic effects during HSG examinations, however, accumulated doses arising from the scattered radiation to the eyes, legs, and neck could be substantial and might lead to certain effects. More staff are required to administer 99m

  19. Playing Piano Can Improve Upper Extremity Function after Stroke: Case Studies

    Directory of Open Access Journals (Sweden)

    Myriam Villeneuve

    2013-01-01

    Full Text Available Music-supported therapy (MST is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3, prior to (week6 and after the intervention (week9, and at 3-week follow-up (week12. Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test and gross (box and block test manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test. Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke.

  20. Playing piano can improve upper extremity function after stroke: case studies.

    Science.gov (United States)

    Villeneuve, Myriam; Lamontagne, Anouk

    2013-01-01

    Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke.

  1. Assessment of genotoxic and cytotoxic hazards in brain and bone marrow cells of newborn rats exposed to extremely low-frequency magnetic field.

    Science.gov (United States)

    Rageh, Monira M; El-Gebaly, Reem H; El-Bialy, Nihal S

    2012-01-01

    The present study aimed to evaluate the association between whole body exposure to extremely low frequency magnetic field (ELF-MF) and genotoxic , cytotoxic hazards in brain and bone marrow cells of newborn rats. Newborn rats (10 days after delivery) were exposed continuously to 50 Hz, 0.5 mT for 30 days. The control group was treated as the exposed one with the sole difference that the rats were not exposed to magnetic field. Comet assay was used to quantify the level of DNA damage in isolated brain cells. Also bone marrow cells were flushed out to assess micronucleus induction and mitotic index. Spectrophotometric methods were used to measure the level of malondialdehyde (MDA) and the activity of glutathione (GSH) and superoxide dismutase (SOD). The results showed a significant increase in the mean tail moment indicating DNA damage in exposed group (P < 0.01, 0.001, 0.0001). Moreover ELF-MF exposure induced a significant (P < 0.01, 0.001) four folds increase in the induction of micronucleus and about three folds increase in mitotic index (P < 0.0001). Additionally newborn rats exposed to ELF-MF showed significant higher levels of MDA and SOD (P < 0.05). Meanwhile ELF-MF failed to alter the activity of GSH. In conclusion, the present study suggests an association between DNA damage and ELF-MF exposure in newborn rats.

  2. Assessment of Genotoxic and Cytotoxic Hazards in Brain and Bone Marrow Cells of Newborn Rats Exposed to Extremely Low-Frequency Magnetic Field

    Directory of Open Access Journals (Sweden)

    Monira M. Rageh

    2012-01-01

    Full Text Available The present study aimed to evaluate the association between whole body exposure to extremely low frequency magnetic field (ELF-MF and genotoxic , cytotoxic hazards in brain and bone marrow cells of newborn rats. Newborn rats (10 days after delivery were exposed continuously to 50 Hz, 0.5 mT for 30 days. The control group was treated as the exposed one with the sole difference that the rats were not exposed to magnetic field. Comet assay was used to quantify the level of DNA damage in isolated brain cells. Also bone marrow cells were flushed out to assess micronucleus induction and mitotic index. Spectrophotometric methods were used to measure the level of malondialdehyde (MDA and the activity of glutathione (GSH and superoxide dismutase (SOD. The results showed a significant increase in the mean tail moment indicating DNA damage in exposed group (P<0.01,0.001,0.0001. Moreover ELF-MF exposure induced a significant (P<0.01,0.001 four folds increase in the induction of micronucleus and about three folds increase in mitotic index (P<0.0001. Additionally newborn rats exposed to ELF-MF showed significant higher levels of MDA and SOD (P<0.05. Meanwhile ELF-MF failed to alter the activity of GSH. In conclusion, the present study suggests an association between DNA damage and ELF-MF exposure in newborn rats.

  3. Application of virtual reality technique in rehabilitation of hemiplegic upper extremities function of stroke patients%虚拟现实技术在脑卒中患者偏瘫上肢功能康复中的应用

    Institute of Scientific and Technical Information of China (English)

    梁明; 窦祖林; 王清辉; 熊巍; 郑雅丹; 陈颖蓓; 杨琼; 邱雅贤

    2013-01-01

    目的:初步观察虚拟厨房上肢康复训练结合常规作业治疗对脑卒中恢复期患者偏瘫上肢功能康复的临床疗效.方法:将33例脑卒中恢复期偏瘫上肢功能障碍的患者随机分为治疗组(16例)和对照组(17例).对照组接受常规作业治疗每次40min,每日1次,每周5次,共3周.治疗组接受常规作业治疗和虚拟厨房上肢康复训练各20min,每次共40min,每日1次,每周5次,共3周.其余康复治疗如运动疗法和日常生活活动训练等两组均相同.两组患者分别于治疗前、治疗后予以FMA上肢部分(FMA-UE)、MAS上肢部分(MAS-UE)和MBI评定,比较两组的疗效.结果:两组患者治疗后FMA-UE、MAS-UE及MBI的评分均较治疗前提高,治疗前、后各量表的评分差异具有显著性(P< 0.05);与对照组相比,治疗组患者FMA-UE、MBI的评分提高幅度更大(P<0.05).结论:虚拟厨房上肢康复训练结合常规康复作业治疗能更好地改善脑卒中恢复期患者偏瘫上肢的运动功能,更有效地提高患者日常生活活动能力.%Objective: To observe the effect of virtual kitchen upper extremities training combined with traditional occupational therapy on hemiplegic upper extremities function of stroke patients in convalescent phase. Method: Thirty-three stroke patients with hemiplegic upper extremities dysfunction in convalescent phase, were divided into therapy group (n=16) and control group (n=17). The patients in control group accepted traditional occupational therapy, 40 min/d, 5d/week for 3 weeks. The patients in therapy group accepted virtual kitchen upper extremities training and traditional occupational therapy. Each part of virtual reality trainning lasted 20 min and the total was 40 min, the training schedule in therapy group was 40min/rl, 5d/week for 3 weeks. Physical therapy and training of activities of daily living were the same in both groups. Fugl-Meyer assessment of upper extremity (FMA-UE), motor assessment scale

  4. Distinctive metaphyseal chondrodysplasia with severe distal radius and ulna involvement (upper extremity mesomelia) and normal height.

    Science.gov (United States)

    Camera, Andrea; Camera, Gianni

    2003-10-01

    Metaphyseal chondrodysplasias (MCD) are skeletal disorders characterized by metaphyseal irregularities and, usually, by short stature. In MCD, wide heterogeneity exists with regard to clinical and radiological changes. We report on a patient with clinical and radiological findings of MCD who had coxa valga and normal height with metaphyseal involvement of the long bones. The short radii and ulnae showed a very severe change in their distal metaphyses, leading to mesomelic shortening confined to the upper limbs. Hematological, ophthalmological, and hearing examinations were normal. This type of MCD appears to represent a yet undescribed syndrome.

  5. Simultaneous toe-to-hand transfer and lower extremity amputations for severe upper and lower limb defects: the use of spare parts.

    Science.gov (United States)

    Chang, J; Jones, N F

    2002-06-01

    From 1995 to 2000, five microvascular toe-to-hand transfers were performed in three children who were simultaneously undergoing lower extremity amputations. Their ages at time of transfer ranged from 4 to 10 years and the types of lower extremity amputation included toe amputation, foot amputation and through-knee amputation. The resulting toe-to-hand transfers included three great toe-to-thumb transfers and one combined great and second toe-to-hand transfer. The toe-to-hand transfers were all successful and all the lower extremity amputations healed without complications. In all cases, improved hand function and lower extremity function was noted by the families. These unique cases represent the ultimate use of spare parts in congenital hand surgery.

  6. EMG-Torque correction on Human Upper extremity using Evolutionary Computation

    Science.gov (United States)

    JL, Veronica; Parasuraman, S.; Khan, M. K. A. Ahamed; Jeba DSingh, Kingsly

    2016-09-01

    There have been many studies indicating that control system of rehabilitative robot plays an important role in determining the outcome of the therapy process. Existing works have done the prediction of feedback signal in the controller based on the kinematics parameters and EMG readings of upper limb's skeletal system. Kinematics and kinetics based control signal system is developed by reading the output of the sensors such as position sensor, orientation sensor and F/T (Force/Torque) sensor and there readings are to be compared with the preceding measurement to decide on the amount of assistive force. There are also other works that incorporated the kinematics parameters to calculate the kinetics parameters via formulation and pre-defined assumptions. Nevertheless, these types of control signals analyze the movement of the upper limb only based on the movement of the upper joints. They do not anticipate the possibility of muscle plasticity. The focus of the paper is to make use of the kinematics parameters and EMG readings of skeletal system to predict the individual torque of upper extremity's joints. The surface EMG signals are fed into different mathematical models so that these data can be trained through Genetic Algorithm (GA) to find the best correlation between EMG signals and torques acting on the upper limb's joints. The estimated torque attained from the mathematical models is called simulated output. The simulated output will then be compared with the actual individual joint which is calculated based on the real time kinematics parameters of the upper movement of the skeleton when the muscle cells are activated. The findings from this contribution are extended into the development of the active control signal based controller for rehabilitation robot.

  7. 牵拉成骨技术治疗下肢大段骨缺损%Distraction osteogenesis for large bone defect of the lower extremity

    Institute of Scientific and Technical Information of China (English)

    王富明; 陈鸿奋; 陈滨; 任高宏; 杨运平; 秦煜; 王钢

    2011-01-01

    Objective To discuss the therapeutic effect of distraction osteogenesis for large bone defect of the lower extremity. Methods From August 2002 to August 2010, 11 patients with large bone defect at the lower extremity were treated with distraction osteogenesis. They were 10 men and one woman, aged from 14 to 53 years (average, 34. S years). The defect was at the right tibia in 7 cases, left tibia in 3 cases and right femur in one case. The lengths of bone defect ranged from 5 to 15 cm (average, 8. 6 cm). Results The patients were followed up for 7 to 48 months, with a mean period of 27. 3 months. The treatment of 9 cases was over, with a mean healing index of 1. 99 months/cm. According to the Paley evaluation system, the bony results were excellent in 6 and good in 3 patients; the functional results were excellent in 4, good in 4, and fair in one patient. Two cases were still in the mineralization period. Conclusion Treatment of large bone defects with distraction osteogenesis is simple and can obtain satisfactory therapeutic effects, especially when a monolateral external fixator is used for the simple shaft bone defect.%目的 探讨应用牵拉成骨技术治疗下肢大段骨缺损的临床疗效.方法 回顾性分析2002年8月至2010年8月收治的11例下肢大段骨缺损患者临床资料,男10例,女1例;年龄14~53岁,平均34.5岁.均行牵拉成骨治疗,右侧胫骨7例,左侧胫骨3例,右侧股骨1例;骨缺损长度5~15cm,平均8.6 cm;9例治疗已结束,2例仍处于矿化阶段.结果 所有患者术后获7~48个月(平均27.3个月)随访.9例治疗结束患者,平均骨愈合指数为1.99个月/cm;根据Paley评价系统评价骨性结果:优6例,良3例,优良率为100%;功能结果:优4例,良4例,一般1例.结论应用牵拉成骨技术治疗大段骨缺损,手术操作简单,尤其是对于单纯骨干缺损患者,采用单边外固定支架治疗,且其手术操作更为简洁.

  8. Limb salvage surgery in a patient with macrodystrophia lipomatosa involving an entire upper extremity

    Institute of Scientific and Technical Information of China (English)

    GAO Bo; ZHENG Long-po; CAI Zheng-dong

    2010-01-01

    @@ Macrodystrophia lipomatosa is a rare form of congenital localized gigantism, which is characterized by slowly progressive overgrowth of the mesenchymal elements, especially the fibroadipose tissue,in a limb. Frequently, multiple contiguous digits are involved on the lateral side of the hand or the medial side of the foot. Overabundance of the fibroadipose tissue and osseous overgrowth are most remarkable at the distal ends of the extremity. Macrodystrophia lipomatosa involving an entire limb has been previously reported for only one case in a 45-year-old adult male;1 however, no details of treatment were described. Here, we present the first report of successful limb salvage surgery of macrodystrophia lipomatosa in an adolescent involving an entire upper extremity.

  9. Intraosseous lipoma of adjacent upper cervical vertebral bodies with significant paravertebral expansion

    Institute of Scientific and Technical Information of China (English)

    ZHU Bin; LIU Xiao-guang; LIU Zhong-jun; Hung-I Liao; JIANG Liang; WEI Feng

    2010-01-01

    @@ Intraosseous lipomas are rare, benign bone tumors,comprising less than 0. 1% of all primary bone tumors.Common sites of intraosseous lipomas include the os calcis and the metaphyses of the long bones of the lower limbs.2 Cases involving the spine are extremely rare; a meta-analysis of 206 cases reported that intraosseous lipomas involving the spine (including the sacrum)accounted for 6% of all cases.2 A review of the English literature reveals only 14 reported cases involving the spine (Table). The case involving the upper cervical spine (C 1 and C2) is presented, followed by a discussion of the diagnosis and treatment strategies.

  10. Pseudoanaplastic tumors of bone

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Won-Jong [Uijongbu St. Mary Hospital, The Catholic University of Korea, Department of Orthopaedic Surgery, Gyunggido, 480-821 (Korea); Mirra, Joseph M. [Orthopaedic Hospital, Orthopedic Oncology, Los Angeles, California (United States)

    2004-11-01

    To discuss the concept of pseudoanaplastic tumors of bone, which pathologically show hyperchromatism and marked pleomorphism with quite enlarged, pleomorphic nuclei, but with no to extremely rare, typical mitoses, and to propose guidelines for their diagnosis. From a database of 4,262 bone tumors covering from 1971 to 2001, 15 cases of pseudoanaplastic bone tumors (0.35% of total) were retrieved for clinical, radiographic and pathologic review. Postoperative follow-up after surgical treatment was at least 3 years and a maximum of 7 years. There were eight male and seven female patients. Their ages ranged from 10 to 64 years with average of 29.7 years. Pathologic diagnoses of pseudoanaplastic variants of benign bone tumors included: osteoblastoma (4 cases), giant cell tumor (4 cases), chondromyxoid fibroma (3 cases), fibrous dysplasia (2 cases), fibrous cortical defect (1 case) and aneurysmal bone cyst (1 case). Radiography of all cases showed features of a benign bone lesion. Six cases, one case each of osteoblastoma, fibrous dysplasia, aneurysmal bone cyst, chondromyxoid fibroma, giant cell tumor and osteoblastoma, were initially misdiagnosed as osteosarcoma. The remaining cases were referred for a second opinion to rule out sarcoma. Despite the presence of significant cytologic aberrations, none of our cases showed malignant behavior following simple curettage or removal of bony lesions. Our observation justifies the concept of pseudoanaplasia in some benign bone tumors as in benign soft tissue tumors, especially in their late evolutionary stage when bizarre cytologic alterations strongly mimic a sarcoma. (orig.)

  11. Upper airway obstruction and pulmonary abnormalities due to lymphoproliferative disease following bone marrow transplantation in children

    Energy Technology Data Exchange (ETDEWEB)

    Fletcher, B.D. [Department of Diagnostic Imaging, St. Jude Children`s Research Hospital, 332 N. Lauderdale St., Memphis, TN 38105 (United States)]|[Departments of Radiology and Pediatrics, University of Tennessee, Memphis, Tennessee (United States); Heslop, H.E. [Department of Hematology/Oncology, St. Jude Children`s Research Hospital, Department of Pediatrics, University of Tennessee, Memphis, Tennessee (United States); Kaste, S.C. [Department of Diagnostic Imaging, St. Jude Children`s Research Hospital, Department of Radiology, University of Tennessee, Memphis, Tennessee (United States); Bodner, S. [Department of Pathology, St. Jude Children`s Research Hospital, Department of Pathology, University of Tennessee, Memphis, Tennessee (United States)

    1998-07-01

    We report three patients who developed severe supraglottic airway obstruction due to Epstein-Barr virus lymphoproliferative disease following allogeneic bone marrow transplantation. In addition to enlarged pharyngeal lymphoid tissue seen in all three patients, two had supraglottic airway narrowing and two developed pulmonary lymphoproliferative disease. They were treated with unmanipulated T cells or EBV-specific cytotoxic T lymphocytes. Life-threatening upper airway obstruction is a radiologically detectable complication of allogeneic bone marrow transplantation in children. (orig.) With 3 figs., 1 tab., 12 refs.

  12. Treatment of 38 cases with multiple open fractures in ipsilateral upper extremity%同侧上肢多发性开放性骨折38例的救治

    Institute of Scientific and Technical Information of China (English)

    张进

    2015-01-01

    目的:探究同侧上肢多发性、开放性骨折的治疗方法及效果。方法:收治同侧上肢多发性开放性骨折患者38例,主要进行皮瓣移植及外固定术方法治疗。结果:治疗后骨折愈合良好28例(73.7%),发生骨折延迟愈合7例(18.4%),截肢3例(7.9%)。结论:同侧上肢多发性开放性骨折多采用手术方法治疗,能促进肢体功能的恢复。%Objective:To explore the treatment and effect of multiple open fractures in ipsilateral upper extremity.Methods:38 cases of patients with multiple open fractures in ipsilateral upper extremity were mainly treated with flap transplantation and external fixation method.Results:After treatment,28 cases healed well(73.7% ),7 cases had delayed heal of fractures(18.4% ),3 cases had amputation(7.9%).Conclusion:Multiple open fractures in ipsilateral upper extremity were mainly treated with surgical method,which could promote the recovery of limb function.

  13. Comparison of the effects of remote after-effects of static contractions for different upper-extremity positions and pinch-force strengths in patients with restricted wrist flexion range of motion.

    Science.gov (United States)

    Arai, Mitsuo; Shiratani, Tomoko

    2015-10-01

    The objective of the study was to examine the after-effects of static contractions of upper extremity muscles in different shoulder joint positions and at different pinch-force strengths on the maximal active range of motion (MAROM) and wrist agonist/antagonist IEMG activities for patients with restricted wrist flexion range of motion (ROM) due to upper limb pain and dysfunction. The subjects were 10 outpatients (3 males, 7 females) with restricted wrist joints. These subjects performed four static contractions of upper extremity muscles in neutral and diagonal shoulder joint positions and with weak and strong pinch-force strengths in random order. Two-way repeated measures analysis of variance showed that the change in MAROM was significantly larger (P contractions than after neutral-weak static contractions. There were no significant correlations between changes in MAROM and IEMG activities. These results indicate that shoulder joint position and pinch-force strength should be considered for effective induction of remote after-effects of static contractions for increasing MAROM for restricted wrist flexion ROM.

  14. Preconditioning electromyographic data for an upper extremity model using neural networks

    Science.gov (United States)

    Roberson, D. J.; Fernjallah, M.; Barr, R. E.; Gonzalez, R. V.

    1994-01-01

    A back propagation neural network has been employed to precondition the electromyographic signal (EMG) that drives a computational model of the human upper extremity. This model is used to determine the complex relationship between EMG and muscle activation, and generates an optimal muscle activation scheme that simulates the actual activation. While the experimental and model predicted results of the ballistic muscle movement are very similar, the activation function between the start and the finish is not. This neural network preconditions the signal in an attempt to more closely model the actual activation function over the entire course of the muscle movement.

  15. Recurrent Upper Quadrant Pain: A Fish Bone Secondary to Gastric Perforation and Liver Abscess

    Directory of Open Access Journals (Sweden)

    Hui Liang

    2011-12-01

    Full Text Available A 60-year-old male patient was admitted to our hospital for recurrent upper quadrant pain for 1 month. He had a past history of coronary artery disease. After admission, he repeatedly suffered from high-grade fever, chills and upper quadrant pain. Computed tomography (CT showed a round hypodense mass in the left lobe of the liver, approximately 2.7 × 2.2 cm in size, and a fish bone was confirmed by surgery in the left lobe of liver. The patient was cured completely after surgical removal of the fish bone and liver abscess. CT scan 1 month after discharge showed that the liver abscess had disappeared completely.

