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Sample records for upper-extremity training program

  1. "Ballistic Six" Upper-Extremity Plyometric Training for the Pediatric Volleyball Players.

    Science.gov (United States)

    Turgut, Elif; Cinar-Medeni, Ozge; Colakoglu, Filiz F; Baltaci, Gul

    2017-09-19

    The Ballistic Six exercise program includes commonly used upper-body exercises, and the program is recommended for overhead throwing athletes. The purpose of the current study was to investigate the effects of a 12-week the Ballistic Six upper-extremity plyometric training program on upper-body explosive power, endurance, and reaction time in pediatric overhead athletes. Twenty-eight female pediatric volleyball players participated in the study. The participants were randomly divided into 2 study groups: an intervention group (upper-extremity plyometric training in addition to the volleyball training; n = 14) and a control group (the volleyball training only; n = 14). All the participants were assessed before and after a 12-week training program for upper-body power, strength and endurance, and reaction time. Statistical comparison was performed using an analysis of variance test. Comparisons showed that after a 12-week training program, the Ballistic Six upper-body plyometric training program resulted in more improvements in an overhead medicine ball throwing distance and a push-up performance, as well as greater improvements in the reaction time in the nonthrowing arm when compared with control training. In addition, a 12-week training program was found to be effective in achieving improvements in the reaction time in the throwing arm for both groups similarly. Compared with regular training, upper-body plyometric training resulted in additional improvements in upper-body power and strength and endurance among pediatric volleyball players. The findings of the study provide a basis for developing training protocols for pediatric volleyball players.

  2. 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.

  3. S-22: Upper Extremity Plyometric Training for the Pediatric Overhead Athletes; Randomized Controled Trial

    Directory of Open Access Journals (Sweden)

    Elif Turgut

    2017-03-01

    Full Text Available INTRODUCTION/ PURPOSE: The purpose of the current study was to investigate the effects of a 12-week upper extremity plyometric training program on upper body explosive power, strength and endurance in pediatric overhead athletes.MATERIALS-METHOD: Twenty-eight female pediatric volleyball players participated in the study. The participants were randomly divided into two study groups: an intervention group (upper extremity plyometric training, n = 14 and a control group (n = 14. All of the participants were assessed before and after a 12-week training program for upper body explosive power, strength and endurance. Statistical comparison was performed using an analysis of variance test. FINDINGS: Comparisons showed that after a 12-week training program, the upper body plyometric training program resulted in more improvements in an overhead medicine-ball throwing distance and a push-up performance when compared to control training. DISCUSSION / CONCLUSION: Compared to regular training, upper body plyometric training resulted in additional improvements in upper body power and strength and endurance among female pediatric volleyball players. The findings of the study provide a basis for developing training protocols for pediatric volleyball players.

  4. The Effect of Shoulder Plyometric Training on Amortization Time and Upper-Extremity Kinematics.

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    Swanik, Kathleen A; Thomas, Stephen J; Struminger, Aaron H; Bliven, Kellie C Huxel; Kelly, John D; Swanik, Charles B

    2016-12-01

    Plyometric training is credited with providing benefits in performance and dynamic restraint. However, limited prospective data exist quantifying kinematic adaptations such as amortization time, glenohumeral rotation, and scapulothoracic position, which may underlie the efficacy of plyometric training for upper-extremity rehabilitation or performance enhancement. To measure upper-extremity kinematics and plyometric phase times before and after an 8-wk upper-extremity strength- and plyometric-training program. Randomized pretest-posttest design. Research laboratory. 40 recreationally active men (plyometric group, age 20.43 ± 1.40 y, height 180.00 ± 8.80 cm, weight 73.07 ± 7.21 kg; strength group, age 21.95 ± 3.40 y, height 173.98 ± 11.91 cm, weight 74.79 ± 13.55 kg). Participants were randomly assigned to either a strength-training group or a strength- and plyometric-training group. Each participant performed the assigned training for 8 wk. Dynamic and static glenohumeral and scapular-rotation measurements were taken before and after the training programs. Dynamic measurement of scapular rotation and time spent in each plyometric phase (concentric, eccentric, and amortization) during a ball-toss exercise were recorded while the subjects were fitted with an electromagnetic tracking system. Static measures included scapular upward rotation at 3 different glenohumeral-abduction angles, glenohumeral internal rotation, and glenohumeral external rotation. Posttesting showed that both groups significantly decreased the time spent in the amortization, concentric, and eccentric phases of a ball-toss exercise (P plyometric-training group exhibited an increase in internal rotation that was not present in the strength-training group (P plyometrics and strength training for reducing commonly identified upper-extremity-injury risk factors and improving upper-extremity performance.

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

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    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.

  6. Virtual Reality Training for Upper Extremity in Subacute Stroke (VIRTUES)

    DEFF Research Database (Denmark)

    Brunner, Iris; Skouen, Jan Sture; Hofstad, Håkon

    2017-01-01

    Objective: To compare the effectiveness of upper extremity virtual reality rehabilitation training (VR) to time-matched conventional training (CT) in the subacute phase after stroke. Methods: In this randomized, controlled, single-blind phase III multicenter trial, 120 participants with upper...... extremity motor impairment within 12 weeks after stroke were consecutively included at 5 rehabilitation institutions. Participants were randomized to either VR or CT as an adjunct to standard rehabilitation and stratified according to mild to moderate or severe hand paresis, defined as $20 degrees wrist...... were assessed at baseline, after intervention, and at the 3-month follow-up. Results: Mean time from stroke onset for the VR group was 35 (SD 21) days and for the CT group was 34 (SD 19) days. There were no between-group differences for any of the outcome measures. Improvement of upper extremity motor...

  7. Upper Extremity Muscle Volumes and Functional Strength After Resistance Training in Older Adults

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    Daly, Melissa; Vidt, Meghan E.; Eggebeen, Joel D.; Simpson, W. Greg; Miller, Michael E.; Marsh, Anthony P.; Saul, Katherine R.

    2014-01-01

    Aging leads to a decline in strength and an associated loss of independence. The authors examined changes in muscle volume, maximum isometric joint moment, functional strength, and 1-repetition maximum (1RM) after resistance training (RT) in the upper extremity of older adults. They evaluated isometric joint moment and muscle volume as predictors of functional strength. Sixteen healthy older adults (average age 75 ± 4.3 yr) were randomized to a 6-wk upper extremity RT program or control group. The RT group increased 1RM significantly (p strength (p = .003), isometric shoulder-adduction moment (p = .041), elbow-flexor volume (p = .017), and shoulder-adductor volume (p = .009). Shoulder-muscle volumes and isometric moments were good predictors of functional strength. The authors conclude that shoulder strength is an important factor for performing functional reaching and pulling tasks and a key target for upper extremity RT interventions. PMID:22952203

  8. Effect of Robot-Assisted Game Training on Upper Extremity Function in Stroke Patients

    Science.gov (United States)

    2017-01-01

    Objective To determine the effects of combining robot-assisted game training with conventional upper extremity rehabilitation training (RCT) on motor and daily functions in comparison with conventional upper extremity rehabilitation training (OCT) in stroke patients. Methods Subjects were eligible if they were able to perform the robot-assisted game training and were divided randomly into a RCT and an OCT group. The RCT group performed one daily session of 30 minutes of robot-assisted game training with a rehabilitation robot, plus one daily session of 30 minutes of conventional rehabilitation training, 5 days a week for 2 weeks. The OCT group performed two daily sessions of 30 minutes of conventional rehabilitation training. The effects of training were measured by a Manual Function Test (MFT), Manual Muscle Test (MMT), Korean version of the Modified Barthel Index (K-MBI) and a questionnaire about satisfaction with training. These measurements were taken before and after the 2-week training. Results Both groups contained 25 subjects. After training, both groups showed significant improvements in motor and daily functions measured by MFT, MMT, and K-MBI compared to the baseline. Both groups demonstrated similar training effects, except motor power of wrist flexion. Patients in the RCT group were more satisfied than those in the OCT group. Conclusion There were no significant differences in changes in most of the motor and daily functions between the two types of training. However, patients in the RCT group were more satisfied than those in the OCT group. Therefore, RCT could be a useful upper extremity rehabilitation training method. PMID:28971037

  9. Effect of Robot-Assisted Game Training on Upper Extremity Function in Stroke Patients.

    Science.gov (United States)

    Lee, Kyeong Woo; Kim, Sang Beom; Lee, Jong Hwa; Lee, Sook Joung; Kim, Jin Wan

    2017-08-01

    To determine the effects of combining robot-assisted game training with conventional upper extremity rehabilitation training (RCT) on motor and daily functions in comparison with conventional upper extremity rehabilitation training (OCT) in stroke patients. Subjects were eligible if they were able to perform the robot-assisted game training and were divided randomly into a RCT and an OCT group. The RCT group performed one daily session of 30 minutes of robot-assisted game training with a rehabilitation robot, plus one daily session of 30 minutes of conventional rehabilitation training, 5 days a week for 2 weeks. The OCT group performed two daily sessions of 30 minutes of conventional rehabilitation training. The effects of training were measured by a Manual Function Test (MFT), Manual Muscle Test (MMT), Korean version of the Modified Barthel Index (K-MBI) and a questionnaire about satisfaction with training. These measurements were taken before and after the 2-week training. Both groups contained 25 subjects. After training, both groups showed significant improvements in motor and daily functions measured by MFT, MMT, and K-MBI compared to the baseline. Both groups demonstrated similar training effects, except motor power of wrist flexion. Patients in the RCT group were more satisfied than those in the OCT group. There were no significant differences in changes in most of the motor and daily functions between the two types of training. However, patients in the RCT group were more satisfied than those in the OCT group. Therefore, RCT could be a useful upper extremity rehabilitation training method.

  10. Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke.

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    Lee, Myung Mo; Lee, Kyeong Jin; Song, Chang Ho

    2018-04-27

    BACKGROUND Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. MATERIAL AND METHODS Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. RESULTS At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (pGame-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

  11. A Survey of Fellowship-Trained Upper Extremity Surgeons on Treatment of Lateral Epicondylitis.

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    Niedermeier, Steven R; Crouser, Nisha; Speeckaert, Amy; Goyal, Kanu S

    2018-04-01

    The aim of the study is to investigate current management strategies for lateral epicondylitis by fellowship-trained upper extremity surgeons. A 17-question survey of treatment approaches and outcomes related to lateral epicondylitis was sent to 3354 surgeons using the American Society for Surgery of the Hand and American Shoulder and Elbow Surgeons member databases. Six hundred twelve upper extremity surgeons completed the survey. The 6 most frequently prescribed nonoperative treatments for lateral epicondylitis were home exercise program/stretching (81%), nonsteroidal anti-inflammatory drugs (75%), steroid injection (71%), counterforce bracing (68%), formal physical therapy (65%), and wrist brace (47%). Less commonly performed nonoperative treatment measures included platelet-rich plasma injection (16%), Tenex procedure (6%), and iontophoresis (2%). There is a lack of consensus in the literature for the management of lateral epicondylitis, which is reflected by individual variation in clinical treatment among the experts. Future prospective randomized control studies are needed to establish evidence-based practice standards for this common diagnosis.

  12. 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

  13. Computer-assisted upper extremity training using interactive biking exercise (iBikE) platform.

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    Jeong, In Cheol; Finkelstein, Joseph

    2012-01-01

    Upper extremity exercise training has been shown to improve clinical outcomes in different chronic health conditions. Arm-operated bicycles are frequently used to facilitate upper extremity training however effective use of these devices at patient homes is hampered by lack of remote connectivity with clinical rehabilitation team, inability to monitor exercise progress in real time using simple graphical representation, and absence of an alert system which would prevent exertion levels exceeding those approved by the clinical rehabilitation team. We developed an interactive biking exercise (iBikE) platform aimed at addressing these limitations. The platform uses a miniature wireless 3-axis accelerometer mounted on a patient wrist that transmits the cycling acceleration data to a laptop. The laptop screen presents an exercise dashboard to the patient in real time allowing easy graphical visualization of exercise progress and presentation of exercise parameters in relation to prescribed targets. The iBikE platform is programmed to alert the patient when exercise intensity exceeds the levels recommended by the patient care provider. The iBikE platform has been tested in 7 healthy volunteers (age range: 26-50 years) and shown to reliably reflect exercise progress and to generate alerts at pre-setup levels. Implementation of remote connectivity with patient rehabilitation team is warranted for future extension and evaluation efforts.

  14. Short-term effects of upper extremity circuit resistance training on muscle strength and functional independence in patients with paraplegia.

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    Yildirim, Adem; Sürücü, Gülseren Dost; Karamercan, Ayşe; Gedik, Dilay Eken; Atci, Nermin; Dülgeroǧlu, Deniz; Özgirgin, Neşe

    2016-11-21

    A number of exercises to strengthen the upper extremities are recommended to increase functional independence and quality of life (QoL) in patients with paraplegia. Circuit resistance training (CRT) is a type of progressive resistive exercise performed repeatedly at fixed mechanical exercise stations. The aim of this study was to investigate the potential benefits of CRT for upper extremity muscle strength, functional independence, and QoL in patients with paraplegia. Twenty-six patients with paraplegia who were participating in a conventional rehabilitation program at a tertiary education and research hospital were enrolled in this study. The participants were randomly assigned to two groups. The exercise group participated in the CRT program, which consisted of repetitive exercises for the upper extremities performed at fixed mechanical stations 5 sessions per week for 6 weeks, in addition to conventional rehabilitation. Participants in the control group received only conventional rehabilitation over the same period. We compared the groups with respect to QoL, as well as isokinetic muscle test outcomes in the upper extremities, using the Functional Independence Measure (FIM) and Borg's scale. We observed significant increases in scores on the physical component of the FIM, Borg's scale, and QoL in both the exercise and control groups. Furthermore, the large majority of isokinetic values were significantly more improved in the exercise group compared to the control group. When post-treatment outcomes were compared between the groups, improvements in scores on the physical component of the FIM and in most isokinetic values were significantly greater in the exercise group. This study showed that CRT has positive effects on muscle strength in the upper extremities and the physical disability components of the FIM when added to conventional rehabilitation programs for paraplegic patients. However, we observed no significant improvement in QoL scores after adding CRT

  15. Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke

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    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

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

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    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.

  17. 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.

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

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    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.

  19. 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.

  20. Feasibility of task-specific brain-machine interface training for upper-extremity paralysis in patients with chronic hemiparetic stroke.

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    Nishimoto, Atsuko; Kawakami, Michiyuki; Fujiwara, Toshiyuki; Hiramoto, Miho; Honaga, Kaoru; Abe, Kaoru; Mizuno, Katsuhiro; Ushiba, Junichi; Liu, Meigen

    2018-01-10

    Brain-machine interface training was developed for upper-extremity rehabilitation for patients with severe hemiparesis. Its clinical application, however, has been limited because of its lack of feasibility in real-world rehabilitation settings. We developed a new compact task-specific brain-machine interface system that enables task-specific training, including reach-and-grasp tasks, and studied its clinical feasibility and effectiveness for upper-extremity motor paralysis in patients with stroke. Prospective beforeâ€"after study. Twenty-six patients with severe chronic hemiparetic stroke. Participants were trained with the brain-machine interface system to pick up and release pegs during 40-min sessions and 40 min of standard occupational therapy per day for 10 days. Fugl-Meyer upper-extremity motor (FMA) and Motor Activity Log-14 amount of use (MAL-AOU) scores were assessed before and after the intervention. To test its feasibility, 4 occupational therapists who operated the system for the first time assessed it with the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) 2.0. FMA and MAL-AOU scores improved significantly after brain-machine interface training, with the effect sizes being medium and large, respectively (pmachine interface system is feasible for use in real-world clinical settings.

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

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    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.

  2. Home programs for upper extremity recovery post-stroke: a survey of occupational therapy practitioners.

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    Donoso Brown, Elena V; Fichter, Renae

    2017-12-01

    Upper extremity hemiparesis is an impairment post-stroke that impacts quality of life. Home programs are an intervention strategy used by many occupational therapists to support continued motor recovery post-stroke, yet little is known about how these programs are designed and implemented. The purpose of this study was to describe how occupational therapy practitioners approach this task and specifically what strategies they use to support adherence and what types of technology are most commonly used. An on-line survey methodology was used. Participants were recruited through multiple sources including state associations and occupational therapy educational program directors. A total of 73 occupational therapy practitioners submitted complete surveys. It was found that majority of occupational therapy practitioners in the sample (n = 53) reported creating home programs focused on upper extremity motor recovery more than 80% of the time. Range of motion and strengthening were reported as being in the top three most commonly used interventions by more than half the sample, however incorporating clients' goals and interests were reported most often as strategies to create meaning in the home program. Respondents also reported limited incorporation of technology and strategies to support adherence. Personal motivation was reported by occupational therapy practitioners to be a key moderator of adherence to a home program. Occupational therapy practitioners often provide home programs for individuals post-stroke focusing on upper extremity function. Future research that aims to understand stakeholders' perspectives on home programs and determine effective strategies for ensuring adherence is needed.

  3. Survey of upper extremity injuries among martial arts participants.

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    Diesselhorst, Matthew M; Rayan, Ghazi M; Pasque, Charles B; Peyton Holder, R

    2013-01-01

    To survey participants at various experience levels of different martial arts (MA) about upper extremity injuries sustained during training and fighting. A 21-s question survey was designed and utilised. The survey was divided into four groups (Demographics, Injury Description, Injury Mechanism, and Miscellaneous information) to gain knowledge about upper extremity injuries sustained during martial arts participation. Chi-square testing was utilised to assess for significant associations. Males comprised 81% of respondents. Involvement in multiple forms of MA was the most prevalent (38%). The hand/wrist was the most common area injured (53%), followed by the shoulder/upper arm (27%) and the forearm/elbow (19%). Joint sprains/muscle strains were the most frequent injuries reported overall (47%), followed by abrasions/bruises (26%). Dislocations of the upper extremity were reported by 47% of participants while fractures occurred in 39%. Surgeries were required for 30% of participants. Females were less likely to require surgery and more likely to have shoulder and elbow injuries. Males were more likely to have hand injuries. Participants of Karate and Tae Kwon Do were more likely to have injuries to their hands, while participants of multiple forms were more likely to sustain injuries to their shoulders/upper arms and more likely to develop chronic upper extremity symptoms. With advanced level of training the likelihood of developing chronic upper extremity symptoms increases, and multiple surgeries were required. Hand protection was associated with a lower risk of hand injuries. Martial arts can be associated with substantial upper extremity injuries that may require surgery and extended time away from participation. Injuries may result in chronic upper extremity symptoms. Hand protection is important for reducing injuries to the hand and wrist.

  4. 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

  5. Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial.

    Science.gov (United States)

    Esmaeilzadeh, Sina; Ozcan, Emel; Capan, Nalan

    2014-01-01

    The aim of the study was to determine effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders (WUEMSDs) among computer workers. Four hundred computer workers answered a questionnaire on work-related upper extremity musculoskeletal symptoms (WUEMSS). Ninety-four subjects with WUEMSS using computers at least 3 h a day participated in a prospective, randomized controlled 6-month intervention. Body posture and workstation layouts were assessed by the Ergonomic Questionnaire. We used the Visual Analogue Scale to assess the intensity of WUEMSS. The Upper Extremity Function Scale was used to evaluate functional limitations at the neck and upper extremities. Health-related quality of life was assessed with the Short Form-36. After baseline assessment, those in the intervention group participated in a multicomponent ergonomic intervention program including a comprehensive ergonomic training consisting of two interactive sessions, an ergonomic training brochure, and workplace visits with workstation adjustments. Follow-up assessment was conducted after 6 months. In the intervention group, body posture (p 0.05). Ergonomic intervention programs may be effective in reducing ergonomic risk factors among computer workers and consequently in the secondary prevention of WUEMSDs.

  6. Robots integrated with virtual reality simulations for customized motor training in a person with upper extremity hemiparesis: a case report

    Science.gov (United States)

    Fluet, Gerard G.; Merians, Alma S.; Qiu, Qinyin; Lafond, Ian; Saleh, Soha; Ruano, Viviana; Delmonico, Andrea R.; Adamovich, Sergei V.

    2014-01-01

    Background and Purpose A majority of studies examining repetitive task practice facilitated by robots for the treatment of upper extremity paresis utilize standardized protocols applied to large groups. Others utilize interventions tailored to patients but don't describe the clinical decision making process utilized to develop and modify interventions. This case report will describe a robot-based intervention customized to match the goals and clinical presentation of a gentleman with upper extremity hemiparesis secondary to stroke. Methods PM is an 85 year-old man with left hemiparesis secondary to an intracerebral hemorrhage five years prior to examination. Outcomes were measured before and after a one month period of home therapy and after a one month robotic intervention. The intervention was designed to address specific impairments identified during his PT examination. When necessary, activities were modified based on the patient's response to his first week of treatment. Outcomes PM trained twelve sessions using six virtually simulated activities. Modifications to original configurations of these activities resulted in performance improvements in five of these activities. PM demonstrated a 35 second improvement in Jebsen Test of Hand Function time and a 44 second improvement in Wolf Motor Function Test time subsequent to the robotic training intervention. Reaching kinematics, 24 hour activity measurement and the Hand and Activities of Daily Living scales of the Stroke Impact Scale all improved as well. Discussion A customized program of robotically facilitated rehabilitation resulted in large short-term improvements in several measurements of upper extremity function in a patient with chronic hemiparesis. PMID:22592063

  7. Effects of interactive metronome training on upper extremity function, ADL and QOL in stroke patients.

    Science.gov (United States)

    Yu, Ga-Hui; Lee, Jae-Shin; Kim, Su-Kyoung; Cha, Tae-Hyun

    2017-01-01

    Rhythm and timing training is stimulation that substitutes for a damaged function controls muscular movement or temporal element, which has positive impacts on the neurological aspect and movement of the brain. This study is to assess the changes caused by rhythm and timing training using an interactive metronome (IM) on upper extremity function, ADL and QOL in stroke patients. In order to assess the effects of IM training, a group experiment was conducted on 30 stroke patients. Twelve sessions of IM training were provided for the experimental group three times a week for four weeks, while the control group was trained with a Bilateral arm Self-Exercise (BSE) for the same period. Both groups were evaluated by pre- and post-tests through MFT, MAL, K-MBI and SS-QOL. There were more statistically significant differences (<0.05) in the total score of MFT and the finger control item in the IM Group than in the BSE Group. With respect to ADL, there were more statistically significant differences (<0.05) in the total score of K-MBI and the dressing item in the IM Group than in the BSE Group. The study proposes that IM training can be applied as an occupational therapy program in patients with various diseases who need to adjust the time for performing movements as well as stroke patients.

  8. Web Based Information System for Job Training Activities Using Personal Extreme Programming (PXP)

    Science.gov (United States)

    Asri, S. A.; Sunaya, I. G. A. M.; Rudiastari, E.; Setiawan, W.

    2018-01-01

    Job training is one of the subjects in university or polytechnic that involves many users and reporting activities. Time and distance became problems for users to reporting and to do obligations tasks during job training due to the location where the job training took place. This research tried to develop a web based information system of job training to overcome the problems. This system was developed using Personal Extreme Programming (PXP). PXP is one of the agile methods is combination of Extreme Programming (XP) and Personal Software Process (PSP). The information system that has developed and tested which are 24% of users are strongly agree, 74% are agree, 1% disagree and 0% strongly disagree about system functionality.

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

    OpenAIRE

    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 a...

  10. Rehabilitation robotics for the upper extremity: review with new directions for orthopaedic disorders.

    Science.gov (United States)

    Hakim, Renée M; Tunis, Brandon G; Ross, Michael D

    2017-11-01

    The focus of research using technological innovations such as robotic devices has been on interventions to improve upper extremity function in neurologic populations, particularly patients with stroke. There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on this evidence, we describe application and feasibility of virtual reality-enhanced robotics integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with upper extremity disorders, specifically emphasizing the wrist and hand. The purpose of this paper is to describe virtual reality-enhanced rehabilitation robotic devices, review evidence of application in patients with upper extremity deficits related to neurologic disorders, and suggest how this technology and task-oriented rehabilitation approach can also benefit patients with orthopaedic disorders of the wrist and hand. We will also discuss areas for further research and development using a task-oriented approach and a commercially available haptic robotic device to focus on training of grasp and manipulation tasks. Implications for Rehabilitation There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches using rehabilitation robotics are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on the evidence in neurologic populations, virtual reality-enhanced robotics

  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 low-cost video game applied for training of upper extremity function in children with cerebral palsy: a pilot study.

    Science.gov (United States)

    Jannink, Michiel J A; van der Wilden, Gelske J; Navis, Dorine W; Visser, Gerben; Gussinklo, Jeanine; Ijzerman, Maarten

    2008-02-01

    The aim of the present study was to determine the user satisfaction of the EyeToy for the training of the upper limb in children with cerebral palsy (CP). User satisfaction was measured in 12 children with CP, using a postexperience questionnaire, primarily based on a presence questionnaire. In general, children with CP were satisfied with and motivated by the EyeToy training. In addition, a first evaluation study was performed to determine the effect of this training method on the upper limb function. Ten children with CP were randomly assigned to the intervention (mean age 11 years, 9 months; SD 2,3) and the control group (mean age 12 years, 3 months; SD 3,2). After a treatment period of 6 weeks, the intervention group completed a user satisfaction questionnaire. Functional outcome was measured using the Melbourne Assessment scores. Percentage scores of the Melbourne Assessment of 7 of the 10 children were the same or changed only 1% to 2% from baseline to followup. However, in the experimental group, two children improved more, 9% and 13% respectively. In conclusion, it can be said that the EyeToy is a motivational training tool for the training of children with CP and has the potential to improve upper extremity function.

  13. Injuries in an Extreme Conditioning Program

    OpenAIRE

    Aune, Kyle T.; Powers, Joseph M.

    2016-01-01

    Background: Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. Hypothesis: The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occ...

  14. Injuries in an Extreme Conditioning Program.

    Science.gov (United States)

    Aune, Kyle T; Powers, Joseph M

    2016-10-19

    Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occur to the shoulder and back. Cross-sectional study. Level 4. This is a retrospective survey of injuries reported by athletes participating in an ECP. An injury survey was sent to 1100 members of Iron Tribe Fitness, a gym franchise with 5 locations across Birmingham, Alabama, that employs exercises consistent with an ECP in this study. An injury was defined as a physical condition resulting from ECP participation that caused the athlete to either seek medical treatment, take time off from exercising, or make modifications to his or her technique to continue. A total of 247 athletes (22%) completed the survey. The majority (57%) of athletes were male (n = 139), and 94% of athletes were white (n = 227). The mean age of athletes was 38.9 years (±8.9 years). Athletes reported participation in the ECP for, on average, 3.6 hours per week (± 1.2 hours). Eighty-five athletes (34%) reported that they had sustained an injury while participating in the ECP. A total of 132 injuries were recorded, yielding an estimated incidence of 2.71 per 1000 hours. The shoulder or upper arm was the most commonly injured body site, accounting for 38 injuries (15% of athletes). Athletes with a previous shoulder injury were 8.1 times as likely to injure their shoulder in the ECP compared with athletes with healthy shoulders. The trunk, back, head, or neck (n = 29, 12%) and the leg or knee (n = 29, 12%) were the second most commonly injured sites. The injury incidence rate among athletes with study estimates the incidence of

  15. Angiography of the upper extremity

    International Nuclear Information System (INIS)

    Janevski, B.K.

    1982-01-01

    This thesis provides a description of the technical and medical aspects of arteriography of the upper extremity and an extensive analysis of the angiographic anatomy and pathology of 750 selective studies performed in more than 500 patients. A short historical review is provided of angiography as a whole and of arteriography of the hand in particular. The method of percutaneous transfemoral catheterization of the arteries of the upper extremity and particularly the arteries of the hand is considered, discussing the problems the angiographer encounters frequently, describing the angiographic complications which may occur and emphasizing the measures to keep them to a minimum. The use of vasodilators in hand angiography is discussed. A short description of the embryological patterns persisting in the arteries of the arm is included in order to understand the congenital variations of the arteries of the upper extremity. The angiographic patterns and clinical aspects of the most common pathological processes involving the arteries of the upper extremities are presented. Special attention is paid to the correlation between angiography and pathology. (Auth.)

  16. Cognitive Impairments and Depressive Symptoms Did Not Impede Upper Extremity Recovery in a Clinical Repetitive Task Practice Program after Stroke

    Science.gov (United States)

    Skidmore, Elizabeth R.; Becker, James T.; Whyte, Ellen M.; Huber, Lynne M.; Waterstram, Laura F.; Ward, Amalie Andrew; Grattan, Emily S.; Holm, Margo B.

    2012-01-01

    Objective We examined whether cognitive impairments or depressive symptoms impeded improvement in upper extremity function in a clinical repetitive task practice program. Design Participants had mild to moderate upper extremity impairment after stroke (n=20). We characterized baseline cognitive function and depressive symptoms with the Repeatable Battery of Neuropsychological Status and the Hamilton Rating Scale for Depression. We measured upper extremity function at baseline, week 4 and week 24 with the Action Research Arm Test. Results Participants with and without cognitive impairments improved significantly over time (F1,17=84.48, pstroke (t17=.07, p=.95). Participants with and without depressive symptoms improved significantly over time (F1,18=86.29, pstroke (t17=.06, p=.95). Conclusions Preliminary findings suggest that cognitive impairments and depressive symptoms may not impede benefit from repetitive task practice after stroke. PMID:22311057

  17. Injuries in an Extreme Conditioning Program

    Science.gov (United States)

    Aune, Kyle T.; Powers, Joseph M.

    2016-01-01

    Background: Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. Hypothesis: The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occur to the shoulder and back. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: This is a retrospective survey of injuries reported by athletes participating in an ECP. An injury survey was sent to 1100 members of Iron Tribe Fitness, a gym franchise with 5 locations across Birmingham, Alabama, that employs exercises consistent with an ECP in this study. An injury was defined as a physical condition resulting from ECP participation that caused the athlete to either seek medical treatment, take time off from exercising, or make modifications to his or her technique to continue. Results: A total of 247 athletes (22%) completed the survey. The majority (57%) of athletes were male (n = 139), and 94% of athletes were white (n = 227). The mean age of athletes was 38.9 years (±8.9 years). Athletes reported participation in the ECP for, on average, 3.6 hours per week (± 1.2 hours). Eighty-five athletes (34%) reported that they had sustained an injury while participating in the ECP. A total of 132 injuries were recorded, yielding an estimated incidence of 2.71 per 1000 hours. The shoulder or upper arm was the most commonly injured body site, accounting for 38 injuries (15% of athletes). Athletes with a previous shoulder injury were 8.1 times as likely to injure their shoulder in the ECP compared with athletes with healthy shoulders. The trunk, back, head, or neck (n = 29, 12%) and the leg or knee (n = 29, 12%) were the second most commonly injured sites. The

  18. Increasing upper limb training intensity in chronic stroke using embodied virtual reality: a pilot study.

    Science.gov (United States)

    Perez-Marcos, Daniel; Chevalley, Odile; Schmidlin, Thomas; Garipelli, Gangadhar; Serino, Andrea; Vuadens, Philippe; Tadi, Tej; Blanke, Olaf; Millán, José D R

    2017-11-17

    Technology-mediated neurorehabilitation is suggested to enhance training intensity and therefore functional gains. Here, we used a novel virtual reality (VR) system for task-specific upper extremity training after stroke. The system offers interactive exercises integrating motor priming techniques and embodied visuomotor feedback. In this pilot study, we examined (i) rehabilitation dose and training intensity, (ii) functional improvements, and (iii) safety and tolerance when exposed to intensive VR rehabilitation. Ten outpatient stroke survivors with chronic (>6 months) upper extremity paresis participated in a ten-session VR-based upper limb rehabilitation program (2 sessions/week). All participants completed all sessions of the treatment. In total, they received a median of 403 min of upper limb therapy, with 290 min of effective training. Within that time, participants performed a median of 4713 goal-directed movements. Importantly, training intensity increased progressively across sessions from 13.2 to 17.3 movements per minute. Clinical measures show that despite being in the chronic phase, where recovery potential is thought to be limited, participants showed a median improvement rate of 5.3% in motor function (Fugl-Meyer Assessment for Upper Extremity; FMA-UE) post intervention compared to baseline, and of 15.4% at one-month follow-up. For three of them, this improvement was clinically significant. A significant improvement in shoulder active range of motion (AROM) was also observed at follow-up. Participants reported very low levels of pain, stress and fatigue following each session of training, indicating that the intensive VR intervention was well tolerated. No severe adverse events were reported. All participants expressed their interest in continuing the intervention at the hospital or even at home, suggesting high levels of adherence and motivation for the provided intervention. This pilot study showed how a dedicated VR system could deliver high

  19. Portable upper extremity robotics is as efficacious as upper extremity rehabilitative therapy: a randomized controlled pilot trial.

    Science.gov (United States)

    Page, Stephen J; Hill, Valerie; White, Susan

    2013-06-01

    To compare the efficacy of a repetitive task-specific practice regimen integrating a portable, electromyography-controlled brace called the 'Myomo' versus usual care repetitive task-specific practice in subjects with chronic, moderate upper extremity impairment. Sixteen subjects (7 males; mean age 57.0 ± 11.02 years; mean time post stroke 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Subjects were administered repetitive task-specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30 minutes in duration, occurring 3 days/week for eight weeks. One group participated in repetitive task-specific practice entirely while wearing the portable robotic, while the other performed the same activity regimen manually. The upper extremity Fugl-Meyer, Canadian Occupational Performance Measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. After intervention, groups exhibited nearly identical Fugl-Meyer score increases of ≈2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian Occupational Performance Measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Findings suggest that therapist-supervised repetitive task-specific practice integrating robotics is as efficacious as manual practice in subjects with moderate upper extremity impairment.

  20. The effect of extremity strength training on fibromyalgia symptoms and disease impact in an existing multidisciplinary treatment program.

    Science.gov (United States)

    Kas, Tamara; Colby, Megan; Case, Maureen; Vaughn, Dan

    2016-10-01

    The purpose of this study was to examine the effect of upper and lower body extremity strengthening exercise in patients with Fibromyalgia (FM) within an existing multidisciplinary treatment program. Patients between the ages of 18-65 with the medical diagnosis of FM. Comparative study design. The control and experimental group received the same multidisciplinary treatment except that the experimental group performed upper and lower extremity strengthening exercises. The Fibromyalgia Impact Questionnaire (FIQ) was administered at evaluation and discharge from the program in order to measure change in quality of life (QOL). Statistically significant changes in FIQ scores were found for both groups. The addition of extremity strengthening in the experimental group produced an average 4 points greater reduction in FIQ score, however, these results are not considered statistically significant. This study appears to validate the success of a multidisciplinary approach in treating patients with FM, with the possibility for further benefit with the addition of extremity strengthening. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. The effects of Nintendo Wii(TM)-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: a randomized controlled study.

    Science.gov (United States)

    Şimşek, Tülay Tarsuslu; Çekok, Kübra

    2016-12-01

    The aim of this study was to investigate the effects of Nintendo Wii(TM)-based balance and upper extremity training on activities of daily living and quality of life in patients with subacute stroke. 42 adults with stroke (mean age (SD) = 58.04 (16.56) years and mean time since stroke (SD) = (55.2 ± 22.02 days (∼8 weeks)) were included in the study. Participants were enrolled from the rehabilitation department of a medical center (a single inpatient rehabilitation facility). Participants were randomly assigned to Nintendo Wii group (n = 20) or Bobath neurodevelopmental treatment (NDT) (n = 22). The treatments were applied for 10 weeks (45-60 minutes/day, 3 days/week) for both of two groups. Nintendo Wii group used five games selected from the Wii sports and Wii Fit packages for upper limb and balance training, respectively. The patients in Bobath NDT group were applied a therapy program included upper extremity activites, strength, balance gait and functional training. The functional independence in daily life activities and health-related quality of life was assessed with Functional Independence Measure (FIM) and Nottingham Health Profile (NHP), respectively. Participant's treatment satisfaction was recorded by using Visual Analogue Scale. A second evaluation (FIM and NHP) occurred after 10 weeks at the end of rehabilitative treatment (post-training). Treatment satisfaction was measured after 10 sessions. There were significant difference between FIM and NHP values in NDT and Nintendo Wii group (p 0.05). The patients in Nintendo Wii group were detected to be better satisfied from the therapy (p Bobath NDT on daily living functions and quality of life in subacute stroke patients.

  2. Upper extremity weightlifting injuries: Diagnosis and management.

    Science.gov (United States)

    Golshani, Kayvon; Cinque, Mark E; O'Halloran, Peter; Softness, Kenneth; Keeling, Laura; Macdonell, J Ryan

    2018-03-01

    Common upper extremity injuries in resistance training athletes include muscle strains, ligament sprains, pectoralis major tendon ruptures, distal biceps tendon ruptures, and chronic shoulder pain and capsulolabral injuries. While each injury is unique in its specific anatomic location and mechanism, each is preventable with proper exercise technique, safety and maintenance of muscle balance. Conservative treatment is the therapeutic modality of choice and these injuries generally resolve with workout modification, appropriate recovery, anti-inflammatory medication, and physical therapy. If conservative treatment fails, surgical intervention is often successful and can return the weightlifter to a level of performance near their pre-injury level.

  3. Comparing unilateral and bilateral upper limb training: The ULTRA-stroke program design

    Directory of Open Access Journals (Sweden)

    Koppe Peter

    2009-11-01

    Full Text Available Abstract Background About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40% regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions - constraint-induced movement therapy (CIMT and bilateral arm training with rhythmic auditory cueing (BATRAC - have shown promising results in the treatment of upper limb paresis in chronic stroke patients. The ULTRA-stroke (acronym for Upper Limb TRaining After stroke program was conceived to assess the effectiveness of these interventions in subacute stroke patients and to examine how the observed changes in sensori-motor functioning relate to changes in stroke recovery mechanisms associated with peripheral stiffness, interlimb interactions, and cortical inter- and intrahemispheric networks. The present paper describes the design of this single-blinded randomized clinical trial (RCT, which has recently started and will take several years to complete. Methods/Design Sixty patients with a first ever stroke will be recruited. Patients will be stratified in terms of their remaining motor ability at the distal part of the arm (i.e., wrist and finger movements and randomized over three intervention groups receiving modified CIMT, modified BATRAC, or an equally intensive (i.e., dose-matched conventional treatment program for 6 weeks. Primary outcome variable is the score on the Action Research Arm test (ARAT, which will be assessed before, directly after, and 6 weeks after the intervention. During those test sessions all patients will also undergo measurements aimed at investigating the associated recovery mechanisms using haptic robots and magneto-encephalography (MEG. Discussion ULTRA-stroke is a 3-year translational research program which aims (1 to assess the relative effectiveness of the three interventions, on a group level but also as a function of patient

  4. Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

    Directory of Open Access Journals (Sweden)

    Seth Stake

    2016-01-01

    Full Text Available Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

  5. Upper Extremity Deep Vein Thromboses: The Bowler and the Barista.

    Science.gov (United States)

    Stake, Seth; du Breuil, Anne L; Close, Jeremy

    2016-01-01

    Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

  6. 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 < 0.01) and the sedentary group (p < 0.01) in all classes of range of motion. The upper-body sports group was significantly more flexible in five classes of range of motion and significantly tighter in range of motion of wrist flexion (p < 0.01) compared to the lower-body sports group. It was concluded that the youths participating in soft martial arts had good upper extremities flexibility that might not result from regular exercise alone.

  7. Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke.

    Science.gov (United States)

    Choi, Yoon-Hee; Ku, Jeonghun; Lim, Hyunmi; Kim, Yeo Hyung; Paik, Nam-Jong

    2016-05-02

    Virtual reality (VR) has the potential to provide intensive, repetitive, and task-oriented training, and game-based therapy can enhance patients' motivation and enjoyment. The objective of the present study was to develop a mobile game-based upper extremity VR program for patients who have experienced stroke, and to evaluate the feasibility and effectiveness of the program. This randomized, double-blind, controlled trial included 24 patients with ischemic stroke. The intervention group (n = 12) received 30 min of conventional occupational therapy (OT) and 30 min of the mobile upper extremity rehabilitation program using a smartphone and a tablet PC (MoU-Rehab). The controls (n = 12) received conventional OT alone for 1 h per day. Rehabilitation consisted of 10 sessions of therapy, 5 days per week, for 2 weeks. The outcome measures (Fugl-Meyer Assessment of the upper extremity [FMA-UE], Brunnström stage [B-stage] for the arm and the hand, manual muscle testing [MMT], modified Barthel index [MBI], EuroQol-5 Dimension [EQ-5D], and Beck Depression Inventory [BDI]) were assessed at the beginning and end of treatment, and at 1 month. User satisfaction was evaluated by a questionnaire. A greater improvement in the FMA-UE, B-stage, and MMT was found after treatment with the MoU-Rehab than with conventional therapy. The extent of improvements in the MBI, EQ-5D, and BDI was not significantly different between the two groups. Patients in the experimental group completed the 2-weeks treatment without adverse effects, and they were generally satisfied with MoU-Rehab. This mobile game-based VR rehabilitation program appears to be feasible and effective for promoting upper limb recovery after ischemic stroke.

  8. Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review

    Directory of Open Access Journals (Sweden)

    Spooren Annemie IF

    2012-07-01

    Full Text Available Abstract Background The upper extremity plays an important role in daily functioning of patients with Multiple Sclerosis (MS and strongly influences their quality of life. However, an explicit overview of arm-hand training programs is lacking. The present review aims to investigate the training components and the outcome of motor training programs for arm and hand in MS. Methods A computerized systematic literature search in 5 databases (PubMed, CINAHL, EMBASE, PEDro and Cochrane was performed using the following Mesh terms: Multiple Sclerosis, Rehabilitation, Physical Education and Training, Exercise, Patient-Centered Care, Upper Extremity, Activities of Daily Living, Motor Skills, Motor Activity, Intervention Studies and Clinical Trial. The methodological quality of the selected articles was scored with the Van Tulder Checklist. A descriptive analyses was performed using the PICO principle, including scoring of training components with the calculation of Hedges’g effect sizes. Results Eleven studies were eligible (mean Van Tulder-score = 10.82(SD2.96. Most studies reported a specific improvement in arm hand performance at the ICF level that was trained at. The mean number of training components was 5.5(SD2.8 and a significant correlation (r = 0.67; p  Conclusion Motor training programs (both at the ICF body function and activity level have shown to improve arm and hand performance in MS in which the value of the training specificity was emphasized. To optimize upper extremity training in MS the component ‘client-centred’ and ‘exercise progression’ may be important. Furthermore, given the importance attributed to the components ‘distribution based practice’, ‘feedback’ and ‘random practice’ in previous research in stroke patients, the use of these components in arm hand training should be explored in future research.

  9. 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.

  10. Factors favorable to frequent extreme precipitation in the upper Yangtze River Valley

    Science.gov (United States)

    Tian, Baoqiang; Fan, Ke

    2013-08-01

    Extreme precipitation events in the upper Yangtze River Valley (YRV) have recently become an increasingly important focus in China because they often cause droughts and floods. Unfortunately, little is known about the climate processes responsible for these events. This paper investigates factors favorable to frequent extreme precipitation events in the upper YRV. Our results reveal that a weakened South China Sea summer monsoon trough, intensified Eurasian-Pacific blocking highs, an intensified South Asian High, a southward subtropical westerly jet and an intensified Western North Pacific Subtropical High (WNPSH) increase atmospheric instability and enhance the convergence of moisture over the upper YRV, which result in more extreme precipitation events. The snow depth over the eastern Tibetan Plateau (TP) in winter and sea surface temperature anomalies (SSTAs) over three key regions in summer are important external forcing factors in the atmospheric circulation anomalies. Deep snow on the Tibetan Plateau in winter can weaken the subsequent East Asian summer monsoon circulation above by increasing the soil moisture content in summer and weakening the land-sea thermal contrast over East Asia. The positive SSTA in the western North Pacific may affect southwestward extension of the WNPSH and the blocking high over northeastern Asia by arousing the East Asian-Pacific pattern. The positive SSTA in the North Atlantic can affect extreme precipitation event frequency in the upper YRV via a wave train pattern along the westerly jet between the North Atlantic and East Asia. A tripolar pattern from west to east over the Indian Ocean can strengthen moisture transport by enhancing Somali cross-equatorial flow.

  11. Black breast cancer survivors experience greater upper extremity disability.

    Science.gov (United States)

    Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

    2015-11-01

    Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

  12. Suitability of Hydraulic Disk Brakes for Passive Actuation of Upper-Extremity Rehabilitation Exoskeleton

    Directory of Open Access Journals (Sweden)

    Arno H. A. Stienen

    2009-01-01

    Full Text Available Passive, energy-dissipating actuators are promising for force-coordination training in stroke rehabilitation, as they are inherently safe and have a high torque-to-weight ratio. The goal of this study is to determine if hydraulic disk brakes are suitable to actuate an upper-extremity exoskeleton, for application in rehabilitation settings. Passive actuation with friction brakes has direct implications for joint control. Braking is always opposite to the movement direction. During standstill, the measured torque is equal to the torque applied by the human. During rotations, it is equal to the brake torque. Actively assisting movement is not possible, nor are energy-requiring virtual environments. The evaluated disk brake has a 20 Nm bandwidth (flat-spectrum, multi-sine of 10 Hz; sufficient for torques required for conventional therapy and simple, passive virtual environments. The maximum static output torque is 120 Nm, sufficient for isometric training of the upper extremity. The minimal impedance is close zero, with only the inertia of the device felt. In conclusion, hydraulic disk brakes are suitable for rehabilitation devices.

  13. 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.

  14. Effects of a sitting boxing program on upper limb function, balance, gait, and quality of life in stroke patients.

    Science.gov (United States)

    Park, Junhyuck; Gong, Jihwan; Yim, Jongeun

    2017-01-01

    Boxing training including traditional stretching, muscular strength training, and duration training would be considered to be effective for improved functional stretching, dynamic balance, walking speed, and quality of life. We aimed to investigate upper limb function, balance, gait, and quality of life in stroke patients before and after a sitting boxing program. Twenty-six participants were randomly allocated to a boxing group (n = 13) and control group (n = 13) after the upper limb function, balance, gait, and quality of Life were recorded. The boxing group underwent a sitting boxing program (3 times/week) as well as conventional physical therapy (3 times/week) for 6 weeks. The control group only underwent conventional physical therapy (3 times/week) for 6 weeks. The Manual Functional Test (MFT), non-affected hand grip, Berg Balance Scale (BBS), velocity moment with eye opened, 10-m Walk Test (10 MWT), and Stroke-Specific Quality of Life questionnaire (SS-QOL) were significantly improved in the boxing group (p boxing group compared to the control group (p boxing program group had positive effects on upper extremity function, balance, gait, and quality of life in stroke patients.

  15. Numerical Analysis of Flood modeling of upper Citarum River under Extreme Flood Condition

    Science.gov (United States)

    Siregar, R. I.

    2018-02-01

    This paper focuses on how to approach the numerical method and computation to analyse flood parameters. Water level and flood discharge are the flood parameters solved by numerical methods approach. Numerical method performed on this paper for unsteady flow conditions have strengths and weaknesses, among others easily applied to the following cases in which the boundary irregular flow. The study area is in upper Citarum Watershed, Bandung, West Java. This paper uses computation approach with Force2 programming and HEC-RAS to solve the flow problem in upper Citarum River, to investigate and forecast extreme flood condition. Numerical analysis based on extreme flood events that have occurred in the upper Citarum watershed. The result of water level parameter modeling and extreme flood discharge compared with measurement data to analyse validation. The inundation area about flood that happened in 2010 is about 75.26 square kilometres. Comparing two-method show that the FEM analysis with Force2 programs has the best approach to validation data with Nash Index is 0.84 and HEC-RAS that is 0.76 for water level. For discharge data Nash Index obtained the result analysis use Force2 is 0.80 and with use HEC-RAS is 0.79.

  16. Upper-extremity phocomelia reexamined: a longitudinal dysplasia.

    Science.gov (United States)

    Goldfarb, Charles A; Manske, Paul R; Busa, Riccardo; Mills, Janith; Carter, Peter; Ezaki, Marybeth

    2005-12-01

    In contrast to longitudinal deficiencies, phocomelia is considered a transverse, intercalated segmental dysplasia. Most patients demonstrate severe, but not otherwise classifiable, upper-extremity deformities, which usually cannot be placed into one of three previously described phocomelia groups. Additionally, these phocomelic extremities do not demonstrate true segmental deficits; the limb is also abnormal proximal and distal to the segmental defect. The purpose of this investigation was to present evidence that upper-extremity abnormalities in patients previously diagnosed as having phocomelia in fact represent a proximal continuum of radial or ulnar longitudinal dysplasia. The charts and radiographs of forty-one patients (sixty extremities) diagnosed as having upper-extremity phocomelia were reviewed retrospectively. On the basis of the findings on the radiographs, the disorders were categorized into three groups: (1) proximal radial longitudinal dysplasia, which was characterized by an absent proximal part of the humerus, a nearly normal distal part of the humerus, a completely absent radius, and a radial-sided hand dysplasia; (2) proximal ulnar longitudinal dysplasia, characterized by a short one-bone upper extremity that bifurcated distally and by severe hand abnormalities compatible with ulnar dysplasia; and (3) severe combined dysplasia, with type A characterized by an absence of the forearm segment (i.e., the radius and ulna) and type B characterized by absence of the arm and forearm (i.e., the hand attached to the thorax). Twenty-nine limbs in sixteen patients could be classified as having proximal radial longitudinal dysplasia. Systemic medical conditions such as thrombocytopenia-absent radius syndrome were common in those patients, but additional musculoskeletal conditions were rare. Twenty limbs in seventeen patients could be classified as having proximal ulnar longitudinal dysplasia. Associated musculoskeletal abnormalities, such as proximal femoral

  17. 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...

  18. Imaging of upper extremity stress fractures in the athlete.

    Science.gov (United States)

    Anderson, Mark W

    2006-07-01

    Although it is much less common than injuries in the lower extremities, an upper extremity stress injury can have a significant impact on an athlete. If an accurate and timely diagnosis is to be made, the clinician must have a high index of suspicion of a stress fracture in any athlete who is involved in a throwing, weightlifting, or upper extremity weight-bearing sport and presents with chronic pain in the upper extremity. Imaging should play an integral role in the work-up of these patients; if initial radiographs are unrevealing, further cross-sectional imaging should be strongly considered. Although a three-phase bone scan is highly sensitive in this regard, MRI has become the study of choice at most centers.

  19. Technology improves upper extremity rehabilitation.

    Science.gov (United States)

    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. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Characteristics of upper extremity's muscle strength in Turkish national wheelchair basketball players team.

    Science.gov (United States)

    Akınoğlu, Bihter; Kocahan, Tuğba

    2017-02-01

    The objective of this study was to reveal characteristics of muscle strength of upper extremities of wheelchair (WC) basketball players and to ensure more-specific training program preparation. Isokinetic muscle strength of 12 WC basketball players were assessed by ISOMED 2000 device. The assessment protocol was evaluated at 60°/sec velocity with 5 times repeated force and at 240°/sec with 15 times repeated force. This protocol was carried out individually for shoulder flexion-extension and wrist flexion-extension movements at the right and left extremities. The flexion/extension ratio was determined to be outside of the ratios accepted as normal for primarily shoulder joint and for wrist joint. The extension movement was stronger than flexion movement in the shoulders at both velocities and the flexion movement was stronger than ex-tension movement in the wrist. The repeat times where the peak torque occurred were 2-3 repeats at 60°/sec velocity during flexion and extension movements for the wrist and shoulders, and the peak torque occurred at an average of 5-6 repeats in the shoulders at 240°/sec velocity and it occurred at 3-4 repeats in the wrist. The angles where the peak torque of the shoulder flexion and extension occurred varied between 80°-115° at both velocities, and it varied between 5°-30° angles for the wrist. As this study revealed, determination of muscle strength characteristics of WC athletes and especially using objective isokinetic devices will guide the planning of the appropriate training and exercise programs and preventing sports injuries in long term.

  1. Biomechanics of fall arrest using the upper extremity: age differences.

    Science.gov (United States)

    Kim, Kyu-Jung; Ashton-Miller, James A

    2003-05-01

    This study tried to isolate critical biomechanical factors in fall arrests using the upper extremity during simulated forward falls. This study also attempted to find the differences in those factors between young and old age groups. The role of the upper extremity is not well defined despite its primary usage as a local shock absorber during fall impact. Comparative study in which two age groups underwent motion analysis.Methods. Ten healthy older males (mean age, 66.4 years) and 10 young males (mean age, 24.1 years) volunteered to perform self-initiated and cable-released falls at selected falling distances, while the joint motion and impact forces at the hand were recorded. Significant age differences were demonstrated in joint kinematics and impact force parameters at close distances. Excessive reflexive responses of the upper extremity in cable-released falls for the older adults resulted in 10-15 times higher peak impact forces and 2-3 times shorter body braking time than in self-initiated falls. Pre-impact activities of the upper extremity predispose the post-impact response during fall arrests. Suppressing excessive pre-impact reflexive activation of the arms could efficiently decrease the risk of fall-related injuries, which calls for securing sufficient arm movement time. Any fall prevention strategy that can increase arm movement time would be effective against injuries of the upper extremity during falling in the older adults. The findings will help to understand underlying mechanisms of fall arrest using the upper extremity for prevention of fall-related fractures.

  2. Force Myography for Monitoring Grasping in Individuals with Stroke with Mild to Moderate Upper-Extremity Impairments: A Preliminary Investigation in a Controlled Environment

    Directory of Open Access Journals (Sweden)

    Gautam P. Sadarangani

    2017-07-01

    Full Text Available There is increasing research interest in technologies that can detect grasping, to encourage functional use of the hand as part of daily living, and thus promote upper-extremity motor recovery in individuals with stroke. Force myography (FMG has been shown to be effective for providing biofeedback to improve fine motor function in structured rehabilitation settings, involving isolated repetitions of a single grasp type, elicited at a predictable time, without upper-extremity movements. The use of FMG, with machine learning techniques, to detect and distinguish between grasping and no grasping, continues to be an active area of research, in healthy individuals. The feasibility of classifying FMG for grasp detection in populations with upper-extremity impairments, in the presence of upper-extremity movements, as would be expected in daily living, has yet to be established. We explore the feasibility of FMG for this application by establishing and comparing (1 FMG-based grasp detection accuracy and (2 the amount of training data necessary for accurate grasp classification, in individuals with stroke and healthy individuals. FMG data were collected using a flexible forearm band, embedded with six force-sensitive resistors (FSRs. Eight participants with stroke, with mild to moderate upper-extremity impairments, and eight healthy participants performed 20 repetitions of three tasks that involved reaching, grasping, and moving an object in different planes of movement. A validation sensor was placed on the object to label data as corresponding to a grasp or no grasp. Grasp detection performance was evaluated using linear and non-linear classifiers. The effect of training set size on classification accuracy was also determined. FMG-based grasp detection demonstrated high accuracy of 92.2% (σ = 3.5% for participants with stroke and 96.0% (σ = 1.6% for healthy volunteers using a support vector machine (SVM. The use of a training set that was 50

  3. Electromyography-controlled exoskeletal upper-limb-powered orthosis for exercise training after stroke.

    Science.gov (United States)

    Stein, Joel; Narendran, Kailas; McBean, John; Krebs, Kathryn; Hughes, Richard

    2007-04-01

    Robot-assisted exercise shows promise as a means of providing exercise therapy for weakness that results from stroke or other neurological conditions. Exoskeletal or "wearable" robots can, in principle, provide therapeutic exercise and/or function as powered orthoses to help compensate for chronic weakness. We describe a novel electromyography (EMG)-controlled exoskeletal robotic brace for the elbow (the active joint brace) and the results of a pilot study conducted using this brace for exercise training in individuals with chronic hemiparesis after stroke. Eight stroke survivors with severe chronic hemiparesis were enrolled in this pilot study. One subject withdrew from the study because of scheduling conflicts. A second subject was unable to participate in the training protocol because of insufficient surface EMG activity to control the active joint brace. The six remaining subjects each underwent 18 hrs of exercise training using the device for a period of 6 wks. Outcome measures included the upper-extremity component of the Fugl-Meyer scale and the modified Ashworth scale of muscle hypertonicity. Analysis revealed that the mean upper-extremity component of the Fugl-Meyer scale increased from 15.5 (SD 3.88) to 19 (SD 3.95) (P = 0.04) at the conclusion of training for the six subjects who completed training. Combined (summated) modified Ashworth scale for the elbow flexors and extensors improved from 4.67 (+/-1.2 SD) to 2.33 (+/-0.653 SD) (P = 0.009) and improved for the entire upper limb as well. All subjects tolerated the device, and no complications occurred. EMG-controlled powered elbow orthoses can be successfully controlled by severely impaired hemiparetic stroke survivors. This technique shows promise as a new modality for assisted exercise training after stroke.

  4. Upper extremity injuries associated with strength training.

    Science.gov (United States)

    Haupt, H A

    2001-07-01

    Most injuries sustained during strength training are mild strains that resolve with appropriate rest. More severe injuries include traumatic shoulder dislocations, tendon ruptures of the pectoralis major, biceps, and triceps; stress fractures of the distal clavicle, humerus, radius, and ulna; traumatic fractures of the distal radius and ulna in adolescent weightlifters; and compressive and stretch neuropathies. These more severe injuries are usually the result of improperly performing a strength training exercise. Educating athletes regarding proper strength-training techniques serves to reverse established injury patterns and to prevent these injuries in the first place. Recognizing the association of anabolic steroid use to several of the injury patterns further reinforces the need for medical specialists to counsel athletes against their use. With the increasing use of supplements such as creatine, the incidence and nature of strength-training injuries may change further. Greater emphasis on the competitive performance of younger athletes undoubtedly will generate enthusiasm for strength training at earlier ages in both sexes. The importance of proper supervision of these young athletes by knowledgeable persons will increase. As the popularity of strength training grows, there will be ample opportunity to continue to catalog the injury patterns associated with this activity.

