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Sample records for upper-limb musculoskeletal disorders

  1. Work-Related Upper Limb Disorders: A Case Report

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    Zlatka Borisova Stoyneva

    2015-03-01

    Full Text Available In this study the complex interrelationship between physical factors, job stress, lifestyle and genetic factors on symptoms of work-related musculoskeletal disorders of the upper limbs is demonstrated by a case report and discussion of the literature. A 58 year old woman with long lasting complaints of the upper limbs with increasing intensity and duration, generalisation, combined with skin thickness, Raynaud’s phenomenon, joint disorders, arterial and pulmonary hypertension, metabolic lipid dysfunctions is presented. Occupational history proves continuous duration of service at a job with occupational physical static load with numerous repetitive monotonous systematic motions of fingers and hands as a weaver of Persian rugs followed by work at an automated loom and variable labour activities. Though the complaints dated since the time she was a manual weaver, the manifestations of generalized joint degenerative changes, system sclerosis with Raynaud’s phenomenon with similar upper extremities signs and symptoms discount upper limbs musculoskeletal disorder as caused only or mainly by occupational risk factors. The main principles and criteria for occupational diagnosis of musculoskeletal upper limb disorders and legislative requirements for their reglamentation are discussed.

  2. WORK RELATED MUSCULOSKELETAL DISORDERS OF THE UPPER LIMBS AMONG STEEL INDUSTRY POPULATIONS

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    S. A. Moussavi-Najarkola A. Khavanin

    2007-08-01

    Full Text Available For high occurrences of upper extremity disorders in working populations and in order to compare the occurrence of musculoskeletal alterations due to ergonomic risk factors such as highly force exertion, repetition, awkward posture between exposed and non-exposed groups, the research was carried out in Tabarestan steel industry. All 526 male workers (316 as exposed group : 132 aged 20-35 years, 184 aged >35 years; 210 as Non-exposed group: 89 aged 20-35 years, 121 aged > 35 years performing tasks exposed / not exposed to risk factors for WMSDS of the upper limbs underwent a clinical examinations as well as completing standardized Nordic Musculoskeletal Questionnaires. The anamnestic cases were defined on the basis of pain, paraesthesia, hyposthenia, and vegetative disorders during previous months. Mean age of exposed and non- exposed groups were obtained 36.3 years (SD= 5.9 and 37.9 years (SD = 7.3 respectively. There were distinguished differences in occurrences of WMSDS of upper limbs between two mentioned groups. The major occurrence was found for the right and left hands. Nocturnal and diurnal paraesthesia obtained an occurrence of about 54% and 53% respectively. Data bears witness to the greater occurrence of affected individuals in exposed group, with a non- exposed / exposed ratio of 1:7.2. The greater occurrences of affected individuals in exposed group (P = 0.006 and in subjects>35 years (P = 0.002 were significant. Structural, organizational and educational measures can be applied to prevent WMSDS or diminish the relative effects to acceptable limit.

  3. The prediction of the incidence rate of upper limb musculoskeletal disorders, with CTD risk index method on potters of Meybod city

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    Reza Khani Jazani

    2012-02-01

    Full Text Available Background: The objective of this study was to predict the incidence of musculoskeletal disorders in potters of Meybod city by performing CTD risk index method.Materials and Method: This is a descriptive cross-sectional study. Target society was all workers in pottery workshops which were located in the Meybod. Information related to musculoskeletal disorders was obtained by the Nordic questionnaire and we used CTD risk index method to predict the incidence of musculoskeletal disorders.Results: We observed in this study that 59.3% of the potters had symptoms of musculoskeletal disorders in at least in one of their upper extremities. Also significant differences between mean CTD risk index on potters with and without symptoms of the upper limb musculoskeletal disorders, respectively (p=0.038.Conclusion: CTD risk index method can be as a suitable method for predicting the incidence of musculoskeletal disorders used in the potters

  4. A tailored workplace exercise program for women at risk for neck and upper limb musculoskeletal disorders: a randomized controlled trial.

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    Rasotto, Chiara; Bergamin, Marco; Sieverdes, John C; Gobbo, Stefano; Alberton, Cristine L; Neunhaeuserer, Daniel; Maso, Stefano; Zaccaria, Marco; Ermolao, Andrea

    2015-02-01

    The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain. Sixty female subjects were randomly assigned to an intervention group or a control group. The IG was administered of a 6-month, twice-a-week, tailored exercise program, whereas the CG received no intervention. The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures. In addition, reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength. This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders, showing clinically meaningful reductions of pain symptoms and disability on upper limb and neck regions.

  5. Three-body segment musculoskeletal model of the upper limb

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    Valdmanová L.

    2013-06-01

    Full Text Available The main aim is to create a computational three-body segment model of an upper limb of a human body for determination of muscle forces generated to keep a given loaded upper limb position. The model consists of three segments representing arm, forearm, hand and of all major muscles connected to the segments. Muscle origins and insertions determination corresponds to a real anatomy. Muscle behaviour is defined according to the Hill-type muscle model consisting of contractile and viscoelastic element. The upper limb is presented by a system of three rigid bars connected by rotational joints. The whole limb is fixed to the frame in the shoulder joint. A static balance problem is solved by principle of virtual work. The system of equation describing the musculoskeletal system is overdetermined because more muscles than necessary contribute to get the concrete upper limb position. Hence the mathematical problem is solved by an optimization method searching the least energetically-consuming solution. The upper limb computational model is verified by electromyography of the biceps brachii muscle.

  6. The association of subjective stress, urinary catecholamine concentrations and PC game room use and musculoskeletal disorders of the upper limbs in young male Koreans.

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    Kang, Jong-Won; Kim, Heon; Cho, Soo-Hun; Lee, Myung-Koo; Kim, Yong-Dae; Nan, Hong-Mei; Lee, Chul-Ho

    2003-06-01

    The use of PCs can cause health problems, including musculoskeletal disorders (MSDs) of the upper limbs. This study was performed to investigate whether using PCs in PC game rooms may induce MSDs of the upper limbs. 284 young male Koreans were included. A self-administered, structured questionnaire was used to gather information about game room use, perceived subjective stress, and the symptoms related to MSDs. Urinary concentrations of epinephrine, norepinephrine, and dopamine were measured in spot urine. The symptom prevalence of MSDs of the upper limbs increased according to the increase of the duration of game room use. The intensity of perceived subjective stress showed a significant dose-response relationship with the frequency of MSDs symptoms in neck and shoulder areas. However, the urinary level of catecholamines was not significantly correlated with the symptom prevalence of MSDs in the upper limbs. These findings suggest that using PCs in game rooms produce physical stress on the upper limbs, strong enough to induce MSDs.

  7. Classical test theory and Rasch analysis validation of the Upper Limb Functional Index in subjects with upper limb musculoskeletal disorders.

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    Bravini, Elisabetta; Franchignoni, Franco; Giordano, Andrea; Sartorio, Francesco; Ferriero, Giorgio; Vercelli, Stefano; Foti, Calogero

    2015-01-01

    To perform a comprehensive analysis of the psychometric properties and dimensionality of the Upper Limb Functional Index (ULFI) using both classical test theory and Rasch analysis (RA). Prospective, single-group observational design. Freestanding rehabilitation center. Convenience sample of Italian-speaking subjects with upper limb musculoskeletal disorders (N=174). Not applicable. The Italian version of the ULFI. Data were analyzed using parallel analysis, exploratory factor analysis, and RA for evaluating dimensionality, functioning of rating scale categories, item fit, hierarchy of item difficulties, and reliability indices. Parallel analysis revealed 2 factors explaining 32.5% and 10.7% of the response variance. RA confirmed the failure of the unidimensionality assumption, and 6 items out of the 25 misfitted the Rasch model. When the analysis was rerun excluding the misfitting items, the scale showed acceptable fit values, loading meaningfully to a single factor. Item separation reliability and person separation reliability were .98 and .89, respectively. Cronbach alpha was .92. RA revealed weakness of the scale concerning dimensionality and internal construct validity. However, a set of 19 ULFI items defined through the statistical process demonstrated a unidimensional structure, good psychometric properties, and clinical meaningfulness. These findings represent a useful starting point for further analyses of the tool (based on modern psychometric approaches and confirmatory factor analysis) in larger samples, including different patient populations and nationalities. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. [Prevalence of upper limb work-related musculoskeletal disorders (UL-WMSDs) in workers of the upholstered furniture industry].

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    Nicoletti, S; Carino, M; Di Leone, G; Trani, G; Carella, F; Rubino, G; Leone, E; Popolizio, R; Colafiglio, S; Ambrosi, L

    2008-01-01

    The upholstered furniture industry, the so-called "triangle of the sofa industry", is a geographic area of national and strategic economic importance in southern Italy. The single tasks are carried out mostly manually, with the characteristics of a handicraft approach. The aim of the survey was to assess the prevalence of upper limb work-related musculoskeletal disorders (UL-WMSDs) in 30 factories of the sofa industry located in a large geographic area of the Puglia and Basilicata Regions. In the period 1 January-31 December 2003 a network of occupational physicians investigated a population of 5.477 subjects (exposed n=3481, controls n=1996, M=3865, F=1612) in 30 different factories of the area. More than 60 percent of the total workforce studied was employed in large-sized companies (>500 employees). The following work tasks were considered: filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. Case-definition was assessed through standardized procedures: symptoms by questionnaire plus physical and laboratory/imaging findings. Cumulative prevalence rates of UL-WMSDs as at 31 December 2003 reached values of up to 30% in high risk groups. Prevalence rates showed good correlation with the concise OCRA index used for assessment of exposure to repetitive strain and movements of the upper limb. The most frequently occurring disorders were tendon-related cysts and wrist tendonitis. Shoulder disorders were more frequent in male and female leather-cutting operators. This survey showed a significantly high prevalence of UL-WMSDs in sofa industry workers. It did not seem to be confirmed in this study that there was a greater female susceptibility to UL-WMSDs with the exception of carpal tunnel syndrome: gender difference seems to be less relevant at increasing levels of occupational exposure to repetitive movements and exertion of the upper limbs.

  9. Musculoskeletal disorders of the lower limb - ultrasound and magnetic resonance imaging correlation

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    Girish, G.; Finlay, K.; Landry, D.; O'Neill, J.; Popowich, T.; Jacobson, J.; Friedman, L.; Jurriaans, E.

    2007-01-01

    The purpose of this paper is to familiarize general radiologists and specialists with the sonographic and corresponding magnetic resonance imaging (MRI) appearance of various musculoskeletal disorders of the lower limb. Technologists and radiologists should be familiar with all imaging techniques for the investigation and evaluation of musculoskeletal abnormalities. The role of high-resolution ultrasound (US) is highlighted, as well as the complimentary relation between both imaging modalities. We also discuss some of the advantages of US over MRI in the investigation of musculoskeletal disorders of the lower limb. The MRI and US appearances of various articular, periarticular, and soft tissue pathologies of the lower limb are compared and reviewed, and where possible, the advantages of each modality are identified. (author)

  10. [Manufacture of upholstered furniture and work-related upper limb musculoskeletal disorders: an industrial sector prevention project].

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    Di Leone, G; Carino, M; Nicoletti, S; Trani, G; Ambrosi, L

    2008-01-01

    In cooperation with the IRCCS Fondazione Maugeri and the IRCCS Fondazione Ospedale Maggiore Policlinico - EPM-CEMOC, of Milan, the Local Health Unit in Bari, Italy carried out a research project, sponsored partly by the Italian Ministry of Health, on upper limb work-related musculoskeletal disorders (UL-WMSDs) in a specific manufacturing sector, the upholstered furniture industry. This "sofa district" is widely represented with approximately 14,000 workers and 500 factories over a wide geographic area of southern Italy. Advanced technology in the manufacturing process is combined with workers performing intensive arm-hand tasks. The aim of the study included: a) assessment of exposure to repetitive strain and movements of the upper limb in a representative sample of the factories using the OCRA method, b) analysis of the annual prevalence and incidence rates, c) definition of possible improvement via ergonomic solutions in the various factories. Via a network of occupational physicians a total of more than 6000 subjects were examined over a 5-year period. Case-definition was assessed through standardized procedures. A detailed description of the manufacturing process of the upholstered furniture industry and of the characteristics of the working population is provided Exposed groups at risk were:filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. Data collected in private companies of different size in this extensive industrial "sofa area" emphasize the importance of prevention through adequate ergonomic solutions and the need to improve training programmes covering the whole area.

  11. Musculoskeletal disorders among workers in plastic manufacturing plants.

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    Fernandes, Rita de Cássia Pereira; Assunção, Ada Avila; Silvany Neto, Annibal Muniz; Carvalho, Fernando Martins

    2010-03-01

    Epidemiological studies have indicated an association between musculoskeletal disorders (MSDs) and physical work demands. Psychosocial work demands have also been identified as possible risk factors, but findings have been inconsistent. To evaluate factors associated with upper back, neck and upper limb MSD among workers from 14 plastic manufacturing companies located in the city of Salvador, Brazil. A cross-sectional study design was used to survey a stratified proportional random sample of 577 workers. Data were collected by questionnaire interviews. Factor analysis was carried out on 11 physical demands variables. Psychosocial work demands were measured by demand, control and social support questions. The role of socio-demographic factors, lifestyle and household tasks was also examined. Multiple logistic regression was used to identify factors related to upper back, neck and upper limb MSDs. Results from multiple logistic regression showed that distal upper limb MSDs were related to manual handling, work repetitiveness, psychosocial demands, job dissatisfaction, and gender. Neck, shoulder or upper back MSDs were related to manual handling, work repetitiveness, psychosocial demands, job dissatisfaction, and physical unfitness. Reducing the prevalence of musculoskeletal disorders requires: improving the work environment, reducing biomechanical risk factors, and replanning work organization. Programs must also be aware of gender specificities related to MSDs.

  12. [Upper limb work-related musculoskeletal disorders (UL-WMSDs) in a large factory of the upholstered furniture industry: risk management].

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    Nicoletti, S; Castoro, V; Iacobellis, M; Loizzo, N; Monopoli, L

    2008-01-01

    The industrial production of upholstered furniture exposes workers to significant risk of occupational disorders due to ergonomics-related problems, such as repetitive strain and movements of the upper limb, manual load lifting, prolonged static postures. This paper describes the main measures taken by the biggest company in the "sofa sector" in southern Italy in order to solve such problems in the years 1996-2004. the classic instruments of ergonomics were used such as risk assessment, medical surveillance, training and information programmes, technological reorganization of the manufacturing process and of single working tasks. The accident rate (number of accidents per million working hours) which showed an increasing trend in the previous years, rose from a value of 31 in 1996 to 51 in the years 1999-2000 (with a percentage of accidents related to load lifting in the range 25-35%). At the same time the incidence rate of work-related upper limb musculoskeletal disorders (UL-WMSDs) in the population of workers (which had increased in the meantime from 2500 to 3500 employees) reached nearly 5% in 2001, with peaks of 8-9% in the work tasks with higher exposure. Accident rates progressively fell in the following three years until a value of 20 was reached in 2004 and 2005, while the mean incidence rate of WMSDs reached a value of nearly 1%. The data need to be compared with the trends in the other companies of the sector in the same period, with an average incidence rate of WMSDs around 2% and a generally increasing trend. Ergonomic interventions not only concur in the management and control of negative events for workers health but also in achieving advantages in terms of lower costs and greater productivity.

  13. Duration of computer use and mouse use in relation to musculoskeletal disorders of neck or upper limb

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    Blatter, B.M.; Bongers, P.M.

    2002-01-01

    The objectives of this study were to examine the association between work-related upper limb disorders (WRULDs) and duration of computer and mouse use, to investigate differences in these associations between men and women, and to examine whether a possible relationship between duration of computer

  14. Diagnostic distribution of non-traumatic upper limb disorders

    DEFF Research Database (Denmark)

    Laursen, Lise H; Sjøgaard, Gisela; Hagert, C G

    2007-01-01

    BACKGROUND: Upper limb disorders (ULDs) are common, and so are the difficulties in specific diagnoses of these disorders. Prior studies have shed light on the nerves in the diagnostic approach beside disorders related to muscles, tendons and joints (MCDs). OBJECTIVE: The study aimed to compare th...

  15. Prevalence of upper limb disorders among female librarians.

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    Pandy, R

    2013-09-01

    Work as a librarian involves exposure to potential risk factors for developing upper limb disorders. The prevalence of upper limb symptoms has, however, not previously been assessed in this occupational group. To estimate the 7-day and annual prevalence of self-reported neck and upper limb symptoms in librarians and to examine associations with specific tasks and ergonomic risk factors. A cross-sectional study using components of the standardized Nordic questionnaire. The study population consisted of librarians employed by a large local authority, and data collection was by means of a self-administered questionnaire. from studies on keyboard workers and on the general population were used as comparators. The 7-day prevalence of self-reported neck and upper limb pain in female librarians was 42% (95% confidence interval (CI) 33.7-50.5) and the annual prevalence was 65% (95% CI 56.6-72.8). The prevalence of reported wrist and hand pain increased with increased working involving a wide thumb-index span (P librarians was high, but there was insufficient evidence to confirm whether the prevalence was higher than in the general population or among keyboard workers. Working with a wide thumb-index span was associated with reporting upper limb symptoms.

  16. Ergonomic Training Reduces Musculoskeletal Disorders among Office Workers: Results from the 6-Month Follow-Up

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    Mahmud, Norashikin; Kenny, Dianna Theadora; Md Zein, Raemy; Hassan, Siti Nurani

    2011-01-01

    Background: Musculoskeletal disorders are commonly reported among computer users. This study explored whether these disorders can be reduced by the provision of ergonomics education. Methods: A cluster randomised controlled trial was conducted in which 3 units were randomised for intervention and received training, and 3 units were given a leaflet. The effect of intervention on workstation habits, musculoskeletal disorders, days and episodes of sick leave, and psychological well-being were assessed. Results: A significant improvement in workstation habits was found, and the differences remained significant at the follow-up time point for keyboard, mouse, chair, and desk use. The largest reduction in the percentage of musculoskeletal disorders was in the neck region (−42.2%, 95% CI −60.0 to −24.4). After adjusting for baseline values, significant differences were found at the follow-up time point in the neck, right shoulder, right and left upper limbs, lower back, and right and left lower limbs. No significant differences were found for the days and episodes of sick leave or the psychological well-being among workers after the intervention. Conclusion: Consistent reductions were observed for all musculoskeletal disorders at the follow-up time point, although the difference was not statistically significant for the upper back. The improvements in the musculoskeletal disorders did not translate into fewer days lost from work or improved psychological well-being. PMID:22135582

  17. Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012.

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    Stocks, S Jill; McNamee, Roseanne; van der Molen, Henk F; Paris, Christophe; Urban, Pavel; Campo, Giuseppe; Sauni, Riitta; Martínez Jarreta, Begoña; Valenty, Madeleine; Godderis, Lode; Miedinger, David; Jacquetin, Pascal; Gravseth, Hans M; Bonneterre, Vincent; Telle-Lamberton, Maylis; Bensefa-Colas, Lynda; Faye, Serge; Mylle, Godewina; Wannag, Axel; Samant, Yogindra; Pal, Teake; Scholz-Odermatt, Stefan; Papale, Adriano; Schouteden, Martijn; Colosio, Claudio; Mattioli, Stefano; Agius, Raymond

    2015-04-01

    The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries. OD surveillance systems that potentially reflected nationally representative trends in incidence within Belgium, the Czech Republic, Finland, France, Italy, the Netherlands, Norway, Spain, Switzerland and the UK provided data. Case counts were analysed using a negative binomial regression model with year as the main covariate. Many systems collected data from networks of 'centres', requiring the use of a multilevel negative binomial model. Some models made allowance for changes in compensation or reporting rules. Reports of contact dermatitis and asthma, conditions with shorter time between exposure to causal substances and OD, were consistently declining with only a few exceptions. For OD with physical causal exposures there was more variation between countries. Reported NIHL was increasing in Belgium, Spain, Switzerland and the Netherlands and decreasing elsewhere. Trends in CTS and upper limb musculoskeletal disorders varied widely within and between countries. This is the first direct comparison of trends in OD within Europe and is consistent with a positive impact of European initiatives addressing exposures relevant to asthma and contact dermatitis. Taking a more flexible approach allowed comparisons of surveillance data between and within countries without harmonisation of data collection methods. 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.

  18. Assessment of Postural Load Index Using LUBA Method and the Prevalence of Musculoskeletal Disorders in Dentists

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    Zeinab Baroonyzade

    2014-06-01

    Full Text Available Background & Objectives : High prevalence of musculoskeletal pain in dentistry represents the importance of investigation of working conditions in this profession to reduce musculoskeletal disorders.The purpose of this study was to determine the postural load on the upper limb postural using macro LUBA technique and the prevalence of musculoskeletal disorders. Methods: This study was conducted on 30 post graduate dental students of Hamadan University of Medical Sciences . LUBA technique was used to evaluate the postural load. The Nordic questionnaire was used to assess the prevalence of musculoskeletal disorders . The results were analyzed using SPSS version 16 . Results: The prevalence of musculoskeletal disorders was as follows neck( 63.3%, back ( 43.3%, back ( 30%, knee ( 20%, shoulder( 13%, wrist ( 10%, legs (10 %, elbows( 6.7% and thigh( 0%. The maximum postural load index was 23 for women and 21for men. In total, 50 % of dentists were in group 3 , 33 % of dentists in group 4 and 16.7 % in group 2 of the corrective measures . There was no significant association b etween demographic variables and presence of musculoskeletal disorders . Besides, there was no significant association between the presence of pain in upper limbs and the postural load index (Pvalue > 0.05. Conclusions: This study showed high levels of p ostural load index and musculoskeletal disorders among dental students of Hamadan University of Medical Sciences. High levels of p ostural load index indicate a high level of risk, which requires immediate corrective action and intervention.

  19. [Risk assessment of work-related upper limb musculoskeletal disorders in thirty factories in the upholstered furniture industry].

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    Nicoletti, S; Carino, M; Di Leone, G; Trani, G; Colombini, Daniela; Occhipinti, E

    2008-01-01

    One of the most common procedures for risk assessment of upper limb work-related musculoskeletal disorders (UL-WMSDs) in Italy is the OCRA synthetic index, which is recommended as the preferred method in the ISO standard 11228-3. The aim of the survey was to assess the risk of UL-WMSDs due to repetitive strain and movements in thirty factories of the sofa industry located in a large geographic area of southern Italy. The most characteristic working tasks of the manufacturing process were studied: filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. The single tasks were carried out almost exclusively manually, with features of a handicraft approach. Data were collected through questionnaires and video tape recordings in each factory. The mean value of the OCRA index of every group of factories was calculated by weighting the values of the index of each single task group with the number of the workers. Figures obtained in the different factories showed values of the OCRA index ranging between 4 and 15. A 2,9 OCRA value was attributed to a low exposure group. Even though the work tasks analyzed were characterized by long duration of the manufacturing cycle (between 5 and 60 min), a particular but rigorous application of the OCRA procedures made it possible for a detailed risk assessment to be made for each of the working groups analysed.

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

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    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

  1. EVALUATION OF DISTAL UPPER EXTREMITY (DUE MUSCULOSKELETAL DISORDERS BY STRAIN INDEX (SI IN AN IRONWORK INDUSTRY

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    Seyed-Ali Moussavi-Najarkola

    2008-04-01

    Full Text Available Background and aims:Work-related musculoskeletal disorders (WMSDS is one of the mostimportant problems in working populations of Iranian industries; so, in order to evaluate theintegrated roles and effects of various ergonomic risk factors inducing such disorders, the StrainIndex (SI methods was used.Methods: This was a cross-sectional study conducted on 448 male subjects including 63controls working in administrative jobs and 385 cases working in lathing, welding, melting andfoundry jobs using integrated procedure which includes observations, interview, NordicMusculoskeletal Questionnaire (NMQ methods and SI model. All workers were questioned.Data were analyzed using SPSS software v. 11 and Excel package.Results: The most prevalent MSDs in upper limbs were found in melting lathing, foundry andwelding respectively. There was a significant relationship between age and job groups (c2=7.33;df=16; p<0.001. One-way analysis of variance showed a significant differences among means ofcalculated Strain Indices of administrative (1.06, lathing (6.52, welding (3.68, melting (7.79and foundry (6.33 jobs (F=5.92; df=16; p=0.005. Also it was revealed that melting job wasattributed as "hazardous job" (4 risk level, lathing and foundry jobs were referred to "moderaterisk level" (3 risk level, welding job was allocated as "uncertain risk level" (2 risk level, andadministrative job was attributed as "safe risk level" (1 risk level. Moreover, there was asignificant relationship between DUE and job groups (c2=11.92; df=12; p=0.004.The paired ttestshowed significant difference with direct and relatively complete correlation between meansof Strain Indices in right (6.53 and left (4.29 hands (r=0.69; t=3.15; p<0.001.Conclusion: The Strain Index (SI model can be referred as an efficient and applicable methodfor the assessment of ergonomics risk factors inducing upper extremity musculoskeletal disorders(UEMSDs, classifying jobs, correcting and modifying work situations

  2. Emulating Upper Limb Disorder for Therapy Education

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    Noor Ayuni binti Che Zakaria

    2014-11-01

    Full Text Available Robotics not only contributes to the invention of rehabilitation devices, it can also enhance the quality of medical education. In recent years, the use of patient simulators and part-task trainers in the medical education field has brought meaningful improvements in the training of medical practitioners. Nevertheless, in the context of therapy training for upper limb disorders, trainee therapists still have to engage directly with the patients to gain experience of the rehabilitation of physical diseases. In this work, a high-fidelity part-task trainer that is able to reproduce the stiffness of spasticity and rigidity symptoms of the upper limb, such as those observed in post-stroke patients and Parkinson's disease patients, has been developed. Based on the evaluation carried out by two experienced therapists, the developed part-task trainer is able to simulate different patient cases and help trainee therapists gain pre-clinical experience in a safe and intuitive learning environment.

  3. [Repetitive movement of the upper limbs: results of exposure evaluation and clinical investigation during jar packaging of preserved vegetables].

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    Panzone, I; Carra, G; Melosi, A; Rappazzo, G; Innocenti, A

    1996-01-01

    In order to assess the prevalence of work-related musculo-skeletal disorders of the upper limbs, a total population of 29 female workers in an industrial vegetable preserving plant were examined. The average age of the workers was 41.3 years (SD = 9.2), and their average length of service was 16.7 years (SD = 7.2). Only 20% of the workers were anamnestically negative, whilst 80% had one or more disorders attributable to repetitive trauma of the upper limbs. The disorders showed no prevalence for the right side, a finding in line with the risk analysis which indicated that both limbs were equally used. The results of the risk analysis and clinical assessment confirm that high-frequency actions, combined with improper posture and a shortage of suitable recovery times, play a causal role in determining the onset of the disorders studied.

  4. High Intensity Physical Exercise and Pain in the Neck and Upper Limb among Slaughterhouse Workers: Cross-Sectional Study

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    Emil Sundstrup

    2014-01-01

    Full Text Available Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49–0.997, whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers.

  5. Work-Related Musculoskeletal Disorders at Two Textile Factories in Edirne, Turkey

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    Ufuk Berberoğlu

    2013-03-01

    Full Text Available Objective: “Work-related musculoskeletal disorders” (WMSDs is a term used to describe a painful or disabling injury to the muscles, tendons or nerves caused or aggravated by work. WMSDs are preventable or at least can be delayed. The aim of this study to determine the work related musculo-skeletal disorders and risk levels of the these factory workers. Study Design: Cross sectional study. Material and Methods: This is a cross-sectional study conducted at two textile factories in Edirne, Turkey and it involved 381 workers. The questionnaire used for data collection consisted of two parts. The first part described some socio-demographic features, working conditions and health problems of workers in the previous four weeks. In the second part, a Rapid Upper Limb Assessment (RULA Employer Assessment worksheet was used. Results: In the assessment of the upper limbs of the workers, the arm/wrist score (AWS is 5.9±1.7 (3-11; neck, trunk, legs score (NTLS is 5.3±2.5 (3-11; and total score (TS is 5.5±1.3 (3-7. The ages of the workers are significantly associated with higher RULA scores (r=0.207, p=0.000. AWS, NTLS and TS of the women workers were found to be statistically significantly lower than for the men. Conclusion: Musculoskeletal disorders are a common problem among textile workers. Employers can prevent WMSD hazards by properly designing the jobs or workstations and selecting the appropriate tools or equipment.

  6. Proprioceptive rehabilitation of upper limb dysfunction in movement disorders: a clinical perspective

    Directory of Open Access Journals (Sweden)

    Giovanni eAbbruzzese

    2014-11-01

    Full Text Available Movement disorders are frequently associated with sensory abnormalities. In particular, proprioceptive deficits have been largely documented in both hypokinetic (Parkinson’s disease and hyperkinetic conditions (dystonia suggesting a possible role in their pathophysiology. Proprioceptive feedback is a fundamental component of sensorimotor integration allowing effective planning and execution of voluntary movements. Rehabilitation has become an essential element in the management of patients with movement disorders and there is a strong rationale to include proprioceptive training in rehabilitation protocols focused on mobility problems of the upper limbs. Proprioceptive training is aimed at improving the integration of proprioceptive signals using task intrinsic or augmented feedback. This perspective article reviews the available evidences on the effects of proprioceptive stimulation in improving upper limb mobility in patients with movement disorders and highlights the emerging innovative approaches targeted to maximizing the benefits of exercise by means of enhanced proprioception.

  7. Prevalence and Associated Factors of Playing-Related Musculoskeletal Disorders in Brazilian Violin Players.

    Science.gov (United States)

    Kochem, Frederico B; Silva, Julio G

    2017-03-01

    To investigate the prevalence of playing-related musculoskeletal disorders (PRMD) and associated factors among violinists from the state of Rio de Janeiro, Brazil. This cross-sectional study included 106 violinists from eight cities in the state of Rio de Janeiro. Sociodemographic and musical characteristic data, pain symptoms, and upper-limb functionality were collected using the DASH and the Standardized Nordic Questionnaires. The associations between musculoskeletal complaints and possible predictors were analyzed by binary logistic regression. Of the 106 surveyed violin players, 86.8% reported at least one painful area in the last 12 months and 77.4% in the last week. These symptoms were responsible for the temporary interruption of musical activity in 8.1% of musicians. More than 50% of violinists showed dysfunctional upper limbs according to the DASH optional module. Women were more likely to develop musculoskeletal disorders (OR 4.4, CI 1.9-10.0, p<0.001). In addition, older musicians were more likely to report pain in the last 7 days (OR 3.3, CI 5.1-10.97; p=0.04) and also had higher scores on the DASH (OR 1.8, CI 1.1-3.1; p=0.01). Other factors associated with the development of PRMD were body mass index, practice hours per week, and final DASH score. Violinists living and working in the state of Rio de Janeiro have a high prevalence of PRMD, especially women and older musicians.

  8. Diagnosis and treatment of upper limb apraxia

    OpenAIRE

    Dovern, A.; Fink, G. R.; Weiss, P. H.

    2012-01-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients’ everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients’ prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed...

  9. Work-organisational and personal factors associated with upper body musculoskeletal disorders among sewing machine operators.

    Science.gov (United States)

    Wang, P-C; Rempel, D M; Harrison, R J; Chan, J; Ritz, B R

    2007-12-01

    To assess the contribution of work-organisational and personal factors to the prevalence of work-related musculoskeletal disorders (WMSDs) among garment workers in Los Angeles. This is a cross-sectional study of self-reported musculoskeletal symptoms among 520 sewing machine operators from 13 garment industry sewing shops. Detailed information on work-organisational factors, personal factors, and musculoskeletal symptoms were obtained in face-to-face interviews. The outcome of interest, upper body WMSD, was defined as a worker experiencing moderate or severe musculoskeletal pain. Unconditional logistic regression models were adopted to assess the association between both work-organisational factors and personal factors and the prevalence of musculoskeletal pain. The prevalence of moderate or severe musculoskeletal pain in the neck/shoulder region was 24% and for distal upper extremity it was 16%. Elevated prevalence of upper body pain was associated with age less than 30 years, female gender, Hispanic ethnicity, being single, having a diagnosis of a MSD or a systemic illness, working more than 10 years as a sewing machine operator, using a single sewing machine, work in large shops, higher work-rest ratios, high physical exertion, high physical isometric loads, high job demand, and low job satisfaction. Work-organisational and personal factors were associated with increased prevalence of moderate or severe upper body musculoskeletal pain among garment workers. Owners of sewing companies may be able to reduce or prevent WMSDs among employees by adopting rotations between different types of workstations thus increasing task variety; by either shortening work periods or increasing rest periods to reduce the work-rest ratio; and by improving the work-organisation to control psychosocial stressors. The findings may guide prevention efforts in the garment sector and have important public health implications for this workforce of largely immigrant labourers.

  10. 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.

  11. Upper and Lower Limb Muscle Architecture of a 104 Year-Old Cadaver.

    Science.gov (United States)

    Ruggiero, Marissa; Cless, Daniel; Infantolino, Benjamin

    2016-01-01

    Muscle architecture is an important component to typical musculoskeletal models. Previous studies of human muscle architecture have focused on a single joint, two adjacent joints, or an entire limb. To date, no study has presented muscle architecture for the upper and lower limbs of a single cadaver. Additionally, muscle architectural parameters from elderly cadavers are lacking, making it difficult to accurately model elderly populations. Therefore, the purpose of this study was to present muscle architecture of the upper and lower limbs of a 104 year old female cadaver. The major muscles of the upper and lower limbs were removed and the musculotendon mass, tendon mass, musculotendon length, tendon length, pennation angle, optimal fascicle length, physiological cross-sectional area, and tendon cross-sectional area were determined for each muscle. Data from this complete cadaver are presented in table format. The data from this study can be used to construct a musculoskeletal model of a specific individual who was ambulatory, something which has not been possible to date. This should increase the accuracy of the model output as the model will be representing a specific individual, not a synthesis of measurements from multiple individuals. Additionally, an elderly individual can be modeled which will provide insight into muscle function as we age.