  16. Entrenamiento de las extremidades superiores en el paciente con enfermedad pulmonar obstructiva crónica Upper extremity exercise training in the rehabilitation of patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    MANUEL DE LA PRIDA C

    2011-06-01

    Full Text Available En los pacientes con enfermedad pulmonar obstructiva crónica (EPOC se observa una reducción de la capacidad de generación de fuerza de los grupos musculares de las extremidades superiores (EESS y de la pared torácica comparado con sujetos sanos. Existen evidencias que el ejercicio de las EESS se asocia a un significativo costo metabólico y ventilatorio que es particularmente evidente en los pacientes con EPOC moderada a severa. Clínicamente, estos pacientes tienen disnea y fatiga con actividades sencillas de la vida diaria. En este capitulo se evaluó la evidencia científica que existe en cuanto a los beneficios del entrenamiento muscular de EESS en la rehabilitación respiratoria en pacientes con EPOC. Las características técnicas de dicho entrenamiento también fueron revisadas. Se recomendó la realización de entrenamiento muscular de EESS en la rehabilitación respiratoria de pacientes con EPOC, por cuanto mejora la capacidad de ejercicio, reduce la ventilación y el consumo de oxígeno (calidad de la evidencia: B, fuerza de la recomendación: moderada. El entrenamiento muscular de EESS puede ser asociado al entrenamiento muscular de extremidades inferiores por cuanto se obtienen mejores resultados para el paciente. Los ejercicios de EESS pueden realizarse sin apoyo, con carga incremental o carga constante.In patients with chronic obstructive pulmonary disease (COPD showed a reduction in force generating capacity of the muscle groups of the upper extremities (UE and the chest wall compared with healthy subjects. Also, there is evidence that the exercise of the UE is associated with significant metabolic and ventilatory cost, this is particularly evident in patients with moderate and severe COPD. Clinically, patients have a significant increase in dyspnea and fatigue for simple activities of daily life.This chapter therefore evaluated the scientific evidence regarding the beneficial effect of upper extremities exercise in the

  17. Climate variability and extreme drought in the upper Solimoes River (western Amazon Basin) : Understanding the exceptional 2010 drought

    OpenAIRE

    J. C. Espinoza; Ronchail, J.; Guyot, Jean-Loup; Junquas, C.; Vauchel, Philippe; Lavado, W.; Drapeau, G; Pombosa, R.

    2011-01-01

    This work provides an initial overview of climate features and their related hydrological impacts during the recent extreme droughts (1995, 1998, 2005 and 2010) in the upper Solimoes River (western Amazon), using comprehensive in situ discharge and rainfall datasets. The droughts are generally associated with positive SST anomalies in the tropical North Atlantic and weak trade winds and water vapor transport toward the upper Solimoes, which, in association with increased subsidence over centr...

  18. Simple and Task-oriented Mirror Therapy for Upper Extremity Function in Stroke Patients: A Pilot Study

    OpenAIRE

    Young-Rim Paik; Su-Kyoung Kim; Jae-Shin Lee; Byoung-Jin Jeon

    2014-01-01

    Objective/Background: To compare the effects of simple and task-oriented mirror therapies on upper extremity function in stroke patients with hemiplegia. Methods: A single-subject, reversal (applied behaviour analysis) research design was used, and the study included four patients and two treatments. Treatment 1 involved simple mirror therapy that was performed using simple upper limb movements. Treatment 2 involved task-oriented mirror therapy that required each patient to perform functio...

  19. Steroid injections in the upper extremity: experienced clinical opinion versus evidence-based practices.

    Science.gov (United States)

    Kegel, Gary; Marshall, Astrid; Barron, O Alton; Catalano, Louis W; Glickel, Steven Z; Kuhn, Margaret

    2013-09-01

    A survey regarding upper-extremity steroid injection practices was distributed to all active members of the American Society for Surgery of the Hand (ASSH) and American Shoulder and Elbow Surgeons (ASES) using SurveyMonkey. Response rates for the ASSH and ASES were 26% and 24%, respectively. The potency-adjusted dose of steroid injected for common hand and wrist injections ranged from 0.375 to 133.33 mg and for shoulder injections ranged from 0.375 to 250 mg. These ranges span 356-fold and 667-fold differences, respectively. Potency-adjusted doses differed significantly between steroid types for all injections evaluated in this study. American Society for Surgery of the Hand members gave significantly smaller doses of steroid for the glenohumeral and acromioclavicular joints than ASES members. Only 9% of respondents based injection practice on a scientific reference. Sixteen percent of ASSH and 31% of ASES respondents reported no specific rationale for their steroid injection practice; 78% of ASSH and 52% of ASES respondents attributed their rationale to some kind of instruction from their mentors or colleagues. Upper-extremity surgeons demonstrate substantial variability in their practice of steroid injections, with up to a 667-fold range in steroid dose. Experienced clinical opinion is the principal rationale for these injection practices; little rationale is based on formal scientific evidence.

  20. Inhibitory Response Capacities of Bilateral Lower and Upper Extremities in Children with Developmental Coordination Disorder in Endogenous and Exogenous Orienting Modes

    Science.gov (United States)

    Tsai, Chia-Liang; Yu, Yi-Kai; Chen, Yung-Jung; Wu, Sheng-Kuang

    2009-01-01

    This study was designed to investigate separately the inhibitory response capacity and the lateralization effect in children with developmental coordination disorder (DCD) in the endogenous and exogenous modes of orienting attention. Children with DCD on the lower extremities (DCD-LEs), along with age-matched controls, completed four tasks that…

  1. Bone printing: new frontiers in the treatment of bone defects.

    Science.gov (United States)

    Arealis, Georgios; Nikolaou, Vasileios S

    2015-12-01

    Bone defects can be congenital or acquired resulting from trauma, infection, neoplasm and failed arthroplasty. The osseous reconstruction of these defects is challenging. Unfortunately, none of the current techniques for the repair of bone defects has proven to be fully satisfactory. Bone tissue engineering (BTE) is the field of regenerative medicine (RM) that focuses on alternative treatment options for bone defects that will ideally address all the issues of the traditional techniques in treating large bone defects. However, current techniques of BTE is laborious and have their own shortcomings. More recently, 2D and 3D bone printing has been introduced to overcome most of the limitations of bone grafts and BTE. So far, results are extremely promising, setting new frontiers in the management of bone defects.

  2. Wearing a Wetsuit Alters Upper Extremity Motion during Simulated Surfboard Paddling.

    Directory of Open Access Journals (Sweden)

    J A Nessler

    Full Text Available Surfers often wear wetsuits while paddling in the ocean. This neoprene covering may be beneficial to upper extremity movement by helping to improve proprioceptive acuity, or it may be detrimental by providing increased resistance. The purpose of this study was to evaluate the effects of wearing a wetsuit on muscle activation, upper extremity motion, heart rate, and oxygen consumption during simulated surfboard paddling in the laboratory. Twelve male, recreational surfers performed two paddling trials at a constant workload on a swim bench ergometer both with and without a wetsuit. Kinematic data and EMG were acquired from the right arm via motion capture, and oxygen consumption and heart rate were recorded with a metabolic cart and heart rate monitor. Wearing a wetsuit had no significant effect on oxygen consumption or heart rate. A significant increase in EMG activation was observed for the middle deltoid but not for any of the other shoulder muscle evaluated. Finally, approximate entropy and estimates of the maximum Lyapunov exponent increased significantly for vertical trajectory of the right wrist (i.e. stroke height when a wetsuit was worn. These results suggest that a 2mm wetsuit has little effect on the energy cost of paddling at lower workloads but does affect arm motion. These changes may be the result of enhanced proprioceptive acuity due to mechanical compression from the wetsuit.

  3. The scapular free flap for aesthetic reconstruction of upper and lower extremity wound%肩胛皮瓣在四肢组织缺损美学修复中的应用

    Institute of Scientific and Technical Information of China (English)

    卢仕良; 谢伟勇; 陶国贵; 柳原

    2011-01-01

    Objective To study the application of the scapular free flap for aesthetic reconstruction of the upper and lower extremity wound. Methods Scapular free flaps were designed to repair the tissue defect of the upper and lower extremity. Results E-leven patients with tissue defect and scar of the upper and lower extremity were treated with the scapular free flaps. The flap size ranged from (10 cm x IS cm) to (16 cm x 25 cm). Ten flaps survived, and partial necrosis developed in the distal end of the flap in one case. Conclusions The scapular free flap provides a reliable blood supply and can be used to construct the tissue defect of the extremity, with satisfactory functional and aesthetic results.%目的 探索应用肩胛皮瓣行四肢组织缺损的美学修复.方法 应用肩胛皮瓣游离移植修复各种原因造成的组织缺损.结果 自1998 -02至2010 -12,临床应用11例,皮瓣面积(10 cm×15 cm) ~(16 cm×25 cm),成活10例,1例因血管变异失败.结论 肩胛皮瓣与四肢皮肤厚薄、质地相似,术后肢体形态、功能恢复良好,是四肢组织缺损美学修复的首选皮瓣.皮瓣预扩张后一期修复效果优良.

  4. Intra-articular Fractures of the Sigmoid Notch of the Distal Radius: Analysis of Progression to Distal Radial Ulnar Joint Arthritis and Impact on Upper Extremity Function in Surgically Treated Fractures.

    Science.gov (United States)

    Vitale, Mark A; Brogan, David M; Shin, Alexander Y; Berger, Richard A

    2016-03-01

    Background Studies have established an increased risk of radiocarpal joint posttraumatic arthritis in patients with displaced intra-articular fractures of the distal radius, although this phenomenon has yet to be evaluated in the distal radioulnar joint (DRUJ). Purpose We hypothesized that patients with displaced intra-articular fractures of the sigmoid notch would have a higher prevalence of DRUJ arthritis and greater upper extremity dysfunction after operative treatment of distal radius fractures compared with fractures without sigmoid notch involvement. We also hypothesized that the degree of sigmoid notch incongruity would be correlated with the grade of DRUJ arthritis and the severity of upper extremity dysfunction. Patients and Methods A retrospective review was conducted on surgically treated patients with distal radius fractures with pre- and/or postoperative computed tomography (CT) scans. Patients were divided into groups based on presence or absence of fracture extension into the sigmoid notch. Within the sigmoid notch group, postoperative CT scans were used to measure sigmoid notch fracture step-off and diastasis (mm), as well as volar or dorsal DRUJ subluxation (%). Patients were administered Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires and radiographs were obtained to grade DRUJ arthritis using the Kellgren-Lawrence (KL) radiographic criteria. Results Thirty-three patients were included (19 with sigmoid notch involvement and 14 without) with an average radiographic follow-up of 6.3 years (range: 3.5-10.1 years). DASH scores were available for all patients, and radiographic follow-up was available in 24 patients (73%). A trend toward higher grade of DRUJ arthritis and poorer average DASH was found in those with sigmoid notch involvement, but was not statistically different. In the sigmoid notch group there were poorer DASH scores in patients with coronal step-off > 1.0-mm (p notch step-off, diastasis or DRUJ

  5. Bioelectrical impedance analysis for severe stroke patients with upper extremity hemiplegia

    Science.gov (United States)

    Yoo, Chanuk; Kim, Jaehyung; Yang, Yeongae; Lee, Jinsu; Jeon, Gyerok

    2016-01-01

    [Purpose] This study is to analyze bioimpedance parameters and occupational assessment for severe stroke patients with upper extremity hemiplegia. [Subjects and Methods] Experimental subjects were 20 hemiplegic stroke patients receiving rehabilitation therapy between November to October, 2015. Prediction marker (PM), and phase angle (θ), a nd characteristic frequency (fc) were measured using bioelectrical impedance spectroscopy (MultiScan 5000). Bioelectrical impedance vector analysis (BIVA) was also obtained from the bioimpedance data. Then, these values were compared with occupational assessment tools. [Results] A significant differences in PM, θ, fc, and BIVA were observed between paretic region and non-paretic region of 5 severe stroke patients. These results were in good agreement with occupational assessment (pinch and hand grip strength, and ADL by MBI). [Conclusion] There were significant differences in impedance parameters between paretic region and non-paretic region of 5 severe stroke patients with upper extremity hemiplegia. Thus, the BIA could be useful tool for evaluating hemiplegic stroke patients receiving the rehabilitation therapy in the clinical application. PMID:27821919

  6. Role of magnetic resonance imaging in entrapment and compressive neuropathy - what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: Part 2. Upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sungjun [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Hanyang University, Kuri Hospital, Department of Diagnostic Radiology, College of Medicine, Kuri City, Kyunggi-do (Korea); Choi, Jin-Young; Huh, Yong-Min; Song, Ho-Taek; Lee, Sung-Ah [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Kim, Seung Min [Yonsei University, Department of Neurology, College of Medicine, Seoul (Korea); Suh, Jin-Suck [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Yonsei University, Research Institute of Radiological Science, College of Medicine, Seoul (Korea)

    2007-02-15

    The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging. (orig.)

  7. Study on reliability of Carroll upper extremities functional test in children with spastic hemiplegia%Carroll上肢功能试验在痉挛型偏瘫儿童中的信度研究

    Institute of Scientific and Technical Information of China (English)

    何璐; 徐开寿; 邱晒红; 靳晓坤; 麦坚凝

    2011-01-01

    Objective: To examine the inter-rater reliability of Carroll upper extremities functional test (UEFT) for children with spastic hemiplegia in order to guide the clinical practice.Method: Thirty children who could understand simple orders with spastic hemiplegia were enrolled into this study. Carroll UEFT was applied to assess both upper extremities of each child by two trained occupational therapists. They evaluated subjects respectively at the same time, but didn't talk each other about children's scores in assessment course. The data statistics was performed by the authors who hadn't taken part in the assessment. The scores of five function areas(including grasping-holding, pinching, placing, rotating and writing) of UEFT and the total scores of UEFT were analyzed respectively.The inter-rater reliability was investigated on each extremity over both test sessions, and it was determined through the calculation of the intraclass correlation coefficient (ICC). Result: There was good inter-rater reliability of UEFT on each function area score, not only for the involved upper extremity (ICC=0.921-1), but also for the non-involved upper extremity (ICC=0.926-0.973). They all concentrated in the 95% confidence interval (P<0.001).Conclusion: The Carroll UEFT demonstrated satisfactory inter-rater reliability for the upper extremities function of children with spastic hemiplegia. The UEFT is easy to implement and accurate for assessment, so it can be used as upper extremities function measure tool for children with spastic hemiplegia.Author's address Department of Neurology and Rehabilitation, Guangzhou Children's Hospital. Guangzhou Women and Children's Medical Center,Guangzhou.510120%检验Carroll上肢功能试验(UEFT)在痉挛型偏瘫儿童中的信度,为Carroll上肢功能试验在痉挛型偏瘫儿童的临床应用提供客观依据.方法:选取30例能理解简单指令的痉挛型偏瘫儿童参加本研究,由两位熟练掌握UEF评分标准的作业治疗师

  8. Determination of bone mineral density of the distal extremity of the radio in Rottweiller, by radiographic optic densitometry;Determinacao da densidade mineral ossea da extremidade distal do radio de caes da raca Rottweiller, por meio da densitometria optica radiografica

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Jefferson Douglas Soares, E-mail: radiologia@unifeob.edu.b [Fundacao de Ensino Octavio Bastos (UNIFEOB), Sao Joao da Boa Vista, SP (Brazil). Fac. de Medicina e Veterinaria; Sterman, Franklin de Almeida [Universidade de Sao Paulo (USP), Butanta, SP (Brazil). Fac. de Medicina Veterinaria e Zootecnia. Dept. de Cirurgia

    2010-06-15

    This study allowed the standardization of the bone mineral density (BMD) of the distal extremity of the radio of 36 dogs adults in Rottweiler breed by radiographic optic densitometry. The limbs of the animals were radiographed with scale of aluminum that served as a reference. The radiographs images were digitalized and analyzed by a computer program for comparison of gray tones between the standard image and the image of the reference scale radiographed with the bone. Afterwards the values of density were expressed in millimeters of aluminum. Also studied the correlations between BMD and the sex, weight and external measures as the length of spine, height of the animal and circumference the distal extremity of the limb in study. The mean values and standard deviations of the bone mineral density of the distal extremity of the radio were: for the metaphyseal region the average of BMD of 7,88+-0,89 mmAl, the diaphyseal region 1 the average of BMD of 8,58+-0,80 mmAl and for diaphyseal region 2 of BMD of 9,00+-0,74 mmAl. (author)

  9. A Rare Cause of Testicular Metastasis: Upper Tract Urothelial Carcinoma

    Directory of Open Access Journals (Sweden)

    Alper Nesip Manav

    2014-01-01

    Full Text Available Metastatic testicular cancers are rare. Primary tumor sources are prostate, lung, and gastrointestinal tract for metastatic testicular cancers. Metastasis of urothelial carcinoma (UC to the testis is extremely rare. Two-thirds of upper tract urothelial carcinoma (UTUC is of invasive stage at diagnosis and metastatic sites are the pelvic lymph nodes, liver, lung, and bone. We report a rare case of metastatic UTUC to the testis which has not been reported before, except one case in the literature. Testicular metastasis of UC should be considered in patients with hematuria and testicular swelling.

  10. [Prosthetic possibilities after amputations in the upper extremities].

    Science.gov (United States)

    Grüttner, B; Frohnauer, G; Burgkart, R

    2004-06-24

    Whereas passive prostheses are fitted onto the patient after the amputation of an arm, hand or finger and are mostly cosmetic in function, active prostheses have much more potential. They can transform the movements of other body regions to movement in the artificial limb. Belts or harnesses, for example, effect the direct transfer of the power from the muscle to the prosthesis. The range of movement possible depends upon the level of the amputation, the length of the residual limb, the age of the patient, his body build and fitness. Myoelectrically controlled prostheses possess their own drive and power source. They control movement through the electrical action potentials of the residual limb muscles, which are detected, amplified and transmitted with help of electrodes.

  11. Pneumatic compression for embolic protection during upper extremity endovascular intervention.

    Science.gov (United States)

    Cassar, Andrew; Barsness, Gregory W; Wysokinski, Waldemar E; Gifford, Shaun M; Bower, Thomas C; Edwards, William D; Gulati, Rajiv

    2014-01-01

    Embolic protection devices are occasionally employed during endovascular interventions to prevent complications caused by embolic debris. However, these devices have imperfect efficacy, confer risk of endovascular trauma, and are expensive. We report a patient with giant cell arteritis and symptomatic axillary artery stenosis, with a perceived elevated risk of distal embolization during endovascular intervention. We describe a straightforward embolic protection technique of brachial pressure cuff inflation during endovascular intervention and aspiration of displaced thrombotic material from the static column of blood. This novel, effective, and cost-free technique could also be employed in other vascular beds during endovascular intervention.