  5. Peripherally inserted central catheters and upper extremity deep vein thrombosis

    International Nuclear Information System (INIS)

    Ong, B.; Gibbs, H.; Catchpole, I.; Hetherington, R.; Harper, J.

    2006-01-01

    The purpose of the study was to determine the incidence and risk factors for venous thrombosis in patients with a peripherally inserted central catheter (PICC). A retrospective study of all upper extremity venous duplex scans was carried out in the Vascular Medicine department from year 2000 to 2002 inclusive. A chart review of positive scans was undertaken to identify possible thrombotic risk factors. Of 317 upper extremity venous duplex scans carried out, 115, or 32%, were positive for upper extremity deep vein thrombosis. Three main risk factors were identified - presence of a central line, malignancy and administration of chemotherapy. PICC were the most common central line present. Symptomatic thrombosis occurred in 7% of PICC inserted for chemotherapy compared with 1% of PICC inserted for other reasons. Ten per cent of the patients receiving chemotherapy through a PICC developed a thrombosis. The post-thrombotic syndrome was infrequent following upper extremity deep vein thrombosis. Patients receiving chemotherapy through a PICC are at increased risk of thrombosis. There may be a role for prophylactic low-dose anticoagulation in these high-risk patients

  6. ''Playstation eyetoy games'' improve upper extremity-related motor functioning in subacute stroke: a randomized controlled clinical trial.

    Science.gov (United States)

    Yavuzer, G; Senel, A; Atay, M B; Stam, H J

    2008-09-01

    To evaluate the effects of ''Playstation EyeToy Games'' on upper extremity motor recovery and upper extremity-related motor functioning of patients with subacute stroke. The authors designed a randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 3 months. A total of 20 hemiparetic inpatients (mean age 61.1 years), all within 12 months post-stroke, received 30 minutes of treatment with ''Playstation EyeToy Games'' per day, consisting of flexion and extension of the paretic shoulder, elbow and wrist as well as abduction of the paretic shoulder or placebo therapy (watching the games for the same duration without physical involvement into the games) in addition to conventional program, 5 days a week, 2-5 hours/day for 4 weeks. Brunnstrom's staging and self-care sub-items of the functional independence measure (FIM) were performed at 0 month (baseline), 4 weeks (post-treatment), and 3 months (follow-up) after the treatment. The mean change score (95% confidence interval) of the FIM self-care score (5.5 [2.9-8.0] vs 1.8 [0.1-3.7], P=0.018) showed significantly more improvement in the EyeToy group compared to the control group. No significant differences were found between the groups for the Brunnstrom stages for hand and upper extremity. ''Playstation EyeToy Games'' combined with a conventional stroke rehabilitation program have a potential to enhance upper extremity-related motor functioning in subacute stroke patients.

  7. What is the most effective posture to conduct vibration from the lower to the upper extremities during whole-body vibration exercise?

    Directory of Open Access Journals (Sweden)

    Tsukahara Y

    2016-01-01

    Full Text Available Yuka Tsukahara, Jun Iwamoto, Kosui Iwashita, Takuma Shinjo, Koichiro Azuma, Hideo MatsumotoInstitute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan Background: Whole-body vibration (WBV exercise is widely used for training and rehabilitation. However, the optimal posture for training both the upper and lower extremities simultaneously remains to be established. Objectives: The objective of this study was to search for an effective posture to conduct vibration from the lower to the upper extremities while performing WBV exercises without any adverse effects. Methods: Twelve healthy volunteers (age: 22–34 years were enrolled in the study. To measure the magnitude of vibration, four accelerometers were attached to the upper arm, back, thigh, and calf of each subject. Vibrations were produced using a WBV platform (Galileo 900 with an amplitude of 4 mm at two frequencies, 15 and 30 Hz. The following three postures were examined: posture A, standing posture with the knees flexed at 30°; posture B, crouching position with no direct contact between the knees and elbows; and posture C, crouching position with direct contact between the knees and elbows. The ratio of the magnitude of vibration at the thigh, back, and upper arm relative to that at the calf was used as an index of vibration conduction. Results: Posture B was associated with a greater magnitude of vibration to the calf than posture A at 15 Hz, and postures B and C were associated with greater magnitudes of vibration than posture A at 30 Hz. Posture C was associated with a vibration conduction to the upper arm that was 4.62 times and 8.26 times greater than that for posture A at 15 and 30 Hz, respectively. Conclusion: This study revealed that a crouching position on a WBV platform with direct contact between the knees and elbows was effective for conducting vibration from the lower to the upper extremities. Keywords: whole-body vibration exercise, upper

  8. Upper extremity deep venous thrombosis after port insertion: What are the risk factors?

    Science.gov (United States)

    Tabatabaie, Omidreza; Kasumova, Gyulnara G; Kent, Tara S; Eskander, Mariam F; Fadayomi, Ayotunde B; Ng, Sing Chau; Critchlow, Jonathan F; Tawa, Nicholas E; Tseng, Jennifer F

    2017-08-01

    Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code. Patients were followed in the State Ambulatory Surgery and Services Database, State Inpatient Database, and State Emergency Department Database for upper extremity deep venous thrombosis occurrence. The cohort was divided into a test cohort and a validation cohort based on the year of port placement. A multivariable logistic regression model was developed to identify risk factors for upper extremity deep venous thrombosis in patients with a port. The model then was tested on the validation cohort. Of the 51,049 patients in the derivation cohort, 926 (1.81%) developed an upper extremity deep venous thrombosis. On multivariate analysis, independently significant predictors of upper extremity deep venous thrombosis included age deep venous thrombosis (odds ratio = 1.77), all-cause 30-day revisit (odds ratio = 2.36), African American race (versus white; odds ratio = 1.86), and other nonwhite races (odds ratio = 1.35). Additionally, compared with genitourinary malignancies, patients with gastrointestinal (odds ratio = 1.55), metastatic (odds ratio = 1.76), and lung cancers (odds ratio = 1.68) had greater risks of developing an upper extremity deep venous thrombosis. This study identified major risk factors of upper extremity deep venous thrombosis. Further studies are needed to evaluate the appropriateness of thromboprophylaxis in patients at greater risk of upper extremity deep venous thrombosis. Copyright © 2017 Elsevier Inc

  9. Upper extremity golf injuries.

    Science.gov (United States)

    Cohn, Michael A; Lee, Steven K; Strauss, Eric J

    2013-01-01

    Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.

  10. 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.

  11. Back and upper extremity disorders among enlisted U.S. Marines: burden and individual risk factors.

    Science.gov (United States)

    Huang, G D; Feuerstein, M; Arroyo, F

    2001-11-01

    Although musculoskeletal disorders of the low back and upper extremities can affect military readiness, little is known about their extent and risk factors in the U.S. Marine Corps. Using the Defense Medical Epidemiology and Defense Medical Surveillance System databases, back and upper extremity diagnostic categories were among the top four sources of outpatient visits and duty limitation among enlisted Marines. Back disorders were also found to be the fifth most common cause for lost time. Subsequently, high-risk occupations were identified, age-related trends for clinic visit rates were determined, and rate ratios were computed for the top 15 low back and upper extremity diagnoses among enlisted Marines from 1997 through 1998. Occupational categories with the highest rates of musculoskeletal-related outpatient visits included image interpretation, auditing and accounting, disturbsing, surveillance/target acquisition, and aircraft launch equipment. Significantly increasing linear trends in rates across age groups were found for most diagnoses. For 1998, age-specific rate ratios indicated significantly higher rates for most low back and upper extremity disorders for females; lower rank (i.e., E1-E4) was also a risk, but for fewer diagnoses. The findings emphasize the need to identify modifiable (e.g., work-related, individual) risk factors and to develop focused primary and secondary prevention programs for musculoskeletal disorders in the Marine Corps. Subsequently, these efforts can assist in reducing associated effects, maximizing resource utilization, and enhancing operational readiness.

  12. New options for vascularized bone reconstruction in the upper extremity.

    Science.gov (United States)

    Houdek, Matthew T; Wagner, Eric R; Wyles, Cody C; Nanos, George P; Moran, Steven L

    2015-02-01

    Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction.

  13. [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.

  14. Strategies for Optimizing Strength, Power, and Muscle Hypertrophy in Women: Contribution of Upper Body Resistance Training

    National Research Council Canada - National Science Library

    Kraemer, William

    1999-01-01

    To determine the performance and physiological effects of various physical conditioning programs in women, total body, upper-body resistance training groups, field training and aerobic training groups (n = 11 to 21...

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

    Directory of Open Access Journals (Sweden)

    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. Brachial index does not reflect upper extremity functionality following surgery for vascular trauma

    Directory of Open Access Journals (Sweden)

    Erdal Simsek

    2014-04-01

    Full Text Available OBJECTIVES: Vascular injuries to the upper extremities requiring surgical repair are common after accidents. However, neither postoperative functionality nor hemodynamic status of the extremity are routinely described. We evaluated the postoperative functional and hemodynamic status of patients with vascular traumas in the upper extremities. METHODS: 26 patients who suffered penetrating vascular traumas in the upper extremities from November 2008 to December 2011 were retrospectively evaluated. Data on first approach, surgical technique employed and early postoperative outcomes were recorded. Further data on the post-discharge period, including clinical functional status of the arm, Doppler ultrasonography and brachial-brachial index were also evaluated. RESULTS: Average follow up was 33.5±10.8 months. Right (1.05±0.09 and left (1.04±0.08 brachial indexes were measured during follow up,. Doppler ultrasonography showed arterial occlusion in 4 patients (15%. Near-normal brachial-brachial indexes was observed in all four of these patients with occlusion of one of the upper extremity arteries, even though they exhibited limited arm function for daily work. CONCLUSIONS: Evaluation of the postoperative outcomes of this small series of patients with penetrating vascular traumas in the upper extremity revealed that 15% of them suffered occlusion of one artery of the upper extremity. Artery occlusion did not correlate with brachial-brachial Doppler index, probably due to rich collateral circulation, but occlusion was associated with an extremity that was dysfunctional for the purposes of daily work. The result of the brachial-brachial index does not therefore correlate with functionality.

  17. Current Practice "Constraints" in the Uptake and Use of Intensive Upper Extremity Training: A Canadian Perspective.

    Science.gov (United States)

    Shikako-Thomas, Keiko; Fehlings, Darcy; Germain, Manon; Gordon, Andrew M; Maynard, Doug; Majnemer, Annette

    2018-05-01

    Intensive upper extremity training (IUET) has demonstrated efficacy in clinical and functioning outcomes in children with hemiplegia. However, implementation in the clinical context requires novel service models and knowledge translation. To map implementation of IUET in Canada, to identify factors associated with the implementation and best practices for implementation. Mixed-methods design; descriptive statistics, chi-square tests. Individual phone interviews and focus groups with purposeful sampling. Thematic analysis; telephone surveys with managers of 31 pediatric rehabilitation centers across Canada. Four focus groups across Canada and one in the Netherlands. Implementation of IUET group interventions is limited in Canada (7/31). Barriers included beliefs and values related to evidence-based practice, opportunities for continuing education, researchers-clinicians partnerships, access to scientific literature, and the presence of a champion. Pressure from parents and media presenting IUET as a novel and effective therapy, support and flexibility of families, having the critical mass of clients and a managerial willingness to accommodate new ideas and restructure service provision were some facilitators. Uptake of the evidence requires many steps described in the knowledge translation cycle. Factors identified in the study could be considered in most clinical settings to facilitate the uptake of research evidence for IUET.

  18. Visuomotor training improves stroke-related ipsilesional upper extremity impairments.

    Science.gov (United States)

    Quaney, Barbara M; He, Jianghua; Timberlake, George; Dodd, Kevin; Carr, Caitlin

    2010-01-01

    Unilateral middle cerebral artery infarction has been reported to impair bilateral hand grasp. Individuals (5 males and 5 females; age 33-86 years) with chronic unilateral middle cerebral artery stroke (4 right lesions and 6 left lesions) repeatedly lifted a 260-g object. Participants were then trained to lift the object using visuomotor feedback via an oscilloscope that displayed their actual grip force (GF) and a target GF, which roughly matched the physical properties of the object. The subjects failed to accurately modulate the predictive GF when relying on somatosensory information from the previous lifts. Instead, for all the lifts, they programmed excessive GF equivalent to the force used for the first lift. The predictive GF was lowered for lifts following the removal of the visual feedback. The mean difference in predictive GF between the lifts before and after visual training was significant (4.35 +/- 0.027 N; P feedforward fingertip force generation is impaired in the ipsilesional hand when lifting a novel object with precision grip. Reacquisition of the motor forces for the grasp of objects is possible after stroke. Potentially, retraining grasp control for the ipsilesional hand may translate to improved function and motor learning within the contralesional hand.

  19. Reoperations following combat-related upper-extremity amputations.

    Science.gov (United States)

    Tintle, Scott M; Baechler, Martin F; Nanos, George P; Forsberg, Jonathan A; Potter, Benjamin K

    2012-08-15

    Amputation revision rates following major upper-extremity amputations have not been previously reported in a large cohort of patients. We hypothesized that the revision rates following major upper-extremity amputation were higher than the existing literature would suggest, and that surgical treatment of complications and persistent symptoms would lead to improved outcomes. We performed a retrospective analysis of a consecutive series of ninety-six combat-wounded personnel who had sustained a total of 100 major upper-extremity amputations in Operation Iraqi Freedom and Operation Enduring Freedom. Prerevision and postrevision outcome measures, including prosthesis use and type, the presence of phantom and residual limb pain, pain medication use, and return to active military duty, were identified for all patients. All amputations resulted from high-energy trauma, with 87% occurring secondary to a blast injury. Forty-two residual limbs (42%) underwent a total of 103 repeat surgical interventions. As compared with patients with all other levels of amputation, those with a transradial amputation were 4.7 (95% confidence interval [CI]: 1.75 to 12.46) times more likely to have phantom limb pain and 2.8 (95% CI: 1.04 to 7.39) times more likely to require neuropathic pain medications. In the group of patients who underwent revision surgery, regular prosthesis use increased from 19% before the revision to 87% after it (p < 0.0001). In our cohort, revision amputation to address surgical complications and persistently symptomatic residual limbs improved the patient's overall acceptance of the prosthesis and led to outcomes equivalent to those following amputations that did not require revision.

  20. Case management services for work related upper extremity disorders. Integrating workplace accommodation and problem solving.

    Science.gov (United States)

    Shaw, W S; Feuerstein, M; Lincoln, A E; Miller, V I; Wood, P M

    2001-08-01

    A case manager's ability to obtain worksite accommodations and engage workers in active problem solving may improve health and return to work outcomes for clients with work related upper extremity disorders (WRUEDs). This study examines the feasibility of a 2 day training seminar to help nurse case managers identify ergonomic risk factors, provide accommodation, and conduct problem solving skills training with workers' compensation claimants recovering from WRUEDs. Eight procedural steps to this case management approach were identified, translated into a training workshop format, and conveyed to 65 randomly selected case managers. Results indicate moderate to high self ratings of confidence to perform ergonomic assessments (mean = 7.5 of 10) and to provide problem solving skills training (mean = 7.2 of 10) after the seminar. This training format was suitable to experienced case managers and generated a moderate to high level of confidence to use this case management approach.

  1. 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.

  2. Skin Cancer of the Hand and Upper Extremity

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon Home Anatomy Skin Cancer of the Hand and Upper Extremity Email ... E – Evolving (changing in any way) How is Skin Cancer Diagnosed? Diagnosis starts with you asking your ...

  3. Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

    Science.gov (United States)

    Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

    2016-06-01

    Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, 25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.

  4. Upper Extremity Proprioception After Stroke: Bridging the Gap Between Neuroscience and Rehabilitation.

    Science.gov (United States)

    Findlater, Sonja E; Dukelow, Sean P

    2017-01-01

    Proprioception is an important aspect of function that is often impaired in the upper extremity following stroke. Unfortunately, neurorehabilitation has few evidence based treatment options for those with proprioceptive deficits. The authors consider potential reasons for this disparity. In doing so, typical assessments and proprioceptive intervention studies are discussed. Relevant evidence from the field of neuroscience is examined. Such evidence may be used to guide the development of targeted interventions for upper extremity proprioceptive deficits after stroke. As researchers become more aware of the impact of proprioceptive deficits on upper extremity motor performance after stroke, it is imperative to find successful rehabilitation interventions to target these deficits and ultimately improve daily function.

  5. Tourniquet Deflation Prior to 20 Minutes in Upper Extremity Intravenous Regional Anesthesia.

    Science.gov (United States)

    Gurich, Richard W; Langan, Justin W; Teasdall, Robert J; Tanner, Stephanie L; Sanders, John L

    2018-03-01

    Bier blocks, or intravenous regional anesthesia (IVRA), are a method of anesthesia for upper extremity surgeries. This study reports our experience with tourniquet deflation prior to 20 minutes with upper extremity IVRA. This study was designed as a retrospective cohort analysis. Records, including intraoperative and immediate postoperative anesthesia notes, of 430 patients who underwent IVRA with an upper extremity Bier block and a corresponding tourniquet time of less than 20 minutes were reviewed. Patient demographics, procedure(s) performed, American Society of Anesthesiologists scores, volume of lidocaine used in Bier block, tourniquet time, and any complications were recorded. This cohort consisted of 127 males and 303 females. The 3 most common procedures performed were carpal tunnel release (315), trigger finger release (47), and excision of masses (34). The average tourniquet time for this cohort was 16 minutes (range, 9-19 minutes), and the average volume of lidocaine (0.5% plain) injected was 44 mL (range, 30-70 mL). A tourniquet time of 17 minutes or less was observed in 339 patients, and 170 patients had tourniquet times of 15 minutes or less. Five complications were recorded: intraoperative vomiting, mild postoperative nausea/vomiting, severe postoperative nausea and vomiting, and transient postoperative hypotension that responded to a fluid bolus. No major complications were observed in our cohort of upper extremity IVRA and tourniquet times of less than 20 minutes. Several variables play a role in the safety of upper extremity IVRA.

  6. Stress fractures of the ribs and upper extremities: causation, evaluation, and management.

    Science.gov (United States)

    Miller, Timothy L; Harris, Joshua D; Kaeding, Christopher C

    2013-08-01

    Stress fractures are common troublesome injuries in athletes and non-athletes. Historically, stress fractures have been thought to predominate in the lower extremities secondary to the repetitive stresses of impact loading. Stress injuries of the ribs and upper extremities are much less common and often unrecognized. Consequently, these injuries are often omitted from the differential diagnosis of rib or upper extremity pain. Given the infrequency of this diagnosis, few case reports or case series have reported on their precipitating activities and common locations. Appropriate evaluation for these injuries requires a thorough history and physical examination. Radiographs may be negative early, requiring bone scintigraphy or MRI to confirm the diagnosis. Nonoperative and operative treatment recommendations are made based on location, injury classification, and causative activity. An understanding of the most common locations of upper extremity stress fractures and their associated causative activities is essential for prompt diagnosis and optimal treatment.

  7. Implementation of a Surface Electromyography-Based Upper Extremity Exoskeleton Controller Using Learning from Demonstration

    Science.gov (United States)

    Arenas, Ana M.; Sun, Tingxiao

    2018-01-01

    Upper-extremity exoskeletons have demonstrated potential as augmentative, assistive, and rehabilitative devices. Typical control of upper-extremity exoskeletons have relied on switches, force/torque sensors, and surface electromyography (sEMG), but these systems are usually reactionary, and/or rely on entirely hand-tuned parameters. sEMG-based systems may be able to provide anticipatory control, since they interface directly with muscle signals, but typically require expert placement of sensors on muscle bodies. We present an implementation of an adaptive sEMG-based exoskeleton controller that learns a mapping between muscle activation and the desired system state during interaction with a user, generating a personalized sEMG feature classifier to allow for anticipatory control. This system is robust to novice placement of sEMG sensors, as well as subdermal muscle shifts. We validate this method with 18 subjects using a thumb exoskeleton to complete a book-placement task. This learning-from-demonstration system for exoskeleton control allows for very short training times, as well as the potential for improvement in intent recognition over time, and adaptation to physiological changes in the user, such as those due to fatigue. PMID:29401754

  8. Implementation of a Surface Electromyography-Based Upper Extremity Exoskeleton Controller Using Learning from Demonstration

    Directory of Open Access Journals (Sweden)

    Ho Chit Siu

    2018-02-01

    Full Text Available Upper-extremity exoskeletons have demonstrated potential as augmentative, assistive, and rehabilitative devices. Typical control of upper-extremity exoskeletons have relied on switches, force/torque sensors, and surface electromyography (sEMG, but these systems are usually reactionary, and/or rely on entirely hand-tuned parameters. sEMG-based systems may be able to provide anticipatory control, since they interface directly with muscle signals, but typically require expert placement of sensors on muscle bodies. We present an implementation of an adaptive sEMG-based exoskeleton controller that learns a mapping between muscle activation and the desired system state during interaction with a user, generating a personalized sEMG feature classifier to allow for anticipatory control. This system is robust to novice placement of sEMG sensors, as well as subdermal muscle shifts. We validate this method with 18 subjects using a thumb exoskeleton to complete a book-placement task. This learning-from-demonstration system for exoskeleton control allows for very short training times, as well as the potential for improvement in intent recognition over time, and adaptation to physiological changes in the user, such as those due to fatigue.

  9. Design and control of RUPERT: a device for robotic upper extremity repetitive therapy.

    Science.gov (United States)

    Sugar, Thomas G; He, Jiping; Koeneman, Edward J; Koeneman, James B; Herman, Richard; Huang, H; Schultz, Robert S; Herring, D E; Wanberg, J; Balasubramanian, Sivakumar; Swenson, Pete; Ward, Jeffrey A

    2007-09-01

    The structural design, control system, and integrated biofeedback for a wearable exoskeletal robot for upper extremity stroke rehabilitation are presented. Assisted with clinical evaluation, designers, engineers, and scientists have built a device for robotic assisted upper extremity repetitive therapy (RUPERT). Intense, repetitive physical rehabilitation has been shown to be beneficial overcoming upper extremity deficits, but the therapy is labor intensive and expensive and difficult to evaluate quantitatively and objectively. The RUPERT is developed to provide a low cost, safe and easy-to-use, robotic-device to assist the patient and therapist to achieve more systematic therapy at home or in the clinic. The RUPERT has four actuated degrees-of-freedom driven by compliant and safe pneumatic muscles (PMs) on the shoulder, elbow, and wrist. They are programmed to actuate the device to extend the arm and move the arm in 3-D space. It is very important to note that gravity is not compensated and the daily tasks are practiced in a natural setting. Because the device is wearable and lightweight to increase portability, it can be worn standing or sitting providing therapy tasks that better mimic activities of daily living. The sensors feed back position and force information for quantitative evaluation of task performance. The device can also provide real-time, objective assessment of functional improvement. We have tested the device on stroke survivors performing two critical activities of daily living (ADL): reaching out and self feeding. The future improvement of the device involves increased degrees-of-freedom and interactive control to adapt to a user's physical conditions.

  10. Overuse injuries of the upper extremity in the competitive athlete: magnetic resonance imaging findings associated with repetitive trauma.

    Science.gov (United States)

    Banks, Kevin P; Ly, Justin Q; Beall, Douglas P; Grayson, David E; Bancroft, Laura W; Tall, Michael A

    2005-01-01

    Overuse injuries are a very common cause of pain in athletes, accounting for a significant loss of training time and missed competitions. Magnetic resonance imaging (MRI) is playing an increasing role in facilitating the expeditious and safe return of these individuals to their preinjury level of physical performance by allowing accurate diagnosis. Sports physicians are increasingly relying on the exquisite anatomic detail afforded by this technique to formulate diagnoses that assist with the optimal management of these athletic injuries. Some upper extremity overuse entities are well recognized; two examples are medial epicondylitis, classically appearing in baseball pitchers, and lateral epicondylitis, in tennis players. Other less well-known injuries of the upper extremity, such as intersection syndrome in rowers and distal clavicular stress fractures in weightlifters, are frequent occurrences in certain circles of athletes. The following article is a pictorial review of the MRI findings of upper extremity overuse injuries encountered in the competitive athlete, with an emphasis on the sports scenarios in which they occur. We will depict mechanisms of injury and applicable anatomy and show characteristic imaging findings. A wide range of entities are addressed, including but not limited to overuse injuries occurring in baseball, swimming, gymnastics, weightlifting, bowling, and cycling.

  11. 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.

  12. Language barriers in Hispanic patients: relation to upper-extremity disability.

    Science.gov (United States)

    Menendez, Mariano E; Eberlin, Kyle R; Mudgal, Chaitanya S; Ring, David

    2015-06-01

    Although upper-extremity disability has been shown to correlate highly with various psychosocial aspects of illness (e.g., self-efficacy, depression, kinesiophobia, and pain catastrophizing), the role of language in musculoskeletal health status is less certain. In an English-speaking outpatient hand surgery office setting, we sought to determine (1) whether a patient's primary native language (English or Spanish) is an independent predictor of upper-extremity disability and (2) whether there are any differences in the contribution of measures of psychological distress to disability between native English- and Spanish-speaking patients. A total of 122 patients (61 native English speakers and 61 Spanish speakers) presenting to an orthopaedic hand clinic completed sociodemographic information and three Patient-Reported Outcomes Measurement Information System (PROMIS)-based computerized adaptive testing questionnaires: PROMIS Pain Interference, PROMIS Depression, and PROMIS Upper-Extremity Physical Function. Bivariate and multivariable linear regression modeling were performed. Spanish-speaking patients reported greater upper-extremity disability, pain interference, and symptoms of depression than English-speaking patients. After adjusting for sociodemographic covariates and measures of psychological distress using multivariable regression modeling, the patient's primary language was not retained as an independent predictor of disability. PROMIS Depression showed a medium correlation (r = -0.35; p Spanish-speaking patients. PROMIS Pain Interference had a large correlation with disability in both patient cohorts (Spanish-speaking: r = -0.66; p immigration to the USA did not correlate with disability among Spanish speakers. Primary language has less influence on symptom intensity and magnitude of disability than psychological distress and ineffective coping strategies. Interventions to optimize mood and to reduce pain interference should be considered in

  13. Comparison of the Effects of Walking with and without Nordic Pole on Upper Extremity and Lower Extremity Muscle Activation.

    Science.gov (United States)

    Shim, Je-Myung; Kwon, Hae-Yeon; Kim, Ha-Roo; Kim, Bo-In; Jung, Ju-Hyeon

    2013-12-01

    [Purpose] The aim of this study was to assess the effect of Nordic pole walking on the electromyographic activities of upper extremity and lower extremity muscles. [Subjects and Methods] The subjects were randomly divided into two groups as follows: without Nordic pole walking group (n=13) and with Nordic pole walking group (n=13). The EMG data were collected by measurement while the subjects walking on a treadmill for 30 minutes by measuring from one heel strike to the next. [Results] Both the average values and maximum values of the muscle activity of the upper extremity increased in both the group that used Nordic poles and the group that did not use Nordic poles, and the values showed statistically significant differences. There was an increase in the average value for muscle activity of the latissimus dorsi, but the difference was not statistically significant, although there was a statistically significant increase in its maximum value. The average and maximum values for muscle activity of the lower extremity did not show large differences in either group, and the values did not show any statistically significant differences. [Conclusion] The use of Nordic poles by increased muscle activity of the upper extremity compared with regular walking but did not affect the lower extremity.

  14. Effect of compensatory acceleration training in combination with accommodating resistance on upper body strength in collegiate athletes

    Science.gov (United States)

    Jones, Margaret T

    2014-01-01

    Purpose To determine the impact of inclusion of a band or chain compensatory acceleration training (CAT), in a 5-week training phase, on maximal upper body strength during a 14-week off-season strength and conditioning program for collegiate male athletes. Patients and methods Twenty-four National Collegiate Athletic Association (NCAA) collegiate baseball players, who were familiar with the current strength and conditioning program and had a minimum of 1 year of formal collegiate strength and conditioning experience, participated in this off-season training study. None of the men had participated in CAT before. Subjects were matched following a maximal effort (1-repetition maximum [1-RM]) bench press test in week 1, then were randomly assigned into a band-based CAT group or a chain-based CAT group and participated in a 5-week training phase that included bench pressing twice per week. Upper body strength was measured by 1-RM bench press again at week 6. A 2 × 2 mixed factorial (method × time) analysis of variance was calculated to compare differences across groups. The alpha level was set at Pbench (F1,22=88.46, P=0.001). Conclusion A 5-week band CAT or chain CAT training program used in conjunction with an off-season strength and conditioning program can increase maximal upper body strength in collegiate baseball athletes. Using band CAT and/or chain CAT as a training modality in the off-season will vary the training stimulus from the traditional and likely help to maintain the athlete’s interest. PMID:25177154

  15. 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...... 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...... Spinal Cord Injury Centers. MATERIAL AND METHODS: In the initial review period, 119 upper extremity surgeries were performed on patients with tetraplegia (n = 49). Seven died and the remaining 42 were invited to complete a follow-up questionnaire with a five-level scale ranging from strongly agree...

  16. 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.

  17. The effects of adding single-joint exercises to a multi-joint exercise resistance training program on upper body muscle strength and size in trained men.

    Science.gov (United States)

    de França, Henrique Silvestre; Branco, Paulo Alexandre Nordeste; Guedes Junior, Dilmar Pinto; Gentil, Paulo; Steele, James; Teixeira, Cauê Vazquez La Scala

    2015-08-01

    The aim of this study was compare changes in upper body muscle strength and size in trained men performing resistance training (RT) programs involving multi-joint plus single-joint (MJ+SJ) or only multi-joint (MJ) exercises. Twenty young men with at least 2 years of experience in RT were randomized in 2 groups: MJ+SJ (n = 10; age, 27.7 ± 6.6 years) and MJ (n = 10; age, 29.4 ± 4.6 years). Both groups trained for 8 weeks following a linear periodization model. Measures of elbow flexors and extensors 1-repetition maximum (1RM), flexed arm circumference (FAC), and arm muscle circumference (AMC) were taken pre- and post-training period. Both groups significantly increased 1RM for elbow flexion (4.99% and 6.42% for MJ and MJ+SJ, respectively), extension (10.60% vs 9.79%, for MJ and MJ+SJ, respectively), FAC (1.72% vs 1.45%, for MJ and MJ+SJ, respectively), and AMC (1.33% vs 3.17% for MJ and MJ+SJ, respectively). Comparison between groups revealed no significant difference in any variable. In conclusion, 8 weeks of RT involving MJ or MJ+SJ resulted in similar alterations in muscle strength and size in trained participants. Therefore, the addition of SJ exercises to a RT program involving MJ exercises does not seem to promote additional benefits to trained men, suggesting MJ-only RT to be a time-efficient approach.

  18. Survey of Hand and Upper Extremity Injuries Among Rock Climbers.

    Science.gov (United States)

    Nelson, Clayton E; Rayan, Ghazi M; Judd, Dustin I; Ding, Kai; Stoner, Julie A

    2017-07-01

    Rock climbing first evolved as a sport in the late 18th century. With its growing popularity, the number of rock climbing-related injuries has potential to increase, spurring a rise in the number of articles associated with it. Despite the available literature, there remains a paucity of information about upper extremity injuries sustained by rock climbers, and no studies to date have focused on gender-specific injuries. A 24-question online survey was distributed to rock climbers about upper extremity injuries sustained during rock climbing. Statistical analysis was used to study association between participants' demographics and injuries. A total of 397 participants responded to the survey. Mean age was 32.5 years with males comprising 85%. No significant differences in demographics or climbing behaviors were found between males and females. Ninety percent of participants reported sustaining an upper extremity injury. Fingers were the most common injury followed by shoulder/arm and elbow/forearm. Our study found females to be more likely to report a rock climbing-related injury, and more likely to undergo surgery for it. Female rock climbers were significantly more likely to report a shoulder/upper arm injury and were also more likely to report undergoing surgery compared with males, where these differences were not due to age or climbing behaviors. Further investigation is warranted into the association between shoulder injuries and female athletes to determine how the gender differences relate to extent of injury as well as health service utilization behaviors.

  19. Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Zhi Yang Ng

    2017-03-01

    Full Text Available BackgroundUpper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity.MethodsA literature review of PubMed and MEDLINE up to December 2016 was performed. The current study focuses on forearm and arm defects from the level at or proximal to the wrist and were assessed based on Tajima's classification (J Trauma 1974. Data reviewed for analysis included patient demographics, causality, defect size, reconstructive technique(s employed, and postoperative follow-up and functional outcomes (when available.ResultsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 14 unique articles were identified for a total of 50 patients (mean=28.1 years. Underlying etiologies varied from extensive thermal or electrical burns to high impact trauma leading to degloving or avulsion, crush injuries, or even occur iatrogenically after tumor extirpation or extensive debridement. Treatment options ranged from the application of negative pressure wound dressings to the opposite end of the spectrum in hand transplantation.ConclusionsWith the evolution of reconstructive techniques over time, the extent of functional and aesthetic rehabilitation of these complex upper extremity injuries has also improved. The proposed management algorithm comprehensively addresses the inherent challenges associated with these complex cases.

  20. Extreme Programming: Maestro Style

    Science.gov (United States)

    Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang; Powell, Mark

    2009-01-01

    "Extreme Programming: Maestro Style" is the name of a computer programming methodology that has evolved as a custom version of a methodology, called extreme programming that has been practiced in the software industry since the late 1990s. The name of this version reflects its origin in the work of the Maestro team at NASA's Jet Propulsion Laboratory that develops software for Mars exploration missions. Extreme programming is oriented toward agile development of software resting on values of simplicity, communication, testing, and aggressiveness. Extreme programming involves use of methods of rapidly building and disseminating institutional knowledge among members of a computer-programming team to give all the members a shared view that matches the view of the customers for whom the software system is to be developed. Extreme programming includes frequent planning by programmers in collaboration with customers, continually examining and rewriting code in striving for the simplest workable software designs, a system metaphor (basically, an abstraction of the system that provides easy-to-remember software-naming conventions and insight into the architecture of the system), programmers working in pairs, adherence to a set of coding standards, collaboration of customers and programmers, frequent verbal communication, frequent releases of software in small increments of development, repeated testing of the developmental software by both programmers and customers, and continuous interaction between the team and the customers. The environment in which the Maestro team works requires the team to quickly adapt to changing needs of its customers. In addition, the team cannot afford to accept unnecessary development risk. Extreme programming enables the Maestro team to remain agile and provide high-quality software and service to its customers. However, several factors in the Maestro environment have made it necessary to modify some of the conventional extreme-programming

  1. Quantification of human upper extremity nerves and fascicular anatomy.

    Science.gov (United States)

    Brill, Natalie A; Tyler, Dustin J

    2017-09-01

    In this study we provide detailed quantification of upper extremity nerve and fascicular anatomy. The purpose is to provide values and trends in neural features useful for clinical applications and neural interface device design. Nerve cross-sections were taken from 4 ulnar, 4 median, and 3 radial nerves from 5 arms of 3 human cadavers. Quantified nerve features included cross-sectional area, minor diameter, and major diameter. Fascicular features analyzed included count, perimeter, area, and position. Mean fascicular diameters were 0.57 ± 0.39, 0.6 ± 0.3, 0.5 ± 0.26 mm in the upper arm and 0.38 ± 0.18, 0.47 ± 0.18, 0.4 ± 0.27 mm in the forearm of ulnar, median, and radial nerves, respectively. Mean fascicular diameters were inversely proportional to fascicle count. Detailed quantitative anatomy of upper extremity nerves is a resource for design of neural electrodes, guidance in extraneural procedures, and improved neurosurgical planning. Muscle Nerve 56: 463-471, 2017. © 2016 Wiley Periodicals, Inc.

  2. Magnetic resonance imaging of acute ''wiiitis'' of the upper extremity

    International Nuclear Information System (INIS)

    Nett, Michael P.; Sperling, John W.; Collins, Mark S.

    2008-01-01

    We present the first reported case of acute ''wiiitis'', documented clinically and by imaging, of the upper extremity, caused by prolonged participation in a physically interactive virtual video-game. Unenhanced magnetic resonance imaging (MRI) demonstrated marked T2-weighted signal abnormality within several muscles of the shoulder and upper arm, without evidence of macroscopic partial- or full-thickness tearing of the muscle or of intramuscular hematoma. (orig.)

  3. Upper Extremity Functional Status of Female Youth Softball Pitchers Using the Kerlan-Jobe Orthopaedic Clinic Questionnaire

    OpenAIRE

    Holtz, Kaila A.; O’Connor, Russell J.

    2018-01-01

    Background: Softball is a popular sport with a high incidence of upper extremity injuries. The Kerlan-Jobe Orthopaedic Clinic (KJOC) questionnaire is a validated performance and functional assessment tool used in overhead athletes. Upper extremity pain patterns and baseline KJOC scores have not been reported for active female youth softball pitchers. Purpose/Hypothesis: The purpose of this study was to establish the prevalence of upper extremity pain and its effect in female youth softball pi...

  4. Hip and upper extremity kinematics in youth baseball pitchers.

    Science.gov (United States)

    Holt, Taylor; Oliver, Gretchen D

    2016-01-01

    The purpose of this study was to examine the relationship between dynamic hip rotational range of motion and upper extremity kinematics during baseball pitching. Thirty-one youth baseball pitchers (10.87 ± 0.92 years; 150.03 ± 5.48 cm; 44.83 ± 8.04 kg) participated. A strong correlation was found between stance hip rotation and scapular upward rotation at maximum shoulder external rotation (r = 0.531, P = 0.002) and at ball release (r = 0.536, P = 0.002). No statistically significant correlations were found between dynamic hip rotational range of motion and passive hip range of motion. Hip range of motion deficits can constrain pelvis rotation and limit energy generation in the lower extremities. Shoulder pathomechanics can then develop as greater responsibility is placed on the shoulder to generate the energy lost from the proximal segments, increasing risk of upper extremity injury. Additionally, it appears that passive seated measurements of hip range of motion may not accurately reflect the dynamic range of motion of the hips through the progression of the pitch cycle.

  5. Capture, learning, and classification of upper extremity movement primitives in healthy controls and stroke patients.

    Science.gov (United States)

    Guerra, Jorge; Uddin, Jasim; Nilsen, Dawn; Mclnerney, James; Fadoo, Ammarah; Omofuma, Isirame B; Hughes, Shatif; Agrawal, Sunil; Allen, Peter; Schambra, Heidi M

    2017-07-01

    There currently exist no practical tools to identify functional movements in the upper extremities (UEs). This absence has limited the precise therapeutic dosing of patients recovering from stroke. In this proof-of-principle study, we aimed to develop an accurate approach for classifying UE functional movement primitives, which comprise functional movements. Data were generated from inertial measurement units (IMUs) placed on upper body segments of older healthy individuals and chronic stroke patients. Subjects performed activities commonly trained during rehabilitation after stroke. Data processing involved the use of a sliding window to obtain statistical descriptors, and resulting features were processed by a Hidden Markov Model (HMM). The likelihoods of the states, resulting from the HMM, were segmented by a second sliding window and their averages were calculated. The final predictions were mapped to human functional movement primitives using a Logistic Regression algorithm. Algorithm performance was assessed with a leave-one-out analysis, which determined its sensitivity, specificity, and positive and negative predictive values for all classified primitives. In healthy control and stroke participants, our approach identified functional movement primitives embedded in training activities with, on average, 80% precision. This approach may support functional movement dosing in stroke rehabilitation.

  6. Treatment for superficial infusion thrombophlebitis of the upper extremity

    NARCIS (Netherlands)

    Di Nisio, Marcello; Peinemann, Frank; Porreca, Ettore; Rutjes, Anne W. S.

    2015-01-01

    Although superficial thrombophlebitis of the upper extremity represents a frequent complication of intravenous catheters inserted into the peripheral veins of the forearm or hand, no consensus exists on the optimal management of this condition in clinical practice. To summarise the evidence from

  7. The biomechanics of upper extremity kinematic and kinetic modeling: applications to rehabilitation engineering.

    Science.gov (United States)

    Slavens, Brooke A; Harris, Gerald F

    2008-01-01

    Human motion analysis has evolved from the lower extremity to the upper extremity. Rehabilitation engineering is reliant upon three-dimensional biome-chanical models for a thorough understanding of upper body motions and forces in order to improve treatment methods, rehabilitation strategies and to prevent injury. Due to the complex nature of upper body movements, a standard biomechanical model does not exist. This paper reviews several kinematic and kinetic rehabilitation engineering models from the literature. These models may capture a single joint; multijoints such as the shoulder, elbow and wrist; or a combination of joints and an ambulatory aid, which serves as the extension of the upper arm. With advances in software and hardware, new models continuously arise due to the clinical questions at hand. When designing a biomechanical upper extremity model, several key components must be determined. These include deciding on the anatomic segments of the model, the number of markers and placement on bony landmarks, the definition of joint coordinate systems, and the description of the joint motions. It is critical to apply the proper model to further our understanding of pathologic populations.

  8. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Hakan Tapar

    2012-09-01

    Full Text Available 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 respiration and hemodynamics and shortness of recovery time. If a plexus brachialis catheter is placed, control of pain is provided without using systemic narcotic analgesic. With these advantages; rare life threatening potential complications can be seen which are pneumothorax, hematoma, neuritis, allergy, systemic and neurologic complications. In this compilation we aimed to review again the complications of upper extremity nerve blocks according to block type. [J Contemp Med 2012; 2(3.000: 195-200

  9. 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.

  10. Upper extremity injuries in Danish children aged 6–12, mechanisms, and risk factors

    DEFF Research Database (Denmark)

    Nauta, J.; Jespersen, Eva; Verhagen, Evert

    2017-01-01

    was found suggesting that girls are at increased acute upper extremity risk compared to boys (HR: 1.40 95% CI: 0.97–2.04). The findings that most injuries occur after a fall, that injury risk increases over age and that girls seem to be at increased injury risk provides essential information to guide future...... caused by a fall. When corrected for exposure to physical activity, this resulted in an acute upper extremity injury incidence density of 0.18 per 1000 h of physical activity. The odds of sustaining an upper extremity injury was higher in the older children (HR: 1.84, 95% CI: 1.10–3.09), a tendency...

  11. Designing instrumented walker to measure upper-extremity's efforts: A case study.

    Science.gov (United States)

    Khodadadi, Mohammad; Baniasad, Mina Arab; Arazpour, Mokhtar; Farahmand, Farzam; Zohoor, Hassan

    2018-02-26

    The high prevalence of shoulder pain in using walkers in patients who have spinal cord injury (SCI). Also, the limited options available to economically measure grip forces in walkers, which drove the need to create one. This article describes a method to obtain upper-extremities' forces and moments in a person with SCI by designing an appropriate instrumented walker. First, since the commercial multidirectional loadcells are too expensive, custom loadcells are fabricated. Ultimately, a complete gait analysis by means of VICON motion analysis and using inverse dynamic method has been held to measure upper-extremities' efforts. The results for a person with SCI using a two-wheel walker in low and high heights and a basic walker show that there are higher shoulder and elbow flexion-extension moments and also higher shoulder forces in superior-inferior direction and higher elbow and wrist forces in anterior-posterior directions. The results are not much different in using two different types of walker. By using the proposed method, upper-extremities' forces and moments were obtained and the results were compared to each other in using two different walkers.

  12. Literature review on wearable systems in upper extremity rehabilitation

    NARCIS (Netherlands)

    Wang, Q.; Chen, Wei; Markopoulos, P.

    2014-01-01

    This paper reports a structured literature survey of research in wearable technology for upper-extremity rehabilitation, e.g., after stroke, spinal cord injury, for multiple sclerosis patients or even children with cerebral palsy. A keyword based search returned 61 papers relating to this topic.

  13. Risk factors for breast cancer-related upper extremity lymphedema: a meta-analysis

    International Nuclear Information System (INIS)

    Xie Yuhuan; Guo Qi; Liu Fenghua; Zhu Yaqun; Tian Ye

    2014-01-01

    Objective: To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations. Methods: PubMed, Ovid, EMbase, and the Cochrane Library were searched to identify clinical trials published up to December 2012. The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2; the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95% confidence intervals (CI). Results: Twenty-two studies involving 10106 patients were included in the meta-analysis. The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR=2.72, 95% CI=1.06-6.99, P=0.038), hypertension (OR=1.84, 95% CI=1.38-2.44, P=0.000), body mass index (OR=1.68, 95% CI=1.22-2.32, P=0.001), and radiotherapy (OR=1.65, 95% CI=1.20-2.25, P=0.002), while no significant associations were found for such factors as chemotherapy, age, number of positive lymph nodes, and number of dissected lymph nodes. Conclusions: The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment, and axillary lymph node dissection, hypertension,body mass index, and radiotherapy are the main risk factors for lymphedema after breast cancer treatment. (authors)

  14. Timing of electromyographic activity and ranges of motion during simple motor tasks of upper extremities

    Directory of Open Access Journals (Sweden)

    Syczewska Małgorzata

    2017-10-01

    Full Text Available Study aim: Improvement of the upper extremities’ performance is one of the key aims in the rehabilitation process. In order to achieve high effectiveness of this process the amount of functional improvement achieved by a patient during the therapy needs to be assessed. The aim of this study was to obtain electromyographic (EMG activity profiles of the upper extremity muscles during execution of simple tasks in healthy subjects. Additionally the ranges of wrist, elbow and shoulder joints were measured and reported during performed trials. The second aim was to determine whether the movement execution and ranges of move­ments and muscular activity depend on age. Material and methods: Twenty-eight healthy adults, age range 21 to 65 years old, participated in the study. Surface electrodes were placed bilaterally on 7 upper extremity muscles. To obtain information about the beginning and end of the movement task and ranges of upper extremity joints, 13 markers were placed on the elbows and wrists of both upper extremities. The move­ments of the segments were calculated (distal vs proximal in five simple functional tasks (each task involved only one joint, performed while sitting. Kinematic data were collected by the VICON 460 system, and electromyographic data with the Mo­tion Lab EMG system. Results: Charts of timing of EMG activity of the upper extremity muscles together with ranges of upper extremity joint motion were obtained. Conclusion: The results show that the number of muscles activated and the time (or percentage of the task during which they are active depend on the type of the task and age. These data can be used as a reference in evaluation of functional deficits of patients.

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

    OpenAIRE

    M. Pourmahabadian; J.N. Saraji; M. Aghabeighi H. Saddeghi-Naeeni

    2005-01-01

    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 ai...

  16. Closed-kinetic chain upper-body training improves throwing performance of NCAA Division I softball players.

    Science.gov (United States)

    Prokopy, Max P; Ingersoll, Christopher D; Nordenschild, Edwin; Katch, Frank I; Gaesser, Glenn A; Weltman, Arthur

    2008-11-01

    Closed-kinetic chain resistance training (CKCRT) of the lower body is superior to open-kinetic chain resistance training (OKCRT) to improve performance parameters (e.g., vertical jump), but the effects of upper-body CKCRT on throwing performance remain unknown. This study compared shoulder strength, power, and throwing velocity changes in athletes training the upper body exclusively with either CKCRT (using a system of ropes and slings) or OKCRT. Fourteen female National Collegiate Athletic Association Division I softball player volunteers were blocked and randomly placed into two groups: CKCRT and OKCRT. Blocking ensured the same number of veteran players and rookies in each training group. Training occurred three times weekly for 12 weeks during the team's supervised off-season program. Olympic, lower-body, core training, and upper-body intensity and volume in OKCRT and CKCRT were equalized between groups. Criterion variables pre- and posttraining included throwing velocity, bench press one-repetition maximum (1RM), dynamic single-leg balance, and isokinetic peak torque and power (PWR) (at 180 degrees x s(-1)) for shoulder flexion, extension, internal rotation, and external rotation (ER). The CKCRT group significantly improved throwing velocity by 2.0 mph (3.4%, p performance. Strength coaches can incorporate upper-body CKCRT without sacrificing gains in maximal strength or performance criteria associated with an athletic open-chain movement such as throwing.

  17. Comparing unilateral and bilateral upper limb training: the ULTRA-stroke program design

    NARCIS (Netherlands)

    van Delden, A.E.Q.; Peper, C.E.; Harlaar, J.; Daffertshofer, A.; Zijp, N.I.; Nienhuys, K.; Koppe, P.; Kwakkel, G.; Beek, P.J.

    2009-01-01

    Background: About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40%) regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions - constraint-induced

  18. 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

  19. Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity.

    Science.gov (United States)

    Patel, Jigna; Qiu, Qinyin; Yarossi, Mathew; Merians, Alma; Massood, Supriya; Tunik, Eugene; Adamovich, Sergei; Fluet, Gerard

    2017-07-01

    Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. Five individuals were trained using priming techniques including virtual reality (VR) based visual mirror feedback and contralaterally controlled passive movement strategies prior to training with an active pinch force modulation task. Clinical, kinetic, and neurophysiological measurements were taken pre and post the training period. Clinical measures were taken at six months post training. The two priming simulations and active training were well tolerated early after stroke. Priming effects were suggested by increased maximal pinch force immediately after visual and movement based priming. Despite having no clinically observable movement distally, the subjects were able to volitionally coordinate isometric force and muscle activity (EMG) in a pinch tracing task. The Root Mean Square Error (RMSE) of force during the pinch trace task gradually decreased over the training period suggesting learning may have occurred. Changes in motor cortical neurophysiology were seen in the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS) mapping. Significant improvements in motor recovery as measured by the Action Research Arm Test (ARAT) and the Upper Extremity Fugl Meyer Assessment (UEFMA) were demonstrated at six months post training by three of the five subjects. This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing. Implications for Rehabilitation Rehabilitation of individuals with severely paretic upper extremities after stroke is challenging due to limited movement capacity and few options for therapeutic training. Long-term functional recovery of the arm after stroke depends on early return

  20. Extreme Conditioning Programs: Potential Benefits and Potential Risks.

    Science.gov (United States)

    Knapik, Joseph J

    2015-01-01

    CrossFit, Insanity, Gym Jones, and P90X are examples of extreme conditioning programs (ECPs). ECPs typically involve high-volume and high-intensity physical activities with short rest periods between movements and use of multiple joint exercises. Data on changes in fitness with ECPs are limited to CrossFit investigations that demonstrated improvements in muscle strength, muscular endurance, aerobic fitness, and body composition. However, no study has directly compared CrossFit or other ECPs to other more traditional forms of aerobic and resistance training within the same investigation. These direct comparisons are needed to more adequately evaluate the effectiveness of ECPs. Until these studies emerge, the comparisons with available literature suggest that improvements in CrossFit, in terms of muscular endurance (push-ups, sit-ups), strength, and aerobic capacity, appear to be similar to those seen in more traditional training programs. Investigations of injuries in ECPs are limited to two observational studies that suggest that the overall injury rate is similar to that seen in other exercise programs. Several cases of rhabdomyolysis and cervical carotid artery dissections have been reported during CrossFit training. The symptoms, diagnosis, and treatment of these are reviewed here. Until more data on ECPs emerge, physical training should be aligned with US Army doctrine. If ECPs are included in exercise programs, trainers should (1) have appropriate training certifications, (2) inspect exercise equipment regularly to assure safety, (3) introduce ECPs to new participants, (4) ensure medical clearance of Soldiers with special health problems before participation in ECPs, (4) tailor ECPs to the individual Soldier, (5) adjust rest periods to optimize recovery and reduce fatigue, (6) monitor Soldiers for signs of overtraining, rhabdomyolysis, and other problems, and (7) coordinate exercise programs with other unit training activities to eliminate redundant activities

  1. The Armeo Spring as training tool to improve upper limb functionality in multiple sclerosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Kerkhofs Lore

    2011-01-01

    Full Text Available Abstract Background Few research in multiple sclerosis (MS has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle strength and functional capacity in MS patients with evident paresis. Methods A case series was applied, with provision of a training program (3×/week, 30 minutes/session, supplementary on the customary maintaining care, by employing a gravity-supporting exoskeleton apparatus (Armeo Spring. Ten high-level disability MS patients (Expanded Disability Status Scale 7.0-8.5 actively performed task-oriented movements in a virtual real-life-like learning environment with the affected upper limb. Tests were administered before and after training, and at 2-month follow-up. Muscle strength was determined through the Motricity Index and Jamar hand-held dynamometer. Functional capacity was assessed using the TEMPA, Action Research Arm Test (ARAT and 9-Hole Peg Test (9HPT. Results Muscle strength did not change significantly. Significant gains were particularly found in functional capacity tests. After training completion, TEMPA scores improved (p = 0.02, while a trend towards significance was found for the 9HPT (p = 0.05. At follow-up, the TEMPA as well as ARAT showed greater improvement relative to baseline than after the 8-week intervention period (p = 0.01, p = 0.02 respectively. Conclusions The results of present pilot study suggest that upper limb functionality of high-level disability MS patients can be positively influenced by means of a technology-enhanced physical rehabilitation program.

  2. Choice-Based Evaluation for the Improvement of Upper-Extremity Function Compared With Other Impairments in Tetraplegia

    NARCIS (Netherlands)

    Snoek, Govert J.; IJzerman, Maarten Joost; Post, Marcel W.; Stiggelbout, Anne M.; Roach, Mary J.; Zilvold, Gerrit

    2005-01-01

    Objectives To assess preference of reconstructive treatment of upper extremities in subjects with tetraplegia compared with preference of treatment of 3 other impairments and to determine the effect of subjects’ characteristics on preference of upper-extremity reconstruction. Design Survey. Setting

  3. Functional studies in 79-year-olds. II. Upper extremity function.

    Science.gov (United States)

    Lundgren-Lindquist, B; Sperling, L

    1983-01-01

    As part of the Gerontological and Geriatric Population Study of 79-year-old people in Göteborg, a representative subsample comprising 112 women and 93 men took part in a study of upper extremity function. Thirty-eight per cent of the women and 37% of the men had disorders in the upper extremities. The investigation included tests of co-ordination, static strength in the key-grip and the transversal volar grip, power capacity in opening jars and a bottle, basal movements in the upper extremities in personal hygiene and dressing activities, function in the kitchen e.g. reaching shelves, manual tasks including tests of pronation and supination of the forearm. In the key-grip as well as in the transversal volar grip men showed a generally larger decrease in strength with age than women compared to 70-year-olds in a previous population study. Significant correlations were found between strength in the key-grip and the performance time in the test of co-ordination. Women produced about 66% of the muscular force of the men when opening jars. Significant correlations were found between strength in the transversal volar grip and the maximal torque for opening the jars. Female and male subjects who were not capable of handling the electric plug in the manual ability test had significantly weaker strength in the key-grip. The importance of designing products and adapting the environment so as to correspond to the functional capacity of the elderly, is emphasized.

  4. Diagnosis and management of deep vein thrombosis of the upper extremity: a review

    International Nuclear Information System (INIS)

    Baarslag, Henk J.; Reekers, Jim A.; Koopman, Maria M.W.; Beek, Edwin J.R. van

    2004-01-01

    Deep vein thrombosis of the upper extremity is an increasing clinical problem due to the use of long-term indwelling catheters for chemotherapy or long-term feeding. The clinical diagnosis is difficult to make, and various imaging modalities have been used for this purpose. The use of (interventional) radiological procedures has been advancing in recent years. This review describes the clinical background, the imaging modalities that may be employed, treatment options and outcome of patients with upper extremity thrombosis. (orig.)

  5. Effect of compensatory acceleration training in combination with accommodating resistance on upper body strength in collegiate athletes

    Directory of Open Access Journals (Sweden)

    Jones MT

    2014-08-01

    Full Text Available Margaret T Jones Sports Medicine Assessment, Rehabilitation, and Testing Laboratory, School of Recreation, Health, and Tourism, George Mason University, Manassas, VA, USA Purpose: To determine the impact of inclusion of a band or chain compensatory acceleration training (CAT, in a 5-week training phase, on maximal upper body strength during a 14-week off-season strength and conditioning program for collegiate male athletes. Patients and methods: Twenty-four National Collegiate Athletic Association (NCAA collegiate baseball players, who were familiar with the current strength and conditioning program and had a minimum of 1 year of formal collegiate strength and conditioning experience, participated in this off-season training study. None of the men had participated in CAT before. Subjects were matched following a maximal effort (1-repetition maximum [1-RM] bench press test in week 1, then were randomly assigned into a band-based CAT group or a chain-based CAT group and participated in a 5-week training phase that included bench pressing twice per week. Upper body strength was measured by 1-RM bench press again at week 6. A 2 × 2 mixed factorial (method × time analysis of variance was calculated to compare differences across groups. The alpha level was set at P<0.05. Results: No difference (F1,22=0.04, P=0.84 existed between the band-based CAT and chain-based CAT groups. A significant difference was observed between pre- and posttests of 1-RM bench (F1,22=88.46, P=0.001. Conclusion: A 5-week band CAT or chain CAT training program used in conjunction with an off-season strength and conditioning program can increase maximal upper body strength in collegiate baseball athletes. Using band CAT and/or chain CAT as a training modality in the off-season will vary the training stimulus from the traditional and likely help to maintain the athlete's interest. Keywords: variable resistance, band, baseball, chain, resistance training

  6. Radiographic assessment of congenital malformations of the upper extremity

    International Nuclear Information System (INIS)

    Winfeld, Matthew J.; Otero, Hansel

    2016-01-01

    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.)

  7. Radiographic assessment of congenital malformations of the upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  8. The influence of wheelchair propulsion technique on upper extremity muscle demand: a simulation study.