  12. Work-related musculoskeletal disorders in the automotive industry due to repetitive work - implications for rehabilitation

    Directory of Open Access Journals (Sweden)

    Quarcoo David

    2010-04-01

    Full Text Available Abstract Background Musculoskeletal disorders (MSDs due to repetitive work are common in manufacturing industries, such as the automotive industry. However, it's still unclear which MSDs of the upper limb are to be expected in the automotive industry in a first aid unit as well as in occupational precaution examinations. It is also unclear which examination method could be performed effectively for practical reasons and under rehabilitation aspects. Additionally, it was to discuss whether the conception of unspecific description for MSDs has advantages or disadvantages in contrast to a precise medical diagnosis. Methods We investigated the health status of two study populations working at two automotive plants in Germany. The first part included 67 consecutive patients who were seen for acute or chronic MSDs at the forearm over a 4-month period at the plants' medical services. Information about patients' working conditions and musculoskeletal symptoms was obtained during a standardized interview, which was followed by a standardized orthopedic-chiropractic physical examination. In the second part, 209 workers with daily exposure to video display terminals (VDT completed a standardized questionnaire and were examined with function-oriented muscular tests on the occasion of their routine occupational precaution medical check-up. Results The majority of the 67 patients seen by the company's medical services were blue-collar works from the assembly lines and trainees rather than white-collar workers from offices. Rates of musculoskeletal complaints were disproportionately higher among experienced people performing new tasks and younger trainees. The most common MSD in this group were disorders of flexor tendons of the forearm. By contrast, among the 209 employees working at VDT disorders of the neck and shoulders were more common than discomfort in the forearm. A positive tendency between restricted rotation of the cervical vertebrae and years

  13. Work-related musculoskeletal disorders in the automotive industry due to repetitive work - implications for rehabilitation.

    Science.gov (United States)

    Spallek, Michael; Kuhn, Walter; Uibel, Stefanie; van Mark, Anke; Quarcoo, David

    2010-04-07

    Musculoskeletal disorders (MSDs) due to repetitive work are common in manufacturing industries, such as the automotive industry. However, it's still unclear which MSDs of the upper limb are to be expected in the automotive industry in a first aid unit as well as in occupational precaution examinations. It is also unclear which examination method could be performed effectively for practical reasons and under rehabilitation aspects. Additionally, it was to discuss whether the conception of unspecific description for MSDs has advantages or disadvantages in contrast to a precise medical diagnosis. We investigated the health status of two study populations working at two automotive plants in Germany. The first part included 67 consecutive patients who were seen for acute or chronic MSDs at the forearm over a 4-month period at the plants' medical services. Information about patients' working conditions and musculoskeletal symptoms was obtained during a standardized interview, which was followed by a standardized orthopedic-chiropractic physical examination. In the second part, 209 workers with daily exposure to video display terminals (VDT) completed a standardized questionnaire and were examined with function-oriented muscular tests on the occasion of their routine occupational precaution medical check-up. The majority of the 67 patients seen by the company's medical services were blue-collar works from the assembly lines and trainees rather than white-collar workers from offices. Rates of musculoskeletal complaints were disproportionately higher among experienced people performing new tasks and younger trainees. The most common MSD in this group were disorders of flexor tendons of the forearm. By contrast, among the 209 employees working at VDT disorders of the neck and shoulders were more common than discomfort in the forearm. A positive tendency between restricted rotation of the cervical vertebrae and years worked at VDT was observed. In addition, only less than 8

  14. Musculoskeletal disorder survey for pond workers

    Science.gov (United States)

    Maryani, A.; Partiwi, S. G.; Dewi, H. N. F.

    2018-04-01

    Mucsuloskeletal disorder will affect worker performance and become serious injury when ignored, so that workers cannot work normally. Therefore, an effective strategy plan is needed to reduce the risk of musculoskeletal disorder. A pond worker is profession with high risk of physical complain. Four main activities are ponds preparation, seed distribution, pond maintenance, and harvesting. The methods employed in this current musculoskeletal disorder survey are questionnaire and interview. The result from 73 questionnaires shown that most of pond workers were working for 7 days a week. Prevalence physical complain are on neck, shoulders, upper back, lower back, and knees. The level of perceived complaint is moderate pain. However, most of them do not contact therapists or physicians. Therefore it is necessary to improve the working methods to be able to reduce physical complains due to musculoskeletal disorder.

  15. [Musculoskeletal disorders among university student computer users].

    Science.gov (United States)

    Lorusso, A; Bruno, S; L'Abbate, N

    2009-01-01

    Musculoskeletal disorders are a common problem among computer users. Many epidemiological studies have shown that ergonomic factors and aspects of work organization play an important role in the development of these disorders. We carried out a cross-sectional survey to estimate the prevalence of musculoskeletal symptoms among university students using personal computers and to investigate the features of occupational exposure and the prevalence of symptoms throughout the study course. Another objective was to assess the students' level of knowledge of computer ergonomics and the relevant health risks. A questionnaire was distributed to 183 students attending the lectures for second and fourth year courses of the Faculty of Architecture. Data concerning personal characteristics, ergonomic and organizational aspects of computer use, and the presence of musculoskeletal symptoms in the neck and upper limbs were collected. Exposure to risk factors such as daily duration of computer use, time spent at the computer without breaks, duration of mouse use and poor workstation ergonomics was significantly higher among students of the fourth year course. Neck pain was the most commonly reported symptom (69%), followed by hand/wrist (53%), shoulder (49%) and arm (8%) pain. The prevalence of symptoms in the neck and hand/wrist area was signifcantly higher in the students of the fourth year course. In our survey we found high prevalence of musculoskeletal symptoms among university students using computers for long time periods on a daily basis. Exposure to computer-related ergonomic and organizational risk factors, and the prevalence ofmusculoskeletal symptoms both seem to increase significantly throughout the study course. Furthermore, we found that the level of perception of computer-related health risks among the students was low. Our findings suggest the need for preventive intervention consisting of education in computer ergonomics.

  16. A Review on Methods for Assessing Risk Factors of the Upper Limb Disorders among Cashiers in Grocery Retail Industries

    OpenAIRE

    Ahmad Zuhaidi Muhammad Fareez; Abdol Rahman Mohd Nasrull

    2017-01-01

    This paper provides an overview of the various methods that have been developed for the assessment of risk factors for upper limb disorders among cashiers in grocery retail industries. This paper is essential as upper limb disorders have been known as one of the prime cause of work-related disability in various countries. The methods used for the assessment were the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Assessment of Repetitive Tasks (ART), the Job Strain Index ...

  17. An investigation of somatosensory profiles in work related upper limb disorders: a case-control observational study protocol.

    LENUS (Irish Health Repository)

    Moloney, Niamh

    2010-01-01

    BACKGROUND: Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP), remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain. METHODS\\/DESIGN: Three groups of participants will be investigated: Groups 1 and 2 will be office workers with either NSAP or cervical radiculopathy and Group 3 will be a control group of non office workers without upper limb pain. Participants will undergo a clinical assessment, pain questionnaires (LANSS, Short Form McGill, DASH and TSK) and quantitative sensory testing comprising thermal detection and pain thresholds, vibration thresholds and pressure pain thresholds. DISCUSSION: The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying neurophysiology in

  18. An investigation of somatosensory profiles in work related upper limb disorders: a case-control observational study protocol

    Directory of Open Access Journals (Sweden)

    Hall Toby

    2010-01-01

    Full Text Available Abstract Background Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP, remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain. Methods/Design Three groups of participants will be investigated: Groups 1 and 2 will be office workers with either NSAP or cervical radiculopathy and Group 3 will be a control group of non office workers without upper limb pain. Participants will undergo a clinical assessment, pain questionnaires (LANSS, Short Form McGill, DASH and TSK and quantitative sensory testing comprising thermal detection and pain thresholds, vibration thresholds and pressure pain thresholds. Discussion The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying

  19. PHYSICAL WORKLOAD AS A RISK FACTOR FOR SYMPTOMS IN THE NECK AND UPPER LIMBS: EXPOSURE ASSESSMENT AND ERGONOMIC INTERVENTION

    OpenAIRE

    Ritva Ketola

    2004-01-01

    The aims of this study were to investigate work related and individual factors as predictors of insident neck pain among video display unit (VDU) workers, to assess the effects of an ergonomic intervention and education on musculoskeletal symptoms, and to study the repeatability and validity of an expert assessment method of VDU workstation ergonomics. A method to assess the risk factors for upper limb disorders was developed, and its validity and repeatability were studied. The annual inc...

  20. The role of psychosocial stress in the development of chronic musculoskeletal pain disorders: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Buscemi, Valentina; Chang, Wei-Ju; Liston, Matthew B; McAuley, James H; Schabrun, Siobhan

    2017-11-03

    Psychosocial factors play an important role in chronic musculoskeletal pain disorders. Although psychosocial stress is likely to contribute to the development of chronic musculoskeletal pain, investigations are limited to work-related stress or examination of specific conditions such as upper limb pain. The purpose of this review is to assess the evidence for an aetiological role of psychological stress in chronic musculoskeletal pain disorders. A systematic review and meta-analysis will be conducted. Electronic databases will be searched using predefined search terms to identify relevant studies. Data will be extracted by two independent reviewers, and disagreement will be resolved by a third reviewer. Only prospective longitudinal studies that assess psychosocial stress at baseline will be included. The population of interest will be inception cohorts or cohorts of people who have not yet developed chronic musculoskeletal pain disorders. The primary outcome measure will be the onset of chronic musculoskeletal pain. To our knowledge, this review will be the first to systematically explore the available evidence on the aetiological role of psychosocial stress for the development of chronic musculoskeletal pain disorders. This review has the capacity to inform clinical practice on the importance of an early identification and, consequently, treatment of individuals who present with acute musculoskeletal disorders accompanied by a high level of stress. PROSPERO CRD42017059949.

  1. Work-related upper limb “overuse” syndromes

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2016-01-01

    A previous review of historical descriptions and theories about the character and pathogenesis of writer’s cramp and other comparable chronic upper limb “overuse” work-related pain syndromes has indicated that somatic dysfunctions explain symptoms and findings. The first case studies and case...... series suggested that these conditions were caused by pathology affecting the peripheral nerves. The general perception gradually changed, however, with symptoms becoming attributed to central nervous system dysfunction and ultimately to represent a psychiatric condition. Work-related upper limb...... disorders remain diagnostically challenging to clinicians and there is still a tendency to see many patients’ pain as a psychiatric problem when a standard physical examination does not explain the condition. This article describes reports of writer’s cramp and comparable occupational upper limb “overuse...

  2. Evaluation of Frequency and Risk Factors of Soft Tissue Rheumatism of Upper Limbs in Diabetic Patients in Kerman in 2001

    Directory of Open Access Journals (Sweden)

    M.R. Shakibi

    2003-10-01

    Full Text Available Diabetes mellitus is a metabolic disorder that affect different systems in human. Wide range of musculoskeletal syndromes have been described in association with diabetes. To determine the prevalence of upper limb soft tissue rheumatism in diabetes patients. In a cross sectional study 300 diabetic patients was examined by COPCORD questionnaire. The examination was performed by internist and rheumatologist . Data was analyzed by logistic regression. 73.3% of patients were female. Average age of cases was 51.2±13.7 years and mean of duration of disease was 7±6.4 years. 152 cases (50.7% had soft tissue rheumatism in upper limbs. 66 cases had carpal tannel syndrome, 23 cases with Dupuytren’s disease, 23 cases with Flexortenosynovitis, 91 cases with shoulder periarthritis, 4 cases had limited joint mobility and 12 had Elbow Epicandititis. Logestic regression analysis showed that type 2 diabetes, weak control of blood sugur and duration of disease>5years were risk factors for incidence of soft tissue rheumatism in upper limbs. Results have showed the high prevalence of soft tissue rheumatism in diabetic patients.

  3. [Epidemiology of illnesses and musculoskeletal disorders in grocery stores and catering].

    Science.gov (United States)

    Bonzini, Matteo; Battevi, Natale; Stucchi, Giulia; Vitelli, Nora

    2014-01-01

    Large scale retail industry and catering industry are characterized by the widespread presence of several risk factors of work-related musculoskeletal disorders (WMSD): repetitive movements, incongruous postures and manual handling tasks. We reviewed current epidemiological evidence related to musculoskeletal disorders within these two sectors, distinguishing between symptoms and clinically documented disorders. In retail industry cashier is the most investigated figure, regarding upper limbs disorders as a consequence of repetitive tasks. In the catering sector there are few studies, mostly focused only on the job as a cook. The majority of studies showed a high prevalence of WMSD and, to a lesser extent, a high frequency ofmusculoskeletal alterations; suggesting the presence of a not negligible risk. These findings, however, are affected by a number of methodological limitations: they derive from cross-sectional studies, are based on voluntary self-selected workers, are focused on not unequivocally defined health outcomes, and are usually lacking a proper comparison. with the prevalence in less exposed/reference working groups. In order to achieve an effective control of the workers' risk, it is therefore necessary to design and conduct prospective studies that compare the risk of developing disorders and/or diseases in workers exposed to different levels of biomechanical load. It appears essential to involve occupational physicians in active health surveillance programs in order to identify critical areas and to develop effective preventive measures.

  4. A Review on Methods for Assessing Risk Factors of the Upper Limb Disorders among Cashiers in Grocery Retail Industries

    Directory of Open Access Journals (Sweden)

    Ahmad Zuhaidi Muhammad Fareez

    2017-01-01

    Full Text Available This paper provides an overview of the various methods that have been developed for the assessment of risk factors for upper limb disorders among cashiers in grocery retail industries. This paper is essential as upper limb disorders have been known as one of the prime cause of work-related disability in various countries. The methods used for the assessment were the Disabilities of the Arm, Shoulder and Hand (DASH questionnaire, the Assessment of Repetitive Tasks (ART, the Job Strain Index (JSI and the Occupational Repetitive Actions (OCRA Checklist. DASH questionnaire is a structured interview in determining the prevalence of the upper limb disorders, while ART, the JSI and OCRA Checklist act as a direct observation in examining the involvement of risk factors. Basically, these tools dealt with the measurements of symptoms, posture observation, and workplace risk assessment, as they are the most relevant tools for assessing the risk factors faced by the workers in grocery industries. The use of these tools assessed the risk factors and consequently reduces the risk of injuries among the workers.

  5. An onsite ergonomics assessment for risk of work-related musculoskeletal disorders among cooks in a Chinese restaurant.

    Science.gov (United States)

    Xu, Yan-Wen; Cheng, Andy S K

    2014-01-01

    This article is a case presentation of an onsite ergonomic assessment of the risk factors for work-related musculoskeletal disorders (WMSDs) among three cooks working at a medium-sized Chinese restaurant in Hong Kong. The weight of workload was measured during the onsite assessment and the Ovako Working Posture Analysis System (OWAS), Rapid Upper Limb Assessment (RULA), and National Institute of Occupational Safety and Health (NIOSH) lifting equation used to assess the risk of WMSDs. The results showed that these cooks usually had to hold utensils for extended periods of time, toss woks, and barbecue meat, all of which demanded a lot of repetitive movements of the upper limbs. Future research is needed on the implementation of effective prevention measures, including administrative and ergonomic controls, to reduce the problems within this industry associated with such high-risk tasks.

  6. Functional Capacity Evaluation in Upper Limb Reduction Deficiency and Amputation : Development and Pilot Testing

    NARCIS (Netherlands)

    Postema, S G; Bongers, R M; Reneman, M F; van der Sluis, C K

    Purpose To develop and pilot test a functional capacity evaluation (FCE) for individuals with upper limb absence (ULA) due to reduction deficiency or amputation, and to examine the relationship between FCE results and presence of musculoskeletal complaints (MSC). Method Five tests (overhead lifting,

  7. Applications of biomechanics for prevention of work-related musculoskeletal disorders.

    Science.gov (United States)

    Garg, Arun; Kapellusch, Jay M

    2009-01-01

    This paper summarises applications of biomechanical principles and models in industry to control musculoskeletal disorders of the low back and upper extremity. Applications of 2-D and 3-D biomechanical models to estimate compressive force on the low back, the strength requirements of jobs, application of guidelines for overhead work and application of strain index and threshold limit value to address distal upper extremity musculoskeletal disorders are presented. Several case studies applied in the railroad industry, manufacturing, healthcare and warehousing are presented. Finally, future developments needed for improved biomechanical applications in industry are discussed. The information presented will be of value to practising ergonomists to recognise how biomechanics has played a significant role in identifying causes of musculoskeletal disorders and controlling them in the workplace. In particular, the information presented will help practising ergonomists with how physical stresses can be objectively quantified.

  8. The risk of musculoskeletal disorders due to repetitive movements of upper limbs for workers employed in hazelnut sorting

    Directory of Open Access Journals (Sweden)

    Andrea Colantoni

    2013-09-01

    Full Text Available In the agro-industrial sector there are many activities whose urgent rhythms can cause a considerable exposure to bio-mechanical risk factors. In the hazelnut sorting, the workers are subject to several biomechanical risks, with repetitive movements, and operations that require a remarkable degree of strength. A thorough study of the workers’ exposure to repetitive manual movements has been carried out, with the aim of setting up the necessary measures to reduce the risk factors. The aim of the research is to assess the risk of work-related musculo-skeletal disorders (WMSDs due to repetitive work, for workers employed to hazelnut shells sorting. The research was carried out in an agricultural cooperative in the Viterbo’s area. For risk assessment authors used a method (Occupational Repetitive Actions “OCRA” index according to ISO 11228- 3:2009, Ergonomics - Manual handling - Part 3: Handling of low loads at high frequency which keeps into consideration several risk factors (such as repetitiveness, prehension force, posture. The risk was assessed for 16 female workers (in eight workplaces and in two different shifts through this classification: workers with experience less than 1 year, from 1 to 10 years and more than 10 years. This classification is very important for knowing if the professional experience could be considered a “prevention measure” for the risk reduction. The results show a high risk level for the right and left limb. The factors which more have contributed to reach such risk level are the great number of movements and the lack of recovering time.

  9. 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.

  10. Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy.

    Science.gov (United States)

    Diogo, Rui; Esteve-Altava, Borja; Smith, Christopher; Boughner, Julia C; Rasskin-Gutman, Diego

    2015-01-01

    How do the various anatomical parts (modules) of the animal body evolve into very different integrated forms (integration) yet still function properly without decreasing the individual's survival? This long-standing question remains unanswered for multiple reasons, including lack of consensus about conceptual definitions and approaches, as well as a reasonable bias toward the study of hard tissues over soft tissues. A major difficulty concerns the non-trivial technical hurdles of addressing this problem, specifically the lack of quantitative tools to quantify and compare variation across multiple disparate anatomical parts and tissue types. In this paper we apply for the first time a powerful new quantitative tool, Anatomical Network Analysis (AnNA), to examine and compare in detail the musculoskeletal modularity and integration of normal and abnormal human upper and lower limbs. In contrast to other morphological methods, the strength of AnNA is that it allows efficient and direct empirical comparisons among body parts with even vastly different architectures (e.g. upper and lower limbs) and diverse or complex tissue composition (e.g. bones, cartilages and muscles), by quantifying the spatial organization of these parts-their topological patterns relative to each other-using tools borrowed from network theory. Our results reveal similarities between the skeletal networks of the normal newborn/adult upper limb vs. lower limb, with exception to the shoulder vs. pelvis. However, when muscles are included, the overall musculoskeletal network organization of the upper limb is strikingly different from that of the lower limb, particularly that of the more proximal structures of each limb. Importantly, the obtained data provide further evidence to be added to the vast amount of paleontological, gross anatomical, developmental, molecular and embryological data recently obtained that contradicts the long-standing dogma that the upper and lower limbs are serial homologues

  11. Management of work-relevant upper limb disorders: a review.

    Science.gov (United States)

    Burton, A Kim; Kendall, Nicholas A S; Pearce, Brian G; Birrell, Lisa N; Bainbridge, L Christopher

    2009-01-01

    Upper limb disorders (ULDs) are clinically challenging and responsible for considerable work loss. There is a need to determine effective approaches for their management. To determine evidence-based management strategies for work-relevant ULDs and explore whether a biopsychosocial approach is appropriate. Literature review using a best evidence synthesis. Data from articles identified through systematic searching of electronic databases and citation tracking were extracted into evidence tables. The information was synthesized into high-level evidence statements, which were ordered into themes covering classification/diagnosis, epidemiology, associations/risks and management/treatment, focusing on return to work or work retention and taking account of distinctions between non-specific complaints and specific diagnoses. Neither biomedical treatment nor ergonomic workplace interventions alone offer an optimal solution; rather, multimodal interventions show considerable promise, particularly for occupational outcomes. Early return to work, or work retention, is an important goal for most cases and may be facilitated, where necessary, by transitional work arrangements. The emergent evidence indicates that successful management strategies require all the players to be on side and acting in a coordinated fashion; this requires engaging employers and workers to participate. The biopsychosocial model applies: biological considerations should not be ignored, but psychosocial factors are more influential for occupational outcomes. Implementation of interventions that address the full range of psychosocial issues will require a cultural shift in the way the relationship between upper limb complaints and work is conceived and handled. Dissemination of evidence-based messages can contribute to the needed cultural shift.

  12. ERGONOMICS INVESTIGATION OF MUSCULOSKELETAL DISORDER AMONG THE WORKFORCE OF WASTE MANAGEMENT INDUSTRY IN NIGERIA

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    Adekunle I. MUSA

    2017-12-01

    Full Text Available The objective of this study is to undertake an Ergonomic Scrutiny of Desecrate Management Industry. Ten (10 employees of the parking and collection department of Kim Waste Management Authority (KWMA were selected. Their activities were video and recorded while working and their different postures were analyzed using Rapid Entire Body Assessment (REBA and Rapid Upper Limb Assessment (RULA. Result showed that 10% were at medium risk; 40% were at high risk and 50% were at very high risk for the workers in KWMA. It as discovered that workers are subjected to Musculoskeletal Disorder (MSDs as a result of the postures adopted during the work process.

  13. 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.

  14. Surveillance case definitions for work related upper limb pain syndromes

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    Harrington, J. M.; Carter, J. T.; Birrell, L.; Gompertz, D.

    1998-01-01

    OBJECTIVES: To establish consensus case definitions for several common work related upper limb pain syndromes for use in surveillance or studies of the aetiology of these conditions. METHODS: A group of healthcare professionals from the disciplines interested in the prevention and management of upper limb disorders were recruited for a Delphi exercise. A questionnaire was used to establish case definitions from the participants, followed by a consensus conference involving the core grou...

  15. Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

    Science.gov (United States)

    Resnik, Linda; Meucci, Marissa R; Lieberman-Klinger, Shana; Fantini, Christopher; Kelty, Debra L; Disla, Roxanne; Sasson, Nicole

    2012-04-01

    The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. 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.

  17. Workplace Stresses and Musculoskeletal Disorders Among Nurses: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Alireza Dehdashti

    2017-07-01

    Full Text Available Objectives Work-related musculoskeletal disorders are a significant occupational problem among employees and workers. This study attempted to explore the effect of stressors in the hospital environment on nurses’ development of musculoskeletal disorders. Methods We conducted a cross-sectional survey in a random sample of 123 hospital nurses from Semnan University of Medical Sciences. Data were collected during working days over 3 months starting from January 2014. Participants completed a standardized questionnaire for stresses and musculoskeletal disorders at work. Musculoskeletal disorders were used as the dependent variables, while demographic, physical, and psychosocial work factors were used as independent variables. Results Our study revealed prevalence of low back ache, neck ache, shoulder ache, arm-elbow ache, and hand-wrist pain rated 48.3%, 39.5%, 33.1%, 31.3%, and 23.4%, respectively. The findings showed significant statistical association between musculoskeletal complaints in neck and upper extremity with exposed stress levels (P = 0.04. Musculoskeletal symptoms rates increased in employees experienced poor work posture (P = 0.01, fatigue (P = 0.04, and work-family conflict (P = 0.04. Conclusions This study provides indication of the relationship between work environment stress levels and musculoskeletal disorders. Physical and psychosocial stressors should be considered for the development of preventive measures.

  18. Work-related musculoskeletal disorders (WMDs) risk assessment at core assembly production of electronic components manufacturing company

    Science.gov (United States)

    Yahya, N. M.; Zahid, M. N. O.

    2018-03-01

    This study conducted to assess the work-related musculoskeletal disorders (WMDs) among the workers at core assembly production in an electronic components manufacturing company located in Pekan, Pahang, Malaysia. The study is to identify the WMDs risk factor and risk level. A set of questionnaires survey based on modified Nordic Musculoskeletal Disorder Questionnaires have been distributed to respective workers to acquire the WMDs risk factor identification. Then, postural analysis was conducted in order to measure the respective WMDs risk level. The analysis were based on two ergonomics assessment tools; Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). The study found that 30 respondents out of 36 respondents suffered from WMDs especially at shoulder, wrists and lower back. The WMDs risk have been identified from unloading process, pressing process and winding process. In term of the WMDs risk level, REBA and RULA assessment tools have indicated high risk level to unloading and pressing process. Thus, this study had established the WMDs risk factor and risk level of core assembly production in an electronic components manufacturing company at Malaysia environment.

  19. Modulation of shoulder muscle and joint function using a powered upper-limb exoskeleton.

    Science.gov (United States)

    Wu, Wen; Fong, Justin; Crocher, Vincent; Lee, Peter V S; Oetomo, Denny; Tan, Ying; Ackland, David C

    2018-04-27

    Robotic-assistive exoskeletons can enable frequent repetitive movements without the presence of a full-time therapist; however, human-machine interaction and the capacity of powered exoskeletons to attenuate shoulder muscle and joint loading is poorly understood. This study aimed to quantify shoulder muscle and joint force during assisted activities of daily living using a powered robotic upper limb exoskeleton (ArmeoPower, Hocoma). Six healthy male subjects performed abduction, flexion, horizontal flexion, reaching and nose touching activities. These tasks were repeated under two conditions: (i) the exoskeleton compensating only for its own weight, and (ii) the exoskeleton providing full upper limb gravity compensation (i.e., weightlessness). Muscle EMG, joint kinematics and joint torques were simultaneously recorded, and shoulder muscle and joint forces calculated using personalized musculoskeletal models of each subject's upper limb. The exoskeleton reduced peak joint torques, muscle forces and joint loading by up to 74.8% (0.113 Nm/kg), 88.8% (5.8%BW) and 68.4% (75.6%BW), respectively, with the degree of load attenuation strongly task dependent. The peak compressive, anterior and superior glenohumeral joint force during assisted nose touching was 36.4% (24.6%BW), 72.4% (13.1%BW) and 85.0% (17.2%BW) lower than that during unassisted nose touching, respectively. The present study showed that upper limb weight compensation using an assistive exoskeleton may increase glenohumeral joint stability, since deltoid muscle force, which is the primary contributor to superior glenohumeral joint shear, is attenuated; however, prominent exoskeleton interaction moments are required to position and control the upper limb in space, even under full gravity compensation conditions. The modeling framework and results may be useful in planning targeted upper limb robotic rehabilitation tasks. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Diagnosis and treatment of upper limb apraxia.

    Science.gov (United States)

    Dovern, A; Fink, G R; Weiss, P H

    2012-07-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

  1. Personality and Its Relationship with Prevalence of Musculoskeletal Disorders

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    Omran Ahmadi

    2016-12-01

    Full Text Available Background Individual factors are usually important as non-occupational parameters that participate in the prevalence of musculoskeletal disorders. Personality traits are one of the individual factors that affect physical illness, which are constant over time, thereby reflecting stable individual differences. Identifying the personality trait can be used to predict musculoskeletal disorders in workers and select individual with appropriate personality traits for different works. Objectives The purpose of the present study was to identify the personality traits used to determine the relationship between different personality traits and the prevalence of musculoskeletal disorders. Methods 136 people of 2 different companies in Tabriz (in 2015 were selected as the study population. The first group was selected from the petrochemical repair workers and the second from a dairy factory. The 50-item version of Goldberg’s big five personality scale was used to assess the personality traits. Nordic questionnaire was employed to evaluate the prevalence of musculoskeletal disorders. Chi-square test was incorporated for analyzing the data. Finally, logistic regression test was used to study the factors affecting upper and lower body pain. Results Results indicated that individual personality traits were associated with musculoskeletal disorder prevalence in some members of body: Extraversion with wrist (P-value = 0.013 and hip (P-value = 0.044, emotional stability with shoulder (P-value = 0.012, wrist (P-value = 0.043, back (P-value = 0.034, low back (P-value = 0.029 and ankle( P-value = 0.014, Conscientiousness with Hip ( P-value = 0.009, Agreeableness with shoulder (P-value = 0.004, back (P-value = 0.001, Hip ( P-value = 0.006 and ankle ( P-value = 0.019. Conclusions According to the results of this study, the personality traits can contribute to musculoskeletal disorders. Therefore, notice of personality traits can be used to predict individuals who

  2. Upper limb movement analysis during gait in multiple sclerosis patients.

    Science.gov (United States)

    Elsworth-Edelsten, Charlotte; Bonnefoy-Mazure, Alice; Laidet, Magali; Armand, Stephane; Assal, Frederic; Lalive, Patrice; Allali, Gilles

    2017-08-01

    Gait disorders in multiple sclerosis (MS) are well studied; however, no previous study has described upper limb movements during gait. However, upper limb movements have an important role during locomotion and can be altered in MS patients due to direct MS lesions or mechanisms of compensation. The aim of this study was to describe the arm movements during gait in a population of MS patients with low disability compared with a healthy control group. In this observational study we analyzed the arm movements during gait in 52 outpatients (mean age: 39.7±9.6years, female: 40%) with relapsing-remitting MS with low disability (mean EDSS: 2±1) and 25 healthy age-matched controls using a 3-dimension gait analysis. MS patients walked slower, with increased mean elbow flexion and decreased amplitude of elbow flexion (ROM) compared to the control group, whereas shoulder and hand movements were similar to controls. These differences were not explained by age or disability. Upper limb alterations in movement during gait in MS patients with low disability can be characterized by an increase in mean elbow flexion and a decrease in amplitude (ROM) for elbow flexion/extension. This upper limb movement pattern should be considered as a new component of gait disorders in MS and may reflect subtle motor deficits or the use of compensatory mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Prevalence of musculoskeletal symptoms and its relations with the occupational performance among public high school teachers

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    Marcos Ferreira Calixto

    2015-09-01

    Full Text Available Objectives: To investigate the frequency of musculoskeletal symptoms and identify their relationships with functional capacity for daily living and working activities among public high school teachers in Ceilândia/DF. Methodological procedures: This was a cross-sectional study with 61 teachers from four different schools. An initial questionnaire covering sociodemographic, clinical and occupational characteristics was used for initial assessment, with the Nordic Musculoskeletal questionnaire (musculoskeletal disorders and the Disabilities of the Arm, Shoulder and Hand questionnaire (upper limb disorders. Descriptive and comparative statistics were used for data analysis. Results: The body areas most affected by musculoskeletal symptoms in the last 12 months were: upper back (42.6%, lower back (41.7% and neck (39.3%. Greater impairment in the daily activities performance was observed among teachers who had some musculoskeletal symptom in the neck (p=.0001, shoulders (p=.001, back (p=.002, elbows (p=.002 or wrist and hand (p=.018. Additionally, it was observed greater interference in work activities among teachers who had some musculoskeletal symptom in the shoulders (p=.023 or elbows (p=.003. Conclusion: This scenario highlights the importance of including regular programs of health promotion and disorders prevention in high schools for correct orientation and to maintain these professionals functional capacity.