  12. Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke

    Directory of Open Access Journals (Sweden)

    Patten Carolynn

    2013-01-01

    Full Text Available Abstract Background Repetitive task practice is argued to drive neural plasticity following stroke. However, current evidence reveals that hemiparetic weakness impairs the capacity to perform, and practice, movements appropriately. Here we investigated how power training (i.e., high-intensity, dynamic resistance training affects recovery of upper-extremity motor function post-stroke. We hypothesized that power training, as a component of upper-extremity rehabilitation, would promote greater functional gains than functional task practice without deleterious consequences. Method Nineteen chronic hemiparetic individuals were studied using a crossover design. All participants received both functional task practice (FTP and HYBRID (combined FTP and power training in random order. Blinded evaluations performed at baseline, following each intervention block and 6-months post-intervention included: Wolf Motor Function Test (WMFT-FAS, Primary Outcome, upper-extremity Fugl-Meyer Motor Assessment, Ashworth Scale, and Functional Independence Measure. Neuromechanical function was evaluated using isometric and dynamic joint torques and concurrent agonist EMG. Biceps stretch reflex responses were evaluated using passive elbow stretches ranging from 60 to 180º/s and determining: EMG onset position threshold, burst duration, burst intensity and passive torque at each speed. Results Primary outcome: Improvements in WMFT-FAS were significantly greater following HYBRID vs. FTP (p = .049, regardless of treatment order. These functional improvements were retained 6-months post-intervention (p = .03. Secondary outcomes: A greater proportion of participants achieved minimally important differences (MID following HYBRID vs. FTP (p = .03. MIDs were retained 6-months post-intervention. Ashworth scores were unchanged (p > .05. Increased maximal isometric joint torque, agonist EMG and peak power were significantly greater following HYBRID vs. FTP (p p

  13. 护理干预预防PICC相关性上肢静脉血栓的系统评价%System evaluation on nursing intervention for prevention of PICC related upper extremity venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    陈璐; 谢新芳; 沈洪; 杨金丽; 宋建文

    2016-01-01

    Objective:To evaluate the effect of nursing intervention for PICC related upper extremity deep vein thrombosis.Methods:The controlled trials of nursing intervention on PICC related upper extremity deep vein thrombosis were collected by using the databases PubMed,Cochrane,OVID,CNKI,Wangfang Data snd VIP. The quantitative or qualitative analysis were selected according to the homogeneity of included studies.Results:8 RCTs were included(973 cases).Comprehensive evaluation before PICC,soak the catheter in advance with heparin sodium and DXM,physical prophylaxis,hot wet compression with magnesium sulfate and using hiru-doid cream after PICC could reduce PICC related upper extremity deep vein thrombosis.Conclusion:Nursing intervention could prevent PICC related upper extremity deep vein thrombosis,which had positive effect for in-travenous infusion therapy.%[目的]评价护理干预预防 PICC 相关性上肢静脉血栓的效果。[方法]计算机检索 PubMed、Cochrane Li-brary、OVID、CNKI、WanFang Data、VIP等数据库,纳入采用护理干预预防PICC相关性上肢静脉血栓的对照试验,根据纳入研究的同质性选择定量或定性评价分析。[结果]纳入8篇文献,均为随机对照试验,共973例病人。分析结果表明置管前全面评估、肝素钠加地塞米松预浸泡导管,置管后采用物理预防、硫酸镁湿热敷、喜疗妥外涂等干预措施能够减少PICC相关性上肢静脉血栓的形成。[结论]护理干预能够预防PICC相关性上肢静脉血栓,对静脉输液治疗有积极意义。

  14. The impact of high-frequency magnetic stimulation of peripheral nerves: muscle hardness, venous blood flow, and motor function of upper extremity in healthy subjects.

    Science.gov (United States)

    Okudera, Yoshihiko; Matsunaga, Toshiki; Sato, Mineyoshi; Chida, Satoaki; Hatakeyama, Kazutoshi; Watanabe, Motoyuki; Shimada, Yoichi

    2015-01-01

    The purpose of this study was to investigate the impact of high-frequency peripheral nerve magnetic stimulation on the upper limb function. Twenty-five healthy adults (16 men and 9 women) participated in this study. The radial nerve of the non-dominant hand was stimulated by high-frequency magnetic stimulation device. A total of 600 impulses were applied at a frequency of 20 Hz and intensity of 1.2 resting motor threshold (rMT). At three time points (before, immediately after, and 15 min after stimulation), muscle hardness of the extensor digitorum muscle on the stimulated side was measured using a mechanical tissue hardness meter and a shear wave imaging device, cephalic venous blood flow on the stimulated side was measured using an ultrasound system, and the Box and Block test (BBT) was performed. Mechanical tissue hardness results did not show any significant differences between before, immediately after, and 15 min after stimulation. Measurements via shear wave imaging showed that muscle hardness significantly decreased both immediately and 15 min after stimulation compared to before stimulation (P nerve magnetic stimulation can achieve effects similar to electrical stimulation in a less invasive manner, and may therefore become an important element in next-generation rehabilitation.

  15. Triangular interval syndrome: A differential diagnosis for upper extremity radicular pain.

    Science.gov (United States)

    Sebastian, Deepak

    2010-02-01

    This case report describes a 57-year-old female who experienced symptoms of scapular pain with pain radiating into the right upper extremity. Initial medical referral suggested, nerve entrapment of a cervical origin. However, the patient did not fit the clinical prediction rule for cervical radiculopathy. Radial nerve bias was positive without cervical provocation, with symptom reproduction at the lateral scapular area. Treatment addressed mechanical dysfunction at the triangular interval formed by the teres major and triceps, comprising manual therapy, neural mobilization, corrective exercise and pain modalities. Reduction in symptoms was observed with a decrease in right scapular and arm pain and improved radial nerve mobility. The triangular interval is described as a predominant contributor to the symptomatology secondary to entrapment and adverse neural tension of the radial nerve. The anatomical and physiological basis is enumerated.

  16. A NEW METHOD OF SINGLE-STAGE ISLAND PLASTY BY TWO BONE AUTOGRAFTS WITH BLOOD SUPPLY IN PATIENTS WITH PSEUDOARTHROSIS OF BOTH FOREARM BONES

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2010-01-01

    Full Text Available The applied topographic-anatomic studies prepared in 14 fixed and 16 unfixed preparations of upper extremity allowed to precise the details of radius blood supply with reference to possibilities of formation of bone autografts with blood supply. Due to this fact the novel method of single-stage bone plasty for pseudoarthrosis of both forearm bones was developed and successfully approved in clinic. This method proposes the formation of two periosteal-cortical grafts with blood supply and small muscle cuff in distal and middle one-thirds of radius simultaneously.

  17. Bone graft substitutes for the treatment of traumatic fractures of the extremities [Knochenersatzmaterialien zur Behandlung von traumatischen Frakturen der Extremitäten

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2012-06-01

    Full Text Available [english] Bone graft substitutes are increasingly being used as supplements to standard care or as alternative to bone grafts in the treatment of traumatic fractures.The efficacy and cost-effectiveness of bone graft substitutes for the treatment of traumatic fractures as well as the ethical, social and legal implications of their use are the main research questions addressed.A systematic literature search was conducted in electronic medical databases (MEDLINE, EMBASE etc. in December 2009. Randomised controlled trials (RCT, where applicable also containing relevant health economic evaluations and publications addressing the ethical, social and legal aspects of using bone graft substitutes for fracture treatment were included in the analysis. After assessment of study quality the information synthesis of the medical data was performed using metaanalysis, the synthesis of the health economic data was performed descriptively. 14 RCT were included in the medical analysis, and two in the heath economic evaluation. No relevant publications on the ethical, social and legal implications of the bone graft substitute use were found. In the RCT on fracture treatment with bone morphogenetic protein-2 (BMP-2 versus standard care without bone grafting (RCT with an elevd high risk of bias there was a significant difference in favour of BMP-2 for several outcome measures. The RCT of calcium phosphate (CaP cement and bone marrow-based composite materials versus autogenous bone grafts (RCT with a high risk of bias revealed significant differences in favour of bone graft substitutes for some outcome measures. Regarding the other bone graft substitutes, almost all comparisons demonstrated no significant difference.The use of BMP-2 in addition to standard care without bone grafting led in the study to increased treatment costs considering all patients with traumatic open fractures. However, cost savings through the additional use of BMP-2 were calculated in a

  18. Olecranon bone graft: revisited.

    Science.gov (United States)

    Mersa, Berkan; Ozcelik, Ismail Bulent; Kabakas, Fatih; Sacak, Bulent; Aydin, Atakan

    2010-09-01

    Autogenous bone grafts are frequently in use in the field of reconstructive upper extremity surgery. Cancellous bone grafts are applied to traumatic osseous defects, nonunions, defects after the resection of benign bone tumors, arthrodesis, and osteotomy procedures. Cancellous bone grafts do not only have benefits such as rapid revascularization, but they also have mechanical advantages. Despite the proximity to the primary surgical field, cancellous olecranon grafts have not gained the popularity they deserve in the field of reconstructive hand surgery. In this study, the properties, advantages, and technical details of harvesting cancellous olecranon grafts are discussed.

  19. 康复机器人训练对脑卒中偏瘫患者上肢功能的影响%Effect of rehabilitation robot on upper extremity function of hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    龙耀斌

    2012-01-01

    Objective: To observe the effect of the upper limb rehabilitation robot combined with conventional rehabilitation on upper extremity function of hemiplegic patients. Methods: 80 cases of hemiplegic upper limb dysfunction were divided into two groups. Both groups were given normal limb function training, at the same time the treatment group was given the upper iitnb rehabilitation robot training. Modified ashworth scale (MAS) score, simplified Fugl-Meyer upper limb motor function (FMA) score and the modified Barthel index (MBI) were compared before and after the treatment. Results: After 1 month of treatment, MAS scores in two groups were decreased as compared with those before treatment (F<0. 05), and those in treatment group was reduced as compared with control group (P<0. 05). FMA and ADL in two groups after treatment were improved as compared with those before treatment(Pof upper limb rehabilitation robot training with conventional rehabilitation can not only effectively improve the upper limb function of hemiplegic patients, but also can promote the recovery of activities of daily living.%目的:探讨上肢康复机器人训练结合常规康复治疗对脑卒中偏瘫患者上肢功能的影响.方法:80例脑梗死患者随机分为2组,均接受基础药物治疗和常规康复治疗;观察组增加上肢康复机器人训练.治疗前后分别进行上肢肌张力改良Ashworth量表(MAS)评分、上肢运动功能(FMA)评分及改良Barthel指数(MBI)评定.结果:治疗1个月后,2组患者上肢MAS评分均较治疗前明显下降(P<0.05),且观察组更低于对照组(P<0.05);FMA及改良Barthel指数(MBI)评分均较治疗前明显提高(P<0.05),且观察组较对照组更加显著(P<0.05).结论:上肢康复机器人训练结合常规康复治疗不仅能改善脑梗死患者上肢功能,而且能促进日常生活活动能力的恢复.

  20. Invited commentary on comparison of robotics, functional electrical stimulation, and motor learning methods for treatment of persistent upper extremity dysfunction after stroke: a randomized controlled trial.

    Science.gov (United States)

    Kwakkel, Gert; van Wegen, Erwin E; Meskers, Carel M

    2015-06-01

    In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe and colleagues report findings from their methodologically sound, dose-matched clinical trial in 39 patients beyond 6 months poststroke. In this phase II trial, the effects of 60 treatment sessions, each involving 3.5 hours of intensive practice plus either 1.5 hours of functional electrical stimulation (FES) or a shoulder-arm robotic therapy, were compared with 5 hours of intensive daily practice alone. Although no significant between-group differences were found on the primary outcome measure of Arm Motor Ability Test and the secondary outcome measure of Fugl-Meyer Arm motor score, 10% to 15% within-group therapeutic gains were on the Arm Motor Ability Test and Fugl-Meyer Arm. These gains are clinically meaningful for patients with stroke. However, the underlying mechanisms that drive these improvements remain poorly understood. The approximately $1000 cost reduction per patient calculated for the use of motor learning (ML) methods alone or combined with FES, compared with the combination of ML and shoulder-arm robotics, further emphasizes the need for cost considerations when making clinical decisions about selecting the most appropriate therapy for the upper paretic limb in patients with chronic stroke.

  1. The Axolotl Fibula as a Model for the Induction of Regeneration across Large Segment Defects in Long Bones of the Extremities.

    Directory of Open Access Journals (Sweden)

    Xiaoping Chen

    Full Text Available We tested the ability of the axolotl (Ambystoma mexicanum fibula to regenerate across segment defects of different size in the absence of intervention or after implant of a unique 8-braid pig small intestine submucosa (SIS scaffold, with or without incorporated growth factor combinations or tissue protein extract. Fractures and defects of 10% and 20% of the total limb length regenerated well without any intervention, but 40% and 50% defects failed to regenerate after either simple removal of bone or implanting SIS scaffold alone. By contrast, scaffold soaked in the growth factor combination BMP-4/HGF or in protein extract of intact limb tissue promoted partial or extensive induction of cartilage and bone across 50% segment defects in 30%-33% of cases. These results show that BMP-4/HGF and intact tissue protein extract can promote the events required to induce cartilage and bone formation across a segment defect larger than critical size and that the long bones of axolotl limbs are an inexpensive model to screen soluble factors and natural and synthetic scaffolds for their efficacy in stimulating this process.

  2. The Axolotl Fibula as a Model for the Induction of Regeneration across Large Segment Defects in Long Bones of the Extremities.

    Science.gov (United States)

    Chen, Xiaoping; Song, Fengyu; Jhamb, Deepali; Li, Jiliang; Bottino, Marco C; Palakal, Mathew J; Stocum, David L

    2015-01-01

    We tested the ability of the axolotl (Ambystoma mexicanum) fibula to regenerate across segment defects of different size in the absence of intervention or after implant of a unique 8-braid pig small intestine submucosa (SIS) scaffold, with or without incorporated growth factor combinations or tissue protein extract. Fractures and defects of 10% and 20% of the total limb length regenerated well without any intervention, but 40% and 50% defects failed to regenerate after either simple removal of bone or implanting SIS scaffold alone. By contrast, scaffold soaked in the growth factor combination BMP-4/HGF or in protein extract of intact limb tissue promoted partial or extensive induction of cartilage and bone across 50% segment defects in 30%-33% of cases. These results show that BMP-4/HGF and intact tissue protein extract can promote the events required to induce cartilage and bone formation across a segment defect larger than critical size and that the long bones of axolotl limbs are an inexpensive model to screen soluble factors and natural and synthetic scaffolds for their efficacy in stimulating this process.

  3. Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy

    Science.gov (United States)

    Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

    2011-01-01

    The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

  4. Comparison of Upper Limb Joint Forces During Straight Line and Turning Wheelchair Maneuvers

    Science.gov (United States)

    2007-11-02

    epicondyle, lateral epicondyle, radial styloid, ulnar styloid and the second metacarpophalangeal joint of the subjects [11]. Another three markers...Gellman, D. R. Chandler, L. Petrasek, I. Sie, R. Adkins, R. L. Waters, “Carpal tunnel syndrome in paraplegia patients,” J. Bone Joint Surg. Am...propulsion during fatigue,” Arch. Phys. Med. Rehabil., vol. 75, pp.85-93, 1994. [5] R. S. Burnham, R. D. Steadward, “Upper extremity peripheral nerve

  5. Archaeomagnetic study of five mounds from Upper Mesopotamia between 2500 and 700 BCE: Further evidence for an extremely strong geomagnetic field ca. 3000 years ago

    Science.gov (United States)

    Ertepinar, P.; Langereis, C. G.; Biggin, A. J.; Frangipane, M.; Matney, T.; Ökse, T.; Engin, A.

    2012-12-01

    The distribution of archaeomagnetic data in eastern Europe and the Near and Middle East shows a remarkable gap in Turkey. This study presents the first archaeomagnetic results from five different mounds in southeast Turkey, the northern part of Mesopotamia. The rock magnetic experiments indicate that in the majority of the samples the dominant magnetic carrier is magnetite, which is stable to heating to temperatures of 700 °C. In general, the demagnetization diagrams are single component and all five sets display well-defined characteristic magnetizations and clustered directions. For the period between 2500 and 700 BCE, the declinations are between 350° and 20° while inclinations are in the range of 49-64°. The directional results are compared with the global geomagnetic field models (CALS7k.2, ARCH3k_cst.1 and CALS3k.4) and the data from the archaeomagnetic database GEOMAGIA50v2. The results are coherent with both the data and the models except for two near-contemporaneous sets dating ˜2000 BCE, which are offset to the east by more than 20° with respect to CALS7k.2. Archaeointensity measurements were made using the microwave and conventional thermal Thellier methods applied to five sets of samples (four furnaces and a mud-brick wall). These yielded comparable and intriguing results. While those from the furnaces are slightly higher than the CALS7k.2 model and in agreement with the GEOMAGIA50v2 and the Middle East data, the results from the mud-brick wall suggest a high intensity of 100.8 μT (17.7×1022 Am2) at ˜1000 BCE. This result is in excellent agreement with recent claims of extremely high intensity measured in other regions of the Middle East for this time period though less consistent with these being associated with extremely short-lived events. Finally, we discuss our new and other recently published archaeointensity results in terms of geomagnetic intensity versus climate.

  6. An archaeomagnetic study of Upper Mesopotamia and Central Anatolia between 2500 and 700 BCE. Further evidence for an extremely strong geomagnetic field ca. 3000 years ago

    Science.gov (United States)

    Ertepinar, Pinar; Langereis, Cor; Biggin, Andrew; de Groot, Lennart

    2014-05-01

    The distribution of archaeomagnetic data in eastern Europe and the Near and Middle East shows a remarkable gap in Turkey. This study presents the first archaeomagnetic results from eight different archaeological sites in Central and Southeast Turkey. We sampled furnaces, burnt mud-brick walls, and granite and ignimbrite foundation stones. The rock magnetic experiments indicate that in the majority of the samples the dominant magnetic carrier is magnetite, which is stable to heating to temperatures of 700° C. In general, the demagnetization diagrams are single component and all sets display well-defined characteristic magnetizations and clustered directions. For the period between 2500 and 700 BCE, the declinations are between 350° and 20° while inclinations are in the range of 49-64° . The directional results are compared with the global geomagnetic field models (CALS7k.2, ARCH3k_cst.1 and CALS3k.4) and the data from the archaeomagnetic database GEOMAGIA50v2. The results are coherent with both the data and the models except for two near-contemporaneous sets dating ~2000 BCE, which are offset to the east by more than 20° with respect to CALS7k.2. Archaeointensity measurements were made using the microwave and conventional thermal Thellier methods, as well as the multi-specimen method. These different methods yielded comparable and intriguing results. While intensities from the furnaces are slightly higher than the CALS7k.2 model and in agreement with the GEOMAGIA50v2 and the Middle East data, the results from mud-brick walls suggest a high intensity of 100.8μT (17.7 x 1022 Am2 )at ~1000 BCE. This result is in excellent agreement with recent claims of extremely high intensity measured in other regions of the Middle East for this time period though less consistent with these being associated with extremely short-lived events. Finally, we discuss our new and other recently published archaeointensity results in terms of geomagnetic intensity versus climate.

  7. 两种不同强度上下肢训练对老年COPD患者的疗效比较%Comparison of the effect of different intensity of upper and lower extremity exercises with elderly COPD Patients

    Institute of Scientific and Technical Information of China (English)

    杜井波; 李珍; 杨炎良; 周文益; 任蕾

    2010-01-01

    目的 比较两种不同强度的上下肢训练对老年COPD患者的疗效评价.方法 采用随机分组的方法将73例稳定期老年COPD患者分为2组,分别接受2种不同强度的上下肢训练,为期12周.比较康复前后及2组患者的肺功能、6 min步行距离、基线呼吸困难指数评分、体重指数的差异及2组的脱漏率.结果 经过12周的两种不同强度的上下肢训练干预,高强度肺康复组在6 min步行距离、呼吸困难程度评分较低强度肺康复组明显改善(P<0.01);但脱漏率明显增高(P<0.05).两组的肺功能、体重指数在康复前后无明显改变.结论 对于老年稳定期COPD患者两种不同强度的上下肢训练均能改善其呼吸困难症状及运动耐力;高强度肺康复组较低强度肺康复组疗效明显;但脱漏率明显增高;而肺功能、体重指数两组在康复前后无明显改善.%Objective To compare the effect of different intensity of upper and lower extremity exercise with elderly COPD patients of pulmonary rehabilitation. Methods 73 stable elderly COPD patients were divided into two groups randomly. After a baseline multi-dimensional assessment, patients underwent a 12-week rehabilitation cycle including training higher and lower exercise intensity of the upper and lower extremities, The pulmonary function ,6-minute walking distance, baseline dyspnea index, BMI and ellipsis were evaluated and compared between pre and post-training. Results After 12-weeks of different intensity of the upper and lower extremities,compared with lower exercise intensity group, higher exercise intensity group were improved significantly on 6minute walking distance and dyspneic symptom( P < 0.01 ), but lost were high (P < 0.05 ). The pulmonary function, BMI were not increased between pre and post-training. Conclusion The two different intensity of the upper and lower extremities were proved to be effective for improving the dyspneic symptoms and exercise

  8. Upper extremity injury management by non-physician emergency practitioners in rural Uganda: A pilot study

    Directory of Open Access Journals (Sweden)

    Daniel S. Frank

    2014-03-01

    Conclusions: When compared to the standardised Quick DASH outcomes (no work limitation at 27.5 vs. work limited by injury at 52.6 the non-physician clinicians appear to be performing upper extremity repairs with good outcomes. The key variable to successful repair was the initial injury type. Although accommodations needed to be made to the standard Quick DASH protocol, the tool appears to be usable in non-traditional settings.