    Science.gov (United States)

    Rankin, Jeffery W; Kwarciak, Andrew M; Richter, W Mark; Neptune, Richard R

    2012-11-01

    The majority of manual wheelchair users will experience upper extremity injuries or pain, in part due to the high force requirements, repetitive motion and extreme joint postures associated with wheelchair propulsion. Recent studies have identified cadence, contact angle and peak force as important factors for reducing upper extremity demand during propulsion. However, studies often make comparisons between populations (e.g., able-bodied vs. paraplegic) or do not investigate specific measures of upper extremity demand. The purpose of this study was to use a musculoskeletal model and forward dynamics simulations of wheelchair propulsion to investigate how altering cadence, peak force and contact angle influence individual muscle demand. Forward dynamics simulations of wheelchair propulsion were generated to emulate group-averaged experimental data during four conditions: 1) self-selected propulsion technique, and while 2) minimizing cadence, 3) maximizing contact angle, and 4) minimizing peak force using biofeedback. Simulations were used to determine individual muscle mechanical power and stress as measures of muscle demand. Minimizing peak force and cadence had the lowest muscle power requirements. However, minimizing peak force increased cadence and recovery power, while minimizing cadence increased average muscle stress. Maximizing contact angle increased muscle stress and had the highest muscle power requirements. Minimizing cadence appears to have the most potential for reducing muscle demand and fatigue, which could decrease upper extremity injuries and pain. However, altering any of these variables to extreme values appears to be less effective; instead small to moderate changes may better reduce overall muscle demand. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Unilateral versus bilateral upper limb training after stroke: The upper limb training after stroke clinical trial

    OpenAIRE

    van Delden, AL; Peper, CE; Nienhuys, KN; Zijp, NI; Beek, PJ; Kwakkel, G

    2013-01-01

    This article is available open access through the publisher’s website at the link below. Copyright © 2013 American Heart Association, Inc. Background and Purpose — Unilateral and bilateral training protocols for upper limb rehabilitation after stroke represent conceptually contrasting approaches with the same ultimate goal. In a randomized controlled trial, we compared the merits of modified constraint-induced movement therapy, modified bilateral arm training with rhythmic auditory cueing,...

  10. Relative incidence of phlebitis associated with peripheral intravenous catheters in the lower versus upper extremities.

    Science.gov (United States)

    Benaya, A; Schwartz, Y; Kory, R; Yinnon, A M; Ben-Chetrit, E

    2015-05-01

    Peripheral venous access in elderly, hospitalized patients is often challenging. The usual alternative is insertion of a central venous catheter, with associated risk for complications. The purpose of this investigation was to determine the relative incidence of phlebitis secondary to lower as compared to upper extremity intravenous catheters (IVCs) and associated risk factors. A non-randomized, observational, cohort-controlled study was carried out. Consecutive patients receiving a lower extremity IVC were enrolled and compared with patients receiving an upper extremity IVC. Patients were followed from insertion until removal of the IVC. The major endpoint was phlebitis. The incidence of phlebitis secondary to upper extremity IVCs was 3/50 (6 %) compared to 5/53 (9.4 %) in lower extremity IVCs (χ(2) Yates = 0.08, p = 0.776). Age, gender, obesity, diabetes mellitus, site (arm versus leg, left versus right), and size of needle were not found to be risk factors for phlebitis according to univariate analysis. None of the patients developed bloodstream infection. In elderly patients with poor venous access, lower extremity IVCs are a reasonable and low-risk alternative to central venous catheters.

  11. 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.

  12. 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.

  13. Evaluation of the Plastic Surgery In-Service Training Exam: Lower Extremity Questions.

    Science.gov (United States)

    Silvestre, Jason; Basta, Marten N; Serletti, Joseph M; Chang, Benjamin

    2015-01-01

    To facilitate the training of plastic surgery residents, we analyzed a knowledge-based curriculum for plastic and reconstructive surgery of the lower extremity. The Plastic Surgery In-Service Training Exam (PSITE) is a commonly used tool to assess medical knowledge in plastic surgery. We reviewed the lower extremity content on 6 consecutive score keys (2008-2013). Questions were classified by taxonomy, anatomy, and subject. Answer references were quantified by source and relative year of publication. Totally, 107 questions related to the lower extremity (9.1% of all questions) and 14 questions had an associated image (13.1%). Questions required decision making (49%) over interpretation (36%) and direct recall (15%) skills (p < 0.001). Conditions of the leg (42.1%) and thigh (24.3%) constituted most of the questions. Subject matter focused on flap reconstruction (38.3%), nerve injury (8.4%), and congenital deformity (6.5%). Analysis of 263 citations to 66 unique journals showed that Plastic and Reconstructive Surgery (54.9%) was the highest yield primary source. The median year of publication relative to PSITE administration was 6 (range: 1-58) with a mode of 2 years. Plastic Surgery by Mathes et al. was the most referenced textbook (21.9%). These data establish a benchmark for lower extremity training during plastic surgery residency. Study efforts focused on the most common topics and references will enhance trainee preparation for lower extremity PSITE questions. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. Diagnostic accuracy of ultrasound in upper and lower extremity long bone fractures of emergency department trauma patients.

    Science.gov (United States)

    Frouzan, Arash; Masoumi, Kambiz; Delirroyfard, Ali; Mazdaie, Behnaz; Bagherzadegan, Elnaz

    2017-08-01

    Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures. The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures in traumatic patients. This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity. The mean age of patients with upper and lower limb trauma were 31.43±12.32 years and 29.63±5.89 years, respectively. Radius fracture was the most frequent compared to other fractures (27%). Sensitivity, specificity, positive predicted value, and negative predicted value of ultrasound compared with plain radiography in the diagnosis of upper extremity long bones were 95.3%, 87.7%, 87.2% and 96.2%, respectively, and the highest accuracy was observed in left arm fractures (100%). Tibia and fibula fractures were the most frequent types compared to other fractures (89.2%). Sensitivity, specificity, PPV and NPV of ultrasound compared with plain radiography in the diagnosis of upper extremity long bone fractures were 98.6%, 83%, 65.4% and 87.1%, respectively, and the highest accuracy was observed in men, lower ages and femoral fractures. The results of this study showed that ultrasound compared with plain radiography has a high accuracy in the diagnosis of upper and lower extremity long bone fractures.

  15. Revealing the impact of local access-site complications and upper extremity dysfunction post transradial percutaneous coronary procedures

    NARCIS (Netherlands)

    Zwaan, E.M.; Koopman, A.G.M.M.; Holtzer, C.A.J.; Zijlstra, F.; Ritt, M.J.P.F.; Amoroso, G.; Moerman, E.; Kofflard, M.J.M.; Ijsselmuiden, A.J.J.

    2015-01-01

    Objectives Little is known about local access-site complications and upper extremity dysfunction after transradial percutaneous coronary procedures (TR-PCP). This systematic review study aimed to summarise the current knowledge on the incidences of access-site complications and upper extremity

  16. Upper extremity transplantation: current concepts and challenges in an emerging field.

    Science.gov (United States)

    Elliott, River M; Tintle, Scott M; Levin, L Scott

    2014-03-01

    Loss of an isolated upper limb is an emotionally and physically devastating event that results in significant impairment. Patients who lose both upper extremities experience profound disability that affects nearly every aspect of their lives. While prosthetics and surgery can eventually provide the single limb amputee with a suitable assisting hand, limited utility, minimal haptic feedback, weight, and discomfort are persistent problems with these techniques that contribute to high rates of prosthetic rejection. Moreover, despite ongoing advances in prosthetic technology, bilateral amputees continue to experience high levels of dependency, disability, and distress. Hand and upper extremity transplantation holds several advantages over prosthetic rehabilitation. The missing limb is replaced with one of similar skin color and size. Sensibility, voluntary motor control, and proprioception are restored to a greater degree, and afford better dexterity and function than prosthetics. The main shortcomings of transplantation include the hazards of immunosuppression, the complications of rejection and its treatment, and high cost. Hand and upper limb transplantation represents the most commonly performed surgery in the growing field of Vascularized Composite Allotransplantation (VCA). As upper limb transplantation and VCA have become more widespread, several important challenges and controversies have emerged. These include: refining indications for transplantation, optimizing immunosuppression, establishing reliable criteria for monitoring, diagnosing, and treating rejection, and standardizing outcome measures. This article will summarize the historical background of hand transplantation and review the current literature and concepts surrounding it.

  17. Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: A review and meta-analysis.

    Science.gov (United States)

    Tedesco Triccas, L; Burridge, J H; Hughes, A M; Pickering, R M; Desikan, M; Rothwell, J C; Verheyden, G

    2016-01-01

    To systematically review the methodology in particular treatment options and outcomes and the effect of multiple sessions of transcranial direct current stimulation (tDCS) with rehabilitation programmes for upper extremity recovery post stroke. A search was conducted for randomised controlled trials involving tDCS and rehabilitation for the upper extremity in stroke. Quality of included studies was analysed using the Modified Downs and Black form. The extent of, and effect of variation in treatment parameters such as anodal, cathodal and bi-hemispheric tDCS on upper extremity outcome measures of impairment and activity were analysed using meta-analysis. Nine studies (371 participants with acute, sub-acute and chronic stroke) were included. Different methodologies of tDCS and upper extremity intervention, outcome measures and timing of assessments were identified. Real tDCS combined with rehabilitation had a small non-significant effect of +0.11 (p=0.44) and +0.24 (p=0.11) on upper extremity impairments and activities at post-intervention respectively. Various tDCS methods have been used in stroke rehabilitation. The evidence so far is not statistically significant, but is suggestive of, at best, a small beneficial effect on upper extremity impairment. Future research should focus on which patients and rehabilitation programmes are likely to respond to different tDCS regimes. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  18. 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.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

    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. (paper)

  20. Deep venous thrombosis of the upper extremity. A review

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    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...... 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....... Treatment modalities and strategies: the treatment modalities include anticoagulation therapy, catheter-directed thrombolysis, surgical decompression, percutaneous transluminal angioplasty and stenting and they may be combined. However, the optimal treatment and timing of treatment remains controversial...

  1. Upper extremity injuries in Homer's Iliad.

    Science.gov (United States)

    Hutchison, Richard L; Hirthler, Maureen A

    2013-09-01

    Homer's Iliad remains a fascinating source of medical history. This epic poem, compiled around 800 BCE, describes several weeks of the last year of the 10-year siege of Troy (Ilion) by the Achaeans. Homer composed the epic by combining and formalizing oral poems, legends, customs, and experiences that originated in the later Mycenaean age (1600-1100 bce). The story centers on the rage of the great warrior Achilles. The Iliad remains the oldest record of Greek medicine and a unique source of surgical history. This study examines the upper extremity injuries described in the Iliad and compares them to those other sites of injury. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. INTERSESSION RELIABILITY OF UPPER EXTREMITY ISOKINETIC PUSH-PULL TESTING.

    Science.gov (United States)

    Riemann, Bryan L; Davis, Sarah E; Huet, Kevin; Davies, George J

    2016-02-01

    Based on the frequency pushing and pulling patterns are used in functional activities, there is a need to establish an objective method of quantifying the muscle performance characteristics associated with these motions, particularly during the later stages of rehabilitation as criteria for discharge. While isokinetic assessment offers an approach to quantifying muscle performance, little is known about closed kinetic chain (CKC) isokinetic testing of the upper extremity (UE). To determine the intersession reliability of isokinetic upper extremity measurement of pushing and pulling peak force and average power at slow (0.24 m/s), medium (0.43 m/s) and fast (0.61 m/s) velocities in healthy young adults. The secondary purpose was to compare pushing and pulling peak force (PF) and average power (AP) between the upper extremity limbs (dominant, non-dominant) across the three velocities. Twenty-four physically active men and women completed a test-retest (>96 hours) protocol in order to establish isokinetic UE CKC reliability of PF and AP during five maximal push and pull repetitions at three velocities. Both limb and speed orders were randomized between subjects. High test-retest relative reliability using intraclass correlation coefficients (ICC2, 1) were revealed for PF (.91-.97) and AP (.85-.95) across velocities, limbs and directions. PF typical error (% coefficient of variation) ranged from 6.1% to 11.3% while AP ranged from 9.9% to 26.7%. PF decreased significantly (p pushing were significantly greater than pulling at all velocities, however the push-pull differences in PF became less as velocity increased. There were no significant differences identified between the dominant and nondominant limbs. Isokinetically derived UE CKC push-pull PF and AP are reliable measures. The lack of limb differences in healthy normal participants suggests that clinicians can consider bilateral comparisons when interpreting test performance. The increase in pushing PF and

  3. Direct venous thrombolysis and venous angioplasty in the upper extremity

    International Nuclear Information System (INIS)

    Hollmann, J.P.; Guenther, R.W.

    1987-01-01

    Venous thromboses of stenoses in the upper extremity are often the result of a compression syndrome of the shoulder girdle, the Paget-von Schroetter syndrome, vascular surgery, space-occupying lesions in the mediastinum or the result of catheterisation. Direct venous thrombolysis and venous angioplasty were performed successfully in six patients. (orig.) [de

  4. Gender-related Factors Associated with Upper Extremity Function in Workers

    Directory of Open Access Journals (Sweden)

    Kyoo Sang Kim

    2010-12-01

    Conclusion: This study addressed sociodemographic factors and work-related factors that affect each gender’s upper extremity function during daily living and working activities. Each factor had a different influence. Further studies are needed to identify the effect that role changes, not being influenced by risks at work, have on musculoskeletal disorders.

  5. Rehabilitation of Upper Extremity Casualties via Firearms Training Simulation

    National Research Council Canada - National Science Library

    Harvey, Karolina; Yancosek, Karthleen E

    2005-01-01

    ...%ty to remain vital assets to the American fighting force. The FATS supports training for both individual marksmanship skills and squad level skills, to include tactical exercises with a variety...

  6. 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)

    Ng, Shamay S. M.; Cheng, Yoyo T. Y.; Yu, Esther Y. T.; Chow, Gary C. C.; Chak, Yvonne T. C.; Chan, Ivy K. Y.; Zhang, Joni; Macfarlane, Duncan

    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. PMID:27525020

  7. 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.

  8. 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.

  9. Magnetic resonance imaging of acute 'wiiitis' of the upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Nett, Michael P.; Sperling, John W. [Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN (United States); Collins, Mark S. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2008-05-15

    We present the first reported case of acute 'wiiitis', documented clinically and by imaging, of the upper extremity, caused by prolonged participation in a physically interactive virtual video-game. Unenhanced magnetic resonance imaging (MRI) demonstrated marked T2-weighted signal abnormality within several muscles of the shoulder and upper arm, without evidence of macroscopic partial- or full-thickness tearing of the muscle or of intramuscular hematoma. (orig.)

  10. CRPS of the upper or lower extremity: surgical treatment outcomes

    Directory of Open Access Journals (Sweden)

    Rosson Gedge D

    2009-02-01

    Full Text Available Abstract The hypothesis is explored that CRPS I (the "new" RSD persists due to undiagnosed injured joint afferents, and/or cutaneous neuromas, and/or nerve compressions, and is, therefore, a misdiagnosed form of CRPS II (the "new" causalgia. An IRB-approved, retrospective chart review on a series of 100 consecutive patients with "RSD" identified 40 upper and 30 lower extremity patients for surgery based upon their history, physical examination, neurosensory testing, and nerve blocks. Based upon decreased pain medication usage and recovery of function, outcome in the upper extremity, at a mean of 27.9 months follow-up (range of 9 to 81 months, gave results that were excellent in 40% (16 of 40 patients, good in 40% (16 of 40 patients and failure 20% (8 of 40 patients. In the lower extremity, at a mean of 23.0 months follow-up (range of 9 to 69 months the results were excellent in 47% (14 of 30 patients, good in 33% (10 of 30 patients and failure 20% (6 of 30 patients. It is concluded that most patients referred with a diagnosis of CRPS I have continuing pain input from injured joint or cutaneous afferents, and/or nerve compressions, and, therefore, similar to a patient with CRPS II, they can be treated successfully with an appropriate peripheral nerve surgical strategy.

  11. Design and preliminary evaluation of an exoskeleton for upper limb resistance training

    Science.gov (United States)

    Wu, Tzong-Ming; Chen, Dar-Zen

    2012-06-01

    Resistance training is a popular form of exercise recommended by national health organizations, such as the American College of Sports Medicine (ACSM) and the American Heart Association (AHA). This form of training is available for most populations. A compact design of upper limb exoskeleton mechanism for homebased resistance training using a spring-loaded upper limb exoskeleton with a three degree-of-freedom shoulder joint and a one degree-of-freedom elbow joint allows a patient or a healthy individual to move the upper limb with multiple joints in different planes. It can continuously increase the resistance by adjusting the spring length to train additional muscle groups and reduce the number of potential injuries to upper limb joints caused by the mass moment of inertia of the training equipment. The aim of this research is to perform a preliminary evaluation of the designed function by adopting an appropriate motion analysis system and experimental design to verify our prototype of the exoskeleton and determine the optimal configuration of the spring-loaded upper limb exoskeleton.

  12. Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints

    NARCIS (Netherlands)

    Bot, S.D.M.; Terwee, C.B.; Windt, D.A.W.M. van der; Beek, A.J. van der; Bouter, L.M.; Dekker, J.

    2007-01-01

    Objectives: To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods: Three hundred and forty two patients with neck or upper extremity complaints completed self-report

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Treatment of the Upper Extremity Contracture/Deformities.

    Science.gov (United States)

    Oishi, Scott N; Agranovich, Olga; Pajardi, Giorgio E; Novelli, Chiara; Baindurashvili, Alexey G; Trofimova, Svetlana I; Abdel-Ghani, Hisham; Kochenova, Evgenia; Prosperpio, Giulietta; Jester, Andrea; Yilmaz, Güney; Şenaran, Hakan; Kose, Oksana; Butler, Lesley

    Patients with arthrogryposis multiplex congenita have a characteristic upper extremity resting posture consisting of internal rotation of the shoulders, elbow extension, flexed wrists, thumb-in palm deformities, and variable degrees of finger contractures. Treatment of these patients is aimed at improving independence and performance of activities of daily living. Although each area needs to be assessed independently for the most appropriate surgical procedure, often multiple areas can be addressed at the same operative setting. This limits the number of anesthetic exposures and cast immobilization time. The following is a synopsis of treatment strategies presented at the second international symposium on Arthrogryposis which took place in St Petersburg in September 2014.

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

    Directory of Open Access Journals (Sweden)

    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

  16. INFLUENCE OF STRENGTH TRAINING PROGRAM ON ISOMETRIC MUSCLE STRENGTH IN YOUNG ATHLETES

    Directory of Open Access Journals (Sweden)

    Dragan Radovanovic

    2007-10-01

    Full Text Available Strength training, or resistance training, is a form of physical conditioning used to increase the ability to resist force. Since muscular strength is required for success in many sports, it is logical to assume that stronger and more powerful young athletes will achieve better results. The aim of the study was to examine the effects of strength training on young athletes. An eight-week strength training program for developing muscle strength was performed in this study. Training protocol was designed specifically for young adolescent’s athletes. The program consisted of exercises for lower and upper body, abdominal and lower back muscles. The programs did not involve the maximal (1-3 repetitions maximum and other very hard intensity exercises that may had negative effect on young athletes. The results showed that strength training program had positive effects on maximal isometric muscle force (Fmax and motor skill. The increase presents the combined influence of strength training and growth.

  17. Mitochondrial Plasticity With Exercise Training and Extreme Environments

    DEFF Research Database (Denmark)

    Boushel, Robert; Lundby, Carsten; Qvortrup, Klaus

    2014-01-01

    Mitochondria form a reticulum in skeletal muscle. Exercise training stimulates mitochondrial biogenesis, yet an emerging hypothesis is that training also induces qualitative regulatory changes. Substrate oxidation, oxygen affinity and biochemical coupling efficiency may be differentially regulated...... with training and exposure to extreme environments. Threshold training doses inducing mitochondrial up-regulation remain to be elucidated considering fitness level. SUMMARY: Muscle mitochondrial are responsive to training and environment, yet thresholds for volume vs. regulatory changes and their physiological...

  18. Asymmetric training using virtual reality reflection equipment and the enhancement of upper limb function in stroke patients: a randomized controlled trial.

    Science.gov (United States)

    Lee, DongJin; Lee, MyungMo; Lee, KyoungJin; Song, ChangHo

    2014-07-01

    Asymmetric movements with both hands contributed to the improvement of spatially coupled motion. Thus, the aim of this study was to investigate the effects of an asymmetric training program using virtual reality reflection equipment on upper limb function in stroke patients. Twenty-four stroke patients were randomly allocated to an experimental group (n=12) or a control group (n=12). Both groups participated in conventional physical therapy for 2×30 min/d, 5 d/wk, for 4 weeks. The experimental group also participated in an asymmetric training program using virtual reality reflection equipment, and the control group participated in a symmetric training program. Both asymmetric and symmetric programs were conducted for 30 min/d, 5 d/wk, for 4 weeks. To compare upper limb function before and after intervention, the Fugl-Meyer Assessment (FMA), the Box and Block Test (BBT), grip strength, range of motion (ROM), and spasticity were assessed. Both groups showed significant increases in upper limb function, excepting spasticity, after intervention (Pinteraction was demonstrated only for shoulder/elbow/wrist items of FMA, BBT, grip strength, and ROM of wrist flexion, extension, and ulnar deviation (Pvirtual reality reflection equipment is an effective intervention method for improving upper limb function in stroke patients. We consider that an additional study based on a program using virtual reflection, which is more functional than performing simple tasks, and consisting of tasks relevant to the activities of daily living be conducted. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

    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. (paper)

  1. 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

    on the COPM and with the COPM satisfaction score, and it can be argued that a finding of a low DASH score in elderly women with upper extremity fractures should be followed up by a referral to occupational therapy. Future studies, preferably follow-up studies, are called for to further explore the multiple......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...

  2. 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.)

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

    International Nuclear Information System (INIS)

    Lam, Alan Cheuk Si; Lau, Vince Wing Hang; Au Yeung, Rex Kwok Him

    2015-01-01

    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.)

  4. Mirror Electromyografic Activity in the Upper and Lower Extremity: A Comparison between Endurance Athletes and Non-Athletes

    Directory of Open Access Journals (Sweden)

    Tom Maudrich

    2017-09-01

    Full Text Available During unimanual motor tasks, muscle activity may not be restricted to the contracting muscle, but rather occurs involuntarily in the contralateral resting limb, even in healthy individuals. This phenomenon has been referred to as mirror electromyographic activity (MEMG. To date, the physiological (non-pathological form of MEMG has been observed predominately in upper extremities (UE, while remaining sparsely described in lower extremities (LE. Accordingly, evidence regarding the underlying mechanisms and modulation capability of MEMG, i.e., the extent of MEMG in dependency of exerted force during unilateral isometric contractions are insufficiently investigated in terms of LE. Furthermore, it still remains elusive if and how MEMG is affected by long-term exercise training. Here, we provide novel quantitative evidence for physiological MEMG in homologous muscles of LE (tibialis anterior (TA, rectus femoris (RF during submaximal unilateral dorsiflexion in healthy young adults. Furthermore, endurance athletes (EA, n = 11 show a higher extent of MEMG in LE compared to non-athletes (NA, n = 11 at high force demands (80% MVC, maximum voluntary contraction. While the underlying neurophysiological mechanisms of MEMG still remain elusive, our study indicates, at least indirectly, that sport-related long-term training might affect the amount of MEMG during strong isometric contractions specifically in trained limbs. To support this assumption of exercise-induced limb-specific MEMG modulation, future studies including different sports disciplines with contrasting movement patterns and parameters should additionally be performed.

  5. Mirror Electromyografic Activity in the Upper and Lower Extremity: A Comparison between Endurance Athletes and Non-Athletes.

    Science.gov (United States)

    Maudrich, Tom; Kenville, Rouven; Lepsien, Jöran; Villringer, Arno; Ragert, Patrick; Steele, Christopher J

    2017-01-01

    During unimanual motor tasks, muscle activity may not be restricted to the contracting muscle, but rather occurs involuntarily in the contralateral resting limb, even in healthy individuals. This phenomenon has been referred to as mirror electromyographic activity (MEMG). To date, the physiological (non-pathological) form of MEMG has been observed predominately in upper extremities (UE), while remaining sparsely described in lower extremities (LE). Accordingly, evidence regarding the underlying mechanisms and modulation capability of MEMG, i.e., the extent of MEMG in dependency of exerted force during unilateral isometric contractions are insufficiently investigated in terms of LE. Furthermore, it still remains elusive if and how MEMG is affected by long-term exercise training. Here, we provide novel quantitative evidence for physiological MEMG in homologous muscles of LE (tibialis anterior (TA), rectus femoris (RF)) during submaximal unilateral dorsiflexion in healthy young adults. Furthermore, endurance athletes (EA, n = 11) show a higher extent of MEMG in LE compared to non-athletes (NA, n = 11) at high force demands (80% MVC, maximum voluntary contraction). While the underlying neurophysiological mechanisms of MEMG still remain elusive, our study indicates, at least indirectly, that sport-related long-term training might affect the amount of MEMG during strong isometric contractions specifically in trained limbs. To support this assumption of exercise-induced limb-specific MEMG modulation, future studies including different sports disciplines with contrasting movement patterns and parameters should additionally be performed.

  6. Upper extremity peripheral neuropathies: role and impact of MR imaging on patient management

    International Nuclear Information System (INIS)

    Andreisek, Gustav; Burg, Doris; Studer, Ansgar; Weishaupt, Dominik

    2008-01-01

    To investigate the role of MR imaging (MRI) in the evaluation of peripheral nerve lesions of the upper extremities and to assess its impact on the patient management. Fifty-one patients with clinical evidence of radial, median, and/or ulnar nerve lesions and unclear or ambiguous clinical findings had MRI of the upper extremity at 1.5 T. MR images and clinical data were reviewed by two blinded radiologists and a group of three clinical experts, respectively, with regard to radial, median, and/or ulnar nerve, as well as muscle abnormalities. MRI and clinical findings were correlated using Spearman's (p) rank correlation test. The impact of MRI on patient management was assessed by the group of experts and ranked as ''major,'' ''moderate,'' or ''no'' impact. The correlation of MRI and clinical findings was moderate for the assessment of the median/radial nerve and muscles (p=0.51/0.51/0.63, respectively) and weak for the ulnar nerve (p=0.40). The impact of MRI on patient management was assessed as ''major'' in 24/51 (47%), ''moderate'' in 19/51 (37%), and ''no'' in 8/51 (16%) patients. MRI in patients with upper extremity peripheral neuropathies and unclear or ambiguous clinical findings substantially influences the patient management. (orig.)

  7. PENERAPAN GLOBAL EXTREME PROGRAMMING PADA SISTEM INFORMASI WORKSHOP, SEMINAR DAN PELATIHAN DI LEMBAGA EDUKASI

    Directory of Open Access Journals (Sweden)

    Baginda Oloan Lubis

    2016-09-01

    Full Text Available Abstract Institutions of education as one of the service agencies workshops, seminars and training with information systems that are still manual at the time of printing id cards, the manufacture of attendance, printing certificates and report generation often had difficulty in searching data and other impacts arising from manual systems. Therefore the design of information systems or desktop based application creation is a solution to provide convenience to the user in the process of data processing, data retrieval to preparing reports. Model systems development workshops, seminars and training used in the design of information systems workshops, seminars and training using a model of Agile Software Development, which was discovered and developed by Robert Cecil Martin with process models Global Extreme Programming, namely the development of XP (Extreme Programming Life Cycle. While the tools used by the UML (Unifed Modeling Language and ERD (Entity Relationship Diagram. Hopefully, by the design of this system will allow a user who uses the id card printing, manufacture of attendance, certificate printing and reporting each end of the activity.

  8. Investigation of hand function among children diagnosed with autism spectrum disorder with upper extremity trauma history.

    Science.gov (United States)

    Huri, Meral; Şahin, Sedef; Kayıhan, Hülya

    2016-11-01

    The present study was designed to compare hand function in autistic children with history of upper extremity trauma with that of autistic children those who do not have history of trauma. The study group included total of 65 children diagnosed with autism spectrum disorder (ASD) and was divided into 2 groups: children with trauma history (Group I) and control group (Group II) (Group I: n=28; Group II: n=37). Hand function was evaluated with 9-Hole Peg Test and Jebsen Hand Function Test. Somatosensory function was evaluated using somatosensory subtests of Sensory Integration and Praxis Test. Results were analyzed with Student's t-test and Mann-Whitney U test using SPSS version 20 software. Hand function and somatosensory perception test scores were statistically significantly better in children without upper extremity trauma history (pManual Form Perception and Localization of Tactile Stimuli Test results (p<0.05). Autistic children with upper extremity trauma history had poor somatosensory perception and hand function. It is important to raise awareness among emergency service staff and inform them about strong relationship between somatosensory perception, hand function, and upper extremity trauma in children with ASD in order to develop appropriate rehabilitation process and prevent further trauma.

  9. CAN UPPER EXTREMITY FUNCTIONAL TESTS PREDICT THE SOFTBALL THROW FOR DISTANCE: A PREDICTIVE VALIDITY INVESTIGATION

    Science.gov (United States)

    Hanney, William J.; Kolber, Morey J.; Davies, George J.; Riemann, Bryan

    2011-01-01

    Introduction: Understanding the relationships between performance tests and sport activity is important to the rehabilitation specialist. The purpose of this study was two- fold: 1) To identify if relationships exist between tests of upper body strength and power (Single Arm Seated Shot Put, Timed Push-Up, Timed Modified Pull-Up, and The Davies Closed Kinetic Chain Upper Extremity Stability Test, and the softball throw for distance), 2) To determine which variable or group of variables best predicts the performance of a sport specific task (the softball throw for distance). Methods: One hundred eighty subjects (111 females and 69 males, aged 18-45 years) performed the 5 upper extremity tests. The Pearson product moment correlation and a stepwise regression were used to determine whether relationships existed between performance on the tests and which upper extremity test result best explained the performance on the softball throw for distance. Results: There were significant correlations (r=.33 to r=.70, p=0.001) between performance on all of the tests. The modified pull-up test was the best predictor of the performance on the softball throw for distance (r2= 48.7), explaining 48.7% of variation in performance. When weight, height, and age were added to the regression equation the r2 values increased to 64.5, 66.2, and 67.5 respectively. Conclusion: The results of this study indicate that several upper extremity tests demonstrate significant relationships with one another and with the softball throw for distance. The modified pull up test was the best predictor of performance on the softball throw for distance. PMID:21712942

  10. Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

    Science.gov (United States)

    Patel, Jigna; Qiu, Qinyin; Yarossi, Mathew; Merians, Alma; Massood, Supriya; Tunik, Eugene; Adamovich, Sergei; Fluet, Gerard

    2016-01-01

    Purpose Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. Methods Five individuals were trained using priming techniques including virtual reality (VR) based visual mirror feedback and contralaterally controlled passive movement strategies prior to training with an active pinch force modulation task. Clinical, kinetic, and neurophysiological measurements were taken pre and post the training period. Clinical measures were taken at six months post training. Results The two priming simulations and active training were well tolerated early after stroke. Priming effects were suggested by increased maximal pinch force immediately after visual and movement based priming. Despite having no clinically observable movement distally, the subjects were able to volitionally coordinate isometric force and muscle activity (EMG) in a pinch tracing task. The Root Mean Square Error (RMSE) of force during the pinch trace task gradually decreased over the training period suggesting learning may have occurred. Changes in motor cortical neurophysiology were seen in the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS) mapping. Significant improvements in motor recovery as measured by the Action Research Arm Test (ARAT) and the Upper Extremity Fugl Meyer Assessment (UEFMA) were demonstrated at six months post training by three of the five subjects. Conclusion This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing. PMID:27636200

  11. Robotic training and kinematic analysis of arm and hand after incomplete spinal cord injury: a case study.

    Science.gov (United States)

    Kadivar, Z; Sullivan, J L; Eng, D P; Pehlivan, A U; O'Malley, M K; Yozbatiran, N; Francisco, G E

    2011-01-01

    Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic training in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be catalyzed by repetitive movement training such as that available with robotic devices, it is probable that robotic upper-extremity training of persons with SCI could be clinically beneficial. The primary goal of this pilot study was to test the feasibility of using a novel robotic device for the upper extremity (RiceWrist) and to evaluate robotic rehabilitation using the RiceWrist in a tetraplegic person with incomplete SCI. A 24-year-old male with incomplete SCI participated in 10 sessions of robot-assisted therapy involving intensive upper limb training. The subject successfully completed all training sessions and showed improvements in movement smoothness, as well as in the hand function. Results from this study provide valuable information for further developments of robotic devices for upper limb rehabilitation in persons with SCI. © 2011 IEEE

  12. Effect of programmed strength training on explosive strength of lower extremities in children aged 11 to 14 years

    Directory of Open Access Journals (Sweden)

    Atanasković Andrija

    2014-01-01

    Full Text Available Vertical jumps are an integral part of many sport activities. There are several factors that affect the athlete's jumping ability: strength, force and acceleration that occur when we jump. The jump is a complex and more articulated activity that requires not only strength, but great power as well. The main types of training to increase explosive strength are plyometric training and myogenic training with weight load on the lower extremities. The aim of this study was to determine the effect of myogenic training with weight load on explosive strength of the lower extremities. The first group is the control group (K, while the second group is an experimental group (E, each consisting of eighteen respondents. By Using the Myotest and performing the squat jump (SJ, the Height, Power, Force and Velocity were determined. The programme of power lasted for six weeks, twice a week for up to 60 minutes. We conclude that there is a statistically significant difference between the final and initial measurements in the experimental group, the multivariate level sig = 0.000. Increase in jump height ΔHeight = 3.28 in cm, force ΔForce = 4.68 in N/kg, the strength ΔPower = 6.18 in W/kg, the acceleration ΔVelocity = 21.8 in cm/s. The results of this study show that myogenic training with weight load has a positive impact on the explosive power of the lower extremities. This research was carried out against children aged 11 to 14 years, so we cannot say with certainty that this type of programme can have identical effects on athletes.

  13. Climate Change Impacts on the Upper Indus Hydrology: Sources, Shifts and Extremes.

    Directory of Open Access Journals (Sweden)

    A F Lutz

    Full Text Available The Indus basin heavily depends on its upstream mountainous part for the downstream supply of water while downstream demands are high. Since downstream demands will likely continue to increase, accurate hydrological projections for the future supply are important. We use an ensemble of statistically downscaled CMIP5 General Circulation Model outputs for RCP4.5 and RCP8.5 to force a cryospheric-hydrological model and generate transient hydrological projections for the entire 21st century for the upper Indus basin. Three methodological advances are introduced: (i A new precipitation dataset that corrects for the underestimation of high-altitude precipitation is used. (ii The model is calibrated using data on river runoff, snow cover and geodetic glacier mass balance. (iii An advanced statistical downscaling technique is used that accounts for changes in precipitation extremes. The analysis of the results focuses on changes in sources of runoff, seasonality and hydrological extremes. We conclude that the future of the upper Indus basin's water availability is highly uncertain in the long run, mainly due to the large spread in the future precipitation projections. Despite large uncertainties in the future climate and long-term water availability, basin-wide patterns and trends of seasonal shifts in water availability are consistent across climate change scenarios. Most prominent is the attenuation of the annual hydrograph and shift from summer peak flow towards the other seasons for most ensemble members. In addition there are distinct spatial patterns in the response that relate to monsoon influence and the importance of meltwater. Analysis of future hydrological extremes reveals that increases in intensity and frequency of extreme discharges are very likely for most of the upper Indus basin and most ensemble members.

  14. Climate Change Impacts on the Upper Indus Hydrology: Sources, Shifts and Extremes

    Science.gov (United States)

    Immerzeel, W. W.; Kraaijenbrink, P. D. A.; Shrestha, A. B.; Bierkens, M. F. P.

    2016-01-01

    The Indus basin heavily depends on its upstream mountainous part for the downstream supply of water while downstream demands are high. Since downstream demands will likely continue to increase, accurate hydrological projections for the future supply are important. We use an ensemble of statistically downscaled CMIP5 General Circulation Model outputs for RCP4.5 and RCP8.5 to force a cryospheric-hydrological model and generate transient hydrological projections for the entire 21st century for the upper Indus basin. Three methodological advances are introduced: (i) A new precipitation dataset that corrects for the underestimation of high-altitude precipitation is used. (ii) The model is calibrated using data on river runoff, snow cover and geodetic glacier mass balance. (iii) An advanced statistical downscaling technique is used that accounts for changes in precipitation extremes. The analysis of the results focuses on changes in sources of runoff, seasonality and hydrological extremes. We conclude that the future of the upper Indus basin’s water availability is highly uncertain in the long run, mainly due to the large spread in the future precipitation projections. Despite large uncertainties in the future climate and long-term water availability, basin-wide patterns and trends of seasonal shifts in water availability are consistent across climate change scenarios. Most prominent is the attenuation of the annual hydrograph and shift from summer peak flow towards the other seasons for most ensemble members. In addition there are distinct spatial patterns in the response that relate to monsoon influence and the importance of meltwater. Analysis of future hydrological extremes reveals that increases in intensity and frequency of extreme discharges are very likely for most of the upper Indus basin and most ensemble members. PMID:27828994

  15. Climate Change Impacts on the Upper Indus Hydrology: Sources, Shifts and Extremes.

    Science.gov (United States)

    Lutz, A F; Immerzeel, W W; Kraaijenbrink, P D A; Shrestha, A B; Bierkens, M F P

    2016-01-01

    The Indus basin heavily depends on its upstream mountainous part for the downstream supply of water while downstream demands are high. Since downstream demands will likely continue to increase, accurate hydrological projections for the future supply are important. We use an ensemble of statistically downscaled CMIP5 General Circulation Model outputs for RCP4.5 and RCP8.5 to force a cryospheric-hydrological model and generate transient hydrological projections for the entire 21st century for the upper Indus basin. Three methodological advances are introduced: (i) A new precipitation dataset that corrects for the underestimation of high-altitude precipitation is used. (ii) The model is calibrated using data on river runoff, snow cover and geodetic glacier mass balance. (iii) An advanced statistical downscaling technique is used that accounts for changes in precipitation extremes. The analysis of the results focuses on changes in sources of runoff, seasonality and hydrological extremes. We conclude that the future of the upper Indus basin's water availability is highly uncertain in the long run, mainly due to the large spread in the future precipitation projections. Despite large uncertainties in the future climate and long-term water availability, basin-wide patterns and trends of seasonal shifts in water availability are consistent across climate change scenarios. Most prominent is the attenuation of the annual hydrograph and shift from summer peak flow towards the other seasons for most ensemble members. In addition there are distinct spatial patterns in the response that relate to monsoon influence and the importance of meltwater. Analysis of future hydrological extremes reveals that increases in intensity and frequency of extreme discharges are very likely for most of the upper Indus basin and most ensemble members.

  16. Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Farheen Mirza

    2011-01-01

    Full Text Available Anesthesia options for upper extremity surgery include general and regional anesthesia. Brachial plexus blockade has several advantages including decreased hemodynamic instability, avoidance of airway instrumentation, and intra-, as well as post-operative analgesia. Prior to the availability of ultrasound the risks of complications and failure of regional anesthesia made general anesthesia a more desirable option for anesthesiologists inexperienced in the practice of regional anesthesia. Ultrasonography has revolutionized the practice of regional anesthesia. By visualizing needle entry throughout the procedure, the relationship between the anatomical structures and the needle can reduce the incidence of complications. In addition, direct visualization of the spread of local anesthesia around the nerves provides instant feedback regarding the likely success of the block. This review article outlines how ultrasound has improved the safety and success of brachial plexus blocks. The advantages that ultrasound guidance provides are only as good as the experience of the anesthesiologist performing the block. For example, in experienced hands, with real time needle visualization, a supraclavicular brachial plexus block has changed from an approach with the highest risk of pneumothorax to a block with minimal risks making it the ideal choice for most upper extremity surgeries.

  17. Evaluation of the Physiological Challenges in Extreme Environments: Implications for Enhanced Training, Operational Performance and Sex-Specific Responses

    Science.gov (United States)

    2017-10-01

    Operational Performance and Sex -Specific Responses PRINCIPAL INVESTIGATOR: Brent C. Ruby CONTRACTING ORGANIZATION: The University of Montana Missoula...Implications for Enhanced Training, Operational Performance and Sex -Specific Responses 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...Evaluation of the physiological challenges in extreme environments: Implications for enhanced training, operational performance and sex -specific

  18. EFFECTIVENESS OF INTEGRATED NEUROMUSCULAR INHIBITORY TECHNIQUE (INIT WITH SPECIFIC STRENGTH TRAINING EXERCISES IN SUBJECTS WITH UPPER TRAPEZIUS TRIGGER POINTS

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    B. Jyothirmai

    2015-10-01

    Full Text Available Background: Upper trapezius trigger points is a common cause for neck pain, decreased cervical range of motion and functional activities. The purpose of the study was to evaluate the effectiveness of integrated neuromuscular inhibitory technique (INIT along with specific strength training exercises in reducing pain, improving ROM and functional activities in subjects with upper trapezius trigger point. Methods: Thirty subjects were diagnosed with upper trapezius trigger points were included in the study. These patients were randomly allocated to intervention group (n=15, which underwent a 4- weeks training program of INIT along with specific strength training & control group (n=15 that received INIT alone. The outcome measures were taken before and after treatment. Outcomes were measured by visual analogue scale, cervical range of motion and neck disability index. Within the groups VAS, NDI, and cervical lateral flexion and rotation showed significant change in the mean value. The comparison of pre and post VAS in experimental group and control group showed a significant change in the experimental group .Paired sample t- test was used to analyze changes from before and after intervention programmed. Results: There is a statistically significant (p<0.00 improvement in both variables from baseline to 4th week in experimental group and control group but compared to control group, experimental group shows highly significant values in all parameters. Conclusion: INIT along with specific strength training is proved to be effective in reducing pain, decreasing disability and improving range of motion in individuals with upper trapezius trigger points.

  19. Using Upper Extremity Skin Temperatures to Assess Thermal Comfort in Office Buildings in Changsha, China.

    Science.gov (United States)

    Wu, Zhibin; Li, Nianping; Cui, Haijiao; Peng, Jinqing; Chen, Haowen; Liu, Penglong

    2017-09-21

    Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments' conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm) and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC) located in the hot summer and cold winter (HSCW) climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET*) was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*.

  20. Using Upper Extremity Skin Temperatures to Assess Thermal Comfort in Office Buildings in Changsha, China

    Directory of Open Access Journals (Sweden)

    Zhibin Wu

    2017-09-01

    Full Text Available Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments’ conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC located in the hot summer and cold winter (HSCW climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET* was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*.

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

    Science.gov (United States)

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

    2016-03-01

    To compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only. 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 and daily exercise program for 2 weeks. After randomization, half of all patients received ultrasound-guided injection of scalene muscles before exercise, while the other was invested for the other patients. After two weeks, there was a significant decrease of the visual analog scale score of treatment effect compared with baseline in both groups (6.90 to 2.85 after injection and 5.65 to 4.05 after stretching exercise, p50% reduction in post-treatment visual analog scale, was 18 of 20 (90.0%) after injection, compared to 5 of 20 (25.0%) after stretching exercise. There were no cases of unintended brachial plexus block after injection. Ultrasound-guided steroid injection or stretching exercise of scalene muscles led to reduced upper extremity paresthesia in patients who present with localized tenderness in the scalene muscle without electrodiagnostic test abnormalities, although injection treatment resulted in more improvements. The results suggest that symptoms relief might result from injection into the muscle alone not related to blockade of the brachial plexus.

  2. Improvement of upper limb’s condition of women with post mastectomy syndrome with the help of problem-oriented program of physical rehabilitation

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    Y.A. Briskin

    2015-11-01

    Full Text Available Purpose: to determine effectiveness of problem-oriented program of women’s physical rehabilitation with post mastectomy syndrome in improvement of upper limb’s functional state. Material: 50 women with early symptoms of post mastectomy syndrome at stationary rehabilitation stage, who underwent radical mastectomy by Madden were involved in the research. Testing of movement amplitude in shoulder joint, swelling of upper limb and muscular strength of hand’s flexors was conducted on 2 nd day after surgery and at the end of stationary rehabilitation period (12-14 th day. Results: Main means of the authors’ program were: general and special physical exercises; static and dynamic breathing exercises; breathing through preloaded lips, controlled coughing, autogenic drainage, manual pressing, manual vibration; post-isometric relaxation; elements of labor therapy; lymphatic drainage massage and self massage; topical talks; consultations; auto training. The trainings were conducted individually 2-3 times a day; 20-30 minutes every session. The patients’ independent trainings included: fulfillment of therapeutic positions, self-massage, relaxation exercises and auto-training. Conclusions: application of problem-oriented physical rehabilitation program facilitates improvement of upper limb’s functional potentials of women with post mastectomy syndrome.

  3. JIGSAW PUZZLE IMPROVE FINE MOTOR ABILITIES OF UPPER EXTREMITIES IN POST-STROKE ISCHEMIC CLIENTS

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    Kusnanto Kusnanto

    2017-06-01

    Full Text Available Introduction: Ischemic stroke is a disease caused by focal cerebral ischemia, where is a decline in blood flow that needed for neuronal metabolism, leading to neurologic deficit include motor deficit such as fine motor skills impairment. Therapy of fine motor skills disorders is to improve motor function, prevent contractures and complications. These study aimed to identify the effect of playing Jigsaw Puzzle on muscle strength, extensive motion, and upper extremity fine motor skills in patients with ischemic stroke at Dr. Moewardi Hospital, Surakarta. Methods: Experimental Quasi pre-posttest one group control. The number of samples were 34 respondents selected using purposive sampling technique. The samples were divided into intervention and control groups. The intervention group was 17 respondents who were given standard treatment hospital and played Jigsaw Puzzle 2 times a day for six days. Control group is one respondent given by hospital standard therapy without given additional Jigsaw Puzzle game. Evaluation of these research is done on the first and seventh day for those groups. Result: The results showed that muscle strength, the range of joint motion and fine motor skills of upper extremities increased (p = 0.001 significantly after being given the Jigsaw Puzzle games. These means playing Jigsaw Puzzle increase muscle strength, the range of joint motion and upper extremity fine motor skill of ischemic stroke patients. Discussion and conclusion: Jigsaw puzzle game administration as additional rehabilitation therapy in upper extremity fine motor to minimize the occurrence of contractures and motor disorders in patients with ischemic stroke. Jigsaw puzzle game therapy capable of creating repetitive motion as a key of neurological rehabilitation in Ischemic Stroke. This study recommends using jigsaw puzzle game as one of intervention in the nursing care of Ischemic Stroke patients.

  4. Upper Extremity Injuries in Tennis Players: Diagnosis, Treatment, and Management.

    Science.gov (United States)

    Chung, Kevin C; Lark, Meghan E

    2017-02-01

    Upper extremity tennis injuries are most commonly characterized as overuse injuries to the wrist, elbow, and shoulder. The complex anatomy of these structures and their interaction with biomechanical properties of tennis strokes contributes to the diagnostic challenges. A thorough understanding of tennis kinetics, in combination with the current literature surrounding diagnostic and treatment methods, will improve clinical decision-making. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Effect of short-term upper-body resistance training on muscular strength, bone metabolic markers, and BMD in premenopausal women

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    Liang MT

    2012-11-01

    Full Text Available Michael TC Liang,1 Lorena Quezada,1 WY Jamie Lau,1 Bulent Sokmen,2 Thomas W Spalding11Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, USA; 2Department of Kinesiology, Sonoma State University, Rohnert Park, CA, USAAbstract: To examine the effect of a 10-week upper-body resistance training program on bone turnover markers and site-specific bone mineral density (BMD in the wrist and distal half of the ulna and radius in untrained and healthy young premenopausal women.Methods: Twenty-two subjects (aged 22.1 ± 1.8 years were randomly assigned to a resistance training (n = 12 or no training control (n = 10 group. The following outcome variables were measured before and after 10 weeks of resistance training: (1 bone formation biomarker osteocalcin, and bone resorption biomarker tartrate-resistant acid phosphatase isoform 5b; (2 BMD in the wrist and distal half of the ulna and radius; (3 isokinetic strength of the elbow and knee extensors and flexors; (4 dynamic strength of the arm extensors and flexors; and (5 maximum number of push-ups.Results: The 10-week upper body resistance training intervention resulted in improved strength performance in push-ups (resistance training versus control: P < 0.05, chest presses (P < 0.05, and pulldowns (P < 0.05. However, there was no improvement in the BMD of the wrist (P > 0.05, BMD of the distal half of the ulna and radius (P > 0.05, and metabolic biomarkers osteocalcin (P > 0.05 and tartrate-resistant acid phosphatase isoform 5b (P > 0.05, except for the osteocalcin/tartrate-resistant acid phosphatase isoform 5b ratio. Also, no improvement in the resistance training group was observed for isokinetic strength of the knee and elbow flexion/extension.Conclusion: Upper-body muscular strength performance, but not bone metabolic markers and BMD of the wrist, can be improved with a 10-week upper body resistance training program of the nonweight-bearing limbs in

  6. Ultrasonographic findings of Kimura's disease presenting in the upper extremities.

    Science.gov (United States)

    Shin, Gi Won; Lee, Sun Joo; Choo, Hye Jung; Park, Young Mi; Jeong, Hae Woong; Lee, Sung-Moon; Suh, Jin-Suck; Jung, Soo-Jin

    2014-12-01

    To describe ultrasound findings of Kimura's disease arising in the upper extremities. Five patients with Kimura's disease confirmed by surgical resection were retrospectively reviewed by two musculoskeletal radiologists and a pathologist. All six lesions involved the epitrochlear area and appeared as partially (n = 5) or poorly (n = 1) marginated subcutaneous masses with the presence of curvilinear hyperechoic bands intermingled within the hypoechoic components by US. Moderate (n = 4) to severe (n = 2) vascular signals were observed in some proportion of the hyperechoic bands by color Doppler US. The associated findings were the increased echogenicity of surrounding subcutaneous fat (n = 6) and adjacent lymphadenopathy (n = 4). Microscopic examination showed proliferation of lymphoid follicles with prominent germinal centers and intervening fibrosis. In this study, Kimura's disease arising in the upper extremities showed a partially defined hypoechoic subcutaneous mass with internal hyperechoic bands and moderate-to-severe vascularities, increased echogenicity of the surrounding subcutaneous fat and adjacent lymphadenopathy on US. Thus, when these US features are observed in the typical epitrochlear region of an Asian individual, especially if accompanied by peripheral eosinophilia, Kimura's disease should be considered as a possible diagnosis.

  7. CRUX: A compliant robotic upper-extremity exosuit for lightweight, portable, multi-joint muscular augmentation.

    Science.gov (United States)

    Lessard, Steven; Pansodtee, Pattawong; Robbins, Ash; Baltaxe-Admony, Leya Breanna; Trombadore, James M; Teodorescu, Mircea; Agogino, Adrian; Kurniawan, Sri

    2017-07-01

    Wearable robots can potentially offer their users enhanced stability and strength. These augmentations are ideally designed to actuate harmoniously with the user's movements and provide extra force as needed. The creation of such robots, however, is particularly challenging due to the underlying complexity of the human body. In this paper, we present a compliant, robotic exosuit for upper extremities called CRUX. This exosuit, inspired by tensegrity models of the human arm, features a lightweight (1.3 kg), flexible multi-joint design for portable augmentation. We also illustrate how CRUX maintains the full range of motion of the upper-extremities for its users while providing multi-DoF strength amplification to the major muscles of the arm, as evident by tracking the heart rate of an individual exercising said arm. Exosuits such as CRUX may be useful in physical therapy and in extreme environments where users are expected to exert their bodies to the fullest extent.

  8. Retrospective Review of Air Transportation Use for Upper Extremity Amputations at a Level-1 Trauma Center.

    Science.gov (United States)

    Grantham, W Jeffrey; To, Philip; Watson, Jeffry T; Brywczynski, Jeremy; Lee, Donald H

    2016-08-01

    Air transportation to tertiary care centers of patients with upper extremity amputations has been utilized in hopes of reducing the time to potential replantation; however, this mode of transportation is expensive and not all patients will undergo replantation. The purpose of this study is to review the appropriateness and cost of air transportation in upper extremity amputations. Consecutive patients transported by aircraft with upper extremity amputations in a 7-year period at a level-1 trauma center were retrospectively reviewed. The distance traveled was recorded, along with the times of the injury, referral, transportation duration, arrival, and start of the operation. The results of the transfer were defined as replantation or revision amputation. Overall, 47 patients were identified with 43 patients going to the operating room, but only 14 patients (30%) undergoing replantation. Patients arrived at the tertiary hand surgery center with a mean time of 182.3 minutes following the injury, which includes 105.2 minutes of transportation time. The average distance traveled was 105.4 miles (range, 22-353 miles). The time before surgery of those who underwent replantation was 154.6 minutes. The average cost of transportation was $20,482. Air transportation for isolated upper extremity amputations is costly and is not usually the determining factor for replantation. The type of injury and patients' expectations often dictate the outcome, and these may be better determined at the time of referral with use of telecommunication photos, discussion with a hand surgeon, and patient counseling. III.

  9. [Effect of disease severity on upper extremity muscle strength, exercise capacity, and activities of daily living in individuals with pulmonary arterial hypertension].

    Science.gov (United States)

    Özcan Kahraman, Buse; Özsoy, İsmail; Acar, Serap; Özpelit, Ebru; Akdeniz, Bahri; Sevinç, Can; Savcı, Sema

    2017-07-01

    Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study. Upper-extremity exercise capacity and limitations in performing activities of daily living were assessed with 6-minute pegboard and ring test (6PBRT) and the Milliken activities of daily living scale (MAS), respectively. Shoulder flexion, elbow extension, elbow flexion muscle strength, and handgrip strength were measured with dynamometer. There were no significant differences in age, gender, body mass index, or mean pulmonary artery pressure between groups (p>0.05). The 6PBRT, MAS, and elbow flexion (right) and grip strength (right and left) results were significantly lower in NYHA III group than in NYHA II group (p=0.004, p=0.002, p=0.043, p=0.002 and p=0.003, respectively). There was no significant difference in shoulder flexion, elbow flexion (left), or elbow extension between groups (p>0.05). Results suggest that upper extremity exercise capacity, elbow flexion muscle strength (right), and handgrip strength decrease and that limitations in activities of daily living grow as disease severity increases in patients with PAH. When planning rehabilitation programs, disease severity should be considered and evaluations and treatments for the upper extremities should be included.

  10. The PROMIS physical function correlates with the QuickDASH in patients with upper extremity illness.

    Science.gov (United States)

    Overbeek, Celeste L; Nota, Sjoerd P F T; Jayakumar, Prakash; Hageman, Michiel G; Ring, David

    2015-01-01

    To assess disability more efficiently with less burden on the patient, the National Institutes of Health has developed the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function-an instrument based on item response theory and using computer adaptive testing (CAT). Initially, upper and lower extremity disabilities were not separated and we were curious if the PROMIS Physical Function CAT could measure upper extremity disability and the Quick Disability of Arm, Shoulder and Hand (QuickDASH). We aimed to find correlation between the PROMIS Physical Function and the QuickDASH questionnaires in patients with upper extremity illness. Secondarily, we addressed whether the PROMIS Physical Function and QuickDASH correlate with the PROMIS Depression CAT and PROMIS Pain Interference CAT instruments. Finally, we assessed factors associated with QuickDASH and PROMIS Physical Function in multivariable analysis. A cohort of 93 outpatients with upper extremity illnesses completed the QuickDASH and three PROMIS CAT questionnaires: Physical Function, Pain Interference, and Depression. Pain intensity was measured with an 11-point ordinal measure (0-10 numeric rating scale). Correlation between PROMIS Physical Function and the QuickDASH was assessed. Factors that correlated with the PROMIS Physical Function and QuickDASH were assessed in multivariable regression analysis after initial bivariate analysis. There was a moderate correlation between the PROMIS Physical Function and the QuickDASH questionnaire (r=-0.55, p<0.001). Greater disability as measured with the PROMIS and QuickDASH correlated most strongly with PROMIS Depression (r=-0.35, p<0.001 and r=0.34, p<0.001 respectively) and Pain Interference (r=-0.51, p<0.001 and r=0.74, p<0.001 respectively). The factors accounting for the variability in PROMIS scores are comparable to those for the QuickDASH except that the PROMIS Physical Function is influenced by other pain conditions while the QuickDASH is

  11. Pattern of improvement in upper limb pointing task kinematics after a 3-month training program with robotic assistance in stroke.