  4. WORK RELATED MUSCULOSKELETAL DISORDERS: A SURVEY OF PHYSIOTHERAPISTS IN TRICITY

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    Priyanka Maheshwari

    2015-12-01

    Full Text Available Background: Musculoskeletal system disorders are common among health care workers worldwide. They are common causes of severe long-term pain and physical disability. Musculoskeletal disorders (MSDs are defined as “regional impairments of the muscles, tendons, nerves and joints. Physiotherapy can lead to WRMSDs in physiotherapist because of the nature of their profession. Despite of having expert knowledge of musculoskeletal injuries and injury prevention strategies they still report a high incidence of work-related injuries during their professional practice due to their training and continuous professional development Methods: A total of 100 Physiotherapists which included 78 females and 22 males in the age group of 21 to 40 years were recruited in the study. The subjects were taken as per the inclusion and exclusion criteria from Tricity. Results: Pearson’s correlation and Chi square analysis was used to determine correlation and the association of prevalence of self-reported musculoskeletal symptoms with personal characteristics, job risk factors and coping strategies. The data obtained from this study documents that majority of Physiotherapists have experienced WRMSDs at some time. The prevalence of WRMSDs among Physiotherapists in Tricity is high (91%. The most common risk factors identified in the present study were dealing with an excessive number of patients in one day; continuing to work while injured or hurt; lifting or transferring dependent patients and work scheduling. In present study, the low back and neck regions were the most commonly affected site among physiotherapists (72.5% each followed by upper back (28.6 %, shoulder (20.9%, wrist and hand (17.6%, knee (12.1%, ankle and foot (12.1% and hip (7.70% Conclusions: Work-related musculoskeletal disorders are an important health risk within the physiotherapy profession. The prevalence of work-related musculoskeletal disorders among the Physiotherapists in Tricity is high that

  5. Prevalence of musculoskeletal disorders among Norwegian female biathlon athletes

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    Østerås H

    2013-03-01

    Full Text Available Håvard Østerås,1 Kirsti Krohn Garnæs,2 Liv Berit Augestad3 1Department of Physical Therapy, Faculty of Health Education and Social Work, Sør-Trøndelag University College, Trondheim, Norway; 2Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway; 3Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway Abstract: The purpose was to examine musculoskeletal disorders in Norwegian female biathlon athletes (age ≥ 16, both juniors and seniors. The design was a retrospective cross-sectional study. In all, 148 athletes (79.1% responded; of these, 118 athletes were 16–21 years (juniors (77.6%, and 30 athletes were 22 years or older (seniors (20.3%, and mean age was 19.1. A validated questionnaire was used to collect the data. The prevalence of musculoskeletal disorders was 57.8%. The most affected parts were the knee (23.0% of the total injuries, calf (12.2%, ankle/foot (10.8%, lower back (10.8%, and thigh (10.1%. The disorders resulted in training/competition cessation for 73.5% of athletes, in alternative training for 87.8%. Fifty percent of the athletes had one or several musculoskeletal disorders. Most of the problems occurred preseason, and the duration of symptoms was often prolonged. Few differences between the juniors and seniors were found. This study showed the prevalence of musculoskeletal problems among female biathlon athletes. The results indicate that prevention of lower limb problems must be prioritized, especially during the preseason. Keywords: injuries, cross-country skiing, skating

  6. Differences in ergonomic and workstation factors between computer office workers with and without reported musculoskeletal pain.

    Science.gov (United States)

    Rodrigues, Mirela Sant'Ana; Leite, Raquel Descie Veraldi; Lelis, Cheila Maira; Chaves, Thaís Cristina

    2017-01-01

    Some studies have suggested a causal relationship between computer work and the development of musculoskeletal disorders. However, studies considering the use of specific tools to assess workplace ergonomics and psychosocial factors in computer office workers with and without reported musculoskeletal pain are scarce. The aim of this study was to compare the ergonomic, physical, and psychosocial factors in computer office workers with and without reported musculoskeletal pain (MSP). Thirty-five computer office workers (aged 18-55 years) participated in the study. The following evaluations were completed: Rapid Upper Limb Assessment (RULA), Rapid Office Strain Assessment (ROSA), and Maastricht Upper Extremity Questionnaire revised Brazilian Portuguese version (MUEQ-Br revised). Student t-tests were used to make comparisons between groups. The computer office workers were divided into two groups: workers with reported MSP (WMSP, n = 17) and workers without positive report (WOMSP, n = 18). Those in the WMSP group showed significantly greater mean values in the total ROSA score (WMSP: 6.71 [CI95% :6.20-7.21] and WOMSP: 5.88 [CI95% :5.37-6.39], p = 0.01). The WMSP group also showed higher scores in the chair section of the ROSA, workstation of MUEQ-Br revised, and in the upper limb RULA score. The chair height and armrest sections from ROSA showed the higher mean values in workers WMSP compared to workers WOMSP. A positive moderate correlation was observed between ROSA and RULA total scores (R = 0.63, p ergonomics indexes for chair workstation and worse physical risk related to upper limb (RULA upper limb section) than workers without pain. However, there were no observed differences in workers with and without MSP regarding work-related psychosocial factors. The results suggest that inadequate workstation conditions, specifically the chair height, arm and back rest, are linked to improper upper limb postures and that these factors are contributing to

  7. Upper Limb Absence: Predictors of Work Participation and Work Productivity.

    Science.gov (United States)

    Postema, Sietke G; Bongers, Raoul M; Brouwers, Michael A; Burger, Helena; Norling-Hermansson, Liselotte M; Reneman, Michiel F; Dijkstra, Pieter U; van der Sluis, Corry K

    2016-06-01

    To analyze work participation, work productivity, contributing factors, and physical work demands of individuals with upper limb absence (ULA). Cross-sectional study: postal survey (response rate, 45%). Twelve rehabilitation centers and orthopedic workshops. Individuals (n=207) with unilateral transverse upper limb reduction deficiency (RD) or acquired amputation (AA), at or proximal to the carpal level, between the ages of 18 and 65 years, and a convenience sample of control subjects (n=90) matched on age and sex. Not applicable. Employment status, self-reported work productivity measured with the Quality-Quantity method, and self-reported upper extremity work demands measured with the Upper Extremity Work Demands scale. Seventy-four percent of the individuals with RD and 57% of the individuals with AA were employed (vs 82% of the control group and 66% of the general population). Male sex, younger age, a medium or higher level of education, prosthesis use, and good general health were predictors of work participation. Work productivity was similar to that of the control group. Higher work productivity was inversely related to musculoskeletal complaint-related pain. When having predominantly mentally demanding work, individuals with ULA perceived higher upper extremity work demands compared with controls. Work participation of individuals with RD was slightly higher compared with that of the general population, whereas employment rates of individuals with AA were slightly lower. Furthermore, work productivity did not differ between individuals with RD, AA, and controls. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Technical guide to evaluate upper limb joints (shoulder, elbow and wrist) by ultrasound

    International Nuclear Information System (INIS)

    Obregon Baez, Luis Rafael

    2014-01-01

    A guideline to follow is offered to radiologists and residents of radiology service of medical imaging, when evaluating by ultrasound the shoulder joints, elbow, wrist. The importance to performing of musculoskeletal ultrasound by its pathology variable is established. The use of appropriate equipment and effective application of the techniques exposed of echography exploration have made enable the valuation of many pathologies with high sensitivity and specificity. The echography has been the musculoskeletal imaging technique that more rapidly has evolved. Currently, this technique has been replaced by magnetic resonance imaging in various clinical fields and also serves as a complement to other techniques. Exposed techniques have been of great benefit for radiologists medical and residents, obtaining with its use a quick guide for the realization of upper limb musculoskeletal ultrasounds. The appropriate and easy techniques are better known for the evaluation of these structures, and so document both sports injuries, as joint and rheumatic diseases [es

  9. Entrapment Neuropathies in the Upper and Lower Limbs: Anatomy and MRI Features

    International Nuclear Information System (INIS)

    Dong, Q.; Jacobson, J.A.; Jamadar, D.A.; Gandikota, G.; Brandon, C.; Morag, Y.; Fessell, D.P.; Kim, S.M.

    2012-01-01

    Peripheral nerve entrapment occurs at specific anatomic locations. Familiarity with the anatomy and the magnetic resonance imaging (MRI) features of nerve entrapment syndromes is important for accurate diagnosis and early treatment of entrapment neuropathies. The purpose of this paper is to illustrate the normal anatomy of peripheral nerves in the upper and lower limbs and to review the MRI features of common disorders affecting the peripheral nerves, both compressive/entrapment and non compressive, involving the supra scapular nerve, the axillary nerve, the radial nerve, the ulnar nerve, and the median verve in the upper limb and the sciatic nerve, the common peroneal nerve, the tibial nerve, and the interdigital nerves in the lower limb

  10. A review of supernumerary and absent limbs and digits of the upper limb.

    Science.gov (United States)

    Klaassen, Zachary; Choi, Monica; Musselman, Ruth; Eapen, Deborah; Tubbs, R Shane; Loukas, Marios

    2012-03-01

    For years people have been enamored by anomalies of the human limbs, particularly supernumerary and absent limbs and digits. Historically, there are a number of examples of such anomalies, including royal families of ancient Chaldea, tribes from Arabia, and examples from across nineteenth century Europe. The development of the upper limbs in a growing embryo is still being elucidated with the recent advent of homeobox genes, but researchers agree that upper limbs develop between stages 12-23 through a complex embryological process. Maternal thalidomide intake during limb development is known to cause limb reduction and subsequent amelia or phocomelia. Additionally, a number of clinical reports have illustrated different limb anomaly cases, with each situation unique in phenotype and developmental abnormality. Supernumerary and absent limbs and digits are not unique to humans, and a number of animal cases have also been reported. This review of the literature illustrates the historical, anatomical, and clinical aspects of supernumerary and absent limbs and digits for the upper limb.

  11. Effects of participatory ergonomic intervention on the development of upper extremity musculoskeletal disorders and disability in office employees using a computer.

    Science.gov (United States)

    Baydur, Hakan; Ergör, Alp; Demiral, Yücel; Akalın, Elif

    2016-06-16

    To evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees. This study is a randomized controlled intervention study. It comprised 116 office workers using computers. Those in the intervention group were taught office ergonomics and the risk assessment method. Cox proportional hazards model and generalized estimating equations (GEEs) were used. In the 10-month postintervention follow-up, the possibility of developing symptoms was 50.9%. According to multivariate analysis results, the possibility of developing symptoms on the right side of the neck and in the right wrist and hand was significantly less in the intervention group than in the control group (pergonomic intervention decreases the possibility of musculoskeletal complaints and disability/symptom level in office workers.

  12. Musculoskeletal disorders and mental health-related issues as occupational hazards among dental practitioners in Salem city: A cross-sectional study

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    Vanita D Revankar

    2017-01-01

    Full Text Available Background: Like in any other profession, dental surgeons are also afflicted by many occupational health hazards such as Musculoskeletal disorders (MSD and mental health related issues. Aims: To assess the distribution of MSD and mental health related issues amidst dentists in Salem City according to age, sex and number of working hours per week. Objectives: A survey was organized to check the rate of occurrence of these occupational health hazards among dental practitioners in Salem city. Materials and Methods: The study was conducted among one hundred and fifty dentists practicing in Salem City in the form of questionnaire. Dentists were asked about any occupational disease that they suffered related to a musculo–skeletal pain and its location whether in the back, upper limbs or lower limbs. In addition to this,dentists were asked about mental stress that they had experienced. Results: MSD showed higher rate of prevalence compared to mental health related issues. Conclusion: The application of preventive measures is necessary, in view of the high rate of these disorders in the society of dental practitioners.

  13. Upper limb position control in fibromyalgia

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    Bardal Ellen

    2012-09-01

    Full Text Available Abstract Background Motor problems are reported by patients with fibromyalgia (FM. However, the mechanisms leading to alterations in motor performance are not well understood. In this study, upper limb position control during sustained isometric contractions was investigated in patients with FM and in healthy controls (HCs. Methods Fifteen female FM patients and 13 HCs were asked to keep a constant upper limb position during sustained elbow flexion and shoulder abduction, respectively. Subjects received real-time visual feedback on limb position and both tasks were performed unloaded and while supporting loads (1, 2, and 3 kg. Accelerations of the dominant upper limb were recorded, with variance (SD of mean position and power spectrum analysis used to characterize limb position control. Normalized power of the acceleration signal was extracted for three frequency bands: 1–3 Hz, 4–7 Hz, and 8–12 Hz. Results Variance increased with load in both tasks (P 0.001 but did not differ significantly between patients and HCs (P > 0.17. Power spectrum analysis showed that the FM patients had a higher proportion of normalized power in the 1–3 Hz band, and a lower proportion of normalized power in the 8–12 Hz band compared to HCs (P 0.05. The results were consistent for all load conditions and for both elbow flexion and shoulder abduction. Conclusion FM patients exhibit an altered neuromuscular strategy for upper limb position control compared to HCs. The predominance of low-frequency limb oscillations among FM patients may indicate a sensory deficit.

  14. Isolated primary lymphedema tarda of the upper limb.

    Science.gov (United States)

    Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

    2013-03-01

    Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

  15. PHYSICAL WORKLOAD AS A RISK FACTOR FOR SYMPTOMS IN THE NECK AND UPPER LIMBS: EXPOSURE ASSESSMENT AND ERGONOMIC INTERVENTION

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    Ritva Ketola

    2004-06-01

    Full Text Available The aims of this study were to investigate work related and individual factors as predictors of insident neck pain among video display unit (VDU workers, to assess the effects of an ergonomic intervention and education on musculoskeletal symptoms, and to study the repeatability and validity of an expert assessment method of VDU workstation ergonomics. A method to assess the risk factors for upper limb disorders was developed, and its validity and repeatability were studied. The annual incidence of neck pain was 34.4%. A poor physical work environment and placement of the keyboard were work-related factors increasing the risk of neck pain. Among the individual factors, female sex was a strong predictor. The randomized intervention study included questionnaire survey, a diary of discomfort, and ergonomic rating of the workstations. The subjects (n=124 were allocated into three groups. The intensive and the education groups had less musculoskeletal discomfort than the control group at the 2-month follow-up. After the intervention, the level of ergonomics was distinctly higher in the intensive ergonomic group than in the education or control group. Two experts in ergonomics analyzed and rated the ergonomics of workstations before and after intervention. The validity of the assessment method was rated against the technical measurements, assessment of tidiness and space, and work chair ergonomics. The intraclass correlation coefficient between ratings of the two experts was 0.74. Changes in the location of the input devises and the screen, as well as the values of tidiness and space and work chair ergonomics showed a significant association with the ratings of both experts. The method to assess the loads imposed on the upper limbs was validated against the expert observations from the video, continuous recordings of myoelectric activity of forearm muscles, and wrist posture, measured with goniometers. Inter-observer repeatability and validity were

  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. Effects of participatory ergonomic intervention on the development of upper extremity musculoskeletal disorders and disability in office employees using a computer

    Science.gov (United States)

    Baydur, Hakan; Ergör, Alp; Demiral, Yücel; Akalın, Elif

    2016-01-01

    Objective: To evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees. Methods: This study is a randomized controlled intervention study. It comprised 116 office workers using computers. Those in the intervention group were taught office ergonomics and the risk assessment method. Cox proportional hazards model and generalized estimating equations (GEEs) were used. Results: In the 10-month postintervention follow-up, the possibility of developing symptoms was 50.9%. According to multivariate analysis results, the possibility of developing symptoms on the right side of the neck and in the right wrist and hand was significantly less in the intervention group than in the control group (pergonomic intervention decreases the possibility of musculoskeletal complaints and disability/symptom level in office workers. PMID:27108647

  18. Infantile lipofibromatosis of the upper limb

    Energy Technology Data Exchange (ETDEWEB)

    Teo, Harvey E.L.; Peh, Wilfred C.G. [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Chan, Mei-Yoke [KK Women' s and Children' s Hospital, Department of Paediatric Medicine, Singapore (Singapore); Walford, Norman [Tan Tock Seng Hospital, Department of Pathology, Singapore (Singapore)

    2005-12-01

    The imaging features of extensive lipofibromatosis presenting in a 1-day-old female infant are reported. This lesion involved her entire right upper limb, extending from the axilla to the palm of the hand. Radiographs showed marked deformity and thinning of all the right upper-limb bones due to pressure effect of soft-tissue enlargement, especially affecting the distal humerus and proximal forearm bones. Magnetic resonance imaging showed a huge soft-tissue mass infiltrating most of the muscles of the entire upper limb, with bony erosion. The mass was largely T1-isointense, moderately T2-hyperintense and showed marked enhancement. There were intra-lesional signal changes consistent with fatty elements. A lesion debulking procedure was performed and the histology was that of lipofibromatosis. The limb was found to be non-viable after the procedure and a subsequent above-elbow amputation was performed. Although the resection margins were not clear, she had no further recurrence over a subsequent 3-year follow-up period. (orig.)

  19. Functional rehabilitation of upper limb apraxia in poststroke patients: study protocol for a randomized controlled trial

    OpenAIRE

    P?rez-M?rmol, Jose Manuel; Garc?a-R?os, M? Carmen; Barrero-Hernandez, Francisco J.; Molina-Torres, Guadalupe; Brown, Ted; Aguilar-Ferr?ndiz, Mar?a Encarnaci?n

    2015-01-01

    Background Upper limb apraxia is a common disorder associated with stroke that can reduce patients? independence levels in activities of daily living and increase levels of disability. Traditional rehabilitation programs designed to promote the recovery of upper limb function have mainly focused on restorative or compensatory approaches. However, no previous studies have been completed that evaluate a combined intervention method approach, where patients concurrently receive cognitive trainin...

  20. Relationship between Comorbid Health Problems and Musculoskeletal Disorders Resulting in Musculoskeletal Complaints and Musculoskeletal Sickness Absence among Employees in Korea.

    Science.gov (United States)

    Baek, Ji Hye; Kim, Young Sun; Yi, Kwan Hyung

    2015-06-01

    To investigate the relationship between musculoskeletal disorders and comorbid health problems, including depression/anxiety disorder, insomnia/sleep disorder, fatigue, and injury by accident, and to determine whether certain physical and psychological factors reduce comorbid health problems. In total, 29,711 employees were selected from respondents of the Third Korean Working Conditions Survey and categorized into two groups: Musculoskeletal Complaints or Musculoskeletal Sickness Absence. Four self-reported health indicators (overall fatigue, depression/anxiety, insomnia/sleep disorder, and injury by accident) were selected as outcomes, based on their high prevalence in Korea. We used multiple logistic regression analysis to determine the relationship between comorbid health problems, musculoskeletal complaints, and sickness absence. The prevalence of musculoskeletal complaints and musculoskeletal sickness absence due to muscular pain was 32.26% and 0.59%, respectively. Compared to the reference group, depression/anxiety disorder and overall fatigue were 5.2-6.1 times more prevalent in the Musculoskeletal Complaints Group and insomnia/sleep disorder and injury by accident were 7.6-11.0 times more prevalent in the Sickness Absence Group. When adjusted for individual and work-related physical factors, prevalence of all four comorbid health problems were slightly decreased in both groups. Increases in overall fatigue and depression/anxiety disorder were observed in the Musculoskeletal Complaints Group, while increases in insomnia/sleep disorder and injury by accident were observed in the Sickness Absence Group. For management of musculoskeletal complaints and sickness absence in the workplace, differences in health problems between employees with musculoskeletal complaints and those with sickness absence as well as the physical and psychological risk factors should be considered.

  1. Work related upper limb disorders in telecommunication workers in Malaysia.

    Science.gov (United States)

    Premalatha, G D; Noor Hassim, I

    1999-06-01

    A total of 323 workers from 5 different occupational groups in the telecommunication industry were studied in this cross sectional study, which sought to determine the prevalence of Work Related Upper Limb Disorders (WRULD) in 5 occupational groups; operators using the Video Display Terminals, switchboard operators, clerks, data entry processors and the supervisors. WRULD was also studied with regard to factors such as sex, race, height, age, stress and the discomfort perceived due to the work station design. The possibility of WRULD was determined from a self-administered questionnaire and confirmed by history and physical examination. Psychological stress and the discomfort due to the workstation were measured from the questionnaire. The overall prevalence was found to be 31.2% and the prevalence among the various occupations differed with it being the highest in the switchboard operators and data processors and the lowest in the supervisors. The older workers and the female workers were found to have higher prevalences of WRULD. It was also found that a higher stress score and a higher score of discomfort perceived at the work station were associated with higher prevalences of WRULD.

  2. [Muskuloskeletal disorders in construction industry: hospital cases].

    Science.gov (United States)

    Santini, M; Riva, M M; Mosconi, G

    2012-01-01

    The authors analyse 493 hospital cases in 356 workers from the construction industry, came to observation for musculoskeletal disorders (average age 48, 2 years, SD 9; work seniority 32, 2 years, SD 9, 7; work seniority in construction industry 27, 3 years, SD 12, 4). The evaluation was required in 305 subjects (85.7% of the sample) to investigate one or more suspected WMDS; in 51 subjects (14.3% of the sample) to express an opinion on fitness to work or residual work capacity. Investigations led to diagnosis of 479 musculoskeletal disorders; the districts most affected are spine and upper limb. 64.7% of the musculoskeletal disorders was evaluated to be work-related, the percentage rises to 68% when considering only cases sent for evaluation of suspected WMDS. The most frequent reasons to exclude relation between the musculoskeletal disorders and work were an high age at diagnosis, presence of comorbidity or outcome of trauma, a disease mismatch exposure.

  3. Exoskeleton robots for upper-limb rehabilitation: state of the art and future prospects.

    Science.gov (United States)

    Lo, Ho Shing; Xie, Sheng Quan

    2012-04-01

    Current health services are struggling to provide optimal rehabilitation therapy to victims of stroke. This has motivated researchers to explore the use of robotic devices to provide rehabilitation therapy for strokepatients. This paper reviews the recent progress of upper limb exoskeleton robots for rehabilitation treatment of patients with neuromuscular disorders. Firstly, a brief introduction to rehabilitation robots will be given along with examples of existing commercial devices. The advancements in upper limb exoskeleton technology and the fundamental challenges in developing these devices are described. Potential areas for future research are discussed. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  4. Ergonomic assessment of musculoskeletal disorders risk among the computer users by Rapid Upper Limb Assessment method

    Directory of Open Access Journals (Sweden)

    Ehsanollah Habibi

    2016-01-01

    Conclusion: This study result showed that frequency of musculoskeletal problems in the neck, back, elbow, and wrist was generally high among our subjects, and ergonomic interventions such as computer workstation redesign, users educate about ergonomic principles computer with work, reduced working hours in computers with work must be carried out.

  5. "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

  6. Shoulder Strength Requirements for Upper Limb Functional Tasks: Do Age and Rotator Cuff Tear Status Matter?

    Science.gov (United States)

    Santago, Anthony C; Vidt, Meghan E; Li, Xiaotong; Tuohy, Christopher J; Poehling, Gary G; Freehill, Michael T; Saul, Katherine R

    2017-12-01

    Understanding upper limb strength requirements for daily tasks is imperative for early detection of strength loss that may progress to disability due to age or rotator cuff tear. We quantified shoulder strength requirements for 5 upper limb tasks performed by 3 groups: uninjured young adults and older adults, and older adults with a degenerative supraspinatus tear prior to repair. Musculoskeletal models were developed for each group representing age, sex, and tear-related strength losses. Percentage of available strength used was quantified for the subset of tasks requiring the largest amount of shoulder strength. Significant differences in strength requirements existed across tasks: upward reach 105° required the largest average strength; axilla wash required the largest peak strength. However, there were limited differences across participant groups. Older adults with and without a tear used a larger percentage of their shoulder elevation (p functional tasks to effectively detect early strength loss, which may lead to disability.

  7. THE PREVALENCE OF MUSCULOSKELETAL DISORDERS AMONG BUS DRIVERS IN TRICITY

    Directory of Open Access Journals (Sweden)

    Lalit

    2015-10-01

    Full Text Available Background: Musculoskeletal disorders are widespread in many countries around the world. It has been reported that about 58 percent of the world's population over the age of 10 years spent one third of their life span at work. The population at a high risk include nursing facilities, transportation, mining, food processing, leather tanning, heavy and light manufacturing. Transport workers have been found to be at high risk of developing work related musculoskeletal disorders (WRMSDs. There has been literature evidence regarding the prevalence of musculoskeletal disorders in bus drivers of various cities of different countries. But no study has been done so far in Tricity (Chandigarh, Panchkula and Mohali for the same. The purpose of this study is to investigate the prevalence and characteristics of work related musculoskeletal disorders (WRMSDs among bus drivers of Tricity. Methods: 300 bus drivers were included in the study according to the inclusion and exclusion criteria. The standardized Nordic questionnaire for musculoskeletal disorder and a self administered questionnaire were filled by therapist after the personal interview of each driver. Results: Unpaired t test was used to measure the difference in variable of two groups and Karl Pearson’s correlation coefficient was used to determine the correlation between two entities. In the present study, the subjects were in the age group of 25 to 50 years. Out of the total sample of 300 male bus drivers in Tricity, 159 reported that they had WRMSDs. The prevalence of WRMSDs among bus drivers in Tricity was 53%. In present study, the prevalence of low back pain was highest among the bus drivers that are 30.3%, then neck pain 17.3%, knee pain 14.7%, shoulder 6.3%, ankle and feet 5.7%, upper back 4%, hip and thigh 4%, elbow 1.3% and wrist and hand 1.3%. Thus low back pain, neck pain and knee pain are the most prevalent WRMSDs amongst bus drivers. Conclusions: Work-related biomechanical

  8. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  9. Upper limb injury in rugby union football: results of a cohort study.

    Science.gov (United States)

    Usman, Juliana; McIntosh, Andrew Stuart

    2013-04-01

    There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

  10. Musculoskeletal disorders and psychosocial risk factors among workers of the aircraft maintenance industry.

    Science.gov (United States)

    Nogueira, Helen Cristina; Diniz, Ana Carolina Parise; Barbieri, Dechristian França; Padula, Rosimeire Simprini; Carregaro, Rodrigo Luiz; de Oliveira, Ana Beatriz

    2012-01-01

    During the recent decades Brazil has experienced an exponential growth in the aviation sector resulting in an increasing workforce. The aircraft maintenance industry stands out, where the workers have to handle different kind of objects. The aim of this study was to evaluate psychosocial indicators as well as musculoskeletal symptoms and disorders among aircraft maintenance workers. One hundred and one employees were evaluated (32.69 ± 8.25 yr, 79.8 ± 13.4 kg, and 1.75 ± 0.07 m). Musculoskeletal symptoms and disorders were assessed through the Nordic Musculoskeletal Questionnaire (NMQ) and a standardized physical examination. The Job Content Questionnaire (JCQ) and the Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial indicators. Results of the NMQ indicate the lower back as the most affected body region. On the other hand, the physical examination has shown clinical diagnosis of shoulder disorders. Neck, upper back and ankle/foot were also reported as painful sites. Most of workers have active work-demand profile and high work engagement levels. We suggest that musculoskeletal symptoms may be related to high biomechanical demand of the tasks performed by workers, what must be further investigated.

  11. 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.

  12. THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

    Directory of Open Access Journals (Sweden)

    M. Jaszczak

    2011-09-01

    Full Text Available This study 1 examined the influence of lower limb movement on upper limb movement symmetry, 2 determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3 diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limbs while in the second one only by the upper limbs. The pressure differentials exerted by the water on the back and on the palm of the right and left hand were measured. Then, the asymmetry coefficient of the hand movement was determined. No changes in the level of the asymmetry index in participants performing correct (symmetrical lower limb movement were observed. Incorrect (asymmetrical leg motion resulted in an increase of hand asymmetry. It could be concluded that lower limb faults neutralize upper limb performance when swimming on a rectilinear path. However, most asymmetrical arm performance should be identified with the conversion of propulsion into recovery. Nevertheless, its proneness to influence improper leg performance might be expected at the beginning of arm propulsion.

  13. Modeling and dynamic simulation of astronaut's upper limb motions considering counter torques generated by the space suit.

    Science.gov (United States)

    Li, Jingwen; Ye, Qing; Ding, Li; Liao, Qianfang

    2017-07-01

    Extravehicular activity (EVA) is an inevitable task for astronauts to maintain proper functions of both the spacecraft and the space station. Both experimental research in a microgravity simulator (e.g. neutral buoyancy tank, zero-g aircraft or a drop tower/tube) and mathematical modeling were used to study EVA to provide guidance for the training on Earth and task design in space. Modeling has become more and more promising because of its efficiency. Based on the task analysis, almost 90% of EVA activity is accomplished through upper limb motions. Therefore, focusing on upper limb models of the body and space suit is valuable to this effort. In previous modeling studies, some multi-rigid-body systems were developed to simplify the human musculoskeletal system, and the space suit was mostly considered as a part of the astronaut body. With the aim to improve the reality of the models, we developed an astronauts' upper limb model, including a torque model and a muscle-force model, with the counter torques from the space suit being considered as a boundary condition. Inverse kinematics and the Maggi-Kane's method was applied to calculate the joint angles, joint torques and muscle force given that the terminal trajectory of upper limb motion was known. Also, we validated the muscle-force model using electromyogram (EMG) data collected in a validation experiment. Muscle force calculated from our model presented a similar trend with the EMG data, supporting the effectiveness and feasibility of the muscle-force model we established, and also, partially validating the joint model in kinematics aspect.

  14. THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

    OpenAIRE

    M. Jaszczak

    2011-01-01

    This study 1) examined the influence of lower limb movement on upper limb movement symmetry, 2) determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3) diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limb...

  15. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  16. Upper limb fractures in rugby in Huddersfield 1986-1990.

    OpenAIRE

    Eyres, K S; Abdel-Salam, A; Cleary, J

    1991-01-01

    Most injuries sustained by rugby players affect the soft tissues, and fracture is relatively uncommon. Whereas the lower limb is most affected in footballers, the upper limb tends to be injured in rugby players. Thirty consecutive fractures and ten dislocations affecting the upper limb, sustained by 35 rugby players, are reported.

  17. Development and reliability of the rating of compensatory movements in upper limb prosthesis wearers during work-related tasks.

    Science.gov (United States)

    van der Laan, Tallie M J; Postema, Sietke G; Reneman, Michiel F; Bongers, Raoul M; van der Sluis, Corry K

    2018-02-10

    Reliability study. Quantifying compensatory movements during work-related tasks may help to prevent musculoskeletal complaints in individuals with upper limb absence. (1) To develop a qualitative scoring system for rating compensatory shoulder and trunk movements in upper limb prosthesis wearers during the performance of functional capacity evaluation tests adjusted for use by 1-handed individuals (functional capacity evaluation-one handed [FCE-OH]); (2) to examine the interrater and intrarater reliability of the scoring system; and (3) to assess its feasibility. Movement patterns of 12 videotaped upper limb prosthesis wearers and 20 controls were analyzed. Compensatory movements were defined for each FCE-OH test, and a scoring system was developed, pilot tested, and adjusted. During reliability testing, 18 raters (12 FCE experts and 6 physiotherapists/gait analysts) scored videotapes of upper limb prosthesis wearers performing 4 FCE-OH tests 2 times (2 weeks apart). Agreement was expressed in % and kappa value. Feasibility (focus area's "acceptability", "demand," and "implementation") was determined by using a questionnaire. After 2 rounds of pilot testing and adjusting, reliability of a third version was tested. The interrater reliability for the first and second rating sessions were к = 0.54 (confidence interval [CI]: 0.52-0.57) and к = 0.64 (CI: 0.61-0.66), respectively. The intrarater reliability was к = 0.77 (CI: 0.72-0.82). The feasibility was good but could be improved by a training program. It seems possible to identify compensatory movements in upper limb prosthesis wearers during the performance of FCE-OH tests reliably by observation using the developed observational scoring system. Interrater reliability was satisfactory in most instances; intrarater reliability was good. Feasibility was established. Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  18. Chest pain in focal musculoskeletal disorders

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-01-01

    overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence......The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several...... arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice....

  19. Upper limb treatment technigues for stroke survivors

    Directory of Open Access Journals (Sweden)

    Martyna Kornet

    2017-03-01

    It was considered that the most important elements of the treatment used in the rehabilitation of the paretic upper limb are: exercise matching the anti-spasm pattern, maintaining appropriate position for exercise that provide an approximation of the shoulder joint and the use of cross-facilitation. The study indicates that the treatment of a post stroke upper limb should be based on the: physiotherapy, kinesiotherapy and specific positioning - all of them corresponding to a given stage of the disease. The work also presents the most frequently used methods, especially highlighting: the Prorioceptive Neuromuscular Facilitation (PNF, Bobath, Brunnstrom, CIMT and OIT. It was also shown that in order to enhance the effects of a post-stroke upper limb rehabilitation, it should be extended by modern methods such as Mirror Therapy, Virtual Reality or Robot-assisted Therapy.

  20. Distúrbios musculoesqueléticos em trabalhadores do setor saúde de Belo Horizonte, Minas Gerais, Brasil Musculoskeletal disorders among healthcare workers in Belo Horizonte, Minas Gerais State, Brazil

    Directory of Open Access Journals (Sweden)

    Rose Elizabeth Cabral Barbosa

    2012-08-01

    Full Text Available Estudo transversal que investigou a prevalência de distúrbios musculoesqueléticos e os fatores associados em uma amostra de 1.808 sujeitos do universo de 13.602 trabalhadores do sistema municipal de saúde de Belo Horizonte, Minas Gerais, Brasil. A prevalência foi avaliada com base no autorrelato de dor nos membros superiores, membros inferiores e dorso; a magnitude das associações foi estimada por meio da regressão de Poisson, em modelos univariados (p This cross-sectional study investigated the prevalence of musculoskeletal disorders and associated factors in a sample of 1,808 workers (from a total of 13,602 in the municipal health system in Belo Horizonte, Minas Gerais State, Brazil. Prevalence was calculated according to self-reported pain in the upper or lower limbs and/or back, and size of associations was estimated by univariate (p < 0.20 and multivariate Poisson regression (p < 0.05. Musculoskeletal disorders showed a prevalence of 49.9% and were statistically associated with female gender, living with a partner, physical activity less than twice a week, self-reported common mental disorder, certain job positions (dentists, dental technicians, and community health workers, high physical demand, and inadequate working conditions. The results confirm the complexity of musculoskeletal disorders and suggest areas for development of health promotion programs in health services.

  1. Musculoskeletal disorders associated with HIV infection and AIDS. Part I: Infectious musculoskeletal conditions

    International Nuclear Information System (INIS)

    Tehranzadeh, Jamshid; Ter-Oganesyan, Ramon R.; Steinbach, Lynne S.