  9. Fatigue, bone pain, lower extremity weakness and bone mineral density%乏力、骨痛、双下肢酸软与骨密度

    Institute of Scientific and Technical Information of China (English)

    徐秀兰; 陈莉; 张童茜; 施宝颖

    2011-01-01

    Objective To explore the relationship among fatigue, bone pain, weakness in both lower extremities, and bone mineral density. Methods The bone mineral density of the lumbar vertebra 1-4 ( LI -4) and the femoral neck was measured in 2069 clinical patients with fatigue, bone pain, and weakness in both lower extremities. Results Most patients with above symptoms were women, especially those who were over SO years of age. Most patients existed abnormal bone mass. The lower the bone mass wag, the more severe the pain was. The incidence of osteoporosis increased with age growing.%目的 探讨乏力、骨痛、双下肢酸软等症状与骨密度的关系.方法 对2069名以乏力、骨痛及双下肢酸软临床症状就诊者进行了腰椎( L1-4)及股骨颈骨密度测定.结果 以此症状就诊者女性居多,且以50岁为甚,就诊者中大多存在着骨量异常,骨量越低,疼痛程度越重,随着年龄增大,骨质疏松发病率也随之增高.结论 疼痛程度与骨量下降、年龄增长成正比.

  10. Dating of cremated bones

    NARCIS (Netherlands)

    Lanting, JN; Aerts-Bijma, AT; van der Plicht, J; Boaretto, E.; Carmi, I.

    2001-01-01

    When dating unburnt bone, bone collagen, the organic fraction of the bone, is used. Collagen does not survive the heat of the cremation pyre, so dating of cremated bone has been considered impossible. Structural carbonate in the mineral fraction of the bone, however, survives the cremation process.

  11. Harvesting olecranon bone graft in adults by using bone biopsy trephine

    Directory of Open Access Journals (Sweden)

    Fatih Kabakas

    2016-08-01

    Conclusion: Bone graft harvesting with trephine is technically easy and fast, and donor site morbidity is diminished compared other methods and donor sites. It can be performed under axillary anesthesia and provides adequate amounts of bone graft for upper extremity reconstructions. [Hand Microsurg 2016; 5(2.000: 44-49

  12. Statistics of extremes

    CERN Document Server

    Gumbel, E J

    2012-01-01

    This classic text covers order statistics and their exceedances; exact distribution of extremes; the 1st asymptotic distribution; uses of the 1st, 2nd, and 3rd asymptotes; more. 1958 edition. Includes 44 tables and 97 graphs.

  13. Principios de evaluación y resultados funcionales en los reimplantes de miembro superior Principles of evaluation and functional results in upper extremity replantation surgery

    Directory of Open Access Journals (Sweden)

    D. Camporro Fernández

    2012-09-01

    Full Text Available El objetivo de este trabajo es evaluar nuestros resultados funcionales y subjetivos en pacientes sometidos a reimplante de miembro superior. Medimos rango de movilidad articular, fuerza de la prensión y otros tests en 41 pacientes con edad media 44,8 años que sufrieron amputación de miembro superior y fueron sometidos a reimplante quirúrgico en nuestro hospital entre enero del 2005 y diciembre del 2009. Los resultados funcionales se midieron con la tabla de Mayo modificada para lesiones de pulgar, dedos largos y mano, distal a muñeca. Las amputaciones proximales a muñeca se evaluaron según los criterios de Chen. Los resultados subjetivos fueron documentados aplicando a todos los casos el cuestionario de Russell. La mayoría de las lesiones fueron provocadas por mecanismos de avulsión y 30 (74 % fueron accidentes laborales. La tasa final de supervivencia fue del 85 % (35 pacientes incluyendo 2 pacientes en los que se realizó trasplante de pie a mano para salvar la amputación. Aplicando la tabla de Mayo modificada, los resultados fueron buenos en pulgar y discretos en mano y dedos largos. En reimplantes proximales obtuvimos 1 resultado excelente y 2 discretos. Diecinueve pacientes retornaron al mundo laboral en una media de 10 meses. Veintisiete manifiestan satisfacción alta con los resultados obtenidos. Los resultados de cualquier reimplante deben superar los del cierre simple de una amputación. Aunque los resultados objetivos de la serie son moderados, muchos pacientes retornan al trabajo y la mayoría es capaz de realizar sus actividades cotidianas.The aim of this study was to evaluate functional and subjective outcome after upper limb replantation, with assessment or range of motions, grip strength, and additional functional tests. Forty-one patients, mean age 44.8 years old, with upper limb amputations were treated in our hospital with replantation between January 2005 and December 2009. Functional results were assessed by

  14. Arm positions and movement analysis that are used on the upper extremity in Bolu women dances

    Directory of Open Access Journals (Sweden)

    Nihal Ötken

    2011-07-01

    Full Text Available Folk dances are the cultural products that are created by the people and transferred from generation to generation. These cultural products have a very rich variety that differ from region to region, in terms of style and type. These differences are tight-knit with the past, civilization level, beliefs and traditions of a society which creates every dance. These differences also reveal themselves on elements, such as the movement styles used during the dance, dance forms, the accompanying music, rhythm and costume. Thus, the differences that are seen on all of these factors appear as the dance richness. Being a part of this richness, Bolu women dances have a remarkable significance among the folk dances, as well. The process of recording and analysing the movement scientifically has been made with a gradually increasing consciousness in also folk dances, just like in all other disciplines related to the body. Considering that our folk dances have been changing each passing day as a part of the tradition as well, it is inevitable to determine our existing dances in terms of all of the elements that constitute them and hand them down the next generations. Therefore, some of the women dances of the region of Bolu, Which is a small city in Turkey, will be discussed in terms of the factor of movement that constitutes the dance and examined in this article. The arm positions that are used on the upper extremity which is one of the main parts of the body in the dances of Adayolu, Men men, Karaköy Sekmesi, Ziller, Estireyim mi, Halimem, Değirmen and Ördek that are still being performed by women in the center and villages of Bolu, were determined through being assessed via some video images that are shot during various shows and competitions. These determined positions were exposed by digital camera records that were taken for this study one by one and the determined visual material was computerized with the help of various programs. After this

  15. Arm positions and movement analysis that are used on the upper extremity in Bolu women dances

    Directory of Open Access Journals (Sweden)

    Nihal Ötken

    2011-07-01

    Full Text Available Folk dances are the cultural products that are created by the people and transferred from generation to generation. These cultural products have a very rich variety that differs from region to region, in terms of style and type. These differences are tight-knit with the past, civilization level, beliefs and traditions of a society which creates every dance. These differences also reveal themselves on elements, such as the movement styles used during the dance, dance forms, the accompanying music, rhythm and costume. Thus, the differences that are seen on all of these factors appear as the dance richness. Being a part of this richness, Bolu women dances have a remarkable significance among the folk dances, as well.The process of recording and analyzing the movement scientifically has been made with a gradually increasing consciousness in also folk dances, just like in all other disciplines related to the body. Considering that our folk dances have been changing each passing day as a part of the tradition as well, it is inevitable to determine our existing dances in terms of all of the elements that constitute them and hand them down the next generations. Therefore, some of the women dances of the region of Bolu, Which is a small city in Turkey, will be discussed in terms of the factor of movement that constitutes the dance and examined in this article. The arm positions that are used on the upper extremity which is one of the main parts of the body in the dances of Adayolu, Men men, Karaköy Sekmesi, Ziller, Estireyim mi, Halimem, Değirmen and Ördek that are still being performed by women in the center and villages of Bolu, were determined through being assessed via some video images that are shot during various shows and competitions. These determined positions were exposed by digital camera records that were taken for this study one by one and the determined visual material was computerized with the help of various programs. After this phase

  16. Upper Extremity Motor Learning among Individuals with Parkinson's Disease: A Meta-Analysis Evaluating Movement Time in Simple Tasks

    Directory of Open Access Journals (Sweden)

    K. Felix

    2012-01-01

    Full Text Available Motor learning has been found to occur in the rehabilitation of individuals with Parkinson's disease (PD. Through repetitive structured practice of motor tasks, individuals show improved performance, confirming that motor learning has probably taken place. Although a number of studies have been completed evaluating motor learning in people with PD, the sample sizes were small and the improvements were variable. The purpose of this meta-analysis was to determine the ability of people with PD to learn motor tasks. Studies which measured movement time in upper extremity reaching tasks and met the inclusion criteria were included in the analysis. Results of the meta-analysis indicated that people with PD and neurologically healthy controls both demonstrated motor learning, characterized by a decrease in movement time during upper extremity movements. Movement time improvements were greater in the control group than in individuals with PD. These results support the findings that the practice of upper extremity reaching tasks is beneficial in reducing movement time in persons with PD and has important implications for rehabilitation.

  17. Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy: A New Strategy for Improving Upper Extremity Function in Patients with Hemiparesis following Stroke

    Directory of Open Access Journals (Sweden)

    Toshiyuki Fujiwara

    2017-01-01

    Full Text Available Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS therapy is one of the neurorehabilitation therapeutic approaches that facilitates the use of the paretic upper extremity (UE in daily life by combining closed-loop electromyography- (EMG- controlled neuromuscular electrical stimulation (NMES with a wrist-hand splint. This closed-loop EMG-controlled NMES can change its stimulation intensity in direct proportion to the changes in voluntary generated EMG amplitudes recorded with surface electrodes placed on the target muscle. The stimulation was applied to the paretic finger extensors. Patients wore a wrist-hand splint and carried a portable stimulator in an arm holder for 8 hours during the daytime. The system was active for 8 hours, and patients were instructed to use their paretic hand as much as possible. HANDS therapy was conducted for 3 weeks. The patients were also instructed to practice bimanual activities in their daily lives. Paretic upper extremity motor function improved after 3 weeks of HANDS therapy. Functional improvement of upper extremity motor function and spasticity with HANDS therapy is based on the disinhibition of the affected hemisphere and modulation of reciprocal inhibition. HANDS therapy may offer a promising option for the management of the paretic UE in patients with stroke.

  18. Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy: A New Strategy for Improving Upper Extremity Function in Patients with Hemiparesis following Stroke

    Science.gov (United States)

    Honaga, Kaoru; Tochikura, Michi; Abe, Kaoru

    2017-01-01

    Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS) therapy is one of the neurorehabilitation therapeutic approaches that facilitates the use of the paretic upper extremity (UE) in daily life by combining closed-loop electromyography- (EMG-) controlled neuromuscular electrical stimulation (NMES) with a wrist-hand splint. This closed-loop EMG-controlled NMES can change its stimulation intensity in direct proportion to the changes in voluntary generated EMG amplitudes recorded with surface electrodes placed on the target muscle. The stimulation was applied to the paretic finger extensors. Patients wore a wrist-hand splint and carried a portable stimulator in an arm holder for 8 hours during the daytime. The system was active for 8 hours, and patients were instructed to use their paretic hand as much as possible. HANDS therapy was conducted for 3 weeks. The patients were also instructed to practice bimanual activities in their daily lives. Paretic upper extremity motor function improved after 3 weeks of HANDS therapy. Functional improvement of upper extremity motor function and spasticity with HANDS therapy is based on the disinhibition of the affected hemisphere and modulation of reciprocal inhibition. HANDS therapy may offer a promising option for the management of the paretic UE in patients with stroke. PMID:28191352

  19. Upper Extremity Functional Evaluation by Fugl-Meyer Assessment Scoring Using Depth-Sensing Camera in Hemiplegic Stroke Patients.

    Directory of Open Access Journals (Sweden)

    Won-Seok Kim

    Full Text Available Virtual home-based rehabilitation is an emerging area in stroke rehabilitation. Functional assessment tools are essential to monitor recovery and provide current function-based rehabilitation. We developed the Fugl-Meyer Assessment (FMA tool using Kinect (Microsoft, USA and validated it for hemiplegic stroke patients. Forty-one patients with hemiplegic stroke were enrolled. Thirteen of 33 items were selected for upper extremity motor FMA. One occupational therapist assessed the motor FMA while recording upper extremity motion with Kinect. FMA score was calculated using principal component analysis and artificial neural network learning from the saved motion data. The degree of jerky motion was also transformed to jerky scores. Prediction accuracy for each of the 13 items and correlations between real FMA scores and scores using Kinect were analyzed. Prediction accuracies ranged from 65% to 87% in each item and exceeded 70% for 9 items. Correlations were high for the summed score for the 13 items between real FMA scores and scores obtained using Kinect (Pearson's correlation coefficient = 0.873, P<0.0001 and those between total upper extremity scores (66 in full score and scores using Kinect (26 in full score (Pearson's correlation coefficient = 0.799, P<0.0001. Log transformed jerky scores were significantly higher in the hemiplegic side (1.81 ± 0.76 compared to non-hemiplegic side (1.21 ± 0.43 and showed significant negative correlations with Brunnstrom stage (3 to 6; Spearman correlation coefficient = -0.387, P = 0.046. FMA using Kinect is a valid way to assess upper extremity function and can provide additional results for movement quality in stroke patients. This may be useful in the setting of unsupervised home-based rehabilitation.

  20. Upper Extremity Functional Evaluation by Fugl-Meyer Assessment Scoring Using Depth-Sensing Camera in Hemiplegic Stroke Patients.

    Science.gov (United States)

    Kim, Won-Seok; Cho, Sungmin; Baek, Dongyoub; Bang, Hyunwoo; Paik, Nam-Jong

    2016-01-01

    Virtual home-based rehabilitation is an emerging area in stroke rehabilitation. Functional assessment tools are essential to monitor recovery and provide current function-based rehabilitation. We developed the Fugl-Meyer Assessment (FMA) tool using Kinect (Microsoft, USA) and validated it for hemiplegic stroke patients. Forty-one patients with hemiplegic stroke were enrolled. Thirteen of 33 items were selected for upper extremity motor FMA. One occupational therapist assessed the motor FMA while recording upper extremity motion with Kinect. FMA score was calculated using principal component analysis and artificial neural network learning from the saved motion data. The degree of jerky motion was also transformed to jerky scores. Prediction accuracy for each of the 13 items and correlations between real FMA scores and scores using Kinect were analyzed. Prediction accuracies ranged from 65% to 87% in each item and exceeded 70% for 9 items. Correlations were high for the summed score for the 13 items between real FMA scores and scores obtained using Kinect (Pearson's correlation coefficient = 0.873, Phemiplegic side (1.81 ± 0.76) compared to non-hemiplegic side (1.21 ± 0.43) and showed significant negative correlations with Brunnstrom stage (3 to 6; Spearman correlation coefficient = -0.387, P = 0.046). FMA using Kinect is a valid way to assess upper extremity function and can provide additional results for movement quality in stroke patients. This may be useful in the setting of unsupervised home-based rehabilitation.

  1. The MR trainer. Upper extremities. 2. rev. and enl. ed.; Der MR-Trainer. Obere Extremitaet

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, Martin [Landesklinikum Waldviertel Horn (Austria). Inst. fuer Radiologie und Interventionelle Radiologie

    2016-05-01

    The MR (magnetic resonance) trainer covers the indications in NMR images of hands, elbows and shoulder, including fractures and instabilities at the wrist, tendon and ligament lesions, carpal tunnel syndrome, ulnar tunnel syndrome, scaphoid bone fracture, (posttraumatic) osteonecrosis, synovial lesions, luxations, osteocondrosis, soft tissue rumors and bone tumors. The book includes training tasks for each issue.

  2. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports.

    Science.gov (United States)

    Escamilla, Rafael F; Andrews, James R

    2009-01-01

    Understanding when and how much shoulder muscles are active during upper extremity sports is helpful to physicians, therapists, trainers and coaches in providing appropriate treatment, training and rehabilitation protocols to these athletes. This review focuses on shoulder muscle activity (rotator cuff, deltoids, pectoralis major, latissimus dorsi, triceps and biceps brachii, and scapular muscles) during the baseball pitch, the American football throw, the windmill softball pitch, the volleyball serve and spike, the tennis serve and volley, baseball hitting, and the golf swing. Because shoulder electromyography (EMG) data are far more extensive for overhead throwing activities compared with non-throwing upper extremity sports, much of this review focuses on shoulder EMG during the overhead throwing motion. Throughout this review shoulder kinematic and kinetic data (when available) are integrated with shoulder EMG data to help better understand why certain muscles are active during different phases of an activity, what type of muscle action (eccentric or concentric) occurs, and to provide insight into the shoulder injury mechanism. Kinematic, kinetic and EMG data have been reported extensively during overhead throwing, such as baseball pitching and football passing. Because shoulder forces, torques and muscle activity are generally greatest during the arm cocking and arm deceleration phases of overhead throwing, it is believed that most shoulder injuries occur during these phases. During overhead throwing, high rotator cuff muscle activity is generated to help resist the high shoulder distractive forces approximately 80-120% bodyweight during the arm cocking and deceleration phases. During arm cocking, peak rotator cuff activity is 49-99% of a maximum voluntary isometric contraction (MVIC) in baseball pitching and 41-67% MVIC in football throwing. During arm deceleration, peak rotator cuff activity is 37-84% MVIC in baseball pitching and 86-95% MVIC in football

  3. SWALLOWED FISH BONES IN MALI

    Directory of Open Access Journals (Sweden)

    Sacko HB

    2015-07-01

    Full Text Available Objective: To study the different aspects, clinical, diagnostic and therapeutic of 114 cases of fish bones in the upper digestive tract . Methods: One hundred fourteen patients with fish bones suspected in the upper digestive tract were admitted in our department between February 2010 and October 2012. Results: There was a predominance of the male: 66 men (58%. The average age of the patients was 26 years with extremes 3 to 62 years old. The tongue base and vallecula are constituted the principals locations 66.66%. In the majority of the cases the fish bones were removed by direct pharyngoscopy in 43.86 %. We have not notified any serious complications. Conclusion: Therefore this study shows the foreign fish bones are frequently just as well in children as adult. The fish bones are particularly lodged in tongue base. The classical methods of extraction are permit to remove the all foreign fish bones.

  4. OrthoJacket: an active FES-hybrid orthosis for the paralysed upper extremity.

    Science.gov (United States)

    Schill, Oliver; Wiegand, Roland; Schmitz, Bastian; Matthies, Richard; Eck, Ute; Pylatiuk, Christian; Reischl, Markus; Schulz, Stefan; Rupp, Rüdiger

    2011-02-01

    The loss of the grasp function in cervical spinal cord injured (SCI) patients leads to life-long dependency on caregivers and to a tremendous decrease of the quality of life. This article introduces the novel non-invasive modular hybrid neuro-orthosis OrthoJacket for the restoration of the restricted or completely lost hand and arm functions in high tetraplegic SCI individuals. The primary goal of the wearable orthosis is to improve the paralysed upper extremity function and, thus, to enhance a patient's independence in activities of daily living. The system combines the advantage of orthotics in mechanically stabilising joints together with the possibilities of functional electrical stimulation for activation of paralysed muscles. In patients with limited capacity, for force generation, flexible fluidic actuators are used to support the movement. Thus, the system is not only intended for functional restoration but also for training. Several sensor systems together with an intelligent signal processing allow for automatic adaptation to the anatomical and neurological individualities of SCI patients. The integration of novel user interfaces based on residual muscle activities and detection of movement intentions by real-time data mining methods will enable the user to autonomously control the system in a natural and cooperative way.

  5. [Remote intelligent Brunnstrom assessment system for upper limb rehabilitation for post-stroke based on extreme learning machine].

    Science.gov (United States)

    Wang, Yue; Yu, Lei; Fu, Jianming; Fang, Qiang

    2014-04-01

    In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.