    Science.gov (United States)

    Pila, Ophélie; Duret, Christophe; Laborne, François-Xavier; Gracies, Jean-Michel; Bayle, Nicolas; Hutin, Emilie

    2017-10-13

    When exploring changes in upper limb kinematics and motor impairment associated with motor recovery in subacute post stroke during intensive therapies involving robot-assisted training, it is not known whether trained joints improve before non-trained joints and whether target reaching capacity improves before movement accuracy. Twenty-two subacute stroke patients (mean delay post-stroke at program onset 63 ± 29 days, M2) underwent 50 ± 17 (mean ± SD) 45-min sessions of robot-assisted (InMotion™) shoulder/elbow training over 3 months, in addition to conventional occupational therapy. Monthly evaluations (M2 to M5) included Fugl-Meyer Assessment (FM), with subscores per joint, and four robot-based kinematic measures: mean target distance covered, mean velocity, direction accuracy (inverse of root mean square error from straight line) and movement smoothness (inverse of mean number of zero-crossings in the velocity profile). We assessed delays to reach statistically significant improvement for each outcome measure. At M5, all clinical and kinematic parameters had markedly improved: Fugl-Meyer, +65% (median); distance covered, +87%; mean velocity, +101%; accuracy, +134%; and smoothness, +96%. Delays to reach statistical significance were M3 for the shoulder/elbow Fugl-Meyer subscore (+43%), M4 for the hand (+80%) and M5 for the wrist (+133%) subscores. For kinematic parameters, delays to significant improvements were M3 for distance (+68%), velocity (+65%) and smoothness (+50%), and M5 for accuracy (+134%). An intensive rehabilitation program combining robot-assisted shoulder/elbow training and conventional occupational therapy was associated with improvement in shoulder and elbow movements first, which suggests focal behavior-related brain plasticity. Findings also suggested that recovery of movement quantity related parameters (range of motion, velocity and smoothness) might precede that of movement quality (accuracy). EudraCT 2016-005121-36 . Date of

  12. Biomechanical loading on the upper extremity increases from single key tapping to directional tapping.

    Science.gov (United States)

    Qin, Jin; Trudeau, Matthieu; Katz, Jeffrey N; Buchholz, Bryan; Dennerlein, Jack T

    2011-08-01

    Musculoskeletal disorders associated with computer use span the joints of the upper extremity. Computing typically involves tapping in multiple directions. Thus, we sought to describe the loading on the finger, wrist, elbow and shoulder joints in terms of kinematic and kinetic difference across single key switch tapping to directional tapping on multiple keys. An experiment with repeated measures design was conducted. Six subjects tapped with their right index finger on a stand-alone number keypad placed horizontally in three conditions: (1) on single key switch (the number key 5); (2) left and right on number key 4 and 6; (3) top and bottom on number key 8 and 2. A force-torque transducer underneath the keypad measured the fingertip force. An active-marker infrared motion analysis system measured the kinematics of the fingertip, hand, forearm, upper arm and torso. Joint moments for the metacarpophalangeal, wrist, elbow, and shoulder joints were estimated using inverse dynamics. Tapping in the top-bottom orientation introduced the largest biomechanical loading on the upper extremity especially for the proximal joint, followed by tapping in the left-right orientation, and the lowest loading was observed during single key switch tapping. Directional tapping on average increased the fingertip force, joint excursion, and peak-to-peak joint torque by 45%, 190% and 55%, respectively. Identifying the biomechanical loading patterns associated with these fundamental movements of keying improves the understanding of the risks of upper extremity musculoskeletal disorders for computer keyboard users. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies.

    Science.gov (United States)

    Hoozemans, M J M; Knelange, E B; Frings-Dresen, M H W; Veeger, H E J; Kuijer, P P F M

    2014-11-01

    Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. A descriptive analysis of nontuberculous mycobacterial infections (NTM of the upper extremity

    Directory of Open Access Journals (Sweden)

    M Al-Knawy

    2015-01-01

    Conclusion: Diagnosis of NTM infection of the upper extremity is often delayed due to its indolent presentation and lack of clinical suspicion. Healthcare professionals should be aware of the increasing incidence of soft tissue NTM infection after percutaneous injury, especially in immunosuppressed patients, to improve diagnostic promptness and treatment outcome.

  15. Current management strategies and long-term clinical outcomes of upper extremity venous thrombosis

    NARCIS (Netherlands)

    Bleker, S. M.; van Es, N.; Kleinjan, A.; Buller, H. R.; Kamphuisen, P. W.; Aggarwal, A.; Beyer-Westendorf, J.; Camporese, G.; Cosmi, B.; Gary, T.; Ghirarduzzi, A.; Kaasjager, K.; Lerede, T.; Marschang, P.; Meijer, Karina; Otten, H. -M.; Porreca, E.; Righini, M.; Verhamme, P.; van Wissen, S.; Di Nisio, M.

    Background: There is scant information on the optimal management and clinical outcome of deep and superficial vein thrombosis of the upper extremity (UEDVT and UESVT). Objectives: To explore treatment strategies and the incidence of recurrent venous thromboembolism (VTE), mortality, postthrombotic

  16. Well-circumscribed deep-seated lipomas of the upper extremity. A report of 13 cases.

    Science.gov (United States)

    Elbardouni, A; Kharmaz, M; Salah Berrada, M; Mahfoud, M; Elyaacoubi, M

    2011-04-01

    The purpose of this study is to determine if giant size is of bad prognosis in deep lipomas of the upper extremity. We report a retrospective study of 13 patients with deep-seated lipomas of the upper extremity treated during the period from April 1997 to April 2008. We evaluated the clinical and radiological characteristics, treatment and evolution profile of these patients. There were 10 women and three men, with an average age of 53 years (range 30-79 years). Seven of these lipomas were in the arm, one in the shoulder, and five in the forearm. Six lipomas were intramuscular, six intermuscular (three of them being attached to bone and labelled parosteal lipoma) and one epivaginal lipoma of the flexor tendon sheath. All patients presented a progressive slow-growing mass that was associated with radial paralysis in one case and carpal tunnel syndrome in one case. Plain radiographs showed a radiolucent soft-tissue image in all cases and an associated osteochondroma in one parosteal lipoma. Computer tomography (CT) or magnetic resonance imaging (MRI) suggested the lipomatous nature and benign characteristics of these deep lipomas that were giant in all cases (mean size: 7 cm). Lipoma marginal excision was performed and histopathological examination demonstrated features consistent with a benign lipoma. There was good function and no clinical recurrence was observed after a mean follow-up of three years. Giant deep-seated lipomas of the upper extremity are uncommon and can be intermuscular or intramuscular. A painless soft-tissue mass is the most frequent chief complaint. MRI with fat suppression suggests the diagnosis and studies the extension of deep lipoma. Marginal excision is the treatment of choice and histopathology eliminates diagnosis of well-differentiated liposarcoma. Appropriate evaluation of deep lipoma is to rule out malignancy by systematically performing MRI and biopsy. In contrast to deep-seated lipomas of the lower extremity or the retroperitoneal

  17. Comparative outcome of bomb explosion injuries versus high-powered gunshot injuries of the upper extremity in a civilian setting.

    Science.gov (United States)

    Luria, Shai; Rivkin, Gurion; Avitzour, Malka; Liebergall, Meir; Mintz, Yoav; Mosheiff, Ram

    2013-03-01

    Explosion injuries to the upper extremity have specific clinical characteristics that differ from injuries due to other mechanisms. To evaluate the upper extremity injury pattern of attacks on civilian targets, comparing bomb explosion injuries to gunshot injuries and their functional recovery using standard outcome measures. Of 157 patients admitted to the hospital between 2000 and 2004, 72 (46%) sustained explosion injuries and 85 (54%) gunshot injuries. The trauma registry files were reviewed and the patients completed the DASH Questionnaire (Disabilities of Arm, Shoulder and Hand) and SF-12 (Short Form-12) after a minimum period of 1 year. Of the 157 patients, 72 (46%) had blast injuries and 85 (54%) had shooting injuries. The blast casualties had higher Injury Severity Scores (47% vs. 22% with a score of > 16, P = 0.02) and higher percent of patients treated in intensive care units (47% vs. 28%, P = 0.02). Although the Abbreviated Injury Scale score of the upper extremity injury was similar in the two groups, the blast casualties were found to have more bilateral and complex soft tissue injuries and were treated surgically more often. No difference was found in the SF-12 or DASH scores between the groups at follow up. The casualties with upper extremity blast injuries were more severely injured and sustained more bilateral and complex soft tissue injuries to the upper extremity. However, the rating of the local injury to the isolated limb is similar, as was the subjective functional recovery.

  18. Bilateral Upper Extremity DVT in a 43-Year-Old Man: Is It Thoracic Outlet Syndrome?!

    Directory of Open Access Journals (Sweden)

    Hadoun Jabri

    2014-01-01

    Full Text Available Recurrent deep venous thrombosis, involving bilateral upper extremities, is an extremely rare phenomenon. We are presenting a 43-year-old man who was diagnosed with left upper extremity deep vein thrombosis (UEDVT and was treated with anticoagulation and surgical decompression in 2004. 9 years later, he presented with right arm swelling and was diagnosed with right UEDVT using US venous Doppler. Venogram showed compression of the subclavian vein by the first rib, diagnosing thoracic outlet syndrome (TOS. He was treated with anticoagulation and local venolysis and later by surgical decompression of the subclavian vein. Bilateral UEDVT, as mentioned above, is an extremely rare condition that is uncommonly caused by TOS. To our knowledge, we are reporting the first case of bilateral UEDVT due to TOS. Diagnosis usually starts with US venous Doppler to detect the thrombosis, followed by the gold standard venogram to locate the area of obstruction and lyse the thrombus if needed. The ultimate treatment for TOS remains surgical decompression of the vascular bundle at the thoracic outlet.

  19. Effects of robot-assisted training on upper limb functional recovery during the rehabilitation of poststroke patients.

    Science.gov (United States)

    Daunoraviciene, Kristina; Adomaviciene, Ausra; Grigonyte, Agne; Griškevičius, Julius; Juocevicius, Alvydas

    2018-05-18

    The study aims to determine the effectiveness of robot-assisted training in the recovery of stroke-affected arms using an exoskeleton robot Armeo Spring. To identify the effect of robot training on functional recovery of the arm. A total of 34 stroke patients were divided into either an experimental group (EG; n= 17) or a control group (n= 17). EG was also trained to use the Armeo Spring during occupational therapy. Both groups were clinically assessed before and after treatment. Statistical comparison methods (i.e. one-tailed t-tests for differences between two independent means and the simplest test) were conducted to compare motor recovery using robot-assisted training or conventional therapy. Patients assigned to the EG showed a statistically significant improvement in upper extremity motor function when compared to the CG by FIM (Peffect in the EG and CG was meaningful for shoulder and elbow kinematic parameters. The findings show the benefits of robot therapy in two areas of functional recovery. Task-oriented robotic training in rehabilitation setting facilitates recovery not only of the motor function of the paretic arm but also of the cognitive abilities in stroke patients.

  20. The Use of Nerve Transfers to Restore Upper Extremity Function in Cervical Spinal Cord Injury.

    Science.gov (United States)

    Fox, Ida K; Novak, Christine B; Krauss, Emily M; Hoben, Gwendolyn M; Zaidman, Craig; Ruvinskaya, Rimma; Juknis, Neringa; Winter, Anke C; Mackinnon, Susan E

    2018-03-15

    Nerve transfer surgery to restore upper extremity function in cervical spinal cord injury (SCI) is novel and may transform treatment. Determining candidacy even years post-SCI is ill defined and deserves investigation. To develop a diagnostic algorithm, focusing on electrodiagnostic (EDX) studies, to determine eligibility for nerve transfer surgery. Retrospective descriptive case series. Tertiary university-based institution. Individuals with cervical SCI (n = 45). The electronic medical records of people referred to the Plastic Surgery Multidisciplinary Upper Extremity Surgery unit in the SCI clinic from 2010-2015 were reviewed. People were considered for nerve transfers to restore elbow extension or finger flexion and/or extension. Data including demographic, clinical evaluation, EDX results, surgery, and outcomes were collected and analyzed. EDX data, including nerve conduction studies and electromyography, for bilateral upper extremities of each patient examined was used to assess for the presence of lower motor neuron injury, which would preclude late nerve transfer. Based on our criteria and the results of EDX testing, a substantial number of patients presenting even years post-SCI were candidates for nerve transfers. Clinical outcome results are heterogeneous but promising and suggest that further refinement of eligibility, long-term follow-up, and standardized assessment will improve our understanding of the role of nerve transfer surgery to restore function in people with midcervical SCI. Many patients living with SCI are candidates for nerve transfer surgery to restore upper extremity function. Although the ultimate efficacy of these surgeries is not yet determined, this study attempts to report the criteria we are using and may ultimately determine the timing for intervention and which transfers are most useful for this heterogeneous population. IV. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All

  1. Effects of Assist-As-Needed Upper Extremity Robotic Therapy after Incomplete Spinal Cord Injury: A Parallel-Group Controlled Trial

    Directory of Open Access Journals (Sweden)

    John Michael Frullo

    2017-06-01

    Full Text Available BackgroundRobotic rehabilitation of the upper limb following neurological injury has been supported through several large clinical studies for individuals with chronic stroke. The application of robotic rehabilitation to the treatment of other neurological injuries is less developed, despite indications that strategies successful for restoration of motor capability following stroke may benefit individuals with incomplete spinal cord injury (SCI as well. Although recent studies suggest that robot-aided rehabilitation might be beneficial after incomplete SCI, it is still unclear what type of robot-aided intervention contributes to motor recovery.MethodsWe developed a novel assist-as-needed (AAN robotic controller to adjust challenge and robotic assistance continuously during rehabilitation therapy delivered via an upper extremity exoskeleton, the MAHI Exo-II, to train independent elbow and wrist joint movements. We further enrolled seventeen patients with incomplete spinal cord injury (AIS C and D levels in a parallel-group balanced controlled trial to test the efficacy of the AAN controller, compared to a subject-triggered (ST controller that does not adjust assistance or challenge levels continuously during therapy. The conducted study is a stage two, development-of-concept pilot study.ResultsWe validated the AAN controller in its capability of modulating assistance and challenge during therapy via analysis of longitudinal robotic metrics. For the selected primary outcome measure, the pre–post difference in ARAT score, no statistically significant change was measured in either group of subjects. Ancillary analysis of secondary outcome measures obtained via robotic testing indicates gradual improvement in movement quality during the therapy program in both groups, with the AAN controller affording greater increases in movement quality over the ST controller.ConclusionThe present study demonstrates feasibility of subject-adaptive robotic therapy

  2. Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures.

    Science.gov (United States)

    McDonough, Christine M; Colla, Carrie H; Carmichael, Donald; Tosteson, Anna N A; Tosteson, Tor D; Bell, John-Erik; Cantu, Robert V; Lurie, Jonathan D; Bynum, Julie P W

    2017-03-01

    Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Observational cohort. Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007-2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. © 2017

  3. Identifying barriers to recovery from work related upper extremity disorders: use of a collaborative problem solving technique.

    Science.gov (United States)

    Shaw, William S; Feuerstein, Michael; Miller, Virginia I; Wood, Patricia M

    2003-08-01

    Improving health and work outcomes for individuals with work related upper extremity disorders (WRUEDs) may require a broad assessment of potential return to work barriers by engaging workers in collaborative problem solving. In this study, half of all nurse case managers from a large workers' compensation system were randomly selected and invited to participate in a randomized, controlled trial of an integrated case management (ICM) approach for WRUEDs. The focus of ICM was problem solving skills training and workplace accommodation. Volunteer nurses attended a 2 day ICM training workshop including instruction in a 6 step process to engage clients in problem solving to overcome barriers to recovery. A chart review of WRUED case management reports (n = 70) during the following 2 years was conducted to extract case managers' reports of barriers to recovery and return to work. Case managers documented from 0 to 21 barriers per case (M = 6.24, SD = 4.02) within 5 domains: signs and symptoms (36%), work environment (27%), medical care (13%), functional limitations (12%), and coping (12%). Compared with case managers who did not receive the training (n = 67), workshop participants identified more barriers related to signs and symptoms, work environment, functional limitations, and coping (p Problem solving skills training may help focus case management services on the most salient recovery factors affecting return to work.

  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. Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study.

    Science.gov (United States)

    Lee, Stephanie Hyeyoung; Lee, Ji-Yeong; Kim, Mi-Young; Jeon, Yu-Jin; Kim, Suyoung; Shin, Joon-Ho

    2018-03-02

    To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke. A pilot, randomized, single-blind, controlled trial. Stroke rehabilitation inpatient unit. Participants (N=48) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3. FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity-based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period. Primary outcome measures were changes in Fugl-Meyer Assessment-Upper Extremity and Wolf Motor Function Test scores. Secondary outcome measures were changes in Box and Block Test, Jebsen-Taylor Hand Function Test, and Stroke Impact Scale scores. Assessments were performed at baseline (t0) and at 2 weeks (t1), 4 weeks (t4), and 8 weeks (t8). Between-group comparisons were evaluated using a repeated-measures analysis of variance. Forty-one participants were included in the analysis. Compared with FES alone, VR-FES produced a substantial increase in Fugl-Meyer Assessment-distal score (P=.011) and marginal improvement in Jebsen-Taylor Hand Function Test-gross score (P=.057). VR-FES produced greater, although nonsignificant, improvements in all other outcome measures, except in the Stroke Impact Scale-activities of daily living/instrumental activities of daily living score. FES with VR-based rehabilitation may be more effective than cyclic FES in improving distal upper extremity gross motor performance poststroke. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. The push-off test: development of a simple, reliable test of upper extremity weight-bearing capability.

    Science.gov (United States)

    Vincent, Joshua I; MacDermid, Joy C; Michlovitz, Susan L; Rafuse, Richard; Wells-Rowsell, Christina; Wong, Owen; Bisbee, Leslie

    2014-01-01

    Longitudinal clinical measurement study. The push-off test (POT) is a novel and simple measure of upper extremity weight-bearing that can be measured with a grip dynamometer. There are no published studies on the validity and reliability of the POT. The relationship between upper extremity self-report activity/participation and impairment measures remain an unexplored realm. The primary purpose of this study is to estimate the intra and inter-rater reliability and construct validity of the POT. The secondary purpose is to estimate the relationship between upper extremity self-report activity/participation questionnaires and impairment measures. A convenience sample of 22 patients with wrist or elbow injuries were tested for POT, wrist/elbow range of motion (ROM), isometric wrist extension strength (WES) and grip strength; and completed two self-report activity/participation questionnaires: Disability of the Arm, Shoulder and the Hand (DASH) and Work Limitations Questionnaire (WLQ-26). POT's inter and intra-rater reliability and construct validity was tested. Pearson's correlations were run between the impairment measures and self-report questionnaires to look into the relationship amongst them. The POT demonstrated high inter-rater reliability (ICC affected = 0.97; 95% C.I. 0.93-0.99; ICC unaffected = 0.85; 95% C.I. 0.68-0.94) and intra-rater reliability (ICC affected = 0.96; 95% C.I. 0.92-0.97; ICC unaffected = 0.92; 95% C.I. 0.85-0.97). The POT was correlated moderately with the DASH (r = -0.47; p = 0.03). While examining the relationship between upper extremity self-reported activity/participation questionnaires and impairment measures the strongest correlation was between the DASH and the POT (r = -0.47; p = 0.03) and none of the correlations with the other physical impairment measures reached significance. At-work disability demonstrated insignificant correlations with physical impairments. The POT test provides a reliable and easily

  8. Training Accreditation Program

    International Nuclear Information System (INIS)

    1989-01-01

    The Training Accreditation Program establishes the objectives and criteria against which DOE nuclear facility training is evaluated to determine its readiness for accreditation. Training programs are evaluated against the accreditation objectives and criteria by facility personnel during the initial self-evaluation process. From this self-evaluation, action plans are made by the contractor to address the scope of work necessary in order to upgrade any deficiencies noted. This scope of work must be formally documented in the Training Program Accreditation Plan. When reviewed and approved by the responsible Head of the Field Organization and cognizant Program Secretarial Office, EH-1 concurrence is obtained. This plan then becomes the document which guides accreditation efforts for the contractor

  9. The Reliability of Quality of Upper Extremity Skills Test in Children with Cerebral Palsy

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    Nazila Akbar-Fahimi

    2012-01-01

    Full Text Available Objective: The aim of this study was to survey the reliability of Intra-rater and Inter-rater with and without video camera assessment in children with spastic cerebral palsy. Materials & Methods: In this cross-sectional study, we validate the Quality of Upper Extremity Skill Test questionnaire. Fifty children with hemiplegia aged 19 to 95 months (mean age 61.31 ± 25.7 month were enrolled in our study using non random available approach. After obtaining parents’ consent, intra-rater assessment was performed in one session and intera rater assessment with camera after 10 days. Then, the third examiner did the reassessment using film observation of 46 children from 50. Spearman correlation for survey the reliability of intra-rater & inter rater with & without video recording assessment & gross motor function classification system 66 for determined functionality of child were used. Results: Intra-rater correlation was 0.774-0.996, Inter-rater correlation was 0.663-0.998 and correlation for video camera assessment was 0.710-0.974 for the first and third evaluation and 0.652-0.938 for second and third evaluation. P value for sub scales and total score was P<0.01. Conclusion: There is a high correlation in Intra rater and inter rater assessment with and without video recording in Quality of Upper Extremity Skill Test in children with cerebral palsy. So that it can be used as a reliable test to evaluate Quality of Upper Extremity Skills in these children.

  10. Effects of reduced training and detraining on upper and lower body explosive strength in adolescent male basketball players.

    Science.gov (United States)

    Santos, Eduardo J A M; Janeira, Manuel A A S

    2009-09-01

    The purpose of this study was to assess and compare the effects of detraining and of a reduced training program on upper- and lower-body explosive strength in adolescent male basketball players. To study this, 15 subjects, aged 14 to 15 years old, were randomly assigned to 1 of the 2 following groups: reduced training (RT; n = 8) and detraining (DTR; n = 7). The participants were assessed on squat jump (SJ), countermovement jump (CMJ), Abalakov test (ABA), depth jump (DJ), mechanical power (MP), and medicine ball throw (MBT) after a 10-week in-season complex training program (T0) and at the end of 4 (T4), 8 (T8), 12 (T12), and 16 (T16) weeks of detraining and of the reduced training periods. Both groups showed maintenance of explosive strength values and statistical similarity between them whatever the moment of evaluation. In conclusion, 16 weeks of detraining or of reduced training allow for the maintenance of the gains previously achieved by the application of a 10-week in-season complex training program. However, the lack of differences between detraining and reduced training leads to the conclusion that regular basketball practice can sustain by itself the previously achieved explosive strength gains, considering its mainly explosive characteristics.

  11. Quantitative Motion Analysis of Tai Chi Chuan: The Upper Extremity Movement

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    Tsung-Jung Ho

    2018-01-01

    Full Text Available The quantitative and reproducible analysis of the standard body movement in Tai Chi Chuan (TCC was performed in this study. We aimed to provide a reference of the upper extremities for standardizing TCC practice. Microsoft Kinect was used to record the motion during the practice of TCC. The preparation form and eight essential forms of TCC performed by an instructor and 101 practitioners were analyzed in this study. The instructor completed an entire TCC practice cycle and performed the cycle 12 times. An entire cycle of TCC was performed by practitioners and images were recorded for statistics analysis. The performance of the instructor showed high similarity (Pearson correlation coefficient (r=0.71~0.84 to the first practice cycle. Among the 9 forms, lay form had the highest similarity (rmean=0.90 and push form had the lowest similarity (rmean=0.52. For the practitioners, ward off form (rmean=0.51 and roll back form (rmean=0.45 had the highest similarity with moderate correlation. We used Microsoft Kinect to record the spatial coordinates of the upper extremity joints during the practice of TCC and the data to perform quantitative and qualitative analysis of the joint positions and elbow joint angle.

  12. Development of an Upper Extremity Function Measurement Model.

    Science.gov (United States)

    Hong, Ickpyo; Simpson, Annie N; Li, Chih-Ying; Velozo, Craig A

    This study demonstrated the development of a measurement model for gross upper-extremity function (GUE). The dependent variable was the Rasch calibration of the 27 ICF-GUE test items. The predictors were object weight, lifting distance from floor, carrying, and lifting. Multiple regression was used to investigate the contribution that each independent variable makes to the model with 203 outpatients. Object weight and lifting distance were the only statistically and clinically significant independent variables in the model, accounting for 83% of the variance (p model indicates that, with each one pound increase in object weight, item challenge increases by 0.16 (p measurement model for the ICF-GUE can be explained by object weight and distance lifted from the floor.

  13. Relationship between upper extremity kinesthetic sense and writing performance by students with low vision.

    Science.gov (United States)

    Aki, Esra; Atasavun, Songül; Kayihan, Holya

    2008-06-01

    Kinesthetic sense plays an important role in writing. Children with low vision lack sensory input from the environment given their loss of vision. This study assessed the effect of upper extremity kinesthetic sense on writing function in two groups, one of students with low vision (9 girls and 11 boys, 9.4 +/- 1.9 yr. of age) and one of sighted students (10 girls and 10 boys, 10.1 +/- 1.3 yr. of age). All participants were given the Kinesthesia Test and Jebsen Hand Function Test-Writing subtest. Students with low vision scored lower on kinesthetic perception and writing performance than sighted peers. The correlation between scores for writing performance and upper extremity kinesthetic sense in the two groups was significant (r = -.34). The probability of deficiencies in kinesthetic information in students with low vision must be remembered.

  14. Validity of the Dictionary of Occupational Titles for Assessing Upper Extremity Work Demands

    Science.gov (United States)

    Opsteegh, Lonneke; Soer, Remko; Reinders-Messelink, Heleen A.; Reneman, Michiel F.; van der Sluis, Corry K.

    2010-01-01

    Objectives The Dictionary of Occupational Titles (DOT) is used in vocational rehabilitation to guide decisions about the ability of a person with activity limitations to perform activities at work. The DOT has categorized physical work demands in five categories. The validity of this categorization is unknown. Aim of this study was to investigate whether the DOT could be used validly to guide decisions for patients with injuries to the upper extremities. Four hypotheses were tested. Methods A database including 701 healthy workers was used. All subjects filled out the Dutch Musculoskeletal Questionnaire, from which an Upper Extremity Work Demands score (UEWD) was derived. First, relation between the DOT-categories and UEWD-score was analysed using Spearman correlations. Second, variance of the UEWD-score in occupational groups was tested by visually inspecting boxplots and assessing kurtosis of the distribution. Third, it was investigated whether occupations classified in one DOT-category, could significantly differ on UEWD-scores. Fourth, it was investigated whether occupations in different DOT-categories could have similar UEWD-scores using Mann Whitney U-tests (MWU). Results Relation between the DOT-categories and the UEWD-score was weak (rsp = 0.40; p<.01). Overlap between categories was found. Kurtosis exceeded ±1.0 in 3 occupational groups, indicating large variance. UEWD-scores were significantly different within one DOT-category (MWU = 1.500; p<.001). UEWD scores between DOT-categories were not significantly different (MWU = 203.000; p = .49). Conclusion All four hypotheses could not be rejected. The DOT appears to be invalid for assessing upper extremity work demands. PMID:21151934

  15. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    Science.gov (United States)

    Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul; Andersen, Johan Hviid

    2013-10-01

    Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender. High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14-3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30-3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.

  16. 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.

  17. Meaningful task-specific training (MTST) for stroke rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Arya, Kamal Narayan; Verma, Rajesh; Garg, R K; Sharma, V P; Agarwal, Monika; Aggarwal, G G

    2012-01-01

    The upper extremity motor deficit is one of the functional challenges in post stroke patients. The objective of the present study was to evaluate the effectiveness of the meaningful task-specific training (MTST) on the upper extremity motor recovery during the subacute phase after a stroke. This was a randomized, controlled, double-blinded trial in the neurology department of a university hospital and occupational therapy unit of a rehabilitation institute. A convenience sample of 103 people, 4 to 24 weeks (mean, 12.15 weeks) after the stroke, was randomized into 2 groups (MTST, 51; standard training group, 52). Subjects in the Brunnstrom stage of arm recovery of 2 to 5 were included in the study. Ninety-five participants completed the 8-week follow-up. Participants were assigned to receive either the MTST or dose-matched standard training program based on the Brunnstrom stage and Bobath neurodevelopmental technique, 4 to 5 days a week for 4 weeks. Fugl-Meyer assessment (FMA), Action Research Arm Test (ARAT), Graded Wolf Motor Function Test (GWMFT), and Motor Activity Log (MAL) were outcome measures The MTST group showed a positive improvement in the mean scores on the outcome measures at post and follow-up assessments in comparison to the control group. Further, statistically significant differences were observed in changes between the groups at post and follow-up assessment for FMA, ARAT, GWMFT, and MAL. The MTST produced statistically significant and clinically relevant improvements in the upper extremity motor recovery of the patients who had a subacute stroke.

  18. The upper extremity deep venous thrombosis and its interventional treatment

    International Nuclear Information System (INIS)

    Yang Chao; Ni Caifang

    2011-01-01

    Upper extremity deep vein thrombosis (UEDVT) was once regarded as a kind of disorder that was not serious. With the development of medical knowledge and research, it is now has been well recognized that UEDVT is an important risk factor that can bring about the pulmonary embolus, even cause death in severe patients. This article aims to make a comprehensive review of UEDVT, focusing on the etiology, epidemiology, the clinical features, the diagnosis, the interventional treatment options, the nursing care, the complications as well as prevention strategies, etc. (authors)

  19. Rehab-let: touchscreen tablet for self-training impaired dexterity post stroke: study protocol for a pilot randomized controlled trial.

    Science.gov (United States)

    Rand, Debbie; Zeilig, Gabi; Kizony, Rachel

    2015-06-18

    Impaired dexterity of the weaker upper extremity is common post stroke and it is recommended that these individuals practice many repetitions of movement to regain function. However, stroke rehabilitation methods do not achieve the required intensity to be effective. Touchscreen tablet technology may be used as a motivating tool for self-training impaired dexterity of the weaker upper extremity post stroke. Rehab-let is a self-training protocol utilizing game apps on a touchscreen for practicing movement of the weaker upper extremity. We will conduct a pilot randomized controlled trial to assess Rehab-let compared to traditional self-training to improve dexterity of the weaker hand, and to increase self-training time and satisfaction in individuals with subacute stroke. Forty individuals with stroke undergoing subacute rehabilitation will be randomly allocated to Rehab-let or a traditional self-training program using therapeutic aids such as balls, blocks and pegs. All participants will be requested to perform self-training for 60 minutes a day, 5 times a week for 4 weeks. Dexterity assessed by The Nine Hole Peg Test is the main outcome measure. Assessments will be administered pre and post the self-training intervention by assessors blind to the group allocation. The outcomes of this study will inform the design of a fully powered randomized controlled trial to evaluate the effectiveness of Rehab-let. If found to be effective, Rehab-let can be used during subacute rehabilitation to increase treatment intensity and improve dexterity. Potentially, Rehab-let can also be used after discharge and might be ideal for individuals with mild stroke who are often not referred to formal rehabilitation. Current Controlled Trials NCT02136433 registered on 17 September 2014.

  20. Risk factors for generally reduced productivity--a prospective cohort study of young adults with neck or upper-extremity musculoskeletal symptoms.

    Science.gov (United States)

    Boström, Maria; Dellve, Lotta; Thomée, Sara; Hagberg, Mats

    2008-04-01

    This study prospectively assessed the importance of individual conditions and computer use during school or work and leisure time as risk factors for self-reported generally reduced productivity due to musculoskeletal complaints among young adults with musculoskeletal symptoms in the neck or upper extremities. A cohort of 2914 young adults (18-25 years, vocational school and college or university students) responded to an internet-based questionnaire concerning musculoskeletal symptoms related to individual conditions and computer use during school or work and leisure time that possibly affected general productivity. Prevalence ratios (PR) were used to assess prospective risk factors for generally reduced productivity. The selected study sample (N=1051) had reported neck or upper-extremity symptoms. At baseline, 280 of them reported reduced productivity. A follow-up of the 771 who reported no reduced productivity was carried out after 1 year. Risk factors for self-reported generally reduced productivity for those followed-up were symptoms in two or three locations or dimensions for the upper back or neck and the shoulders, arms, wrists, or hands [PR 2.30, 95% confidence interval (95% CI) 1.40-3.78], symptoms persisting longer than 90 days in the shoulders, arms, wrists, or hands (PR 2.50, 95% CI 1.12-5.58), current symptoms in the shoulders, arms, wrists, or hands (PR 1.78, 95% CI 1.10-2.90) and computer use 8-14 hours/week during leisure time (PR 2.32, 95% CI 1.20-4.47). A stronger relationship was found if three or four risk factors were present. For women, a relationship was found between generally reduced productivity and widespread and current symptoms in the upper extremities. The main risk factors for generally reduced productivity due to musculoskeletal symptoms among young adults in this study were chronic symptoms in the upper extremities and widespread symptoms in the neck and upper extremities.

  1. Scintigraphy in diagnostics of algodystrophy in the upper extremity: a review

    International Nuclear Information System (INIS)

    Zyluk, A.

    1995-01-01

    Basing on the literature, the information concerning usefulness of the three phase scintigraphy in algodystrophy of the upper extremity, both in diagnostic and etiopathogenetic aspects were presented. Delayed image phase is the examination of the best value in the diagnostics of the condition (the highest sensitivity and specificity). Typical feature of algodystrophy on the bone scan is diffuse periarticular hyperfixation of the tracer, in many joints of the distal part of the extremity. Early phases of scintigraphy are valuable in staging of the disease (distinguishing between 1. and 2. stage), in choice of the method of the treatment (vasoconstrictive or vasodilatative) and in monitoring of the course of the treatment. Haemodynamic changes in dystrophic extremity, appearing in early phases, provide interesting information about the etiopathogenesis of algodystrophy. Prognostic implications of scintigraphy (the prediction of the possibility of algodystrophy developing and prediction of good result of the treatment) were mentioned. The method of quantitative analysis of the scans and the problems concerning the choice of proper region of interesting were discussed. (author). 20 refs, 1 tab

  2. Emotion regulation strategies mediate the associations of positive and negative affect to upper extremity physical function.

    Science.gov (United States)

    Talaei-Khoei, Mojtaba; Nemati-Rezvani, Hora; Fischerauer, Stefan F; Ring, David; Chen, Neal; Vranceanu, Ana-Maria

    2017-05-01

    The Gross process model of emotion regulation holds that emotion-eliciting situations (e.g. musculoskeletal illness) can be strategically regulated to determine the final emotional and behavioral response. Also, there is some evidence that innate emotional traits may predispose an individual to a particular regulating coping style. We enrolled 107 patients with upper extremity musculoskeletal illness in this cross-sectional study. They completed self-report measures of positive and negative affect, emotion regulation strategies (cognitive reappraisal and expressive suppression), upper extremity physical function, pain intensity, and demographics. We used Preacher and Hayes' bootstrapping approach to process analysis to infer the direct effect of positive and negative affect on physical function as well as their indirect effects through activation of emotion regulation strategies. Negative affect was associated with decreased physical function. The association was partly mediated by expressive suppression (b (SE)=-.10 (.05), 95% BCa CI [-.21, -.02]). Positive affect was associated with increased physical function. Cognitive reappraisal partially mediated this association (b (SE)=.11 (.05), 95% BCa CI [.03, .24]). After controlling for pain intensity, the ratio of the mediated effect to total effect grew even larger in controlled model comparing to uncontrolled model (33% vs. 26% for expressive suppression and 32% vs. 30% for cognitive reappraisal). The relationships between affect, emotion regulation strategies and physical function appear to be more dependent on the emotional response to an orthopedic condition rather than the intensity of the nociceptive stimulation of the pain. Findings support integration of emotion regulation training in skill-based psychotherapy in this population to mitigate the effect of negative affect and enhance the influence of positive affect on physical function. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Case Report: Impact of Botulinum Toxin Injection on Function of Affected Upper Extremity in A Patient, 16 Years after Stroke

    Directory of Open Access Journals (Sweden)

    Malek Amini

    2012-10-01

    Full Text Available Objective: Case report Impact of Botulinum Toxin injection on function of affected upper extremity in a patient after 16 years since stroke (CVA. Botulinum toxin injection is one the treatments in spasticity reduction and consequently in recovery of upper limb function in stroke patients. The purpose of this case study is to report the effect of Botulinum toxin injection on upper extremity function after 16 years of stroke. Materials & Methods: The patient was a 63-year-old man who has had a cerebrovascular accident that happened in the left hemisphere about 16 years ago, and as a result, a paresis in dominant hand and arm. Although the patient was able to perform simple movements but he was complaining about the slowness and stiffness in the movements. To treat spasticity the Botulinum toxin type A was used. Injection into selected muscles of hemiparetic upper limb was done by a specialist physician and was between 50-150IU based on specific volume of each muscle. After injection, the patient was monitored for 3 months and at the end of each month, the assessments were reevaluated. During this period, although research team suggested the patient to continue the rehabilitation but for personal reasons he didn’t participate in any treatment and didn`t receive any other antispasmodic medications. Results: An increase in range of motion was seen in all joints but this improvement was not significant. The greatest improvement in passive and active range of motion was seen in Metacarpophalengeal joints. At the end of each month, compared to the first month the recovery of function in upper extremity was significant. Maximum recovery of upper extremity function was related to the hand section of fugl-meyer assessment. At the end of the first month, spasticity significantly decreased so that the patient was able to extend all his joints more easily than before injection. Although spasticity never reached zero. Conclusion: Botulinum toxin injection

  4. 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.

  5. Upper extremity disorders in heavy industry workers in Greece.

    Science.gov (United States)

    Tsouvaltzidou, Thomaella; Alexopoulos, Evangelos; Fragkakis, Ioannis; Jelastopulu, Eleni

    2017-06-18

    To investigate the disability due to musculoskeletal disorders of the upper extremities in heavy industry workers. The population under study consisted of 802 employees, both white- and blue-collar, working in a shipyard industry in Athens, Greece. Data were collected through the distribution of questionnaires and the recording of individual and job-related characteristics during the period 2006-2009. The questionnaires used were the Quick Disabilities of the Arm, Shoulder and Hand (QD) Outcome Measure, the Work Ability Index (WAI) and the Short-Form-36 (SF-36) Health Survey. The QD was divided into three parameters - movement restrictions in everyday activities, work and sports/music activities - and the SF-36 into two items, physical and emotional. Multiple linear regression analysis was performed by means of the SPSS v.22 for Windows Statistical Package. The answers given by the participants for the QD did not reveal great discomfort regarding the execution of manual tasks, with the majority of the participants scoring under 5%, meaning no disability. After conducting multiple linear regression, age revealed a positive association with the parameter of restrictions in everyday activities (b = 0.64, P = 0.000). Basic education showed a statistically significant association regarding restrictions during leisure activities, with b = 2.140 ( P = 0.029) for compulsory education graduates. WAI's final score displayed negative charging in the regression analysis of all three parameters, with b = -0.142 ( P = 0.0), b = -0.099 ( P = 0.055) and b = -0.376 ( P = 0.001) respectively, while the physical and emotional components of SF-36 associated with movement restrictions only in daily activities and work. The participants' specialty made no statistically significant associations with any of the three parameters of the QD. Increased musculoskeletal disorders of the upper extremity are associated with older age, lower basic education and physical and mental/emotional health

  6. Effort-reward imbalance and one-year change in neck-shoulder and upper extremity pain among call center computer operators.

    Science.gov (United States)

    Krause, Niklas; Burgel, Barbara; Rempel, David

    2010-01-01

    The literature on psychosocial job factors and musculoskeletal pain is inconclusive in part due to insufficient control for confounding by biomechanical factors. The aim of this study was to investigate prospectively the independent effects of effort-reward imbalance (ERI) at work on regional musculoskeletal pain of the neck and upper extremities of call center operators after controlling for (i) duration of computer use both at work and at home, (ii) ergonomic workstation design, (iii) physical activities during leisure time, and (iv) other individual worker characteristics. This was a one-year prospective study among 165 call center operators who participated in a randomized ergonomic intervention trial that has been described previously. Over an approximate four-week period, we measured ERI and 28 potential confounders via a questionnaire at baseline. Regional upper-body pain and computer use was measured by weekly surveys for up to 12 months following the implementation of ergonomic interventions. Regional pain change scores were calculated as the difference between average weekly pain scores pre- and post intervention. A significant relationship was found between high average ERI ratios and one-year increases in right upper-extremity pain after adjustment for pre-intervention regional mean pain score, current and past physical workload, ergonomic workstation design, and anthropometric, sociodemographic, and behavioral risk factors. No significant associations were found with change in neck-shoulder or left upper-extremity pain. This study suggests that ERI predicts regional upper-extremity pain in -computer operators working >or=20 hours per week. Control for physical workload and ergonomic workstation design was essential for identifying ERI as a risk factor.

  7. Effectiveness of commercial gaming-based virtual reality movement therapy on functional recovery of upper extremity in subacute stroke patients.

    Science.gov (United States)

    Choi, Jun Hwan; Han, Eun Young; Kim, Bo Ryun; Kim, Sun Mi; Im, Sang Hee; Lee, So Young; Hyun, Chul Woong

    2014-08-01

    To investigate the effectiveness of commercial gaming-based virtual reality (VR) therapy on the recovery of paretic upper extremity in subacute stroke patients. Twenty patients with the first-onset subacute stroke were enrolled and randomly assigned to the case group (n=10) and the control group (n=10). Primary outcome was measured by the upper limb score through the Fugl-Meyer Assessment (FMA-UL) for the motor function of both upper extremities. Secondary outcomes were assessed for motor function of both upper extremities including manual function test (MFT), box and block test (BBT), grip strength, evaluated for activities of daily living (Korean version of Modified Barthel Index [K-MBI]), and cognitive functions (Korean version of the Mini-Mental State Examination [K-MMSE] and continuous performance test [CPT]). The case group received commercial gaming-based VR therapy using Wii (Nintendo, Tokyo, Japan), and the control group received conventional occupational therapy (OT) for 30 minutes a day during the period of 4 weeks. All patients were evaluated before and after the 4-week intervention. There were no significant differences in the baseline between the two groups. After 4 weeks, both groups showed significant improvement in the FMA-UL, MFT, BBT, K-MBI, K-MMSE, and correct detection of auditory CPT. However, grip strength was improved significantly only in the case group. There were no significant intergroup differences before and after the treatment. These findings suggested that the commercial gaming-based VR therapy was as effective as conventional OT on the recovery of upper extremity motor and daily living function in subacute stroke patients.

  8. [Upper extremities, neck and back symptoms in office employees working at computer stations].

    Science.gov (United States)

    Zejda, Jan E; Bugajska, Joanna; Kowalska, Małgorzata; Krzych, Lukasz; Mieszkowska, Marzena; Brozek, Grzegorz; Braczkowska, Bogumiła

    2009-01-01

    To obtain current data on the occurrence ofwork-related symptoms of office computer users in Poland we implemented a questionnaire survey. Its goal was to assess the prevalence and intensity of symptoms of upper extremities, neck and back in office workers who use computers on a regular basis, and to find out if the occurrence of symptoms depends on the duration of computer use and other work-related factors. Office workers in two towns (Warszawa and Katowice), employed in large social services companies, were invited to fill in the Polish version of Nordic Questionnaire. The questions included work history and history of last-week symptoms of pain of hand/wrist, elbow, arm, neck and upper and lower back (occurrence and intensity measured by visual scale). Altogether 477 men and women returned the completed questionnaires. Between-group symptom differences (chi-square test) were verified by multivariate analysis (GLM). The prevalence of symptoms in individual body parts was as follows: neck, 55.6%; arm, 26.9%; elbow, 13.3%; wrist/hand, 29.9%; upper back, 49.6%; and lower back, 50.1%. Multivariate analysis confirmed the effect of gender, age and years of computer use on the occurrence of symptoms. Among other determinants, forearm support explained pain of wrist/hand, wrist support of elbow pain, and chair adjustment of arm pain. Association was also found between low back pain and chair adjustment and keyboard position. The findings revealed frequent occurrence of symptoms of pain in upper extremities and neck in office workers who use computers on a regular basis. Seating position could also contribute to the frequent occurrence of back pain in the examined population.

  9. 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.

  10. TAP 1, Training Program Manual

    International Nuclear Information System (INIS)

    1991-01-01

    Training programs at DOE nuclear facilities should provide well-trained, qualified personnel to safely and efficiently operate the facilities in accordance with DOE requirements. A need has been identified for guidance regarding analysis, design, development, implementation, and evaluation of consistent and reliable performance-based training programs. Accreditation of training programs at Category A reactors and high-hazard and selected moderate-hazard nonreactor nuclear facilities will assure consistent, appropriate, and cost-effective training of personnel responsible for the operation, maintenance, and technical support of these facilities. Training programs that are designed and based on systematically determined job requirements, instead of subjective estimation of trainee needs, yield training activities that are consistent and develop or improve knowledge, skills, and abilities that can be directly related to the work setting. Because the training is job-related, the content of these programs more efficiently meets the needs of the employee. Besides a better trained work force, a greater level of operational reactor safety can be realized. This manual is intended to provide an overview of the accreditation process and a brief description of the elements necessary to construct and maintain training programs that are based on the requirements of the job. Two companion manuals provide additional information to assist contractors in their efforts to accredit training programs

  11. Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints.

    Science.gov (United States)

    Bot, Sandra D M; Terwee, Caroline B; van der Windt, Daniëlle A W M; van der Beek, Allard J; Bouter, Lex M; Dekker, Joost

    2007-08-01

    To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR=0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave. Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results.

  12. Complex regional pain syndrome type I in the upper extremity - how efficient physical therapy and rehabilitation are.

    Science.gov (United States)

    Zečević Luković, Tanja; Ristić, Branko; Jovanović, Zorica; Rančić, Nemanja; Ignjatović Ristić, Dragana; Cuković, Saša

    2012-08-01

    To evaluate the effects of early started combined therapy in Complex Regional Pain Syndrome-1 (CRPS-1) on the upper extremities. The study included 36 patients in the first stadium of CRPS-1 on the upper extremities The mean age of patients was 42.6±14.6, the majority of them (26 of 36) were females. The right side of the upper extremity was affected much more then the left side. They were treated by combined therapy including analgetics, electrotherapy, magneto therapy and kinesitherapy. The average length of observation was 172.1 days (from 90 to 250 days). The average length of treatment was 91.5±42.16 days. Intensity of pain, swelling of the extremity, the change in skin coloration and cutaneous manifestations were assessed three times, at the beginning of the treatment, after 6 weeks and at the end of the treatment. The pain was registered in all patients at visit 1 (average pain intensity was 5.70 ±1.44 on 100 mm visual analogue scale), and it was progressively decreased during the treatment from 3.60±1.22 at the second visit to 0.34±0.68 at the third visit. Vasodilatation was registered in 30 (83.33%) patients and skin temperature asymmetries was found in 21 (58.33%) patients. The difference of size was detected in 30 (83.33%) patients at the first visit compared to four (11.11%) patients at the end of the treatment. There were six (16.66%) patients without swelling at the beginning compared to 26 (72.22%) at the end of the treatment (p less than 0.000). Complete healing was achieved in 32 patients (88.88%). The carefully chosen physical agents in combination with analgesic and non-steroidal anti-inflammatory drugs may benefit in patients with CRPS-1 on the upper extremity if the treatment starts as soon as possible.

  13. Mycobacterium marinum infections of the distal upper extremities: clinical course and imaging findings in two cases with delayed diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Amrami, K.K.; Sundaram, M. [Dept. of Radiology, Mayo Clinic, SW, Rochester, MN (United States); Shin, A.Y.; Bishop, A.T. [Dept. of Orthopedics, Mayo Clinic, Rochester, MN (United States)

    2003-09-01

    Mycobacterium marinum infections cause tenosynovitis of the distal upper extremities and develop as a consequence of skin abrasions acquired in contaminated water. We report on two patients whose MR imaging studies showed tenosynovitis of the distal upper extremity secondary to M. marinum. In one patient sequential MR imaging showed development of bony erosions. Appropriate treatment was delayed in both patients because the diagnosis was not considered. We report on and discuss the clinical course and MR imaging findings in two patients with M. marinum infection. (orig.)

  14. Mycobacterium marinum infections of the distal upper extremities: clinical course and imaging findings in two cases with delayed diagnosis

    International Nuclear Information System (INIS)

    Amrami, K.K.; Sundaram, M.; Shin, A.Y.; Bishop, A.T.

    2003-01-01

    Mycobacterium marinum infections cause tenosynovitis of the distal upper extremities and develop as a consequence of skin abrasions acquired in contaminated water. We report on two patients whose MR imaging studies showed tenosynovitis of the distal upper extremity secondary to M. marinum. In one patient sequential MR imaging showed development of bony erosions. Appropriate treatment was delayed in both patients because the diagnosis was not considered. We report on and discuss the clinical course and MR imaging findings in two patients with M. marinum infection. (orig.)

  15. Extreme Programming Pocket Guide

    CERN Document Server

    Chromatic

    2003-01-01

    Extreme Programming (XP) is a radical new approach to software development that has been accepted quickly because its core practices--the need for constant testing, programming in pairs, inviting customer input, and the communal ownership of code--resonate with developers everywhere. Although many developers feel that XP is rooted in commonsense, its vastly different approach can bring challenges, frustrations, and constant demands on your patience. Unless you've got unlimited time (and who does these days?), you can't always stop to thumb through hundreds of pages to find the piece of info

  16. 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.

  17. Virtual Reality Training With Three-Dimensional Video Games Improves Postural Balance and Lower Extremity Strength in Community-Dwelling Older Adults.

    Science.gov (United States)

    Lee, Yongwoo; Choi, Wonjae; Lee, Kyeongjin; Song, Changho; Lee, Seungwon

    2017-10-01

    Avatar-based three-dimensional technology is a new approach to improve physical function in older adults. The aim of this study was to use three-dimensional video gaming technology in virtual reality training to improve postural balance and lower extremity strength in a population of community-dwelling older adults. The experimental group participated in the virtual reality training program for 60 min, twice a week, for 6 weeks. Both experimental and control groups were given three times for falls prevention education at the first, third, and fifth weeks. The experimental group showed significant improvements not only in static and dynamic postural balance but also lower extremity strength (p < .05). Furthermore, the experimental group was improved to overall parameters compared with the control group (p < .05). Therefore, three-dimensional video gaming technology might be beneficial for improving postural balance and lower extremity strength in community-dwelling older adults.

  18. Computed tomographic myelography characteristics of spinal cord atrophy in juvenile muscular atrophy of the upper extremity

    International Nuclear Information System (INIS)

    Hirabuki, Norio; Mitomo, Masanori; Miura, Takashi; Hashimoto, Tsutomu; Kawai, Ryuji; Kozuka, Takahiro

    1991-01-01

    Although atrophy of the lower cervical and upper thoracic cord in juvenile muscular atrophy of distal upper extremity has been reported, the atrophic patterns of the cord, especially in the transverse section, have not been studied extensively. The aim of this study is to clarify the atrophic patterns of the cord by CT myelography (CTM) and to discuss the pathogenesis of cord atrophy. Sixteen patients with juvenile muscular atrophy of distal upper extremity were examined by CTM. Atrophy of the lower cervical and upper thoracic cord, consistent with the segmental weakness, was seen in all patients. Flattening of the ventral convexity was a characteristic atrophic pattern of the cord. Bilateral cord atrophy was commonly observed; 8/12 patients with unilateral clinical form and all 4 patients with bilateral form showed bilateral cord atrophy with dominance on the clinical side. There was no correlation between the degree of cord atrophy and duration of symptoms. Flattening of the ventral convexity, associated with purely motor disturbances, reflects selective atrophy of the anterior horns in the cord, which is attributable to chronic ischemia. Cord atrophy proved to precede clinical manifestations. The characteristic atrophy of the cord provides useful information to confirm the diagnosis without long-term observation. (author). 21 refs.; 3 figs.; 2 tabs

  19. Morel-Lavallee Lesion in the Upper Extremity.

    Science.gov (United States)

    Cochran, Grant K; Hanna, Kathryn H

    2017-01-01

    Background: The Morel-Lavallee lesion (MLL) is a closed internal degloving injury that results from shearing of the skin and subcutaneous tissue from the underlying fascia. Disruption of the perforating blood vessels and lymphatics results in a lesion filled with serosanguinous fluid and necrotized fat. MLLs are most commonly described in association with pelvic and lower extremity trauma, and there are limited reports of these lesions in other locations. Methods: This case report describes a 58-year-old male referred from his primary care physician with a soft tissue mass in the upper arm. Careful history discovered prior trauma with extensive bruising and MRI revealed a large encapsulated mass consistent with MLL. Results: An open debridement with excision of pseudocapsule was performed. Meticulous closure over a drain was performed and the patient healed without complication or recurrence. Intra-operative cultures were negative and pathology was consistent with MLL. Conclusion: MLL should always be considered in the setting of previous trauma regardless the location. In the chronic setting an open approach with excision of pseudocapsule can have an acceptable result.

  20. Improving Upper Extremity Function and Quality of Life with a Tongue Driven Exoskeleton: A Pilot Study Quantifying Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Stephen N. Housley

    2017-01-01

    Full Text Available Stroke is a leading cause of long-term disability around the world. Many survivors experience upper extremity (UE impairment with few rehabilitation opportunities, secondary to a lack of voluntary muscle control. We developed a novel rehabilitation paradigm (TDS-HM that uses a Tongue Drive System (TDS to control a UE robotic device (Hand Mentor: HM while engaging with an interactive user interface. In this study, six stroke survivors with moderate to severe UE impairment completed 15 two-hour sessions of TDS-HM training over five weeks. Participants were instructed to move their paretic arm, with synchronized tongue commands to track a target waveform while using visual feedback to make accurate movements. Following TDS-HM training, significant improvements in tracking performance translated into improvements in the UE portion of the Fugl-Meyer Motor Assessment, range of motion, and all subscores for the Stroke Impact Scale. Regression modeling found daily training time to be a significant predictor of decreases in tracking error, indicating the presence of a potential dose-response relationship. The results of this pilot study indicate that the TDS-HM system can elicit significant improvements in moderate to severely impaired stroke survivors. This pilot study gives preliminary insight into the volume of treatment time required to improve outcomes.

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

    International Nuclear Information System (INIS)

    Madaric, Juraj; Klepanec, Andrej; Mistrik, Martin; Altaner, Cestmir; Vulev, Ivan

    2013-01-01

    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.

  2. Quantitative assessment based on kinematic measures of functional impairments during upper extremity movements: A review.

    Science.gov (United States)

    de los Reyes-Guzmán, Ana; Dimbwadyo-Terrer, Iris; Trincado-Alonso, Fernando; Monasterio-Huelin, Félix; Torricelli, Diego; Gil-Agudo, Angel

    2014-08-01

    Quantitative measures of human movement quality are important for discriminating healthy and pathological conditions and for expressing the outcomes and clinically important changes in subjects' functional state. However the most frequently used instruments for the upper extremity functional assessment are clinical scales, that previously have been standardized and validated, but have a high subjective component depending on the observer who scores the test. But they are not enough to assess motor strategies used during movements, and their use in combination with other more objective measures is necessary. The objective of the present review is to provide an overview on objective metrics found in literature with the aim of quantifying the upper extremity performance during functional tasks, regardless of the equipment or system used for registering kinematic data. A search in Medline, Google Scholar and IEEE Xplore databases was performed following a combination of a series of keywords. The full scientific papers that fulfilled the inclusion criteria were included in the review. A set of kinematic metrics was found in literature in relation to joint displacements, analysis of hand trajectories and velocity profiles. These metrics were classified into different categories according to the movement characteristic that was being measured. These kinematic metrics provide the starting point for a proposed objective metrics for the functional assessment of the upper extremity in people with movement disorders as a consequence of neurological injuries. Potential areas of future and further research are presented in the Discussion section. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. 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.

  4. Nerve transfers for restoration of upper extremity motor function in a child with upper extremity motor deficits due to transverse myelitis: case report.

    Science.gov (United States)

    Dorsi, Michael J; Belzberg, Allan J

    2012-01-01

    Transverse myelitis (TM) may result in permanent neurologic dysfunction. Nerve transfers have been developed to restore function after peripheral nerve injury. Here, we present a case report of a child with permanent right upper extremity weakness due to TM that underwent nerve transfers. The following procedures were performed: double fascicle transfer from median nerve and ulnar nerve to the brachialis and biceps branches of the musculocutaneous nerve, spinal accessory to suprascapular nerve, and medial cord to axillary nerve end-to-side neurorraphy. At 22 months, the patient demonstrated excellent recovery of elbow flexion with minimal improvement in shoulder abduction. We propose that the treatment of permanent deficits from TM represents a novel indication for nerve transfers in a subset of patients. Copyright © 2011 Wiley Periodicals, Inc.

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

    International Nuclear Information System (INIS)

    Wagner, M.; Muehldorfer-Fodor, M.; Prommersberger, K.J.; Schmitt, R.

    2011-01-01

    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.

  6. 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.

  7. 18F-FDG PET/CT Findings Following Repeated Intramuscular Injections of "Site Enhancement Oil" in the Upper Extremities

    DEFF Research Database (Denmark)

    Dejanović, Danijela; Loft, Annika

    2017-01-01

    We present the findings on F-FDG PET/CT in a 50-year-old man known to self-administer intramuscular injections with site enhancement oil in the upper extremities. PET images show diffuse pathological high FDG uptake in soft tissue of the upper arms and in scanned portions of the forearms. On the CT...

  8. 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

  9. WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP): Factor Analysis and Internal Consistency.

    Science.gov (United States)

    Aerts, Bas R; Kuijer, P Paul; Beumer, Annechien; Eygendaal, Denise; Frings-Dresen, Monique H

    2018-04-17

    To test a 17-item questionnaire, the WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP), for dimensionality of the items (factor analysis) and internal consistency. Cross-sectional study. Outpatient clinic. A consecutive sample of patients (N=150) consisting of all new referral patients (either from a general physician or other hospital) who visited the orthopedic outpatient clinic because of an upper extremity musculoskeletal disorder. Not applicable. Number and dimensionality of the factors in the WORQ-UP. Four factors with eigenvalues (EVs) >1.0 were found. The factors were named exertion, dexterity, tools & equipment, and mobility. The EVs of the factors were, respectively, 5.78, 2.38, 1.81, and 1.24. The factors together explained 65.9% of the variance. The Cronbach alpha values for these factors were, respectively, .88, .74, .87, and .66. The 17 items of the WORQ-UP resemble 4 factors-exertion, dexterity, tools & equipment, and mobility-with a good internal consistency. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Cortical disconnection of the ipsilesional primary motor cortex is associated with gait speed and upper extremity motor impairment in chronic left hemispheric stroke.