    2004-01-01

    The musculoskeletal system can be affected by a variety of abnormalities in association with human immunodeficiency virus (HIV) infection. Although not as common as complications involving other organ systems, such as the pulmonary and the central nervous systems, HIV-associated musculoskeletal disorders are sometimes the initial presentation of the viral illness. Knowledge of the existence and the characteristic appearance of the conditions affecting bone, joint, and muscle in HIV-infected patients is valuable to radiologists for diagnosis and to clinicians for detection and appropriate treatment. We reviewed recent literature to provide a comprehensive assessment of the HIV-associated musculoskeletal disorders, and present radiologic examples from our own collection. This article is divided into two parts. In the first part we review the infectious musculoskeletal disorders associated with HIV illness and AIDS, including cellulitis, abscesses, pyomyositis, septic bursitis, septic arthritis, osteomyelitis, and bacillary angiomatosis. We also present a comprehensive spectrum of mycobacterial infections, consisting of tuberculous spondylitis and spondylodiskitis, arthritis, osteomyelitis, and tenosynovitis, as well as infections caused by atypical mycobacteria. Part II of this review will concentrate on non-infectious musculoskeletal conditions, including rheumatic disorders and neoplasms. (orig.)

  2. Musculoskeletal disorders associated with HIV infection and AIDS. Part I: Infectious musculoskeletal conditions

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, Jamshid [Department of Radiological Sciences, University of California, Irvine, Irvine, California (United States); Department of Radiological Sciences, Rt. 140, 101 The City Drive ZC 5005, CA 92868-3298, Orange (United States); Ter-Oganesyan, Ramon R. [College of Medicine, University of California, Irvine, Irvine, California (United States); Steinbach, Lynne S. [Department of Radiological Sciences, University of California, San Francisco, San Francisco, California (United States)

    2004-05-01

    The musculoskeletal system can be affected by a variety of abnormalities in association with human immunodeficiency virus (HIV) infection. Although not as common as complications involving other organ systems, such as the pulmonary and the central nervous systems, HIV-associated musculoskeletal disorders are sometimes the initial presentation of the viral illness. Knowledge of the existence and the characteristic appearance of the conditions affecting bone, joint, and muscle in HIV-infected patients is valuable to radiologists for diagnosis and to clinicians for detection and appropriate treatment. We reviewed recent literature to provide a comprehensive assessment of the HIV-associated musculoskeletal disorders, and present radiologic examples from our own collection. This article is divided into two parts. In the first part we review the infectious musculoskeletal disorders associated with HIV illness and AIDS, including cellulitis, abscesses, pyomyositis, septic bursitis, septic arthritis, osteomyelitis, and bacillary angiomatosis. We also present a comprehensive spectrum of mycobacterial infections, consisting of tuberculous spondylitis and spondylodiskitis, arthritis, osteomyelitis, and tenosynovitis, as well as infections caused by atypical mycobacteria. Part II of this review will concentrate on non-infectious musculoskeletal conditions, including rheumatic disorders and neoplasms. (orig.)

  3. A Framework to Automate Assessment of Upper-Limb Motor Function Impairment: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Paul Otten

    2015-08-01

    Full Text Available Standard upper-limb motor function impairment assessments, such as the Fugl-Meyer Assessment (FMA, are a critical aspect of rehabilitation after neurological disorders. These assessments typically take a long time (about 30 min for the FMA for a clinician to perform on a patient, which is a severe burden in a clinical environment. In this paper, we propose a framework for automating upper-limb motor assessments that uses low-cost sensors to collect movement data. The sensor data is then processed through a machine learning algorithm to determine a score for a patient’s upper-limb functionality. To demonstrate the feasibility of the proposed approach, we implemented a system based on the proposed framework that can automate most of the FMA. Our experiment shows that the system provides similar FMA scores to clinician scores, and reduces the time spent evaluating each patient by 82%. Moreover, the proposed framework can be used to implement customized tests or tests specified in other existing standard assessment methods.

  4. Upper limb robotics applied to neurorehabilitation: An overview of clinical practice.

    Science.gov (United States)

    Duret, Christophe; Mazzoleni, Stefano

    2017-01-01

    During the last two decades, extensive interaction between clinicians and engineers has led to the development of systems that stimulate neural plasticity to optimize motor recovery after neurological lesions. This has resulted in the expansion of the field of robotics for rehabilitation. Studies in patients with stroke-related upper-limb paresis have shown that robotic rehabilitation can improve motor capacity. However, few other applications have been evaluated (e.g. tremor, peripheral nerve injuries or other neurological diseases). This paper presents an overview of the current use of upper limb robotic systems for neurorehabilitation, and highlights the rationale behind their use for the assessment and treatment of common neurological disorders. Rehabilitation robots are little integrated in clinical practice, except after stroke. Although few studies have been carried out to evaluate their effectiveness, evidence from the neurosciences and indications from pilot studies suggests that upper limb robotic rehabilitation can be applied safely in various other neurological conditions. Rehabilitation robots provide an intensity, quality and dose of treatment that exceeds therapist-mediated rehabilitation. Moreover, the use of force fields, multi-sensory environments, feedback etc. renders such rehabilitation engaging and motivating. Future studies should evaluate the effectiveness of rehabilitation robots in neurological pathologies other than stroke.

  5. Infant carrying methods: Correlates and associated musculoskeletal disorders among nursing mothers in Nigeria.

    Science.gov (United States)

    Ojukwu, Chidiebele Petronilla; Anyanwu, Godson Emeka; Anekwu, Emelie Morris; Chukwu, Sylvester Caesar; Fab-Agbo, Chukwubuikem

    2017-10-01

    Infant carrying is an integral part of the mothering occupation. Paucity of data exists on its correlates and associated musculoskeletal injuries. In this study, factors and musculoskeletal injuries associated with infant carrying were investigated in 227 nursing mothers, using a structured questionnaire. 77.1% utilised the back infant carrying methods (ICM). Maternal comfort was the major factor influencing participants' (37.4%) choices of ICMs. Infant's age (p = .000) and transportation means (p = .045) were significantly associated with ICMs. Low back pain (82.8%) and upper back pain (74.9%) were the most reported musculoskeletal discomforts associated with ICMs, especially among women who utilised back ICM. Back ICM is predominantly used by nursing mothers. Impact statement Infant carrying has been associated with increased energy cost and biomechanical changes. Currently, there is a paucity of data on infant carrying-related musculoskeletal injuries. In this study, investigating factors and musculoskeletal injuries associated with infant carrying, the results showed that back infant carrying method is predominantly used by nursing mothers. Age of the infant and mothers' means of transportation were determinant factors of infant carrying methods. Among the several reported infant carrying-related musculoskeletal disorders, low back and upper back pain were the most prevalent, especially among women who utilised the back infant carrying method. There is need for women's health specialists to introduce appropriate ergonomic training and interventions on infant carrying tasks in order to improve maternal musculoskeletal health during the childbearing years and beyond. Further experimental studies on the effects of various infant carrying methods on the musculoskeletal system are recommended.

  6. Radiogrammetric analysis of upper limb long bones

    Directory of Open Access Journals (Sweden)

    Stojanović Zlatan

    2011-01-01

    Full Text Available Radiogrammetry is radiological method of bone mineral density quantification. Besides giving an insight in diagnostics and evolution of metabolic bone disorders (osteoporosis, osteomalacia, osteitis deformans- Paget's disease, it can also explain some specific biomechanical characteristics of bone structures. The aim of this study is to evaluate the significance and perspectives of radiogrammetry as a scientific model for further inquiry of skeletal system. The work demonstrates mathematical parameters (Ca-Cortical area, CI- Cortical index, GI- Garn's index, ESI- Exton Smith's index of upper limb long bones (humerus, radius, ulna. Two standard radiological projections of bones were taken: antero-posterior (AP and latero-lateral (LL. Correlation with metacarpal and lower limb bones was also performed. The value of the cortical area of humerus is significantly higher comparing with the two other examined bones (Xmean 2,2443 cm2, p < 0.01. Radial bone has the highest values of the relational mathematical parameters, which implicates its higher strength by volumetric unit concerning humerus and ulna. Despite the development of contemporary osteometric procedures (ultrasound densitometry, dual X-ray absorptiometry, digital X-ray radiogrammetry, the classical radiogrammetry sustains its important role in diagnostics of metabolic bone disorders and it can be successfully used for biomechanical inquiry of skeletal system.

  7. A short overview of upper limb rehabilitation devices

    Science.gov (United States)

    Macovei, S.; Doroftei, I.

    2016-08-01

    As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

  8. Back and neck pain disability and upper limb symptoms of home healthcare workers: A case-control study from Northern Italy.

    Science.gov (United States)

    Riccò, Matteo; Pezzetti, Federica; Signorelli, Carlo

    2017-03-30

    Work-related musculoskeletal disorders (MSD) are quite frequent in healthcare workers (HCWs), but data about MSD in home-based healthcare workers (HHWs) are lacking. In this study we describe the prevalence of MSD among Italian HHWs. A case-control study was carried out among 300 random-selected female HCWs, the sample comprising 100 HHWs, 100 HCWs with a low exposure to patient handling (MAPO - Movimentazione e Assistenza Pazienti Ospedalizzati - Movement and Assistance of Hospital Patients index 0-5) and 100 HCWs with high exposure to patient handling (MAPO index ≥ 5.01). As a negative control group, 200 visual display unit workers were also randomly selected. Musculoskeletal disorder cases were collected using a standardized case definition. A multivariate logistic regression analysis was performed comparing the MSD prevalence in the 4 groups. The overall prevalence of MSD was 17% in the reference group and 28.3% for HCWs. HHWs and HCWs with MAPO index ≥ 5.01 had similar prevalence of neck pain (9% and 11%, respectively), whereas lumbosacral pain prevalence was higher in the HHWs group (31%), with similar results in residential HCWs groups (21% in MAPO index 0-5 group and 25% in MAPO index ≥ 5.01 group). HCWs of group MAPO index ≥ 5.01 and HHWs showed the higher prevalence of upper limb complaints, with a prevalence of 20% and 10%, respectively. In multivariate regression analysis, prevalence of MSD complaints was quite similar in HHWs (adjusted odds ratio (ORadj) = 2.335, 95% confidence interval (CI): 1.318-4.138) and in HCWs of the group MAPO ≥ 5.01 (ORadj = 2.729, 95% CI: 1.552-4.797). The prevalence of MSD in the examined HCWs was relatively high, with HHWs appearing as a particularly high-risk group for lumbosacral back pain. In higher exposed HCWs, upper-limb symptoms were particularly frequent, probably reflecting the different tasks required to manage residential and homebased patients. In conclusion, this study reaffirms the high prevalence of

  9. An approach to the painful upper limb

    African Journals Online (AJOL)

    Pain in the upper limb is a common presenting complaint in the primary health care setting and the ... disruptions or pathological fracture, as opposed to ... and a neurological assessment of the lower limbs. This is in addition to a thorough.

  10. Upper limb function in adults with Duchenne muscular dystrophy

    NARCIS (Netherlands)

    B. Bartels (Bart); R.F. Pangalila (Robert); M.P. Bergen (Michael); N.A.M. Cobben (Nicolle); H.J. Stam (Henk); M.E. Roebroeck (Marij)

    2011-01-01

    textabstractTo determine upper limb function and associated factors in adults with Duchenne muscular dystrophy. Design: Cross-sectional study. Subjects: A sample of 70 men with Duchenne muscular dystrophy (age range 20-43 years). Methods: General motor function and, in particular, upper limb distal

  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. UPPER LIMB FUNCTIONAL ASSESSMENT USING HAPTIC INTERFACE

    Directory of Open Access Journals (Sweden)

    Aleš Bardorfer

    2004-12-01

    haptic virtual environment, was carried out. 19 healthy subjects and a total of 80 patients with various neurological and neuro-muscular disorders took part in the study. In this paper, only some typical characteristics of the upper limb movement, affected by Becker type muscular dystrophy are shown in a quantitave manner and compared to a healthy subject. The numerical results of the comprehensive study were analysed using data mining techniques, leading to the most important numerical parameters and revealed the content validity of the proposed tests.The developed measurement methodology utilizing haptic interface provides objective, quantitative and repeatable method for the assesment of the upper limb functional state.

  13. Occupational ergonomics: work related musculoskeletal disorders of the upper limb and back

    National Research Council Canada - National Science Library

    Kilbom, Åsa; Violante, Francesco; Armstrong, Thomas J

    2000-01-01

    ... and researchers in ergonomics, occupational health, epidemiology, psychology and engineering. It will also serve as an important source of information for policy makers. Francesco Violante is currently Director of the Regional Program in Occupational Health, a centre for research, teaching and clinical investigation into occupational disorders in Bol...

  14. Tailor's chair and musculoskeletal disorders in Nigeria | Akanbi ...

    African Journals Online (AJOL)

    It is concluded that seat devices which are not ergonomically designed, impose various work postures on operators which may partly be responsible for their musculoskeletal disorders. Hence, the redesign of sitting devices with ergonomic characteristics is recommended. Keywords: Musculoskeletal disorders, sewing ...

  15. Evaluation of Musculoskeletal Disorders in Household Appliances Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Aioob Ghanbary

    2015-12-01

    Full Text Available Work-related musculoskeletal disorders are the most prevalent work-related disorders and injuries and being the main cause of disability. This study was conducted to assessment of the prevalence of musculoskeletal disorders in worker company household appliances production. Posture analysis was evaluated by OWAS method and prevalence of musculoskeletal disorders by Nordic questionnaire. With evaluating musculoskeletal disorders among company household appliances production can intervention action to reduce musculoskeletal disorders was carried out. This cross-sectional study was performed on 100 workers of the appliance manufacturing industry. These Individuals were included 15 persons from foam injection workshop, 17 persons from molding workshop, 17 operators of presses, 17 persons from packaging, 17 person from cutting unit and 17 operators of rivet. The Nordic questionnaire was completed by Individuals for the organs of arm, back, leg and wrist and Posture analysis was performed by OWAS method. The data were analyzed using Spss software version 18 and descriptive statistics and Anova test. Nordic questionnaire results revealed that highest disorders were observed in the arm (25%, back (22% and leg (21%. Also Anova test showed that was observed a significant correlation respectively between age and work experience with the prevalence of musculoskeletal disorders (p<0.02 (p<0.01. The results showed based on the level of risk OWAS for each job respectively, the highest level of risk associated with foam injection unit, packaging and cutting unit (risk level 4 and the lowest level of risk associated with molding workshop unit (risk level 2.The results of this study showed that household appliances Manufacturing workers due to the nature of their jobs are at risk of musculoskeletal disorders and Ergonomic interventions to do such as workstation redesign, reduced working hours, cycle of rest-work development.

  16. Risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers: A case-control study

    NARCIS (Netherlands)

    Hartman, E.; Vrielink, H.H.E.O.; Huirne, R.B.M.; Metz, J.H.M.

    2006-01-01

    Background In Dutch agriculture, musculoskeletal disorders are a main cause of sick leave. Among self-employed insured farmers, neck, shoulder upper extremity, and back disorders accounted for 30% of the claims for sick leave of less than 1 year This case-control study set out to identify and

  17. Risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers : A case-control study

    NARCIS (Netherlands)

    Hartman, E; Vrielink, HHEO; Huirne, RBM; Metz, JHM

    Background In Dutch agriculture, musculoskeletal disorders are a main cause of sick leave. Among self-employed insured farmers, neck, shoulder upper extremity, and back disorders accounted for 30% of the claims for sick leave of less than 1 year This case-control study set out to identify and

  18. Risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers: a case-control study

    NARCIS (Netherlands)

    Hartman, E.; Oude Vrielink, H.H.E.; Huirne, R.B.M.; Metz, J.H.M.

    2006-01-01

    Background In Dutch agriculture, musculoskeletal disorders are a main cause of sick leave. Among self-employed insured farmers, neck, shoulder, upper extremity, and back disorders accounted for 30% of the claims for sick leave of less than 1 year This case-control study set out to identify and

  19. Musculoskeletal disorders in main battle tank personnel

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Guldager, Bernadette; Gyntelberg, Finn

    2009-01-01

    PURPOSE: To compare the prevalence of musculoskeletal disorders of personnel in the main battle tank (MBT) units in the Danish army with those of personnel in other types of army units, and to investigate associations between job function in the tank, military rank, and musculoskeletal problems......, and ankle. RESULTS AND CONCLUSIONS: There were only 4 women in the MBT group; as a consequence, female personnel were excluded from the study. The participation rate was 58.0% (n = 184) in the MBT group and 56.3% (n = 333) in the reference group. The pattern of musculoskeletal disorders among personnel...

  20. Potential of robots as next-generation technology for clinical assessment of neurological disorders and upper-limb therapy.

    Science.gov (United States)

    Scott, Stephen H; Dukelow, Sean P

    2011-01-01

    Robotic technologies have profoundly affected the identification of fundamental properties of brain function. This success is attributable to robots being able to control the position of or forces applied to limbs, and their inherent ability to easily, objectively, and reliably quantify sensorimotor behavior. Our general hypothesis is that these same attributes make robotic technologies ideal for clinically assessing sensory, motor, and cognitive impairments in stroke and other neurological disorders. Further, they provide opportunities for novel therapeutic strategies. The present opinionated review describes how robotic technologies combined with virtual/augmented reality systems can support a broad range of behavioral tasks to objectively quantify brain function. This information could potentially be used to provide more accurate diagnostic and prognostic information than is available from current clinical assessment techniques. The review also highlights the potential benefits of robots to provide upper-limb therapy. Although the capital cost of these technologies is substantial, it pales in comparison with the potential cost reductions to the overall healthcare system that improved assessment and therapeutic interventions offer.

  1. Distress and worry as mediators in the relationship between psychosocial risks and upper body musculoskeletal complaints in highly automated manufacturing.

    Science.gov (United States)

    Wixted, Fiona; Shevlin, Mark; O'Sullivan, Leonard W

    2018-03-15

    As a result of changes in manufacturing including an upward trend in automation and the advent of the fourth industrial revolution, the requirement for supervisory monitoring and consequently, cognitive demand has increased in automated manufacturing. The incidence of musculoskeletal disorders has also increased in the manufacturing sector. A model was developed based on survey data to test if distress and worry mediate the relationship between psychosocial factors (job control, cognitive demand, social isolation and skill discretion), stress states and symptoms of upper body musculoskeletal disorders in highly automated manufacturing companies (n = 235). These constructs facilitated the development of a statistically significant model (RMSEA 0.057, TLI 0.924, CFI 0.935). Cognitive demand was shown to be related to higher distress in employees, and distress to a higher incidence of self-reported shoulder and lower back symptoms. The mediation model incorporating stress states (distress, worry) as mediators is a novel approach in linking psychosocial risks to musculoskeletal disorders. Practitioners' Summary With little requirement for physical work in many modern automated manufacturing workplaces, there is often minimal management focus on Work-Related Musculoskeletal Disorders (WRMSDs) as important occupational health problems. Our model provides evidence that psychosocial factors are important risk factors in symptoms of WRMSD and should be managed.

  2. Predictors of return to work with upper limb disorders.

    Science.gov (United States)

    Moshe, S; Izhaki, R; Chodick, G; Segal, N; Yagev, Y; Finestone, A S; Juven, Y

    2015-10-01

    Return to work (RTW) is a key goal in the proper management of upper limb disorders (ULDs). ULDs stem from diverse medical aetiologies and numerous variables can affect RTW. The abundance of factors, their complex interactions and the diversity of human behaviour make it difficult to pinpoint those at risk of not returning to work (NRTW) and to intervene effectively. To weigh various clinical, functional and occupational parameters that influence RTW in ULD sufferers and to identify significant predictors. A retrospective analysis of workers with ULD referred to an occupational health clinic and further examined by an occupational therapist. Functional assessment included objective and subject ive [Disability of the Arm, Shoulder and Hand (DASH) score] parameters. Quantification of work requirements was based on definitions from the Dictionary of Occupational Titles web site. RTW status was confirmed by a follow-up telephone questionnaire. Among the 52 subjects, the RTW rate was 42%. The DASH score for the RTW group was 27 compared with 56 in the NRTW group (P < 0.001). In multivariate analyses, only the DASH score was found to be a significant independent predictor of RTW (P < 0.05). Physicians and rehabilitation staff should regard a high DASH score as a warning sign when assessing RTW prospects in ULD cases. It may be advisable to focus on workers with a large discrepancy between high DASH scores and low objective disability and to concentrate efforts appropriately. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Evaluation of Musculoskeletal Disorders among computer Users in Isfahan

    Directory of Open Access Journals (Sweden)

    Ayoub Ghanbary

    2015-08-01

    Full Text Available Along with widespread use of computers, work-related musculoskeletal disorders (MSDs have become the most prevalent ergonomic problems in computer users. With evaluating musculoskeletal disorders among Computer Users can intervent a action to reduce musculoskeletal disorders carried out. The aim of the present study was to Assessment of Musculoskeletal Disorders among Computer Users in Isfahan University with Rapid Office Strain Assessment (ROSA method and Nordic questionnaire. This cross-sectional study was conducted on 96 computer users in Isfahan university. The data were analyzed using correlation and line regression by test spss 20. and descriptive statistics and Anova test. Data collection tool was Nordic questionnaire and Rapid Office Strain Assessment method checklist. The results of Nordic questionnaire showed that prevalence of musculoskeletal disorders in computer users were in the shoulder (62.1%, neck (54.9% and back (53.1% respectively more than in other parts of the body. Based on the level of risk of ROSA were 19 individuals in an area of low risk, 50 individual area of notification and 27 individual in the area hazard and need for ergonomics interventions. Musculoskeletal disorders prevalence were in women more than men. Also Anova test showed that there is a direct and significant correlation between age and work experience with a final score ROSA (p<0.001. The study result showed that the prevalence of MSDs among computer users of Isfahan universities is pretty high and must ergonomic interventions such as computer workstation redesign, users educate about ergonomic principles computer with work, reduced working hours in computers with work, and elbows should be kept close to the body with the angle between 90 and 120 degrees to reduce musculoskeletal disorders carried out.

  4. Physical Ergonomics and Musculoskeletal Disorders: What's hot? What's cool?

    NARCIS (Netherlands)

    Beek, A.J. van der; IJmker, S.

    2007-01-01

    This chapter discusses the physical ergonomics and musculoskeletal disorders and summarizes the Triennial International Ergonomics Association (IEA) World Congress 2006-IEA2006-highlights on physical ergonomics and work-related MusculoSkeletal Disorders (MSDs). Two general trends are observed.

  5. Pressure pain sensitivity maps, self-reported musculoskeletal disorders and sickness absence among cleaners

    DEFF Research Database (Denmark)

    Binderup, Asbjørn Thalund; Holtermann, Andreas; Søgaard, Karen

    2011-01-01

    back regions (27 points). LTSA was defined as ten or more consecutive workdays with sick leave. RESULTS: The PPT maps revealed the spatial heterogeneity in mechanical sensitivity among cleaners. The level of pain in the neck and dominant shoulder and upper back within the last 7 days correlated......BACKGROUND: Pressure pain threshold mapping is a valuable method for the identification of distinct zones of mechanical pain sensitivity. Such approach was applied for the first time in relation to self-reported musculoskeletal disorders and long-term sickness absence (LTSA) within the last 12...... months among cleaners. METHODS: About 29 cleaners filled out a self-administered questionnaire regarding health, work-related measures and musculoskeletal disorders. Subsequently, PPTs were measured at (1) tibialis anterior (control location, 1 point), (2) the neck-shoulder (48 points) and (3) the low...

  6. 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/.

  7. Reducing musculoskeletal disorders among computer operators: comparison between ergonomics interventions at the workplace.

    Science.gov (United States)

    Levanon, Yafa; Gefen, Amit; Lerman, Yehuda; Givon, Uri; Ratzon, Navah Z

    2012-01-01

    Typing is associated with musculoskeletal disorders (MSDs) caused by multiple risk factors. This control study aimed to evaluate the efficacy of a workplace intervention for reducing MSDs among computer workers. Sixty-six subjects with and without MSD were assigned consecutively to one of three groups: ergonomics intervention (work site and body posture adjustments, muscle activity training and exercises) accompanied with biofeedback training, the same ergonomics intervention without biofeedback and a control group. Evaluation of MSDs, body posture, psychosocial status, upper extremity (UE) kinematics and muscle surface electromyography were carried out before and after the intervention in the workplace and the motion lab. Our main hypothesis that significant differences in the reduction of MSDs will exist between subjects in the study groups and controls was confirmed (χ(2) = 13.3; p = 0.001). Significant changes were found in UE kinematics and posture as well. Both ergonomics interventions effectively reduced MSD and improved body posture. This study aimed to test the efficacy of an individual workplace intervention programme among computer workers by evaluating musculoskeletal disorders (MSDs), body posture, upper extremity kinematics, muscle activity and psychosocial factors were tested. The proposed ergonomics interventions effectively reduced MSDs and improved body posture.

  8. γ -phlebography of the upper limbs

    International Nuclear Information System (INIS)

    Jacolot, G.; Legendre, P.; Millour, L.; Barra, J.A.; Perramant, M.; Morin, P.P.

    1981-01-01

    γ-phlebography is an easy and repetitive exploration of deep venous thrombosis. This investigation becomes very useful for the upper limbs on account of the present frequency of iatrogenic thrombosis [fr

  9. Reflections on the present and future of upper limb prostheses.

    Science.gov (United States)

    Farina, Dario; Amsüss, Sebastian

    2016-01-01

    Despite progress in research and media attention on active upper limb prostheses, presently the most common commercial upper limb prosthetic devices are not fundamentally different from solutions offered almost one century ago. Limited information transfer for both control and sensory-motor integration and challenges in socket technology have been major obstacles. By analysing the present state-of-the-art and academic achievements, we provide our opinion on the future of upper limb prostheses. We believe that surgical procedures for muscle reinnervation and osseointegration will become increasingly clinically relevant; muscle electrical signals will remain the main clinical means for prosthetic control; and chronic electrode implants, first in muscles (control), then in nerves (sensory feedback), will become viable clinical solutions. After decades of suspended clinically relevant progress, it is foreseeable that a new generation of upper limb prostheses will enter the market in the near future based on such advances, thereby offering substantial clinical benefit for patients.

  10. Pattern of Nerve Blocks for Upper Limb Surgery at the University of ...

    African Journals Online (AJOL)

    Background: Central and peripheral neural blockade techniques are popular for lower and upper limb surgeries respectively. Lower limb surgery is amenable to central neural blockade techniques, anatomical and physiological imperatives makes peripheral neural blockade more suited for upper limb surgeries. We looked ...

  11. Gender differences in workers with identical repetitive industrial tasks: exposure and musculoskeletal disorders.

    Science.gov (United States)

    Nordander, Catarina; Ohlsson, Kerstina; Balogh, Istvan; Hansson, Gert-Ake; Axmon, Anna; Persson, Roger; Skerfving, Staffan

    2008-08-01

    For unknown reasons, females run a higher risk than males of work-related musculoskeletal disorders. The aim of this study was to evaluate whether male and female workers, with identical repetitive work tasks, differ concerning risk of disorders, physical or psychosocial exposures. Employees in two industries were studied; one rubber manufacturing and one mechanical assembly plant. These industries were selected since in both, large groups of males and females worked side by side performing identical repetitive work tasks. Physical exposure was measured by technical equipment. Postures and movements were registered by inclinometry for the head and upper arms, and by electrogoniometry for the wrists. Muscular activity (muscular rest and %max) was registered by surface electromyography for m. trapezius and the forearm extensors (18 males and 19 females). Psychosocial work environment was evaluated by the demand-control-support model (85 males and 138 females). Musculoskeletal disorders were assessed (105 males and 172 females), by interview (last 7-days complaints), and by physical examination (diagnoses). Concerning physical exposure, females showed higher muscular activity related to maximal voluntary contractions [(%MVE); m. trapezius: females 18 (SD 9.2), males 12 (SD 4.3); forearm extensors: females 39 (SD 11), males 27 (SD 10), right side, 90th percentile]. Working postures and movements were similar between genders. Also, concerning psychosocial work environment, no significant gender differences were found. Females had higher prevalences of disorders [complaints: age-adjusted prevalence odds ratio (POR) 2.3 (95% CI 1.3-3.8) for neck/shoulders, 2.4 (1.4-4.0) for elbows/hands; diagnoses: neck/shoulder 1.9 (1.1-3.6), elbows/hands 4.1 (1.2-9.3)]. In 225 workers, PORs were adjusted for household work, personal recovery and exercise, which only slightly affected the risk estimates. In identical work tasks, females showed substantially higher muscular activity in

  12. Arterial variations of upper limb: a case report

    Directory of Open Access Journals (Sweden)

    Vollala V

    2005-01-01

    Full Text Available Variations of upper limb arteries are common and there are many reports about this subject. We report multiple variations in arterial pattern of upper extremity, which were encountered in a single cadaver.

  13. The role and effectiveness of adjunctive hyperbaric oxygen therapy in the management of musculoskeletal disorders.

    Directory of Open Access Journals (Sweden)

    Wang J

    2002-07-01

    Full Text Available The management of musculoskeletal disorders is an increasing challenge to clinicians. Successful treatment relies on a wide range of multidisciplinary interventions. Adjunctive hyperbaric oxygen (HBO therapy has been used as an orthopaedic treatment for several decades. Positive outcomes have been reported by many authors for orthopaedic infections, wound healing, delayed union and non-union of fractures, acute traumatic ischemia of the extremities, compromised grafts, and burn injuries. Severe side effects have also been reported with this therapy. To aid in the use of HBO therapy in orthopaedics, we reviewed 43 papers published in the past four decades and summarised the mechanisms, effectiveness, indications and contraindications, side effects, and cost impact of adjunctive hyperbaric oxygen therapy in the management of difficult musculoskeletal disorders. Adjunctive HBO therapy is an effective treatment modality for the management of some severe and refractory musculoskeletal problems. If appropriate candidates are carefully identified, hyperbaric oxygen is a limb- and sometimes life-saving therapy. HBO therapy significantly reduces the length of the patient′s hospital stay, amputation rate, and wound care expenses. Thus, it is a cost-effective modality. A clinician must understand the side effects and risks of HBO treatment. Close monitoring throughout the treatment is warranted to minimise the risk to the patients.

  14. 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.

  15. Prevalence and Associated Factors for Musculoskeletal Pain and Disability Among Spanish Music Conservatory Students.

    Science.gov (United States)

    Rodríguez-Romero, Beatriz; Pérez-Valiño, Coral; Ageitos-Alonso, Beatriz; Pértega-Díaz, Sonia

    2016-12-01

    To assess the prevalence of and factors associated with musculoskeletal pain (MSP) and neck and upper limb disability among music conservatory students. An observational study in two Spanish conservatories, investigating a total of 206 students, administered the Nordic Musculoskeletal Questionnaire, visual analog scale for pain intensity, Neck Disability Index, DASH, and SF-36. Demographic and lifestyle characteristics and musical performance variables were recorded. Regression models were performed to identify variables associated with MSP for the four most affected anatomical regions and with neck and upper limb disability. The locations with the highest prevalence of MSP were the neck, upper back, shoulders, and lower back. Mild disability affected 47% of participants in the neck and 31% in the upper limbs. Mental health (SF-36) was below the average for the general population (45.5±10.2). Women were more likely to suffer neck pain (odds ratio [OR] 1.1-5.2), lower back pain (OR 1.7-8.7), and neck disability (B 0.6-7.8). The risk for shoulder pain was higher in those who played for more hours (OR 1.7-24.7) and lower among those who performed physical activity (OR 0.23-1.00). Disability in the neck (B -0.3) and upper limbs (B -0.4) was associated with poorer mental health (SF-36). MSP is highly prevalent in music students. Neck and upper limb disability were slight to moderate and both were associated with poorer mental health. The main factors associated with MSP were being female, hours spent practicing, and physical activity. Physical and psychological factors should be taken into account in the prevention of MSP in student-musicians.

  16. Musculoskeletal disorders among Thai women in construction-related work.

    Science.gov (United States)

    Hanklang, Suda; Kaewboonchoo, Orawan; Silpasuwan, Pimpan; Mungarndee, Suriyaphun S

    2014-03-01

    A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorder symptoms and its risk factors among women rebar workers. A simple random sampling method was used and data were collected by face-to-face interview and ergonomic assessment from February to March 2011. A total of 272 women rebar workers with at least 6 months' job experience participated in this study. The findings revealed that 57.7% of workers reported musculoskeletal disorder symptoms with low back and shoulders as the most common body parts affected (46.0%). Multiple logistic regression analysis indicated 2 variables that are significantly associated with musculoskeletal disorders: prolonged working hours (adjusted odds ratio = 7.63; 95% confidence interval = 2.06-28.31) and awkward posture (adjusted odds ratio = 43.79; 95% confidence interval = 17.09-112.20). The high prevalence of musculoskeletal disorders among women rebar workers suggests that an appropriate ergonomic workstation design and ergonomic training for women rebar workers are necessary.

  17. Work related musculoskeletal disorders among farm workers: A case ...

    African Journals Online (AJOL)

    Work related musculoskeletal disorders among farm workers: A case study of an agricultural college in Zimbabwe. ... hazards, therefore a need for intervention to protect them from musculoskeletal complaints. Improvement in farm work practices through ergonomic training might help reduce musculoskeletal complaints.