  6. Video Recording With a GoPro in Hand and Upper Extremity Surgery.

    Science.gov (United States)

    Vara, Alexander D; Wu, John; Shin, Alexander Y; Sobol, Gregory; Wiater, Brett

    2016-10-01

    Video recordings of surgical procedures are an excellent tool for presentations, analyzing self-performance, illustrating publications, and educating surgeons and patients. Recording the surgeon's perspective with high-resolution video in the operating room or clinic has become readily available and advances in software improve the ease of editing these videos. A GoPro HERO 4 Silver or Black was mounted on a head strap and worn over the surgical scrub cap, above the loupes of the operating surgeon. Five live surgical cases were recorded with the camera. The videos were uploaded to a computer and subsequently edited with iMovie or the GoPro software. The optimal settings for both the Silver and Black editions, when operating room lights are used, were determined to be a narrow view, 1080p, 60 frames per second (fps), spot meter on, protune on with auto white balance, exposure compensation at -0.5, and without a polarizing lens. When the operating room lights were not used, it was determined that the standard settings for a GoPro camera were ideal for positioning and editing (4K, 15 frames per second, spot meter and protune off). The GoPro HERO 4 provides high-quality, the surgeon perspective, and a cost-effective video recording of upper extremity surgical procedures. Challenges include finding the optimal settings for each surgical procedure and the length of recording due to battery life limitations.

  7. 上肢深度烧伤肌皮瓣修复术35例护理体会%Flap myocutaneous flap to repair the upper extremity deep burn patients during operation period nursing points of

    Institute of Scientific and Technical Information of China (English)

    谭海燕

    2014-01-01

    目的:总结上肢深度烧伤患者采用皮瓣肌皮瓣修复围手术期护理要点。方法选取我院2012年10月-2013年10月收治的经皮瓣肌皮瓣修复上肢深度烧伤患者35例,给予其心理护理、皮肤准备、控制感染、疼痛护理、皮瓣观察与护理、功能锻炼等全面性护理。结果本组35例患者经护理后,30例Ⅰ期愈合,4例Ⅱ期愈合,1例皮瓣坏死。结论全面性护理是上肢深度烧伤皮瓣肌皮瓣修复术成功的有力保障。%Objective Explore the depth of the burn patients with upper limb muscle flap flap perioperative care points. Method Our hospital in October 2012, October 2013 received by the muscle flap flap 35 patients with upper extremity deep burn, given its psychological care, skin preparation, control infection, pain care, observation and nursing flaps, functional exercise and other comprehensive care. Results The group of 35 patients after treatment, 30 cases of healing Ⅰ,4 cases of healingⅡ,1 case of flap necrosis. Conclusion Upper limb muscle flap flap given the depth of burn patients comprehensive care, can accelerate wound healing and reduce the incidence of complications.

  8. Upper extremity limb loss: functional restoration from prosthesis and targeted reinnervation to transplantation.

    Science.gov (United States)

    Carlsen, Brian T; Prigge, Pat; Peterson, Jennifer

    2014-01-01

    For several decades, prosthetic use was the only option to restore function after upper extremity amputation. Recent years have seen advances in the field of prosthetics. Such advances include prosthetic design and function, activity-specific devices, improved aesthetics, and adjunctive surgical procedures to improve both form and function. Targeted reinnervation is one exciting advance that allows for more facile and more intuitive function with prosthetics following proximal amputation. Another remarkable advance that holds great promise in nearly all fields of medicine is the transplantation of composite tissue, such as hand and face transplantation. Hand transplantation holds promise as the ultimate restorative procedure that can provide form, function, and sensation. However, this procedure still comes with a substantial cost in terms of the rehabilitation and toxic immunosuppression and should be limited to carefully selected patients who have failed prosthetic reconstruction. Hand transplantation and prosthetic reconstruction should not be viewed as competing options. Rather, they are two treatment options with different risk/benefit profiles and different indications and, hence vastly different implications.

  9. Study of treating tibial large bone defect with migration of lengthened bone segment in goats

    Institute of Scientific and Technical Information of China (English)

    YANG liu; LI Qi-hong; ZHOU Zhong-an; TAN Zu-jian; PENG Yi-liang

    2001-01-01

    To study the effects of migration of lengthened bone segment (MLBS) on the blood circulation and repair remodeling process at the ends of large bone defect of a long bone. Methods: A total of 18 adult goats were used and more than 35% of the original length of their left tibia was resected. Upper metaphysiotomy to lengthen upper part of the tibia was done and the lengthened bone segment was migrated to repair the large bone defect. The results were observed with X-ray films, Chinese-ink permeated transparent sections and histological study. Results: After MLBS, the defect ends of the tibia were supplied with abundant blood circulation which resulted in rapid and solid long bone healing. Conclusion: Repair of large bone defect of long bones with MLBS provides a new method for clinical practice.

  10. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.

    2015-04-10

    Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event of interest may be very limited, efficient methods of inference play an important role. This article reviews this domain, emphasizing current research topics. We first sketch the classical theory of extremes for maxima and threshold exceedances of stationary series. We then review multivariate theory, distinguishing asymptotic independence and dependence models, followed by a description of models for spatial and spatiotemporal extreme events. Finally, we discuss inference and describe two applications. Animations illustrate some of the main ideas. © 2015 by Annual Reviews. All rights reserved.

  11. Precursors of extreme increments

    CERN Document Server

    Hallerberg, S; Holstein, D; Kantz, H; Hallerberg, Sarah; Altmann, Eduardo G.; Holstein, Detlef; Kantz, Holger

    2006-01-01

    We investigate precursors and predictability of extreme events in time series, which consist in large increments within successive time steps. In order to understand the predictability of this class of extreme events, we study analytically the prediction of extreme increments in AR(1)-processes. The resulting strategies are then applied to predict sudden increases in wind speed recordings. In both cases we evaluate the success of predictions via creating receiver operator characteristics (ROC-plots). Surprisingly, we obtain better ROC-plots for completely uncorrelated Gaussian random numbers than for AR(1)-correlated data. Furthermore, we observe an increase of predictability with increasing event size. Both effects can be understood by using the likelihood ratio as a summary index for smooth ROC-curves.

  12. 作业疗法对脑卒中患者上肢运动功能的影响%Effect of Occupational Therapy on Upper Extremity Function in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    邸叶青; 韩振萍; 马将

    2011-01-01

    Objective: To investigate the effect of occupational therapy on stroke patients with motor dysfunction of upper extremities. Methods: Forty patients with stoke, aged from 60 to 75 years, were randomly divided into the occupational therapy group (n= 20) and control group (n = 20). Both two groups received exercise therapy, including active movement,passive movement and motor imagery therapy, etc. Besides, patients in the occupational therapy group received occupational therapy additionally, including the training of control ability of upper limbs, the training of ROM and the training of mental movement. The motor function of upper extremities was evaluated by Fugl-Meyer Assessment (FMA) before and 2, 4, 8 weeks after treatment. Results: The scores of FMA in occupational therapy group were continually increased from 2nd week, 8th week>4th week>2nd week (P<0. 05 ). The scores of FMA in control group were increased from 4th week (P<0.05). The scores of FMA in occupational therapy group were significantly higher than in control group at each time point (P<0.05 or P<0.01). Conclusion: Early intervention of occupational therapy in stroke patients with hemiplegia can provide positive effects on recovery of upper extremities function.%目的:比较两种不同的康复治疗技术对存在有上肢运动功能障碍的脑卒中患者的治疗作用.方法:40例脑卒中患者随机分为作业组和对照组各20例,均配合运动疗法,包括主被动运动,运动想象等.作业组增加作业疗法,主要内容为上肢控制能力、关节活动度及精细动作训练.训练前及训练2、4、6及8周时均采用Fugl-Meyer评定量表(FMA)对2组患者上肢运动功能评分.结果:与训练前比较,作业组在介入训练2周后FMA评分持续上升,8周>4周>2周;对照组在训练4周后FMA评分开始上升,作业组在各训练时间段FMA评分均高于对照组(均P<0.05,0.01).结论:早期介入作业疗法对脑卒中偏瘫患者

  13. 体位固定法在婴幼儿上肢静脉穿刺中的应用效果评价%Effect evaluation of position fixed method on application of infant's upper extremity venous puneture

    Institute of Scientific and Technical Information of China (English)

    杨明珊; 陈环; 梁芳娟; 黄五星; 蔡小梅

    2013-01-01

    Objective To explore the clinical effect of immobilization applications in upper extremity venous puncture in infants.Methods Six hundreds infants who accepted infusion therapy in hospital outpatient were chosen and randomly divided into the experimental group with odd outpatient number and the control group with even outpatient number,each with 300 cases.The experimental group used immobilization in upper extremity venous puncture while the control group used a random postural,and two groups'success rate of the first puncture,nurses'confidence in vein puncture as well as the satisfaction of the patients'family were compared.Results Success rate of the first puncture,nurses'confidence in vein puncture and satisfaction of the patients'family were 92%,96%,95% respectively in experimental group and 75%,72%,76% in control group,the differences were statistically significant (x2 =31.5,43.6,45.6;P <0.01).Conclusions Immobilization applications in upper extremity venous puncture in infants could increase success rate of the first puncture,nurses'confidence in vein puncture,and satisfaction of the patients'family.It is a simple and practical method.%目的 探讨体位固定在婴幼儿上肢静脉穿刺中的应用效果.方法 选取门诊输液治疗的600例婴幼儿,按门诊号的单双分为观察组及对照组各300例,观察组应用体位固定法进行上肢静脉穿刺,对照组进行上肢静脉穿刺时不固定体位,比较两组一针穿刺的成功率、护士对静脉穿刺的信心及家属对护士的满意度.结果 观察组一针穿刺成功率为92%,护士对静脉穿刺的信心为96%,家属对护士的满意度为95%,均明显高于对照组(75%,72%,76%),两组比较差异有统计学意义(x2值分别为31.5,43.6,45.6;P<0.01).结论 婴幼儿静脉输液选择体位固定法进行上肢静脉穿刺,能提高静脉一针穿刺成功率、护士静脉穿刺的信心及家属的满意度.

  14. Effects of denosumab on bone mineral density and bone turnover in postmenopausal women.

    Science.gov (United States)

    Wensel, Terri M; Iranikhah, Maryam M; Wilborn, Teresa W

    2011-05-01

    Osteoporosis is a degenerative bone disease affecting approximately 10 million American adults. Several options are available to prevent development of the disease or slow and even stop its progression. Nonpharmacologic measures include adequate intake of calcium and vitamin D, exercise, fall prevention, and avoidance of tobacco and excessive alcohol intake. Current drug therapy includes bisphosphonates, calcitonin, estrogen or hormone therapy, selective estrogen receptor modulators, and teriparatide. Denosumab, a receptor activator of nuclear factor-K B ligand (RANKL) inhibitor, was recently approved by the United States Food and Drug Administration for treatment of postmenopausal osteoporosis. Patients treated with denosumab experienced significant gains in bone mineral density, rapid reductions in markers of bone turnover, and a reduced risk for new vertebral fracture. Compared with placebo, patients receiving denosumab 60 mg subcutaneously once every 6 months experienced gains in bone mineral density of 6.5-11% when treated for 24-48 months. One trial demonstrated the superiority of denosumab compared with alendronate, but the differences were small. The most common adverse reactions to denosumab include back pain, pain in extremities, musculoskeletal pain, and cystitis. Serious, but rare, adverse reactions include the development of serious infections, dermatologic changes, and hypocalcemia. The recommended dosing of denosumab is 60 mg every 6 months as a subcutaneous injection in the upper arm, upper thigh, or abdomen. Although beneficial effects on bone mineral density and fracture rate have been established in clinical trials, the risks associated with denosumab must be evaluated before therapy initiation. Of concern is the risk of infection, and denosumab should likely be avoided in patients taking immunosuppressive therapy or at high risk for infection. Therefore, bisphosphonates will likely remain as first-line therapy. Denosumab should be considered in

  15. Estimation of levels of radiation in the upper and lower extremities of interventional physicians;Estimativa dos niveis de radiacao nas extremidades superiores e inferiores de medicos intervencionistas

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, B.B.O. [Universidade Federal do Rio de Janeiro (PEN/COPPE/UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-Graduacao de Engenharia. Programa de Energia Nuclear; Lima, A.L.S.; Silva, M.W.; Mione, F.R.; Canevaro, L.V.; Mauricio, C.L.P. [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    Interventional cardiology procedures are, in general, associated with high doses in patients and professionals. The objective of this study is to measure the radiation levels on the hands and left knees of professionals. The professional dosimetry was performed in three departments of hemodynamics of Rio de Janeiro in procedures of coronary angiography of percutaneous transluminal coronary angioplasty (PTCA) and electrophysiology. For this, we used thermoluminescent dosimeters of LiF: Mg, Ti to monitor the knee and left wrist of professional. The results show a higher dose of radiation in the left knee on the left wrist. This is due to the proximity of the X-ray tube. The lack of an adequate quality control in equipment can raise the levels of exposure of professionals. Due to the non-homogeneous exposure of professionals, in some cases it is recommended the use of additional dosimeters and quality control in the X-ray equipment. (author)

  16. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    . A theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

  17. Orchestration of bone remodeling

    NARCIS (Netherlands)

    Moester, Martiene Johanna Catharina

    2014-01-01

    In healthy individuals, a balance exists between bone formation and resorption. Disruption of this balance can lead to higher or lower bone mass, and disease such as osteoporosis. Treatment for osteoporosis generally inhibits bone resorption, but does not rebuild bone to a healthy strength. More kno

  18. The effects of a 12-week program of static upper extremity weight bearing exercises on weight bearing in children with hemiplegic type of cerebral palsy

    Directory of Open Access Journals (Sweden)

    P. Jayaraman

    2010-02-01

    Full Text Available The  major  objective  of  this  study  was  to  quantify  the  effects  of a  12-week  program  of  weight  bearing  exercises  on  weight  borne  through  the hand and grip pressures in children with hemiplegic cerebral palsy. This study also sought to monitor the change in spasticity immediately following weight-bearing  exercises.  A  quasi-experimental,  one  group  pre-test,  post-test  study  was used. Eleven children with hemiplegic type of cerebral palsy from a special school in KwaZulu Natal participated after fully informed written consent. The intervention consisted of a 12-week program of weight bearing. The Tekscan Grip system was used to quantify weight borne through the hand during extended arm prone and quadruped positions and whilst holding a pencil and a tumbler. The modified Ashworth grading of spasticity was used to monitor spasticity. The data was analysed using the random effects GLS model Wald Chi Square test. Significant increases in contact pressure in extended arms prone (p=0,012 and quadruped (p=0,002 and when holding a pencil (p=0,045 was noted post-test compared to pre-test. Significant increases in contact area of the hand was also noted in prone (p=0,000, quadruped (p=0, 03 at assessment 7 and when holding a pencil (p=0,035.  A significant decrease in spasticity during elbow extension (p=0,004, and wrist flexion (p=0,026 and extension (p=0,004 was noted. An overall significant effect of static weight bearing exercises on weight borne through the hands, grip strength and spasticity justifies the use of static weight-bearing in therapy.

  19. Multiscale Modeling of Bone

    Science.gov (United States)

    2014-12-01

    DISEASE Both age and disease can affect the structure of bone, the effects of which are often similar. The most common bone disease is osteoporosis ... Osteoporosis is a disease that results in reduced bone mass and density. This reduction of bone mass and density has a greater impact on trabecular...Bone loss in females is linked to a decrease in estrogen ; the decrease of estrogen associated with menopause increases osteoclast activity [89]. This

  20. Hormonal and neuromuscular responses to mechanical vibration applied to upper extremity muscles.

    Directory of Open Access Journals (Sweden)

    Riccardo Di Giminiani

    Full Text Available OBJECTIVE: To investigate the acute residual hormonal and neuromuscular responses exhibited following a single session of mechanical vibration applied to the upper extremities among different acceleration loads. METHODS: Thirty male students were randomly assigned to a high vibration group (HVG, a low vibration group (LVG, or a control group (CG. A randomized double-blind, controlled-parallel study design was employed. The measurements and interventions were performed at the Laboratory of Biomechanics of the University of L'Aquila. The HVG and LVG participants were exposed to a series of 20 trials ×10 s of synchronous whole-body vibration (WBV with a 10-s pause between each trial and a 4-min pause after the first 10 trials. The CG participants assumed an isometric push-up position without WBV. The outcome measures were growth hormone (GH, testosterone, maximal voluntary isometric contraction during bench-press, maximal voluntary isometric contraction during handgrip, and electromyography root-mean-square (EMGrms muscle activity (pectoralis major [PM], triceps brachii [TB], anterior deltoid [DE], and flexor carpi radialis [FCR]. RESULTS: The GH increased significantly over time only in the HVG (P = 0.003. Additionally, the testosterone levels changed significantly over time in the LVG (P = 0.011 and the HVG (P = 0.001. MVC during bench press decreased significantly in the LVG (P = 0.001 and the HVG (P = 0.002. In the HVG, the EMGrms decreased significantly in the TB (P = 0.006 muscle. In the LVG, the EMGrms decreased significantly in the DE (P = 0.009 and FCR (P = 0.006 muscles. CONCLUSION: Synchronous WBV acutely increased GH and testosterone serum concentrations and decreased the MVC and their respective maximal EMGrms activities, which indicated a possible central fatigue effect. Interestingly, only the GH response was dependent on the acceleration with respect to the subjects' responsiveness.

  1. 青少年上肢远端肌萎缩症临床解剖及MRI特点%Juvenile muscular atrophy of the distal upper extremity: clinical anatomy and MRI study

    Institute of Scientific and Technical Information of China (English)

    梁秋发; 王文军; 刘文松; 王麓山; 孟红旗; 陈圣龙

    2012-01-01

    Objective To study clinical characteristics of juvenile muscular atrophy of the distal upper extremity, for early diagnosis and treatment. Methods The clinical data, neuro-electrophysiological features, clinical anatomy and MRI features of 13 patients diagnosed by the criteria of Hirayama Disease were retrospectively analyzed. Results The mean age of onset was about 18.6 years old. Hirayama disease was characterized by muscular atrophy in the hand and forearm. The brachioradialis was spared (oblique amyotrophy). EMG indicated that the impairment of spinal anterior cells was limited to the arm relevant segments and both sides were involved. During neck flexion, the spinal cord was placed forward and flattened. The diameter of cervical spine cord in the sixth cervical vertebra along the horizontal in juvenile muscular atrophy of the distal upper extremity was smaller than that in normal volunteers significantly (P<0.05). Conclusions Juvenile muscular atrophy of the distal upper extremity may be a special type of cervical myelopathy. The neuro-electrophysiological check and the neck flexion MRI check are valuable to the clinical diagnosis and differential diagnosis. Cervical collar therapy is recommended the sooner the better and avoiding long time neck flexion position is very important for the patients.%目的 探讨青少年上肢远端肌萎缩症的临床解剖及MRI特点,为该病的早期诊断和治疗提供依据.方法 对13例确诊的青少年上肢远端肌萎缩症患者的临床表现、临床解剖、神经电生理特征及影像学资料进行回顾性分析.结果 青少年上肢远端肌萎缩症平均发病年龄18.6岁,表现为局限于手和前臂的肌萎缩,前臂呈斜坡样;肌电图显示患者双侧上肢远端肌肉均呈神经源性损害,受损节段多在下颈髓前角细胞;屈颈MRI均见下段颈髓前移、变平,硬脊膜向前移位,硬脊膜外间隙增宽,硬脊膜外间隙内半月形信号影;与正常自愿者比较,在C6

  2. NEW ABELISAURID MATERIAL FROM THE UPPER CRETACEOUS (CENOMANIAN OF MOROCCO

    Directory of Open Access Journals (Sweden)

    SIMONE D'ORAZI PORCHETTI

    2011-11-01

    Full Text Available Fragmentary cranial bones of dinosaur origin have been recently recovered from the Kem Kem beds (Upper Cretaceous, Cenomanian of Morocco. They include two incompletely preserved maxillary bones evidencing diagnostic features of abelisaurid theropods. These new finds provide further evidence of Abelisauridae in the Late Cretaceous of Morocco. 