    Science.gov (United States)

    Peters, Denise M; Fridriksson, Julius; Stewart, Jill C; Richardson, Jessica D; Rorden, Chris; Bonilha, Leonardo; Middleton, Addie; Gleichgerrcht, Ezequiel; Fritz, Stacy L

    2018-01-01

    Advances in neuroimaging have enabled the mapping of white matter connections across the entire brain, allowing for a more thorough examination of the extent of white matter disconnection after stroke. To assess how cortical disconnection contributes to motor impairments, we examined the relationship between structural brain connectivity and upper and lower extremity motor function in individuals with chronic stroke. Forty-three participants [mean age: 59.7 (±11.2) years; time poststroke: 64.4 (±58.8) months] underwent clinical motor assessments and MRI scanning. Nonparametric correlation analyses were performed to examine the relationship between structural connectivity amid a subsection of the motor network and upper/lower extremity motor function. Standard multiple linear regression analyses were performed to examine the relationship between cortical necrosis and disconnection of three main cortical areas of motor control [primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA)] and motor function. Anatomical connectivity between ipsilesional M1/SMA and the (1) cerebral peduncle, (2) thalamus, and (3) red nucleus were significantly correlated with upper and lower extremity motor performance (P ≤ 0.003). M1-M1 interhemispheric connectivity was also significantly correlated with gross manual dexterity of the affected upper extremity (P = 0.001). Regression models with M1 lesion load and M1 disconnection (adjusted for time poststroke) explained a significant amount of variance in upper extremity motor performance (R 2  = 0.36-0.46) and gait speed (R 2  = 0.46), with M1 disconnection an independent predictor of motor performance. Cortical disconnection, especially of ipsilesional M1, could significantly contribute to variability seen in locomotor and upper extremity motor function and recovery in chronic stroke. Hum Brain Mapp 39:120-132, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. A Six-Week Resistance Training Program Does Not Change Shear Modulus of the Triceps Brachii.

    Science.gov (United States)

    Akagi, Ryota; Shikiba, Tomofumi; Tanaka, Jun; Takahashi, Hideyuki

    2016-08-01

    We investigated the effect of a 6-week resistance training program on the shear modulus of the triceps brachii (TB). Twenty-three young men were randomly assigned to either the training (n = 13) or control group (n = 10). Before and after conducting the resistance training program, the shear modulus of the long head of the TB was measured at the point 70% along the length of the upper arm from the acromial process of the scapula to the lateral epicondyle of the humerus using shear wave ultrasound elastography. Muscle thickness of the long head of the TB was also determined at the same site by ultrasonography used during both tests. A resistance exercise was performed 3 days a week for 6 weeks using a dumbbell mass-adjusted to 80% of the 1-repetition maximum (1RM). The training effect on the muscle thickness and 1RM was significant. Nevertheless, the muscle shear modulus was not significantly changed after the training program. From the perspective of muscle mechanical properties, the present results indicate that significant adaptation must occur to make the TB more resistant to subsequent damaging bouts during the 6-week training program to target the TB.

  12. Salvage of mangled upper extremity using the Masquelet technique in a child: A case report.

    Science.gov (United States)

    Alassaf, Nabil; Alhoukail, Amro; Alsahli, Abdullah; Althubaiti, Ghazi

    2017-01-01

    To report our experience with the Masquelet concept in a pediatric upper extremity following an open injury to the elbow. A case report and literature review. An 11-year-old boy was transferred to our institution after a motor vehicle collision. There was a primary loss of the ulnohumeral articulation and the surrounding soft tissues as well as the ulnar nerve. Reconstruction used the Masquelet-induced membrane technique and a soft tissue flap. At the 30-month follow-up, the extremity was pain free and functional. This case highlights the value of the Masquelet technique in pediatric extremity injuries, where there is a loss of a major articular segment, as well as significant soft tissue compromise.

  13. "What if": The use of biomechanical models for understanding and treating upper extremity musculoskeletal disorders

    NARCIS (Netherlands)

    Veeger, H.E.J.

    2011-01-01

    To aid understanding of the working of the upper extremity, several musculoskeletal models of the shoulder and arm have been developed. These models comprise the full shoulder girdle, which implies that the thoracohumeral link is formed by a scapular and clavicular segment. These models are based

  14. Privacy Training Program

    Science.gov (United States)

    Recognizing that training and awareness are critical to protecting agency Personally Identifiable Information (PII), the EPA is developing online training for privacy contacts in its programs and regions.

  15. NTC operator training program viewed from SAT-based training process

    International Nuclear Information System (INIS)

    Matsumoto, Yoshio

    1996-01-01

    The Nuclear Power Training Center Ltd. (NTC) was established in June 1972 to train PWR plant operators. Operator training was started in Apr. 1974. Presently we have three full-scope, control-room simulators. Recently IAEA recommended that its Systematic Approach to Training (SAT) be used for the training of NPP personnel. We thoroughly examined the SAT-based process and compared it against the NTC training program. As a result, we have recognized that the NTC training program satisfies the SAT-based training process. We now intend to improve the feedback step of the NTC training system. Our efforts continue to produce a relevant program at the forefront of our profession. (author)

  16. The efficacy of stuttering measurement training: evaluating two training programs.

    Science.gov (United States)

    Bainbridge, Lauren A; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J

    2015-04-01

    Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of stuttering events on eight 3-min audiovisual speech samples from adults and children who stutter. Stuttering judgment training involved use of either the Stuttering Measurement System (SMS), Stuttering Measurement Assessment and Training (SMAAT) programs, or no training. To test for the reliability of any training effect, SMS training was repeated with the 4th group. Both SMS-trained groups produced approximately 34% improvement, significantly better than no training or the SMAAT program. The SMAAT program produced a mixed result. The SMS program was shown to produce a "medium" effect size improvement in the accuracy of stuttering event counts, and this improvement was almost perfectly replicated in a 2nd group. Half of the SMAAT judges produced a 36% improvement in accuracy, but the other half showed no improvement. Additional studies are needed to demonstrate the durability of the reported improvements, but these positive effects justify the importance of stuttering measurement training.

  17. TAP 3, Training Program Support Manual

    International Nuclear Information System (INIS)

    1991-07-01

    Training programs at DOE facilities should provide well-trained, qualified personnel to safely and efficiently operate the facilities in accordance with DOE requirements. A need has been identified for guidance regarding analysis, design, development, implementation, and evaluation of consistent and reliable performance-based training programs. Accreditation of training programs at Category A reactors and high-hazard and selected moderate-hazard nonreactor nuclear facilities will assure consistent, appropriate, and cost-effective training of personnel responsible for the operation, maintenance, and technical support of these facilities. Training programs that are designed and based on systematically determined job requirements, instead of subjective estimation of trainee needs, yield training activities that are consistent and develop or improve knowledge, skills, and abilities that can be directly related to the work setting. Because the training is job-related, the content of these programs more efficiently and effectively meets the needs of the employee. Besides a better trained work force, a greater level of operational reactor safety can be realized. This manual is intended to provide an overview of the accreditation process and a brief description of the elements necessary to construct and maintain training programs that are based on the requirements of the job. Two companion manuals provide additional information to assist contractors in their efforts to accredit training programs

  18. Effect of an office ergonomic randomised controlled trial among workers with neck and upper extremity pain.

    Science.gov (United States)

    Dropkin, Jonathan; Kim, Hyun; Punnett, Laura; Wegman, David H; Warren, Nicholas; Buchholz, Bryan

    2015-01-01

    Office computer workers are at increased risk for neck/upper extremity (UE) musculoskeletal pain. A seven-month office ergonomic intervention study evaluated the effect of two engineering controls plus training on neck/UE pain and mechanical exposures in 113 computer workers, including a 3-month follow-up period. Participants were randomised into an intervention group, who received a keyboard/mouse tray (KBT), touch pad (TP) for the non-dominant hand and keyboard shortcuts, and a control group who received keyboard shortcuts. Participants continued to have available a mouse at the dominant hand. Outcomes were pain severity, computer rapid upper limb assessment (RULA), and hand activity level. Prevalence ratios (PRs) evaluated intervention effects using dichotomised pain and exposure scores. In the intervention group, the dominnt proximal UE pain PR=0.9, 95% CI 0.7 to 1.2 and the dominant distal UE PR=0.8, 95% CI 0.5 to 1.3, postintervention. The non-dominant proximal UE pain PR=1.0, 95% CI 0.8 to 1.4, while the non-dominant distal UE PR=1.2, 95% CI 0.6 to 2.2, postintervention. Decreases in non-neutral postures were found in two RULA elements (non-dominant UE PR=0.9, 95% CI 0.8 to 0.9 and full non-dominant RULA PR=0.8, 95% CI 0.8 to 0.9) of the intervention group. Hand activity increased on the non-dominant side (PR=1.4, 95% CI 1.2 to 1.6) in this group. While the intervention reduced non-neutral postures in the non-dominant UE, it increased hand activity in the distal region of this extremity. To achieve lower hand activity, a KBT and TP used in the non-dominant hand may not be the best devices to use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Training Accreditation Program

    International Nuclear Information System (INIS)

    1989-01-01

    The cornerstone of safe operation of Department of Energy (DOE) nuclear facilities is personnel performing the day-to-day functions which accomplish the facility mission. Training that is conducted efficiently and effectively and is directly related to the needs of the job (i.e. performance-based training) is fundamental to safe operation. Responsibility for the safe operation of these facilities is a line management function. Therefore, achieving performance-based training requires commitment from the organization for which training is provided. This commitment includes making subject matter experts available for participation in and review of the products of the performance-based training process. It also includes budgeting and scheduling the time required for both initial and continuing training. This commitment must be made by corporate and facility senior management from the beginning. Management must get involved at the start to ensure that they are not only cognizant of ongoing activities, but are also involved to the degree necessary to thoroughly understand the process. Policies implemented and support demonstrated by senior management provide the driving force to ensure that training programs receive the attention that is imperative if facility training programs are to be successful

  20. Large-Scale Skin Resurfacing of the Upper Extremity in Pediatric Patients Using a Pre-Expanded Intercostal Artery Perforator Flap.

    Science.gov (United States)

    Wei, Jiao; Herrler, Tanja; Gu, Bin; Yang, Mei; Li, Qingfeng; Dai, Chuanchang; Xie, Feng

    2018-05-01

    The repair of extensive upper limb skin lesions in pediatric patients is extremely challenging due to substantial limitations of flap size and donor-site morbidity. We aimed to create an oversize preexpanded flap based on intercostal artery perforators for large-scale resurfacing of the upper extremity in children. Between March 2013 and August 2016, 11 patients underwent reconstructive treatment for extensive skin lesions in the upper extremity using a preexpanded intercostal artery perforator flap. Preoperatively, 2 to 4 candidate perforators were selected as potential pedicle vessels based on duplex ultrasound examination. After tissue expander implantation in the thoracodorsal area, regular saline injections were performed until the expanded flap was sufficient in size. Then, a pedicled flap was formed to resurface the skin lesion of the upper limb. The pedicles were transected 3 weeks after flap transfer. Flap survival, complications, and long-term outcome were evaluated. The average time of tissue expansion was 133 days with a mean final volume of 1713 mL. The thoracoabdominal flaps were based on 2 to 6 pedicles and used to resurface a mean skin defect area of 238 cm ranging from 180 to 357 cm. In all cases, primary donor-site closure was achieved. Marginal necrosis was seen in 5 cases. The reconstructed limbs showed satisfactory outcome in both aesthetic and functional aspects. The preexpanded intercostal artery perforator flap enables 1-block repair of extensive upper limb skin lesions. Due to limited donor-site morbidity and a pedicled technique, this resurfacing approach represents a useful tool especially in pediatric patients.

  1. A 3-month jump-landing training program: a feasibility study using the RE-AIM framework.

    Science.gov (United States)

    Aerts, Inne; Cumps, Elke; Verhagen, Evert; Mathieu, Niels; Van Schuerbeeck, Sander; Meeusen, Romain

    2013-01-01

    Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Randomized controlled trial. National and regional basketball teams. Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries.

  2. 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.

  3. Brachial plexus injury management through upper extremity amputation with immediate postoperative prostheses.

    Science.gov (United States)

    Malone, J M; Leal, J M; Underwood, J; Childers, S J

    1982-02-01

    Management of patients with brachial plexus injuries requires a team approach so that all aspects of their care are addressed simultaneously. This report examines elective amputation and prosthetic rehabilitation in a patient with brachial plexus avulsion of the left arm. The best possibility for good prosthetic rehabilitation is the early application of prosthetic devices with intensive occupational therapy. Using this type of approach, we have achieved significant improvement in amputation rehabilitation of upper extremity amputees treated with immediate postoperative conventional electric and myoelectric prostheses.

  4. Injuries to the upper extremities in polytrauma: limited effect on outcome more than ten years after injury - a cohort study in 629 patients.

    Science.gov (United States)

    Macke, C; Winkelmann, M; Mommsen, P; Probst, C; Zelle, B; Krettek, C; Zeckey, C

    2017-02-01

    To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients. A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients' injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion. In all, 307 multiply-injured patients with and 322 without upper extremity injuries were included in the study. The groups with and without upper limb injuries were similar with respect to demographic data and injury pattern, except for midface trauma. There were no significant differences in the long-term outcome. In patients with brachial plexus lesions there were significantly more who were unemployed, required greater retraining and a worse HASPOC. Injuries to the upper extremities seem to have limited effect on long-term outcome in patients with polytrauma, as long as no injury was caused to the brachial plexus. Cite this article: Bone Joint J 2017;99-B:255-60. ©2017 The British Editorial Society of Bone & Joint Surgery.

  5. 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.

  6. 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.

  7. Training programming: revisiting terminology

    Directory of Open Access Journals (Sweden)

    Mário C. Marques

    2017-11-01

    Full Text Available Does the way the literature presents the classic periodization or programming make sense? In our opinion, the answer is clearly no. To get started, periodization and programming are terms used interchangeably (as synonyms in scientific literature when they actually have different meanings. Thus, to periodize is to set periods for a process (e.g., to a season or the sports life, whereas programming is defined as to devise and order the necessary actions to carry out a project. Accordingly, coaches and physical conditioning professionals should divide or periodize the season in different cycles and then, within each cycle, programming the training sessions. The periodization should not only help to structure the training process, but also to express the goals to achieve, to control the training process evolution and allow a great execution of the action plan. When designing a plan, we simply organize all the “ingredients” that should be part of the work/training design in a concrete and detailed way. From a scientific point of view, the programming is nothing more than an adequate interpretation of the training biological laws (Tschione, 1992; Latonov, 1997, Issurin, 2008 and must have the performance improvement as the major reference criteria (Issurin 2010. In practice, during the last decades, we have followed a set of instructions mainly based on experienced coaches (Matveyev, 1981, Bompa, 1994, Zatsiorsky, 1995 who have obtained relevant results. As a consequence, it is very difficult to accept another solid scientific based vision or proposal since the accumulation of systematic experiences has led to the construction of a theoretical model, even though there are no scientific evidences. The multiplication and implementation of the traditional programming models (Matveyev, 1981, Bompa, 1994 have guided us to a set of erroneous terms, among which we highlight the “micro”, the “meso” and the “macro” cycles, that were never

  8. Development of a training assurance program

    International Nuclear Information System (INIS)

    Palchinsky, J.; Waylett, W.J. Jr.

    1987-01-01

    The nuclear industry has made a significant commitment to improve training through the implementation of accredited performance-based training programs. Senior management expects that human performance will improve as a result of significant resource allocations. How do they know if training is effective in achieving improved human performance? Florida Power and Light Company is developing a Training Assurance Program to track indicators of training performance and future trends. Integrating the company's Quality Improvement Program processes with systematic training processes is resulting in personnel functioning in a proactive mode and increased customer satisfaction with training performance

  9. Multi-level programming paradigm for extreme computing

    International Nuclear Information System (INIS)

    Petiton, S.; Sato, M.; Emad, N.; Calvin, C.; Tsuji, M.; Dandouna, M.

    2013-01-01

    In order to propose a framework and programming paradigms for post peta-scale computing, on the road to exa-scale computing and beyond, we introduced new languages, associated with a hierarchical multi-level programming paradigm, allowing scientific end-users and developers to program highly hierarchical architectures designed for extreme computing. In this paper, we explain the interest of such hierarchical multi-level programming paradigm for extreme computing and its well adaptation to several large computational science applications, such as for linear algebra solvers used for reactor core physic. We describe the YML language and framework allowing describing graphs of parallel components, which may be developed using PGAS-like language such as XMP, scheduled and computed on supercomputers. Then, we propose experimentations on supercomputers (such as the 'K' and 'Hooper' ones) of the hybrid method MERAM (Multiple Explicitly Restarted Arnoldi Method) as a case study for iterative methods manipulating sparse matrices, and the block Gauss-Jordan method as a case study for direct method manipulating dense matrices. We conclude proposing evolutions for this programming paradigm. (authors)

  10. Qualification and training of the trainers, verifiers, licensors and upper management

    International Nuclear Information System (INIS)

    Recker, M.

    1986-01-01

    Within the scope of technology transfer, also the know-how transfer should be included. It is no longer sufficient to train once the operating personnel, retraining and training of new employees must be performed during all the time. For the performance of training, qualified trainers and instructors should be available. A suitable training program will be explained in detail. To operate a plant effectively, it is important to train the operating personnel, but of the same importance is also to have a well functioning management, which will be achieved by training methods and programs to be defined in detail. The adherence to rules and regulations has to be controlled by authorities. The duties and the respective training programs are shown in this report. (orig.)

  11. Lower-extremity resistance training on unstable surfaces improves proxies of muscle strength, power and balance in healthy older adults: a randomised control trial.

    Science.gov (United States)

    Eckardt, Nils

    2016-11-24

    It is well documented that both balance and resistance training have the potential to mitigate intrinsic fall risk factors in older adults. However, knowledge about the effects of simultaneously executed balance and resistance training (i.e., resistance training conducted on unstable surfaces [URT]) on lower-extremity muscle strength, power and balance in older adults is insufficient. The objective of the present study was to compare the effects of machine-based stable resistance training (M-SRT) and two types of URT, i.e., machine-based (M-URT) and free-weight URT (F-URT), on measures of lower-extremity muscle strength, power and balance in older adults. Seventy-five healthy community-dwelling older adults aged 65-80 years, were assigned to three intervention groups: M-SRT, M-URT and F-URT. Over a period of ten weeks, all participants exercised two times per week with each session lasting ~60 min. Tests included assessment of leg muscle strength (e.g., maximal isometric leg extension strength), power (e.g., chair rise test) and balance (e.g., functional reach test), carried out before and after the training period. Furthermore, maximal training load of the squat-movement was assessed during the last training week. Maximal training load of the squat-movement was significantly lower in F-URT in comparison to M-SRT and M-URT. However, lower-extremity resistance training conducted on even and uneven surfaces meaningfully improved proxies of strength, power and balance in all groups. M-URT produced the greatest improvements in leg extension strength and F-URT in the chair rise test and functional reach test. Aside from two interaction effects, overall improvements in measures of lower-extremity muscle strength, power and balance were similar across training groups. Importantly, F-URT produced similar results with considerably lower training load as compared to M-SRT and M-URT. Concluding, F-URT seems an effective and safe alternative training program to mitigate

  12. Comparison of In-Season-Specific Resistance vs. A Regular Throwing Training Program on Throwing Velocity, Anthropometry, and Power Performance in Elite Handball Players.

    Science.gov (United States)

    Hermassi, Souhail; van den Tillaar, Roland; Khlifa, Riadh; Chelly, Mohamed Souhaiel; Chamari, Karim

    2015-08-01

    The purpose of this study was to compare the effect of a specific resistance training program (throwing movement with a medicine ball) with that of regular training (throwing with regular balls) on ball velocity, anthropometry, maximal upper-body strength, and power. Thirty-four elite male team handball players (age: 18 ± 0.5 years, body mass: 80.6 ± 5.5 kg, height: 1.80 ± 5.1 m, body fat: 13.4 ± 0.6%) were randomly assigned to 1 of the 3 groups: control (n = 10), resistance training group (n = 12), or regular throwing training group (n = 12). Over the 8-week in season, the athletes performed 3 times per week according to an assigned training program alongside their normal team handball training. One repetition maximum (1RM) bench press and 1RM pullover scores assessed maximal arm strength. Anthropometry was assessed by body mass, fat percentage, and muscle volumes of upper body. Handball throwing velocity was measured by a standing throw, a throw with run, and a jump throw. Power was measured by measuring total distance thrown by a 3-kg medicine ball overhead throw. Throwing ball velocity, maximal strength, power, and muscle volume increases for the specific resistance training group after the 8 weeks of training, whereas only maximal strength, muscle volume and power and in the jump throw increases were found for the regular throwing training group. No significant changes for the control group were found. The current findings suggest that elite male handball players can improve ball velocity, anthropometrics, maximal upper-body strength, and power during the competition season by implementing a medicine ball throwing program.

  13. The effect of enhanced trunk control on balance and falls through bilateral upper extremity exercises among chronic stroke patients in a standing position

    OpenAIRE

    Shin, Ji Won; Don Kim, Kyoung

    2016-01-01

    [Purpose] This study examined the effects of bilateral upper extremity exercises on trunk control, balance, and risk of falls in stroke patients. [Subjects and Methods] A total of 30 study subjects were selected and randomly divided into experimental and control groups containing 15 subjects each, who received bilateral upper extremity activities and conventional rehabilitation treatment, respectively. [Results] There were statistically significant differences between groups in all sub-items ...

  14. Evaluating Research Ethics Training in the Maryland Sea Grant REU Program

    Science.gov (United States)

    Allen, M. R.; Kumi, G. A.; Kumi, B. C.; Moser, F. C.

    2016-02-01

    The NSF's Research Experiences for Undergraduates (REU) program is an opportunity to cultivate responsible research practices in researchers at an early stage in their career. However, teaching responsible research conduct and science ethics in this program has been challenging because of a lack of consensus regarding which instructional methods are most effective for educating students about ethical concepts and establishing the process of ethical decision-making. Over the last 15 years, Maryland Sea Grant's REU ethics program has evolved by exploring different teaching models and looking for ways to effectively engage upper level undergraduates throughout their summer experience in ethical responsibility training. Since 2007, we have adopted a concerted experiential learning approach that includes an ethics seminar, role playing, case studies, and reflection. Currently, our summer long ethics training includes: 1) an interactive seminar; 2) a workshop with role playing and case studies; 3) 1-2 readings; and 4) a roundtable discussion with faculty mentors and their mentees to discuss researchers' real-world experiences with ethical dilemmas. Within the last 3 years, we have expanded our student learning outcomes assessments by administering pre- and post-program surveys to assess ethical skills students acquire through the program. Reevaluations administered three and six years after the REU experience will measure long term effectiveness of the training. Results from the first group of students reveal a greater awareness of ethical issues following our summer program. Students show a high level of competence about "black and white" issues (falsification, fabrication, plagiarism), but are more challenged by ethical "gray areas" such as data ownership and authorship. Results suggest many undergraduates come to research programs with basic ethics training, but benefit from our additional focus on complex ethical dilemmas.

  15. Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load - A randomized controlled trial of 1020 army recruits

    DEFF Research Database (Denmark)

    Brushoj, C.; Larsen, K.; Albrecht-Beste, E.

    2008-01-01

    Background: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. Hypothesis: A preventive training program base...

  16. Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

    Science.gov (United States)

    Farrell, Elizabeth; Naber, Erin; Geigle, Paula

    2010-01-01

    This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

  17. BWR Services maintenance training program

    International Nuclear Information System (INIS)

    Cox, J.H.; Chittenden, W.F.

    1979-01-01

    BWR Services has implemented a five-phase program to increase plant availability and capacity factor in operating BWR's. One phase of this program is establishing a maintenance training program on NSSS equipment; the scope encompasses maintenance on both mechanical equipment and electrical control and instrumentation equipment. The program utilizes actual product line equipment for practical Hands-on training. A total of 23 formal courses will be in place by the end of 1979. The General Electric Company is making a multimillion dollar investment in facilities to support this training. These facilities are described

  18. Influence of the type of training task on intermanual transfer effects in upper-limb prosthesis training : A randomized pre-posttest study

    NARCIS (Netherlands)

    Romkema, Sietske; Bongers, Raoul M.; van der Sluis, Corry K.

    2017-01-01

    Intermanual transfer, the transfer of motor skills from the trained hand to the untrained hand, can be used to train upper limb prosthesis skills. The aim of this study was to determine the relation between the magnitude of the intermanual transfer effect and the type of training task. The used

  19. General Employee Radiological Training and Radiological Worker Training: Program management manual

    International Nuclear Information System (INIS)

    1992-10-01

    This manual defines and describes the DOE General Employee Radiological Training (GERT) and Radiological Worker I and II (RW I and II) Training programs. It includes material development requirements, standards and policies, and program administration. This manual applies to General Employee Radiological Training and Radiological Worker Training at all DOE contractor sites. The training materials of both GERT and RW I and II training reflect the requirements identified in the DOE Radiological Control Manual and DOE Order 5480.11. The training programs represent the minimum requirement for the standardized core materials. Each contractor shall implement the program in its entirety and may augment the standardized core materials to increase the general employee and radiological worker level of competency

  20. Thermograpic study of upper extremities in patients with cerebral palsy

    Science.gov (United States)

    Lampe, R.; Kawelke, S.; Mitternacht, J.; Turova, V.; Blumenstein, T.; Alves-Pinto, A.

    2015-03-01

    Trophic disorders like reduced skin blood circulation are well-known epiphenomenon of cerebral palsy (CP). They can influence quality of life and can lead to skin damages and, as a consequence, to decubitus. Therefore, it is important to analyse temperature regulation in patients with CP. Thermal imaging camera FLIR BCAM SD was used to study the dependency of skin blood circulation in upper extremities of patients with CP on hand dominance, hand force and hand volume. The hand force was evaluated using a conventional dynamometer. The hand volume was measured with a volumeter. A cold stress test for hands was applied in 22 patients with CP and 6 healthy subjects. The warming up process after the test was recorded with the thermal camera. It was confirmed that the hands of patients warm up slower comparing to healthy persons. The patients' working hands warm up faster than non-working ones. A slight correlation was established between the hand grip force of the working hands and their warm up time. No correlation was found between the warming up time and the volume of the hand. The results confirm our assumption that there is a connection of peripheral blood circulation to upper limb motor functions.

  1. 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.

  2. The effect of asymmetrical body orientation during simulated forward falls on the distal upper extremity impact response of healthy people.

    Science.gov (United States)

    Burkhart, Timothy A; Brydges, Evan; Stefanczyk, Jennifer; Andrews, David M

    2017-04-01

    The occurrence of distal upper extremity injuries resulting from forward falls (approximately 165,000 per year) has remained relatively constant for over 20years. Previous work has provided valuable insight into fall arrest strategies, but only symmetric falls in body postures that do not represent actual fall scenarios closely have been evaluated. This study quantified the effect of asymmetric loading and body postures on distal upper extremity response to simulated forward falls. Twenty participants were suspended from the Propelled Upper Limb fall ARest Impact System (PULARIS) in different torso and leg postures relative to the ground and to the sagittal plane (0°, 30° and 45°). When released from PULARIS (hands 10cm above surface, velocity 1m/s), participants landed on two force platforms, one for each hand. Right forearm impact response was measured with distal (radial styloid) and proximal (olecranon) tri-axial accelerometers and bipolar EMG from seven muscles. Overall, the relative height of the torso and legs had little effect on the forces, or forearm response variables. Muscle activation patterns consistently increased from the start to the peak activation levels after impact for all muscles, followed by a rapid decline after peak. The impact forces and accelerations suggest that the distal upper extremity is loaded more medial-laterally during asymmetric falls than symmetric falls. Altering the direction of the impact force in this way (volar-dorsal to medial-lateral) may help reduce distal extremity injuries caused when landing occurs symmetrically in the sagittal plane as it has been shown that volar-dorsal forces increase the risk of injury. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Methods for evaluation of industry training programs

    International Nuclear Information System (INIS)

    Morisseau, D.S.; Roe, M.L.; Persensky, J.J.

    1987-01-01

    The NRC Policy Statement on Training and Qualification endorses the INPO-managed Training Accreditation Program in that it encompasses the elements of effective performance-based training. Those elements are: analysis of the job, performance-based learning objectives, training design and implementation, trainee evaluation, and program evaluation. As part of the NRC independent evaluation of utilities implementation of training improvement programs, the staff developed training review criteria and procedures that address all five elements of effective performance-based training. The staff uses these criteria to perform reviews of utility training programs that have already received accreditation. Although no performance-based training program can be said to be complete unless all five elements are in place, the last two, trainee and program evaluation, are perhaps the most important because they determine how well the first three elements have been implemented and ensure the dynamic nature of training. This paper discusses the evaluation elements of the NRC training review criteria. The discussion will detail the elements of evaluation methods and techniques that the staff expects to find as integral parts of performance-based training programs at accredited utilities. Further, the review of the effectiveness of implementation of the evaluation methods is discussed. The paper also addresses some of the qualitative differences between what is minimally acceptable and what is most desirable with respect to trainee and program evaluation mechanisms and their implementation

  4. [Training, the key to improving eHealth literacy of upper secondary school students].

    Science.gov (United States)

    Hernández-Rabanal, Carme; Vall, Aurora; Boter, Clara

    To explore whether training on strategies to identify and assess health-related information online has a positive impact on students' perception of their own eHealth literacy. The validated eHealth Literacy Scale (eHEALS) was administered to a sample of upper secondary school students, aged 15-18. One week later, they attended a training session on how to search and identify reliable health-related information and resources online. The eHEALS was administered again at the end of this session. Information about gender and school year was collected in both sessions. Perceived eHealth literacy was assessed by comparing the scores obtained before and after the session. Bivariate and multiple linear regressions were completed. Of the 298 students enrolled in upper secondary school (Bachillerato), 285 were included in the study. Approximately 52.28% (149) were female, and 47.72% (136) were male. The mean eHEALS score before the session was 24.19 (range: 8-40), and was 28.54 after it. The training was associated with higher perceived eHealth literacy scores (p <0,0001). Health literacy was positively associated with the usefulness and importance students give the Internet. Attendance at a training session on strategies to identify and assess health-related resources online is associated with higher levels of perceived eHealth literacy. Implementing specific training sessions on eHealth literacy in upper secondary school is a promising approach for enhancing students' eHealth literacy. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. The assessment of psychological factors on upper extremity disability: A scoping review.

    Science.gov (United States)

    MacDermid, Joy C; Valdes, Kristin; Szekeres, Mike; Naughton, Nancy; Algar, Lori

    2017-11-29

    The primary purpose of this scoping review was to describe the nature and extent of the published research that assesses the relationship between psychological features and patient-reported outcome following surgery or rehabilitation of upper extremity disease or injury. Twenty-two included studies were examined for quantitative study design, outcome measure, inclusion/exclusion criteria, follow-up and recruitment strategy. Patient population and psychological assessment tools were examined for validity. Twenty-two studies met the inclusion criteria for this study. Only 7 of the 22 studies were longitudinal and the rest were cross sectional studies. Depression was the most common psychological status of interest and was included in 17 studies. Pain catastrophizing was the psychological status of interest in 5 of the studies. Four studies considered anxiety, 3 considered pain anxiety, 3 considered distress, 2 considered coping, 2 considered catastrophic thinking, and 2 considered fear avoidance beliefs. The majority of studies in this review were cross-sectional studies. Cross-sectional studies may not provide conclusive information about cause-and-effect relationships. This review encourages clinicians to be mindful of the psychological implications found in rehabilitation of individuals with upper extremity disease or injury along with being cognizant of choosing appropriate measurement tools that best represent each patient's characteristics and diagnoses. The nature of the research addressing psychological factors affecting outcomes after hand injury focus on negative traits and have limited strength to suggest causation as most have used cross-sectional designs. Stronger longitudinal designs and consideration of positive traits are needed in future studies. Copyright © 2017. Published by Elsevier Inc.

  6. Cernavoda NPP operations training programs

    International Nuclear Information System (INIS)

    1993-01-01

    The purpose of this document is to describe the philosophy, content and minimum requirements for the Cernavoda Training Programs for all Station staff and to identify the training department organization and respective responsibilities necessary to provide the required training. The hierarchical documentation and requirements related to these programs is shown in figure Rd-TR1-1

  7. Neck-upper extremity musculoskeletal disorders among workers in the telecommunications company at Mansoura City.

    Science.gov (United States)

    El-Bestar, Sohair Fouad; El-Mitwalli, Ashraf Abdel-Moniem; Khashaba, Eman Omar

    2011-01-01

    This study was to determine the prevalence and work-related risk factors of neck-upper extremity musculoskeletal disorders (MSDs) among video display terminal (VDT) users. A comparative cross-sectional study was conducted; there were 60 VDT users and 35 controls. The participants filled in a structured questionnaire, had electrophysiological tests and an X-ray of the neck. The prevalence of MSDs was higher (28.3%) among VDTs users compared to controls (14.3%) with no statistically significant difference. The prevalence of cervical disorders with or without radiculopathy (18.3%) was the most common disorder followed by carpal tunnel syndrome (6.6%). The mean (SD) age of MSD cases (51 ± 7.2 years) was statistically significantly higher than of the controls (42.8 ± 9). Physical exposure to prolonged static posture (OR: 6.9; 95% CI: 0.83-57.9), awkward posture (OR: 5.5; 95% CI: 0.6-46.4) and repetitive movements (OR: 5.5; 95% CI: 0.65-46.4) increased risk of MSDs with a statistically significant difference for static posture only (p < .05). VDT users experienced more job dissatisfaction, work-overload and limited social support from supervisors and colleagues. VDT use did not increase the risk of neck-upper extremity MSDs. The risk increased with older age and static posture.

  8. Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity.

    Science.gov (United States)

    Armijo-Olivo, Susan; Woodhouse, Linda J; Steenstra, Ivan A; Gross, Douglas P

    2016-12-01

    To determine whether the Disabilities of the Arm, Shoulder, and Hand (DASH) tool added to the predictive ability of established prognostic factors, including patient demographic and clinical outcomes, to predict return to work (RTW) in injured workers with musculoskeletal (MSK) disorders of the upper extremity. A retrospective cohort study using a population-based database from the Workers' Compensation Board of Alberta (WCB-Alberta) that focused on claimants with upper extremity injuries was used. Besides the DASH, potential predictors included demographic, occupational, clinical and health usage variables. Outcome was receipt of compensation benefits after 3 months. To identify RTW predictors, a purposeful logistic modelling strategy was used. A series of receiver operating curve analyses were performed to determine which model provided the best discriminative ability. The sample included 3036 claimants with upper extremity injuries. The final model for predicting RTW included the total DASH score in addition to other established predictors. The area under the curve for this model was 0.77, which is interpreted as fair discrimination. This model was statistically significantly different than the model of established predictors alone (pmodels (p=0.34). The DASH tool together with other established predictors significantly helped predict RTW after 3 months in participants with upper extremity MSK disorders. An appealing result for clinicians and busy researchers is that DASH item 23 has equal predictive ability to the total DASH score. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Feasibility of Using an Arm Weight-Supported Training System to Improve Hand Function Skills in Children With Hemiplegia.

    Science.gov (United States)

    Krishnaswamy, Swetha; Coletti, Daniel J; Berlin, Hilary; Friel, Kathleen

    This investigation was a pilot feasibility trial evaluating the use of an arm-weight-supported training device to improve upper-extremity function in children with hemiplegia. A single-group within-subject design was used. Participants were 6 children ages 7-17 yr with upper-extremity weakness secondary to hemiplegia. The intervention consisted of 15-18 treatment sessions using an arm-weight-supported training device with the affected upper extremity. Fine motor function was assessed using the Jebsen-Taylor Hand Function Test, the Box and Block Test, and the Assisting Hand Assessment. We examined participants' interactions with the device and assessment scores pre- and postintervention. Five of the 6 children exhibited some changes after the therapy. The system required significant modifications to ensure appropriate positioning. The arm-weight-supported system may be viable for therapeutic use. Future studies should use randomized controlled designs and compare effectiveness of weight-supported training with that of other rehabilitation strategies. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  10. Psychosocial Risk Factors for Upper Respiratory Infection: Demographic and Health History Predictors of URI (Upper Respiratory Illness) During Basic Training

    Science.gov (United States)

    1988-07-05

    Symptom Reporting scores represent hypochondriasis , somatic responses to acute stress, or simple response biases in filling out questionnaires. The...laboratory settings which presumably are not as stressful as basic training and may tend, therefore, to minimize the expression of hypochondriasis ... somatization , and related factors that could be important in basic training. However: the present findings make it clear that even if the upper limit of the

  11. 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…

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

    NARCIS (Netherlands)

    Beerekamp, M. S. H. Suzan; Sulkers, George S. I.; Ubbink, Dirk T.; Maas, Mario; Schep, Niels W. L.; Goslings, J. Carel

    2012-01-01

    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

  13. Quantitative release planning in extreme programming

    NARCIS (Netherlands)

    van Valkenhoef, Gert; Tervonen, Tommi; de Brock, Bert; Postmus, Douwe

    Context: Extreme Programming (XP) is one of the most popular agile software development methodologies. XP is defined as a consistent set of values and practices designed to work well together, but lacks practices for project management and especially for supporting the customer role. The customer

  14. Quantitative release planning in extreme programming

    NARCIS (Netherlands)

    van Valkenhoef, Gert; Tervonen, Tommi; de Brock, Bert; Postmus, Douwe

    2011-01-01

    Context: Extreme Programming (XP) is one of the most popular agile software development methodologies. XP is defined as a consistent set of values and practices designed to work well together, but lacks practices for project management and especially for supporting the customer role. The customer

  15. Development and simulation of a passive upper extremity orthosis for amyoplasia

    DEFF Research Database (Denmark)

    Jensen, Erik Føge; Raunsbæk, Joakim; Lund, Jan Nørgaard

    2018-01-01

    Introduction People who are born with arthrogryposis multiplex congenita are typically not able to perform activities of daily living (ADL) due to decreased muscle mass, joint contractures and unnatural upper extremity positioning. They are, therefore, potential users of an assistive device capable....... Results For a given configuration using a mono- and a bi-articular spring, the simulations showed that spring stiffnesses of 400?Nm?1 and of 1029?Nm?1, respectively, were able to lower the maximal muscle activity estimated by the musculoskeletal model to a level in which the 10 postures can be realized....... Conclusion By augmenting residual muscle strength with a partially gravity-balanced passive orthosis, ADLs may be achievable for people with arthrogryposis multiplex congenita....

  16. Guidance for training program evaluation

    International Nuclear Information System (INIS)

    1984-01-01

    An increased concern about the training of nuclear reactor operators resulted from the incident at TMI-2 in 1979. Purpose of this guide is to provide a general framework for the systematic evaluation of training programs for DOE Category-A reactors. The primary goal of such evaluations is to promote continuing quality improvements in the selection, training and qualification programs

  17. Extreme conditioning programs and injury risk in a US Army Brigade Combat Team.

    Science.gov (United States)

    Grier, Tyson; Canham-Chervak, Michelle; McNulty, Vancil; Jones, Bruce H

    2013-01-01

    Brigades and battalions throughout the US Army are currently implementing a variety of exercise and conditioning programs with greater focus on preparation for mission-specific tasks. An Army physical therapy clinic working with a light infantry brigade developed the Advanced Tactical Athlete Conditioning (ATAC) program. The ATAC program is a unique physical training program consisting of high-intensity aquatic exercises, tactical agility circuits, combat core conditioning, and interval speed training. Along with ATAC, battalions have also incorporated components of fitness programs such as the Ranger Athlete Warrior program and CrossFit (Crossfit, Inc, Santa Monica, CA) an extreme conditioning program (ECP). To determine if these new programs (ATAC, ECP) had an effect on injury rates and physical fitness. Surveys were administered to collect personal characteristics, tobacco use, personal physical fitness training, Army physical fitness test results, and self-reported injuries. Medical record injury data were obtained 6 months before and 6 months after the implementation of the new program. Predictors of injury risk were assessed using multivariate logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported. Injury incidence among Soldiers increased 12% for overall injuries and 16% for overuse injuries after the implementation of the ATAC/ECPs. However, injury incidence among Soldiers not participating in ATAC/ECPs also increased 14% for overall injuries and 10% for overuse injuries. Risk factors associated with higher injury risk for Soldiers participating in ATAC/ECPs included: greater mileage run per week during unit physical training (OR (>16 miles per week÷≤7 miles per week)=2.24, 95% CI, 1.33-3.80); higher body mass index (BMI) (OR (BMI 25-29.9÷BMI<25)=1.77, 95% CI, 1.29-2.44), (OR (BMI =30÷BMI<25)=2.72, 95% CI, 1.67-4.43); cigarette use (OR (smoker÷nonsmoker)=1.80, 95% CI, 1.34-2.42); poor performance on the 2-mile run during

  18. Psychosocial reactions to upper extremity limb salvage: A cross-sectional study.

    Science.gov (United States)

    Sposato, Lindsay; Yancosek, Kathleen; Lospinoso, Josh; Cancio, Jill

    2017-08-09

    Descriptive cross-sectional survey study. Limb salvage spares an extremity at risk for amputation after a major traumatic injury. Psychosocial recovery for individuals with lower extremity limb salvage has been discussed in the literature. However, to date, psychosocial reactions for individuals with upper extremity (UE) limb salvage have not been examined. To determine which factors may influence psychosocial adaptation to UE limb salvage. Participants (n = 30; 28 males) were adults (mean, 30.13; range, 18-61) who sustained an UE limb salvage from a traumatic event. Adaptation was measured using a modified version of the Reactions to Impairment and Disability Inventory. A linear mixed-effects regression found that worse psychosocial adaptation was associated with having less than a college degree, being less than 6 months post-injury, being older than 23 years, and having more pain. Dominant hand injuries were found to influence poor adaptation on the denial Reactions to Impairment and Disability Inventory subscale only. The results of this study indicate that there is potential for nonadaptive reactions and psychological distress with certain variables in UE limb salvage. Therapists may use these results to anticipate which clients may be at risk for poor psychosocial outcomes. This study indicates the need for early consideration to factors that affect psychological prognosis for the UE limb salvage population. However, future research is indicated to better understand the unique psychosocial challenges and needs of these individuals. 4. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  19. Isometric and isokinetic muscle strength in the upper extremity can be reliably measured in persons with chronic stroke.

    Science.gov (United States)

    Ekstrand, Elisabeth; Lexell, Jan; Brogårdh, Christina

    2015-09-01

    To evaluate the test-retest reliability of isometric and isokinetic muscle strength measurements in the upper extremity after stroke. A test-retest design. Forty-five persons with mild to moderate paresis in the upper extremity > 6 months post-stroke. Isometric arm strength (shoulder abduction, elbow flexion), isokinetic arm strength (elbow extension/flexion) and isometric grip strength were measured with electronic dynamometers. Reliability was evaluated with intra-class correlation coefficients (ICC), changes in the mean, standard error of measurements (SEM) and smallest real differences (SRD). Reliability was high (ICCs: 0.92-0.97). The absolute and relative (%) SEM ranged from 2.7 Nm (5.6%) to 3.0 Nm (9.4%) for isometric arm strength, 2.6 Nm (7.4%) to 2.9 Nm (12.6%) for isokinetic arm strength, and 22.3 N (7.6%) to 26.4 N (9.2%) for grip strength. The absolute and relative (%) SRD ranged from 7.5 Nm (15.5%) to 8.4 Nm (26.1%) for isometric arm strength, 7.1 Nm (20.6%) to 8.0 Nm (34.8%) for isokinetic arm strength, and 61.8 N (21.0%) to 73.3 N (25.6%) for grip strength. Muscle strength in the upper extremity can be reliably measured in persons with chronic stroke. Isometric measurements yield smaller measurement errors than isokinetic measurements and might be preferred, but the choice depends on the research question.

  20. Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study.

    Science.gov (United States)

    Zhang, Di; Sessa, Salvatore; Kong, Weisheng; Cosentino, Sarah; Magistro, Daniele; Ishii, Hiroyuki; Zecca, Massimiliano; Takanishi, Atsuo

    2015-11-01

    Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload. A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli. We found that subliminal visual stimulation is a valid method to improve trainees' upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level. We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.

  1. Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography.

    Science.gov (United States)

    Kaplanoglu, Hatice; Beton, Osman

    2017-04-01

    To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure. A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance. Also, the computed tomography angiography classification of superficial palmar arch distribution and anatomic configuration was performed. The mean baseline diameters of the radial, ulnar and brachial arteries of the cases were; 2.8 ± 0.6, 2.5 ± 0.7, and 4.7 ± 0.6 mm, respectively. A complete superficial palmar arch was observed in 69.2 % of the right hands and 70.5 % of the left hands. For the superficial palmar arches on the right side, the radial artery was dominant in two and the ulnar artery was dominant in 47 with the remaining showing codominance. On the left side, the radial artery was dominant in one hand, with the ulnar artery being dominant in 49 cases, and in 28 cases, there was codominance. In the superficial palmar arch classification, four of the arches (A-D) were defined as complete and the remaining three (E-G) as incomplete. The current study clarified different variations in palmar circulation and forearm arteries to aid the surgeon during trans-radial or trans-ulnar catheterization, hemodialysis, or coronary artery bypass grafting.

  2. Ultra-high field upper extremity peripheral nerve and non-contrast enhanced vascular imaging.

    Directory of Open Access Journals (Sweden)

    Shailesh B Raval

    Full Text Available The purpose of this study was to explore the efficacy of Ultra-high field [UHF] 7 Tesla [T] MRI as compared to 3T MRI in non-contrast enhanced [nCE] imaging of structural anatomy in the elbow, forearm, and hand [upper extremity].A wide range of sequences including T1 weighted [T1] volumetric interpolate breath-hold exam [VIBE], T2 weighted [T2] double-echo steady state [DESS], susceptibility weighted imaging [SWI], time-of-flight [TOF], diffusion tensor imaging [DTI], and diffusion spectrum imaging [DSI] were optimized and incorporated with a radiofrequency [RF] coil system composed of a transverse electromagnetic [TEM] transmit coil combined with an 8-channel receive-only array for 7T upper extremity [UE] imaging. In addition, Siemens optimized protocol/sequences were used on a 3T scanner and the resulting images from T1 VIBE and T2 DESS were compared to that obtained at 7T qualitatively and quantitatively [SWI was only qualitatively compared]. DSI studio was utilized to identify nerves based on analysis of diffusion weighted derived fractional anisotropy images. Images of forearm vasculature were extracted using a paint grow manual segmentation method based on MIPAV [Medical Image Processing, Analysis, and Visualization].High resolution and high quality signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]-images of the hand, forearm, and elbow were acquired with nearly homogeneous 7T excitation. Measured [performed on the T1 VIBE and T2 DESS sequences] SNR and CNR values were almost doubled at 7T vs. 3T. Cartilage, synovial fluid and tendon structures could be seen with higher clarity in the 7T T1 and T2 weighted images. SWI allowed high resolution and better quality imaging of large and medium sized arteries and veins, capillary networks and arteriovenous anastomoses at 7T when compared to 3T. 7T diffusion weighted sequence [not performed at 3T] demonstrates that the forearm nerves are clearly delineated by fiber tractography. The

  3. Upper and Lower Urinary Tract Endoscopy Training on Thiel-embalmed Cadavers.

    Science.gov (United States)

    Bele, Uros; Kelc, Robi

    2016-07-01

    To evaluate Thiel-embalmed cadavers as a new training model for urological endoscopy procedures. Twelve urologists performed upper and lower urinary tract endoscopies on 5 different Thiel-embalmed cadavers to evaluate this potentially new training model in urological endoscopic procedural training. Using a 5-point Likert scale, the participants assessed the quality of the tissue and the overall experience of the endoscopy in comparison to a live patient procedure. Thiel-embalmed cadavers have shown to mimic live patient endoscopy of the upper and lower urinary tract in terms of almost identical overall anatomical conditions and manipulation characteristics of the tissue. The mucosa of the urethra and ureters showed similar colors and consistency in comparison to a live patient, whereas bladder mucosa was lacking the visibility of the vessels, thus was unsuitable for identifying any mucosal abnormalities. The flexibility of the muscles allowed for proper patient positioning, whereas the loss of muscle tonus made ureteroscopy more difficult although sufficiently comparable to the procedure done in a live patient. Thiel-embalmed cadavers have already been proven to be a suitable training model for several medical procedures. They are known for preserving tissue color, consistency, and flexibility without the irritant odors or risk of infection, which make them resemble live patients with real-life surgical challenges. The results of our study strongly suggest that despite some minor drawbacks, Thiel-embalmed cadavers are a suitable simulation model for initial training of urethrocystoscopy and ureteroscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Lower extremity robotic exoskeleton training: Case studies for complete spinal cord injury walking.

    Science.gov (United States)

    Lemaire, Edward D; Smith, Andrew J; Herbert-Copley, Andrew; Sreenivasan, Vidya

    2017-01-01

    Recent advances in exoskeleton technology has made lower extremity powered exoskeletons (LEPE) a viable treatment tool to restore upright walking mobility to persons with spinal cord injury (SCI). Evaluate ARKE exoskeleton training within a rehabilitation centre environment. Case studies are presented for two male participants, age 41 and 30, motor complete SCI at T6 (N01) and T12 (N02), respectively, as they progress from new LEPE users to independent walking. The ARKE 2.0 LEPE (Bionik Laboratories Inc., Toronto, Canada) was used for all training (hip and knee powered, forearm crutches, control tablet). Data were collected on session times, activity metrics from ARKE system logs, and qualitative questionnaire feedback. N01 required 18, 30-minute training sessions to achieve independent walking. N01 walked independently within the 12 session target. Foot strikes were frequently before the end of the programmed swing phase, which were handled by the ARKE control system. Subjective ratings of LEPE learning, comfort, pain, fatigue, and overall experience were high for sitting-standing and moderate to high for walking. This reflected the complexity of learning to safely walk. Qualitative feedback supported the continuation of LEPE use in rehabilitation settings based on end-user desire for upright mobility.

  5. Lower-extremity resistance training on unstable surfaces improves proxies of muscle strength, power and balance in healthy older adults: a randomised control trial

    Directory of Open Access Journals (Sweden)

    Nils Eckardt

    2016-11-01

    Full Text Available Abstract Background It is well documented that both balance and resistance training have the potential to mitigate intrinsic fall risk factors in older adults. However, knowledge about the effects of simultaneously executed balance and resistance training (i.e., resistance training conducted on unstable surfaces [URT] on lower-extremity muscle strength, power and balance in older adults is insufficient. The objective of the present study was to compare the effects of machine-based stable resistance training (M-SRT and two types of URT, i.e., machine-based (M-URT and free-weight URT (F-URT, on measures of lower-extremity muscle strength, power and balance in older adults. Methods Seventy-five healthy community-dwelling older adults aged 65–80 years, were assigned to three intervention groups: M-SRT, M-URT and F-URT. Over a period of ten weeks, all participants exercised two times per week with each session lasting ~60 min. Tests included assessment of leg muscle strength (e.g., maximal isometric leg extension strength, power (e.g., chair rise test and balance (e.g., functional reach test, carried out before and after the training period. Furthermore, maximal training load of the squat-movement was assessed during the last training week. Results Maximal training load of the squat-movement was significantly lower in F-URT in comparison to M-SRT and M-URT. However, lower-extremity resistance training conducted on even and uneven surfaces meaningfully improved proxies of strength, power and balance in all groups. M-URT produced the greatest improvements in leg extension strength and F-URT in the chair rise test and functional reach test. Conclusion Aside from two interaction effects, overall improvements in measures of lower-extremity muscle strength, power and balance were similar across training groups. Importantly, F-URT produced similar results with considerably lower training load as compared to M-SRT and M-URT. Concluding, F-URT seems an

  6. "Extreme Programming" in a Bioinformatics Class

    Science.gov (United States)

    Kelley, Scott; Alger, Christianna; Deutschman, Douglas

    2009-01-01

    The importance of Bioinformatics tools and methodology in modern biological research underscores the need for robust and effective courses at the college level. This paper describes such a course designed on the principles of cooperative learning based on a computer software industry production model called "Extreme Programming" (EP).…

  7. Hand dominance in upper extremity musculoskeletal disorders.

    Science.gov (United States)

    Shiri, Rahman; Varonen, Helena; Heliövaara, Markku; Viikari-Juntura, Eira

    2007-05-01

    To investigate the role of hand dominance in common upper extremity musculoskeletal disorders (UEMSD) in a population study. The target population consisted of a representative sample of people aged 30 years or older residing in Finland during 2000-2001. Of the 7977 eligible subjects, 6254 (78.4%) were included in the study. The prevalence of UEMSD was as follows: rotator cuff tendinitis 3.8%, bicipital tendinitis 0.5%, lateral epicondylitis 1.1%, medial epicondylitis 0.3%, carpal tunnel syndrome (CTS) 3.8%, and surgery due to CTS 1.3%. CTS was 2.5 times as prevalent in women as men, whereas the other UEMSD were as common in both sexes. Rotator cuff and bicipital tendinitis and medial epicondylitis were more prevalent in the dominant arm only in women, whereas lateral epicondylitis was more prevalent in the dominant elbow in both sexes. The higher prevalence of rotator cuff and bicipital tendinitis in the dominant side persisted beyond working age. The prevalence of CTS did not differ by hand dominance. Dominant hand had been operated more frequently for CTS in women. Our findings show that UEMSD are more prevalent in the dominant than nondominant arm mainly in women. For shoulder tendinitis, the difference persists throughout adult age. Physical load factors may have long-lasting effects on the shoulder and they may play a greater role in women than men.

  8. Using Wearable Sensors and Machine Learning Models to Separate Functional Upper Extremity Use From Walking-Associated Arm Movements.

    Science.gov (United States)

    McLeod, Adam; Bochniewicz, Elaine M; Lum, Peter S; Holley, Rahsaan J; Emmer, Geoff; Dromerick, Alexander W

    2016-02-01

    To improve measurement of upper extremity (UE) use in the community by evaluating the feasibility of using body-worn sensor data and machine learning models to distinguish productive prehensile and bimanual UE activity use from extraneous movements associated with walking. Comparison of machine learning classification models with criterion standard of manually scored videos of performance in UE prosthesis users. Rehabilitation hospital training apartment. Convenience sample of UE prosthesis users (n=5) and controls (n=13) similar in age and hand dominance (N=18). Participants were filmed executing a series of functional activities; a trained observer annotated each frame to indicate either UE movement directed at functional activity or walking. Synchronized data from an inertial sensor attached to the dominant wrist were similarly classified as indicating either a functional use or walking. These data were used to train 3 classification models to predict the functional versus walking state given the associated sensor information. Models were trained over 4 trials: on UE amputees and controls and both within subject and across subject. Model performance was also examined with and without preprocessing (centering) in the across-subject trials. Percent correct classification. With the exception of the amputee/across-subject trial, at least 1 model classified >95% of test data correctly for all trial types. The top performer in the amputee/across-subject trial classified 85% of test examples correctly. We have demonstrated that computationally lightweight classification models can use inertial data collected from wrist-worn sensors to reliably distinguish prosthetic UE movements during functional use from walking-associated movement. This approach has promise in objectively measuring real-world UE use of prosthetic limbs and may be helpful in clinical trials and in measuring response to treatment of other UE pathologies. Copyright © 2016 American Congress of

  9. Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

    Science.gov (United States)

    Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

    2016-12-01

    Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

  10. The Effect of a Nine-Weeks Training Program on The Center of Pressure Indicators With Open and Closed Eyes Condition in the Elderly Male

    Directory of Open Access Journals (Sweden)

    Ahmad Gol Rafati

    2018-04-01

    Conclusion The lower extremity muscle resistance training improves the center of pressure, static balance and reduces the fall risk. It is suggested that planning sufficient physical activities and training among all age groups is necessary. Appropriate resistance training program can prevent balance disorders and falling among the elderly population.

  11. Effects of robotic-aided rehabilitation on recovery of upper extremity function in chronic stroke: a single case study.

    Science.gov (United States)

    Flinn, Nancy A; Smith, Jennifer L; Tripp, Christopher J; White, Matthew W

    2009-01-01

    The objective of the study was to examine the results of robotic therapy in a single client. A 48-year-old female client 15 months post-stroke, with right hemiparesis, received robotic therapy as an outpatient in a large Midwestern rehabilitation hospital. Robotic therapy was provided three times a week for 6 weeks. Robotic therapy consisted of goal-directed, robotic-aided reaching tasks to exercise the hemiparetic shoulder and elbow. No other therapeutic intervention for the affected upper extremity was provided during the study or 3 months follow-up period. The outcome measures included the Fugl-Meyer, graded Wolf motor function test (GWMFT), motor activity log, active range of motion and Canadian occupational performance measure. The participant made gains in active movement; performance; and satisfaction of functional tasks, GWMFT and functional use. Limitations involved in this study relate to the generalizability of the sample size, effect of medications, expense of robotic technologies and the impact of aphasia. Future research should incorporate functional use training along with robotic therapy.

  12. 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.

  13. DOE Radiological Control Manual Core Training Program

    International Nuclear Information System (INIS)

    Scott, H.L.; Maisler, J.

    1993-01-01

    Over the past year, the Department of Energy (DOE) Office of Health (EH-40) has taken a leading role in the development of new standardized radiological control training programs for use throughout the DOE complex. The Department promulgated its Radiological Control (RadCon) Manual in June 1992. To ensure consistent application of the criteria presented in the RadCon Manual, standardized radiological control core training courses and training materials have been developed for implementation at all DOE facilities. In producing local training programs, standardized core courses are to be supplemented with site-specific lesson plans, viewgraphs, student handbooks, qualification standards, question banks, and wallet-sized training certificates. Training programs for General Employee Radiological Training, Radiological Worker I and II Training, and Radiological Control Technician Training have been disseminated. Also, training committees under the direction of the Office of Health (EH-40) have been established for the development of additional core training courses, development of examination banks, and the update of the existing core training courses. This paper discusses the current activities and future direction of the DOE radiological control core training program

  14. 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

    -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...