  18. The artery blood supply variant of the upper limb

    Science.gov (United States)

    MASLARSKI, IVAN

    2015-01-01

    Variations of arterial patterns in the upper limb have represented the most common subject of vascular anatomy. Different types of artery branching pattern of the upper limb are very important for orthopedists in angiographic and microvascular surgical practice. The brachial artery (BA) is the most important vessel in the normal vascular anatomy of the upper limb. The classical pattern of the palmar hand region distribution shows the superficial palmar arch. Normally this arch is formed by the superficial branch of the ulnar artery and completed on the lateral side by one of these arteries: the superficial palmar branch of the radial artery, the princeps pollicis artery, the superficial palmar branch of the radial artery or the median artery. After the routine dissection of the right upper limb of an adult male cadaver, we found a very rare variant of the superficial arch artery – a division in a higher level brachial artery. We found this division at 10.4 cm from the beginning of the brachial artery. This superficial brachial artery became a radial artery and was not involved in the formation of the palm arch. In the forearm region, the artery variant was present with the median artery and the ulnar artery, which form the superficial palm arch. PMID:26733754

  19. 3D-printed upper limb prostheses: a review.

    Science.gov (United States)

    Ten Kate, Jelle; Smit, Gerwin; Breedveld, Paul

    2017-04-01

    This paper aims to provide an overview with quantitative information of existing 3D-printed upper limb prostheses. We will identify the benefits and drawbacks of 3D-printed devices to enable improvement of current devices based on the demands of prostheses users. A review was performed using Scopus, Web of Science and websites related to 3D-printing. Quantitative information on the mechanical and kinematic specifications and 3D-printing technology used was extracted from the papers and websites. The overview (58 devices) provides the general specifications, the mechanical and kinematic specifications of the devices and information regarding the 3D-printing technology used for hands. The overview shows prostheses for all different upper limb amputation levels with different types of control and a maximum material cost of $500. A large range of various prostheses have been 3D-printed, of which the majority are used by children. Evidence with respect to the user acceptance, functionality and durability of the 3D-printed hands is lacking. Contrary to what is often claimed, 3D-printing is not necessarily cheap, e.g., injection moulding can be cheaper. Conversely, 3D-printing provides a promising possibility for individualization, e.g., personalized socket, colour, shape and size, without the need for adjusting the production machine. Implications for rehabilitation Upper limb deficiency is a condition in which a part of the upper limb is missing as a result of a congenital limb deficiency of as a result of an amputation. A prosthetic hand can restore some of the functions of a missing limb and help the user in performing activities of daily living. Using 3D-printing technology is one of the solutions to manufacture hand prostheses. This overview provides information about the general, mechanical and kinematic specifications of all the devices and it provides the information about the 3D-printing technology used to print the hands.

  20. [Upper limb work-related musculoskeletal disorders (UL-WMSDs): a retrospective cohort study in three large factories of the upholstered furniture industry].

    Science.gov (United States)

    Nicoletti, S; Consonni, D; Carino, M; Di Leone, G; Trani, G; Battevi, N; Colombini, Daniela; Ambrosi, L

    2008-01-01

    The epidemiological evidence of work-related musculoskeletal disorders (UL-WMSDs) due to repetitive strain and movements in the various industries has been collected in the literature mainly through cross-sectional surveys. In particular there are no contributions so far regarding the upholstered furniture industry with a longitudinal design. The aim of the study was to evaluate the incidence rate of WMSDs such as hand-wrist and shoulder tendonitis, carpal tunnel syndrome, and epicondylitis in exposed workers of three large companies of the upholstered furniture industry in a large geographic area of southern Italy. The OCRA method, recommended by international standard ISO 11228-3 and EN 1005-5, was used for risk assessment. The following work tasks were considered:.filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. A total population of 5,278 subjects (exposed n=2927, controls n=2351) was investigated. The person/year at risk parameters were calculated from 1 January 2000, or from the date of engagement if later, until the first diagnosis of WMSD or, in absence of disorders, until the end of the study, i.e. 31 December 2004. Disorders occurring after the first were not considered. A multiple regression analysis was used to evaluate relationships between rates. Incidence rates correlated with risk classes of the OCRA index. An incidence rate of WMSDs higher than 1.2 cases per 100 person/year may be considered as a threshold value to suspect an occupational exposure to repetitive strain and movements warranting further investigation. The analysis of single factors did not show a greater predisposition of the female gender, with the single exception of the carpal tunnel syndrome (RR 2.92; 95% CI 1.57-5.43). Shoulder disorders affected mainly male leather-cutting operators (RR 4.97; 95% CI 2.03-12.16) and among all the factors influencing risk (frequency, force, posture, additional risk factors, pauses) posture seems to

  1. Revised upper limb module for spinal muscular atrophy: Development of a new module.

    Science.gov (United States)

    Mazzone, Elena S; Mayhew, Anna; Montes, Jacqueline; Ramsey, Danielle; Fanelli, Lavinia; Young, Sally Dunaway; Salazar, Rachel; De Sanctis, Roberto; Pasternak, Amy; Glanzman, Allan; Coratti, Giorgia; Civitello, Matthew; Forcina, Nicola; Gee, Richard; Duong, Tina; Pane, Marika; Scoto, Mariacristina; Pera, Maria Carmela; Messina, Sonia; Tennekoon, Gihan; Day, John W; Darras, Basil T; De Vivo, Darryl C; Finkel, Richard; Muntoni, Francesco; Mercuri, Eugenio

    2017-06-01

    There is a growing need for a robust clinical measure to assess upper limb motor function in spinal muscular atrophy (SMA), as the available scales lack sensitivity at the extremes of the clinical spectrum. We report the development of the Revised Upper Limb Module (RULM), an assessment specifically designed for upper limb function in SMA patients. An international panel with specific neuromuscular expertise performed a thorough review of scales currently available to assess upper limb function in SMA. This review facilitated a revision of the existing upper limb function scales to make a more robust clinical scale. Multiple revisions of the scale included statistical analysis and captured clinically relevant changes to fulfill requirements by regulators and advocacy groups. The resulting RULM scale shows good reliability and validity, making it a suitable tool to assess upper extremity function in the SMA population for multi-center clinical research. Muscle Nerve 55: 869-874, 2017. © 2016 Wiley Periodicals, Inc.

  2. Does muscle strength predict future musculoskeletal disorders and sickness absence?

    DEFF Research Database (Denmark)

    Faber, A; Sell, L; Hansen, J V

    2012-01-01

    High muscle strength is considered relevant for preventing musculoskeletal disorders and long-term sickness absence. However, prospective studies on the association between muscle strength and future musculoskeletal disorders and long-term sickness absence are few and show contrasting results....

  3. Musculoskeletal disorders among visual display terminal users in a telecommunications company.

    Science.gov (United States)

    Hales, T R; Sauter, S L; Peterson, M R; Fine, L J; Putz-Anderson, V; Schleifer, L R; Ochs, T T; Bernard, B P

    1994-10-01

    The relationship between workplace factors and work-related upper extremity musculoskeletal disorders (UE disorders) was assessed in a cross-sectional study of 533 telecommunication employees utilizing video display terminals (VDTs). Cases of UE disorders were defined using symptom questionnaires and physical examinations. Data on demographics, individual factors (medical conditions and recreational activities), work organization and practices, and psychosocial aspects of work, including electronic performance monitoring (EPM), were obtained by questionnaire. Associations between workplace factors and UE disorders were assessed by multiple logistic models generated for each of the four UE areas (neck, shoulder, elbow, hand/wrists). One-hundred and eleven (22%) participants met our case definition for UE disorders. Probable tendon-related disorders were the most common (15% of participants). Probable nerve entrapment syndromes were found in 4% of participants. The hand/wrist was the area most affected, 12% of participants. The following variables had associations in the final models (p < 0.05) with at least one of the four UE disorders, although the strength of these associations were modest. Non-white race, a diagnosis of a thyroid condition (self-reported) use of bifocals at work, and seven psychosocial variables (fear of being replaced by computers, increasing work pressure, surges in workload, routine work lacking decision-making opportunities, high information processing demands, jobs which required a variety of tasks and lack of a production standard) were associated with UE disorders. This study indicates that work-related UE musculoskeletal disorders are relatively common among telecommunication workers who use VDTs, and adds to the evidence that the psychosocial work environment is related to the occurrence of these disorders.

  4. Importance of upper-limb inertia in calculating concentric bench press force.

    Science.gov (United States)

    Rambaud, Olivier; Rahmani, Abderrahmane; Moyen, Bernard; Bourdin, Muriel

    2008-03-01

    The purpose of this study was to investigate the influence of upper-limb inertia on the force-velocity relationship and maximal power during concentric bench press exercise. Reference peak force values (Fpeakp) measured with a force plate positioned below the bench were compared to those measured simultaneously with a kinematic device fixed on the barbell by taking (Fpeakt) or not taking (Fpeakb) upper-limb inertia into account. Thirteen men (27.8 +/- 4.1 years, 184.6 +/- 5.5 cm, 99.5 +/- 18.6 kg) performed all-out concentric bench press exercise against 8 loads ranging between 7 and 74 kg. The results showed that for each load, Fpeakb was significantly less than Fpeakp (P force (F0), maximal velocity (V0), optimal velocity (Vopt), and maximal power (Pmax), extrapolated from the force- and power-velocity relationships determined with the kinematic device, were significantly underestimated when upper-limb inertia was ignored. The results underline the importance of taking account of the total inertia of the moving system to ensure precise evaluation of upper-limb muscular characteristics in all-out concentric bench press exercise with a kinematic device. A major application of this study would be to develop precise upper-limb muscular characteristic evaluation in laboratory and field conditions by using a simple and cheap kinematic device.

  5. 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.

  6. Effects of muscular endurance training on musculoskeletal disorders in teachers

    Directory of Open Access Journals (Sweden)

    Elisângela Valevein Rodrigues

    Full Text Available AbstractIntroduction Physical exercise is indicated to reduce the incidence of musculoskeletal symptoms in teachers.Objective To evaluate the effects of muscular endurance training on muscle strength and musculoskeletal symptoms related to the lower limbs of public elementary school teachers.Materials and methods Thirty-one female teachers were divided into two groups: control (CG, n = 15 and muscular endurance training (TG, n = 16. The training consisted of two sets of 15 repetitions of exercises for quadriceps and hamstring muscle groups, twice a week, for 7 weeks, which were conducted with 50% of 10 repetition maximum(10RM (first to fourth week and 60% of 10 RM (fifth to seventh week. Musculoskeletal symptoms (Nordic Musculoskeletal Questionnaire, isometric peak torque (Load cell and muscle strength (10RM were assessed before and after intervention. ANOVA for repeated measures and Tukey post hoc were used to analyse strength and peak torque of quadriceps and hamstrings and Chi-square goodness-of-fit test were used to analyse the frequency of occurrence of osteomuscular symptoms.Results The highest incidence of symptoms was found in the lumbar region in both groups. Training caused increased muscle strength of the quadriceps and hamstrings, but there were no significant differences in either the peak torque in the quadriceps and hamstrings or in the reduction of musculoskeletal symptoms.Conclusion The exercise program performed in this study increased the dynamic strength in the TG in relation to the CG, but did not alter the incidence of symptoms in the lumbar region and lower limbs in neither of the groups. Thus, results suggest that the duration of intervention may not have been enough to increase peak torque and decrease musculoskeletal symptoms.

  7. Responsibility for managing musculoskeletal disorders--a cross-sectional postal survey of attitudes.

    Science.gov (United States)

    Larsson, Maria E H; Nordholm, Lena A

    2008-08-05

    Musculoskeletal disorders are a major burden on individuals, health systems and social care systems and rehabilitation efforts in these disorders are considerable. Self-care is often considered a cost effective treatment alternative owing to limited health care resources. But what are the expectations and attitudes in this question in the general population? The purpose of this study was to describe general attitudes to responsibility for the management of musculoskeletal disorders and to explore associations between attitudes and background variables. A cross-sectional, postal questionnaire survey was carried out with a random sample of a general adult Swedish population of 1770 persons. Sixty-one percent (n = 1082) responded to the questionnaire and was included for the description of general attitudes towards responsibility for the management of musculoskeletal disorders. For the further analyses of associations to background variables 683-693 individuals could be included. Attitudes were measured by the "Attitudes regarding Responsibility for Musculoskeletal disorders" (ARM) instrument, where responsibility is attributed on four dimensions; to myself, as being out of my hands, to employers or to (medical) professionals. Multiple logistic regression was used to explore associations between attitudes to musculoskeletal disorders and the background variables age, sex, education, physical activity, presence of musculoskeletal disorders, sick leave and whether the person had visited a care provider. A majority of participants had internal views, i.e. showed an attitude of taking personal responsibility for musculoskeletal disorders, and did not place responsibility for the management out of their own hands or to employers. However, attributing shared responsibility between self and medical professionals was also found. The main associations found between attitude towards responsibility for musculoskeletal disorders and investigated background variables were that

  8. Development of an Upper Limb Motorized Assistive-Rehabilitative Robot

    Science.gov (United States)

    Amiri, Masoud; Casolo, Federico

    While the number of people requiring help for the activities of daily living are increasing, several studies have been shown the effectiveness of robot training for upper limb functionality recovery. The robotic system described in this paper is an active end-effector based robot which can be used for assisting and rehabilitating of human upper limb. The robot is able to take into account desire of the patient for the support that patient needs to complete the task.

  9. Upper limb contributions to frontal plane balance control in rollator-assisted walking.

    Science.gov (United States)

    Tung, James Y; Gage, William H; Poupart, Pascal; McIlroy, William E

    2014-01-01

    While assisting with balance is a primary reason for rollator use, few studies have examined how the upper limbs are used for balance. This study examines upper limb contributions to balance control during rollator-assisted walking. We hypothesized that there would be an increased upper limb contribution, measured by mean vertical loading (Fz) and variation in frontal plane center-of-pressure (COPhigh), when walking balance is challenged/impaired. Experiment 1 compared straight-line and beam-walking in young adults (n = 11). As hypothesized, Fz and COPhighincreased in beam-walking compared to baseline (mean Fz: 13.7 vs. 9.1% body weight (BW), p < 0.001, RMS COPhigh: 1.35 vs. 1.07 cm, p < 0.001). Experiment 2 compared older adults who regularly use rollators (RU, n = 10) to older adult controls (CTL, n = 10). The predicted higher upper limb contribution in the RU group was not supported. However, when individuals were grouped by balance impairment, those with the lowest Berg Balance scores (< 45) demonstrated greater speed-adjusted COPhigh than those with higher scores (p = 0.013). Furthermore, greater COPhigh and Fz were correlated to greater reduction in step width, supporting the role of upper limb contributions to frontal plane balance. This work will guide studies assessing reliance on rollators by providing a basis for measurement of upper limb balance contributions.

  10. Adaptive behaviour and motor skills in children with upper limb deficiency.

    Science.gov (United States)

    Mano, Hiroshi; Fujiwara, Sayaka; Haga, Nobuhiko

    2018-04-01

    The dysfunction of individuals with upper limb deficiencies affects their daily lives and social participation. To clarify the adaptive behaviours and motor skills of children with upper limb deficiencies. Cross-sectional survey. The subjects were 10 children ranging from 1 to 6 years of age with unilateral upper limb deficiencies at the level distal to the elbow who were using only cosmetic or passive prostheses or none at all. To measure their adaptive behaviour and motor skills, the Vineland Adaptive Behavior Scales, Second Edition was used. They were evaluated on the domains of communication, daily living skills, socialization and motor skills. We also examined the relationship of the scores with age. There were no statistically significant scores for domains or subdomains. The domain standard score of motor skills was significantly lower than the median scores of the domains and was negatively correlated with age. Children with upper limb deficiencies have individual weaknesses in motor skill behaviours, and these weaknesses increase with age. It may be helpful in considering approaches to rehabilitation and the prescription of prostheses to consider the characteristics and course of children's motor skill behaviours. Clinical relevance Even if children with unilateral upper limb deficiencies seem to compensate well for their affected limb function, they have or will experience individual weaknesses in motor skills. We should take this into consideration to develop better strategies for rehabilitation and prostheses prescriptions.

  11. Serious games for upper limb rehabilitation: a systematic review.

    Science.gov (United States)

    Proença, João Pedro; Quaresma, Cláudia; Vieira, Pedro

    2018-01-01

    The aim of this research is to carry out a systematic review of the use of technological gaming platforms with serious games in the upper limb rehabilitation of patients with neuromotor disorders. Through a systematic review, the first two authors defined the inclusion criteria and extracted the data, resulting in 38 studies collected from B-On, PubMed and Medline. Ninety-two per cent of the selected articles were published since 2010. This review documents 35 different gaming platforms types. Twenty-one of the 38 articles included in this review conducted a clinical trial and of those only eight report improvements in the target population following the use of the games and platforms. This review concludes that a new paradigm is emerging in the rehabilitation field, characterized by the systematic use of technological gaming platforms with serious games in/for rehabilitation. The use of this approach seems to be beneficial. However, to facilitate the full integration of these platforms, it is necessary to conduct more research in this area, explore new approaches and carry out in-depth clinical studies into the benefits of these platforms. Implications for rehabilitation This review states that the use serious games and gaming platforms for upper limb rehabilitation are starting a new paradigm in the rehabilitation. For a full integration of this technologies in the rehabilitation field more studies are needed.

  12. Musculoskeletal disorders of the neck and upper extremity in computer workers

    International Nuclear Information System (INIS)

    Rasool, A.; Bashir, M.S.; Noor, R.

    2017-01-01

    To evaluate the prevalence of Work related musculoskeletal disorders (WRMSD) for computer office worker, who work 6 hours or more per day on the computer. Methodology: This cross sectional study was conducted in different government and private banks and mobile franchises. Demographic information, work ergonomics and relevant data were collected by using a standardized questionnaire after obtaining signed consent from them. Data were analyzed through SPSS version 16. Results: Out of 150 potential subjects, 128 were returned completed questionnaires with the response rate of 85%. Age ranged between 25-35 years. Neck associated complaints were in 47.42% males and in 67.74% females. Shoulder complaints were 45.36% in males and 77.42% in females. Hand complaints were 20.62% in males and 54.84% in females. Conclusion: The prevalence rate of WRMSD was higher among females than males. (author)

  13. Gaze direction effects on perceptions of upper limb kinesthetic coordinate system axes.

    Science.gov (United States)

    Darling, W G; Hondzinski, J M; Harper, J G

    2000-12-01

    The effects of varying gaze direction on perceptions of the upper limb kinesthetic coordinate system axes and of the median plane location were studied in nine subjects with no history of neuromuscular disorders. In two experiments, six subjects aligned the unseen forearm to the trunk-fixed anterior-posterior (a/p) axis and earth-fixed vertical while gazing at different visual targets using either head or eye motion to vary gaze direction in different conditions. Effects of support of the upper limb on perceptual errors were also tested in different conditions. Absolute constant errors and variable errors associated with forearm alignment to the trunk-fixed a/p axis and earth-fixed vertical were similar for different gaze directions whether the head or eyes were moved to control gaze direction. Such errors were decreased by support of the upper limb when aligning to the vertical but not when aligning to the a/p axis. Regression analysis showed that single trial errors in individual subjects were poorly correlated with gaze direction, but showed a dependence on shoulder angles for alignment to both axes. Thus, changes in position of the head and eyes do not influence perceptions of upper limb kinesthetic coordinate system axes. However, dependence of the errors on arm configuration suggests that such perceptions are generated from sensations of shoulder and elbow joint angle information. In a third experiment, perceptions of median plane location were tested by instructing four subjects to place the unseen right index fingertip directly in front of the sternum either by motion of the straight arm at the shoulder or by elbow flexion/extension with shoulder angle varied. Gaze angles were varied to the right and left by 0.5 radians to determine effects of gaze direction on such perceptions. These tasks were also carried out with subjects blind-folded and head orientation varied to test for effects of head orientation on perceptions of median plane location. Constant

  14. Reliability and validity of the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower limb musculoskeletal disorders.

    Science.gov (United States)

    Negahban, Hossein; Hessam, Masumeh; Tabatabaei, Saeid; Salehi, Reza; Sohani, Soheil Mansour; Mehravar, Mohammad

    2014-01-01

    The aim was to culturally translate and validate the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower extremity musculoskeletal disorders (n = 304). This is a prospective methodological study. After a standard forward-backward translation, psychometric properties were assessed in terms of test-retest reliability, internal consistency, construct validity, dimensionality, and ceiling or floor effects. The acceptable level of intraclass correlation coefficient >0.70 and Cronbach's alpha coefficient >0.70 was obtained for the Persian LEFS. Correlations between Persian LEFS and Short-Form 36 Health Survey (SF-36) subscales of Physical Health component (rs range = 0.38-0.78) were higher than correlations between Persian LEFS and SF-36 subscales of Mental Health component (rs range = 0.15-0.39). A corrected item--total correlation of >0.40 (Spearman's rho) was obtained for all items of the Persian LEFS. Horn's parallel analysis detected a total of two factors. No ceiling or floor effects were detected for the Persian LEFS. The Persian version of the LEFS is a reliable and valid instrument that can be used to measure functional status in Persian-speaking patients with different musculoskeletal disorders of the lower extremity. Implications for Rehabilitation The Persian lower extremity functional scale (LEFS) is a reliable, internally consistent and valid instrument, with no ceiling or floor effects, to determine functional status of heterogeneous patients with musculoskeletal disorders of the lower extremity. The Persian version of the LEFS can be used in clinical and research settings to measure function in Iranian patients with different musculoskeletal disorders of the lower extremity.

  15. Balneotherapy in treatment of spastic upper limb after stroke.

    Science.gov (United States)

    Erceg-Rukavina, Tatjana; Stefanovski, Mihajlo

    2015-02-01

    After stroke, spasticity is often the main problem that prevents functional recovery. Pain occurs in up to 70% of patients during the first year post-stroke. A total of 70 patients (30 female and 45 male) mean age (65.67) participated in prospective, controlled study. ischaemic stroke, developed spasticity of upper limb, post-stroke interval balneotherapy and inability to follow commands. Experimental group (Ex) (n=35) was treated with sulphurous baths (31°-33°C) and controlled group (Co) with taped water baths, during 21 days. All patients were additionally treated with kinesitherapy and cryotherapy. The outcome was evaluated using Modified Ashworth scale for spasticity and VAS scale for pain. The significance value was sat at pbalneotherapy with sulphurous bath on spasticity and pain in affected upper limb. Reduction in tone of affected upper limb muscles was significant in Ex group (pbalneotherapy with sulphurous water reduces spasticity and pain significantly and can help in treatment of post-stroke patients.

  16. Musculoskeletal disorders among construction workers: a one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Boschman Julitta S

    2012-10-01

    Full Text Available Abstract Background Work-related musculoskeletal disorders (MSDs are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints and supervisors (31% of the complaints. Participants in both occupations report that mainly back and knee complaints result in additional problems

  17. [Analysis of musculoskeletal disorders, work load and working postures among manufacturing workers].

    Science.gov (United States)

    Yu, Shan-fa; Gu, Gui-zhen; Sun, Shi-yi; Wang, Hai-sheng; Cui, Shou-ming; Yang, Xiao-fa; Yang, Shu-le; He, Li-hua; Wang, Sheng

    2011-03-01

    To analyze the distribution of the musculoskeletal disorders, work load and working postures in different factories, gender, education levels, age and working years among manufacturing workers. In a cross-sectional study of 5134 manufacturing workers in 12 factories, the morbidities for musculoskeletal disorders in one year period were measured with questionnaires. The morbidities for musculoskeletal disorders in body sites: waist, neck, shoulder, wrist, ankle/feet, knee, hip/buttocks and elbows were 59.7%, 47.9%, 38.1%, 33.7%, 26.9%, 25.4%, 15.2%, and 14.9%, respectively in one year period. There were significant differences of morbidities for musculoskeletal symptoms in body sites of workers among different factories (P manufacturing workers were higher; the gender, education level, age and working years could influenced the morbidities for musculoskeletal disorders.

  18. The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb.

    Science.gov (United States)

    Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A; Danish, Qazi

    2016-09-01

    Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.

  19. The prevalence of musculoskeletal disorders and occupational risk factors in Kashan SAIPA automobile industry workers by key indicator method (KIM, 1390

    Directory of Open Access Journals (Sweden)

    2012-05-01

    Full Text Available Introduction: work related musculoskeletal disorders are the most wide spread type of occupational diseases among workers. Awkward body postures during work and manual material handling are among the most important risk factors of musculoskeletal disorders in different jobs. Due to importance of recognizing these factors prevalence and risk factor of work related musculoskeletal disorders, this research was aimed to study the among employees of Kashan City’s Saipa automobile industry in 2011. .Material and Method: This study is a descriptive-cross sectional study conducted among workers with manual material handling 37 activities and 84 work duties. To recognize musculoskeletal disorders, body map questionnaire was applied and occupational risk factors were evaluated using Key Index Method (KIM. Data was analyzed using SPSS and Excel software. .Result: Highest prevalence of musculoskeletal disorders was in low and upper back region (%92. Based on the results from KIM, workers in the installing the tire, shuttle-aided fitting of seat, and engine work station had higher risk level with the scores of 66, 52 and 52, respectively. Risk level among three individuals (%3.6 was at 1, 40 (%47.6 at 2, 38 (%45.2 risk level 3, and 3 (%3.6 at 4. .Conclusion: Awkward body posture, improper twisting and flexion of low back were major risk factor among worker doing manual material handling tasks. Regarding the high prevalence of musculoskeletal disorders, appropriate ergonomic interventions such as engineering and organization interactions can reduce this risk factors (posture, heavy load, duration, workplace conditions as much as the risk level reach to an acceptable level.

  20. Outcomes of the Bobath concept on upper limb recovery following stroke.

    Science.gov (United States)

    Luke, Carolyn; Dodd, Karen J; Brock, Kim

    2004-12-01

    To determine the effectiveness of the Bobath concept at reducing upper limb impairments, activity limitations and participation restrictions after stroke. Electronic databases were searched to identify relevant trials published between 1966 and 2003. Two reviewers independently assessed articles for the following inclusion criteria: population of adults with upper limb disability after stroke; stated use of the Bobath concept aimed at improving upper limb disability in isolation from other approaches; outcomes reflecting changes in upper limb impairment, activity limitation or participation restriction. Of the 688 articles initially identified, eight met the inclusion criteria. Five were randomized controlled trials, one used a single-group crossover design and two were single-case design studies. Five studies measured impairments including shoulder pain, tone, muscle strength and motor control. The Bobath concept was found to reduce shoulder pain better than cryotherapy, and to reduce tone compared to no intervention and compared to proprioceptive neuromuscular facilitation (PNF). However, no difference was detected for changes in tone between the Bobath concept and a functional approach. Differences did not reach significance for measures of muscle strength and motor control. Six studies measured activity limitations, none of these found the Bobath concept was superior to other therapy approaches. Two studies measured changes in participation restriction and both found equivocal results. Comparisons of the Bobath concept with other approaches do not demonstrate superiority of one approach over the other at improving upper limb impairment, activity or participation. However, study limitations relating to methodological quality, the outcome measures used and contextual factors investigated limit the ability to draw conclusions. Future research should use sensitive upper limb measures, trained Bobath therapists and homogeneous samples to identify the influence of

  1. Effects of upper-limb immobilisation on driving safety.

    Science.gov (United States)

    Gregory, J J; Stephens, A N; Steele, N A; Groeger, J A

    2009-03-01

    Doctors are frequently asked by patients whether it is safe to drive with an upper limb immobilised in a cast. In the literature there are no objective measurements of the effects of upper-limb immobilisation upon driving performance. Eight healthy volunteers performed four 20-min driving circuits in a driving simulator (STISIM 400W), circuits 1 and 4 without immobilisation and circuits 2 and 3 with immobilisation. Immobilisation involved a lightweight below-elbow cast with the thumb left free. Volunteers were randomised to right or left immobilisation for circuit 2, and the contralateral wrist was immobilised for circuit 3. Circuits included urban and rural environments and specific hazards (pedestrians crossing, vehicles emerging from a concealed entrance, traffic lights changing suddenly, avoidance of an oncoming vehicle in the driver's carriageway). Limb immobilisation led to more cautious rural and urban driving, with less adjustment of speed and lateral road position than when unrestricted. However when responding to hazards immobilisation caused less safe driving, with higher speeds, a greater proximity to the hazard before action was taken and less steering adjustment. The effects of restriction upon performance were more prevalent and severe with right-arm immobilisation. Upper-limb immobilisation appears to have little effect on the ability to drive a car unchallenged, but to adversely affect responses to routine hazards. Advice on ability to drive safely should be cautious, as the impact of immobilisation appears to be more subtle and wide ranging than previously thought.

  2. Musculoskeletal pain in patients with myotonic dystrophy type 2.

    Science.gov (United States)

    George, Annette; Schneider-Gold, Christiane; Zier, Sandra; Reiners, Karlheinz; Sommer, Claudia

    2004-12-01

    Myotonic dystrophy type 2/proximal myotonic myopathy (DM2/PROMM) is an autosomal dominant multisystem disorder. Musculoskeletal pain is one of its frequent symptoms but also occurs in other chronic noninflammatory muscle disorders (OMD). To characterize the phenotype of DM2/PROMM-associated musculoskeletal pain and to test whether it shows features distinct from OMD. Outpatient clinic for patients with neuromuscular disorders, university hospital. Twenty-four patients with DM2/PROMM (12 women and 12 men; median age, 57 years) and 24 age- and sex-matched patients with OMD consecutively recruited during a 3-year period were examined for musculoskeletal pain. Standardized pain assessment; McGill Pain Questionnaire; depression score; and quantification of pain thresholds to blunt pressure on limb muscles with analgometer. Unlike patients with OMD who have musculoskeletal pain, patients with DM2/PROMM distinguished a wide spectrum of coexisting pain types. The major pain type in patients with DM2/PROMM was exercise-related, temperature-modulated, and palpation-induced, whereas, cramps were rare. In 8 of the patients with DM2/PROMM and in 3 of the patients with OMD, musculoskeletal pain was the most disabling symptom. Besides many similarities, DM2/PROMM-associated musculoskeletal pain shows features distinct from OMD.

  3. Physical recreational activity and musculoskeletal disorders in nurses

    Directory of Open Access Journals (Sweden)

    Władysław Mynarski

    2014-04-01

    Full Text Available Background: The role of physical activity (PA in the prevention and treatment of civilization diseases has been recognized by the medical society. Despite extensive knowledge and well-documented evidence of health aspects of PA, the identification and assessment of the PA level in various social and professional groups are still needed. The main goal of this research was to work out a preliminary assessment of possible relationship between recreational physical activity and reduced common musculoskeletal disorders in nurses. Material and Methods: The study included 93 nurses, aged 41.4±7.31, with body height of 164.4±7.04 and body weight of 64.5±10.8. The Nordic Musculoskeletal Questionnaire (NMQ was applied to assess pain and the International Physical Activity Questionnaire (IPAQ (long version to assess the level of physical activity. The intergroup differences, due to the occurrence of pain and physical activity levels, were determined using the Mann Whitney test and the Kruskal Wallis test. To evaluate the significance of individual factors potentially influencing the onset of musculoskeletal pains, the Chi2 test for independence was performed. Results: Over 70% of the examined nurses reported musculoskeletal complaints, mostly related with lower back pain. Taking up recreational activity, of at least moderate to vigorous physical activity (MVPA, reduces the risk of musculoskeletal disorders. Conclusion: It is most likely that recreational physical activity at appropriate parameters may prevent musculoskeletal disorders, especially in nurses with long work experience. However, this hypothesis needs to be verified by experimental studies with use of objective tools for the assessment of physical activity. Med Pr 2014;65(2:181–188

  4. Mental health and satisfaction with life among upper limb amputees: a Norwegian population-based survey comparing adult acquired major upper limb amputees with a control group.

    Science.gov (United States)

    Østlie, Kristin; Magnus, Per; Skjeldal, Ola H; Garfelt, Beate; Tambs, Kristian

    2011-01-01

    To assess how upper limb amputation affects mental health and life satisfaction. Cross-sectional study comparing the mental health and perceived satisfaction with life among adult acquired major upper limb amputees in Norway with a control group drawn from the Norwegian general population. The scales used were the Satisfaction With Life Scale (SWLS) and the Hopkins Symptom Check List 25-item (SCL-25). The groups were compared using multiple linear regression analyses. The amputees scored significantly lower on life satisfaction than the control group. A tendency to poorer mental health in the amputee group was observed, but there was no clear evidence of such a difference. The amputation effect on life satisfaction seemed to be mediated mainly by changes in occupational status and by the occurrence of short- or long-term complications related to the amputation. Our findings imply that rehabilitation of upper limb amputees should emphasise facilitating return to work as well as the prevention of short- and long-term complications, and that this will be of importance not only for the amputees' physical function, but for the maintenance of acceptable life satisfaction. Further studies on the effect of upper limb amputation on mental health are recommended.