  3. Bone marrow stem cell transplantation for lymphedema of the extremities%干细胞移植治疗肢体淋巴肿29例临床研究

    Institute of Scientific and Technical Information of China (English)

    孙岩; 阴法文; 金星; 吴学君; 袁海; 周华; 高斌斌

    2012-01-01

    目的:探讨自体骨髓基质干细胞移植术治疗肢体淋巴水肿.方法:回顾性分析山东大学附属省立医院血管外科2008年8月-2011年6月采用自体骨髓基质干细胞移植术治疗的29例淋巴肿患者的临床资料.结果:抽取骨髓过程中2例出现乏力症状,第2天好转,其余患者均无异常.分离的单个核细胞计数为(110 ~ 820)×108 mL-1,干细胞移植过程顺利.术后有3例患者自述患肢局部注射部位发热、胀痛感,后逐渐缓解,无其他明显并发症.平均随访18.3个月,10例患者肢围较术前无明显改善,但肢体皮质硬化程度有所下降;19例患者患肢与健肢周径之差明显减小,未发现明显并发症.结论:骨髓间充质干细胞移植治疗淋巴水肿在理论上具有可行性,但远期安全问题需密切关注.%Objective:To explore autologous bone marrow stem cell transplantation for lym phedema of the extremities. Methods: Retrospective analysis of 29 cases of lymphedema of the extremities hospitalized in department of vascular surgery, Provincial Hospital affiliated to Shandong University from Aug 2008 to Jun 2011. All patients underwent autologous bone marrow stem cell transplantation and were followed up after discharge from hospital. Results: Bone marrow aspiration was performed successfully in all patients. Besides, 2 patients felt week during the procedure but recovered well after the aspiration. The number of isolated mononuclear cell was 110~820 ×108 mL-1 Subsequent bone marrow stem cell transplantation was successfully performed in all patients. No intraoperative and postoperative complications occurred, except 3 patients felt fever and pain on operative location but gradually decreased. The average follow- up was 18.3 months, Swelling of the extremities were improved obviously in 19 patients, but not improved in 10 patients. However, scle-roderma of the extremities in these 10 patients was alleviated. Conclusion* Autologous bone marrow stem

  4. Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone

    Directory of Open Access Journals (Sweden)

    Al Kaissi, Ali

    2014-09-01

    Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

  5. Abdominal Skin Flaps in the Repair of 108 Patients with Complex Defects of Upper Extremity%腹部皮瓣修复上肢复杂损伤108例

    Institute of Scientific and Technical Information of China (English)

    王恒; 胡洪良; 沈卫军; 王战磊; 闫纪涛; 龚俊武

    2016-01-01

    目的:探讨应用腹部皮瓣修复上肢复杂损伤的临床疗效及安全性。方法:回顾性分析2011年8月-2014年8月在本院接受腹部皮瓣修复上肢复杂损伤的108例患者的临床资料。术后随访6~12个月,观察修复效果。结果:108例患者皮瓣均成活,其中101例获得随访,随访率为93.5%。随访101例患者皮瓣血运良好,皮瓣质地柔软,厚度适中,触之弹性较好,皮瓣恢复保护性感觉,两点分辨觉15 mm左右。供区愈合良好,无明显瘢痕,仅有少量增生,上肢功能基本得到恢复。1例患者因皮瓣下血肿压迫出现皮瓣供血障碍,经拆除部分缝线后血运恢复;2例多指脱套损伤患者在修复后对外观不甚满意,经二期整形修复后满意出院;2例手部掌背两侧复合脱套伤患者修复后精细活动功能受到轻微的影响。101例随访患者中96例评价满意,满意率为95.0%。结论:腹部皮瓣适用于修复各类上肢复杂性损伤,安全可靠。不过,临床需要加强修复过程的护理,以切实减少后遗症,提高患者生存质量。%Objective:To investigate the clinical efficacy and safety of the application of abdominal skin flaps in the repair of complex defects of upper extremity.Method:The clinical data of 108 patients with complex defects of upper extremity who accepted abdominal skin flaps admitted to our hospital from August 2011 to August 2014 were retrospectively analyzed.The postoperative followed-up was taken for 6 to 12 months,the repair effects were observed.Result:All flaps of the 108 cases survived,and 101 cases got followed-up service,so the follow-up rate was 93.5%.The flaps of the followed-up 101 cases were soft with good blood circulation,the thickness of the skin was moderate,the elasticity of the skin was good with touching,the sense of protection of the skin flaps restored,the two-point-discrimination of the digits was 15 mm.The donor sites healed

  6. Effect of occupational therapy on upper extremity function and daily activities in spastic hemiplegic cerebral palsied children%作业治疗对痉挛型偏瘫患儿上肢运动功能的影响

    Institute of Scientific and Technical Information of China (English)

    张洪梅; 姜南; 赵晓科; 高夫宁

    2012-01-01

    Objective To investigate the occupational therapeutic effect on the upper extremity function and daily activities in spastic hemiplegic cerebral palsied childrea Methods Thirty children with spastic hemiplegic cerebral palsy were equally randomized into two groups of A (treated with occupational therapy plus conventional treatments of exercise, massage and neuromuscular electrostimulation) and B( treated with conventional treatments alone). The fine motor, suitability and individual-society were evaluated with Gesell development scale and the activities of daily living( ADD before and after one month therapy. Results Compared with group B, the scores of Gesell and ADL after treatment in group A were significantly increased (P<0. 05). Conclusion The occupational therapy can improve movement of the upper extremities and daily living activity.%目的 探讨作业治疗对痉挛型偏瘫儿童上肢精细运动功能及日常生活能力的治疗作用.方法 30例痉挛型偏瘫患儿随机均分为治疗组和对照组,均进行运动疗法、推拿、神经肌肉电刺激等常规康复治疗1个月;治疗组在此基础上加用作业治疗.治疗前后采用Gesell发育量表进行评估,计算精细运动、适应性、个人社会的发育商及总发育商及日常生活活动能力.结果 治疗后,治疗组患儿精细运动、适应性、个人社会等能区的发育商、总发育商及日常生活活动能力均较对照组显著改善(P<0.05).结论 作业治疗有助于提高痉挛型偏瘫患儿的精细运动功能及日常生活活动能力.

  7. Hybrid fusion of linear, non-linear and spectral models for the dynamic modeling of sEMG and skeletal muscle force: an application to upper extremity amputation.

    Science.gov (United States)

    Potluri, Chandrasekhar; Anugolu, Madhavi; Schoen, Marco P; Subbaram Naidu, D; Urfer, Alex; Chiu, Steve

    2013-11-01

    Estimating skeletal muscle (finger) forces using surface Electromyography (sEMG) signals poses many challenges. In general, the sEMG measurements are based on single sensor data. In this paper, two novel hybrid fusion techniques for estimating the skeletal muscle force from the sEMG array sensors are proposed. The sEMG signals are pre-processed using five different filters: Butterworth, Chebychev Type II, Exponential, Half-Gaussian and Wavelet transforms. Dynamic models are extracted from the acquired data using Nonlinear Wiener Hammerstein (NLWH) models and Spectral Analysis Frequency Dependent Resolution (SPAFDR) models based system identification techniques. A detailed comparison is provided for the proposed filters and models using 18 healthy subjects. Wavelet transforms give higher mean correlation of 72.6 ± 1.7 (mean ± SD) and 70.4 ± 1.5 (mean ± SD) for NLWH and SPAFDR models, respectively, when compared to the other filters used in this work. Experimental verification of the fusion based hybrid models with wavelet transform shows a 96% mean correlation and 3.9% mean relative error with a standard deviation of ± 1.3 and ± 0.9 respectively between the overall hybrid fusion algorithm estimated and the actual force for 18 test subjects' k-fold cross validation data.

  8. 极限学习机集成在骨髓细胞分类中的应用%Classification of bone marrow cells based on ensemble of extreme learning machine

    Institute of Scientific and Technical Information of China (English)

    陈林伟; 吴向平; 潘晨; 侯庆岑

    2015-01-01

    骨髓细胞的分类有重要的医学诊断意义。先对骨髓细胞图像分割和特征提取,用提取出来的训练集对极限学习机训练,再用该分类器对未知样本识别。针对单个分类器性能的不稳定,提出基于元胞自动机的极限学习机集成算法。通过元胞自动机抽样策略构建差异大的训练子集,多个分类器并行学习,多数投票法联合决策。实验结果表明,与BP、支持向量机比较,该算法基本无参数调整,学习速度快,分类精度高能达到97.33%,且有效克服了神经网络分类器不稳定的缺点。%Classification of bone marrow cells has important medical diagnostic significance. The training samples set extracted from the segmented images of bone marrow cells is used to train the extreme learning machine. Then this trained extreme learning machine automatically classifies the unknown bone marrow cells. For the instability of perfor-mance of single classifier, the ensemble of extreme learning machine algorithm based on cellular automata is proposed. The different training subsets are constructed by cellular automata strategy through sampling, then they are learned in par-allel with multiple classifiers, finally the outputs are combined by majority voting. Experimental results show that this pro-posed algorithm has fast learning speed and gains high classification accuracy reached 97.33% without adjusting any parameters during run-time compared with BP neural networks and support vector machines. Moreover, it effectively solves the disadvantage of instability for the neural network classifier.

  9. Retrograde Tempofilter II{sup TM} Placement within the Superior Vena Cava in a Patient with Acute Upper Extremity Deep Venous Thrombosis: the Filter Stands on Its Head

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Nam Yeol [The Armed Forces Yangju Hospital, Yangju (Korea, Republic of); Chang, Nam Kyu; Lim, Jae Hoon; Kim, Jae Kyu [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2011-02-15

    The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofi lter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis

  10. Image diagnosis of nasal bone fracture

    Energy Technology Data Exchange (ETDEWEB)

    Hirota, Yoshiharu; Shimizu, Yayoi; Iinuma, Toshitaka.

    1988-04-01

    Twenty cases of nasal bone fractures were evaluated as to the types of fractures based upon HRCT findings. Conventional X-Ray films for nasal bones were analyzed and compared with HRCT findings. Nasal bone fractures were classified into lateral and frontal fractures. HRCT images were evaluated in three planes including upper, middle and lower portions of the nasal bone. Fractures favored males of teens. Lateral fracture gave rise to the fractures of the nasal bone opposite to the external force, loosening of the ipsilateral nasomaxillary sutures and fractures of the frontal process of the maxilla. Conventional X-Ray films were reevaluated after HRCT evaluation and indications of nasal bone fractures were determined. In addition to the discontinuity of the nasal dorsum, fracture lines parallel to and beneath the nasal dorsum and indistinct fracture lines along the nasomaxillary sutures are the indication of nasal bone fractures by conventional X-Ray films.

  11. Regulation of Bone Metabolism.

    Science.gov (United States)

    Shahi, Maryam; Peymani, Amir; Sahmani, Mehdi

    2017-04-01

    Bone is formed through the processes of endochondral and intramembranous ossification. In endochondral ossification primary mesenchymal cells differentiate to chondrocytes and then are progressively substituted by bone, while in intramembranous ossification mesenchymal stem cells (MSCs) differentiate directly into osteoblasts to form bone. The steps of osteogenic proliferation, differentiation, and bone homeostasis are controlled by various markers and signaling pathways. Bone needs to be remodeled to maintain integrity with osteoblasts, which are bone-forming cells, and osteoclasts, which are bone-degrading cells.In this review we considered the major factors and signaling pathways in bone formation; these include fibroblast growth factors (FGFs), bone morphogenetic proteins (BMPs), wingless-type (Wnt) genes, runt-related transcription factor 2 (RUNX2) and osteoblast-specific transcription factor (osterix or OSX).

  12. Regulation of Bone Metabolism

    Science.gov (United States)

    Shahi, Maryam; Peymani, Amir; Sahmani, Mehdi

    2017-01-01

    Bone is formed through the processes of endochondral and intramembranous ossification. In endochondral ossification primary mesenchymal cells differentiate to chondrocytes and then are progressively substituted by bone, while in intramembranous ossification mesenchymal stem cells (MSCs) differentiate directly into osteoblasts to form bone. The steps of osteogenic proliferation, differentiation, and bone homeostasis are controlled by various markers and signaling pathways. Bone needs to be remodeled to maintain integrity with osteoblasts, which are bone-forming cells, and osteoclasts, which are bone-degrading cells.In this review we considered the major factors and signaling pathways in bone formation; these include fibroblast growth factors (FGFs), bone morphogenetic proteins (BMPs), wingless-type (Wnt) genes, runt-related transcription factor 2 (RUNX2) and osteoblast-specific transcription factor (osterix or OSX). PMID:28367467

  13. Effect of Hydrotherapy Combined with Tizanidine Efficacy for Stroke Patients with Upper Extremity Spasticity%水疗联合替扎尼定用于脑卒中患者上肢痉挛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    莫林宏; 聂忆秋; 刘翠; 路芳; 刘爱贤

    2015-01-01

    目的:观察水疗联合替扎尼定对脑卒中患者上肢痉挛的改善作用.方法:将26例脑卒中恢复期患者随机分为治疗组和对照组,两组均给予康复训练、常规治疗、口服替扎尼定,治疗组除上诉治疗外,联合温水疗法.治疗前与治疗1月后根据改良Ashworth痉挛评定量表(MAS)、简式Fugl-Meyer运动量表(FMA)和改良Barthel指数评定法(MBI)对两组患者进行评定.结果:治疗后两组患者上肢肌张力较治疗前均有明显降低(P<0.05),日常生活活动能力、上肢运动功能较治疗前均有提高(P<0.05),观察组疗效明显优于对照组(P<0.05).结论:康复训练结合替扎尼定对脑卒中后出现的上肢痉挛可起到显著改善作用;结合水疗后,上肢痉挛的改善、运动功能及生活生活活动能力的提高更加显著.%Objective: To observe the effect of hydrotherapy combined with Tizanidine on stroke patients with upper extremity spasticity. Methods: 26 patients with stroke recovery period were randomly divided into the treatment group and control group, two groups were given rehabilitation training, conventional treatment,oral tizanidine set, the treatment group in addition to the appeal treatment, combined with warm water therapy. Before treatment and after treatment, the patients were assessed by the modified Ashworth spasm Rating Scale (MAS), Fugl-Meyer (FMA) and modified Barthel index (MBI) in January. Results:After treatment, the upper limb muscle tension in the two groups were significantly lower than before treatment (P<0.05), daily living activity and the upper limb motor function were significantly improved (P<0.05), the observation group was significantly beter than the control group (P<0.05).Conclusion:Combined with rehabilitation training of tizanidine on upper limb spasm after stroke can play to significantly improve; combination of spa, improvement in upper limb spasticity, motor function and daily life ability is more significant.

  14. Evaluation of the Risk for Work-Related Upper Extremity Musculoskeletal Symptoms in USAF Air Traffic Controllers: A Pilot Feasibility Study

    Science.gov (United States)

    2011-07-28

    shoulders were level, the range of motion of the shoulder to abduction, cervical flexion , extension and side 15 bending, Phalen’s, Tinel’s, and...recorded as equal, or either left or right side elevations. Flexion and extension of the cervical region was grossly determined, with flexion being mildly...physical examination of both the cervical and iliosacral areas including standing and seated flexion tests, anterior superior iliac spine position, iliac

  15. Restoring motor control and sensory feedback in people with upper extremity amputations using arrays of 96 microelectrodes implanted in the median and ulnar nerves

    Science.gov (United States)

    Davis, T. S.; Wark, H. A. C.; Hutchinson, D. T.; Warren, D. J.; O'Neill, K.; Scheinblum, T.; Clark, G. A.; Normann, R. A.; Greger, B.

    2016-06-01

    Objective. An important goal of neuroprosthetic research is to establish bidirectional communication between the user and new prosthetic limbs that are capable of controlling >20 different movements. One strategy for achieving this goal is to interface the prosthetic limb directly with efferent and afferent fibres in the peripheral nervous system using an array of intrafascicular microelectrodes. This approach would provide access to a large number of independent neural pathways for controlling high degree-of-freedom prosthetic limbs, as well as evoking multiple-complex sensory percepts. Approach. Utah Slanted Electrode Arrays (USEAs, 96 recording/stimulating electrodes) were implanted for 30 days into the median (Subject 1-M, 31 years post-amputation) or ulnar (Subject 2-U, 1.5 years post-amputation) nerves of two amputees. Neural activity was recorded during intended movements of the subject’s phantom fingers and a linear Kalman filter was used to decode the neural data. Microelectrode stimulation of varying amplitudes and frequencies was delivered via single or multiple electrodes to investigate the number, size and quality of sensory percepts that could be evoked. Device performance over time was assessed by measuring: electrode impedances, signal-to-noise ratios (SNRs), stimulation thresholds, number and stability of evoked percepts. Main results. The subjects were able to proportionally, control individual fingers of a virtual robotic hand, with 13 different movements decoded offline (r = 0.48) and two movements decoded online. Electrical stimulation across one USEA evoked >80 sensory percepts. Varying the stimulation parameters modulated percept quality. Devices remained intrafascicularly implanted for the duration of the study with no significant changes in the SNRs or percept thresholds. Significance. This study demonstrated that an array of 96 microelectrodes can be implanted into the human peripheral nervous system for up to 1 month durations. Such an

  16. Rehabilitation of the Upper Extremity after Stroke: A Case Series Evaluating REO Therapy and an Auditory Sensor Feedback for Trunk Control

    Directory of Open Access Journals (Sweden)

    G. Thielman

    2012-01-01

    Full Text Available Background and Purpose. Training in the virtual environment in post stroke rehab is being established as a new approach for neurorehabilitation, specifically, ReoTherapy (REO a robot-assisted virtual training device. Trunk stabilization strapping has been part of the concept with this device, and literature is lacking to support this for long-term functional changes with individuals after stroke. The purpose of this case series was to measure the feasibility of auditory trunk sensor feedback during REO therapy, in moderate to severely impaired individuals after stroke. Case Description. Using an open label crossover comparison design, 3 chronic stroke subjects were trained for 12 sessions over six weeks on either the REO or the control condition of task related training (TRT; after a washout period of 4 weeks; the alternative therapy was given. Outcomes. With both interventions, clinically relevant improvements were found for measures of body function and structure, as well as for activity, for two participants. Providing auditory feedback during REO training for trunk control was found to be feasible. Discussion. The degree of changes evident varied per protocol and may be due to the appropriateness of the technique chosen, as well as based on patients impaired arm motor control.

  17. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Shirley S. M. Fong

    2016-01-01

    Full Text Available Objectives. To evaluate the effects of Ving Tsun (VT martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5±6.7 years underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice, and 18 (mean age ± SD = 72.0±6.7 years received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P=0.007 in the VT group and the time to reach peak force decreased (9.9% differentially in the VT group compared to the control group (P=0.033. For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P=0.002. Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

  18. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

    Science.gov (United States)

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

  19. Observed differences in upper extremity forces, muscle efforts, postures, velocities and accelerations across computer activities in a field study of office workers

    NARCIS (Netherlands)

    Garza, J.L.B.; Eijckelhof, B.H.W.; Johnson, P.W.; Raina, S.M.; Rynell, P.W.; Huysmans, M.A.; Dieën, J.H. van; Beek, A.J. van der; Blatter, B.M.; Dennerlein, J.T.

    2012-01-01

    This study, a part of the PRedicting Occupational biomechanics in OFfice workers (PROOF) study, investigated whether there are differences in field-measured forces, muscle efforts, postures, velocities and accelerations across computer activities. These parameters were measured continuously for 120

  20. Increased serum and musculotendinous fibrogenic proteins following persistent low-grade inflammation in a rat model of long-term upper extremity overuse.

    Directory of Open Access Journals (Sweden)

    Helen G L Gao

    Full Text Available We examined the relationship between grip strength declines and muscle-tendon responses induced by long-term performance of a high-repetition, low-force (HRLF reaching task in rats. We hypothesized that grip strength declines would correlate with inflammation, fibrosis and degradation in flexor digitorum muscles and tendons. Grip strength declined after training, and further in weeks 18 and 24, in reach limbs of HRLF rats. Flexor digitorum tissues of reach limbs showed low-grade increases in inflammatory cytokines: IL-1β after training and in week 18, IL-1α in week 18, TNF-α and IL-6 after training and in week 24, and IL-10 in week 24, with greater increases in tendons than muscles. Similar cytokine increases were detected in serum with HRLF: IL-1α and IL-10 in week 18, and TNF-α and IL-6 in week 24. Grip strength correlated inversely with IL-6 in muscles, tendons and serum, and TNF-α in muscles and serum. Four fibrogenic proteins, TGFB1, CTGF, PDGFab and PDGFbb, and hydroxyproline, a marker of collagen synthesis, increased in serum in HRLF weeks 18 or 24, concomitant with epitendon thickening, increased muscle and tendon TGFB1 and CTGF. A collagenolytic gelatinase, MMP2, increased by week 18 in serum, tendons and muscles of HRLF rats. Grip strength correlated inversely with TGFB1 in muscles, tendons and serum; with CTGF-immunoreactive fibroblasts in tendons; and with MMP2 in tendons and serum. Thus, motor declines correlated with low-grade systemic and musculotendinous inflammation throughout task performance, and increased fibrogenic and degradative proteins with prolonged task performance. Serum TNF-α, IL-6, TGFB1, CTGF and MMP2 may serve as serum biomarkers of work-related musculoskeletal disorders, although further studies in humans are needed.