  15. Transcranial direct current stimulation does not affect lower extremity muscle strength training in healthy individuals

    DEFF Research Database (Denmark)

    Maeda, Kazuhei; Yamaguchi, Tomofumi; Tatemoto, Tsuyoshi

    2017-01-01

    The present study investigated the effects of anodal transcranial direct current stimulation (tDCS) on lower extremity muscle strength training in 24 healthy participants. In this triple-blind, sham-controlled study, participants were randomly allocated to the anodal tDCS plus muscle strength...... training (anodal tDCS) group or sham tDCS plus muscle strength training (sham tDCS) group. Anodal tDCS (2 mA) was applied to the primary motor cortex of the lower extremity during muscle strength training of the knee extensors and flexors. Training was conducted once every 3 days for 3 weeks (7 sessions......). Knee extensor and flexor peak torques were evaluated before and after the 3 weeks of training. After the 3-week intervention, peak torques of knee extension and flexion changed from 155.9 to 191.1 Nm and from 81.5 to 93.1 Nm in the anodal tDCS group. Peak torques changed from 164.1 to 194.8 Nm...

  16. 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.

  17. Individualised and adaptive upper limb rehabilitation with industrial robot using dynamic movement primitives

    DEFF Research Database (Denmark)

    Nielsen, Jacob; Sørensen, Anders Stengaard; Christensen, Thomas Søndergaard

    Stroke is a leading cause of serious long-term disability. Post-stroke rehabilitation is a demanding task for the patient and a costly challenge for both society and healthcare systems. We present a novel approach for training of upper extremities after a stroke by utilising an industrial robotic...

  18. Effectiveness of Stellate Ganglion Block Under Fuoroscopy or Ultrasound Guidance in Upper Extremity CRPS.

    Science.gov (United States)

    Imani, Farnad; Hemati, Karim; Rahimzadeh, Poupak; Kazemi, Mohamad Reza; Hejazian, Kokab

    2016-01-01

    Stellate Ganglion Block (SGB) is an effective technique which may be used to manage upper extremities pain due to Chronic Regional Pain Syndrome (CRPS), in this study we tried to evaluate the effectiveness of this procedure under two different guidance for management of this syndrome. The purpose of this study was to evaluate the effectiveness of ultrsound guide SGB by comparing it with the furoscopy guided SGB in upper extermities CRPS patients in reducing pain & dysfuction of the affected link. Fourteen patients with sympathetic CRPS in upper extremities in a randomized method with block randomization divided in two equal groups (with ultrasound or fluoroscopic guidance). First group was blocked under fluoroscopic guidance and second group blocked under ultrasound guidance. After correct positioning of the needle, a mixture of 5 ml bupivacaine 0.25% and 1 mL of triamcinolone was injected. These data represent no meaningful statistical difference between the two groups in terms of the number of pain attacks before the blocks, a borderline correlation between two groups one week and one month after the block and a significant statistical correlation between two groups three month after the block. These data represent no meaningful statistical difference between the patients of any group in terms of the pain intensity (from one week to six months after block), p-value = 0.61. These data represent a meaningful statistical difference among patients of any group and between the two groups in terms of the pain intensity (before the block until six months after block), p-values were 0.001, 0.031 respectively. According the above mentioned data, in comparison with fluoroscopic guidance, stellate ganglion block under ultrasound guidance is a safe and effective method with lower complication and better improvement in patient's disability indexes.

  19. Upper Midwest Gap Analysis Program, Image Processing Protocol

    National Research Council Canada - National Science Library

    Lillesand, Thomas

    1998-01-01

    This document presents a series of technical guidelines by which land cover information is being extracted from Landsat Thematic Mapper data as part of the Upper Midwest Gap Analysis Program (UMGAP...

  20. Relationship between stress and pain in work-related upper extremity disorders: the hidden role of chronic multisymptom illnesses.

    Science.gov (United States)

    Clauw, Daniel J; Williams, David A

    2002-05-01

    Pain and fatigue are commonly associated with work-related upper extremity disorders. Occasionally these symptoms persist beyond a reasonable healing period. One potential explanation for prolonged symptom expression is the concurrent development of a stress-mediated illness or CMI (Chronic Multi-Symptom Illness). In such a scenario, the chronic regional pain and other symptoms that the individual is experiencing would be attributable to the CMI rather than to tissue damage or a biomechanical dysfunction of the upper-extremity. This article critically reviews the case definitions of the new class of CMI disorders and evaluates the existing evidence supporting centrally mediated physiological changes (e.g., sensory hypervigilance, dysautonomia) that manifest as symptoms of pain and fatigue in some individuals experiencing chronic stressors. While explanations for prolonged pain and fatigue have historically focused on mechanisms involving peripheral pathology or psychiatric explanations, ample evidences support the role of altered Central Nervous System function in accounting for symptom manifestation in CMI. A model is presented that unites seemingly disparate findings across numerous investigations and provides a framework for understanding how genetics, triggering events, stressors, and early life events can affect CNS activity. Resultant symptom expression (e.g., pain and fatigue) from central dysregulation would be expected to occur in a subset of individuals in the population, including a subset of individuals with work-related upper extremity disorders. Thus when symptoms such as pain and fatigue persist beyond a reasonable period, consideration of CMI and associated assessment and interventions focused on central mechanisms may be worthwhile.

  1. Cross-cultural adaptation and validation of the Japanese version of the Toronto Extremity Salvage Score (TESS) for patients with malignant musculoskeletal tumors in the upper extremities.

    Science.gov (United States)

    Akiyama, Toru; Uehara, Kosuke; Ogura, Koichi; Shinoda, Yusuke; Iwata, Shintaro; Saita, Kazuo; Tanzawa, Yoshikazu; Nakatani, Fumihiko; Yonemoto, Tsukasa; Kawano, Hirotaka; Davis, Aileen M; Kawai, Akira

    2017-01-01

    The Toronto Extremity Salvage Score (TESS) is a widely used disease-specific patient-completed questionnaire for the assessment of physical function in patients with musculoskeletal tumors; however, there had not been the validated Japanese version of the TESS. The aim of this study was to validate the Japanese version of the TESS in patients with musculoskeletal tumors in the upper extremity. After developing a Japanese version of the TESS, the questionnaire was administered to 53 patients to examine its reliability and validity in comparison with the Musculoskeletal Tumor Society (MSTS) scoring system and Short Form-36 (SF-36). Test-retest reliability with intraclass correlation coefficient (0.93) and internal consistency with Cronbach's alpha (0.90) were excellent. Factor analysis showed that the construct structure consisted of 3-item clusters, and the Akaike Information Criterion network also demonstrated that the items could be divided into 3 domains according to their content. The TESS strongly correlated with the MSTS rating scale (r = 0.750; P TESS had low correlations with the SF-36 mental health and role-emotional subscales and the MSTS scoring system manual dexterity domain. Our study suggests that the TESS is a reliable and valid instrument to measure patient-reported physical functioning in patients with upper extremity sarcoma. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  2. Facilitating mathematics learning for students with upper extremity disabilities using touch-input system.

    Science.gov (United States)

    Choi, Kup-Sze; Chan, Tak-Yin

    2015-03-01

    To investigate the feasibility of using tablet device as user interface for students with upper extremity disabilities to input mathematics efficiently into computer. A touch-input system using tablet device as user interface was proposed to assist these students to write mathematics. User-switchable and context-specific keyboard layouts were designed to streamline the input process. The system could be integrated with conventional computer systems only with minor software setup. A two-week pre-post test study involving five participants was conducted to evaluate the performance of the system and collect user feedback. The mathematics input efficiency of the participants was found to improve during the experiment sessions. In particular, their performance in entering trigonometric expressions by using the touch-input system was significantly better than that by using conventional mathematics editing software with keyboard and mouse. The participants rated the touch-input system positively and were confident that they could operate at ease with more practice. The proposed touch-input system provides a convenient way for the students with hand impairment to write mathematics and has the potential to facilitate their mathematics learning. Implications for Rehabilitation Students with upper extremity disabilities often face barriers to learning mathematics which is largely based on handwriting. Conventional computer user interfaces are inefficient for them to input mathematics into computer. A touch-input system with context-specific and user-switchable keyboard layouts was designed to improve the efficiency of mathematics input. Experimental results and user feedback suggested that the system has the potential to facilitate mathematics learning for the students.

  3. Mixing implants of differing metallic composition in the treatment of upper-extremity fractures.

    Science.gov (United States)

    Acevedo, Daniel; Loy, Bo Nasmyth; Loy, Bo Nasymuth; Lee, Brian; Omid, Reza; Itamura, John

    2013-09-01

    Mixing implants with differing metallic compositions has been avoided for fear of galvanic corrosion and subsequent failure of the implants and of bone healing. The purpose of this study was to evaluate upper-extremity fractures treated with open reduction and internal fixation with metallic implants that differed in metallic composition placed on the same bone. The authors studied the effects of using both stainless steel and titanium implants on fracture healing, implant failure, and other complications associated with this method of fixation. Their hypothesis was that combining these metals on the same bone would not cause clinically significant nonunions or undo clinical effects from galvanic corrosion. A retrospective review was performed of 17 patients with upper-extremity fractures fixed with metal implants of differing metallic compositions. The primary endpoint was fracture union. Eight clavicles, 2 proximal humeri, 3 distal humeri, 3 olecranons, and 1 glenoid fracture with an average follow-up 10 months were reviewed. All fractures healed. One patient experienced screw backout, which did not affect healing. This study implies that mixing implants with differing metallic compositions on the same bone for the treatment of fractures does not adversely affect bone healing. No evidence existed of corrosion or an increase in complications with this method of treatment. Contrary to prior belief, small modular hand stainless steel plates can be used to assist in reduction of smaller fracture fragments in combination with anatomic titanium plates to obtain anatomic reduction of the fracture without adversely affecting healing. Copyright 2013, SLACK Incorporated.

  4. Wireless peripheral nerve stimulation for complex regional pain syndrome type I of the upper extremity: a case illustration introducing a novel technology.

    Science.gov (United States)

    Herschkowitz, Daniel; Kubias, Jana

    2018-04-13

    Complex regional pain syndrome (CRPS) is a debilitating painful disorder, cryptic in its pathophysiology and refractory condition with limited therapeutic options. Type I CRPS with its variable relationship to trauma has often no discernible fractures or nerve injuries and remains enigmatic in its response to conservative treatment as well as the other limited interventional therapies. Neuromodulation in the form of spinal cord and dorsal root ganglion stimulation (SCS, DRGS) has shown encouraging results, especially of causalgia or CRPS I of lower extremities. Upper extremity CRPS I is far more difficult. To report a case of upper extremity CRPS I treated by wireless peripheral nerve stimulation (WPNS) for its unique features and minimally invasive technique. The system does not involve implantation of battery or its connections. A 47 year old female patient presented with refractory CRPS I following a blunt trauma to her right forearm. As interventional treatment in the form of local anesthetics (Anesthesia of peripheral branches of radial nerve) and combined infusions of ketamine/lidocaine failed to provide any significant relief she opted for WPNS treatment. Based on the topographic distribution, two electrodes (Stimwave Leads: FR4A-RCV-A0 with tines, Generation 1 and FR4A-RCV-B0 with tines, Generation 1), were placed along the course of radial and median nerves under ultrasonography monitoring and guided by intraoperative stimulation. This procedure did not involve implantation of extension cables or the power source. At a frequency of 60 Hz and 300 μs the stimulation induced paresthesia along the distribution of the nerves. Therapeutic relief was observed with high frequency (HF) stimulation (HF 10 kHz/32 μs, 2.0 mA) reducing her pain from a visual analogue scale (VAS) score of 7-4 postoperatively. Three HF stimulations programs were provided at the time of discharge, as she improved in her sensory impairment to touch, pressure and temperature at her first

  5. Improving the Teaching Skills of Residents in a Surgical Training Program: Results of the Pilot Year of a Curricular Initiative in an Ophthalmology Residency Program.

    Science.gov (United States)

    Chee, Yewlin E; Newman, Lori R; Loewenstein, John I; Kloek, Carolyn E

    2015-01-01

    To design and implement a teaching skills curriculum that addressed the needs of an ophthalmology residency training program, to assess the effect of the curriculum, and to present important lessons learned. A teaching skills curriculum was designed for the Harvard Medical School (HMS) Residency Training Program in Ophthalmology. Results of a needs assessment survey were used to guide curriculum objectives. Overall, 3 teaching workshops were conducted between October 2012 and March 2013 that addressed areas of need, including procedural teaching. A postcurriculum survey was used to assess the effect of the curriculum. Massachusetts Eye and Ear Infirmary, a tertiary care institution in Boston, MA. Overall, 24 residents in the HMS Residency Training Program in Ophthalmology were included. The needs assessment survey demonstrated that although most residents anticipated that teaching would be important in their future career, only one-third had prior formal training in teaching. All residents reported they found the teaching workshops to be either very or extremely useful. All residents reported they would like further training in teaching, with most residents requesting additional training in best procedural teaching practices for future sessions. The pilot year of the resident-as-teacher curriculum for the HMS Residency Training Program in Ophthalmology demonstrated a need for this curriculum and was perceived as beneficial by the residents, who reported increased comfort in their teaching skills after attending the workshops. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Customer Satisfaction with Training Programs.

    Science.gov (United States)

    Mulder, Martin

    2001-01-01

    A model for evaluating customer satisfaction with training programs was tested with training purchasers. The model confirmed two types of projects: training aimed at achieving learning results and at changing job performance. The model did not fit for training intended to support organizational change. (Contains 31 references.) (SK)

  7. Supervisor's role in training programs as a manager of learning program

    Directory of Open Access Journals (Sweden)

    2011-06-01

    Full Text Available According to the training literature, a supervisor's role in training programs has two major elements: supervisor support and supervisor communication. The ability of supervisors to play effective roles in training programs may increase employees' motivation to learn. The nature of this relationship is interesting, but the role of supervisor's role as a predicting variable is less emphasized in a training program models. Therefore, this study was conducted to examine the effect of supervisor's role in training programs on motivation to learn using 152 usable questionnaires gathered from non-academic employees who have worked in a technological based public university, Malaysia. The outcomes of stepwise regression analysis showed that the supervisor support and supervisor communication significantly associated with motivation to learn. Statistically, this result demonstrates that supervisor's role in training programs does act as an important predictor of motivation to learn in the organizational sample. In addition, discussion, implication and conclusion are elaborated.

  8. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    DEFF Research Database (Denmark)

    Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul

    2013-01-01

    's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. METHODS: This is a prospective study...

  9. Gram stain microbiological pattern of upper extremities suppuration at Baptist Medical Centre, Ogbomoso Nigeria: a fifteen month review.

    Science.gov (United States)

    Oke, A J; Olaolorun, D A; Meier, D E; Tarpley, J L

    2011-06-01

    Sixty-eight (68) patients with serious upper extremity suppurative infections, presenting within a period of fifteen (15) months, were prospectively studied clinically, Gram stain of aspirates/pus were performed, specimen cultured, planted, and where indicated glucose levels and haemoglobin genotype determined. Half of the patients had hand infections. Staphylococcus aureus was isolated from thirty-nine (39) patients. Gram Negative bacilli, including Salmonella were more isolated from patients with diabetes mellitus or Hgb SS or SC. The Gram stain results correlated with the culture result 90%. When Gram Positive cocci were demonstrated in the primary microscopic examination, cultures were not mandatory. When no organism was demonstrated on primary Gram stain or the patient was diabetic or a sickler, cultures of the specimens were done. The Gram stain, well performed, remains a useful, inexpensive, technologically appropriate laboratory test for abetting decision making in patients with upper extremity suppurative infections. Organisms encountered in this study included: Staphylococcus aureus, Streptococcus pyogenes, Salmonella typhi, Proteus mirabilis, Pseudomonas aeruginosa, and Coliforms.

  10. Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.

    Science.gov (United States)

    Feuerstein, Michael; Huang, Grant D; Ortiz, Jose M; Shaw, William S; Miller, Virginia I; Wood, Patricia M

    2003-08-01

    An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills.

  11. Pulse monitor for upper extremities dosimetry in nuclear medicine

    International Nuclear Information System (INIS)

    Cledison de Jesus, Cunha; Divanizia do Nascimento, Souza

    2006-01-01

    In the manipulation of radioactive materials in Nuclear Medicine service the body parts of workers that are more displayed to the ionizing radiation are hands, underarm and arm. Therefore is necessary to developing personal dosimeters to monitoring of easy reproduction and low cost with purpose to determine the doses level radiation received by the worker in these extremities. However thermoluminescent dosimeters do not provide an instantaneous exposure reading, they are suitable for personal dosimetry because of their following advantages: wide useful dose range, small physical size and no need for high voltage or cables, i.e. stand alone character. The aim of this work is to investigation of a new pulse monitor, that has been developing with thermoluminescent detectors of CaSO 4 :Dy (TLD) using a small plate of acrylic, perforated cardboard to deposit the TLD. This set was involved in plastic to protect from humidity and other harmful ambient factors; moreover, a bracelet was inserted, adaptable for any worker. During the preparation of the personal dosimeters to monitor exposure it was necessary to verify their effectiveness to use by workers in a nuclear medicine service. The monitors have been submitted to procedures of performance evaluations by several tests: badges homogeneity, reproducibility, linearity, low detection limit, auto-irradiation, dosimeters stability, verification of the residual T.L. signal, visible light effect on dosimeters, energetic and angular dependence and TLD answer by influence of a simulator during radiation. Was possible to verify the efficiency of such upper extremities dosimeters and were obtained satisfactory results within of the limits demanded in the described tests above to this type of personal dosimeters. (authors)

  12. 25 CFR 26.30 - Does the Job Training Program provide part-time training or short-term training?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does the Job Training Program provide part-time training or short-term training? 26.30 Section 26.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.30 Does the Job Training...

  13. 14 CFR 121.407 - Training program: Approval of airplane simulators and other training devices.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training program: Approval of airplane... Program § 121.407 Training program: Approval of airplane simulators and other training devices. (a) Each airplane simulator and other training device that is used in a training course permitted under § 121.409...

  14. Physical Therapy Intervention to Augment Outcomes Of Lymph Node Transfer Surgery for a Breast Cancer Survivor with Secondary Upper Extremity Lymphedema: A Case Report.

    Science.gov (United States)

    McKey, Katelyn P; Alappattu, Meryl J

    Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one's own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient's main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema. A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery. At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth. The patient's smallest upper extremity volumes were documented before the operation after two

  15. Feasibility of an Exoskeleton-Based Interactive Video Game System for Upper Extremity Burn Contractures.

    Science.gov (United States)

    Schneider, Jeffrey C; Ozsecen, Muzaffer Y; Muraoka, Nicholas K; Mancinelli, Chiara; Della Croce, Ugo; Ryan, Colleen M; Bonato, Paolo

    2016-05-01

    Burn contractures are common and difficult to treat. Measuring continuous joint motion would inform the assessment of contracture interventions; however, it is not standard clinical practice. This study examines use of an interactive gaming system to measure continuous joint motion data. To assess the usability of an exoskeleton-based interactive gaming system in the rehabilitation of upper extremity burn contractures. Feasibility study. Eight subjects with a history of burn injury and upper extremity contractures were recruited from the outpatient clinic of a regional inpatient rehabilitation facility. Subjects used an exoskeleton-based interactive gaming system to play 4 different video games. Continuous joint motion data were collected at the shoulder and elbow during game play. Visual analog scale for engagement, difficulty and comfort. Angular range of motion by subject, joint, and game. The study population had an age of 43 ± 16 (mean ± standard deviation) years and total body surface area burned range of 10%-90%. Subjects reported satisfactory levels of enjoyment, comfort, and difficulty. Continuous joint motion data demonstrated variable characteristics by subject, plane of motion, and game. This study demonstrates the feasibility of use of an exoskeleton-based interactive gaming system in the burn population. Future studies are needed that examine the efficacy of tailoring interactive video games to the specific joint impairments of burn survivors. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. AExaCTT - Aerobic Exercise and Consecutive Task-specific Training for the upper limb after stroke: Protocol for a randomised controlled pilot study.

    Science.gov (United States)

    Valkenborghs, Sarah R; Visser, Milanka M; Dunn, Ashlee; Erickson, Kirk I; Nilsson, Michael; Callister, Robin; van Vliet, Paulette

    2017-09-01

    Motor function may be enhanced if aerobic exercise is paired with motor training. One potential mechanism is that aerobic exercise increases levels of brain-derived neurotrophic factor (BDNF), which is important in neuroplasticity and involved in motor learning and motor memory consolidation. This study will examine the feasibility of a parallel-group assessor-blinded randomised controlled trial investigating whether task-specific training preceded by aerobic exercise improves upper limb function more than task-specific training alone, and determine the effect size of changes in primary outcome measures. People with upper limb motor dysfunction after stroke will be allocated to either task-specific training or aerobic exercise and consecutive task-specific training. Both groups will perform 60 hours of task-specific training over 10 weeks, comprised of 3 × 1 hour sessions per week with a therapist and 3 × 1 hours of home-based self-practice per week. The combined intervention group will also perform 30 minutes of aerobic exercise (70-85%HR max ) immediately prior to the 1 hour of task-specific training with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events will be recorded. Clinical outcome measures will be performed pre-randomisation at baseline, at completion of the training program, and at 1 and 6 months follow-up. Primary clinical outcome measures will be the Action Research Arm Test (ARAT) and the Wolf Motor Function Test (WMFT). If aerobic exercise prior to task-specific training is acceptable, and a future phase 3 randomised controlled trial seems feasible, it should be pursued to determine the efficacy of this combined intervention for people after stroke.

  17. Tactical Vulnerability Assessment Training Program

    International Nuclear Information System (INIS)

    Al-Ayat, R.A.; Judd, B.R.; Renis, T.A.; Paulus, W.K.; Winblad, A.G.; Graves, B.R.

    1987-01-01

    The Department of Energy sponsors a 9-day training program for individuals who are responsible for evaluating and planning safeguards systems and for preparing DOE Master and Security Agreements (MSSAs). These agreements between DOE headquarters and operations offices establish required levels of protection. The curriculum includes: (1) the nature of potential insider and outsider threats involving theft or diversion of special nuclear material, (2) use of computerized tools for evaluating the effectiveness of physical protection and material control and accountability systems, and (3) methods for analyzing the benefits and costs of safeguards improvements and for setting priorities among proposed upgrades. The training program is varied and high interactive. Presentations are intermixed with class discussions and ''hands-on'' analysis using computer tools. At the end of the program, participants demonstrate what they have learned in a two-and-one-half day ''field exercise,'' which is conducted on a facility scale-model. The training program has been conducted six times and has been attended by representatives of all DOE facilities. Additional sessions are planned at four-month intervals. This paper describes the training program, use of the tools in preparing MSSAs for various DOE sites, and recent extensions and refinements of the evaluation tools

  18. Tactical Vulnerability Assessment Training Program

    International Nuclear Information System (INIS)

    Al-Ayat, R.A.; Judd, B.R.; Renis, T.A.; Paulus, W.K.; Winblad, A.E.; Graves, B.R.

    1987-01-01

    The Department of Energy sponsors a 9-day training program for individual who are responsible for evaluating and planning safeguards systems and for preparing DOE Master and Security Agreements (MSSAs). These agreements between DOE headquarters and operations offices establish required levels of protection. The curriculum includes: (1) the nature of potential insider and outsider threats involving theft or diversion of special nuclear material, (2) use of computerized tools for evaluating the effectiveness of physical protection and material control and acoountability systems, and (3) methods for analyzing the benefits and costs of safeguards improvements and for setting priorities among proposed upgrades. The training program is varied and highly interactive. Presentations are intermixed with class discussions and ''hands-on'' analysis using computer tools. At the end of the program, participants demonstrate what they have learned in a two-and-one-half day ''field excercise,'' which is conducted on a facility scale-model. The training programs has been conducted six times and has been attended by representatives of all DOE facilities. Additional sessions are planned at four-month intervals. This paper describes the training program, use of the tools in preparing MSSAs for various DOE sites, and recent extensions and refinements of the evaluation tools

  19. Creatine supplementation elicits greater muscle hypertrophy in upper than lower limbs and trunk in resistance-trained men.

    Science.gov (United States)

    Nunes, João Pedro; Ribeiro, Alex S; Schoenfeld, Brad J; Tomeleri, Crisieli M; Avelar, Ademar; Trindade, Michele Cc; Nabuco, Hellen Cg; Cavalcante, Edilaine F; Junior, Paulo Sugihara; Fernandes, Rodrigo R; Carvalho, Ferdinando O; Cyrino, Edilson S

    2017-12-01

    Creatine (Cr) supplementation associated with resistance training produces greater muscular strength improvements in the upper compared with the lower body; however, no study has investigated if such region-specific results are seen with gains in muscle mass. We aimed to evaluate the effect of Cr supplementation in combination with resistance training on lean soft tissue changes in the upper and lower limbs and trunk in resistance-trained young adult men. In a randomized, double-blind and placebo-controlled design, 43 resistance-trained men (22.7 ± 3.0 years, 72.9 ± 8.7 kg, 177.9 ± 5.7 cm, 23.0 ± 2.5 kg/m 2 ) received either creatine (Cr, n = 22) or placebo (PLA, n = 21) over an 8-week study period. The supplementation protocol included a loading phase (7 days, four doses of 0.3 g/kg per day) and a maintenance phase (7 weeks, single dose of 0.03 g/kg per day). During the same period, subjects performed resistance training four times per week using the following two-way split routine: Monday and Thursday = pectoral, shoulders, triceps, and abdomen, Tuesday and Friday = back, biceps, thighs, and calves. Lean soft tissue of the upper limbs (ULLST), lower limbs (LLLST), and trunk (TLST) was assessed by dual-energy X-ray absorptiometry before and after the intervention. Both groups showed significant ( p hypertrophy (ULLST = 1.6 ± 3.0%; LLLST = 0.7 ± 2.8%; TLST = 0.7 ± 2.8%). Our results suggest that Cr supplementation can positively augment muscle hypertrophy in resistance-trained young adult men, particularly in the upper limbs.

  20. Observed changes in extremes of daily rainfall and temperature in Jemma Sub-Basin, Upper Blue Nile Basin, Ethiopia

    Science.gov (United States)

    Worku, Gebrekidan; Teferi, Ermias; Bantider, Amare; Dile, Yihun T.

    2018-02-01

    Climate variability has been a threat to the socio-economic development of Ethiopia. This paper examined the changes in rainfall, minimum, and maximum temperature extremes of Jemma Sub-Basin of the Upper Blue Nile Basin for the period of 1981 to 2014. The nonparametric Mann-Kendall, seasonal Mann-Kendall, and Sen's slope estimator were used to estimate annual trends. Ten rainfall and 12 temperature indices were used to study changes in rainfall and temperature extremes. The results showed an increasing trend of annual and summer rainfall in more than 78% of the stations and a decreasing trend of spring rainfall in most of the stations. An increase in rainfall extreme events was detected in the majority of the stations. Several rainfall extreme indices showed wetting trends in the sub-basin, whereas limited indices indicated dryness in most of the stations. Annual maximum and minimum temperature and extreme temperature indices showed warming trend in the sub-basin. Presence of extreme rainfall and a warming trend of extreme temperature indices may suggest signs of climate change in the Jemma Sub-Basin. This study, therefore, recommended the need for exploring climate induced risks and implementing appropriate climate change adaptation and mitigation strategies.

  1. Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors.

    Science.gov (United States)

    Wolff, Margaret S; Rhodes, Erinn T; Ludwig, David S

    2010-02-17

    Information about the availability and effectiveness of childhood obesity training during residency is limited. We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. The response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%), diagnosis (N = 282, 94.3%), diagnosis of complications (N = 249, 83.3%), and treatment (N = 242, 80.9%). However, only 18.1% (N = 54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p obesity training was competing curricular demands (58.5%). While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

  2. [Training program in endourological surgery. Future perspectives.

    Science.gov (United States)

    Soria, Federico; Villacampa, Felipe; Serrano, Alvaro; Moreno, Jesús; Rioja, Jorge; Sánchez, Francisco Miguel

    2018-01-01

    Current training in urological endoscopy lacks a specific training program. However, there is a clear need for a specific and uniform program, which will ensure the training, regardless of the unit where it is carried out. So, the goal is to first evaluate the current model and then bring improvements for update. The hospital training accreditation programme are only the adjustment of the official program of the urology specialty to the specific circumstances of each center, which causes variability in training of residents. After reviewing 19 training programs belonging to 12 Spanish regions. The current outlook shows that scarcely 10% of hospitals quantify the number of procedures/ year, although the Spanish program emphasizes that the achievement of the residents should be quantified. Urology residents, sense their training as inadequate and therefore their level of satisfaction is moderate. The three main problems detected by residents as an obstacle on their training are: the lack of supervision, tutors completing their own learning. Finally, the lack of quantification in surgical activities is described as a threat. This has no easy solution, since the learning curve of the most common techniques in endourology is not correctly established. Regarding aspects that can improve the current model, they highlight the need to design a specific program. The need to customize the training, the ineludible accreditation of tutors and obviously dignify the tutor's teaching activity. Another basic aspect is the inclusion of new technologies as training tools, e-learning. As well as the implementation of an adequate competency assessment plan and the possibility of relying on simulation systems. Finally, they highlight the need to attend monographic meetings and external clinic rotations to promote critical training.

  3. Training Program Handbook: A systematic approach to training

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-01

    This DOE handbook describes a systematic method for establishing and maintaining training programs that meet the requirements and expectations of DOE Orders 5480.18B and 5480.20. The systematic approach to training includes 5 phases: Analysis, design, development, implementation, and evaluation.

  4. Prevalence of Injuries during Brazilian Jiu-Jitsu Training

    Directory of Open Access Journals (Sweden)

    Alex R. McDonald

    2017-06-01

    Full Text Available Brazilian jiu-jitsu (BJJ is a martial art that focuses on groundwork, joint locks, and chokeholds. The purpose of this study is to determine the prevalence of injuries sustained during BJJ training. A 27-question research survey was e-mailed to 166 BJJ gyms in the United States. Demographic information, belt level, weight class, training hours, competition experience, and injury prevalence data were collected. The majority of respondents were Caucasian (n = 96 males (n = 121 with an average age of 30.3 years. Overall, the most common injury locations were to the hand and fingers (n = 70, foot and toes (n = 52, and arm and elbow (n = 51. The most common medically diagnosed conditions were skin infections (n = 38, injuries to the knee (n =26, and foot and toes (n = 19. The most common non-medically diagnosed injuries occurred to the hand and fingers (n = 56, arm and elbow (n = 40, and foot and toes (n = 33. In general, athletes were more likely to sustain distal rather than proximal injuries. Athletes reported more frequent medically diagnosed injuries to the lower extremity and more frequent self-diagnosed injuries to the upper extremity. Upper extremity injuries appear to be more frequent but less severe than lower extremity injuries with the opposite being true for lower extremity injuries.

  5. Radiological control technician: Training program management manual

    International Nuclear Information System (INIS)

    1992-10-01

    This manual defines and describes the DOE Radiological Control Technician Core Training Program qualification and training process, material development requirements, standards and policies, and administration. The manual applies to Radiological Control Technician Training Programs at all DOE contractor sites

  6. A Bilevel Programming Model to Optimize Train Operation Based on Satisfaction for an Intercity Rail Line

    Directory of Open Access Journals (Sweden)

    Zhipeng Huang

    2014-01-01

    Full Text Available The passenger travel demands for intercity rail lines fluctuate obviously during different time periods, which makes the rail departments unable to establish an even train operation scheme. This paper considers an optimization problem for train operations which respond to passenger travel demands of different periods in intercity rail lines. A satisfactory function of passenger travelling is proposed by means of analyzing the passengers’ travel choice behavior and correlative influencing factors. On this basis, the paper formulates a bilevel programming model which maximizes interests of railway enterprises and travelling satisfaction of each passenger. The trains operation in different periods can be optimized through upper layer planning of the model, while considering the passenger flow distribution problem based on the Wardrop user equilibrium principle in the lower layer planning. Then, a genetic algorithm is designed according to model features for solving the upper laying. The Frank-Wolfe algorithm is used for solving the lower layer planning. Finally, a numerical example is provided to demonstrate the application of the method proposed in this paper.

  7. Unilateral versus bilateral upper limb training after stroke: the ULTRA-Stroke clinical trial

    NARCIS (Netherlands)

    van Delden, A.E.Q.; Peper, C.E.; Nienhuys, K.; Zijp, N.I.; Beek, P.J.; Kwakkel, G.

    2013-01-01

    Background and Purpose - Unilateral and bilateral training protocols for upper limb rehabilitation after stroke represent conceptually contrasting approaches with the same ultimate goal. In a randomized controlled trial, we compared the merits of modified constraint-induced movement therapy,

  8. Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.

    Science.gov (United States)

    Grobet, Cécile; Marks, Miriam; Tecklenburg, Linda; Audigé, Laurent

    2018-04-13

    The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as

  9. Short-term high intensity plyometric training program improves strength, power and agility in male soccer players.

    Science.gov (United States)

    Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

    2013-03-01

    The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 - 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer.

  10. Short-Term High Intensity Plyometric Training Program Improves Strength, Power and Agility in Male Soccer Players

    Science.gov (United States)

    Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

    2013-01-01

    The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 – 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer. PMID:23717351

  11. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

    Science.gov (United States)

    Asselin, Pierre K.; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M.

    2016-01-01

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment. PMID:27340808

  12. Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review

    NARCIS (Netherlands)

    Basteris, A.; Nijenhuis, S.M.; Stienen, Arno; Buurke, Jaap; Prange, Grada Berendina; Amirabdollahian, F

    2014-01-01

    Robot-mediated post-stroke therapy for the upper-extremity dates back to the 1990s. Since then, a number of robotic devices have become commercially available. There is clear evidence that robotic interventions improve upper limb motor scores and strength, but these improvements are often not

  13. Influence of upper extremity positioning on pain, paresthesia, and tolerance: advancing current practice.

    Science.gov (United States)

    Lester, Mark E; Hazelton, Jill; Dewey, William S; Casey, James C; Richard, Reginald

    2013-01-01

    Loss of upper extremity motion caused by axillary burn scar contracture is a major complication of burn injury. Positioning acutely injured patients with axillary burns in positions above 90° of shoulder abduction may improve shoulder motion and minimize scar contracture. However, these positions may increase injury risk to the nerves of the brachial plexus. This study evaluated the occurrence of paresthesias, pain, and positional intolerance in four shoulder abduction positions in healthy adults. Sixty men and women were placed in four randomly assigned shoulder abduction positions for up to 2 hours: 1) 90° with elbow extension (90 ABD); 2) 130° with elbow flexion at 110° (130 ABD); 3) 150° with elbow extension (150 ABD); and 4) 170° with elbow extension (170 ABD). Outcome measures were assessed at baseline and every 30 minutes and included the occurrence of upper extremity paresthesias, position comfort/tolerance, and pain. Transient paresthesias, lasting less than 3 minutes, occurred in all test positions in 10 to 37% of the cases. Significantly fewer subjects reported paresthesias in the 90 ABD position compared with the other positions (P < .01). Pain was reported more frequently in the 170° position (68%) compared with the other positions (P < .01). Positioning with the elbow flexed or in terminal extension is not recommended, regardless of the degree of shoulder abduction. Positioning patients in a position of 150° of shoulder abduction was shown to be safe and well tolerated. Consideration of positions above this range should be undertaken cautiously and only with strict monitoring in alert and oriented patients for short time periods.

  14. Patients’ and Health Professionals’ Experiences of Using Virtual Reality Technology for Upper Limb Training after Stroke:

    DEFF Research Database (Denmark)

    Pallesen, Hanne; Andersen, Mette Brændstrup; Hansen, Gunhild Mo

    2018-01-01

    Background. In recent years, virtual reality (VR) therapy systems for upper limb training after stroke have been increasingly used in clinical practice.Therapy systems employing VR technology can enhance the intensity of training and can also boost patients’ motivation by adding a playful element...... to therapy. However, reports on user experiences are still scarce. Methods. A qualitative investigation of patients’ and therapists’ perspectives on VR upper limb training. Semistructured face-to-face interviews were conducted with six patients in the final week of the VR intervention.Therapists participated......) engagement, (iii) perceived improvements, (iv) individualization, and (v) device malfunction. The health professionals described the same themes as the patients but less positively, emphasizing negative technical challenges. Conclusion. Patients and therapists mainly valued the intensive and motivational...

  15. Play Therapy Training among School Psychology, Social Work, and School Counseling Graduate Training Programs

    Science.gov (United States)

    Pascarella, Christina Bechle

    2012-01-01

    This study examined play therapy training across the nation among school psychology, social work, and school counseling graduate training programs. It also compared current training to previous training among school psychology and school counseling programs. A random sample of trainers was selected from lists of graduate programs provided by…

  16. Evaluation of training programs: A pragmatic perspective

    International Nuclear Information System (INIS)

    Wilkinson, J.D.

    1996-01-01

    The Canadian nuclear regulatory agency endorses the Systematic Approach to Training (SAT) as the most reliable method of providing effective, efficient training to Nuclear Power Plant (NPP) personnel. However the benefits of SAT cannot be realized unless all five phases of SAT are implemented. This is particularly true with respect to evaluation. Although each phase of SAT builds on the preceding one, the evaluation phase continuously feeds back into each of the others and also provides the means to verify the entire training programme building process. It is useful, therefore, to examine the issues relating to the what, why, who, when and how of training programme evaluation. ''What'' identifies the various aspects of the training programme to be evaluated, including the need for training, the training standard, the task list, trainer competence, test results, training results, program acceptance and numerous indicators that identify a need for evaluation. ''Why'' addresses legal and regulatory aspects, resource management, worker and public safety, worker and trainer competence and morale, and the cost/benefit of the training program. ''Who'' examines the need to involve trainers, trainees, plant subject matter experts (SMEs), and both plant and training centre supervisory and management staff. ''When'' addresses time-related concerns such as the importance of ensuring at the outset that the training program is actually needed, the necessity of responding promptly to local, national and world events, changes in legal and regulatory responsibilities, and the overriding importance of timely, routine training program evaluations. ''How'' describes the process of conducting a training program evaluation, and addresses the relationships of these five aspects of evaluation to each other. (author). 10 refs

  17. 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.

  18. Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke

    Science.gov (United States)

    2012-01-01

    This study, conducted in a group of nine chronic patients with right-side hemiparesis after stroke, investigated the effects of a robotic-assisted rehabilitation training with an upper limb robotic exoskeleton for the restoration of motor function in spatial reaching movements. The robotic assisted rehabilitation training was administered for a period of 6 weeks including reaching and spatial antigravity movements. To assess the carry-over of the observed improvements in movement during training into improved function, a kinesiologic assessment of the effects of the training was performed by means of motion and dynamic electromyographic analysis of reaching movements performed before and after training. The same kinesiologic measurements were performed in a healthy control group of seven volunteers, to determine a benchmark for the experimental observations in the patients’ group. Moreover degree of functional impairment at the enrolment and discharge was measured by clinical evaluation with upper limb Fugl-Meyer Assessment scale (FMA, 0–66 points), Modified Ashworth scale (MA, 0–60 pts) and active ranges of motion. The robot aided training induced, independently by time of stroke, statistical significant improvements of kinesiologic (movement time, smoothness of motion) and clinical (4.6 ± 4.2 increase in FMA, 3.2 ± 2.1 decrease in MA) parameters, as a result of the increased active ranges of motion and improved co-contraction index for shoulder extension/flexion. Kinesiologic parameters correlated significantly with clinical assessment values, and their changes after the training were affected by the direction of motion (inward vs. outward movement) and position of target to be reached (ipsilateral, central and contralateral peripersonal space). These changes can be explained as a result of the motor recovery induced by the robotic training, in terms of regained ability to execute single joint movements and of improved interjoint coordination of

  19. Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke

    Directory of Open Access Journals (Sweden)

    Frisoli Antonio

    2012-06-01

    Full Text Available Abstract This study, conducted in a group of nine chronic patients with right-side hemiparesis after stroke, investigated the effects of a robotic-assisted rehabilitation training with an upper limb robotic exoskeleton for the restoration of motor function in spatial reaching movements. The robotic assisted rehabilitation training was administered for a period of 6 weeks including reaching and spatial antigravity movements. To assess the carry-over of the observed improvements in movement during training into improved function, a kinesiologic assessment of the effects of the training was performed by means of motion and dynamic electromyographic analysis of reaching movements performed before and after training. The same kinesiologic measurements were performed in a healthy control group of seven volunteers, to determine a benchmark for the experimental observations in the patients’ group. Moreover degree of functional impairment at the enrolment and discharge was measured by clinical evaluation with upper limb Fugl-Meyer Assessment scale (FMA, 0–66 points, Modified Ashworth scale (MA, 0–60 pts and active ranges of motion. The robot aided training induced, independently by time of stroke, statistical significant improvements of kinesiologic (movement time, smoothness of motion and clinical (4.6 ± 4.2 increase in FMA, 3.2 ± 2.1 decrease in MA parameters, as a result of the increased active ranges of motion and improved co-contraction index for shoulder extension/flexion. Kinesiologic parameters correlated significantly with clinical assessment values, and their changes after the training were affected by the direction of motion (inward vs. outward movement and position of target to be reached (ipsilateral, central and contralateral peripersonal space. These changes can be explained as a result of the motor recovery induced by the robotic training, in terms of regained ability to execute single joint movements and of improved

  20. Excisional biopsy of suspected benign soft tissue tumors of the upper extremity: correlation between preoperative diagnosis and actual pathology

    NARCIS (Netherlands)

    Sluijmer, Heleen C. E.; Becker, Stéphanie J. E.; Bossen, Jeroen K. J.; Ring, David

    2014-01-01

    Tumors of the upper extremity are common and mostly benign. However, the prevalence of discordant diagnosis of a solid hand tumor is less studied. The objectives of this retrospective study were (1) to determine the proportion of patients with a different (discrepant or discordant) pathological

  1. BLENDED LEARNING STRATEGY IN TEACHER TRAINING PROGRAMS

    Directory of Open Access Journals (Sweden)

    Marian F. Byrka

    2017-12-01

    Full Text Available The article examines the implementation of blended learning strategy in teacher training programs as an innovation in online learning. The blended learning idea comes from blending elements which use online technology with more traditional face-to-face teaching in the same course. The article analyses teacher training programs offered by Chernivtsi Regional Institute of Postgraduate Pedagogical Education. Additional data were gathered through a questionnaire administered to teachers who attended training courses. The characteristics of blended learning strategy, its benefits and limitations for teacher training are supported by a review of literature. The article closes with the comparison of curriculum components (content delivery, learner activities, materials, and required competences between traditional and blended learning teacher training programs. Having obvious benefits in teacher training programs, the implementation of blended learning strategy sets some additional requirements to a learner, as well as to course instructors and lectors.

  2. Plant services (maintenance) foreman training. Inception to implementation

    International Nuclear Information System (INIS)

    Dunlap, M.S.

    1991-01-01

    Training content and time allocated for training have become essential and auditable commodities. This additional awareness, by upper management, has increased the pressure on training organizations to demonstrate effective and efficient programs. Structured program design and administration can assist training organizations in meeting these requirements and assuring a quality program. Sequential development of the job analysis, qualification standard, associated lesson plans, and a methodology for tracking program changes which affect the system, are all required components in a systematic approach to training. This paper addresses these facets in establishing a training program. It describes the methods utilized, problems identified and resolved as they occurred in the development of the Westinghouse Idaho Nuclear Company (WINCO) Plant Services (Maintenance) Foreman Training Program

  3. A telescope for observation from space of extreme lightnings in the upper atmosphere

    International Nuclear Information System (INIS)

    Nam, S.; Artikova, S.; Chung, T.; Garipov, G.; Jeon, J.A.; Jeong, S.; Jin, J.Y.; Khrenov, B.A.; Kim, J.E.; Kim, M.; Kim, Y.K.; Klimov, P.; Lee, J.; Lee, H.Y.; Na, G.W.; Oh, S.J.; Panasyuk, M.; Park, I.H.; Park, J.H.; Park, Y.-S.

    2008-01-01

    A new type of telescope with a wide field-of-view and functions of fast zoom-in has been introduced. Two kinds of MEMS (Micro-Electro-Mechanical Systems) micromirrors, digital and analog, are used for reflectors of the telescope, placed at different focal lengths. We apply this technology to the observation from space of TLE (Transient Luminous Events), extremely large transient sparks occurring at the upper atmosphere. TLE are one type of important backgrounds to be understood for future space observation of UHECR (Ultra-High Energy Cosmic Rays). The launch of the payload carried by a Russian microsatellite is foreseen in the middle of 2008

  4. Studying creativity training programs: A methodological analysis

    DEFF Research Database (Denmark)

    Valgeirsdóttir, Dagný; Onarheim, Balder

    2017-01-01

    Throughout decades of creativity research, a range of creativity training programs have been developed, tested, and analyzed. In 2004 Scott and colleagues published a meta‐analysis of all creativity training programs to date, and the review presented here sat out to identify and analyze studies...... published since the seminal 2004 review. Focusing on quantitative studies of creativity training programs for adults, our systematic review resulted in 22 publications. All studies were analyzed, but comparing the reported effectiveness of training across studies proved difficult due to methodological...... inconsistencies, variations in reporting of results as well as types of measures used. Thus a consensus for future studies is called for to answer the question: Which elements make one creativity training program more effective than another? This is a question of equal relevance to academia and industry...

  5. Addressing extreme precipitation change under future climates in the Upper Yangtze River Basin

    Science.gov (United States)

    Yang, Z.; Yuan, Z.; Gao, X.

    2017-12-01

    Investigating the impact of climate change on extreme precipitation accurately is of importance for application purposes such as flooding mitigation and urban drainage system design. In this paper, a systematical analysis framework to assess the impact of climate change on extreme precipitation events is developed and practiced in the Upper Yangtze River Basin (UYRB) in China. Firstly, the UYRB is gridded and five extreme precipitation indices (annual maximum 3- 5- 7- 15- and 30-day precipitation) are selected. Secondly, with observed precipitation from China's Ground Precipitation 0.5°×0.5° Gridded Dataset (V2.0) and simulated daily precipitation from ten general circulation models (GCMs) of CMIP5, A regionally efficient GCM is selected for each grid by the skill score (SS) method which maximizes the overlapped area of probability density functions of extreme precipitation indices between observations and simulations during the historical period. Then, simulations of assembled efficient GCMs are bias corrected by Equidistant Cumulative Distribution Function method. Finally, the impact of climate change on extreme precipitation is analyzed. The results show that: (1) the MRI-CGCM3 and MIROC-ESM perform better in the UYRB. There are 19.8 to 20.9% and 14.2 to 18.7% of all grids regard this two GCMs as regionally efficient GCM for the five indices, respectively. Moreover, the regionally efficient GCMs are spatially distributed. (2) The assembled GCM performs much better than any single GCM, with the SS>0.8 and SS>0.6 in more than 65 and 85 percent grids. (3) Under the RCP4.5 scenario, the extreme precipitation of 50-year and 100-year return period is projected to increase in most areas of the UYRB in the future period, with 55.0 to 61.3% of the UYRB increasing larger than 10 percent for the five indices. The changes are spatially and temporal distributed. The upstream region of the UYRB has a relatively significant increase compared to the downstream basin, while

  6. Salvage of mangled upper extremity using the Masquelet technique in a child: A case report

    OpenAIRE

    Alassaf, Nabil; Alhoukail, Amro; Alsahli, Abdullah; Althubaiti, Ghazi

    2017-01-01

    Aim: To report our experience with the Masquelet concept in a pediatric upper extremity following an open injury to the elbow. Methods: A case report and literature review. Results: An 11-year-old boy was transferred to our institution after a motor vehicle collision. There was a primary loss of the ulnohumeral articulation and the surrounding soft tissues as well as the ulnar nerve. Reconstruction used the Masquelet-induced membrane technique and a soft tissue flap. At the 30-month follow-up...

  7. Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors

    Directory of Open Access Journals (Sweden)

    Rhodes Erinn T

    2010-02-01

    Full Text Available Abstract Background Information about the availability and effectiveness of childhood obesity training during residency is limited. Methods We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds, and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. Results The response rate was 42.2% (299/709 and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%, diagnosis (N = 282, 94.3%, diagnosis of complications (N = 249, 83.3%, and treatment (N = 242, 80.9%. However, only 18.1% (N = 54 of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p Conclusions While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

  8. How to Buy Training Programs.

    Science.gov (United States)

    Geber, Beverly

    1989-01-01

    Discusses how to select the best training program for your needs. Includes information on deciding whether to develop your own program or buy one; identifying the kind of program you need; examining what is available; networking; choosing a supplier; and evaluating programs. (JOW)

  9. Congenital unilateral absence of the upper extremity may give rise to a specific kind of thoracolumbar curve.

    Science.gov (United States)

    Olgun, Z Deniz; Demirkiran, Gokhan; Polly, David; Yazici, Muharrem

    2018-03-01

    There is an increased incidence of scoliosis in patients with congenital malformations of the upper extremity even in the absence of overt vertebral abnormalities. In this case series, we summarize the curve characteristics of four patients presenting to two spine surgery clinics with unilateral amelia or phocomelia and a progressive scoliotic curve with the apex on the side of deficiency. All patients required orthopedic intervention for their curves. Amelia and phocomelia are severe congenital malformations of the upper limb affecting trunk balance and, conceivably, causing scoliosis with the absence of counterbalancing weight on the affected side. The combination of upper limb absence and same-sided scoliosis in these patients may provide a clue of the mechanical factors causing scoliosis in other disorders. In this article, we attempt to define this exceptional deformity, theorize on its etiology, and draw attention to this particular combination of problems. Case series; Level IV.

  10. Psychological Assessment Training in Clinical Psychology Doctoral Programs.

    Science.gov (United States)

    Mihura, Joni L; Roy, Manali; Graceffo, Robert A

    2017-01-01

    We surveyed American Psychological Association-accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment-specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method-self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.

  11. Psychosocial reactions to upper extremity limb salvage: A case series.

    Science.gov (United States)

    Sposato, Lindsay; Yancosek, Kathleen; Cancio, Jill

    2017-11-30

    Case series. A salvaged limb is one that has undergone a major traumatic injury, followed by repeated surgical attempts in order to avoid amputation. Psychological recovery for individuals with lower extremity limb salvage has been examined in a number of studies. However, psychosocial reactions for individuals with upper extremity (UE) limb salvage are understudied in the literature. The purpose of this study was to explore the process of psychosocial adaptation for 3 trauma cases after UE limb salvage. The Reactions to Impairment and Disability Inventory was used to assess psychosocial adaptation. Physical function outcomes (pain, range of motion, edema, sensation, and dexterity) are presented. The Disabilities of the Arm, Shoulder, and Hand measure was used to assess perceived disability. Medical and rehabilitation history are discussed for each case, in order to provide in-depth understanding of the impact of these injuries. Reactions to injury varied across the cases; however, outcomes suggest that psychosocial adaptation may be influenced by the experience of pain, the ability to participate in valued roles and activities, and having a supportive social network. For this population, therapists may consider emphasizing pain management, focusing on client-centered goals and interventions, and facilitating peer support. Providers should closely monitor patients for signs of poor adaptation, such as hand-hiding behaviors. This study is among the first to examine psychological outcomes for the UE limb salvage population. Future research would be beneficial to provide deeper understanding of the psychosocial challenges for these individuals. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  12. Criteria to evaluate SAT-based training programs

    International Nuclear Information System (INIS)

    Arjona, O.; Venegas, M.; Rodriguez, L.; Lopez, M.

    1997-01-01

    This paper present some coefficients of error obtained to evaluate the quality of the design development and implementation of SAT-based personnel training programs. With the attainment of these coefficients, with the use of the GESAT system, is facilitated the continuos evaluation of training programs and the main deficiencies in the design, development and implementation of training programs are obtained, through the comparison between the program features and their standards or wanted features and doing an statistics analysis of the data kept in the GESAT system

  13. The diagnosis of a fully flexed neck position MRI diagnosis in juvenile muscular atrophy of the distal upper extremity

    International Nuclear Information System (INIS)

    Liu Huaijun; Li Caiying; He Dan; Chi Chen; Cui Caixia; Huang Boyuan; Wang Guoshi; Zhu Qingfeng

    2006-01-01

    Objective: To investigate the value of the diagnosis of MRI during neck flexion in juvenile muscular atrophy of the distal upper extremity. Methods: Five young male patients (mean age 21 years old) with clinical and electrophysiological alterations were performed MR examination with routine neck position and a fully flexed neck position. Eight age-match young men were examined as control subjects. SE T 1 WI, T 2 WI, Fluid-attenuated inversion recovery (FLAIR) sequences were scanned. Results: A distinctive finding in the disorder was forward displacement of the cervical dural sac, compressive flattening of the lower cervical cord during neck flexion and flow void in the posterior epidural space. The forward displacement was significantly greater in patients than in age-matched control subjects. Conclusion: Flexed neck position MRI is helpful to find radiological abnormalities of the lower cervical dural sac and spinal cord, which were combined with clinical disorder to diagnose juvenile muscular atrophy of the distal upper extremity. (authors)

  14. Young planets under extreme UV irradiation. I. Upper atmosphere modelling of the young exoplanet K2-33b

    Science.gov (United States)

    Kubyshkina, D.; Lendl, M.; Fossati, L.; Cubillos, P. E.; Lammer, H.; Erkaev, N. V.; Johnstone, C. P.

    2018-04-01

    The K2-33 planetary system hosts one transiting 5 R⊕ planet orbiting the young M-type host star. The planet's mass is still unknown, with an estimated upper limit of 5.4 MJ. The extreme youth of the system (age of the system indicates that the planet is more massive than 10 M⊕.

  15. How extreme is extreme hourly precipitation?

    Science.gov (United States)

    Papalexiou, Simon Michael; Dialynas, Yannis G.; Pappas, Christoforos

    2016-04-01

    The importance of accurate representation of precipitation at fine time scales (e.g., hourly), directly associated with flash flood events, is crucial in hydrological design and prediction. The upper part of a probability distribution, known as the distribution tail, determines the behavior of extreme events. In general, and loosely speaking, tails can be categorized in two families: the subexponential and the hyperexponential family, with the first generating more intense and more frequent extremes compared to the latter. In past studies, the focus has been mainly on daily precipitation, with the Gamma distribution being the most popular model. Here, we investigate the behaviour of tails of hourly precipitation by comparing the upper part of empirical distributions of thousands of records with three general types of tails corresponding to the Pareto, Lognormal, and Weibull distributions. Specifically, we use thousands of hourly rainfall records from all over the USA. The analysis indicates that heavier-tailed distributions describe better the observed hourly rainfall extremes in comparison to lighter tails. Traditional representations of the marginal distribution of hourly rainfall may significantly deviate from observed behaviours of extremes, with direct implications on hydroclimatic variables modelling and engineering design.

  16. Timing training in three children with diplegic cerebral palsy: Short- and long-term effects on upper-limb movement organization and functioning

    Directory of Open Access Journals (Sweden)

    Anna-Maria eJohansson

    2014-03-01

    Full Text Available Despite the great need of interventions to maintain and improve motor functions in children with diplegic cerebral palsy (DCP, scientific evaluations of existing training methods are rare. This study aimed to explore individual effects of synchronized metronome training (SMT on motor timing, spatio-temporal movement organization, and subjective experiences of changes in upper-limb functions in three children with DCP. All children participated in an individualized 4-week/12 session SMT training regime. Measurements before training (Pre, after training (Post1 and at 6 months post completed training (Post2 were made by the applied SMT training equipment, optoelectronic registrations of goal-directed upper-limb movements, and a questionnaire assessing subjective experiences of changes in upper-limb functions and usability. In general, the training regime was shown to have little effect on motor timing. However, some positive changes in spatio-temporal movement organization were found. Two children also reported substantial long-lasting positive changes in subjective experiences of hand/arm functionality in terms of increased movement control and reduced muscle tone. For these children, parallel kinematic findings also indicated smoother and faster movement trajectories that remained at Post2. Although highly individualized, the shown improvements in upper-limb kinematics and subjective experiences of improved functionality of the hands/arms for two of the cases warrant further explorations of SMT outcomes in children with DCP.

  17. [Women boxing athletes' EMG of upper limbs and lumbar muscles in the training of air striking of straight punch].

    Science.gov (United States)

    Zhang, Ri-Hui; Kang, Zhi-Xin

    2011-05-01

    To study training effect of upper limbs and lumbar muscles in the proceed of air striking of straight punch by analyzing boxing athletes' changes of electromyogram (EMG). We measured EMG of ten women boxing athletes' upper arm biceps (contractor muscle), upper arm triceps (antagonistic muscle), forearm flexor muscle (contractor muscle), forearm extensor muscle (antagonistic muscle), and lumbar muscles by ME6000 (Mega Electronics Ltd.). The stipulated exercise was to do air striking of straight punch with loads of 2.5 kg of dumbbell in the hand until exhausted. In the proceed of exercise-induce exhausted, the descend magnitude and speed of median frequency (MF) in upper limb antagonistic muscle exceeded to contracting muscle, moreover, the work percentage showed that contractor have done a larger percentage of work than antagonistic muscle. Compared with world champion's EMG, the majority of ordinary athletes' lumbar muscles MF revealed non-drop tendency, and the work percentage showed that lumbar muscles had a very little percentage of work. After comparing the EMG test index in upper limb and lumbar muscle of average boxing athletes with that of the world champion, we find the testees lack of the training of upper limb antagonistic muscle and lumbar muscle, and more trainings aimed at these muscles need to be taken.