  5. Functional rehabilitation of upper limb apraxia in poststroke patients: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Pérez-Mármol, Jose Manuel; García-Ríos, M Carmen; Barrero-Hernandez, Francisco J; Molina-Torres, Guadalupe; Brown, Ted; Aguilar-Ferrándiz, María Encarnación

    2015-11-05

    Upper limb apraxia is a common disorder associated with stroke that can reduce patients' independence levels in activities of daily living and increase levels of disability. Traditional rehabilitation programs designed to promote the recovery of upper limb function have mainly focused on restorative or compensatory approaches. However, no previous studies have been completed that evaluate a combined intervention method approach, where patients concurrently receive cognitive training and learn compensatory strategies for enhancing daily living activities. This study will use a two-arm, assessor-blinded, parallel, randomized controlled trial design, involving 40 patients who present a left- or right-sided unilateral vascular lesion poststroke and a clinical diagnosis of upper limb apraxia. Participants will be randomized to either a combined functional rehabilitation or a traditional health education group. The experimental group will receive an 8-week combined functional program at home, including physical and occupational therapy focused on restorative and compensatory techniques for upper limb apraxia, 3 days per week in 30-min intervention periods. The control group will receive a conventional health education program once a month over 8 weeks, based on improving awareness of physical and functional limitations and facilitating the adaptation of patients to the home. Study outcomes will be assessed immediately postintervention and at the 2-month follow-up. The primary outcome measure will be basic activities of daily living skills as assessed with the Barthel Index. Secondary outcome measures will include the following: 1) the Lawton and Brody Instrumental Activities of Daily Living Scale, 2) the Observation and Scoring of ADL-Activities, 3) the De Renzi Test for Ideational Apraxia, 4) the De Renzi Test for Ideomotor Apraxia, 5) Recognition of Gestures, 6) the Test of Upper Limb Apraxia (TULIA), and 7) the Quality of Life Scale For Stroke (ECVI-38). This trial is

  6. Musculoskeletal disorders among video display terminal (VDT workers comparing with other office workers

    Directory of Open Access Journals (Sweden)

    H. Akbari

    2010-07-01

    Full Text Available Background and aimsScientific and industrial development has led to increased production,which has been associated with different complications, including occupational stress, and increased incidence of work-related musculoskeletal disorders. Musculoskeletal disorders arefrequent causes of absenteeism in developed countries. We designed this study to assess musculoskeletal disorders and occupational stress among video display terminal (VDT workers in comparison with other office workers.MethodsThis was a cross-sectional study on 72 VDT workers (case and 145 office workers (control. In this study we used Nordic and Osipow questionnaires in order to evaluate musculoskeletal disorders and job stress, respectively. The questionnaires were filled by direct interview. T test, chi square, Fisher test and logistic regression were used for data analysis.ResultsThe frequency of musculoskeletal disorders among VDT users in the last 12 months was 46.5%, 20.3%, 5.1%, 12.4% and 57.6% in neck, shoulder, elbow, wrist and low back areas, respectively. The frequency of musculoskeletal complaints in neck, shoulder and wrist and mean score of occupational stress was significantly higher in the case group comparing with controlgroup, and both results were statistically significant.ConclusionVDT working is a high-risk job for musculoskeletal disorders. In this study the frequency of musculoskeletal disorders, especially in high-risk regions for this job, was higher in VDTworkers than other office workers. We recommend to perform other studies in order to find non-ergonomic points and postures in these persons.

  7. Assessment Mental Health and Musculoskeletal Disorders among Military Personnel in Bandar Abbas (Iran in 2016

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    Mehdi Ashnagar

    2017-02-01

    Full Text Available Musculoskeletal disorders represent a major issue in the military setting. Musculoskeletal disorders and mental disorders (MSD are a major cause of disability in the working population. Musculoskeletal disorders and premature tiredness caused by work are arisen from incompatible individual work capacity and job demands. Physical and psychology condition may lead to the generation, amplification musculoskeletal disorders. Musculoskeletal disorders and mental health disorders are high in military personnel. The purpose of this study was Assessment Mental Health and musculoskeletal disorders in military personnel. In this cross-sectional study 70 personnel military participated in May 2016. Cornell Questionnaire and Mental health inventory (MHI-28 were used for data gathering. Finally, Statistical analysis was performed using SPSS version 20, descriptive statistics, Pearson correlation test and One Way Anova test. The findings of the current study showed that personnel situation of mental health were in moderate condition (56.01±13.3. Results Cornell Questionnaire showed that the most of musculoskeletal disorders were respectively in the back (46%, shoulder (34% and wrist (31%. Also Pearson correlation test showed significantly associated between musculoskeletal disorders and mental health (r=0.72 (p-value=0.001. One Way Anova test showed that with increase age (p

  8. Impairment of complex upper limb motor function in de novo parkinson's disease.

    NARCIS (Netherlands)

    Ponsen, M.M.; Daffertshofer, A.; Wolters, E.C.M.J.; Beek, P.J.; Berendse, H.W.

    2008-01-01

    The aim of the present study was to evaluate complex upper limb motor function in newly diagnosed, untreated Parkinson's disease (PD) patients. Four different unimanual upper limb motor tasks were applied to 13 newly diagnosed, untreated PD patients and 13 age- and sex-matched controls. In a

  9. Prevalence and Associated Factors of Musculoskeletal Disorders among Young Dentists in Indonesia

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    Phedy P

    2016-07-01

    Full Text Available Introduction: Musculoskeletal problems are often work related. Dentists have been reported to have a high prevalence of musculoskeletal problems. Dentists have to perform repetitive tasks, often in awkward and nonergonomic positions in their practice. Materials and Methods: This is a cross-sectional study. Five-hundred copies of Nordic Musculoskeletal Questionnaire were distributed to dentists who participated in a congress of a regional branch of the Indonesian Dentist Association. Data such as sex, length of practice, the presence of assistance, smoking, occupational stress, body mass index, hand dominance, and exercise were collected. Dentist who had practised for more than five years were excluded. Results: Two hundred and forty-one respondents fulfilled the research criteria. Musculoskeletal symptoms occurred in 63.5% respondents. Fatigue and pain were the most common manifestations of musculoskeletal symptoms among dentists (36.5 and 24.9% respectively. Prolonged sitting was the most common aggravating factor (26.6% while exercise successfully relieved symptoms in 35.3% of respondents. Neck, upper back and lower back were the most common sites involved with prevalence of 25.7, 22.4, and 20.7% respectively. Neck was also the most common site of the symptoms preventing normal work during the preceding 12 months (8.3%. Exercise and stress are associated with the presence of musculoskeletal symptoms (p=0.01 and p<0.01 respectively. Exercise is associated with fatigue (p<0.01 and click (p<0.01, stress is associated with pain (p=0.00, stiffness (p=0.00, fatigue (p<0.01, and discomfort (p<0.01. Conclusions: The prevalence of musculoskeletal disorders in young dentists is 63.5%. Neck is the most common affected region. Stress and exercise are the main associated factor for musculoskeletal problems in dentists.

  10. Golf and upper limb injuries: a summary and review of the literature

    Directory of Open Access Journals (Sweden)

    Pollard Henry P

    2005-05-01

    Full Text Available Abstract Background Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. Objective To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing. Discussion An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury.

  11. Prevention of upper limb symptoms and signs of nerve afflictions in computer operators

    DEFF Research Database (Denmark)

    Riis Jepsen, Jørgen; Thomsen, Gert

    2008-01-01

    could be drawn regarding the relation to the intervention of this reduction. Incident pain correlated to findings in accordance with the three locations of nerve affliction. CONCLUSION: A six month course of stretching seems to reduce upper limb symptoms in computer operators but we could......ABSTRACT: BACKGROUND: In a previous study of computer operators we have demonstrated the relation of upper limb pain to individual and patterns of neurological findings (reduced function of muscles, sensory deviations from normal and mechanical allodynia of nerve trunks). The identified patterns......, respectively, computer operators in two divisions of an engineering consultancy company were invited to answer a questionnaire on upper limb symptoms and to undergo a blinded neurological examination. Participants in one division were subsequently instructed to participate in an upper limb stretching course...

  12. Dermatological and musculoskeletal assessment of diabetic foot: A narrative review.

    Science.gov (United States)

    Arsanjani Shirazi, Azam; Nasiri, Morteza; Yazdanpanah, Leila

    2016-01-01

    Diabetic Foot Syndrome (DFS) is the most costly and devastating complication of diabetes mellitus (DM), which early effective assessment can reduce the severity of complications including ulceration and amputations. This study aimed to review dermatological and musculoskeletal assessment of diabetic foot. In this review article, we searched for articles published between March 1, 1980 and July 28, 2015 in PubMed, Science Direct, Embase, Web of Science, and Scopus, for both English and non-English language articles with the following keywords: "Diabetic foot syndrome", "Ulceration", "Amputation", "Foot assessment", "Skin disorders" and "Musculoskeletal deformities". In dermatological dimension, most studies focused on elucidated changes in skin temperature, color, hardiness and turgor as well as common skin disorders such as Diabetic Dermopathy (DD), Necrobiosis Lipoidica Diabeticorum (NLD) and Diabetic Bullae (DB), which are common in diabetic patients and have high potential for leading to limb-threatening problems such as ulceration and infection. In musculoskeletal dimension, most studies focused on range of motion and muscle strength, gait patterns and as well as foot deformities especially Charcot osteoarthropathy (COA), which is the most destructive musculoskeletal complication of diabetes. DFS as a common condition in DM patients lead to ulceration and lower limb amputation frequently unless a prompt and comprehensive assessment was taken. So that dermatological and musculoskeletal assessments are usually neglected in primary health care, these assessments should be done frequently to reduce the high risk of serious complications. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  13. Playing-related musculoskeletal disorders in music students-associated musculoskeletal signs.

    Science.gov (United States)

    Steinmetz, A; Möller, H; Seidel, W; Rigotti, T

    2012-12-01

    Pain and overuse are common problems for musicians. Up to 80% of professional musicians suffer from playing-related musculoskeletal disorders (PRMD). The prevalence rate in music students is very high as well. Sufficient data on the underlying musculoskeletal dysfunctions however is scarce. Additionally, the self-assessment of health in musicians seems to differ compared to non-musicians, which might influence their attitudes concerning preventive strategies. Evaluation of frequency of PRMD in music students, investigation of signs and symptoms in music students compared to non-music controls, comparison of self-reported health and well-being between the two groups. Prospective, cross-sectional, case control, non-randomized. Other (University volunteers). Music students in comparison to a non-music control group. Musculoskeletal examination and questionnaire of 36 volunteers of a music university and 19 volunteer students of an university of education were analyzed. The total number of musculoskeletal dysfunctions and differences between the student groups were examined. The personal pain and health self-rating were compared between music and non-music students. Eighty one percent of musicians experienced PRMD. Musicians experienced 6.19 pain regions on average compared to 4.31 of non-musicians. Musicians experiencing PRMD reported significantly (PMusic students presented with nearly the double amount (8.39 versus 4.37) of musculoskeletal dysfunctions per person compared to the non-music control group. Nevertheless, musicians significantly (P<0.05) rated their health more positively than the controls. Musicians presented with more pain regions and a higher amount of musculoskeletal dysfunctions. Further studies evaluating the clinical relevance and their role in the development of PRMD are warranted. Screening of musicians for musculoskeletal dysfunction may identify those musicians at increased risk. Early treatment may prevent PRMD in musicians. Additional

  14. Algorithm of Functional Musculoskeletal Disorders Diagnostics

    OpenAIRE

    Alexandra P. Eroshenko

    2012-01-01

    The article scientifically justifies the algorithm of complex diagnostics of functional musculoskeletal disorders during resort treatment, aimed at the optimal application of modern methods of physical rehabilitation (correction programs formation), based on diagnostic methodologies findings

  15. Prevalence of Musculoskeletal Disorders Among Office Workers

    Directory of Open Access Journals (Sweden)

    Valipour Noroozi

    2015-01-01

    Full Text Available Background Musculoskeletal disorders are among common occupational diseases in the world, which have high prevalence not only among hard and hurtful jobs, but also in office works. Objectives The purpose of this study was to describe the prevalence of musculoskeletal disorders (MSDs among office workers of Ahvaz Jundishapur University of Medical Sciences. Patients and Methods This study carried out intermittently among 392 individuals of Ahvaz Jundishapur University of Medical Sciences office workers by Nordic questionnaire from October 2013 to December 2013. Study population included office workers of different departments as well as central organization and library. We use descriptive statistic, t test and chi-square test for data analysis. Results The mean and standard deviation of participants’ age was 35.4 ± 6.7 years and their work experience was 9.7 ± 6.65 years, respectively. Most signs (51% were in back region, which forced 18.9% of individuals to withdraw from daily activities. Statistical analysis also showed 36.7% neck disorders in office workers, which demonstrated significant association with age and work experience (P < 0.001. Conclusions Significant association of work experience and age with musculoskeletal disorders shows that individual’s education and knowledge improvements with regard to ergonomics risk factors and correction of work postures are very important and ought to follow management and technical practices in the organization.

  16. Technology that Touches Lives: Teleconsultation to Benefit Persons with Upper Limb Loss

    Directory of Open Access Journals (Sweden)

    Lynsay R. Whelan

    2011-12-01

    Full Text Available While over 1.5 million individuals are living with limb loss in the United States (Ziegler-Graham et al., 2008, only 10% of these individuals have a loss that affects an upper limb. Coincident with the relatively low incidence of upper limb loss, is a shortage of the community-based prosthetic rehabilitation experts that can help prosthetic users to more fully integrate their devices into their daily routines. This article describes how expert prosthetists and occupational therapists at Touch Bionics, a manufacturer of advanced upper limb prosthetic devices, employ Voice over the Internet Protocol (VoIP videoconferencing software telehealth technologies to engage in remote consultation with users of prosthetic devices and/or their local practitioners. The Touch Bionics staff provide follow-up expertise to local prosthetists, occupational therapists, and other health professionals. Contrasted with prior telephone-based consultations, the video-enabled approach provides enhanced capabilities to benefit persons with upper limb loss.  Currently, the opportunities for Touch Bionics occupational therapists to fully engage in patient-based services delivered through telehealth technologies are significantly reduced by their need to obtain and maintain professional licenses in multiple states.

  17. Stellate ganglion blockade for analgesia following upper limb surgery.

    LENUS (Irish Health Repository)

    McDonnell, J G

    2012-01-31

    We report the successful use of a stellate ganglion block as part of a multi-modal postoperative analgesic regimen. Four patients scheduled for orthopaedic surgery following upper limb trauma underwent blockade of the stellate ganglion pre-operatively under ultrasound guidance. Patients reported excellent postoperative analgesia, with postoperative VAS pain scores between 0 and 2, and consumption of morphine in the first 24 h ranging from 0 to 14 mg. While these are preliminary findings, and must be confirmed in a clinical trial, they highlight the potential for stellate ganglion blockade to provide analgesia following major upper limb surgery.

  18. Kinematics and Dynamics Analysis of a 3-DOF Upper-Limb Exoskeleton with an Internally Rotated Elbow Joint

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2018-03-01

    Full Text Available The contradiction between self-weight and load capacity of a power-assisted upper-limb exoskeleton for material hanging is unresolved. In this paper, a non-anthropomorphic 3-degree of freedom (DOF upper-limb exoskeleton with an internally rotated elbow joint is proposed based on an anthropomorphic 5-DOF upper-limb exoskeleton for power-assisted activity. The proposed 3-DOF upper-limb exoskeleton contains a 2-DOF shoulder joint and a 1-DOF internally rotated elbow joint. The structural parameters of the 3-DOF upper-limb exoskeleton were determined, and the differences and singularities of the two exoskeletons were analyzed. The workspace, the joint torques and the power consumption of two exoskeletons were analyzed by kinematics and dynamics, and an exoskeleton prototype experiment was performed. The results showed that, compared with a typical anthropomorphic upper-limb exoskeleton, the non-anthropomorphic 3-DOF upper-limb exoskeleton had the same actual workspace; eliminated singularities within the workspace; improved the elbow joint force situation; and the maximum elbow joint torque, elbow external-flexion/internal-extension and shoulder flexion/extension power consumption were significantly reduced. The proposed non-anthropomorphic 3-DOF upper-limb exoskeleton can be applied to a power-assisted upper-limb exoskeleton in industrial settings.

  19. Association between Upper Extremity Musculoskeletal Disorders and Psychosocial Factors at Work: A Review on the Job DCS Model’s Perspective

    Directory of Open Access Journals (Sweden)

    Jung-Keun Park

    2010-09-01

    Full Text Available 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.

  20. Responsibility for managing musculoskeletal disorders – A cross-sectional postal survey of attitudes

    Directory of Open Access Journals (Sweden)

    Larsson Maria EH

    2008-08-01

    Full Text Available Abstract Background Musculoskeletal disorders are a major burden on individuals, health systems and social care systems and rehabilitation efforts in these disorders are considerable. Self-care is often considered a cost effective treatment alternative owing to limited health care resources. But what are the expectations and attitudes in this question in the general population? The purpose of this study was to describe general attitudes to responsibility for the management of musculoskeletal disorders and to explore associations between attitudes and background variables. Methods A cross-sectional, postal questionnaire survey was carried out with a random sample of a general adult Swedish population of 1770 persons. Sixty-one percent (n = 1082 responded to the questionnaire and was included for the description of general attitudes towards responsibility for the management of musculoskeletal disorders. For the further analyses of associations to background variables 683–693 individuals could be included. Attitudes were measured by the "Attitudes regarding Responsibility for Musculoskeletal disorders" (ARM instrument, where responsibility is attributed on four dimensions; to myself, as being out of my hands, to employers or to (medical professionals. Multiple logistic regression was used to explore associations between attitudes to musculoskeletal disorders and the background variables age, sex, education, physical activity, presence of musculoskeletal disorders, sick leave and whether the person had visited a care provider. Results A majority of participants had internal views, i.e. showed an attitude of taking personal responsibility for musculoskeletal disorders, and did not place responsibility for the management out of their own hands or to employers. However, attributing shared responsibility between self and medical professionals was also found. The main associations found between attitude towards responsibility for musculoskeletal

  1. Effectiveness of Ergonomic Chair against Musculoskeletal Disorders in Female Batik Workers of Sragen District

    Directory of Open Access Journals (Sweden)

    Sumardiyono Sumardiyono

    2014-08-01

    Full Text Available The majority of female batik workers uses non-ergonomic chairs (dingklik that pose risks of musculoskeletal disorders. This study aimed to design an ergonomic chair and evaluate its effectiveness in reducing musculoskeletal disorders among the workers. This is a quasi-experimental study (using one group pre and post-test design on 50 female batik workers selected by quota sampling. Musculoskeletal disorders were measured among the samples before and after the use of the designed ergonomic chair which they were asked to use for two months. T-test, ANCOVA, Wilcoxon test, McNemar test and Chi Square test were used for the analysis. The study found statistical significant differences of risk factor against musculoskeletal disorders among the workers before and after their use of the designed ergonomic chair (p=0.000; and of musculoskeletal disorders before and after using the ergonomic chair (p= 0,035. Body Mass Index (BMI was identified as a confounding factor, and statistical significant difference of musculoskeletal disorders were also found among the workers with 25 BMI even before and after using the ergonomic chair (p=0.033 and p=0.015 respectively. By ANCOVA statistical test, after controlling BMI, another statistical difference of musculoskeletal disorders was also identified before and after using the ergonomic chair (p=0.033. It is concluded that the designed ergonomic chair is effective to reduce the risk of musculoskeletal disorders.

  2. Upper limb functional electrical stimulation devices and their man-machine interfaces.

    Science.gov (United States)

    Venugopalan, L; Taylor, P N; Cobb, J E; Swain, I D

    2015-01-01

    Functional Electrical Stimulation (FES) is a technique that uses electricity to activate the nerves of a muscle that is paralysed due to hemiplegia, multiple sclerosis, Parkinson's disease or spinal cord injury (SCI). FES has been widely used to restore upper limb functions in people with hemiplegia and C5-C7 tetraplegia and has improved their ability to perform their activities of daily living (ADL). At the time of writing, a detailed literature review of the existing upper limb FES devices and their man-machine interfaces (MMI) showed that only the NESS H200 was commercially available. However, the rigid arm splint doesn't fit everyone and prevents the use of a tenodesis grip. Hence, a robust and versatile upper limb FES device that can be used by a wider group of people is required.

  3. Algorithm of Functional Musculoskeletal Disorders Diagnostics

    Directory of Open Access Journals (Sweden)

    Alexandra P. Eroshenko

    2012-04-01

    Full Text Available The article scientifically justifies the algorithm of complex diagnostics of functional musculoskeletal disorders during resort treatment, aimed at the optimal application of modern methods of physical rehabilitation (correction programs formation, based on diagnostic methodologies findings

  4. Effects of postural changes of the upper limb on reflex transmission in the lower limb. Cervicolumbar reflex interactions in man.

    Science.gov (United States)

    Delwaide, P J; Figiel, C; Richelle, C

    1977-06-01

    The influence of passive changes in upper limb position on the excitability of three myotatic arc reflexes (soleus, quadriceps, and biceps femoris) of the lower limb has been explored on 42 volunteers. The results indicate that the excitability of the three myotatic arcs can be influenced at a distance by postural modifications of the upper limb. When the ipsilateral upper limb is forwards or the contralateral backwards, a facilitation of both soleus and quadriceps tendon reflexes is observed while the biceps femoris reflexes are reduced. This pattern of facilitation and inhibition is reversed when the ipsilateral upper limb is backwards or the contralateral forwards. The facilitations as well as inhibitions of proximal myotatic arc reflexes are quantitatively more marked than that of the soleus reflex. Facilitation and inhibition are not linearly related to the angle of the arm with the trunk. Effects begin at a considerable angle, become maximal at 45 degrees, and progressively disappear for greater values. It is suggested that the distinct pattern of facilitation and inhibition which is exerted in reciprocal fashion on extensor and flexor motor nuclei might depend on the long propriospinal neurones connecting cervical and lumbar enlargements.

  5. A 3D musculoskeletal model of the western lowland gorilla hind limb: moment arms and torque of the hip, knee and ankle.

    Science.gov (United States)

    Goh, Colleen; Blanchard, Mary L; Crompton, Robin H; Gunther, Michael M; Macaulay, Sophie; Bates, Karl T

    2017-10-01

    Three-dimensional musculoskeletal models have become increasingly common for investigating muscle moment arms in studies of vertebrate locomotion. In this study we present the first musculoskeletal model of a western lowland gorilla hind limb. Moment arms of individual muscles around the hip, knee and ankle were compared with previously published data derived from the experimental tendon travel method. Considerable differences were found which we attribute to the different methodologies in this specific case. In this instance, we argue that our 3D model provides more accurate and reliable moment arm data than previously published data on the gorilla because our model incorporates more detailed consideration of the 3D geometry of muscles and the geometric constraints that exist on their lines-of-action about limb joints. Our new data have led us to revaluate the previous conclusion that muscle moment arms in the gorilla hind limb are optimised for locomotion with crouched or flexed limb postures. Furthermore, we found that bipedalism and terrestrial quadrupedalism coincided more regularly with higher moment arms and torque around the hip, knee and ankle than did vertical climbing. This indicates that the ability of a gorilla to walk bipedally is not restricted by musculoskeletal adaptations for quadrupedalism and vertical climbing, at least in terms of moment arms and torque about hind limb joints. © 2017 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

  6. Musculoskeletal Disorders in Ophthalmologists After Simulated Cataract Operation: A Pilot Study.

    Science.gov (United States)

    Pearce, Zachary D; Zatkin, Mathew A; Bruner, Jon

    2017-12-01

    Musculoskeletal disorders are a common problem among ophthalmologists, likely due to ergonomic challenges. Most research on the topic has been survey-based studies, which carry inherent weaknesses. To examine the frequency and pattern of musculoskeletal dysfunction induced by performing a surgical procedure and to quantify the improvement after ergonomic interventions. Ophthalmology residents from a single academic institution were invited to participate in the study on a volunteer basis. Preexisting musculoskeletal disorders; previous spinal, cervical, or shoulder surgery; or limited range of motion of the upper body or arms were exclusion criteria. The interventions consisted of a surgical simulation session and a control session, each lasting 2 hours. For the surgical simulation session, a musculoskeletal examination was performed at the beginning and end of the 2-hour session after the participants used the Eyesi Cataract Surgery Simulator (VRmagic). A musculoskeletal examination was performed by the palpatory screener (M.A.Z.) at the beginning and conclusion of the 2-hour control session, which consisted of both passive and active tasks. The musculoskeletal screener was blinded as to which session the participant was completing at the time of the examinations, as well as any musculoskeletal examination findings from before the intervention. All participants completed both sessions, but they were randomized into which session they were to complete first. Participants completed each session one after the other. Eight participants completed both sessions, and 32 musculoskeletal examinations were performed. In the surgical simulation session, after using the simulator, 5 of 8 participants had an increase in the number of spinal levels with tissue texture abnormalities, and 3 had no change. Of those in the control session, 5 participants had a decrease in the number of spinal levels with tissue texture abnormalities after a period of rest. Three participants in the

  7. Validity Evaluation of the Assessment Method for Postural Loading on the Upper Body in Printing Industry

    Directory of Open Access Journals (Sweden)

    Mohammad Khandan

    2016-07-01

    Full Text Available Background and Objectives: Musculoskeletal disorders and injuries are known as a global occupational challenge. These injuries are more are concentrated in the upper limb. There are several methods to assess this kind of disorders, each of which have different efficiencies for various jobs based on their strengths and weaknesses. This study aimed to assess the validity of LUBA method in order to evaluate risk factors for musculoskeletal disorders in a printing industry in Qom province, 2014. Methods: In this descriptive cross-sectional study, all operational workers (n=94 were investigated in 2014. Nordic Musculoskeletal Questionnaire (NMQ was used to collect data on musculoskeletal disorders. We also used LUBA method to analyze postures in four different parts of the body (neck, shoulder, elbow, and wrist. The obtained data were analyzed using Mann-Whitney, Kruskal Wallis, and Kappa agreement tests. Results: Lumbar region of back with 35.1% prevalence had the most problems. The results of LUBA method showed that most postures were located at the second corrective action level, and need further studies. Agreement between assessment of shoulder posture and its disorders was significant (p0.05.  Conclusion: According to the results of this study on reliability and predictive validity of the LUBA method in printing industry, it can be concluded that this method is not a reliable method for posture assessment; however, further and more comprehensive studies are recommended.  

  8. Patients' views on responsibility for the management of musculoskeletal disorders – A qualitative study

    Directory of Open Access Journals (Sweden)

    Larsson Maria EH

    2009-08-01

    Full Text Available Abstract Background Musculoskeletal disorders are very common and almost inevitable in an individual's lifetime. Enabling self-management and allowing the individual to take responsibility for care is stated as desired in the management of these disorders, but this may be asking more than people can generally manage. A willingness among people to take responsibility for musculoskeletal disorders and not place responsibility out of their hands or on employers but to be shared with medical professionals has been shown. The aim of the present study was to describe how people with musculoskeletal disorders think and reason regarding responsibility for prevention, treatment and management of the disorder. Methods Individual interviews with a strategic sample of 20 individuals with musculoskeletal disorders were performed. The interviews were tape-recorded, transcribed verbatim and analysed according to qualitative content analysis. Results From the interviews an overarching theme was identified: own responsibility needs to be met. The analysis revealed six interrelated categories: Taking on responsibility, Ambiguity about responsibility, Collaborating responsibility, Complying with recommendations, Disclaiming responsibility, and Responsibility irrelevant. These categories described different thoughts and reasoning regarding the responsibility for managing musculoskeletal disorders. Generally the responsibility for prevention of musculoskeletal disorders was described to lie primarily on society/authorities as they have knowledge of what to prevent and how to prevent it. When musculoskeletal disorders have occurred, health care should provide fast accessibility, diagnosis, prognosis and support for recovery. For long-term management, the individuals themselves are responsible for making the most out of life despite disorders. Conclusion No matter what the expressions of responsibility for musculoskeletal disorders are, own responsibility needs to be

  9. Primed Physical Therapy Enhances Recovery of Upper Limb Function in Chronic Stroke Patients.

    Science.gov (United States)

    Ackerley, Suzanne J; Byblow, Winston D; Barber, P Alan; MacDonald, Hayley; McIntyre-Robinson, Andrew; Stinear, Cathy M

    2016-05-01

    Recovery of upper limb function is important for regaining independence after stroke. To test the effects of priming upper limb physical therapy with intermittent theta burst stimulation (iTBS), a form of noninvasive brain stimulation. Eighteen adults with first-ever chronic monohemispheric subcortical stroke participated in this randomized, controlled, triple-blinded trial. Intervention consisted of priming with real or sham iTBS to the ipsilesional primary motor cortex immediately before 45 minutes of upper limb physical therapy, daily for 10 days. Changes in upper limb function (Action Research Arm Test [ARAT]), upper limb impairment (Fugl-Meyer Scale), and corticomotor excitability, were assessed before, during, and immediately, 1 month and 3 months after the intervention. Functional magnetic resonance images were acquired before and at one month after the intervention. Improvements in ARAT were observed after the intervention period when therapy was primed with real iTBS, but not sham, and were maintained at 1 month. These improvements were not apparent halfway through the intervention, indicating a dose effect. Improvements in ARAT at 1 month were related to balancing of corticomotor excitability and an increase in ipsilesional premotor cortex activation during paretic hand grip. Two weeks of iTBS-primed therapy improves upper limb function at the chronic stage of stroke, for at least 1 month postintervention, whereas therapy alone may not be sufficient to alter function. This indicates a potential role for iTBS as an adjuvant to therapy delivered at the chronic stage. © The Author(s) 2015.

  10. Age Effects on Upper Limb Kinematics Assessed by the REAplan Robot in Healthy School-Aged Children.

    Science.gov (United States)

    Gilliaux, Maxime; Dierckx, Floriane; Vanden Berghe, Lola; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine

    2015-05-01

    The use of kinematics is recommended to quantitatively evaluate upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish norms in healthy children. Ninety-three healthy children, aged 3-12 years, participated in this study. Twenty-eight kinematic indices were computed from four tasks. Each task was performed with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-four of the 28 indices showed an improvement during childhood. Indeed, older children showed better upper limb movements. This study was the first to use a robotic device to show the age effects on upper limb kinematics and establish norms in healthy children.

  11. The application of accelerometers to measure movements of upper limbs: Pilot study

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    Patrik Kutilek

    2017-03-01

    Full Text Available Background: Even though inertial measurement units (IMU are already being used experimentally for evaluating movements of segment of the axial skeleton, no studies have been found which have used IMUs to measure the behavior of the segments of upper limbs during quiet stance. Objective: The objective is to design a suitable application of IMUs to measure movements of the upper extremities in Romberg's test and analyze spontaneous arm movements. Second aim is to identify possible discrepancies between the dominant and non-dominant arm movements. Methods: The dominant and non-dominant upper limb of each participant was identified. Then, the movements of both upper limbs were measured by the Xsens system equipped with MTx motion trackers during the quiet stance on a firm surface with eyes open (EO and eyes closed (EC. The measured data was used to calculate the medians and maximums of the superior-inferior, medio-lateral and anterior-posterior acceleration. Also, tremor intensity was calculated to quantitatively evaluate the measured data. Results: The comparison of values of maximal accelerations of the dominant and non-dominant arms showed significant difference between the arms during EC conditions. The comparison of values of median accelerations of the dominant and non-dominant arms showed significant differences between the acceleration of arms in medio-lateral direction during EO and EC conditions. In all cases, values of maximal and median accelerations and values of tremor intensity of the dominant limb strongly correlated with values on the non-dominant limb. Conclusions: Findings suggest possible usefulness of the designed application of IMUs and evaluation methods for their use in Romberg's test in clinical practice for evaluation of upper limb movements.

  12. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    OpenAIRE

    Susan Armijo-Olivo; David Magee

    2012-01-01

    ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maxima...

  13. Work-related musculoskeletal disorders : prevention report

    NARCIS (Netherlands)

    Podniece, Z.; Heuvel, S. van den; Blatter, B.

    2008-01-01

    Work-related musculoskeletal disorders (MSDs) can interfere with activities at work and can lead to reduced productivity, sickness absence and chronic occupational disability. The aim of this report is to systematic evaluate the effectiveness of interventions at the workplace since 2002 and to

  14. Musculoskeletal Asymmetry in Football Athletes: A Product of Limb Function over Time.

    Science.gov (United States)

    Hart, Nicolas H; Nimphius, Sophia; Weber, Jason; Spiteri, Tania; Rantalainen, Timo; Dobbin, Michael; Newton, Robert U

    2016-07-01

    Asymmetrical loading patterns are commonplace in football sports. Our aim was to examine the influence of training age and limb function on lower-body musculoskeletal morphology. Fifty-five elite football athletes were stratified into less experienced (≤3 yr; n = 27) and more experienced (>3 yr; n = 28) groups by training age. All athletes underwent whole-body dual-energy x-ray absorptiometry scans and lower-body peripheral quantitative computed tomography tibial scans on the kicking and support limbs. Significant interactions between training age and limb function were evident across all skeletal parameters (F16, 91 = 0.182, P = 0.031, Wilks Λ = 0.969). Asymmetries between limbs were significantly larger in the more experienced players than the less experienced players for tibial mass (P ≤ 0.044, d ≥ 0.50), total cross-sectional area (P ≤ 0.039, d ≥ 0.53), and stress-strain indices (P ≤ 0.050, d ≥ 0.42). No significant asymmetry was evident for total volumetric density. More experienced players also exhibited greater lower-body tibial mass (P ≤ 0.001, d ≥ 1.22), volumetric density (P ≤ 0.009, d ≥ 0.79), cross-sectional area (P ≤ 0.387, d ≥ 0.21), stress-strain indices (P ≤ 0.012, d ≥ 0.69), fracture loads (P ≤ 0.018, d ≥ 0.57), and muscle mass and cross-sectional area (P ≤ 0.016, d ≥ 0.68) than less experienced players. Asymmetries were evident in athletes as a product of limb function over time. Chronic exposure to routine high-impact gravitational loads afforded to the support limb preferentially improved bone mass and structure (cross-sectional area and cortex thickness) as potent contributors to bone strength relative to the high-magnitude muscular loads predominantly afforded to the kicking limb.

  15. 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,...