  1. Skin temperature measured by infrared thermography after specific ultrasound-guided blocking of the musculocutaneous, radial, ulnar, and median nerves in the upper extremity

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S

    2011-01-01

    Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area....

  2. 镜像疗法对偏瘫患者上肢功能康复疗效的观察%Effects of Mirror Therapy on Hemiplegic Upper Extremity Motor Recovery in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    张洪翠; 于大君; 刘志华; 李铁山

    2011-01-01

    目的 观察镜像疗法对卒中后偏瘫患者上肢功能康复的疗效.方法 选择50例入选卒中后8周内偏瘫患者随机分为两组:镜像疗法组和对照组,分别于治疗前及治疗后4周采用Fugl-Meyer运动评价(Fugl-Meyer motor assessment,FMA)(上肢部分),上肢运动研究测试(the action research arm test,ARAT)、运动功能评估量表(motor & ssessment scale,MAS)对上肢运动功能进行评分,同时评定患者的视觉模拟评分(visual analogue scale/score,VAS).痉挛程度以及改良Bzrthel指数,以观察镜像疗法对偏瘫患者上肢功能康复的疗效.结果 治疗4周后,两组上肢运动能FMA评分、ARAT评分、MAS评分、改良Barthel指数均较治疗前提高(P0.05).治疗组VAS评分较治疗前有下降(P0.05),治疗后两组间的VAS差异有统计学意义(P0.05).结论 镜像疗法能提高偏瘫患者的上肢运动功能,且能减轻患者偏瘫上肢的疼痛,但对患者日常生 活活动能力(activity of daily living scale,ADL)及惠肢痉挛程度的改善无明显影响.%Objective To observe the effects of mirror therapy (MT) compared with the conventional training therapy (CTT) on hemiplegic upper extremity recovery after stroke.Methods Thirty sub-acute patients with upper limb paralysis were randomly divided into two groups: MT group and CTT group. All 30 patients received physical treatment for a period of 4 weeks. All patients were assessed with Fugl-Meyer motor assessment (FMA), motor assessment scale (MAS), the action research arm test (ARAT), the modified Ashworth scale, visual analogue score (VAS) and the modified Barthel index before treatment and after 4 weeks.Results After 4 weeks, FMA, MAS, ARAT and Barthel index scores in the two groups had improved (P<0.01), and the FMA, ARAT scores in the MT group were significantly higher than those of the control group (P<0.05), but the scores of MAS, Barthel index had no significant difference between the two groups (P>0.05). After 4

  3. Metagenomics of extreme environments.

    Science.gov (United States)

    Cowan, D A; Ramond, J-B; Makhalanyane, T P; De Maayer, P

    2015-06-01

    Whether they are exposed to extremes of heat or cold, or buried deep beneath the Earth's surface, microorganisms have an uncanny ability to survive under these conditions. This ability to survive has fascinated scientists for nearly a century, but the recent development of metagenomics and 'omics' tools has allowed us to make huge leaps in understanding the remarkable complexity and versatility of extremophile communities. Here, in the context of the recently developed metagenomic tools, we discuss recent research on the community composition, adaptive strategies and biological functions of extremophiles.

  4. Upper extremities musculoskeletal disorders: Prevalence and associated ergonomic factors in an electronic assembly factory

    Directory of Open Access Journals (Sweden)

    Somthus Pullopdissakul

    2013-10-01

    Full Text Available Objectives:To determine the magnitude, distribution and associated ergonomic factors of upper extremities musculoskeletal disorders (UEMSD among workers of electronic assembly in Thailand. Material and Methods: This was a cross-sectional study. 591 of 853 workers in an electronic and electrical appliance assembly factory in Bangkok, Thailand, participated in this study. A self-administered questionnaire consisting of demographic data and ergonomic factors was collected from October 2010 to January 2011. Clinical examination of each worker was performed by an occupational physician. The criteria for diagnosis of UEMSD came as a result of a consensus reached by a group of orthopedists. The associated factors were analyzed using a multiple logistic regression. Results: The point prevalence of clinically diagnosed UEMSD was as follows: radial styloid tenosynovitis - 13.03% (95% CI: 10.31-15.75, trigger finger - 9.48% (95% CI: 7.11-11.84, carpal tunnel syndrome - 8.12% (95% CI: 5.91-10.33, lateral epicondylitis - 3.38% (95% CI: 1.92-4.85, and medial epicondylitis - 1.69% (95% CI: 0.65-2.73, respectively. The adjusted odds ratio with statistical significance associated with UEMSD was as follows: high force of wrist - 1.78 (95% CI: 1.06-2.99, awkward posture of wrist - 2.37 (95% CI: 1.28-4.37 and contact stress at wrists - 1.75 (95% CI: 1.02-3.00 to develop radial styloid tenosynovitis. For trigger finger, the ratios were awkward posture of fingers - 2.09 (95% CI: 1.12-3.90 and contact stress on finger - 1.86 (95% CI: 1.04-3.34. For medial epicondylitis, it was an awkward posture of using elbows - 3.14 (95% CI: 1.10-8.95. However, this study did not find any associations between repetitive motion and any UEMSD. Conclusions: UEMSD are most commonly found in electronic assembly workers. The relevant parties should provide comprehensive ergonomic resolution for these workers.

  5. Properties of deproteinized bone for reparation of big segmental defect in long bone

    Institute of Scientific and Technical Information of China (English)

    JIAN Yue-kui; TIAN Xiao-bin; LI Bo; QIU Bing; ZHOU Zuo-jia; YANG Zheng; LI Qi-hong

    2008-01-01

    Objective: To explore suitable scaffold material for big segmental long bone defect by studying the properties of the prepared deproteinized bone. Methods: Cancellated bone were made as 30 mm ×3 mm ×3 mm bone blocks from inferior extremity of pig femur along bone trabecula. The deproteinized bone was prepared with an improved method. Their morphological features, components, cell compatibility, mechanical and immunological properties were investigated respectively. Results: Deproteinized bone maintained natural re ticular pore system. The main organic material is collagen Ⅰand inorganic composition is hydroxyapatite. It has good mechanical properties, cell adhesion rate and histocompatibility. Conlusion: This deproteinized bone can be applicable as scaffold for reparation of big segmental defect in long bone.

  6. Findings of skin and bones in mastocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Rohner, H.G.; Bartl, R.; Koischwitz, D.; Rodermund, O.E.

    1982-12-01

    The syndrome of mastocytosis can include isolated urticaria pigmentosa, systemic mastocytosis, or the extremely rare form of mast cell leucemia. Our investigations of many patients have shown more frequently than earlier suspected, that the mastocytosis is a systemic disease. The frequency of attacked bone marrow is noteworthy. Because of the inflammatory granulomatous manifestation in bone marrow, considerations of the pathogenesis of an immune and reactive event are taken into account. The mast cell granulomas are mostly found in the endosteal region, which is the reason for frequently occurring bone lesions (half of all patients show bone lesions). The bone changes can develop generalized (osteoporosis-osteosclerosis) or localized (osteolytic-osteosclerotic foci). In clinical work bone biopsies and skeletal radiology are supplementing each other: bone biopsy and skin biopsy give the first diagnosis of mastocytosis and reveal the systemic disease; X-ray pictures give information of shape and dimension of the induced osteopathy.

  7. Taphonomy of the vertebrate bone beds from the Klūnas fossil site, Upper Devonian Tērvete Formation of Latvia

    Directory of Open Access Journals (Sweden)

    Jeļena Vasiļkova

    2012-05-01

    Full Text Available Combined sedimentological and taphonomical study of the siliciclastic sequence of the Tērvete Formation in the stratotypical area was aimed at revealing the formation of the three oryctocoenoses discovered and related structural and textural features of the deposits, as well as at detailed observation of the taphonomical peculiarities of the obtained palaeontological material. The fossil vertebrate assemblage is represented by 14 taxa comprising placoderms, acanthodians, sarcopterygians and actinopterygians. The three oryctocoenoses, first recognized in 2010, differ in the proportions of repeatedly buried material, in the number and degree of preservation of small and fragile skeletal elements, as well as in the evaluated current velocity and the transportation distance. Sedimentary concentrations of marine vertebrate remains, dominated by the antiarchs Bothriolepis ornata and B. jani, have been formed under the influence of fluvial and tidal processes in the shallow-water environment, deltaic or estuarine settings. Elongated placoderm and sarcopterygian bones are probably better indicators of the palaeoflow direction than acanthodian spines or sarcopterygian teeth.

  8. Bone marrow-derived myofibroblasts recruited to the upper dermis appear beneath regenerating epidermis after deep dermal burn injury.

    Science.gov (United States)

    Yamaguchi, Ryo; Takami, Yoshihiro; Yamaguchi, Yoshihiro; Shimazaki, Syuji

    2007-01-01

    Fibroblasts and myofibroblasts migrating to sites of tissue repair after injury may not only be locally recruited but could also be recruited from the bone marrow. However, the characteristics and functional roles, if any, of these cells in wound healing are poorly understood. Here, we show unequivocally that bone marrow-derived fibroblasts do contribute to deep dermal burn wound healing. Bone-marrow stromal cells were collected from femurs of male Lewis rats, cultured for a week, and then the adherent cells were labeled with the fluorescent marker PKH-26. These cells stained positive for alpha-smooth muscle actin and prolyl 4-hydroxylase, but did not express RM-4 (a macrophage marker), CD34, or cytokeratin, characteristic of myofibroblastic differentiation. When injected intravenously into Lewis rats, they homed to the bone marrow. Five days after transplantation, a deep dermal burn was made on the back of the rat, and biopsies were taken 7, 10, and 14 days later. PKH-positive cells were not found at day 7, but by day 10, they were easily detected mainly in the upper dermis close beneath the regenerating epidermis. These PKH-positive cells still stained for alpha-SMA and prolyl 4-hydroxylase, but not RM4. Thus, it is suggested that myofibroblasts originating in the bone marrow contribute not only to promotion of granulation but also enhancement of dermal-epidermal interaction after thermal injury.

  9. Rare giant cell tumor involvement of the olecranon bone.

    Science.gov (United States)

    Yang, Chen; Gong, Yubao; Liu, Jianguo; Qi, Xin

    2014-06-01

    Giant cell tumor (GCT) of bone is a relatively common benign bone lesion and is usually located in long bones, but involvement of the olecranon is extremely rare. Here, we present a case of solitary GCT of bone in the olecranon that was confirmed by preoperative needle biopsy and postoperative histological examination. The treatment included intralesional curettage, allogeneic bone grafting, and plating. At 26 months follow-up, the patient had no local recurrence.

  10. Rare giant cell tumor involvement of the olecranon bone

    Directory of Open Access Journals (Sweden)

    Chen Yang

    2014-01-01

    Full Text Available Giant cell tumor (GCT of bone is a relatively common benign bone lesion and is usually located in long bones, but involvement of the olecranon is extremely rare. Here, we present a case of solitary GCT of bone in the olecranon that was confirmed by preoperative needle biopsy and postoperative histological examination. The treatment included intralesional curettage, allogeneic bone grafting, and plating. At 26 months follow-up, the patient had no local recurrence.

  11. The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects

    Directory of Open Access Journals (Sweden)

    Nicki Zelenski

    2013-01-01

    Full Text Available Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed eleven pediatric patients treated with FVFG reconstructions of the upper extremity after tumor resection. Eight male and three female patients were identified, including four who underwent epiphyseal transfer. All eleven patients retained a functional salvaged limb. Nonunion and graft fracture were the most common complications relating to graft site (27%. Peroneal nerve palsy occurred in 4/11 patients, all of whom received epiphyseal transfer. Patients receiving epiphyseal transplant had a mean annual growth of 1.7 cm/year. Mean graft hypertrophy index increased by more than 10% in all cases. Although a high complication rate may be anticipated, the free vascularized fibula may be used to reconstruct large skeletal defects in the pediatric upper extremity after oncologic resection. Transferring the vascularized physis is a viable option when longitudinal growth is desired.

  12. Constraint-induced movement therapy as a rehabilitation intervention for upper extremity in stroke patients: systematic review and meta-analysis.

    Science.gov (United States)

    Etoom, Mohammad; Hawamdeh, Mohannad; Hawamdeh, Ziad; Alwardat, Mohammad; Giordani, Laura; Bacciu, Serenella; Scarpini, Claudia; Foti, Calogero

    2016-09-01

    Constraint-induced movement therapy (CIMT) is a neurorehabilitation technique designed to improve upper extremity motor functions after stroke. This review aimed to investigate evidence of the effect of CIMT on upper extremity in stroke patients and to identify optimal methods to apply CIMT. Four databases (MEDLINE, EMBASE, CINHAL, and PEDro) and reference lists of relevant articles and reviews were searched. Randomized clinical trials that studied the effect of CIMT on upper extremity outcomes in stroke patients compared with other rehabilitative techniques, usual care, or no intervention were included. Methodological quality was assessed using the PEDro score. The following data were extracted for each trial: patients' characteristics, sample size, eligibility criteria, protocols of CIMT and control groups, outcome measurements, and the PEDro score. A total of 38 trials were identified according to the inclusion criteria. The trials included were heterogeneous in CIMT protocols, time since stroke, and duration and frequency of treatment. The pooled meta-analysis of 36 trials found a heterogeneous significant effect of CIMT on upper extremity. There was no significant effect of CIMT at different durations of follow-up. The majority of included articles did not fulfill powered sample size and quality criteria. The effect of CIMT changed in terms of sample size and quality features of the articles included. These meta-analysis findings indicate that evidence for the superiority of CIMT in comparison with other rehabilitative interventions is weak. Information on the optimal dose of CIMT and optimal time to start CIMT is still limited.

  13. Translating measurement findings into rehabilitation practice: An example using Fugl-Meyer Assessment-Upper Extremity with patients following stroke

    Directory of Open Access Journals (Sweden)

    Craig A. Velozo, PhD, OTR/L

    2011-12-01

    Full Text Available Standardized assessments are critical for advancing clinical rehabilitation, yet assessment scores often provide little information for rehabilitation treatment planning. A keyform recovery map is an innovative way for a therapist to record patient responses to standardized assessment items. The form enables a therapist to view the specific items that a patient can or cannot perform. This information can assist a therapist in tailoring treatments to a patient’s individual ability level. We demonstrate how a keyform recovery map can be used to inform clinical treatment planning for individuals with stroke-related upper-limb motor impairment. A keyform map of poststroke upper-limb recovery defined by items of the Fugl-Meyer Assessment-Upper Extremity (FMA-UE was generated by a previously published Rasch analysis. Three individuals with stroke enrolled in a separate research study were randomly selected from each of the three impairment strata of the FMA-UE. Their performance on each item was displayed on the FMA-UE keyform. The forms directly connected qualitative descriptions of patients’ motor ability to assessment measures, thereby suggesting appropriate shorter and longer term rehabilitation goals. This study demonstrates how measurement theory can be used to translate a standardized assessment into a useful, evidence-based tool for making clinical practice decisions.

  14. Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders.

    Science.gov (United States)

    Kwon, Jung Won; Son, Sung Min; Lee, Na Kyung

    2015-06-01

    [Purpose] This study investigated upper-extremity muscle activities in natural, ideal, and corrected head positions. [Subjects and Methods] Forty subjects with a forward head posture and rounded shoulder were recruited and randomly assigned to the natural head position group (n = 13), ideal head position group (n = 14), or corrected head position group (n = 13). Muscle activities were measured using a four-channel surface electromyography system at the sternocleidomastoideus, upper and lower trapezius, and serratus anterior muscles on the right side during an overhead reaching task. [Results] The muscle activities of the upper trapezius and serratus anterior differed significantly among head positions. Post hoc tests revealed significant differences between natural and ideal head positions, and natural and ideal head positions for both the upper trapezius and serratus anterior. [Conclusion] Recovery of normal upper trapezius and serratus anterior muscle functions plays an important role in correcting forward head posture and rounded shoulders.

  15. Virtual reality for the rehabilitation of upper extremity function after stroke%虚拟现实技术对不同类型脑卒中患者偏瘫上肢功能的影响

    Institute of Scientific and Technical Information of China (English)

    梁明; 窦祖林; 王清辉; 熊巍; 温红梅; 姜丽; 郑雅丹; 陈颖蓓; 杨琼

    2014-01-01

    Objective To observe the effect of upper extremity training in a virtual kitchen combined with conventional occupational therapy on the hemiplegic upper extremity function of patients with hemorrhagic and ischemic stroke in the convalescent phase.Methods Sixty convalescing stroke patients with hemiplegia were divided into a therapy group (n =30) and a control group (n =30) using a random number table.The control group accepted conventional occupational therapy.The therapy group accepted virtual kitchen training in addition.Before the experiment and after 3 weeks of therapy,surface electromyogram (sEMG) signals over the biceps and triceps brachii during maximum isometric voluntary contractions (MIVCs) flexing and extending the affected elbow were recorded.The Fugl-Meyer assessment for the upper extremities (FMA-UE),the modified Barthel index (MBI) and the relevant cocontraction ratio (CR) were used as outcome measures.Results Compared with pre-training,both groups showed significant improvements post-training on all of the measures.But the therapy group showed significantly greater improvement in terms of both average FMA-UE score and average MBI.Both hemorrhagic and ischemic stroke patients showed these significant improvements.Conclusion Conventional occupational therapy for retraining the upper limbs after stroke may be more effective when combined with training using a virtual kitchen.%目的 观察虚拟厨房上肢训练结合常规作业治疗对不同类型脑卒中(脑出血和脑梗死)恢复期患者偏瘫上肢功能康复的临床疗效.方法 选取脑卒中恢复期偏瘫患者60例,按随机数字表法随机分为治疗组(30例)和对照组(30例).对照组接受常规作业治疗,治疗组在常规作业治疗基础上增加虚拟厨房上肢训练.2组患者均于治疗前和治疗3周后(治疗后)进行上肢运动功能评定(FMA-UE)及以改良巴氏指数(MBI)评定日常生活活动能力,同时记录患肘屈曲/伸展最大等长收

  16. Rescue and treatment of severely injured lower extremities

    Institute of Scientific and Technical Information of China (English)

    GUO Qi-feng; XU Zhong-he

    2005-01-01

    Objective: To explore a treatment approach for severely injured lower extremities. Methods: The data of 42 patients with severely traumatic lower extremities from 1989 to 1999 were retrospectively reviewed. According to MESS(mangled extremity severity score) the mean score of all the limbs was 6.24±1.45, 34 cases had MESS score<7 and 8 cases had MESS score≥7. Treatment approaches included microvascular anastomosis technique, compound tissue flap transplantation technique and compound bone tissue flap transplantation. Conclusions: Successful emergency treatment of severely injured lower extremities could be achieved by using microsurgery techniques and strict controlling of lower extremity salvagel indications.

  17. Enzymatic maceration of bone

    DEFF Research Database (Denmark)

    Uhre, Marie-Louise; Eriksen, Anne Marie; Simonsen, Kim Pilkjær;

    2015-01-01

    the bones. The DNA analysis showed that DNA was preserved on all the pieces of bones which were examined. Finally, the investigation suggests that enzyme maceration could be gentler on the bones, as the edges appeared less frayed. The enzyme maceration was also a quicker method; it took three hours compared...

  18. Developing a framework for predicting upper extremity muscle activities, postures, velocities, and accelerations during computer use: the effect of keyboard use, mouse use, and individual factors on physical exposures.