  18. Student retention in athletic training education programs.

    Science.gov (United States)

    Dodge, Thomas M; Mitchell, Murray F; Mensch, James M

    2009-01-01

    The success of any academic program, including athletic training, depends upon attracting and keeping quality students. The nature of persistent students versus students who prematurely leave the athletic training major is not known. Understanding the profiles of athletic training students who persist or leave is important. To (1) explore the relationships among the following variables: anticipatory factors, academic integration, clinical integration, social integration, and motivation; (2) determine which of the aforementioned variables discriminate between senior athletic training students and major changers; and (3) identify which variable is the strongest predictor of persistence in athletic training education programs. Descriptive study using a qualitative and quantitative mixed-methods approach. Thirteen athletic training education programs located in District 3 of the National Athletic Trainers' Association. Ninety-four senior-level athletic training students and 31 college students who changed majors from athletic training to another degree option. Data were collected with the Athletic Training Education Program Student Retention Questionnaire (ATEPSRQ). Data from the ATEPSRQ were analyzed via Pearson correlations, multivariate analysis of variance, univariate analysis of variance, and a stepwise discriminant analysis. Open-ended questions were transcribed and analyzed using open, axial, and selective coding procedures. Member checks and peer debriefing techniques ensured trustworthiness of the study. Pearson correlations identified moderate relationships among motivation and clinical integration (r = 0.515, P accounting for 37.2% of the variance between groups. The theoretic model accurately classified 95.7% of the seniors and 53.8% of the major changers. A common theme emerging from the qualitative data was the presence of a strong peer-support group that surrounded many of the senior-level students. Understanding student retention in athletic training is

  19. The influences of obesity and age on functional performance during intermittent upper extremity tasks.

    Science.gov (United States)

    Cavuoto, Lora A; Nussbaum, Maury A

    2014-01-01

    In this study, the main and interactive effects of obesity and age on functional performance were assessed during intermittent exertions involving the upper extremity. The prevalence of obesity has doubled over the past 30 years and this increase is associated with higher health care costs, rates of workplace injury, and lost workdays. Obesity and aging can modify job demands and affect worker capacity in terms of muscular and psychomotor function. However, there is a lack of empirical studies quantifying the work-relevant (or ergonomic) impacts related to task demands, capacities, and their potential imbalance. Eight obese and eight non-obese participants from each of two age groups (18-25 and 50-65 years) completed three endurance tasks involving fixed levels of task demands: hand grip, shoulder flexion, and a simulated assembly task using the upper extremity. Measures of functional performance including endurance, discomfort, motor control, and task performance were recorded for each of the task conditions. Endurance times were ∼60% longer for the non-obese group, and older participants had longer endurance times; however there was no evidence of interactive effects of obesity and age. Obesity also impaired functional performance, as indicated by higher rates of strength loss, increases in discomfort, and declines in task performance. These observed impairments may reflect underlying physiological differences among individuals who are obese, but that are independent of age. Obesity-related impairments may have implications for the design of work duration and demand level to prevent fatigue development for workers who are obese.

  20. Effect of upper body plyometric training on physical performance in healthy individuals: A systematic review.

    Science.gov (United States)

    Singla, Deepika; Hussain, M Ejaz; Moiz, Jamal Ali

    2018-01-01

    To determine the impact of upper body plyometric training (UBPT) on physical performance parameters such as strength, ball throwing speed, ball throw distance and power in healthy individuals. PubMed, Scopus, ResearchGate and ERIC databases were searched up to August 2017. Selection of articles was done if they described the outcomes of an upper body plyometric exercise intervention; included measures of strength, ball throwing speed, ball throw distance, or power; included healthy individuals; used a randomized control trial; and had full text available in English language. The exclusion criteria were unpublished research work and clubbing of UBPT with some other type(s) of training apart from routine sports training. PEDro scale was used to rate the quality of studies eligible for this review. Initially 264 records were identified and out of them only 11 articles met the eligibility criteria and were selected (PEDro score = 4 to 6). Though large to very small effects observed in improving ball throwing velocity, ball throwing distance, power and strength of upper limb muscles after UBPT, the results should be implemented with caution. Inconclusive results obtained preclude any strong conclusion regarding the efficacy of UBPT on physical performance in healthy individuals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. 76 FR 2147 - UAW-Chrysler National Training Center Technology Training Joint Programs Staff, Detroit, MI; UAW...

    Science.gov (United States)

    2011-01-12

    ...-Chrysler National Training Center Technology Training Joint Programs Staff, Detroit, MI; UAW-Chrysler Technical Training Center Technology Training Joint Programs Staff, Warren, MI; Notice of Revised... investigation, the Department confirmed that the proportion of Technology Training Joint Programs Staff...

  2. Catheter-Directed Thrombolysis for Treatment of Deep Venous Thrombosis in the Upper Extremities

    International Nuclear Information System (INIS)

    Vik, Anders; Holme, Pal Andre; Singh, Kulbir; Dorenberg, Eric; Nordhus, Kare Christian; Kumar, Satish; Hansen, John-Bjarne

    2009-01-01

    Traditional anticoagulant treatment of deep venous thrombosis (DVT) in the upper extremities (UEDVT) is associated with a relatively high incidence of postthrombotic syndrome (PTS). Catheter-directed thrombolysis (CDT) for UEDVT would provide efficient thrombolysis with less subsequent PTS than during traditional anticoagulation. Primary efficacy, complications, and long-term results after CDT are reported in a retrospective cohort (2002-2007) of patients (n = 30) with DVT in the upper extremities. PTS was assessed by a modified Villalta scale. UEDVT was unprovoked in 11 (37%) cases and effort related in 9 (30%) cases. The median duration of symptoms prior to CDT was 7.0 days (range, 1-30); median duration of thrombolysis treatment, 70 h (range, 24-264 h); and the median amount of rt-PA infused during CDT, 52 mg (range, 19-225 mg). Major bleeding was registered in three (9%) patients, and CDT was stopped prematurely in three patients due to local hematoma. No intracerebral bleeding, clinical pulmonary embolism, or deaths occurred during treatment. Grade II (>50%) or III (>90%) lysis was present in 29 patients (97%) at the end of CDT. Bleeding complications increased by each day of delay from the debut of symptoms to the start of treatment (OR, 1.20; 95% CI, 1.01-1.42). At follow-up (n = 29; median, 21 months; range, 5-58 months), 11 (38%) patients had occluded veins, whereas 18 (62%) had patent veins. However, stenosis of varying severity was present in eight of those with a patent vein. No patients had severe PTS, whereas six (21%) experienced mild PTS. In conclusion, our retrospective cohort study of patients with UEDVT showed that treatment restored venous drainage, with a subsequent low frequency of mild PTS at follow-up. Early intervention with CDT prevented bleeding complications.

  3. Secondary prevention of work-related upper extremity disorders: recommendations from the Annapolis conference.

    Science.gov (United States)

    Feuerstein, Michael; Harrington, Cherise B

    2006-09-01

    Efforts to improve the secondary prevention of work-related upper extremity (WRUE) symptoms continue to present a challenge. As with many occupational musculoskeletal pain disorders no single, direct cause-effect relationship exists among specific exposures, pathologic processes, and symptoms. The field has yet to create truly effective and efficient interventions for these problems that are based on current epidemiological and clinical knowledge. A working conference was held in Annapolis, Maryland on September 23rd and 24th, 2005 with leaders in research and application related to upper extremity disorders to address this challenge. The intent of the meeting was to review "state of the art" evidence in epidemiology and intervention research in order to develop suggestions regarding next steps in intervention research and application. On day 2 a number of stakeholders were present to discuss what they perceived as the missing pieces in both epidemiological research and applied intervention research in order to generate more effective workplace interventions. The papers in this series of the Journal of Occupational Rehabilitation indicate that scientifically sound progress has been made over the past decade in identifying ergonomic, workplace psychosocial, and individual factors in both the etiology and exacerbation of these symptoms/disorders. However, there is a gap between this knowledge and the development and practical implementation of comprehensive interventions for these problems. The conference also highlighted the paucity of economic analyses of the impact of these disorders as well as the economic study of the impact of intervention. Approaches for such evaluations were presented and are included in this special section of the journal. This series of papers and the summary of the invited group's discussions provided in this paper clearly emphasize the need for innovative ways to think about these problems and specific research topics that can help

  4. A survey of anatomical items relevant to the practice of rheumatology: upper extremity, head, neck, spine, and general concepts.

    Science.gov (United States)

    Villaseñor-Ovies, Pablo; Navarro-Zarza, José Eduardo; Saavedra, Miguel Ángel; Hernández-Díaz, Cristina; Canoso, Juan J; Biundo, Joseph J; Kalish, Robert A; de Toro Santos, Francisco Javier; McGonagle, Dennis; Carette, Simon; Alvarez-Nemegyei, José

    2016-12-01

    This study aimed to identify the anatomical items of the upper extremity and spine that are potentially relevant to the practice of rheumatology. Ten rheumatologists interested in clinical anatomy who published, taught, and/or participated as active members of Clinical Anatomy Interest groups (six seniors, four juniors), participated in a one-round relevance Delphi exercise. An initial, 560-item list that included 45 (8.0 %) general concepts items; 138 (24.8 %) hand items; 100 (17.8 %) forearm and elbow items; 147 (26.2 %) shoulder items; and 130 (23.2 %) head, neck, and spine items was compiled by 5 of the participants. Each item was graded for importance with a Likert scale from 1 (not important) to 5 (very important). Thus, scores could range from 10 (1 × 10) to 50 (5 × 10). An item score of ≥40 was considered most relevant to competent practice as a rheumatologist. Mean item Likert scores ranged from 2.2 ± 0.5 to 4.6 ± 0.7. A total of 115 (20.5 %) of the 560 initial items reached relevance. Broken down by categories, this final relevant item list was composed by 7 (6.1 %) general concepts items; 32 (27.8 %) hand items; 20 (17.4 %) forearm and elbow items; 33 (28.7 %) shoulder items; and 23 (17.6 %) head, neck, and spine items. In this Delphi exercise, a group of practicing academic rheumatologists with an interest in clinical anatomy compiled a list of anatomical items that were deemed important to the practice of rheumatology. We suggest these items be considered curricular priorities when training rheumatology fellows in clinical anatomy skills and in programs of continuing rheumatology education.

  5. Nuclear safety training program (NSTP) for dismantling

    International Nuclear Information System (INIS)

    Cretskens, Pieter; Lenie, Koen; Mulier, Guido

    2014-01-01

    European Control Services (GDF Suez) has developed and is still developing specific training programs for the dismantling and decontamination of nuclear installations. The main topic in these programs is nuclear safety culture. We therefore do not focus on technical training but on developing the right human behavior to work in a 'safety culture' environment. The vision and techniques behind these programs have already been tested in different environments: for example the dismantling of the BN MOX Plant in Dessel (Belgium), Nuclear Safety Culture Training for Electrabel NPP Doel..., but also in the non-nuclear industry. The expertise to do so was found in combining the know-how of the Training and the Nuclear Department of ECS. In training, ECS is one of the main providers of education in risky tasks, like elevation and manipulation of charges, working in confined spaces... but it does also develop training on demand to improve safety in a certain topic. Radiation Protection is the core business in the Nuclear Department with a presence on most of the nuclear sites in Belgium. Combining these two domains in a nuclear safety training program, NSTP, is an important stage in a dismantling project due to specific contamination, technical and other risks. It increases the level of safety and leads to a harmonization of different working cultures. The modular training program makes it possible to evaluate constantly as well as in group or individually. (authors)

  6. MR imaging findings of high-voltage electrical burns in the upper extremities: correlation with angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Min, Seon Jung; Han, You Mi (Dept. of Radiology, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of)); Suh, Kyung Jin (Dept. of Radiology, Dongguk Univ. College of Medicine, Gyeongju Hospital, Gyeongju (Korea, Republic of)), email: kyungjin.suh@gmail.com; Choi, Min Ho (Dept. of Internal Medicine, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of))

    2011-02-15

    Background: A high-voltage electrical burn is often associated with deep muscle injuries. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, and this can lead to major amputations or sepsis. MRI has excellent soft tissue contrast and it may aid in differentiating the areas of viable deep muscle from the areas of non-viable deep muscle. Purpose: To describe the MR imaging findings of a high-voltage electrical burn in the upper extremity with emphasis on the usefulness of the gadolinium-enhanced MRI and to compare the MR imaging findings with angiography. Material and Methods: We retrospectively reviewed the imaging studies of six patients with high-voltage electrical burns who underwent both MRI and angiography at the burn center of our hospital from January 2005 to December 2009. The imaging features were evaluated for the involved locations, the MR signal intensity of the affected muscles, the MR enhancement pattern, the involved arteries and the angiographic findings (classified as normal, sluggish flow, stenosis or occlusion) of the angiography of the upper extremity. We assessed the relationship between the MR imaging findings and the angiographic findings. Results: The signal intensities of affected muscles were isointense or of slightly high signal intensity as compared with the adjacent unaffected skeletal muscle on the T1-weighted MR images. Affected muscles showed heterogenous high signal intensity relative to the adjacent unaffected skeletal muscle on the T2- weighted images. The gadolinium-enhanced T1-weighted images showed diffuse inhomogeneous enhancement or peripheral rim enhancement of the affected muscles. The angiographic findings of the arterial injuries showed complete occlusion in three patients, severe stenosis in two patients and sluggish flow in one patient. Of these, the five patients with complete occlusion or severe stenosis on angiography showed non-perfused and non-viable areas of edematous muscle on

  7. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training at Home randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Amanda Bates

    2018-04-01

    Full Text Available Introduction: Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. Research questions: This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Design: Randomised, controlled trial. Participants and setting: A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Intervention: Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. Outcome measures: The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated

  8. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training) at Home randomised, controlled trial.

    Science.gov (United States)

    Bates, Amanda; Furber, Susan; Tiedemann, Anne; Ginn, Karen; van den Dolder, Paul; Howard, Kirsten; Bauman, Adrian; Chittenden, Catherine; Franco, Lisa; Kershaw, Michelle; Sherrington, Catherine

    2018-04-01

    Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Randomised, controlled trial. A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated. Negative binomial regression models will be used to estimate the between-group difference in fall rates. Modified

  9. Reading assessment and training program

    International Nuclear Information System (INIS)

    Lewis, C.L.

    1991-01-01

    The objective was to ensure ourselves and the general public that the workers in the Nuclear Materials Processing Department (NMPD) could read, follow, and understand procedures. Procedures were randomly selected and analyzed for reading levels. A tenth grade reading level was established as the standard for all NMPD employees. Employees were tested to determine reading levels and approximately 12% could not read at the target level. A Procedure Walk-Through Evaluation was administered to each person not reaching tenth grade reading level. This was a job performance measure given to ensure that the worker was competent in his/her present job, and should remain there while completing reading training. A mandatory Reading Training Program utilizing Computer Based Training was established. This program is self-paced, individualized instruction and provided to the worker on Company time. Results of the CBT Program have been very good. Instruction is supplemented with test-taking skills seminars, practice exams, individual conferences with their own reading specialist, and some self-directed study books. This paper describes the program at Savannah River Site

  10. Emergency medicine task shifting: Quick dash outcome scores of upper extremity injury management

    Directory of Open Access Journals (Sweden)

    D.S. Frank*

    2013-12-01

    Results and conclusions: There were a total of 25 initial candidates, of which only 17 were able to complete the survey. Using the Quick DASH Outcome Measure, our 17 patients had a mean score of 29.5 (range 5.0– 56.8. When compared to the standardized 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.

  11. [Upper extremity kinetics and energy expenditure during walker-assisted gait in children with cerebral palsy].

    Science.gov (United States)

    Konop, Katherine A; Strifling, Kelly M B; Wang, Mei; Cao, Kevin; Eastwood, Daniel; Jackson, Scott; Ackman, Jeffrey; Altiok, Haluk; Schwab, Jeffrey; Harris, Gerald F

    2009-01-01

    We evaluated the relationships between upper extremity (UE) kinetics and the energy expenditure index during anterior and posterior walker-assisted gait in children with spastic diplegic cerebral palsy (CP). Ten children (3 boys, 7 girls; mean age 12.1 years; range 8 to 18 years) with spastic diplegic CP, who ambulated with a walker underwent gait analyses that included UE kinematics and kinetics. Upper extremity kinetics were obtained using instrumented walker handles. Energy expenditure index was obtained using the heart rate method (EEIHR) by subtracting resting heart rate from walking heart rate, and dividing by the walking speed. Correlations were sought between the kinetic variables and the EEIHR and temporal and stride parameters. In general, anterior walker use was associated with a higher EEIHR. Several kinetic variables correlated well with temporal and stride parameters, as well as the EEIHR. All of the significant correlations (r>0.80; pwalker use and involved joint reaction forces (JRF) rather than moments. Some variables showed multiple strong correlations during anterior walker use, including the medial JRF in the wrist, the posterior JRF in the elbow, and the inferior and superior JRFs in the shoulder. The observed correlations may indicate a relationship between the force used to advance the body forward within the walker frame and an increased EEIHR. More work is needed to refine the correlations, and to explore relationships with other variables, including the joint kinematics.

  12. Computer-aided training sensorimotor cortex functions in humans before the upper limb transplantation using virtual reality and sensory feedback.

    Science.gov (United States)

    Kurzynski, Marek; Jaskolska, Anna; Marusiak, Jaroslaw; Wolczowski, Andrzej; Bierut, Przemyslaw; Szumowski, Lukasz; Witkowski, Jerzy; Kisiel-Sajewicz, Katarzyna

    2017-08-01

    One of the biggest problems of upper limb transplantation is lack of certainty as to whether a patient will be able to control voluntary movements of transplanted hands. Based on findings of the recent research on brain cortex plasticity, a premise can be drawn that mental training supported with visual and sensory feedback can cause structural and functional reorganization of the sensorimotor cortex, which leads to recovery of function associated with the control of movements performed by the upper limbs. In this study, authors - based on the above observations - propose the computer-aided training (CAT) system, which generating visual and sensory stimuli, should enhance the effectiveness of mental training applied to humans before upper limb transplantation. The basis for the concept of computer-aided training system is a virtual hand whose reaching and grasping movements the trained patient can observe on the VR headset screen (visual feedback) and whose contact with virtual objects the patient can feel as a touch (sensory feedback). The computer training system is composed of three main components: (1) the system generating 3D virtual world in which the patient sees the virtual limb from the perspective as if it were his/her own hand; (2) sensory feedback transforming information about the interaction of the virtual hand with the grasped object into mechanical vibration; (3) the therapist's panel for controlling the training course. Results of the case study demonstrate that mental training supported with visual and sensory stimuli generated by the computer system leads to a beneficial change of the brain activity related to motor control of the reaching in the patient with bilateral upper limb congenital transverse deficiency. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. 42 CFR 432.30 - Training programs: General requirements.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE PERSONNEL ADMINISTRATION Training Programs... of the program; (2) Be related to job duties performed or to be performed by the persons trained; and (3) Be consistent with the program objectives of the agency. ...

  14. EFFECTS OF A SHORT-TERM PLYOMETRIC AND RESISTANCE TRAINING PROGRAM ON FITNESS PERFORMANCE IN BOYS AGE 12 TO 15 YEARS

    Directory of Open Access Journals (Sweden)

    Avery D. Faigenbaum

    2007-12-01

    Full Text Available The purpose of this study was to compare the effects of a six week training period of combined plyometric and resistance training (PRT, n = 13 or resistance training alone (RT, n = 14 on fitness performance in boys (12-15 yr. The RT group performed static stretching exercises followed by resistance training whereas the PRT group performed plyometric exercises followed by the same resistance training program. The training duration per session for both groups was 90 min. At baseline and after training all participants were tested on the vertical jump, long jump, medicine ball toss, 9.1 m sprint, pro agility shuttle run and flexibility. The PRT group made significantly (p < 0.05 greater improvements than RT in long jump (10.8 cm vs. 2.2 cm, medicine ball toss (39.1 cm vs. 17.7 cm and pro agility shuttle run time (-0.23 sec vs. -0.02 sec following training. These findings suggest that the addition of plyometric training to a resistance training program may be more beneficial than resistance training and static stretching for enhancing selected measures of upper and lower body power in boys

  15. Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

    Science.gov (United States)

    Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

    2017-06-01

    Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

  16. Spatiotemporal trends in extreme rainfall and temperature indices over Upper Tapi Basin, India

    Science.gov (United States)

    Sharma, Priyank J.; Loliyana, V. D.; S. R., Resmi; Timbadiya, P. V.; Patel, P. L.

    2017-12-01

    The flood risk across the globe is intensified due to global warming and subsequent increase in extreme temperature and precipitation. The long-term trends in extreme rainfall (1944-2013) and temperature (1969-2012) indices have been investigated at annual, seasonal, and monthly time scales using nonparametric Mann-Kendall (MK), modified Mann-Kendall (MMK), and Sen's slope estimator tests. The extreme rainfall and temperature indices, recommended by the Expert Team on Climate Change Detection Monitoring Indices (ETCCDMI), have been analyzed at finer spatial scales for trend detection. The results of trend analyses indicate decreasing trend in annual total rainfall, significant decreasing trend in rainy days, and increasing trend in rainfall intensity over the basin. The seasonal rainfall has been found to decrease for all the seasons except postmonsoon, which could affect the rain-fed agriculture in the basin. The 1- and 5-day annual maximum rainfalls exhibit mixed trends, wherein part of the basin experiences increasing trend, while other parts experience a decreasing trend. The increase in dry spells and concurrent decrease in wet spells are also observed over the basin. The extreme temperature indices revealed increasing trends in hottest and coldest days, while decreasing trends in coldest night are found over most parts of the basin. Further, the diurnal temperature range is also found to increase due to warming tendency in maximum temperature (T max) at a faster rate compared to the minimum temperature (T min). The increase in frequency and magnitude of extreme rainfall in the basin has been attributed to the increasing trend in maximum and minimum temperatures, reducing forest cover, rapid pace of urbanization, increase in human population, and thereby increase in the aerosol content in the atmosphere. The findings of the present study would significantly help in sustainable water resource planning, better decision-making for policy framework, and setting up

  17. Clinical training: a simulation program for phlebotomy

    Directory of Open Access Journals (Sweden)

    Araki Toshitaka

    2008-01-01

    Full Text Available Abstract Background Basic clinical skills training in the Japanese medical education system has traditionally incorporated on-the-job training with patients. Recently, the complementary use of simulation techniques as part of this training has gained popularity. It is not known, however, whether the participants view this new type of education program favorably; nor is the impact of this program known. In this study we developed a new simulation-based training program in phlebotomy for new medical residents and assessed their satisfaction with the program Methods The education program comprised two main components: simulator exercise sessions and the actual drawing of blood from other trainees. At the end of the session, we surveyed participant sentiment regarding the program. Results There were 43 participants in total. In general, they were highly satisfied with the education program, with all survey questions receiving scores of 3 or more on a scale of 1–5 (mean range: 4.3 – 4.8, with 5 indicating the highest level of satisfaction. Additionally, their participation as a 'patient' for their co-trainees was undertaken willingly and was deemed to be a valuable experience. Conclusion We developed and tested an education program using a simulator for blood collection. We demonstrated a high satisfaction level among the participants for this unique educational program and expect that it will improve medical training, patient safety, and quality of care. The development and dissemination of similar educational programs involving simulation for other basic clinical skills will be undertaken in the future.

  18. The Efficacy of Stuttering Measurement Training: Evaluating Two Training Programs

    Science.gov (United States)

    Bainbridge, Lauren A.; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J.

    2015-01-01

    Purpose: Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Method: Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of…

  19. Neuromuscular Changes in Female Collegiate Athletes Resulting From a Plyometric Jump-Training Program.

    Science.gov (United States)

    Wilkerson, Gary B.; Colston, Marisa A.; Short, Nancy I.; Neal, Kristina L.; Hoewischer, Paul E.; Pixley, Jennifer J.

    2004-03-01

    OBJECTIVE: To assess performance changes induced by a 6- week plyometric jump-training program. DESIGN AND SETTING: We used a quasiexperimental design to compare groups formed on the basis of team membership. Testing was conducted in an athletic training research laboratory, both before and after a 6-week period of preseason basketball conditioning. SUBJECTS: Nineteen female collegiate basketball players from a National Collegiate Athletic Association Division I program (8 subjects) and a National Association of Intercollegiate Athletics Division II program (11 subjects) who had no history of anterior cruciate ligament injury and who had no history of any lower extremity injury during the preceding 6 months. MEASUREMENTS: The variables of primary interest were hamstrings and quadriceps isokinetic peak torque. Of secondary interest were 5 variables derived from step-down and lunging maneuvers performed on a computerized forceplate system and 4 variables derived from tracking the position of the body core during performance of a T-pattern agility drill with a computerized infrared tracking system. RESULTS: A significant group x trial interaction was found for hamstrings peak torque at 60 degrees.s(-1) (F(1,17) = 9.16, P =.008.), and the proportion of total variance attributable to the treatment effect produced by the jump-training program was relatively large (eta(2) =.35, omega(2) =.30). None of the other variables demonstrated statistically significant changes. CONCLUSIONS: Our primary results support plyometric jump training as a strategy for improving neuromuscular attributes that are believed to reduce the risk of anterior cruciate ligament injury in female college basketball players. They also provide the basis for reasonable isokinetic strength goals.

  20. HEALS Hypertension Control Program: Training Church Members as Program Leaders.

    Science.gov (United States)

    Dodani, Sunita; Beayler, Irmatine; Lewis, Jennifer; Sowders, Lindsey A

    2014-01-01

    Health disparities related to cardiovascular diseases (CVDs) including stroke have remained higher in the African-Americans (AAs) than in other populations. HEALS is a faith-based hypertension (HTN) control program modified according to AA community needs, and delivered by the church-lay members called church health advisors (CHAs). This study examined the feasibility and acceptability of training CHAs as HEALS program leaders. Four CHAs completed a 10-hour HEALS program training workshop at the Church, conducted by the nutrition experts. Workshop was evaluated by CHAs on their level of satisfaction, clarity of contents covered and comfort in delivery the program to the church congregation. The overall six main HEALS curriculum components were completed. Workshop was highly evaluated by CHAs on length of training, balance between content and skills development, and level of satisfaction with program delivery. Church-based culturally modified health promotion interventions conducted by the community lay members may be a way to reduce health disparities in ethnic minorities.

  1. Effective safety training program design

    International Nuclear Information System (INIS)

    Chilton, D.A.; Lombardo, G.J.; Pater, R.F.

    1991-01-01

    Changes in the oil industry require new strategies to reduce costs and retain valuable employees. Training is a potentially powerful tool for changing the culture of an organization, resulting in improved safety awareness, lower-risk behaviors and ultimately, statistical improvements. Too often, safety training falters, especially when applied to pervasive, long-standing problems. Stepping, Handling and Lifting injuries (SHL) more commonly known as back injuries and slips, trips and falls have plagued mankind throughout the ages. They are also a major problem throughout the petroleum industry. Although not as widely publicized as other immediately-fatal accidents, injuries from stepping, materials handling, and lifting are among the leading causes of employee suffering, lost time and diminished productivity throughout the industry. Traditional approaches have not turned the tide of these widespread injuries. a systematic safety training program, developed by Anadrill Schlumberger with the input of new training technology, has the potential to simultaneously reduce costs, preserve employee safety, and increase morale. This paper: reviews the components of an example safety training program, and illustrates how a systematic approach to safety training can make a positive impact on Stepping, Handling and Lifting injuries

  2. Customer satisfaction with training programs

    NARCIS (Netherlands)

    Mulder, M.

    2001-01-01

    In this contribution, a model of evaluation of customer satisfaction about training programs is described. The model is developed and implemented for an association of training companies. The evaluation has been conducted by an independent organisation to enhance the thrustworthiness of the

  3. Idaho Chemical Processing Plant training program

    International Nuclear Information System (INIS)

    1975-01-01

    Objectives, regulations and requirements, training methods, certification and recertification, progression and incentives, and coverage of the ICPP operator training program are discussed in detail. (LK)

  4. Juvenile muscular atrophy of the distal upper extremities associated with x-linked periventricular heterotopia with features of Ehlers-Danlos syndrome.

    Science.gov (United States)

    Hommel, Alyson L; Jewett, Tamison; Mortenson, Megan; Caress, James B

    2016-10-01

    Juvenile muscular atrophy of the distal upper extremities (JMADUE) is a rare, sporadic disorder that affects adolescent males and is characterized by progressive but self-limited weakness of the distal upper extremities. The etiology is unknown, but cervical hyperflexion has been hypothesized. We report a case of an adolescent male who presented with typical JMADUE but also had joint hypermobility and multiple congenital anomalies, including periventricular heterotopias, suggesting a multisystem syndrome. Subsequent diagnostic testing confirmed a diagnosis of JMADUE, and sequencing of the filamin-A gene showed a novel, pathogenic mutation that confirmed an additional diagnosis of X-linked periventricular heterotopias with features of Ehlers-Danlos syndrome (XLPH-EDS). The concurrent diagnosis of these 2 rare conditions suggests a pathogenic connection. It is likely that the joint hypermobility from XLPH-EDS predisposed this patient to developing JMADUE. This supports the cervical hyperflexion theory of pathogenesis. This case also expands the phenotype associated with FLNA mutations. Muscle Nerve 54: 794-797, 2016. © 2016 Wiley Periodicals, Inc.

  5. Training Programs for Managing Well-being in Companies

    Directory of Open Access Journals (Sweden)

    Treven Sonja

    2015-08-01

    Full Text Available This paper discussed the significance of well-being (WB and well-being management (WBM. As successful WBM requires the implementation of different training programs, such programs are presented in detail. The cause–effect relationship between training and individual/organizational performance is researched as well. The aim of the research to support this article was to present WBM, its training programs, as well as the determination of WBM activities concerning the mentioned programs implemented in Slovenian organizations.

  6. 76 FR 35474 - UAW-Chrysler Technical Training Center, Technology Training Joint Programs Staff, Including On...

    Science.gov (United States)

    2011-06-17

    ...-Chrysler Technical Training Center, Technology Training Joint Programs Staff, Including On-Site Leased Workers From Cranks, O/E Learning, DBSI, IDEA, and Tonic/MVP, Detroit, MI; UAW-Chrysler Technical Training... workers and former workers of UAW-Chrysler Technical Training Center, Technology Training Joint Programs...

  7. Effects of combined special education treatment and occupational therapy on upper extremities motor skills in adult patients with hemiplegia

    Directory of Open Access Journals (Sweden)

    Savković Nada

    2017-01-01

    Full Text Available Background/Aim. Stroke is the most common single cause of severe and multiple physical disabilities, and rehabilitation that reduces functional deficits is the most effective treatment. The aim of this study was to determine the effect of special education treatment as a supplement to occupational therapy on upper extremities motor skills in adult patients with post stroke hemiplegia. Methods. Standard education tests for motor function evaluation of the upper extremities: O`Connor, Ring and Hand grip test, were applied on a sample of 64 patients who were in the process of rehabilitation in the Clinic for Rehabilitation “Dr. Miroslav Zotović” in Belgrade. After the evaluation, all the participants were included in occupational therapy and divided in two intervention groups per 32 subjects each. The patients from the first experimental group received individually dosed special education treatment which was performed for at least 12 weeks as a supplement together with occupational therapy, while patients from the second experimental group were only in the process of occupational therapy without special education treatment. At the end of the study the same tests were used to re-evaluate the level of motor abilities of the patients in both groups. Results.The patients from the first experimental group with individually dosed special education treatment as a supplement showed significantly better scores after applying the treatment in all tested variables – explosive, static and dynamic muscular strength grip fist, as well as oculomotor skills at the level of the elbow and shoulder for both healthy and paretic hand. Conclusion. On the basis of the obtained results, it can be concluded that special education treatment added to occupational therapy lead to better performing of upper extremities motor skills and that it can be a good supplement to conventional occupational therapy methods and techniques.

  8. NET-ZERO ENERGY BUILDING OPERATOR TRAINING PROGRAM (NZEBOT)

    Energy Technology Data Exchange (ETDEWEB)

    Brizendine, Anthony; Byars, Nan; Sleiti, Ahmad; Gehrig, Bruce; Lu, Na

    2012-12-31

    The primary objective of the Net-Zero Energy Building Operator Training Program (NZEBOT) was to develop certificate level training programs for commercial building owners, managers and operators, principally in the areas of energy / sustainability management. The expected outcome of the project was a multi-faceted mechanism for developing the skill-based competency of building operators, owners, architects/engineers, construction professionals, tenants, brokers and other interested groups in energy efficient building technologies and best practices. The training program draws heavily on DOE supported and developed materials available in the existing literature, as well as existing, modified, and newly developed curricula from the Department of Engineering Technology & Construction Management (ETCM) at the University of North Carolina at Charlotte (UNC-Charlotte). The project goal is to develop a certificate level training curriculum for commercial energy and sustainability managers and building operators that: 1) Increases the skill-based competency of building professionals in energy efficient building technologies and best practices, and 2) Increases the workforce pool of expertise in energy management and conservation techniques. The curriculum developed in this project can subsequently be used to establish a sustainable energy training program that can contribute to the creation of new “green” job opportunities in North Carolina and throughout the Southeast region, and workforce training that leads to overall reductions in commercial building energy consumption. Three energy training / education programs were developed to achieve the stated goal, namely: 1. Building Energy/Sustainability Management (BESM) Certificate Program for Building Managers and Operators (40 hours); 2. Energy Efficient Building Technologies (EEBT) Certificate Program (16 hours); and 3. Energy Efficent Buildings (EEB) Seminar (4 hours). Training Program 1 incorporates the following

  9. The effectiveness of a clinical and home-based physical activity program and simple lymphatic drainage in the prevention of breast cancer-related lymphedema: A prospective randomized controlled study.

    Science.gov (United States)

    Dönmez, Ayşe Arıkan; Kapucu, Sevgisun

    2017-12-01

    To investigate the effectiveness of a clinical and home-based, nurse-led physical activity program (PAP) and simple lymphatic drainage (SLD) in the prevention of breast cancer-related lymphedema. A total of 52 breast cancer patients were randomized to either a PAP and SLD program (n = 25) or a control group (n = 27). Patients in both groups were also provided training for lymphedema. The PAP and SLD were administered through home visits by the investigators, twice a week for six weeks, in the intervention group. The control group did not undergo intervention. The circumference of the upper extremity, symptom severity, and physical function were measured in both groups. The upper extremity circumference increased by about two times from the baseline, in the control group, especially in the sixth week (p breast cancer surgery, starting from before surgery and continuing until after, to prevent breast cancer-related lymphedema. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Reliability and validity of a low load endurance strength test for upper and lower extremities in patients with fibromyalgia.

    Science.gov (United States)

    Munguía-Izquierdo, Diego; Legaz-Arrese, Alejandro

    2012-11-01

    To evaluate the reliability, standard error of the mean (SEM), clinical significant change, and known group validity of 2 assessments of endurance strength to low loads in patients with fibromyalgia syndrome (FS). Cross-sectional reliability and comparative study. University Pablo de Olavide, Seville, Spain. Middle-aged women with FS (n=95) and healthy women (n=64) matched for age, weight, and body mass index (BMI) were recruited for the study. Not applicable. The endurance strength to low loads tests of the upper and lower extremities and anthropometric measures (BMI) were used for the evaluations. The differences between the readings (tests 1 and 2) and the SDs of the differences, intraclass correlation coefficient (ICC) model (2,1), 95% confidence interval for the ICC, coefficient of repeatability, intrapatient SD, SEM, Wilcoxon signed-rank test, and Bland-Altman plots were used to examine reliability. A Mann-Whitney U test was used to analyze the differences in test values between the patient group and the control group. We hypothesized that patients with FS would have an endurance strength to low loads performance in lower and upper extremities at least twice as low as that of the healthy controls. Satisfactory test-retest reliability and SEMs were found for the lower extremity, dominant arm, and nondominant arm tests (ICC=.973-.979; P.05 for all). The Bland-Altman plots showed 95% limits of agreement for the lower extremity (4.7 to -4.5), dominant arm (3.8 to -4.4), and nondominant arm (3.9 to -4.1) tests. The endurance strength to low loads test scores for the patients with FS were 4-fold lower than for the controls in all performed tests (P<.001 for all). The endurance strength to low loads tests showed good reliability and known group validity and can be recommended for evaluating endurance strength to low loads in patients with FS. For individual evaluation, however, an improved score of at least 4 and 5 repetitions for the upper and lower extremities

  11. Upper Extremity Multifocal Neuropathy in a 10-Year-Old Boy Associated With NS6S Disaccharide Antibodies.

    Science.gov (United States)

    Edelman, Frederick; Naddaf, Elie; Waclawik, Andrew J

    2015-06-01

    We present a 10-year-old boy with a predominantly motor multifocal neuropathy with demyelinating and axonal changes with sensory involvement, affecting only one upper extremity. Laboratory studies revealed an elevated titer of immunoglobulin M (IgM) antibodies against the NS6S antigen. He responded to treatment with high dose intravenous immunoglobulins. Focal or multifocal immune-mediated neuropathies are not common in children and may be underdiagnosed. © The Author(s) 2014.

  12. 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. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. NASA's Upper Atmosphere Research Program (UARP) and Atmospheric Chemistry Modeling and Analysis Program (ACMAP): Research Summaries 1997-1999

    Science.gov (United States)

    Kurylo, M. J.; DeCola, P. L.; Kaye, J. A.

    2000-01-01

    Under the mandate contained in the FY 1976 NASA Authorization Act, the National Aeronautics and Space Administration (NASA) has developed and is implementing a comprehensive program of research, technology development, and monitoring of the Earth's upper atmosphere, with emphasis on the upper troposphere and stratosphere. This program aims at expanding our chemical and physical understanding to permit both the quantitative analysis of current perturbations as well as the assessment of possible future changes in this important region of our environment. It is carried out jointly by the Upper Atmosphere Research Program (UARP) and the Atmospheric Chemistry Modeling and Analysis Program (ACMAP), both managed within the Research Division in the Office of Earth Science at NASA. Significant contributions to this effort have also been provided by the Atmospheric Effects of Aviation Project (AEAP) of NASA's Office of Aero-Space Technology. The long-term objectives of the present program are to perform research to: understand the physics, chemistry, and transport processes of the upper troposphere and the stratosphere and their control on the distribution of atmospheric chemical species such as ozone; assess possible perturbations to the composition of the atmosphere caused by human activities and natural phenomena (with a specific emphasis on trace gas geographical distributions, sources, and sinks and the role of trace gases in defining the chemical composition of the upper atmosphere); understand the processes affecting the distributions of radiatively active species in the atmosphere, and the importance of chemical-radiative-dynamical feedbacks on the meteorology and climatology of the stratosphere and troposphere; and understand ozone production, loss, and recovery in an atmosphere with increasing abundances of greenhouse gases. The current report is composed of two parts. Part 1 summarizes the objectives, status, and accomplishments of the research tasks supported

  14. Challenges in Measuring Benefit of Clinical Research Training Programs--the ASH Clinical Research Training Institute Example.

    Science.gov (United States)

    Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott D; Basso, Joe; Burns, Linda

    2015-12-01

    The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient-oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collaboration, job and advancement opportunities, and promotion of work-life balance. The benefits of clinical research training programs need to be measured so that funders and society can judge if they are worth the investment in time and resources. Identification of elements that are important to program benefit is essential to measuring the benefit of the program as well as program planning. Future work should focus on the constructs which contribute to benefits of clinical research training programs such as CRTI.

  15. 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,…

  16. The Effects of Upper-Limb Training Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation Robotic Hand on Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Chingyi Nam

    2017-12-01

    Full Text Available BackgroundImpaired hand dexterity is a major disability of the upper limb after stroke. An electromyography (EMG-driven neuromuscular electrical stimulation (NMES robotic hand was designed previously, whereas its rehabilitation effects were not investigated.ObjectivesThis study aims to investigate the rehabilitation effectiveness of the EMG-driven NMES-robotic hand-assisted upper-limb training on persons with chronic stroke.MethodA clinical trial with single-group design was conducted on chronic stroke participants (n = 15 who received 20 sessions of EMG-driven NMES-robotic hand-assisted upper-limb training. The training effects were evaluated by pretraining, posttraining, and 3-month follow-up assessments with the clinical scores of the Fugl-Meyer Assessment (FMA, the Action Research Arm Test (ARAT, the Wolf Motor Function Test, the Motor Functional Independence Measure, and the Modified Ashworth Scale (MAS. Improvements in the muscle coordination across the sessions were investigated by EMG parameters, including EMG activation level and Co-contraction Indexes (CIs of the target muscles in the upper limb.ResultsSignificant improvements in the FMA shoulder/elbow and wrist/hand scores (P < 0.05, the ARAT (P < 0.05, and in the MAS (P < 0.05 were observed after the training and sustained 3 months later. The EMG parameters indicated a significant decrease of the muscle activation level in flexor digitorum (FD and biceps brachii (P < 0.05, as well as a significant reduction of CIs in the muscle pairs of FD and triceps brachii and biceps brachii and triceps brachii (P < 0.05.ConclusionThe upper-limb training integrated with the assistance from the EMG-driven NMES-robotic hand is effective for the improvements of the voluntary motor functions and the muscle coordination in the proximal and distal joints. Furthermore, the motor improvement after the training could be maintained till 3 months later.Trial registration

  17. The Effects of Upper-Limb Training Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation Robotic Hand on Chronic Stroke.

    Science.gov (United States)

    Nam, Chingyi; Rong, Wei; Li, Waiming; Xie, Yunong; Hu, Xiaoling; Zheng, Yongping

    2017-01-01

    Impaired hand dexterity is a major disability of the upper limb after stroke. An electromyography (EMG)-driven neuromuscular electrical stimulation (NMES) robotic hand was designed previously, whereas its rehabilitation effects were not investigated. This study aims to investigate the rehabilitation effectiveness of the EMG-driven NMES-robotic hand-assisted upper-limb training on persons with chronic stroke. A clinical trial with single-group design was conducted on chronic stroke participants ( n  = 15) who received 20 sessions of EMG-driven NMES-robotic hand-assisted upper-limb training. The training effects were evaluated by pretraining, posttraining, and 3-month follow-up assessments with the clinical scores of the Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), the Wolf Motor Function Test, the Motor Functional Independence Measure, and the Modified Ashworth Scale (MAS). Improvements in the muscle coordination across the sessions were investigated by EMG parameters, including EMG activation level and Co-contraction Indexes (CIs) of the target muscles in the upper limb. Significant improvements in the FMA shoulder/elbow and wrist/hand scores ( P  < 0.05), the ARAT ( P  < 0.05), and in the MAS ( P  < 0.05) were observed after the training and sustained 3 months later. The EMG parameters indicated a significant decrease of the muscle activation level in flexor digitorum (FD) and biceps brachii ( P  < 0.05), as well as a significant reduction of CIs in the muscle pairs of FD and triceps brachii and biceps brachii and triceps brachii ( P  < 0.05). The upper-limb training integrated with the assistance from the EMG-driven NMES-robotic hand is effective for the improvements of the voluntary motor functions and the muscle coordination in the proximal and distal joints. Furthermore, the motor improvement after the training could be maintained till 3 months later. ClinicalTrials.gov. NCT02117089; date of registration: April

  18. The Rwanda Field Epidemiology and Laboratory Training Program ...

    African Journals Online (AJOL)

    The Rwanda Field Epidemiology and Laboratory Training Program (RFELTP) is a 2-year public health leadership development training program that provides applied epidemiology and public health laboratory training while the trainees provide public health service to the Ministry of Health. RFELTP is hosted at the National ...

  19. [Resident evaluation of general surgery training programs].

    Science.gov (United States)

    Espinoza G, Ricardo; Danilla E, Stefan; Valdés G, Fabio; San Francisco R, Ignacio; Llanos L, Osvaldo

    2009-07-01

    The profile of the general surgeon has changed, aiming to incorporate new skills and to develop new specialties. To assess the quality of postgraduate General Surgery training programs given by Chilean universities, the satisfaction of students and their preferences after finishing the training period. A survey with multiple choice and Likert type questions was designed and applied to 77 surgery residents, corresponding to 59% of all residents of general surgery specialization programs of Chilean universities. Fifty five per cent of residents financed with their own resources the specialization program. Thirty nine percent disagreed partially or totally with the objectives and rotations of programs. The opportunity to perform surgical interventions and the support by teachers was well evaluated. However, 23% revealed teacher maltreatment. Fifty six percent performed research activities, 73% expected to continue training in a derived specialty and 69% was satisfied with the training program. Residents considered that the quality and dedication of professors and financing of programs are issues that must be improved. The opportunity to perform surgical interventions, obtaining a salary for their work and teacher support is considered of utmost importance.

  20. Short-Term Effects of Whole-Body Vibration Combined with Task-Related Training on Upper Extremity Function, Spasticity, and Grip Strength in Subjects with Poststroke Hemiplegia: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Lee, Jung-Sun; Kim, Chang-Yong; Kim, Hyeong-Dong

    2016-08-01

    The aim of this study was to determine the effect of whole-body vibration training combined with task-related training on arm function, spasticity, and grip strength in subjects with poststroke hemiplegia. Forty-five subjects with poststroke were randomly allocated to 3 groups, each with 15 subjects as follows: control group, whole-body vibration group, and whole-body vibration plus task-related training group. Outcome was evaluated by clinical evaluation and measurements of the grip strength before and 4 weeks after intervention. Our results show that there was a significantly greater increase in the Fugl-Meyer scale, maximal grip strength of the affected hand, and grip strength normalized to the less affected hand in subjects undergoing the whole-body vibration training compared with the control group after the test. Furthermore, there was a significantly greater increase in the Wolf motor function test and a decrease in the modified Ashworth spasticity total scores in subjects who underwent whole-body vibration plus task-related training compared with those in the other 2 groups after the test. The findings indicate that the use of whole-body vibration training combined with task-related training has more benefits on the improvement of arm function, spasticity, and maximal grip strength than conventional upper limb training alone or with whole-body vibration in people with poststroke hemiplegia.

  1. Evaluating an australian emergency nurse practitioner candidate training program.

    Science.gov (United States)

    Plath, Sharyn J; Wright, Mary; Hocking, Julia

    2017-11-01

    Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate. The training team defined milestones for Semesters one and two, and developed a case review form to assess application of the candidate's knowledge in new clinical situations, as well as check for gaps in understanding. A clinical skills guide was developed for the candidate to work toward, and a comprehensive assessment was carried out at two time points in the training program. Feedback was obtained from the mentors and the candidate at the end point of the training program, and has been used to refine the program for 2017. This in-house training program provided specialised, evidence-based training for the emergency department environment, resulting in development of the nurse practitioner candidate as a high functioning team member. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

  2. The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

    Science.gov (United States)

    Southerst, Danielle; Yu, Hainan; Randhawa, Kristi; Côté, Pierre; D'Angelo, Kevin; Shearer, Heather M; Wong, Jessica J; Sutton, Deborah; Varatharajan, Sharanya; Goldgrub, Rachel; Dion, Sarah; Cox, Jocelyn; Menta, Roger; Brown, Courtney K; Stern, Paula J; Stupar, Maja; Carroll, Linda J; Taylor-Vaisey, Anne

    2015-01-01

    Musculoskeletal disorders (MSDs) of the upper and lower extremities are common in the general population and place a significant burden on the health care system. Manual therapy is recommended by clinical practice guidelines for the management of these injuries; however, there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of manual therapy in adults or children with MSDs of the upper or lower extremity. Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of manual therapy were eligible. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best-evidence synthesis principles. Where available, we computed mean changes between groups, relative risks and 95 % CI. We screened 6047 articles. Seven RCTs were critically appraised and three had low risk of bias. For adults with nonspecific shoulder pain of variable duration, cervicothoracic spinal manipulation and mobilization in addition to usual care may improve self-perceived recovery compared to usual care alone. For adults with subacromial impingement syndrome of variable duration, neck mobilization in addition to a multimodal shoulder program of care provides no added benefit. Finally, for adults with grade I-II ankle sprains of variable duration, lower extremity mobilization in addition to home exercise and advice provides greater short-term improvements in activities and function over home exercise and advice alone. No studies were included that evaluated the effectiveness of manual therapy in children or for the management of other extremity injuries in adults. The current evidence on the effectiveness of manual therapy

  3. The effects of virtual reality-based bilateral arm training on hemiplegic children's upper limb motor skills.

    Science.gov (United States)

    Do, Ji-Hye; Yoo, Eun-Young; Jung, Min-Ye; Park, Hae Yean

    2016-01-01

    Hemiplegic cerebral palsy is a neurological symptom appearing on the unilateral arm and leg of the body that causes affected upper/lower limb muscle weakening and dysesthesia and accompanies tetany and difficulties in postural control due to abnormal muscle tone, and difficulties in body coordination. The purpose of this study was to examine the impact of virtual reality-based bilateral arm training on the motor skills of children with hemiplegic cerebral palsy, in terms of their upper limb motor skills on the affected side, as well as their bilateral coordination ability. The research subjects were three children who were diagnosed with hemiplegic cerebral palsy. The research followed an ABA design, which was a single-subject experimental design. The procedure consisted of a total of 20 sessions, including four during the baseline period (A1), 12 during the intervention period (B), and four during the baseline regression period (A2), For the independent variable bilateral arm training based on virtual reality, Nintendo Wii game was played for 30 minutes in each of the 12 sessions. For the dependent variables of upper limb motor skills on the affected side and bilateral coordination ability, a Wolf Motor Function Test (WMFT) was carried out for each session and the Pediatric Motor Activity Log (PMAL) was measured before and after the intervention, as well as after the baseline regression period. To test bilateral coordination ability, shooting baskets in basketball with both hands and moving large light boxes were carried out under operational definitions, with the number of shots and time needed to move boxes measured. The results were presented using visual graphs and bar graphs. The study's results indicated that after virtual reality-based bilateral arm training, improvement occurred in upper limb motor skills on the affected sides, and in bilateral coordination ability, for all of the research subjects. Measurements of the effects of sustained therapy after

  4. Data Programming: Creating Large Training Sets, Quickly

    Science.gov (United States)

    Ratner, Alexander; De Sa, Christopher; Wu, Sen; Selsam, Daniel; Ré, Christopher

    2018-01-01

    Large labeled training sets are the critical building blocks of supervised learning methods and are key enablers of deep learning techniques. For some applications, creating labeled training sets is the most time-consuming and expensive part of applying machine learning. We therefore propose a paradigm for the programmatic creation of training sets called data programming in which users express weak supervision strategies or domain heuristics as labeling functions, which are programs that label subsets of the data, but that are noisy and may conflict. We show that by explicitly representing this training set labeling process as a generative model, we can “denoise” the generated training set, and establish theoretically that we can recover the parameters of these generative models in a handful of settings. We then show how to modify a discriminative loss function to make it noise-aware, and demonstrate our method over a range of discriminative models including logistic regression and LSTMs. Experimentally, on the 2014 TAC-KBP Slot Filling challenge, we show that data programming would have led to a new winning score, and also show that applying data programming to an LSTM model leads to a TAC-KBP score almost 6 F1 points over a state-of-the-art LSTM baseline (and into second place in the competition). Additionally, in initial user studies we observed that data programming may be an easier way for non-experts to create machine learning models when training data is limited or unavailable. PMID:29872252

  5. Increasing your HCAHPS scores with Extreme Customer Service.

    Science.gov (United States)

    Clouarte, Joe

    2016-10-01

    Providing great customer service is extremely critical in the healthcare setting, especially when it comes to HCAHBPS (Hospital Consumer Assessment of Health care Providers and Systems) scores, the author says. While there are several service training programs within healthcare, they often require six to eight minutes of interaction with patients or guests. This works well for clinical staff, he says, but when it comes to non-clinical staff, including security officers, many times they only have fifteen or thirty seconds to create positive patient or guest experience. In this article he describes Extreme Customer Service © a program he has developed to fill that customer gap for non-clinical staff.

  6. Neuroscience Knowledge Among Athletic Training Professional Programs

    Directory of Open Access Journals (Sweden)

    Douglas M. Seavey

    2016-05-01

    Full Text Available The Journal of Sports Medicine & Allied Health Sciences, 2016;2(1 ISSN: 2376-9289 Seavey, Beatty, Lenhoff, & Krause. Neuroscience Knowledge Among Athletic Training Professional Programs Neuroscience Knowledge Among Athletic Training Professional Programs Douglas M. Seavey, AT, Christopher T. Beatty, Tyler L. Lenhoff, & Bentley A. Krause, PhD, AT Ohio University, College of Health Sciences & Professions, Division of Athletic Training. ____________________________________________________________________ Context: Athletic trainers (ATs, more than any other healthcare professional, has expertise in areas of on-field assessment and management of sport related concussion and spinal cord injury. A search of the key words “brain” (n=>100 or “spinal cord/spine” (n=~50 were identified in National Athletic Trainers’ Association Position Statements on Concussion and Spinal Cord Injury. However, a significant gap exists in the basic science knowledge of neuroscience and neuroanatomy. Objective: The goal of this study is to identify the basic science coursework in professional and post-professional athletic training curricula. Design and Setting: This is a descriptive, curricula analysis of CAATE Professional and Post-Professional Athletic Training Programs using web-based search and review. Participants: Curricula for accredited Professional (n=336 and Post-Professional (n=15 Athletic Training Programs were reviewed and analyzed to characteristics basic science content. Interventions: This web-based program review of CAATE standard course content and elective options occurred. Main Outcome Measures: Course titles, numbers and descriptions were accessed at CAATE.net and offerings of anatomy, gross anatomy, neuroanatomy and neuroscience, human physiology, exercise physiology, psychology, chemistry and physics content were quantified. Main outcome measures include frequencies and distributions of courses in each subject area. Results: We reviewed 309

  7. Upper Extremity Functional Status of Female Youth Softball Pitchers Using the Kerlan-Jobe Orthopaedic Clinic Questionnaire.

    Science.gov (United States)

    Holtz, Kaila A; O'Connor, Russell J

    2018-01-01

    Softball is a popular sport with a high incidence of upper extremity injuries. The Kerlan-Jobe Orthopaedic Clinic (KJOC) questionnaire is a validated performance and functional assessment tool used in overhead athletes. Upper extremity pain patterns and baseline KJOC scores have not been reported for active female youth softball pitchers. The purpose of this study was to establish the prevalence of upper extremity pain and its effect in female youth softball pitchers over a competitive season. We hypothesized that participants who missed time due to injury in the past year would have lower KJOC scores. Cross-sectional study; Level of evidence, 3. Fifty-three female softball pitchers aged 12 to 18 years were recruited from softball clinics in Vancouver, British Columbia, Canada. All participants self-identified as a pitcher on a competitive travel team. Participants were administered the KJOC questionnaire before and during the playing season. Missed time due to injury in the past year, current pain patterns, and KJOC scores were primary outcomes. The mean (±SD) preseason KJOC score was 87.2 ± 10.6. In the preseason, 22.6% of pitchers reported playing with arm trouble, and 32.1% missed time due to injury in the past year. The mean KJOC score for pitchers reporting a previous injury (n = 17) was significantly lower compared with those without an injury (n = 36) (79.5 ± 13.8 vs 90.9 ± 6.2, respectively; P = .02). The posterior shoulder was the most commonly reported pain location. For the cohort completing the questionnaire both before and during the playing season (n = 35), mean KJOC scores did not change significantly over the playing season ( P = .64). Lower preseason KJOC scores were significantly related to the in-season injury risk ( P = .016). Pitchers with a preseason score of less than 90 had a 3.5 (95% CI, 1.1-11.2) times greater risk of reporting an in-season injury. Female youth softball pitchers have a high baseline functional status. However, 1 in 3

  8. 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.

  9. Nucleoelectric energy training programs in Spain

    International Nuclear Information System (INIS)

    Tanarro, A.; Izquierdo, L.

    1977-01-01

    The introduction of nucleoelectric energy in Spain is developing very rapidly. The nuclear power installed in Spain at the present time is 1,1 GWe and it is expected to increase to 8 GWe in 1980 and to 28 GWe in 1990. Spanish industry and technology are also rapidly increasing their participation in building nuclear stations, in manufacturing the necessary components and in the activities related to the nuclear fuel cycle. All of this requires properly trained personnel which is estimated at approximately 1200 high-level technicians, 1100 medium-level technicians and 1500 technical assistants by 1980. This personnel is trained: a) In engineering schools; b) In the Nuclear Studies Institute; and c) In the electric companies with nuclear programs. The majority of the high-level engineering schools in the Country include physics and basic nuclear technology courses in their programs. Some of them have an experimental low-power nuclear reactor. The Nuclear Studies Institute is an official organism depending on the Nuclear Energy Commission responsible, among other subjects, of training personnel for the peaceful use and development of nuclear energy in the Country. The electric companies also participate in training personnel for future nuclear stations and they plan to have advanced simulators of the PWR and BWR type stations for operator training. The report deals with the personnel requirement forecasts and describes the personnel training programs [es

  10. Predicting Attrition in a Military Special Program Training Command

    Science.gov (United States)

    2016-05-20

    made by assessing additional psychological factors. Specifically, motivation (s) to enter the training program (e.g., intrinsic versus extrinsic ...this and other training programs. Motivations to enter the training program could be assessed using a measure such as the Work Extrinsic and...MEDICINE GRADUATE PROGRAMS Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814 APPROVAL OF THE DOCTORAL DISSERTATION IN THE

  11. Emergency repair of upper extremity large soft tissue and vascular injuries with flow-through anterolateral thigh free flaps.

    Science.gov (United States)

    Zhan, Yi; Fu, Guo; Zhou, Xiang; He, Bo; Yan, Li-Wei; Zhu, Qing-Tang; Gu, Li-Qiang; Liu, Xiao-Lin; Qi, Jian

    2017-12-01

    Complex extremity trauma commonly involves both soft tissue and vascular injuries. Traditional two-stage surgical repair may delay rehabilitation and functional recovery, as well as increase the risk of infections. We report a single-stage reconstructive surgical method that repairs soft tissue defects and vascular injuries with flow-through free flaps to improve functional outcomes. Between March 2010 and December 2016 in our hospital, 5 patients with severe upper extremity trauma received single-stage reconstructive surgery, in which a flow-through anterolateral thigh free flap was applied to repair soft tissue defects and vascular injuries simultaneously. Cases of injured artery were reconstructed with the distal trunk of the descending branch of the lateral circumflex femoral artery. A segment of adjacent vein was used if there was a second artery injury. Patients were followed to evaluate their functional recoveries, and received computed tomography angiography examinations to assess peripheral circulation. Two patients had post-operative thumb necrosis; one required amputation, and the other was healed after debridement and abdominal pedicle flap repair. The other 3 patients had no major complications (infection, necrosis) to the recipient or donor sites after surgery. All the patients had achieved satisfactory functional recovery by the end of the follow-up period. Computed tomography angiography showed adequate circulation in the peripheral vessels. The success of these cases shows that one-step reconstructive surgery with flow-through anterolateral thigh free flaps can be a safe and effective treatment option for patients with complex upper extremity trauma with soft tissue defects and vascular injuries. Copyright © 2017. Published by Elsevier Ltd.