  16. Assessing upper limb function in nonambulant SMA patients: development of a new module.

    Science.gov (United States)

    Mazzone, Elena; Bianco, Flaviana; Martinelli, Diego; Glanzman, Allan M; Messina, Sonia; De Sanctis, Roberto; Main, Marion; Eagle, Michelle; Florence, Julaine; Krosschell, Kristin; Vasco, Gessica; Pelliccioni, Marco; Lombardo, Marilena; Pane, Marika; Finkel, Richard; Muntoni, Francesco; Bertini, Enrico; Mercuri, Eugenio

    2011-06-01

    We report the development of a module specifically designed for assessing upper limb function in nonambulant SMA patients, including young children and those with severe contractures. The application of the module to a preschool cohort of 40 children (age 30-48 months) showed that all the items could be completed by 30 months. The module was also used in 45 nonambulant SMA patients (age 30 months to 27 years). Their scores were more variable than in the preschool cohort, ranging from 0 to 18. The magnitude of scores was not related to age (r=-0.19). The upper limb scores had a good correlation with the Hammersmith Functional Motor Scale, r=0.75, but the upper limb function did not always strictly follow the overall gross motor function. These findings suggest that even some of the very weak nonambulant children possess upper limb skills that can be measured. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Chaining of the musculoskeletal disorders from various viewpoints in physiotherapy

    OpenAIRE

    Hák, Jaroslav

    2016-01-01

    Title of diploma thesis: Chaining of the musculoskeletal disorders from various viewpoints in physiotherapy Objective: The purpouse of this thesis is to research available literary sources describing the possible mechanisms of chaining of musculoskeletal disorders from various viewpoints in physiotherapy. Methods: This diploma thesis has descriptively-analytical character. It is structured in the form of literary research. Results: On the basis of the researched literary sources, the thesis s...

  18. Musculoskeletal disorders associated with HIV infection and AIDS. Part II: Non-infectious musculoskeletal conditions

    International Nuclear Information System (INIS)

    Tehranzadeh, Jamshid; Ter-Oganesyan, Ramon R.; Steinbach, Lynne S.

    2004-01-01

    This section of a two-part series on musculoskeletal disorders associated with HIV infection and AIDS reviews the non-infectious musculoskeletal conditions. In the first part, the infectious conditions were reviewed. The non-infectious conditions include polymyositis, drug-induced myopathy, myositis ossificans, adhesive capsulitis, avascular necrosis, bone marrow abnormalities, and hypertrophic osteoarthropathy. Inflammatory and reactive arthropathies are more prevalent in HIV-positive individuals, and a separate section is dedicated to these conditions, including Reiter's syndrome, psoriatic arthritis, HIV-associated arthritis, painful articular syndrome, and acute symmetric polyarthritis. Lastly, we include a discussion of HIV-related neoplastic processes that affect the musculoskeletal system, namely Kaposi's sarcoma and non-Hodgkin's lymphoma. (orig.)

  19. [Functions of participatory ergonomics programs in reducing work-related musculoskeletal disorders].

    Science.gov (United States)

    Guo, M J; Liu, J J; Yao, H Y

    2016-08-10

    Work-related musculoskeletal disorders (MSDs) are most commonly seen in all the occupational non-fatal injuries and illnesses for workers, especially those who are involved in labor-intensive industries. Participatory ergonomics is frequently used to prevent musculoskeletal disorders. This paper gives an overview of a historical perspective on the use of participatory ergonomics approach in reducing the health effects of labor-intensive industries. Progress, barriers and facilitators on the organization, implementation and evaluation of participatory ergonomics programs are studied. Participatory ergonomics seems a successful method to develop, prioritize measures to prevent MSDs. Participatory ergonomics can help industries reduce musculoskeletal injuries and disorders, improve workplace condition and promote health conditions of the workers.

  20. Effect of One Carpet Weaving Workstation on Upper Trapezius Fatigue

    Directory of Open Access Journals (Sweden)

    Neda Mahdavi

    2016-03-01

    Full Text Available Introduction: This study aimed to investigate the effect of carpet weaving at a proposed workstation on Upper Trapezius (UTr fatigue during a task cycle. Fatigue in the shoulder is one of the most important precursors for upper limb musculoskeletal disorders. One of the most prevalent musculoskeletal disorders between carpet weavers is disorder of the shoulder region. Methods: This cross-sectional study, included eight females and three males. During an 80-minute cycle of carpet weaving, Electromyography (EMG signals of right and left UTr were recorded by the surface EMG, continuously. After raw signals were processed, MPF and RMS were considered as EMG amplitude and frequency parameters. Time series model and JASA methods were used to assess and classify the EMG parameter changes during the working time. Results: According to the JASA method, 58%, 16%, 8% and 8% of the participants experienced fatigue, force increase, force decrease and recovery, respectively in the right UTr. Also, 50%, 25%, 8% and 16% of the participants experienced fatigue, force increase, force decrease and recovery, respectively in the left UTr. Conclusions: For the major portion of the weavers, dominant status in Left and right UTr was fatigue, at the proposed workstation during a carpet weaving task cycle. The results of the study provide detailed information for optimal design of workstations. Further studies should focus on fatigue in various muscles and time periods for designing an appropriate and ergonomics carpet weaving workstation

  1. Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review

    Directory of Open Access Journals (Sweden)

    Simone De Sio

    2018-01-01

    working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments. Discussion This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.

  2. Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review.

    Science.gov (United States)

    De Sio, Simone; Traversini, Veronica; Rinaldo, Francesca; Colasanti, Valerio; Buomprisco, Giuseppe; Perri, Roberto; Mormone, Federica; La Torre, Giuseppe; Guerra, Fabrizio

    2018-01-01

    , while 61.5% of the original articles emphasized the use of modern and ergonomic instruments. This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.

  3. Kinematics and Dynamics Analysis of a 3-DOF Upper-Limb Exoskeleton with an Internally Rotated Elbow Joint

    OpenAIRE

    Xin Wang; Qiuzhi Song; Xiaoguang Wang; Pengzhan Liu

    2018-01-01

    The contradiction between self-weight and load capacity of a power-assisted upper-limb exoskeleton for material hanging is unresolved. In this paper, a non-anthropomorphic 3-degree of freedom (DOF) upper-limb exoskeleton with an internally rotated elbow joint is proposed based on an anthropomorphic 5-DOF upper-limb exoskeleton for power-assisted activity. The proposed 3-DOF upper-limb exoskeleton contains a 2-DOF shoulder joint and a 1-DOF internally rotated elbow joint. The structural parame...

  4. Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review

    Directory of Open Access Journals (Sweden)

    Hsiu-Ching Chiu

    2016-07-01

    Full Text Available Questions: Does constraint-induced movement therapy improve activity and participation in children with hemiplegic cerebral palsy? Does it improve activity and participation more than the same dose of upper limb therapy without restraint? Is the effect of constraint-induced movement therapy related to the duration of intervention or the age of the children? Design: Systematic review of randomised trials with meta-analysis. Participants: Children with hemiplegic cerebral palsy with any level of motor disability. Intervention: The experimental group received constraint-induced movement therapy (defined as restraint of the less affected upper limb during supervised activity practice of the more affected upper limb. The control group received no intervention, sham intervention, or the same dose of upper limb therapy. Outcome measures: Measures of upper limb activity and participation were used in the analysis. Results: Constraint-induced movement therapy was more effective than no/sham intervention in terms of upper limb activity (SMD 0.63, 95% CI 0.20 to 1.06 and participation (SMD 1.21, 95% CI 0.41 to 2.02. However, constraint-induced movement therapy was no better than the same dose of upper limb therapy without restraint either in terms of upper limb activity (SMD 0.05, 95% CI –0.21 to 0.32 or participation (SMD –0.02, 95% CI –0.34 to 0.31. The effect of constraint-induced movement therapy was not related to the duration of intervention or the age of the children. Conclusions: This review suggests that constraint-induced movement therapy is more effective than no intervention, but no more effective than the same dose of upper limb practice without restraint. Registration: PROSPERO CRD42015024665. [Chiu H-C, Ada L (2016 Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review. Journal of Physiotherapy 62: 130–137

  5. Biomimetics in the design of a robotic exoskeleton for upper limb therapy

    Science.gov (United States)

    Baniqued, Paul Dominick E.; Dungao, Jade R.; Manguerra, Michael V.; Baldovino, Renann G.; Abad, Alexander C.; Bugtai, Nilo T.

    2018-02-01

    Current methodologies in designing robotic exoskeletons for upper limb therapy simplify the complex requirements of the human anatomy. As a result, such devices tend to compromise safety and biocompatibility with the intended user. However, a new design methodology uses biological analogues as inspiration to address these technical issues. This approach follows that of biomimetics, a design principle that uses the extraction and transfer of useful information from natural morphologies and processes to solve technical design issues. In this study, a biomimetic approach in the design of a 5-degree-of-freedom robotic exoskeleton for upper limb therapy was performed. A review of biomimetics was first discussed along with its current contribution to the design of rehabilitation robots. With a proposed methodological framework, the design for an upper limb robotic exoskeleton was generated using CATIA software. The design was inspired by the morphology of the bones and the muscle force transmission of the upper limbs. Finally, a full design assembly presented had integrated features extracted from the biological analogue. The successful execution of a biomimetic design methodology made a case in providing safer and more biocompatible robots for rehabilitation.

  6. Health status, work limitations, and return-to-work trajectories in injured workers with musculoskeletal disorders

    Science.gov (United States)

    Franche, Renée-Louise; Hogg-Johnson, Sheilah; Côté, Pierre; Lee, Hyunmi; Severin, Colette; Vidmar, Marjan; Carnide, Nancy

    2007-01-01

    Background The purpose of this study was to describe the health status and work limitations in injured workers with musculoskeletal disorders at 1 month post-injury, stratified by return-to-work status, and to document their return-to-work trajectories 6 months post-injury. Methods A sample of 632 workers with a back or upper extremity musculoskeletal disorder, who filed a Workplace Safety and Insurance Board lost-time claim injury, participated in this prospective study. Participants were assessed at baseline (1 month post-injury) and at 6 months follow-up. Results One month post-injury, poor physical health, high levels of depressive symptoms and high work limitations are prevalent in workers, including in those with a sustained first return to work. Workers with a sustained first return to work report a better health status and fewer work limitations than those who experienced a recurrence of work absence or who never returned to work. Six months post-injury, the rate of recurrence of work absence in the trajectories of injured workers who have made at least one return to work attempt is high (38%), including the rate for workers with an initial sustained first return to work (27%). Conclusions There are return-to-work status specific health outcomes in injured workers. A sustained first return to work is not equivalent to a complete recovery from musculoskeletal disorders. PMID:17616838

  7. Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury.

    Science.gov (United States)

    Velstra, Inge-Marie; Bolliger, Marc; Krebs, Jörg; Rietman, Johan S; Curt, Armin

    2016-05-01

    To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia. As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used. Results: Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results. Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials. © The Author(s) 2015.

  8. Defining the role of sensation, strength, and prehension for upper limb function in cervical spinal cord injury.

    Science.gov (United States)

    Kalsi-Ryan, Sukhvinder; Beaton, Dorcas; Curt, Armin; Duff, Susan; Jiang, Depeng; Popovic, Milos R; Rudhe, Claudia; Fehlings, Michael G; Verrier, Mary C

    2014-01-01

    Upper limb function plays a significant role in enhancing independence for individuals with tetraplegia. However, there is limited knowledge about the specific input of sensorimotor deficits on upper limb function. Thus the theoretical framework designed to develop the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) was used as a hypothetical model to analyze the impact of impairment on function. To define the association of impairment (sensation, strength, and prehension measured by the GRASSP) to upper limb function as defined by functional measures (Capabilities of Upper Extremity Questionnaire, Spinal Cord Independence Measure). A hypothetical model representing relationships by applying structural equation modeling was used to estimate the effect of the impairment domains in GRASSP on upper limb function. Data collected on 72 chronic individuals with tetraplegia was used to test the hypothetical model. Structural equation modeling confirmed strong associations between sensation, strength, and prehension with upper limb function, and determined 72% of the variance in "sensorimotor upper limb function" was explained by the model. Statistics of fit showed the data did fit the hypothesized model. Sensation and strength influence upper limb function directly and indirectly with prehension as the mediator. The GRASSP is a sensitive diagnostic tool in distinguishing the relative contribution of strength, sensation and prehension to function. Thus, the impact of interventions on specific domains of impairment and related contribution on clinical recovery of the upper limb can be detailed to optimize rehabilitation programs.

  9. Prevalence and factors contributing to musculoskeletal disorder ...

    African Journals Online (AJOL)

    Journal Home > Vol 9, No 5S (2017) > ... Method used in this study is standard Nordic questionnaire (SNQ) Malay version for 150 garage workers ... Keywords: vehicle maintenance; musculoskeletal disorder; ache, pain, discomfort; prevalence ...

  10. Prevalence of Work Related Musculoskeletal Disorders Among ...

    African Journals Online (AJOL)

    Journal Home > Vol 4, No 4 (2014) > ... Background: Work related musculoskeletal disorders (MSDs) are one of the common occupational ... of the doctor, duration of practice, working hours per week, physical activity and working environment.

  11. Risk factors for more severe regional musculoskeletal symptoms: a two-year prospective study of a general working population

    DEFF Research Database (Denmark)

    Andersen, JH; Haahr, J. P.; Frost, P.

    2007-01-01

    . Highly repetitive work predicted arm pain, heavy lifting and prolonged standing predicted low back pain, and heavy pushing or pulling predicted lower limb pain. Low job satisfaction predicted neck/shoulder pain and lower limb pain, whereas other psychosocial work place factors were only of marginal......OBJECTIVE: To quantify the relative contribution of work-related physical and psychosocial factors, individual factors, and health-related factors to the development of more severe musculoskeletal pain in the neck and upper limbs and the back and lower limbs. METHODS: In this cohort study of 5...

  12. Musculoskeletal disorders associated with HIV infection and AIDS. Part II: Non-infectious musculoskeletal conditions

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, Jamshid [Department of Radiological Sciences, University of California, Irvine, CA (United States); Department of Radiological Sciences, Orange, CA (United States); Ter-Oganesyan, Ramon R. [College of Medicine, University of California, Irvine, CA (United States); Steinbach, Lynne S. [Department of Radiological Sciences, University of California, San Francisco (United States)

    2004-06-01

    This section of a two-part series on musculoskeletal disorders associated with HIV infection and AIDS reviews the non-infectious musculoskeletal conditions. In the first part, the infectious conditions were reviewed. The non-infectious conditions include polymyositis, drug-induced myopathy, myositis ossificans, adhesive capsulitis, avascular necrosis, bone marrow abnormalities, and hypertrophic osteoarthropathy. Inflammatory and reactive arthropathies are more prevalent in HIV-positive individuals, and a separate section is dedicated to these conditions, including Reiter's syndrome, psoriatic arthritis, HIV-associated arthritis, painful articular syndrome, and acute symmetric polyarthritis. Lastly, we include a discussion of HIV-related neoplastic processes that affect the musculoskeletal system, namely Kaposi's sarcoma and non-Hodgkin's lymphoma. (orig.)

  13. THE PREVALENCE OF MUSCULOSKELETAL DISORDERS AMONG MADRASSA TEACHERS AND STUDENTS A CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Fazli Azim

    2016-02-01

    Full Text Available Introduction: Musculoskeletal Disorders (MSD are the disorders that have been developed due to disadvantageous work settings and work related issues. It may involve different regions of body like upper extremity, lower extremity, cervical, back regions etc. The onset of these problems need to be known where as it is a common belief that it is caused by overuse. Madrassa simply means the school does in the English language where students gathered to learn and acquire knowledge whether Muslim, non-Muslim, or secular. Usually teachers in madrassa adopted to sit in some positions in which musculoskeletal system is placed under load. The objective of the study is to determine “The Prevalence of Musculoskeletal Disorders among Madrassa Teachers.” Methods: It was a cross sectional study. 109 madrassa teachers participated in the study; the study was conducted in Karachi. Self-assessment questionnaire was use to collect data. Data was analyzed using SPSS version 20. Results: A total of 109 madrassa teachers taken part in this research study almost all participants were male. There were two types of madrassa teachers; one is full time teachers (73.4% and part time (26.6%. (58.7% madrassa teachers were suffering from discomfort during teaching and 41.3 didn’t feel any discomfort, coming to pain regions 37 said they had back pain (33.9%, 35 said they had shoulder pain (35%, 37 said they had knee pain (24.8% and four said they had heel pain (3.7%. Conclusion: The result showed that the madrassa teachers have high prevalence of Musculoskeletal Disorders. This comprises different regions of body like shoulder, back, knee and heel. This leads to the conclusion that these teachers are not at all aware of the consequences of MSD nor they are aware of the causes of these disorders. Also this was found that the facilities provided to these teachers were not up to the mark. When it comes to the working environment the technology of ergonomics has proved a lot

  14. Periodic Limb Movements During Sleep Mimicking REM Sleep Behavior Disorder: A New Form of Periodic Limb Movement Disorder.

    Science.gov (United States)

    Gaig, Carles; Iranzo, Alex; Pujol, Montserrat; Perez, Hernando; Santamaria, Joan

    2017-03-01

    To describe a group of patients referred because of abnormal sleep behaviors that were suggestive of rapid eye movement (REM) sleep behavior disorder (RBD) in whom video-polysomnography ruled out RBD and showed the reported behaviors associated with vigorous periodic limb movements during sleep (PLMS). Clinical history and video-polysomnography review of patients identified during routine visits in a sleep center. Patients were 15 men and 2 women with a median age of 66 (range: 48-77) years. Reported sleep behaviors were kicking (n = 17), punching (n = 16), gesticulating (n = 8), falling out of bed (n = 5), assaulting the bed partner (n = 2), talking (n = 15), and shouting (n = 10). Behaviors resulted in injuries in 3 bed partners and 1 patient. Twelve (70.6%) patients were not aware of displaying abnormal sleep behaviors that were only noticed by their bed partners. Ten (58.8%) patients recalled unpleasant dreams such as being attacked or chased. Video-polysomnography showed (1) frequent and vigorous stereotyped PLMS involving the lower limbs, upper limbs, and trunk (median PLMS index 61.2; median PLMS index in NREM sleep 61.9; during REM sleep only 8 patients had PLMS and their median PLMS index in REM sleep was 39.5); (2) abnormal behaviors (e.g., punching, groaning) during some of the arousals that immediately followed PLMS in NREM sleep; and (3) ruled out RBD and other sleep disorders such as obstructive sleep apnea. Dopaminergic agents were prescribed in 14 out of the 17 patients and resulted in improvement of abnormal sleep behaviors and unpleasant dreams in all of them. After dopaminergic treatment, follow-up video-polysomnography in 7 patients showed a decrease in the median PLMS index from baseline (108.9 vs. 19.2, p = .002) and absence of abnormal behaviors during the arousals. Abnormal sleep behaviors and unpleasant dreams simulating RBD symptomatology may occur in patients with severe PLMS. In these cases, video-polysomnography ruled out RBD and

  15. Importance of Upper-Limb Inertia in Calculating Concentric Bench Press Force

    OpenAIRE

    RAMBAUD, O; RAHMANI, A; MOYEN, B; BOURDIN, M

    2008-01-01

    The purpose of this study was to investigate the influence of upper-limb inertia on the force-velocity relationship and maximal power during concentric bench press exercise. Reference peak force values (Fpeakp) measured with a force plate positioned below the bench were compared to those measured simultaneously with a kinematic device fixed on the barbell by taking (Fpeakt) or not taking (Fpeakb) upper-limb inertia into account. Thirteen men (27.8 6 4.1 years, 184.6 6 5.5 cm, 99.5 6 18.6 kg) ...

  16. Lysosomal storage disorders: A review of the musculoskeletal features.

    Science.gov (United States)

    James, Rebecca A; Singh-Grewal, Davinder; Lee, Senq-J; McGill, Jim; Adib, Navid

    2016-03-01

    The lysosomal storage disorders are a collection of progressive, multisystem disorders that frequently present in childhood. Their timely diagnosis is paramount as they are becoming increasingly treatable. Musculoskeletal manifestations often occur early in the disease course, hence are useful as diagnostics clues. Non-inflammatory joint stiffness or pain, carpal tunnel syndrome, trigger fingers, unexplained pain crises and short stature should all prompt consideration of a lysosomal storage disorder. Recurrent ENT infections, hepatosplenomegaly, recurrent hernias and visual/hearing impairment - especially when clustered together - are important extra-skeletal features. As diagnostic and therapeutic options continue to evolve, children with lysosomal storage disorders and their families are facing more sophisticated options for screening and treatment. The aim of this article is to highlight the paediatric presentations of lysosomal storage disorders, with an emphasis on the musculoskeletal features. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  17. Psychosocial Factors and Work-related Musculoskeletal Disorders among Southeastern Asian Female Workers Living in Korea.

    Science.gov (United States)

    Lee, Hyeonkyeong; Ahn, Hyunmi; Park, Chang Gi; Kim, Sun Jung; Moon, Sun Hye

    2011-06-01

    A rapid increase in the population of migrant workers in Korea has brought new challenges regarding the possible effects of acculturation on health. The purpose of this study was to examine the influence of acculturation- and work-related psychosocial factors on work-related musculoskeletal disorders among migrant female workers living in Korea. A cross-sectional survey design was used. A translated, structured questionnaire was administrated to 156 southeastern Asian female full-time workers living in Korea. About 35% of the participants experienced some type(s) of work-related musculoskeletal disorder(s), which were more prevalent in Vietnamese women than in Thai and Filipino women. Women who preferred to maintain their own heritage and to reject the host country heritage were at risk for work-related musculoskeletal disorders. Acculturation strategy and nationality were found to be significant factors associated with work-related musculoskeletal disorders. Health professionals need to accommodate acculturation contexts into risk assessment and intervention development for work-related musculoskeletal disorders separately for different nationalities.

  18. Musculoskeletal pain in obese adolescents.

    Science.gov (United States)

    Jannini, Suely Nóbrega; Dória-Filho, Ulysses; Damiani, Durval; Silva, Clovis Artur Almeida

    2011-01-01

    To determine the prevalence of pain, musculoskeletal syndromes, orthopedic disorders and using computers and playing videogames among obese adolescents. This was a cross-sectional study that investigated 100 consecutive obese adolescents and 100 healthy-weight controls using a confidential, self-report questionnaire covering demographic data, sports participation, painful musculoskeletal system symptoms and using computers and playing videogames. The questionnaire's test-retest reliability was tested. Physical examination covered six musculoskeletal syndromes and seven orthopedic disorders. The kappa index for test-retest was 0.724. Pain and musculoskeletal syndromes were equally prevalent in both groups (44 vs. 56%, p = 0.09; 12 vs. 16%, p = 0.541; respectively). Notwithstanding, orthopedic disorders (98 vs. 76%, p = 0.0001), tight quadriceps (89 vs. 44%, p = 0.0001) and genu valgum (87 vs. 24%, p = 0.0001) were significantly more prevalent in obese adolescents than in controls. Median time spent using a computer the day before, on Saturdays and on Sundays were all lower among the obese subjects (30 vs. 60 minutes, p = 0.0001; 1 vs. 60 minutes, p = 0.001; and 0 vs. 30 minutes, p = 0.02; respectively). Obese adolescents were less likely to play handheld videogames (2 vs. 11%, p = 0.003) and there was no difference in the two groups' use of full-sized videogames (p > 0.05). Comparing obese adolescents with pain to those free from pain revealed that pain was more frequent among females (59 vs. 39%, p = 0.048) and was associated with greater median time spent playing on Sundays [0 (0-720) vs. 0 (0-240) minutes, p = 0.028]. Obesity can cause osteoarticular system damage at the start of adolescence, particularly to the lower limbs. Programs developed specifically for obese female adolescents with musculoskeletal pain are needed.

  19. Tracking upper limbs fatigue by means of electronic dynamometry

    Directory of Open Access Journals (Sweden)

    Fernando Max Lima

    2015-06-01

    Full Text Available This study aimed to identify useful electronic grip dynamometry parameters to track differences between trained (TR and untrained (UT participants, and between dominant (DO and non-dominant (ND limbs as a consequence of upper limbs muscle fatigue following 10 RM tests of the brachial biceps. This experimental study with transversal design involved 18 young adult males, of whom 9 were untrained and 9 were experienced in resistance training.Isometric grip force was evaluated (30 seconds long previous and after 10RM tests by means of a G200 Model grip dynamometer with precision load cell (Biometrics(r. Significant differences between initial and final measurements were found only for trained participants: Peak force for TR-DO (67.1 vs 55.5 kgf, p = .0277; Raw average for TR-DO (46.96 vs 42.22 kgf, p = .0464, and for TR-ND (40.34 vs 36.13 kgf, p = .0277. Electronic grip dynamometry efficiently identified upper limbs fatigue in trained participants, being raw average measurements the best parameter.

  20. An Interpreter's Interpretation: Sign Language Interpreters' View of Musculoskeletal Disorders

    National Research Council Canada - National Science Library

    Johnson, William L

    2003-01-01

    Sign language interpreters are at increased risk for musculoskeletal disorders. This study used content analysis to obtain detailed information about these disorders from the interpreters' point of view...

  1. Management of essential hyperhidrosis of upper limbs by ...

    African Journals Online (AJOL)

    Introduction: Essential hyperhidrosis is an idiopathic condition characterized by markedly excessive sweating especially in the hands. Objective: This study was done to evaluate the functional results of radiofrequency thermocoagulation of T2 ganglion in 10 patients suffered from essential hyperhidrosis of both upper limbs.

  2. On the use of information theory for detecting upper limb motor dysfunction: An application to Parkinson’s disease

    Science.gov (United States)

    de Oliveira, M. Elias; Menegaldo, L. L.; Lucarelli, P.; Andrade, B. L. B.; Büchler, P.

    2011-11-01

    Parkinson’s disease (PD) is a chronic neurodegenerative disorder characterized by a selective loss of dopaminergic neurons in the substantia nigra, decreased striatal dopamine levels, and consequent extrapyramidal motor dysfunctions. Several potential early diagnostic markers of PD have been proposed. Since they have not been validated in presymptomatic PD, the diagnosis and monitoring of the disease is based on subjective clinical assessment of cognitive and motor symptoms. In this study, we investigated interjoint coordination synergies in the upper limb of healthy and parkinsonian subjects during the performance of unconstrained linear-periodic movements in a horizontal plane using the mutual information (MI). We found that the MI is a sensitive metric in detecting upper limb motor dysfunction, thus suggesting that this method might be applicable to quantitatively evaluating the effects of the antiparkinsonian medication and to monitor the disease progression.

  3. Upper And Lower Limbs Disability And Personality Traits.

    Science.gov (United States)

    Jabeen, Tahira; Kazmi, Syeda Farhana; Rehman, Atiq Ur; Ahmed, Sajjad

    2016-01-01

    It is believed that the study of personality has the potentials to enhance our prognostic abilities and can better to expose the etiology of mental illness through the relationship of revealed mechanisms. The focus of this study was to investigate and compare the habitual patterns of behavior, thought and emotions of upper and lower limb physically disabled students in terms of personality traits. This cross sectional study consisted of 100 upper limbs and lower limbs disabled students taken from Kingston school Inclusive Education System Abottabad, Mashal special education system Haripur, Syed Ahmed Shaheed special education center Abottabad, Al-Munir Foundation Mansehra and Hera Special Education System Haripur and 100 normal students taken from Islamic International School Abottabad, Falcon Public School Haripur, Iqra Academy Mansehra and Alhamd International School Haripur of Hazara Division by purposive sampling technique. This study was conducted during the month of June 2013 to May 2014. Goldberg five big personality scale was used for measuring personality traits of physically disabled and normal students. The significant difference of personality traits scores between physically disabled students (M = 139.2, SD=12.0) and normal students (M=184.5, SD=13.2), t (198) =25.3, ptraits, i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability and Openness to Experience.

  4. Usability of the Upper Limb Risk Assessment (UPLIRA Method for Assessing the Risk Factors of Upper Limb Disorders

    Directory of Open Access Journals (Sweden)

    Abd Razak Noor Syafiqa

    2017-01-01

    Full Text Available It is important to design ergonomic methods or assessment with a high usability and good ergonomic features, so the method is easily adaptable to the task and the workplace environment. Usability is a measurement on how well the user can use that functionality. The study converged on testing the usability of the new tools for assessing ULDs namely as Upper Limb Risk Assessment (UPLIRA. The UPLIRA method was evaluated by 6 students (3 undergraduate students and 3 postgraduates students from University Tun Hussein Onn Malaysia (UTHM who are conducting research in ergonomic. From the feedback survey of UPLIRA method, the observers agree that the prototype of UPLIRA tool was applicable to workplace assessment for the wide range of jobs/task (mean 4.00, SD:0.632 with 83% percentage of agreement . They also indicate that UPLIRA method is quick to use (mean 3.67, SD:1.033 with percentage agreement of 67%. The scoring system and action level was rated as easy to understand (mean 3.67, SD:1.211 and (mean 4.17, SD:0.408. Conclusively, the UPLIRA method was rated as straightforward to use, applicable to wide range of tasks, and time saving as assessment can be completed within 10 minutes. In addition, the UPLIRA assessment covers an extensive range of physical, psychosocial, work organizational, and individual risk factors.

  5. Exercise Prescriptions to Prevent Musculoskeletal Disorders in Dentists

    Science.gov (United States)

    Kumar, Dodda Kiran; Mohan, Sreevalli; Begum, Mohammadi; Prasad, Bhanu; Prasad, Eswar Ravi Vara

    2014-01-01

    Since the number of dental patients is increasing day by day dentists are forced to spend longer times in dental chairs. This is increasing the prevalence of musculoskeletal disorders in dentists. This article reviews the mechanisms causing musculoskeletal disorders among dentists and also covers the exercises that can be done to prevent them. Exercises that increase the fitness of a dentist are divided into aerobic exercises – concentrating on total body fitness, stretching exercises – that concentrate on the muscles that tend to tighten in prolonged dental postures and strengthening exercises – that concentrate on the muscles that are opposite to the tight muscles. These exercises are made simple and of minimal intensity so that a dentist can practice them independently. PMID:25177661

  6. Detecting elementary arm movements by tracking upper limb joint angles with MARG sensors

    OpenAIRE

    Mazomenos, Evangelos B.; Biswas, Dwaipayan; Cranny, Andy; Rajan, Amal; Maharatna, Koushik; Achner, Josy; Klemke, Jasmin; Jobges, Michael; Ortmann, Steffen; Langendorfer, Peter

    2015-01-01

    This paper reports an algorithm for the detection of three elementary upper limb movements, i.e., reach and retrieve, bend the arm at the elbow and rotation of the arm about the long axis. We employ two MARG sensors, attached at the elbow and wrist, from which the kinematic properties (joint angles, position) of the upper arm and forearm are calculated through data fusion using a quaternion-based gradient-descent method and a two-link model of the upper limb. By studying the kinematic pattern...

  7. Evaluation of bone microstructure in CRPS-affected upper limbs by HR-pQCT.

    Science.gov (United States)

    Mussawy, Haider; Schmidt, Tobias; Rolvien, Tim; Rüther, Wolfgang; Amling, Michael

    2017-01-01

    Complex regional pain syndrome (CRPS) is a major complication after trauma, surgery, and/or immobilization of an extremity. The disease often starts with clinical signs of local inflammation and develops into a prolonged phase that is characterized by trophic changes and local osteoporosis and sometimes results in functional impairment of the affected limb. While the pathophysiology of CRPS remains poorly understood, increased local bone resorption plays an undisputed pivotal role. The aim of this retrospective clinical study was to assess the bone microstructure in patients with CRPS. Patients with CRPS type I of the upper limb whose affected and unaffected distal radii were analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) were identified retrospectively. The osteology laboratory data and dual-energy X-ray absorptiometry (DXA) images of the left femoral neck and lumbar spine, which were obtained on the same day as HR-pQCT, were extracted from the medical records. Five patients were identified. The CRPS-affected upper limbs had significantly lower trabecular numbers and higher trabecular thicknesses than the unaffected upper limbs. However, the trabecular bone volume to total bone volume and cortical thickness values of the affected and unaffected sides were similar. Trabecular thickness tended to increase with time since disease diagnosis. CRPS associated with significant alterations in the bone microstructure of the affected upper limb that may amplify as the duration of disease increases.

  8. Upper-limb sensory impairments after stroke: Self-reported experiences of daily life and rehabilitation

    Directory of Open Access Journals (Sweden)

    Håkan Carlsson

    2017-10-01

    Full Text Available Objective: To describe stroke survivors’ experiences of sensory impairment in the upper limb, the influence of such impairment on daily life, coping strategies used, and sensory training for the affected hand. Design: A qualitative study with a content analysis approach. Subjects: Fifteen post-stroke patients interviewed individually. Results: Five categories emerged from the data: “Changed and varied perception of the sensation”; “Affected movement control”; “Problems using the hand in daily life”; “Various strategies to cope with upper limb disability”; and “Lack of sensory training”. Numbness and tingling, changes in temperature sensitivity, and increased sensitivity to touch and pain were reported. Many subjects had difficulty adjusting their grip force and performing movements with precision. It was problematic and mentally fatiguing managing personal care and carrying out household and leisure activities. Practical adaptations, compensation with vision, increased concentration, and use of the less affected hand were strategies used to overcome difficulties. Despite their problems very few subjects had received any specific sensory training for the hand. Conclusion: Stroke survivors perceive that sensory impairment of the upper limb has a highly negative impact on daily life, but specific rehabilitation for the upper limb is lacking. These findings imply that the clinical management of upper limb sensory impairment after stroke requires more attention.