    Science.gov (United States)

    Bruno Garza, Jennifer L; Catalano, Paul J; Katz, Jeffrey N; Huysmans, Maaike A; Dennerlein, Jack T

    2012-01-01

    Prediction models were developed based on keyboard and mouse use in combination with individual factors that could be used to predict median upper extremity muscle activities, postures, velocities, and accelerations experienced during computer use. In the laboratory, 25 participants performed five simulated computer trials with different amounts of keyboard and mouse use ranging from a highly keyboard-intensive trial to a highly mouse-intensive trial. During each trial, muscle activity and postures of the shoulder and wrist and velocities and accelerations of the wrists, along with percentage keyboard and mouse use, were measured. Four individual factors (hand length, shoulder width, age, and gender) were also measured on the day of data collection. Percentage keyboard and mouse use explained a large amount of the variability in wrist velocities and accelerations. Although hand length, shoulder width, and age were each significant predictors of at least one median muscle activity, posture, velocity, or acceleration exposure, these individual factors explained very little variability in addition to percentage keyboard and mouse use in any of the physical exposures investigated. The amounts of variability explained for models predicting median wrist velocities and accelerations ranged from 75 to 84% but were much lower for median muscle activities and postures (0-50%). RMS errors ranged between 8 to 13% of the range observed. While the predictions for wrist velocities and accelerations may be able to be used to improve exposure assessment for future epidemiologic studies, more research is needed to identify other factors that may improve the predictions for muscle activities and postures.

  19. Upper-extremity and neck disorders associated with keyboard and mouse use.

    Science.gov (United States)

    Mattioli, Stefano; Violante, Francesco S; Bonfiglioli, Roberta

    2015-01-01

    Musculoskeletal disorders are frequently related to computer use in the workplace. The aim of this chapter is to provide an overview of the evidence in the literature concerning the putative association between neck, shoulder, and upper-limb disorders and occupational exposure to use of a computer and its devices. We searched the scientific literature via PubMed, using specific search strategies, including substrings tailored to retrieve papers about: (1) occupational etiology; (2) computer use; and (3) different upper-limb disorders. We intended to include, in our evaluation, systematic reviews and relevant, informative papers published later on. We were able to retrieve 11 systematic reviews and 11 informative studies regarding neck, shoulder, and upper-limb disorders. There is limited/insufficient and/or inconsistent evidence indicating that computer work may be associated to neck, shoulder, or distal arm complaints. There is sufficient evidence indicating no association between carpal tunnel syndrome and computer work. There are no studies regarding the use of computers and some neck, shoulder, and upper-limb diseases, such as tennis elbow and trigger finger. Applying the general principles of ergonomics to computer work is probably the correct strategy to pursue, with the aim of maintaining office workers' well-being.

  20. Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women--the MORGEN study.

    NARCIS (Netherlands)

    Wijnhoven, Hanneke A H; Vet, Henrica C W de; Smit, Henriëtte A; Picavet, H Susan J

    2006-01-01

    STUDY DESIGN: Cross-sectional study of 11,428 women aged 20-59 years who were included in a postal questionnaire survey in the Dutch general population. OBJECTIVE: To examine how hormonal and reproductive factors are associated with chronic low back pain (LBP) and chronic upper extremity pain (UEP)

  1. Bone mineral status in Egyptian children with classic congenital adrenal hyperplasia. A single-center study from Upper Egypt

    Directory of Open Access Journals (Sweden)

    Kotb Abbass Metwalley

    2014-01-01

    Full Text Available Aim of the Study: To evaluate bone mineral density (BMD and levels of bone turnover markers in Egyptian children with classic congenital adrenal hyperplasia (CAH caused by 21-hydroxylase deficiency and its relationship with disease-related variables. Patients and Methods: The study population consisted of 28 children from Upper Egypt with classic CAH, their mean age 8.3 ± 2.4 years and 28 age and sex matched healthy control. They were subjected to measurement of BMD of lumbar spines (L1-L4 and femoral neck using dual-energy-X-ray absorptiometry (DXA and laboratory evaluation of bone turnover markers including Osteocalcin and serum receptor activator of nuclear factor αB-ligand (RANKL. Result: Children with CAH had significantly lower bone-mineral density (BMD for both, vertebrae and femoral neck than controls. This difference is more obvious in children with poor control and in those receiving prednisone therapy. There was a significantly lower serum osteocalcin, and significantly higher serum RANKL levels in patients with CAH than the healthy controls. This differences is more obvious in children with poor control and in those receiving prednisone therapy. Total bone mineral content (BMC [gm] have significant negative correlations to age (r = −0.81, P < 0.001, disease duration (r = −0.881, P < 0.001, 17 OH Progesterone level (r = −0.543, P < 0.05, RANKL level (r = −0.635, P < 0.05, and significant positive correlation with osteocalcin (r = 0.576, P < 0.001. Conclusions: Children from Upper Egypt with classic CAH may have reduced BMD and increase bone turnover compared with controls. This difference is more obvious in children with poor control and in those receiving prednisone therapy. Recommendations: Active monitoring of BMD in CAH children using Dual-energy X-ray absorptiometry (DEXA scanning. Furthermore, effort should be done to bring hydrocortisone to Upper Egypt to replace prednisone in children with classic congenital adrenal

  2. Effect observation on locking plate combining with autologous iliac bone graft in the treatment of aseptic nonunion after surgery of long bone fractures of extremities%锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的效果观察

    Institute of Scientific and Technical Information of China (English)

    刘志军

    2014-01-01

    Objective To research and evaluate the effect of locking plate combining with autologous iliac bone graft on treating aseptic nonunion after surgery of long bone fractures of extremities. Methods 43 cases of patients with aseptic nonunion on limb long bone caused by bone fixation failure were accepted in our hospital from January 2006 to June 2013.All of patients were treated with locking plate combining with autologous iliac bone graft. Results All patients were followed up.The follow-up time ranged from 7 to 24 months,with an average of 12.6 months.All of nonunion were healed in (5.9±1.0) months.Cut surface infection occurred in 3 cases (6.9%),which were cured after treatment.The slow-ly healed wound were 2 cases (4.7%) and limb about 2 cm shortened in 1 case (2.3%).None of cases suffered from malunion.At the final follow-up,joint activity improved more significantly compared with before surgery,including 35 cases (81.4%) with excellent effect,7 cases (16.3%) moderate,and 1 case (2.3%) poor. Conclusion In the treatment of patients with aseptic nonunion after surgery of long bone fractures of extremities,using locking plate for internal fixation is a curative therapy.Locking plate combining with autologous iliac bone graft can provide reliable fixation stability for fractura,and shows good functions on bone induction and conduction,so it obtains a favorable effect.%目的:研究评价锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的临床效果。方法选取2006年1月~2013年6月因内固定失败而造成四肢长骨干无菌性骨不连患者43例,均采用锁定钢板固定联合自体髂骨植骨进行治疗。结果患者均获得随访,随访时间7~24个月,平均12.6个月。骨不连均愈合,愈合时间为(5.9±1.0)个月。3例(6.9%)出现切口表面感染,经治疗后均痊愈;2例(4.7%)切口延迟愈合;1例(2.3%)出现肢体短缩<2 cm,无一例发生骨折畸形愈合。末次随访时关节活

  3. 易化技术配合针炙治疗脑卒中后上肢痉挛%Rehabilitation therapy centralized on facilitation and acupuncture on upper extremities spasm after stroke

    Institute of Scientific and Technical Information of China (English)

    屈云; 盛敏; 蒋毅; 熊淑芳; 何成奇; 罗祖明

    2003-01-01

    AIM: To observe the therapeutic effect of rehabilitation therapy centralized on facilitation and acupuncture on upper extremities spasm after stroke.METHODS:56 cases of stroke patients with upper extremities spasm were divided into two groups by random.28 patients in treatment group were received rehabilitation therapy centralized on facilitation and acupuncture treatment.Others in control group were received traditional method. RESULT:All patients were evaluated by muscle tone evaluation of Ashworth Scale.The outcomes of two groups had significant different (P< 0.01). CONCLUSION:We could archive the satisfactory effects with acupuncture and rehabilitation therapy centralized on facilitation on upper extremities spasm of stroke patients.

  4. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    DEFF Research Database (Denmark)

    Jensen, J. C.; Haahr, J. P.; Frost, P.

    2012-01-01

    . Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. CONCLUSION: Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about...

  5. Early retirement among Danish female cleaners and shop assistants according to work environment characteristics and upper extremity complaints

    DEFF Research Database (Denmark)

    Jensen, Lone Donbæk; Bonde, Jens Peter Ellekilde; Christensen, Michael Victor

    2016-01-01

    BACKGROUND: Studies have shown a negative social gradient in the incidence of early retirement. To prevent undesired early retirement, there is a need for knowledge of specific predictors in addition to social factors with a limited potential for change. The main purpose of this study...... was to examine musculoskeletal complaints and working conditions as predictors of early retirement among Danish female cleaners. METHODS: Using Cox regression with an adjustment for extraneous factors, we compared the risk of disability pension and retirement before the nominal retirement age (65 years) in an 11......-year cohort study with registry-based follow-up of 1430 female cleaners and 579 shop assistants. In subsequent analyses of female cleaners, disability pension and voluntary early retirement were modeled according to work characteristics and upper extremity complaints. RESULTS: The adjusted hazard rate...

  6. Botulinum toxin in severe upper extremity spasticity among patients with traumatic brain injury: an open-labeled trial.

    Science.gov (United States)

    Yablon, S A; Agana, B T; Ivanhoe, C B; Boake, C

    1996-10-01

    We studied the effect of botulinum toxin A (BTXA) among patients with traumatic brain injury (TBI) and severe spasticity unresponsive to conservative management. Twenty-one consecutive adult patients with severe spasticity involving the wrist and finger flexor musculature were treated with BTXA injection (20 to 40 units per muscle) under EMG guidance. After injection, patients received passive range of motion (ROM) exercise, with modalities and casting as clinically indicated. Outcome measures, including wrist ROM and the modified Ashworth Scale (MAS), were assessed 2 to 4 weeks after injection. Among the respective acute and chronic groups, mean ROM improved 42.9 (p = 0.001) and 36.2 degrees (p < 0.001). Mean MAS rating improved 1.5 (p = 0.01) and 1.47 (p = 0.002) points. There were no significant adverse effects. BTXA, in conjunction with conventional modalities, significantly improves spasticity and ROM in the distal upper extremity musculature of patients with TBI.

  7. Computer game-based upper extremity training in the home environment in stroke persons: a single subject design

    Science.gov (United States)

    2014-01-01

    Background The objective of the present study was to assess whether computer game-based training in the home setting in the late phase after stroke could improve upper extremity motor function. Methods Twelve subjects with prior stroke were recruited; 11 completed the study. Design The study had a single subject design; there was a baseline test (A1), a during intervention test (B) once a week, a post-test (A2) measured directly after the treatment phase, plus a follow-up (C) 16–18 weeks after the treatment phase. Information on motor function (Fugl-Meyer), grip force (GrippitR) and arm function in activity (ARAT, ABILHAND) was gathered at A1, A2 and C. During B, only Fugl-Meyer and ARAT were measured. The intervention comprised five weeks of game-based computer training in the home environment. All games were designed to be controlled by either the affected arm alone or by both arms. Conventional formulae were used to calculate the mean, median and standard deviations. Wilcoxon’s signed rank test was used for tests of dependent samples. Continuous data were analyzed by methods for repeated measures and ordinal data were analyzed by methods for ordered multinomial data using cumulative logistic models. A p-value of game time and changes in the outcomes investigated in this study. Conclusion The results indicate that computer game-based training could be a promising approach to improve upper extremity function in the late phase after stroke, since in this study, changes were achieved in motor function and activity capacity. PMID:24625289

  8. Diabetes, Biochemical Markers of Bone Turnover, Diabetes Control, and Bone

    OpenAIRE

    Starup-Linde, Jakob

    2013-01-01

    Diabetes mellitus is known to have late complications including micro vascular and macro vascular disease. This review focuses on another possible area of complication regarding diabetes; bone. Diabetes may affect bone via bone structure, bone density, and biochemical markers of bone turnover. The aim of the present review is to examine in vivo from humans on biochemical markers of bone turnover in diabetics compared to non-diabetics. Furthermore, the effect of glycemic control on bone marker...

  9. Influence of fist frequency on upper extremity venous blood flow in PICC patients%握拳频次对PICC置管病人上肢静脉血液流速的影响

    Institute of Scientific and Technical Information of China (English)

    周晔; 刘扣英; 崔焱

    2016-01-01

    [目的]探讨促进PICC置管病人上肢静脉血液加速和恢复的最佳握拳频次。[方法]选择身体健康志愿者30例和 PICC 置管病人10例为研究对象,采用彩色多普勒超声测量静息时、连续握拳10次、15次、20次、25次、30次、35次、40次及运动停止后每10 min的腋静脉最大血液流速(Vmax)和平均血液流速(TMFV)。[结果]健康人群和 PICC 置管病人握拳运动后腋静脉 Vmax 和TMFV较静息时增加(P<0.05),其中连续握拳25次时血流增加到最高峰,握拳运动停止40 min后 Vmax和 TMFV 恢复接近静息状态。[结论]在握持运动25次时血流动力学效果最佳,主要表现为腋静脉 Vmax和 TMFV均明显增加,平卧40 min后血液流速趋于静息状态,可作为预防PICC相关上肢静脉血栓的参考依据。%Objective:To probe into the best fist frequency for promoting upper extremity vemous blood acceler-ation and recovery in PICC patients.Methods:A total of 30 healthy volunteers and 10 patients with PICC were selected as research obj ects the maximum blood flow velocity(Vmax)and mean blood flow velocity(TMFV)of axillary vein were measured respectively at rest,continuous fist 10 times,15 times,20 times,25 times,30 times, 35 times,40 times,and every 10 mins after movement stop by using color Poppler ultrasound.Results:Vmax and TMFV in healthy crowd and PICC patients after fist movement increased compared resting (P<0.05),af-ter continuous 25 times the velocity of blood flow increased to the peak,Vmax and TMFV recovered close to the resting state 40 min after stopping fist.Conclusion:The effcet of blood flow dynamics was the best in contincous fist 25 times,which mainly showed that the Vmax and TMFV significantly increased,after 40 mins of supining, blood flow tended to resting state,so it could provide reference for preventing PICC related upper venous throm-bosis.

  10. The Extreme Hosts of Extreme Supernovae

    CERN Document Server

    Neill, James D; Gal-Yam, Avishay; Quimby, Robert; Ofek, Eran; Wyder, Ted K; Howell, D Andrew; Nugent, Peter; Seibert, Mark; Martin, D Christopher; Overzier, Roderik; Barlow, Tom A; Foster, Karl; Friedman, Peter G; Morrissey, Patrick; Neff, Susan G; Schiminovich, David; Bianchi, Luciana; Donas, José; Heckman, Timothy M; Lee, Young-Wook; Madore, Barry F; Milliard, Bruno; Rich, R Michael; Szalay, Alex S

    2010-01-01

    We use GALEX ultraviolet (UV) and optical integrated photometry of the hosts of seventeen luminous supernovae (LSNe, having peak M_V 100 M_sun), by appearing in low-SFR hosts, are potential tests for theories of the initial mass function that limit the maximum mass of a star based on the S FR.

  11. Esophageal Cancer with Bone Marrow Hyperplasia Mimicking Bone Metastasis: Report of a Case

    Directory of Open Access Journals (Sweden)

    Hiromi Yasuda

    2016-11-01

    Full Text Available A 63-year-old man visited the clinic with numbness in the right hand. Magnetic resonance imaging demonstrated multiple low-intensity lesions in the cervical vertebrae and sacrum, which was suspicious of cervical bone metastasis. Fluorodeoxyglucose positron emission tomography/computed tomography revealed areas of increased fluorodeoxyglucose uptake in the thoracic esophagus, sternum and sacrum. A flat, elevated esophageal cancer was identified by upper gastrointestinal endoscopy, and the macroscopic appearance indicated early-stage disease. From the cervical, thoracic and abdominal computed tomography images, there were no metastatic lesions except for the bone lesions. To confirm whether the bone lesions were metastatic, we performed bone biopsy. The histopathological diagnosis was bone marrow hyperplasia. It was crucial for treatment planning to establish whether the lesions were distant metastases. Here, we report a case of esophageal cancer with bone marrow hyperplasia mimicking bone metastasis.

  12. Genome-wide association study using extreme truncate selection identifies novel genes affecting bone mineral density and fracture risk.

    Directory of Open Access Journals (Sweden)

    Emma L Duncan

    2011-04-01

    Full Text Available Osteoporotic fracture is a major cause of morbidity and mortality worldwide. Low bone mineral density (BMD is a major predisposing factor to fracture and is known to be highly heritable. Site-, gender-, and age-specific genetic effects on BMD are thought to be significant, but have largely not been considered in the design of genome-wide association studies (GWAS of BMD to date. We report here a GWAS using a novel study design focusing on women of a specific age (postmenopausal women, age 55-85 years, with either extreme high or low hip BMD (age- and gender-adjusted BMD z-scores of +1.5 to +4.0, n = 1055, or -4.0 to -1.5, n = 900, with replication in cohorts of women drawn from the general population (n = 20,898. The study replicates 21 of 26 known BMD-associated genes. Additionally, we report suggestive association of a further six new genetic associations in or around the genes CLCN7, GALNT3, IBSP, LTBP3, RSPO3, and SOX4, with replication in two independent datasets. A novel mouse model with a loss-of-function mutation in GALNT3 is also reported, which has high bone mass, supporting the involvement of this gene in BMD determination. In addition to identifying further genes associated with BMD, this study confirms the efficiency of extreme-truncate selection designs for quantitative trait association studies.

  13. Does low-field dedicated extremity MRI (E-MRI) reliably detect RA bone erosions? A comparison of two different E-MRI units and conventional radiography with high resolution CT

    DEFF Research Database (Denmark)

    Duer, Anne; Ejbjerg, Bo; Albrecht-Beste, Elisabeth;

    2008-01-01

    underwent, within 2 weeks, CR, CT and two E-MRI (Esaote Biomedica; Artoscan and MagneVu; MV1000) examination of one hand. In all modalities each bone of wrist and (MCP) joints was blindedly evaluated for erosions. Furthermore, MagneVu images were assessed for the proportion of each bone being visualized...

  14. Does low-field dedicated extremity MRI (E-MRI) reliably detect bone erosions in rheumatoid arthritis? A comparison of two different E-MRI units and conventional radiography with high-resolution CT scanning

    DEFF Research Database (Denmark)

    Duer-Jensen, A; Ejbjerg, B; Albrecht-Beste, E;

    2008-01-01

    underwent CR, CT and two E-MRI examinations (Esaote Biomedica Artoscan and MagneVu MV1000) of one hand during a 2-week period. In all modalities, each bone of the wrist and MCP joints was blindly evaluated for erosions. MagneVu images were also assessed for the proportion of each bone being visualised...

  15. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  16. Chondroblastoma of the sphenoid bone

    Directory of Open Access Journals (Sweden)

    Patrocíni, Tomas Gomes

    2008-12-01

    Full Text Available Introduction: Chondroblastoma is an uncommon cartilaginous benign neoplasm, highly destructive, which specifically appears in the epiphysis of long bones in young patients. Its occurrence is extremely rare in the cranial base, normally occurring in the temporal bone. Objective: To describe a rare case in a patient presenting with a sphenoid bone chondroblastoma that invaded the middle cranial cavity, submitted to a successful surgical resection, without recurrence after 2 years. Case Report: W.J.S, 37 years old, male, forwarded to the otorhinolaryngology service with persistent and strong otalgia for 3 months. He had normal otoscopy and without visible tumorations. The computerized tomography confirmed tumor mass in the left infra-temporal cavity, invading the middle cranial cavity. The biopsy suggested giant cells tumor. After wide resection by frontal approach via orbitozygomatic osteotomy. During the surgery, we confirmed tomographic statements and didn't find temporal bone involvement. The histopathological exam confirmed chondroblastoma. After 18 months after the surgery, he doesn't present with complaints, without motor, sensitive deficits or of cranial nerves and without recurrence tomographic signals. Conclusion: The importance of differential diagnosis of chondroblastoma is remarkable in the cranial base lesions and its therapeutic approach, whose objective must always be the major possible resection with the maximum function conservation.