  12. Kinematic measures for upper limb motor assessment during robot-mediated training in patients with severe sub-acute stroke.

    Science.gov (United States)

    Duret, Christophe; Courtial, Ophélie; Grosmaire, Anne Gaelle

    2016-01-01

    Kinematic assessments are increasingly used as motor outcome measures during upper limb robot-assisted training, in addition to clinical scales. However, their relevance has not been evaluated much. Thirty-eight patients with severe sub-acute stroke (age 56 ± 17 [19-87] years; time since stroke, 55 ± 22 days) carried out 16 sessions (average 3/week, 35 ± 15 days) of upper limb robot-assisted training combined with standard therapy. Pre/post motor performance was evaluated using the Fugl-Meyer Assessment scale, Motor Status Scale (MSS) and kinematic measures. Motor outcomes were compared and relationships between clinical and kinematic outcomes were analyzed. All clinical and kinematic outcomes improved after training (p kinematic measures were strongly correlated with clinical scores. Correlations between clinical and kinematic changes were moderate (r = -0.65 for change in FM Proximal score and change in accuracy measure). However, smoothness and accuracy indicators were shown to be responsive measures. This study demonstrated that baseline kinematic measures and their pre/post training changes were significantly correlated with clinical motor outcome measures. However, even if kinematic measures are valid for the evaluation of motor impairment we cannot propose to substitute common clinical measures of motor function which also evaluate functional abilities of the upper limb.

  13. Improved Training Program for Fall Prevention of Warfighters with Lower Extremity Trauma

    Science.gov (United States)

    2017-10-01

    Release; Distribution Unlimited The views , opinions and/or findings contained in this report are those of the author(s) and should not be construed...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Overseas Contingency Operations have produced many U.S. warfighters with lower extremity injuries

  14. DANCE, BALANCE AND CORE MUSCLE PERFORMANCE MEASURES ARE IMPROVED FOLLOWING A 9-WEEK CORE STABILIZATION TRAINING PROGRAM AMONG COMPETITIVE COLLEGIATE Dancers.

    Science.gov (United States)

    Watson, Todd; Graning, Jessica; McPherson, Sue; Carter, Elizabeth; Edwards, Joshuah; Melcher, Isaac; Burgess, Taylor

    2017-02-01

    Dance performance requires not only lower extremity muscle strength and endurance, but also sufficient core stabilization during dynamic dance movements. While previous studies have identified a link between core muscle performance and lower extremity injury risk, what has not been determined is if an extended core stabilization training program will improve specific measures of dance performance. This study examined the impact of a nine-week core stabilization program on indices of dance performance, balance measures, and core muscle performance in competitive collegiate dancers. Within-subject repeated measures design. A convenience sample of 24 female collegiate dance team members (age = 19.7 ± 1.1 years, height = 164.3 ± 5.3 cm, weight 60.3 ± 6.2 kg, BMI = 22.5 ± 3.0) participated. The intervention consisted of a supervised and non-supervised core (trunk musculature) exercise training program designed specifically for dance team participants performed three days/week for nine weeks in addition to routine dance practice. Prior to the program implementation and following initial testing, transversus abdominis (TrA) activation training was completed using the abdominal draw-in maneuver (ADIM) including ultrasound imaging (USI) verification and instructor feedback. Paired t tests were conducted regarding the nine-week core stabilization program on dance performance and balance measures (pirouettes, single leg balance in passe' releve position, and star excursion balance test [SEBT]) and on tests of muscle performance. A repeated measures (RM) ANOVA examined four TrA instruction conditions of activation: resting baseline, self-selected activation, immediately following ADIM training and four days after completion of the core stabilization training program. Alpha was set at 0.05 for all analysis. Statistically significant improvements were seen on single leg balance in passe' releve and bilateral anterior reach for the SEBT (both p ≤ 0

  15. 30 CFR 77.107-1 - Plans for training programs.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Plans for training programs. 77.107-1 Section... COAL MINES Qualified and Certified Persons § 77.107-1 Plans for training programs. Each operator must..., a program or plan setting forth what, when, how, and where the operator will train and retrain...

  16. Training within the French nuclear power program

    International Nuclear Information System (INIS)

    Jusselin, F.

    1987-01-01

    Training dispensed by the EDF Nuclear and Fossil Generation Division has contributed significantly toward successful startup and operation of French nuclear power plants. In 1986, the time-based availability of 900 MW PWRs totaled 85 %. This is just one example of how EDF training programs have benefited from 150 reactor-years of operating experience and the ensuing opportunities for perfecting and testing of training tool effectiveness. These programs have been adopted by utilities in other countries where suitable local facilities are making advantageous use of EDF training experience and methods. EDF expertise is also transferred to these countries indirectly through the simulator manufacturer

  17. 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

  18. OSHA Training Programs. Module SH-48. Safety and Health.

    Science.gov (United States)

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on OSHA (Occupational Safety and Health Act) training programs is one of 50 modules concerned with job safety and health. This module provides a list of OSHA training requirements and describes OSHA training programs and other safety organizations' programs. Following the introduction, 11 objectives (each keyed to a page in the…

  19. Application to graduate psychology programs by undergraduate students of color: the impact of a research training program.

    Science.gov (United States)

    Hall, Gordon C Nagayama; Allard, Carolyn B

    2009-07-01

    The top 86 students were selected from a pool of approximately 400 applicants to a summer clinical psychology research training program for undergraduate students of color. Forty-three of the students were randomly assigned to 1 of 2 clinical psychology research training programs, and 43 were randomly assigned to a control condition without training. The multicultural version of the training program emphasized the cultural context of psychology in all areas of training, whereas cultural context was de-emphasized in the monocultural version of the program. Although the cultural content of the 2 training programs was effectively manipulated as indicated by a fidelity check by an outside expert, there were no significant differences between the effects of the 2 programs on the outcomes measured in this study. The primary differences in this study were between students who did versus those who did not participate in a training program. Sixty-five percent of the students who completed the multicultural training program applied to graduate schools in psychology, compared with 47% of those who completed the monocultural training program, and 31% of those in the control group. Participation in summer research training programs also increased self-perceptions of multicultural competence.

  20. Quality assurance in postgraduate pathology training the Dutch way: regular assessment, monitoring of training programs but no end of training examination.

    Science.gov (United States)

    van der Valk, Paul

    2016-01-01

    It might seem self-evident that in the transition from a supervised trainee to an independent professional who is no longer supervised, formal assessment of whether the trainee knows his/her trade well enough to function independently is necessary. This would then constitute an end of training examination. Such examinations are practiced in several countries but a rather heterogeneous situation exists in the EU countries. In the Netherlands, the training program is not concluded by a summative examination and reasons behind this situation are discussed. Quality assurance of postgraduate medical training in the Netherlands has been developed along two tracks: (1) not a single testing moment but continuous evaluation of the performance of the trainee in 'real time' situations and (2) monitoring of the quality of the offered training program through regular site-visits. Regular (monthly and/or yearly) evaluations should be part of every self-respecting training program. In the Netherlands, these evaluations are formative only: their intention is to provide the trainee a tool by which he or she can see whether they are on track with their training schedule. In the system in the Netherlands, regular site-visits to training programs constitute a crucial element of quality assurance of postgraduate training. During the site-visit, the position and perceptions of the trainee are key elements. The perception by the trainee of the training program, the institution (or department) offering the training program, and the professionals involved in the training program is explicitly solicited and systematically assessed. With this two-tiered approach high-quality postgraduate training is assured without the need for an end of training examination.

  1. Motor imagery training improves precision of an upper limb movement in patients with hemiparesis.

    Science.gov (United States)

    Grabherr, Luzia; Jola, Corinne; Berra, Gilberto; Theiler, Robert; Mast, Fred W

    2015-01-01

    In healthy participants, beneficial effects of motor imagery training on movement execution have been shown for precision, strength, and speed. In the clinical context, it is still debated whether motor imagery provides an effective rehabilitation technique in patients with motor deficits. To compare the effectiveness of two different types of movement training: motor imagery vs. motor execution. Twenty-five patients with hemiparesis were assigned to one of two training groups: the imagery or the execution-training group. Both groups completed a baseline test before they received six training sessions, each of which was followed by a test session. Using a novel and precisely quantifiable test, we assessed how accurately patients performed an upper limb movement. Both training groups improved performance over the six test sessions but the improvement was significantly larger in the imagery group. That is, the imagery group was able to perform more precise movements than the execution group after the sixth training session while there was no difference at the beginning of the training. The results provide evidence for the benefit of motor imagery training in patients with hemiparesis and thus suggest the integration of cognitive training in conventional physiotherapy practice.

  2. Training Program in Biostatistics for Breast Cancer Research

    National Research Council Canada - National Science Library

    Little, Roderick

    1998-01-01

    The current training program terminates in the summer of 1998. We had originally planned to develop a training program in biostatistics for cancer research for submission to the National Cancer Institute (Task 9...

  3. Appling Andragogy Theory in Photoshop Training Programs

    Science.gov (United States)

    Alajlan, Abdulrahman Saad

    2015-01-01

    Andragogy is a strategy for teaching adults that can be applied to Photoshop training. Photoshop workshops are frequented by adult learners, and thus andragogical models for instruction would be extremely helpful for prospective trainers looking to improve their classroom designs. Adult learners are much different than child learners, given the…

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Configuration Management for eXtreme Programming

    DEFF Research Database (Denmark)

    Asklund, U.; Bendix, Lars Gotfred; Ekman, T.

    2003-01-01

    Extreme programming (XP) is a software development method that prescribes the use of 12 different practices. Four of these practices (collective code ownership, continuous integration, small releases and refactoring) can indeed be given good support by the use of simple configuration management (CM......) techniques. We report on our experience in providing many groups of novice developers with CM education, processes and tools to support the four CM-related XP practices in their projects. True to the spirit of XP both education and processes are very lightweight and we found that it was sufficient to focus...

  6. Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk?

    Science.gov (United States)

    Silverstein, Barbara; Fan, Z Joyce; Smith, Caroline K; Bao, Stephen; Howard, Ninica; Spielholz, Peregrin; Bonauto, David; Viikari-Juntura, Eira

    2009-03-01

    The aim was to explore whether "adjustment" for gender masks important exposure differences between men and women in a study of rotator cuff syndrome (RCS) and carpal tunnel syndrome (CTS) and work exposures. This cross-sectional study of 733 subjects in 12 health care and manufacturing workplaces used detailed individual health and work exposure assessment methods. Multiple logistic regression analysis was used to compare gender stratified and adjusted models. Prevalence of RCS and CTS among women was 7.1% and 11.3% respectively, and among men 7.8% and 6.4%. In adjusted (gender, age, body mass index) multivariate analyses of RCS and CTS, gender was not statistically significantly different. For RCS, upper arm flexion >/=45 degrees and forceful pinch increased the odds in the gender-adjusted model (OR 2.66, 95% CI 1.26-5.59) but primarily among women in the stratified analysis (OR 6.68, 95% CI 1.81-24.66 versus OR 1.45, 95% CI 0.53-4.00). For CTS, wrist radial/ulnar deviation >/=4% time and lifting >/=4.5kg >3% time, the adjusted OR was higher for women (OR 4.85, 95% CI 2.12-11.11) and in the gender stratified analyses, the odds were increased for both genders (women OR 5.18, 95% CI 1.70-15.81 and men OR 3.63, 95% CI 1.08-12.18). Gender differences in response to physical work exposures may reflect gender segregation in work and potential differences in pinch and lifting capacity. Reduction in these exposures may reduce prevalence of upper extremity disorders for all workers.

  7. Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2018-01-01

    Full Text Available We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.

  8. Safeguards training at Pacific Northwest Laboratory

    International Nuclear Information System (INIS)

    Dickman, D.A.

    1986-10-01

    Safeguarding our country's nuclear materials against theft or diversion is extremely important due to their significantly strategic value. In addition, nuclear materials also have an extremely high monetary value. The term ''safeguards'' is defined as an integrated system of physical protection, accountability, and material control measures designed to deter, prevent, detect, and respond to unauthorized possession and use of special nuclear materials. An aggressive Safeguards program, therefore, employs both good security measures and a strong material control and accountability system. For effective internal control of nuclear materials, having people qualified in the many aspects of safeguards and accountability is essential. At Pacific Northwest Laboratory (PNL), this goal is accomplished through a Laboratory-wide Safeguards Awareness Program. All PNL staff members receive a level of Safeguards training appropriate to their particular function within the Laboratory. This paper presents an overview of the unique training opportunities this topic provides and how the training goals are accomplished through the various training courses given to the staff members

  9. Effects of feedback-based balance and core resistance training vs. Pilates training on balance and muscle function in older women: a randomized-controlled trial.

    Science.gov (United States)

    Markovic, Goran; Sarabon, Nejc; Greblo, Zrinka; Krizanic, Valerija

    2015-01-01

    Aging is associated with decline in physical function that could result in the development of physical impairment and disability. Hence, interventions that simultaneously challenge balance ability, trunk (core) and extremity strength of older adults could be particularly effective in preserving and enhancing these physical functions. The purpose of this study was to compare the effects of feedback-based balance and core resistance training utilizing the a special computer-controlled device (Huber®) with the conventional Pilates training on balance ability, neuromuscular function and body composition of healthy older women. Thirty-four older women (age: 70±4 years) were randomly assigned to a Huber group (n=17) or Pilates group (n=17). Both groups trained for 8 weeks, 3 times a week. Maximal isometric strength of the trunk flexors, extensors, and lateral flexors, leg power, upper-body strength, single- and dual-task static balance, and body composition were measured before and after the intervention programs. Significant group×time interactions and main effects of time (pcore resistance training proved to be more effective in improving single- and dual-task balance ability, trunk muscle strength, leg power, and body composition of healthy older women than the traditional Pilates training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions : A Delphi study

    NARCIS (Netherlands)

    Peters, S. E.; Johnston, V.; Ross, M.; Coppieters, M. W.

    2017-01-01

    This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts (n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (3/485% agreement) was achieved for

  11. Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women - The MORGEN study

    NARCIS (Netherlands)

    Wijnhoven, H. A H; de Vet, Henrica C W; Smit, Henriëtte A.; Picavet, H. Susan J

    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)

  12. 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)

  13. Association between Upper Extremity Musculoskeletal Disorders and Psychosocial Factors at Work: A Review on the Job DCS Model's Perspective.

    Science.gov (United States)

    Park, Jung-Keun; Jang, Seung-Hee

    2010-09-01

    Over years it has been increasingly concerned with how upper extremity musculoskeletal disorders (UEMSDs) are attributed to psychosocial job stressors. A review study was conducted to examine associations between UEMSDs and psychosocial work factors, and to recommend what to consider for the associations. For studies in which the job demand-control-support (DCS) model or its variables were specifically employed, published papers were selected and reviewed. A number of studies have reported relationships between UEMSDs symptoms and psychosocial exposure variables. For example, the findings are: higher numbness in the upper extremity was significantly attributed to by less decision latitude at work; work demands were significantly associated with neck and shoulder symptoms while control over time was associated with neck symptoms; and the combination of high psychosocial demands and low decision latitude was a significant predictor for shoulder and neck pain in a female working population. Sources of bias, such as interaction or study design, were discussed. UEMSDs were shown to be associated with psychosocial work factors in various studies where the job DCS model was addressed. Nonetheless, this review suggests that further studies should be conducted to much more clarify the association between UEMSDs and psychosocial factors.

  14. ARL/OMS Consultant Training Program.

    Science.gov (United States)

    Euster, Joanne R.

    1982-01-01

    Describes Academic Library Consultant Training Program begun in 1979, sponsored by Office of Management Studies (OMS) and designed to provide 80 consultants to aid academic libraries in improving performance. Viewpoints are included from OMS Director and participants concerning program objectives, trainee selection, workshops, internships, and the…

  15. Shoulder Muscle Activation of Novice and Resistance Trained Women during Variations of Dumbbell Press Exercises

    Science.gov (United States)

    Luczak, Joshua; Bosak, Andy; Riemann, Bryan L.

    2013-01-01

    Previous research has compared the effects of trunk inclination angle on muscle activation using barbells and Smith machines in men. Whether similar effects occur with the use of dumbbells or in women remains unknown. The purpose was to compare upper extremity surface electromyographical (EMG) activity between dumbbell bench, incline, and shoulder presses. Dominate arm EMG data were recorded for collegiate-aged female resistance trained individuals (n = 12) and novice female resistance trained exercisers (n = 12) from which average EMG amplitude for each repetition phase (concentric, eccentric) was computed. No significant differences were found between experienced and novice resistance trained individuals. For the upper trapezius and anterior deltoid muscles, shoulder press activation was significantly greater than incline press which in turn was significantly greater than bench press across both phases. The bench and incline presses promoted significantly greater pectoralis major sternal activation compared to the shoulder press (both phases). While pectoralis major clavicular activation during the incline press eccentric phase was significantly greater than both the bench and shoulder presses, activation during the bench press concentric phase promoted significantly greater activation than the incline press which in turn was significantly greater than the shoulder press. These results provide evidence for selecting exercises in resistance and rehabilitation programs. PMID:26464884

  16. Shoulder Muscle Activation of Novice and Resistance Trained Women during Variations of Dumbbell Press Exercises

    Directory of Open Access Journals (Sweden)

    Joshua Luczak

    2013-01-01

    Full Text Available Previous research has compared the effects of trunk inclination angle on muscle activation using barbells and Smith machines in men. Whether similar effects occur with the use of dumbbells or in women remains unknown. The purpose was to compare upper extremity surface electromyographical (EMG activity between dumbbell bench, incline, and shoulder presses. Dominate arm EMG data were recorded for collegiate-aged female resistance trained individuals ( and novice female resistance trained exercisers ( from which average EMG amplitude for each repetition phase (concentric, eccentric was computed. No significant differences were found between experienced and novice resistance trained individuals. For the upper trapezius and anterior deltoid muscles, shoulder press activation was significantly greater than incline press which in turn was significantly greater than bench press across both phases. The bench and incline presses promoted significantly greater pectoralis major sternal activation compared to the shoulder press (both phases. While pectoralis major clavicular activation during the incline press eccentric phase was significantly greater than both the bench and shoulder presses, activation during the bench press concentric phase promoted significantly greater activation than the incline press which in turn was significantly greater than the shoulder press. These results provide evidence for selecting exercises in resistance and rehabilitation programs.

  17. Integrated initial training program for a CEGB operations engineer

    International Nuclear Information System (INIS)

    Tompsett, P.A.

    1987-01-01

    This paper considers the overall training programs undertaken by a newly appointed Operations Engineer at one of the Central Electricity Generating Board's (CEGB) Advanced Gas Cooled Reactor (AGR) nuclear power stations. The training program is designed to equip him with the skills and knowledge necessary for him to discharge his duties safely and effectively. In order to assist the learning process and achieve and integrated program, aspects of reactor technology and operation, initially the subject of theoretical presentations at the CEGB's Nuclear Power Training Center (NPTC) are reinforced by either simulation and/or practical experience on site. In the later stages plant-specific simulators, operated by trained tutors, are incorporated into the training program to provide the trainee with practical experience of plant operation. The trainee's performance is assessed throughout the program to provide feedback to the trainee, the trainers and station management

  18. SIgA response and incidence of upper respiratory tract infections during intensified training in youth basketball players.

    Science.gov (United States)

    Moraes, H; Aoki, M S; Freitas, C G; Arruda, Afs; Drago, G; Moreira, A

    2017-03-01

    The aim of the present study was to examine the effect of an intensified training phase followed by a tapering phase on the salivary immunoglobulin A concentration and on the upper respiratory tract infection (URTI) symptoms in young male basketball players. The session rating of perceived exertion method was used to quantify the internal training load, and the Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. The Yo-Yo IR1 test and saliva collection were carried out at the beginning of the study (T1), after the intensified phase (T2), and after tapering (T3). A higher internal training load was observed for the intensified phase compared with the tapering phase (t=19.10; ptraining load followed by a tapering period negatively affects the mucosal immune function with no significant change in severity of URTI in young basketball players.

  19. Study on Nuclear Facility Cyber Security Awareness and Training Programs

    International Nuclear Information System (INIS)

    Lee, Jung-Woon; Song, Jae-Gu; Lee, Cheol-Kwon

    2016-01-01

    Cyber security awareness and training, which is a part of operational security controls, is defined to be implemented later in the CSP implementation schedule. However, cyber security awareness and training is a prerequisite for the appropriate implementation of a cyber security program. When considering the current situation in which it is just started to define cyber security activities and to assign personnel who has responsibilities for performing those activities, a cyber security awareness program is necessary to enhance cyber security culture for the facility personnel to participate positively in cyber security activities. Also before the implementation of stepwise CSP, suitable education and training should be provided to both cyber security teams (CST) and facility personnel who should participate in the implementation. Since such importance and urgency of cyber security awareness and training is underestimated at present, the types, trainees, contents, and development strategies of cyber security awareness and training programs are studied to help Korean nuclear facilities to perform cyber security activities more effectively. Cyber security awareness and training programs should be developed ahead of the implementation of CSP. In this study, through the analysis of requirements in the regulatory standard RS-015, the types and trainees of overall cyber security training programs in nuclear facilities are identified. Contents suitable for a cyber security awareness program and a technical training program are derived. It is suggested to develop stepwise the program contents in accordance with the development of policies, guides, and procedures as parts of the facility cyber security program. Since any training programs are not available for the specialized cyber security training in nuclear facilities, a long-term development plan is necessary. As alternatives for the time being, several cyber security training courses for industrial control systems by

  20. Study on Nuclear Facility Cyber Security Awareness and Training Programs

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung-Woon; Song, Jae-Gu; Lee, Cheol-Kwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    Cyber security awareness and training, which is a part of operational security controls, is defined to be implemented later in the CSP implementation schedule. However, cyber security awareness and training is a prerequisite for the appropriate implementation of a cyber security program. When considering the current situation in which it is just started to define cyber security activities and to assign personnel who has responsibilities for performing those activities, a cyber security awareness program is necessary to enhance cyber security culture for the facility personnel to participate positively in cyber security activities. Also before the implementation of stepwise CSP, suitable education and training should be provided to both cyber security teams (CST) and facility personnel who should participate in the implementation. Since such importance and urgency of cyber security awareness and training is underestimated at present, the types, trainees, contents, and development strategies of cyber security awareness and training programs are studied to help Korean nuclear facilities to perform cyber security activities more effectively. Cyber security awareness and training programs should be developed ahead of the implementation of CSP. In this study, through the analysis of requirements in the regulatory standard RS-015, the types and trainees of overall cyber security training programs in nuclear facilities are identified. Contents suitable for a cyber security awareness program and a technical training program are derived. It is suggested to develop stepwise the program contents in accordance with the development of policies, guides, and procedures as parts of the facility cyber security program. Since any training programs are not available for the specialized cyber security training in nuclear facilities, a long-term development plan is necessary. As alternatives for the time being, several cyber security training courses for industrial control systems by

  1. System for the quality assurance of personnel training programs

    International Nuclear Information System (INIS)

    Rjona, Orison; Venegas, Maria del C.; Rodriguez, Lazaro; Lopez, Miguel A.; Armenteros, Ana L.

    1999-01-01

    In this work are described the fundamental possibilities and characteristics of a software that allows to carry out the management and automatic evaluation of all data gotten during jobs analysis and design, development, implementation and evaluation of personnel training programs of nuclear and radioactive installations and risk industries. The system that is introduced, GESAT, proportion a tool of centralized managerial control of training data and the obtaining of the quality objectives of each installation in the training of their personnel. GESAT includes all phases of SAT method (Systematic Approach to Training). It constitutes the necessary practical support for the elaboration, implementation and evaluation of training programs, allowing the establishment of restrictions and controls and avoiding inconsistencies in the process. It offers the possibility of automatic evaluation that identify fundamental deficiencies in the planning and implementation of training programs. This evaluation facilitates the systematic feed back and the continuous improvement of the training programs.(author)

  2. General Electric's training program for BWR chemists

    International Nuclear Information System (INIS)

    Osborn, R.N.; Lim, W.

    1981-01-01

    This paper describes the development and implementation of the General Electric boiling water reactor chemistry training program from 1959 to the present. The original intention of this program was to provide practical hands on type training in radiochemistry to BWR chemistry supervisors with fossil station experience. This emphasis on radiochemistry has not changed through the years, but the training has expanded to include the high purity water chemistry of the BWR and has been modified to include new commission requirements, engineering developments and advanced instrumentation. Student and instructor qualifications are discussed and a description of the spin off courses for chemistry technicians and refresher training is presented

  3. Upper atmosphere research satellite program. [to study the chemistry energetics, and dynamics

    Science.gov (United States)

    Huntress, W. T., Jr.

    1978-01-01

    A satellite program to conduct research on the chemistry, energetics, and dynamics of the upper atmosphere was developed. The scientific goals of the Upper Atmospheric Research Program, the program requirements, and the approach toward meeting those requirements are outlined. An initial series of two overlapping spacecraft missions is described. Both spacecraft are launched and recovered by the STS, one in the winter of 1983 at a 56 deg inclination, and the other a year later at a 70 deg inclination. The duration of each mission is 18 months, and each carries instruments to make global measurements of the temperature, winds, composition, irradation, and radiance in the stratosphere, mesosphere, and lower thermosphere between the tropopause and 120 km altitude. The program requires a dedicated ground-based data system and a science team organization that leads to a strong interaction between the experiments and theory. The program includes supportive observations from other platforms such as rockets, balloons, and the Spacelab.

  4. Development and Implementation of an End-Effector Upper Limb Rehabilitation Robot for Hemiplegic Patients with Line and Circle Tracking Training

    Directory of Open Access Journals (Sweden)

    Yali Liu

    2017-01-01

    Full Text Available Numerous robots have been widely used to deliver rehabilitative training for hemiplegic patients to improve their functional ability. Because of the complexity and diversity of upper limb motion, customization of training patterns is one key factor during upper limb rehabilitation training. Most of the current rehabilitation robots cannot intelligently provide adaptive training parameters, and they have not been widely used in clinical rehabilitation. This article proposes a new end-effector upper limb rehabilitation robot, which is a two-link robotic arm with two active degrees of freedom. This work investigated the kinematics and dynamics of the robot system, the control system, and the realization of different rehabilitation therapies. We also explored the influence of constraint in rehabilitation therapies on interaction force and muscle activation. The deviation of the trajectory of the end effector and the required trajectory was less than 1 mm during the tasks, which demonstrated the movement accuracy of the robot. Besides, results also demonstrated the constraint exerted by the robot provided benefits for hemiplegic patients by changing muscle activation in the way similar to the movement pattern of the healthy subjects, which indicated that the robot can improve the patient’s functional ability by training the normal movement pattern.

  5. 30 CFR 75.161 - Plans for training programs.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Plans for training programs. 75.161 Section 75... Provision] § 75.161 Plans for training programs. Each operator must submit to the district manager, of the Coal Mine Safety and Health District in which the mine is located, a program or plan setting forth what...

  6. 45 CFR 235.62 - State plan requirements for training programs.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false State plan requirements for training programs. 235... ADMINISTRATION OF FINANCIAL ASSISTANCE PROGRAMS § 235.62 State plan requirements for training programs. A State plan under title I, IV-A, X, XIV, or XVI (AABD) of the Act must provide for a training program for...

  7. Robotics Programs: Automation Training in Disguise.

    Science.gov (United States)

    Rehg, James A.

    1985-01-01

    Questions and answers from the book "Guidelines for Robotics Program Development" are presented, addressing some of the major issues confronted by the person setting the direction for a robotics training program. (CT)

  8. Quality Assurance Plan for Transportation Management Division Transportation Training Programs

    International Nuclear Information System (INIS)

    1994-10-01

    The U.S. Department of Transportation (DOT) implemented new rules requiring minimum levels of training for certain key individuals who handle, package, transport, or otherwise prepare hazardous materials for transportation. In response to these rules, the U.S. Department of Energy (DOE), Transportation Management Division (TMD), has developed a transportation safety training program. This program supplies designed instructional methodology and course materials to provide basic levels of DOT training to personnel for whom training has become mandatory. In addition, this program provides advanced hazardous waste and radioactive material packaging and transportation training to help personnel achieve proficiency and/or certification as hazardous waste and radioactive material shippers. This training program does not include site-specific or task-specific training beyond DOT requirements

  9. Implementation and evaluation of a training program as part of the Cooperative Biological Engagement Program in Azerbaijan

    Directory of Open Access Journals (Sweden)

    April eJohnson

    2015-10-01

    Full Text Available A training program for animal and human health professionals has been implemented in Azerbaijan through a joint agreement between the United States Defense Threat Reduction Agency and the Government of Azerbaijan. The training program is administered as part of the Cooperative Biological Engagement Program, and targets key employees in Azerbaijan’s disease surveillance system including physicians, veterinarians, epidemiologists, and laboratory personnel. Training is aimed at improving detection, diagnosis, and response to especially dangerous pathogens, although the techniques and methodologies can be applied to other pathogens and diseases of concern. Biosafety and biosecurity training is provided to all trainees within the program. Prior to 2014, a variety of international agencies and organizations provided training, which resulted in gaps related to lack of coordination of training materials and content. In 2014 a new training program was implemented in order to address those gaps. This paper provides an overview of the Cooperative Biological Engagement Program training program in Azerbaijan, a description of how the program fits into existing national training infrastructure, and an evaluation of the new program’s effectiveness to date. Long-term sustainability of the program is also discussed.

  10. Stellar extreme ultraviolet astronomy

    International Nuclear Information System (INIS)

    Cash, W.C. Jr.

    1978-01-01

    The design, calibration, and launch of a rocket-borne imaging telescope for extreme ultraviolet astronomy are described. The telescope, which employed diamond-turned grazing incidence optics and a ranicon detector, was launched November 19, 1976, from the White Sands Missile Range. The telescope performed well and returned data on several potential stellar sources of extreme ultraviolet radiation. Upper limits ten to twenty times more sensitive than previously available were obtained for the extreme ultraviolet flux from the white dwarf Sirius B. These limits fall a factor of seven below the flux predicted for the star and demonstrate that the temperature of Sirius B is not 32,000 K as previously measured, but is below 30,000 K. The new upper limits also rule out the photosphere of the white dwarf as the source of the recently reported soft x-rays from Sirius. Two other white dwarf stars, Feige 24 and G191-B2B, were observed. Upper limits on the flux at 300 A were interpreted as lower limits on the interstellar hydrogen column densities to these stars. The lower limits indicate interstellar hydrogen densitites of greater than .02 cm -3 . Four nearby stars (Sirius, Procyon, Capella, and Mirzam) were observed in a search for intense low temperature coronae or extended chromospheres. No extreme ultraviolet radiation from these stars was detected, and upper limits to their coronal emisson measures are derived

  11. How to Train Safe Drivers: Setting Up and Evaluating a Fatigue Training Program

    Directory of Open Access Journals (Sweden)

    Adamos Giannis

    2015-02-01

    Full Text Available Fatigue is considered as a serious risk driving behavior, causing road accidents, which in many cases involve fatalities and severe injuries. According to CARE database statistics, professional drivers are indicated as a high-risk group to be involved in a fatigue-related accident. Acknowledging these statistics, a training program on driving fatigue was organized, aiming at raising awareness of professional drivers of a leading company in building materials, in Greece. Selected experimental methods were used for collecting data before and after the training program, which allowed monitoring and assessing the potential behavioural changes. A questionnaire survey was conducted before the program implementation to 162 drivers of the company, while two months after the program, the same drivers replied to a second questionnaire. Impact assessment of the program relied on statistical analysis of the responses. Results showed the degree of penetration of the training program in the professional drivers' behavior towards safe driving.

  12. Effectiveness of cervical epidural injections in the management of chronic neck and upper extremity pain.

    Science.gov (United States)

    Diwan, Sudhir; Manchikanti, Laxmaiah; Benyamin, Ramsin M; Bryce, David A; Geffert, Stephanie; Hameed, Haroon; Sharma, Manohar Lal; Abdi, Salahadin; Falco, Frank J E

    2012-01-01

    Chronic persistent neck pain with or without upper extremity pain is common in the general adult population with prevalence of 48% for women and 38% for men, with persistent complaints in 22% of women and 16% of men. Multiple modalities of treatments are exploding in managing chronic neck pain along with increasing prevalence. However, there is a paucity of evidence for all modalities of treatments in managing chronic neck pain. Cervical epidural injections for managing chronic neck pain are one of the commonly performed interventions in the United States. However, the literature supporting cervical epidural steroids in managing chronic pain problems has been scant. A systematic review of cervical interlaminar epidural injections for cervical disc herniation, cervical axial discogenic pain, cervical central stenosis, and cervical postsurgery syndrome. To evaluate the effect of cervical interlaminar epidural injections in managing various types of chronic neck and upper extremity pain emanating as a result of cervical spine pathology. The available literature on cervical interlaminar epidural injections in managing chronic neck and upper extremity pain were reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and limited based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status

  13. Radiation monitor training program at Rocky Flats

    International Nuclear Information System (INIS)

    Medina, L.C.; Kittinger, W.D.; Vogel, R.M.

    The Rocky Flats Radiation Monitor Training Program is tailored to train new health physics personnel in the field of radiation monitoring. The purpose of the prescribed materials and media is to be consistent in training in all areas of Rocky Flats radiation monitoring job involvement

  14. 30 CFR 77.1706 - First aid training program; minimum requirements.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false First aid training program; minimum... OF UNDERGROUND COAL MINES Miscellaneous § 77.1706 First aid training program; minimum requirements. (a) All first aid training programs required under the provisions of §§ 77.1703 and 77.1704 shall...

  15. "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.

  16. Effects of neuromuscular electrical stimulation on arterial hemodynamic properties and body composition in paretic upper extremities of patients with subacute stroke

    Directory of Open Access Journals (Sweden)

    Shu-Chun Huang

    2014-08-01

    Full Text Available Background: Neuromuscular electric stimulation (NMES induces repeated muscular contraction, possibly promoting the perfusion/oxygenation of the regional tissues. It remains unclear how NMES influences vascular hemodynamic property and segmental fluid distribution/composition in paretic extremities of hemiplegic patients. Methods: Eleven hemiplegic patients aged 62.6 ± 12.5 years in the subacute stage of stroke received NMES for paretic wrist extensor and flexor muscles 30 min daily, 5 days per week for 4 weeks. The non-paretic upper extremities (NPUE that did not receive NMES served as control. Distribution of fluid to intra/extracellular milieu and arterial hemodynamic properties were determined by using the multi-frequency bioelectrical impedance and pulse wave analysis, respectively. Results: Compared with NPUE without NMES, paretic upper extremity (PUE with NMES revealed a significantly less decrease in arterial blood flow, impedance quotient, slope quotient, and less increase in crest width and crest time of arterial pulse wave. NMES for 4 weeks increased body cell mass in PUE. Furthermore, NPUE without NMES reduced intracellular water, whereas PUE with NMES retarded loss of intracellular water after stroke. Conclusion: NMES therapy increases body cell mass, attenuates reduction of intracellular water, and alleviates arterial hemodynamic disturbance in PUE in subacute stroke. However, stroke-related physical deconditioning may negatively regulate body composition and impair hemodynamic function in NPUE.

  17. Is upper limb virtual reality training more intensive than conventional training for patients in the subacute phase after stroke?

    DEFF Research Database (Denmark)

    Brunner, Iris; Skouen, Jan Sture; Hofstad, Håkon

    2016-01-01

    Background: Virtual reality (VR) training is thought to improve upper limb (UL) motor function after stroke when utilizing intensive training with many repetitions. The purpose of this study was to compare intensity and content of a VR training intervention to a conventional task......-oriented intervention (CT). Methods: A random sample of 50 video recordings was analyzed of patients with a broad range of UL motor impairments (mean age 61y, 22 women). Patients took part in the VIRTUES trial and were randomized to either VR or CT and stratified according to severity of paresis. A standardized scoring...... and graphical methods were used. Results: Patients in the VR group spent significantly more time actively practicing with an activity rate of 77.6 (8.9) % than patients in the CT 67.3 (13.9) %, (p = .003). This difference was attributed to the subgroup of patients with initially severe paresis (n = 22). While...

  18. Current status of endoscopic simulation in gastroenterology fellowship training programs.

    Science.gov (United States)

    Jirapinyo, Pichamol; Thompson, Christopher C

    2015-07-01

    Recent guidelines have encouraged gastroenterology and surgical training programs to integrate simulation into their core endoscopic curricula. However, the role that simulation currently has within training programs is unknown. This study aims to assess the current status of simulation among gastroenterology fellowship programs. This questionnaire study consisted of 38 fields divided into two sections. The first section queried program directors' experience on simulation and assessed the current status of simulation at their institution. The second portion surveyed their opinion on the potential role of simulation on the training curriculum. The study was conducted at the 2013 American Gastroenterological Association Training Directors' Workshop in Phoenix, Arizona. The participants were program directors from Accreditation Council for Graduate Medical Education accredited gastroenterology training programs, who attended the workshop. The questionnaire was returned by 69 of 97 program directors (response rate of 71%). 42% of programs had an endoscopic simulator. Computerized simulators (61.5%) were the most common, followed by mechanical (30.8%) and animal tissue (7.7%) simulators, respectively. Eleven programs (15%) required fellows to use simulation prior to clinical cases. Only one program has a minimum number of hours fellows have to participate in simulation training. Current simulators are deemed as easy to use (76%) and good educational tools (65%). Problems are cost (72%) and accessibility (69%). The majority of program directors believe that there is a need for endoscopic simulator training, with only 8% disagreeing. Additionally, a majority believe there is a role for simulation prior to initiation of clinical cases with 15% disagreeing. Gastroenterology fellowship program directors widely recognize the importance of simulation. Nevertheless, simulation is used by only 42% of programs and only 15% of programs require that trainees use simulation prior to

  19. Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study.

    Science.gov (United States)

    Peters, S E; Johnston, V; Ross, M; Coppieters, M W

    2017-02-01

    This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes. V.

  20. Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis.

    Science.gov (United States)

    Gauthier, Lynne V; Kane, Chelsea; Borstad, Alexandra; Strahl, Nancy; Uswatte, Gitendra; Taub, Edward; Morris, David; Hall, Alli; Arakelian, Melissa; Mark, Victor

    2017-06-08

    Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI therapy is superior to other rehabilitation paradigms, yet it is available to only a small minority of the estimated 1.2 million chronic stroke survivors with upper extremity disability. The current study aims to establish the comparative effectiveness of a novel, patient-centered approach to rehabilitation utilizing newly developed, inexpensive, and commercially available gaming technology to disseminate CI therapy to underserved individuals. Video game delivery of CI therapy will be compared against traditional clinic-based CI therapy and standard upper extremity rehabilitation. Additionally, individual factors that differentially influence response to one treatment versus another will be examined. This protocol outlines a multi-site, randomized controlled trial with parallel group design. Two hundred twenty four adults with chronic hemiparesis post-stroke will be recruited at four sites. Participants are randomized to one of four study groups: (1) traditional clinic-based CI therapy, (2) therapist-as-consultant video game CI therapy, (3) therapist-as-consultant video game CI therapy with additional therapist contact via telerehabilitation/video consultation, and (4) standard upper extremity rehabilitation. After 6-month follow-up, individuals assigned to the standard upper extremity rehabilitation condition crossover to stand-alone video game CI therapy preceded by a therapist consultation. All interventions are delivered over a period of three weeks. Primary outcome measures include motor improvement as measured by the Wolf Motor Function Test (WMFT), quality of arm use for daily activities as measured by Motor Activity Log (MAL), and quality of life as measured by the Quality of Life in

  1. The manpower training and development programs of NUCLEBRAS for the Brazilian nuclear program

    International Nuclear Information System (INIS)

    Spitalnik, J.; Lerner Neto, C.; Stilben, V.; Botelho, O.

    1984-01-01

    As technology transfer is one of the main objectives of the Brazilian Nuclear Program, the principal aim of manpower training has been to provide the conditions for absorbing this technology. The strategy used for such a program required a quantitative and qualitative planning of manpower needs, through medium-range and long-term forecasts, with the condition of maximum utilization of the existing educational infra-structure. On-the-job training which is considered one of the most important means for technology transfer, was given highest priority. Also, management development was considered very important for the implementation of the Nuclear Program. This paper shows the results achieved from 1973 up to now by the manpower training and development programs. (Author) [pt

  2. Radiation protection technologist training and certification program

    International Nuclear Information System (INIS)

    1982-10-01

    The purpose of this program is to establish training requirements and methods for certifying the technical competence of Radiation Protection Technologists. This manual delineates general requirements as well as academic training, on-the-job training, area of facility training, and examination or evaluation requirements for Radiation Protection Trainees (Trainees), Junior Radiation Protection Technologists (JRPT), Radiation Protection Technologists (RPT), and Senior Radiation Protection Technologists (SRPT). This document also includes recertification requirements for SRPTs. The appendices include training course outlines, on-the-job training outlines, and training certification record forms

  3. Enrollment of SME Managers to Growth-oriented Training Programs

    DEFF Research Database (Denmark)

    Bager, Torben; Jensen, Kent Wickstrøm; Schou Nielsen, Pia

    2015-01-01

    Purpose: Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth-intention......Purpose: Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth...... has from 2012 to 2015 trained about 700 SME managers. Data are currently available for 366 of these participants. This evidence is compared with survey results from a randomly selected control group of 292 growth oriented SME managers in the same firm-size group. The data were analyzed through...... of the program. Originality/value The paper is the first systematic study of the importance of who enrolls in training programs for SME managers....

  4. Directory of Instructional Programs in Supervision and Management Training.

    Science.gov (United States)

    Civil Service Commission, Washington, DC. Training Assistance Div.

    This directory, which is designed for the use of training officers in the Washington, D.C. area in prescribing learning programs to meet employee training needs, describes available group and self instructional programs used for the training of supervisors and managers. Each of the 21 courses listed contains the pertinent information necessary to…

  5. Why do seniors leave resistance training programs?

    Directory of Open Access Journals (Sweden)

    Burton E

    2017-03-01

    Full Text Available Elissa Burton,1 Anne-Marie Hill,1 Simone Pettigrew,2 Gill Lewin,3 Liz Bainbridge,1 Kaela Farrier,1 Phil Airey,4 Keith D Hill1 1School of Physiotherapy and Exercise Science, 2School of Psychology and Speech Pathology, 3School of Nursing, Midwifery and Paramedicine, Curtin University, 4Council on the Ageing, Perth, WA, Australia Purpose: The proportion of the population, that is older, is growing at a faster rate than other age groups. Physical activity is important for older people because it assists in living independently. Participating in resistance training on a regular basis (twice weekly is recommended for older people; yet, fewer than 15% of people over 60 years achieve this level. The aim of this article was to investigate the factors contributing to older people’s decisions to stop participation in a resistance training program.Participants and methods: Participants were older people who had chosen to participate in a structured resistance training program specifically designed for seniors and then after a period of time discontinued. This population received a questionnaire in the mail focused on factors contributing to their cessation of resistance training exercise. Qualitative results were analyzed using inductive content analysis.Results: Fifty-six survey responses were received (average age 71.5 years, SD =9.0; 79% females. Injury, illness, and holidaying were the main reasons for ceasing participation. A small but important number of responses (11% reported that they considered they were not provided with sufficient support during the resistance training programs.Conclusions: To attract and retain their senior clients, the results indicate that program organizers need to provide tailored support to return to resistance training after injury and offer flexible and individualized services that accommodate older people’s life choices in retirement. Keywords: older people, strength training, gymnasium, retention, aging

  6. Effect of Resistance Training using Thera-Band on Muscular Strength and Quality of Life among the Elderly

    Directory of Open Access Journals (Sweden)

    Fatemeh Pourtaghi

    2017-10-01

    Full Text Available Background: Lack of mobility and motor impairments can intensify mental health problems in the elderly. Muscle weakness is one of the most important cause of fall in the old individuals. Muscular performance is regarded as one of the significant components of quality of life in older adults. Aim: This study aimed to investigate the effect of resistance training using Thera-Band on muscular strength and quality of life among the elderly. Method: This randomized clinical trial was conducted on 70 elderly people referring to the health centers of Mashhad in 2016. The participants were randomly assigned into two groups of intervention and control. The intervention group was subjected to lower- and upper-extremity resistance training with Thera-Band performed two thirty-minute sessions a week for six weeks. However, the control group did not receive any training. Data collection was performed using a dynamometer and the short version of the World Health Organization Quality of Life. The data were analyzed in SPSS version 16 using independent t-test, Mann-Whitney U test, paired t-test, Chi-square test, and exact Chi-square. Results: The mean ages of the individuals in the intervention and control groups were 69.7±6.1 and 77.2±6.2 years, respectively. After intervention, the mean scores of quality of life (P>0.001 and muscular strength in the upper and lower extremities (P>0.001 were significantly higher in the intervention group than those in the control group. Implications for Practice: Resistance training with Thera-Band could enhance muscular strength and improve quality of life in the elderly. It was concluded that the promotion of this exercise program could have a positive effect on the muscular strength and quality of life among this population.

  7. Frustrations among graduates of athletic training education programs.

    Science.gov (United States)

    Bowman, Thomas G; Dodge, Thomas M

    2013-01-01

    Although previous researchers have begun to identify sources of athletic training student stress, the specific reasons for student frustrations are not yet fully understood. It is important for athletic training administrators to understand sources of student frustration to provide a supportive learning environment. To determine the factors that lead to feelings of frustration while completing a professional athletic training education program (ATEP). Qualitative study. National Athletic Trainers' Association (NATA) accredited postprofessional education program. Fourteen successful graduates (12 women, 2 men) of accredited professional undergraduate ATEPs enrolled in an NATA-accredited postprofessional education program. We conducted semistructured interviews and analyzed data with a grounded theory approach using open, axial, and selective coding procedures. We negotiated over the coding scheme and performed peer debriefings and member checks to ensure trustworthiness of the results. Four themes emerged from the data: (1) Athletic training student frustrations appear to stem from the amount of stress involved in completing an ATEP, leading to anxiety and feelings of being overwhelmed. (2) The interactions students have with classmates, faculty, and preceptors can also be a source of frustration for athletic training students. (3) Monotonous clinical experiences often left students feeling disengaged. (4) Students questioned entering the athletic training profession because of the fear of work-life balance problems and low compensation. In order to reduce frustration, athletic training education programs should validate students' decisions to pursue athletic training and validate their contributions to the ATEP; provide clinical education experiences with graded autonomy; encourage positive personal interactions between students, faculty, and preceptors; and successfully model the benefits of a career in athletic training.

  8. Measuring movement towards improved emergency obstetric care in rural Kenya with implementation of the PRONTO simulation and team training program.

    Science.gov (United States)

    Dettinger, Julia C; Kamau, Stephen; Calkins, Kimberly; Cohen, Susanna R; Cranmer, John; Kibore, Minnie; Gachuno, Onesmus; Walker, Dilys

    2018-02-01

    As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality care. This study uses 3 dimensions of the Kirkpatrick Model to measure the impact of PRONTO International (PRONTO) simulation-based training as part of the Linda Afya ya Mama na Mtoto (LAMMP, Protect the Health of mother and child) in Kenya. Changes in knowledge of obstetric and neonatal emergency response, self-efficacy, and teamwork were analyzed using longitudinal, fixed-effects, linear regression models. Participants from 26 facilities participated in the training between 2013 and 2014. The results demonstrate improvements in knowledge, self-efficacy, and teamwork self-assessment. When comparing pre-Module I scores with post-training scores, improvements range from 9 to 24 percentage points (p values strategic goals was high: 95.8% of the 192 strategic goals. Participants rated the PRONTO intervention as extremely useful, with an overall score of 1.4 out of 5 (1, extremely useful; 5, not at all useful). Evaluation of how these improvements affect maternal and perinatal clinical outcomes is forthcoming. © 2018 John Wiley & Sons Ltd.

  9. Investigation Stability of Upper Limb Function in Handballers with Glenohumeral Internal Rotation Deficit

    Directory of Open Access Journals (Sweden)

    Noorollah Javdaneh

    2017-09-01

    Conclusion: Based on the results of this study, functional stability of the unstable shoulder of Hanballers with Glenohumeral Internal Rotation Deficit is lower than the functional stability of the healthy subjects; therefore, we suggest that the upper extremity stabilization exercises, specially the closed kinetic chain exercises be added to the shoulder rehabilitation programs.

  10. Use of Simulation in Canadian Neonatal-Perinatal Medicine Training Programs.

    Science.gov (United States)

    Wong, Jonathan; Finan, Emer; Campbell, Douglas

    2017-07-08

    Introduction Simulation is used for the delivery of education and on occasion assessment. Before such a tool is used routinely in neonatal training programs across Canada, a need assessment is required to determine its current usage by accredited training programs. Our aim was to characterize the type of simulation modalities used and the perceived simulation-based training needs in Canadian neonatal-perinatal medicine (NPM) training programs. Methods A 22-item and 13-item online descriptive survey was sent to all NPM program directors and fellows in Canada, respectively. The survey was modeled on a previously validated tool by Johnston, et al. and responses were collected over 30 days. Results In total, eight (63%) program directors and 24 (28%) fellows completed the survey, with all respondents indicating that simulation is being used. Both lab-based and in situ simulations are occurring, with a range of simulation modalities employed to primarily teach resuscitation, procedural and communication skills. Fellows indicated that simulation should also be used to also teach other important topics, including disease-specific management, crisis resource management, and prevention of medical error. Five (63%) programs have faculty with formal simulation training and four (50%) programs have at least one faculty involved in simulation research. Conclusion Simulation is widely used in Canadian NPM training programs, with program directors and fellows identifying this as an important tool. Simulation can be used to teach a range of skills, but programs need to align their curriculum with both training objectives and learner needs. There is an opportunity for faculty development and increased simulation research.

  11. The GRONORUN study: is a graded training program for novice runners effective in preventing running related injuries? Design of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Pepping Gert-Jan

    2007-03-01

    Full Text Available Abstract Background Running is a popular form of recreational exercise. Beside the positive effects of running on health and fitness, the risk of a running related injury has to be considered. The incidence of injuries in runners is high and varies from 30–79%. However, few intervention studies on prevention of running related injuries have been performed and none of these studies involved novice runners. Methods GRONORUN (Groningen Novice Running is a two armed randomized controlled trial, comparing the effects of two different training programs for novice runners on the incidence of running related injuries. Participants are novice runners, who want to train for a four mile running event. The control group will train according a standard 8 week training program. The intervention group will use a more gradual, 13 week training program which is based on "the ten percent training rule". During the thirteen week follow up participants register information on running and RRI's in an internet based running log. The primary outcome measure is RRI. An injury is defined as a musculoskeletal ailment of the lower extremity or back, causing a restriction of running for at least one week. Discussion The GRONORUN trial is the first randomized controlled trial to study a preventive intervention in novice runners. Many different training programs for novice runners are offered, but none are evidence based.

  12. Force Myography to Control Robotic Upper Extremity Prostheses: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Erina eCho

    2016-03-01

    Full Text Available Advancement in assistive technology has led to the commercial availability of multi-dexterous robotic prostheses for the upper extremity. The relatively low performance of the currently used techniques to detect the intention of the user to control such advanced robotic prostheses, however, limits their use. This article explores the use of force myography (FMG as a potential alternative to the well-established surface electro-myography (sEMG. Specifically, the use of FMG to control different grips of a commercially available robotic hand, Bebionic3, are investigated. Four male transradially amputated subjects participated in the study and a protocol was developed to assess the prediction accuracy of eleven grips. Different combinations of grips were examined ranging from six up to eleven grips. The results indicate that it is possible to classify six primary grips important in activities of daily living using FMG with an accuracy of above 70% in the residual limb. Additional strategies to increase classification accuracy, such as using the available modes on the Bebionic3, allowed results to improve up to 88.83% and 89.00% for opposed thumb and non-opposed thumb modes respectively.

  13. Radial nerve measurements in nonsymptomatic upper extremities of Filipinos: A cross-sectional study.

    Science.gov (United States)

    Gonzalez-Suarez, Consuelo B; Dones, Valentin C; Grimmer, Karen; Thoirs, Kerry; Milanese, Steven; Atlas, Alvin

    2015-10-01

    Despite reports on the association of radial nerve (RN) size and lateral epicondylalgia (LE), Filipino normative values on RN size in healthy elbows are not established. An association with upper extremity anthropometric measurements is likewise not reported. Musculoskeletal ultrasound measurements of the RN at the level of the lateral epicondyle (RN-LE), posterior interosseous nerve at the level of the radial head and supinator (PIN-RH and PIN-sup), and superficial RN (SRN) in the elbows of healthy Filipinos were made in Manila from January-September 2011. A total of 198 elbows of 99 healthy participants aged 43 years (range, 33-48 years) [median(IQR)] were investigated. Men have larger PIN-RH, PIN-sup, and SRN compared with women. Arm length was associated with PIN-RH, PIN-sup, and SRN (P values can now be used for comparison in elbows with LE. © 2015 Wiley Periodicals, Inc.

  14. Ethical Issues in Parent Training Programs.

    Science.gov (United States)

    Sapon-Shevin, Mara

    1982-01-01

    Four areas of ethical concern are voiced in the training of parents of handicapped children: (1) selection of program goals, (2) problems involved with both positive reinforcement and punishment, (3) conflicts between experimentation and therapeutic intervention, and (4) level of parent training. Consideration of ethical issues at each step of…

  15. Export Management Specialist. A Training Program. Instructor's Edition.

    Science.gov (United States)

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This publication provides instructors with materials for an export management specialist (EMS) training program. The objective of the training program is to assist companies in reaching their export goals by educating current and potential managers about the basics of exporting. It provides a foundation for considering international trade and for…

  16. 32 CFR 634.10 - Remedial driver training programs.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Driving Privileges § 634.10 Remedial driver training programs. (a) Navy...

  17. E-Basics: Online Basic Training in Program Evaluation

    Science.gov (United States)

    Silliman, Ben

    2016-01-01

    E-Basics is an online training in program evaluation concepts and skills designed for youth development professionals, especially those working in nonformal science education. Ten hours of online training in seven modules is designed to prepare participants for mentoring and applied practice, mastery, and/or team leadership in program evaluation.…

  18. Home-based nerve stimulation to enhance effects of motor training in patients in the chronic phase after stroke: a proof-of-principle study.

    Science.gov (United States)

    Dos Santos-Fontes, Renata Laurenti; Ferreiro de Andrade, Karina Nocelo; Sterr, Annette; Conforto, Adriana Bastos

    2013-01-01

    Somatosensory stimulation in the form of repetitive peripheral nerve stimulation (RPSS) is a promising strategy to improve motor function of the upper limb in chronic stroke. Home-based RPSS may be an alternative to hospital-based RPSS. To investigate the feasibility and safety of an innovative program of home-based RPSS combined with motor training and to collect preliminary data on the efficacy of this program to enhance hand motor function in patients in the chronic phase after stroke. Twenty patients were randomized to either active or sham RPSS associated with daily motor training performed at home over 4 consecutive weeks. All the patients were able to perform tasks of the Jebsen-Taylor Test (JTT). The primary outcome measures were feasibility, evaluated by self-reported compliance with the intervention, and safety (adverse events). Secondary outcomes comprised improvements in hand function in the JTT after end of treatment and after a 4-month follow-up period. There were no relevant adverse events. Compliance with RPSS and motor training was significantly greater in the active group than in the sham group. Upper extremity performance improved significantly more in the active group compared with the sham group at the end of treatment. This difference remained significant 4 months later, even when differences in compliance with motor training were considered. Home-based active RPSS associated with motor training was feasible, was safe, and led to long-lasting enhancement of paretic arm performance in the chronic phase after stroke for those who can perform the JTT. These results point to the need for an efficacy trial.

  19. The U.S. Department of Energy Laboratory Accreditation Program for testing the performance of extremity dosimetry systems: a summary of the program status

    International Nuclear Information System (INIS)

    Cummings, F.M.; Carlson, R.D.; Gesell, T.F.; Loesch, R.M.

    1992-01-01

    In 1986, The U.S. Department of Energy (DOE) implemented a program to test the performance of its personnel whole-body dosimetry systems. This program was the DOE Laboratory Accreditation Program (DOELAP). The program parallels the performance testing program specified in the American National Standard for Dosimetry - Personnel Dosimetry Performance -Criteria for Testing (ANSI N13.11-1983), but also addresses the additional dosimetry needs of DOE facilities. As an extension of the whole-body performance testing program, the DOE is now developing a program to test the performance of personnel extremity dosimetry systems. The draft DOE standard for testing extremity dosimetry systems is much less complex than the whole-body dosimetry standard and reflects the limitations imposed on extremity dosimetry by dosimeter design and irradiation geometry. A pilot performance test session has been conducted to evaluate the proposed performance-testing standard. (author)

  20. Do volunteers reduce the costs of parent training programs?

    DEFF Research Database (Denmark)

    Scavenius Sonne-Schmidt, Christoffer; Amilon, Anna; Schultz, Esben Anton

    ADHD in children has considerable negative consequences for both affected individuals and their families. One way to milden these negative consequences is by offering parents training in how to handle the child’s difficulties. However, running parent training programs is associated with substanti...... programs. Although direct comparison is difficult due to different outcome measures being used in comparable studies, our findings suggest that Caring in Chaos constitutes a commendable alternative to validated parent training programs such as Triple P and The Incredible Years...