  9. Upper Limb-Hand 3D Display System for Biomimetic Myoelectric Hand Simulator

    National Research Council Canada - National Science Library

    Jimenez, Gonzalo

    2001-01-01

    A graphics system displaying both upper limb posture and opening-closing of a prosthetic hand was developed for realtime operation of our biomimetic myoelectric hand simulator, Posture of the upper...

  10. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    Science.gov (United States)

    Magee, David

    2012-01-01

    ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. Results A strong relationship between neck disability and jaw disability was found (r = 0.82). Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD) and healthy subjects. However, the difference was too small (3.3º) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07). However, clinically important effect sizes (0.42 - 0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders. PMID:24422022

  11. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Susan Armijo-Olivo

    2012-09-01

    Full Text Available Objectives: The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods: A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance to determine cervical musculoskeletal impairments. Results: A strong relationship between neck disability and jaw disability was found (r = 0.82. Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD and healthy subjects. However, the difference was too small (3.3º to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07. However, clinically important effect sizes (0.42 - 0.82 were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions: Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders.

  12. Upper limb therapy in children with cerebral palsy (CP – The Pirate Group

    Directory of Open Access Journals (Sweden)

    Pawlak Marta

    2017-12-01

    Full Text Available Introduction: Children with cerebral palsy (CP in the form of spastic hemiplegia experience numerous difficulties concerning an affected upper limb such as reaching for objects, gripping or manipulating them. These limitations affect their everyday activity. Conducting an effective and simultaneously an interesting therapy aimed at meeting the child’s individual needs and improving upper limb function is a challenge for a physiotherapist. The aim of the study was to assess the effectiveness of upper limb therapy carried out within the project titled “The Pirate Group” based on Constraint-Induced Movement Therapy (CIMT and Bimanual Training (BIT conducted in a specially arranged environment. Material and methods: The research included 16 children with CP in the form of spastic hemiplegia. Mean age of the study participants was 4.23 years. The children underwent a two-week Constraint-Induced Movement Therapy (CIMT combined with Bimanual Training (BIT. In order to evaluate the effects of the therapy, each child underwent the Assisting Hand Assessment (AHA prior to the therapy and after its completion. Results: Statistical analysis revealed a significant difference (p<0.05 between the results of AHA prior to and after the therapy (t(14=9.12, p<0.0001. An improvement in the affected upper limb function was noted in all the children participating in the research. Conclusions: The project titled “The Pirate Group”, based on CIMT and BIT is an effective therapeutic intervention which improves spontaneous activity of the affected upper limb in children with hemiplegia.

  13. A 3D musculoskeletal model of the western lowland gorilla hind limb: moment arms and torque of the hip, knee and ankle

    OpenAIRE

    Goh, Colleen; Blanchard, Mary L.; Crompton, Robin H.; Gunther, Michael M.; Macaulay, Sophie; Bates, Karl T.

    2017-01-01

    Abstract Three?dimensional musculoskeletal models have become increasingly common for investigating muscle moment arms in studies of vertebrate locomotion. In this study we present the first musculoskeletal model of a western lowland gorilla hind limb. Moment arms of individual muscles around the hip, knee and ankle were compared with previously published data derived from the experimental tendon travel method. Considerable differences were found which we attribute to the different methodolog...

  14. Vertex epidural haematoma manifesting with bilateral upper limb ...

    African Journals Online (AJOL)

    Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and ...

  15. 3D-printed upper limb prostheses : a review

    NARCIS (Netherlands)

    ten Kate, J; Smit, G.; Breedveld, P.

    2017-01-01

    Goal: This paper aims to provide an overview with quantitative information of existing 3D-printed upper limb prostheses. We will identify the benefits and drawbacks of 3D-printed devices to enable improvement of current devices based on the demands of prostheses users. Methods: A review was

  16. Commercial gaming devices for stroke upper limb rehabilitation: a systematic review.

    Science.gov (United States)

    Thomson, Katie; Pollock, Alex; Bugge, Carol; Brady, Marian

    2014-06-01

    Rehabilitation using commercial gaming devices is a new concept for stroke care. Commercial gaming devices such as Nintendo Wii or Sony PlayStation encourage high repetition of arm movements and are being introduced into some clinical settings. The evidence base for gaming use in rehabilitation is growing rapidly and there is a need to systematically synthesise research. Our review aims to integrate evidence on how gaming is being used, explore patient/therapist experience and synthesise evidence of effectiveness. An integrative systematic review was undertaken searching Cochrane Central Register of Controlled Trials (2013), Medline (2013), Embase (2013) and twelve additional databases. Two review authors independently selected studies based on pre-defined inclusion criteria, extracted data and assessed risk of bias. Nineteen studies including 215 patients met inclusion criteria. Studies were typically small scale feasibility studies using a range of research designs, limiting the ability to reach generalised conclusions. Results have been tabulated (activities of daily living, upper limb function/ movement) and qualitative themes identified. Findings suggest that most patients enjoy using commercial gaming and can tolerate 180 mins per week without significant adverse effects. A trend towards improvement was noted for upper limb function/ movement. Few studies recorded outcomes related to activities of daily living or focused on understanding patients' experiences of this intervention. Commercial gaming can provide high intensity upper limb practice however there is insufficient high quality evidence to reach generalisable conclusions about risks or benefits on activities of daily living or upper limb function/movement. © 2014 The Authors. International Journal of Stroke © 2014 World Stroke Organization.

  17. Ethical considerations in providing an upper limb exoskeleton device for stroke patients.

    Science.gov (United States)

    Bulboacă, Adriana E; Bolboacă, Sorana D; Bulboacă, Angelo C

    2017-04-01

    The health care system needs to face new and advanced medical technologies that can improve the patients' quality of life by replacing lost or decreased functions. In stroke patients, the disabilities that follow cerebral lesions may impair the mandatory daily activities of an independent life. These activities are dependent mostly on the patient's upper limb function so that they can carry out most of the common activities associated with a normal life. Therefore, an upper limb exoskeleton device for stroke patients can contribute a real improvement of quality of their life. The ethical problems that need to be considered are linked to the correct adjustment of the upper limb skills in order to satisfy the patient's expectations, but within physiological limits. The debate regarding the medical devices dedicated to neurorehabilitation is focused on their ability to be beneficial to the patient's life, keeping away damages, injustice, and risks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. An objective assessment of safety to drive in an upper limb cast.

    Science.gov (United States)

    Stevenson, H L; Peterson, N; Talbot, C; Dalal, S; Watts, A C; Trail, I A

    2013-03-01

    Patients managed with upper limb cast immobilization often seek advice about driving. There is very little published data to assist in decision making, and advice given varies between healthcare professionals. There are no specific guidelines available from the UK Drivers and Vehicles Licensing Agency, police, or insurance companies. Evidence-based guidelines would enable clinicians to standardize the advice given to patients. Six individuals (three male, three female; mean age 36 years, range 27-43 years) were assessed by a mobility occupational therapist and driving standards agency examiner while completing a formal driving test in six different types of upper limb casts (above-elbow, below-elbow neutral, and below-elbow cast incorporating the thumb [Bennett's cast]) on both left and right sides. Of the 36 tests, participants passed 31 tests, suggesting that most people were able to safely drive with upper limb cast immobilization. However, driving in a left above-elbow cast was considered unsafe.

  19. Investigation on the relationship between mental workload and musculoskeletal disorders among nursing staff

    Directory of Open Access Journals (Sweden)

    Yousef Mahmoudifar

    2018-01-01

    Full Text Available Aims: High prevalence of musculoskeletal disorders owing to the work is one of the popular discomforts between nursing staff. High level of workload is considered as a serious problem and identified as a stressor in the nursing. This study intends to recognize the relationship between musculoskeletal disorders and mental workload in nursing personnel reside at southern part of West Azerbaijan province Iran in 2017. Materials and Methods: In this analytical-descriptive study, 100 nurses working in West Azerbaijan hospitals have been randomly selected. Nordic and National Aeronautics and Space Administration-Task Load Index workload questionnaires have been simultaneously utilized as data collection tools. Data analysis has also carried out using SPSS, variance analysis tests, multiple linear regression, and Pearson's correlation coefficient. Results: Results suggest that the most frequent complaints of musculoskeletal problems are associated to the back area. Investigation on sextet scales of mental workload indicates that each of the six scales of workload was at the high-risk level and the average of total workload was 72.45 ± 19.45 which confirms a high-risk level. Pearson's correlation coefficient also indicates mental workload elements have a significant relationship with musculoskeletal disorders (P < 0.05. Conclusion: The results suggest there is a relationship between musculoskeletal disorders and mental workload and the majority of personnel had mental workload with high-risk level. The best way of management planning to mitigate the risk of musculoskeletal disorders arising of mental workload is, therefore, managing-controlling approach such as staff training, job rotation, and time management.

  20. Computer assisted surgery for malunited fractures in upper limb

    International Nuclear Information System (INIS)

    Yoneda, Masahiro; Kazuki, Kenichi; Uemura, Takuya; Okada, Mitsuhiro; Takaoka, Kunio

    2006-01-01

    Our objective was to evaluate the usefulness of computer-assisted preoperative simulation of malunited fractures in the upper limb. Ten patients with malunited fractures underwent multislice computed tomography of both upper limbs with reconstruction of three-dimensional bone models using three-dimensional (3D) software. Preoperative simulation was comprised of four main procedures: performance of virtual corrective osteotomy, matching of reposition with a mirror-image model of the unaffected side, creating new data for the bone defect, and machining of an hydroxyapatite block as bone graft. In addition, we used full-sized three-dimensional virtual reality modeling with a rapid prototyping molding device, and performed preoperative rehearsals of osteotomies using plaster models. All patients tolerated the surgical procedure well. This technique permits the surgeon to recognize and correct three-dimensional deformities of malunited fracture with both accuracy and precision. (author)

  1. Upper and Lower Limbs Disability and Personality Traits

    International Nuclear Information System (INIS)

    Jabeen, T.; Kazmi, S. F.; Rehman, A. U.; Ahmed, S.

    2016-01-01

    Background: It is believed that the study of personality has the potentials to enhance our prognostic abilities and can better to expose the etiology of mental illness through the relationship of revealed mechanisms. The focus of this study was to investigate and compare the habitual patterns of behavior, thought and emotions of upper and lower limb physically disabled students in terms of personality traits. Methods: This cross sectional study consisted of 100 upper limbs and lower limbs disabled students taken from Kingston school Inclusive Education System Abottabad, Mashal special education system Haripur, Syed Ahmed Shaheed special education center Abottabad, Al-Munir Foundation Mansehra and Hera Special Education System Haripur and 100 normal students taken from Islamic International School Abottabad, Falcon Public School Haripur, Iqra Academy Mansehra and Alhamd International School Haripur of Hazara Division by purposive sampling technique. This study was conducted during the month of June 2013 to May 2014. Goldberg five big personality scale was used for measuring personality traits of physically disabled and normal students. Results: The significant difference of personality traits scores between physically disabled students (M = 139.2, SD=12.0) and normal students (M=184.5, SD=13.2), t (198) =25.3, p<.05 was observed. Conclusion: Normal students have high scores as compared to physically disabled students on big five traits, i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability and Openness to Experience. (author)

  2. Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders.

    Science.gov (United States)

    Pelletier, René; Higgins, Johanne; Bourbonnais, Daniel

    2015-11-01

    Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear not only to be a consequence of peripheral structural injury but also to play a part in the pathophysiology of chronic musculoskeletal disorders. Neurophysiological changes are consistent with a biopsychosocial formulation reflecting the underlying mechanisms associated with sensory and motor findings, psychological traits, and perceptual changes associated with chronic musculoskeletal conditions. These changes, therefore, have important implications in the clinical manifestation, pathophysiology, and treatment of chronic musculoskeletal disorders. Musculoskeletal rehabilitation professionals have at their disposal tools to address these neuroplastic changes, including top-down cognitive-based interventions (eg, education, cognitive-behavioral therapy, mindfulness meditation, motor imagery) and bottom-up physical interventions (eg, motor learning, peripheral sensory stimulation, manual therapy) that induce neuroplastic changes across distributed areas of the nervous system and affect outcomes in patients with chronic musculoskeletal disorders. Furthermore, novel approaches such as the use of transcranial direct current stimulation and repetitive transcranial magnetic stimulation may be utilized to help renormalize neurological function. Comprehensive treatment addressing peripheral structural injury as well as neurophysiological changes occurring across

  3. Diffusion-weighted and diffusion tensor imaging for pediatric musculoskeletal disorders

    International Nuclear Information System (INIS)

    MacKenzie, John D.; Gonzalez, Leonardo; Hernandez, Andrea; Ruppert, Kai; Jaramillo, Diego

    2007-01-01

    Diffusion-weighted imaging (DWI) is a powerful tool that has recently been applied to evaluate several pediatric musculoskeletal disorders. DWI probes abnormalities of tissue structure by detecting microscopic changes in water mobility that develop when disease alters the organization of normal tissue. DWI provides tissue characterization at a cellular level beyond what is available with other imaging techniques, and can sometimes identify pathology before gross anatomic alterations manifest. These features of early detection and tissue characterization make DWI particularly appealing for probing diseases that affect the musculoskeletal system. This article focuses on the current and future applications of DWI in the musculoskeletal system, with particular attention paid to pediatric disorders. Although most of the applications are experimental, we have emphasized the current state of knowledge and the main research questions that need to be investigated. (orig.)

  4. Limb salvage with microvascular free fibula following primary bone sarcoma resection

    Directory of Open Access Journals (Sweden)

    Sahasrabudhe Parag

    2016-01-01

    Full Text Available Background: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. Materials and Methods: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015. Results: Of the ten cases in the study, there were two females and eight males. There were nine patients with lower limb malignancies and one patient with upper limb malignancy. There were four patients with Ewing's sarcoma of femur, five patients with osteosarcoma of femur and one patient with chondrosarcoma of the humerus. The follow-up period ranged from 1.2 to 6.2 years with mean follow-up of 3.1 years. There were two deaths during follow-up, both were due to distant metastasis. The assessment of the function was done on the basis of Musculoskeletal Tumour Society functional score. Maximum score was 30 and minimum score was 24, the average score being 26. Of the eight surviving patients, three patients had full weightbearing, four patients had partial weightbearing at end of 2 years and one patient of upper limb reconstruction had complete upper limb function. None of the patients had to undergo limb amputation. Conclusion: Limb salvage with vascularised fibula graft offers good functional outcome along with good disease-free survival rates.

  5. CLINICAL REABILITATION OF UPPER LIMB IN CHRONIC STROKE IN PORTUGAL A CROSS SECTIONAL SURVEY

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    Andre Vieira

    2016-02-01

    Full Text Available Background: More than 77% of stroke survivors have upper limb dysfunction. The scientific evidence for interventions in upper limb rehabilitation in stroke has shown variable results. To improve health care treatments in this domain it is needed to know what modalities are actually being used by physiotherapists. Methods: A national web-based survey focused in characterizing the profile of Portuguese physiotherapists working in post-stroke upper limb rehabilitation was conducted in 237 health institutions (n= 462 physiotherapists. The recruitment was conducted from August to December 2014. Analytic and descriptive analysis were used. Results: A total of 179 physiotherapists from 64 different locations from Portugal answered the survey, with a rate of response of 38.7%. The average age of respondents was 29.25±6.4 years old and predominantly finished the graduation or bachelor degree between 2001 and 2010. More than half hadn´t carried out any specialization in neurologic rehabilitation area. The top 5 modalities most used in the rehabilitation of upper limb in acute stroke are Goal Oriented Tasks (93.4% n=141, Motor Learning (89.4% n=135, Passive Mobilization (88.7% n=134, Task Repetition (87.4% n=132 and Bobath/Neurodevelopmental Therapy (86.9% n=131. Conclusions: The main modalities used for physiotherapists in upper limb rehabilitation in acute stroke have sparse levels of evidence. It is important to alert teachers, formers, physiotherapists and students for interventions with supported scientific results.

  6. Upper Limb Immobilisation: A Neural Plasticity Model with Relevance to Poststroke Motor Rehabilitation

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    Leonardo Furlan

    2016-01-01

    Full Text Available Advances in our understanding of the neural plasticity that occurs after hemiparetic stroke have contributed to the formulation of theories of poststroke motor recovery. These theories, in turn, have underpinned contemporary motor rehabilitation strategies for treating motor deficits after stroke, such as upper limb hemiparesis. However, a relative drawback has been that, in general, these strategies are most compatible with the recovery profiles of relatively high-functioning stroke survivors and therefore do not easily translate into benefit to those individuals sustaining low-functioning upper limb hemiparesis, who otherwise have poorer residual function. For these individuals, alternative motor rehabilitation strategies are currently needed. In this paper, we will review upper limb immobilisation studies that have been conducted with healthy adult humans and animals. Then, we will discuss how the findings from these studies could inspire the creation of a neural plasticity model that is likely to be of particular relevance to the context of motor rehabilitation after stroke. For instance, as will be elaborated, such model could contribute to the development of alternative motor rehabilitation strategies for treating poststroke upper limb hemiparesis. The implications of the findings from those immobilisation studies for contemporary motor rehabilitation strategies will also be discussed and perspectives for future research in this arena will be provided as well.

  7. Frequency upper limbs injuries in the emergency health service in Paranaiba, MS, Brazil

    Directory of Open Access Journals (Sweden)

    Eliane Cristina Coelho de Oliveira Correia

    2012-09-01

    Full Text Available To assess the frequency of upper limb injuries in the only emergency medical service inParanaiba, State of Mato Grosso do Sul. Methods: Retrospective study with data collection from medical recordsof patients assisted with upper limb injuries in “Santa Casa de Misericordia” Hospital, the only hospital in the cityto provide emergency care, in 2008. Variables of interest such as gender and type of injury were collected basedon the International Code of Diseases (ICD 10. Results: There were 314 cases of upper limb injury in 2008and men were the most affected with 211 cases (67.2%. The wrist was the most affected segment with 64 cases(20.4%, followed by the shoulder with 55 cases (17.5% and the hand with 50 cases (15.9%. Interventions andsurgeries involving bone portion were the most frequent - 225 (71.7%, followed by tendon - 19 (6.1% and neural - 16 (5.1%; 35 patients (11.1% underwent multiple operations. Osteosyntheses - 94 (29.9%, fractures- 48 (15.3%, and reduction - 46 (14.6% were the most frequent interventions, followed by 26 dislocations(8.3% and 14 tenorrhaphies (4.5%. Conclusion: The involvement of the upper limbs, especially bone lesions,is frequent. The segments most affected by injuries are men’s wrists and shoulders.

  8. Validation of lumbar spine loading from a musculoskeletal model including the lower limbs and lumbar spine.

    Science.gov (United States)

    Actis, Jason A; Honegger, Jasmin D; Gates, Deanna H; Petrella, Anthony J; Nolasco, Luis A; Silverman, Anne K

    2018-02-08

    Low back mechanics are important to quantify to study injury, pain and disability. As in vivo forces are difficult to measure directly, modeling approaches are commonly used to estimate these forces. Validation of model estimates is critical to gain confidence in modeling results across populations of interest, such as people with lower-limb amputation. Motion capture, ground reaction force and electromyographic data were collected from ten participants without an amputation (five male/five female) and five participants with a unilateral transtibial amputation (four male/one female) during trunk-pelvis range of motion trials in flexion/extension, lateral bending and axial rotation. A musculoskeletal model with a detailed lumbar spine and the legs including 294 muscles was used to predict L4-L5 loading and muscle activations using static optimization. Model estimates of L4-L5 intervertebral joint loading were compared to measured intradiscal pressures from the literature and muscle activations were compared to electromyographic signals. Model loading estimates were only significantly different from experimental measurements during trunk extension for males without an amputation and for people with an amputation, which may suggest a greater portion of L4-L5 axial load transfer through the facet joints, as facet loads are not captured by intradiscal pressure transducers. Pressure estimates between the model and previous work were not significantly different for flexion, lateral bending or axial rotation. Timing of model-estimated muscle activations compared well with electromyographic activity of the lumbar paraspinals and upper erector spinae. Validated estimates of low back loading can increase the applicability of musculoskeletal models to clinical diagnosis and treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The occurrence of dystonia in upper-limb multiple sclerosis tremor.

    Science.gov (United States)

    Van der Walt, A; Buzzard, K; Sung, S; Spelman, T; Kolbe, S C; Marriott, M; Butzkueven, H; Evans, A

    2015-12-01

    The pathophysiology of multiple sclerosis (MS) tremor is uncertain with limited phenotypical studies available. To investigate whether dystonia contributes to MS tremor and its severity. MS patients (n = 54) with and without disabling uni- or bilateral upper limb tremor were recruited (39 limbs per group). We rated tremor severity, writing and Archimedes spiral drawing; cerebellar dysfunction (SARA score); the Global Dystonia Scale (GDS) for proximal and distal upper limbs, dystonic posturing, mirror movements, geste antagoniste, and writer's cramp. Geste antagoniste, mirror dystonia, and dystonic posturing were more frequent and severe (p tremor severity in tremor compared to non-tremor patients. A 1-unit increase in distal dystonia predicted a 0.52-Bain unit (95% confidence interval (CI) 0.08-0.97), p = 0.022) increase in tremor severity and a 1-unit (95% CI 0.48-1.6, p = 0.001) increase in drawing scores. A 1-unit increase in proximal dystonia predicted 0.93-Bain unit increase (95% CI 0.45-1.41, p tremor severity and 1.5-units (95% CI 0.62-2.41, p = 0.002) increase in the drawing score. Cerebellar function in the tremor limb and tremor severity was correlated (p tremor suggesting that MS tremor pathophysiology involves cerebello-pallido-thalamo-cortical network dysfunction. © The Author(s), 2015.

  10. Danish Observational Study of Eldercare work and musculoskeletal disorderS (DOSES)

    DEFF Research Database (Denmark)

    Karstad, Kristina; Jørgensen, Anette F B; Greiner, Birgit A

    2018-01-01

    PURPOSE: Musculoskeletal disorders (MSDs), sickness absence and premature retirement are highly prevalent among eldercare workers. We conducted a prospective observational workplace study with the main purpose to investigate longitudinal associations between physical and psychosocial working cond...... and team factors for distribution of physical work demands and development of MSD among the workers. This will provide important knowledge for future workplace interventions to reduce MSD and sickness absence.......PURPOSE: Musculoskeletal disorders (MSDs), sickness absence and premature retirement are highly prevalent among eldercare workers. We conducted a prospective observational workplace study with the main purpose to investigate longitudinal associations between physical and psychosocial working...... conditions and occurrence of MSD and its consequences (pain-related interference with daily work activities and sickness absence) among Danish eldercare workers. PARTICIPANTS: At 20 Danish nursing homes, a total of 941 eldercare workers employed in day and evening shifts were invited to the study. Of those...

  11. Safety Supervisory Strategy for an Upper-Limb Rehabilitation Robot Based on Impedance Control

    Directory of Open Access Journals (Sweden)

    Lizheng Pan

    2013-02-01

    Full Text Available User security is an important consideration for robots that interact with humans, especially for upper-limb rehabilitation robots, during the use of which stroke patients are often more susceptible to injury. In this paper, a novel safety supervisory control method incorporating fuzzy logic is proposed so as to guarantee the impaired limb's safety should an emergency situation occur and the robustness of the upper-limb rehabilitation robot control system. Firstly, a safety supervisory fuzzy controller (SSFC was designed based on the impaired-limb's real-time physical state by extracting and recognizing the impaired-limb's tracking movement features. Then, the proposed SSFC was used to automatically regulate the desired force either to account for reasonable disturbance resulting from pose or position changes or to respond in adequate time to an emergency based on an evaluation of the impaired-limb's physical condition. Finally, a position-based impedance controller was implemented to achieve compliance between the robotic end-effector and the impaired limb during the robot-assisted rehabilitation training. The experimental results show the effectiveness and potential of the proposed method for achieving safety and robustness for the rehabilitation robot.

  12. Associations between biopsychosocial factors and chronic upper limb pain among slaughterhouse workers

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus D; Brandt, Mikkel

    2016-01-01

    of slaughterhouse work (all p > 0.4). CONCLUSIONS: Chronic upper limb pain was paralleled by reduced neuromuscular function of the shoulder and hand along with impaired work ability, work disability and general health. Future studies on chronic pain management at the workplace should carefully consider....... METHODS: Eighty-two male slaughterhouse workers, 49 with chronic upper limb pain and 33 pain-free controls participated in the study. Maximal muscle strength, RFD, and muscle activity was determined from fast and forceful maximal voluntary contractions for the shoulder and hand. Participants filled out...

  13. Sports participation of individuals with major upper limb deficiency

    NARCIS (Netherlands)

    Bragaru, Mihai; Dekker, Rienk; Dijkstra, Pieter U.; Geertzen, Jan H. B.; van der Sluis, Corry K.

    BACKGROUND: The aim of this study was to analyse sports participation of individuals with upper limb deficiency (ULD) and associated factors. METHODS: Individuals with ULD originating from the Netherlands were invited, via their attending physiatrist or prosthetist, to answer a digital or paper

  14. Planar covariance of upper and lower limb elevation angles during hand-foot crawling in healthy young adults.

    Science.gov (United States)

    MacLellan, M J; Catavitello, G; Ivanenko, Y P; Lacquaniti, F

    2017-11-01

    Habitual quadrupeds have been shown to display a planar covariance of segment elevation angle waveforms in the fore and hind limbs during many forms of locomotion. The purpose of the current study was to determine if humans generate similar patterns in the upper and lower limbs during hand-foot crawling. Nine healthy young adults performed hand-foot crawling on a treadmill at speeds of 1, 2, and 3 km/h. A principal component analysis (PCA) was applied to the segment elevation angle waveforms for the upper (upper arm, lower arm, and hand) and lower (thigh, shank, and foot) limbs separately. The planarity of the elevation angle waveforms was determined using the sum of the variance explained by the first two PCs and the orientation of the covariance plane was quantified using the direction cosines of the eigenvector orthogonal to the plane, projected upon each of the segmental semi-axes. Results showed that planarity of segment elevation angles was maintained in the upper and lower limbs (explained variance >97%), although a slight decrease was present in the upper limb when crawling at 3 km/h. The orientation of the covariance plane was highly limb-specific, consistent with animal studies and possibly related to the functional neural control differences between the upper and lower limbs. These results may suggest that the motor patterns stored in the central nervous system for quadrupedal locomotion may be retained through evolution and may still be exploited when humans perform such tasks.

  15. Musculoskeletal pain in Europe: role of personal, occupational and social risk factors

    Science.gov (United States)

    Farioli, Andrea; Mattioli, Stefano; Quaglieri, Anna; Curti, Stefania; Violante, Francesco S; Coggon, David

    2014-01-01

    Objectives Prevalence of musculoskeletal pain in European countries varies considerably. We analyzed data from the fifth European Working Conditions Survey (EWCS) to explore the role of personal, occupational, and social risk factors in determining the national prevalence of musculoskeletal pain. Methods During 2010, 43,816 subjects from 34 countries were interviewed. We analyzed the one-year prevalence of back and neck/upper limb pain. Personal risk factors studied were: sex; age; educational level; socio-economic status; housework or cooking; gardening and repairs; somatising tendency; job demand-control; six physical occupational exposures; and occupational group. Data on national socio-economic risk factors were obtained from eurostat and were available for 29 countries. We fitted Poisson regression models with random intercept on country. Results 35,550 workers entered the main analysis. Among personal risk factors, somatising tendency was the strongest predictor of the symptoms. Major differences were observed by country with back pain more than twice as common in Portugal (63.8%) as Ireland (25.7%), and prevalence rates of neck/upper limb pain ranging from 26.6% in Ireland to 67.7% in Finland. Adjustment by personal risk factors slightly reduced the large variation of prevalence between countries. For back pain, the rates were more homogenous after adjustment for social risk factors. Conclusions Our analysis indicates substantial variation between European countries in the prevalence of back and neck/upper limb pain. This variation is unexplained by established individual risk factors. It may be attributable in part to socio-economic differences between countries, with higher prevalence where there is less poverty and more social support. PMID:24009006

  16. Computer simulations of neural mechanisms explaining upper and lower limb excitatory neural coupling

    Directory of Open Access Journals (Sweden)

    Ferris Daniel P

    2010-12-01

    Full Text Available Abstract Background When humans perform rhythmic upper and lower limb locomotor-like movements, there is an excitatory effect of upper limb exertion on lower limb muscle recruitment. To investigate potential neural mechanisms for this behavioral observation, we developed computer simulations modeling interlimb neural pathways among central pattern generators. We hypothesized that enhancement of muscle recruitment from interlimb spinal mechanisms was not sufficient to explain muscle enhancement levels observed in experimental data. Methods We used Matsuoka oscillators for the central pattern generators (CPG and determined parameters that enhanced amplitudes of rhythmic steady state bursts. Potential mechanisms for output enhancement were excitatory and inhibitory sensory feedback gains, excitatory and inhibitory interlimb coupling gains, and coupling geometry. We first simulated the simplest case, a single CPG, and then expanded the model to have two CPGs and lastly four CPGs. In the two and four CPG models, the lower limb CPGs did not receive supraspinal input such that the only mechanisms available for enhancing output were interlimb coupling gains and sensory feedback gains. Results In a two-CPG model with inhibitory sensory feedback gains, only excitatory gains of ipsilateral flexor-extensor/extensor-flexor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 26%. In a two-CPG model with excitatory sensory feedback gains, excitatory gains of contralateral flexor-flexor/extensor-extensor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 100%. However, within a given excitatory sensory feedback gain, enhancement due to excitatory interlimb gains could only reach levels up to 20%. Interconnecting four CPGs to have ipsilateral flexor-extensor/extensor-flexor coupling, contralateral flexor-flexor/extensor-extensor coupling, and bilateral flexor-extensor/extensor-flexor coupling could enhance

  17. Upper limb joint forces and moments during underwater cyclical movements.

    Science.gov (United States)

    Lauer, Jessy; Rouard, Annie Hélène; Vilas-Boas, João Paulo

    2016-10-03

    Sound inverse dynamics modeling is lacking in aquatic locomotion research because of the difficulty in measuring hydrodynamic forces in dynamic conditions. Here we report the successful implementation and validation of an innovative methodology crossing new computational fluid dynamics and inverse dynamics techniques to quantify upper limb joint forces and moments while moving in water. Upper limb kinematics of seven male swimmers sculling while ballasted with 4kg was recorded through underwater motion capture. Together with body scans, segment inertial properties, and hydrodynamic resistances computed from a unique dynamic mesh algorithm capable to handle large body deformations, these data were fed into an inverse dynamics model to solve for joint kinetics. Simulation validity was assessed by comparing the impulse produced by the arms, calculated by integrating vertical forces over a stroke period, to the net theoretical impulse of buoyancy and ballast forces. A resulting gap of 1.2±3.5% provided confidence in the results. Upper limb joint load was within 5% of swimmer׳s body weight, which tends to supports the use of low-load aquatic exercises to reduce joint stress. We expect this significant methodological improvement to pave the way towards deeper insights into the mechanics of aquatic movement and the establishment of practice guidelines in rehabilitation, fitness or swimming performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Spectrum of musculo-skeletal disorders in sickle cell disease in Lagos, Nigeria

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    Ogo Chidiebere N

    2010-01-01

    Full Text Available Abstract Background Sickle cell anemia (SCA is a common genetic disease in Nigeria. Past studies from West Africa focused on isolated aspects of its medical and surgical presentations. To the best of our knowledge, the musculo-skeletal presentations amongst Nigerians with SCA have not been documented in a single all encompassing study. This work aims to prospectively document the musculo-skeletal disease burden among SCA patients. Methods In a prospective study of 318 consecutive patients with genotype-confirmed SCA at the Lagos University Teaching Hospital (LUTH, the musculo-skeletal pathologies, anatomic sites, grade of disease, age at presentation and management outcome were recorded over a one-year period. Data obtained were analyzed using Epi-Info software version 6.0. Data are presented as frequencies (% and mean values (SD as appropriate. Results The HbSS genotype occurred in 296 (93.0%, while 22 (7.0% were HbSC. 100 (31.4% patients with average presenting haemoglobin concentration of 8.2 g/100 ml in the study group, presented with 131 musculo-skeletal pathologies in 118 anatomic sites. Osteomyelitis 31 (31% and septic arthritis 19 (19% were most commonly observed in children less than 10 years. Skin ulcers and avascular necrosis (AVN occurred predominantly in the older age groups, with frequencies of 13 (13.0% and 26 (26.0% respectively. 20 (71.5% of diagnosed cases of AVN presented with radiological grade 4 disease. The lower limbs were involved in 84 (71.1% of sites affected. Lesions involving the spine were rare 11 (0.9%. Multiple presentations occurred in 89 (28.0% of patients; 62 (69.7% of which were children below 10 years. Conclusions Musculo-skeletal complications are common features of sickle cell anaemia seen in 31.4%. Infectious aetiologies predominate with long bones and joints of lower limbs more commonly affected by osteomyelitis and septic arthritis. Healthcare providers managing SCA should be aware of the potential

  19. Learning by Demonstration for Motion Planning of Upper-Limb Exoskeletons

    Science.gov (United States)

    Lauretti, Clemente; Cordella, Francesca; Ciancio, Anna Lisa; Trigili, Emilio; Catalan, Jose Maria; Badesa, Francisco Javier; Crea, Simona; Pagliara, Silvio Marcello; Sterzi, Silvia; Vitiello, Nicola; Garcia Aracil, Nicolas; Zollo, Loredana

    2018-01-01

    The reference joint position of upper-limb exoskeletons is typically obtained by means of Cartesian motion planners and inverse kinematics algorithms with the inverse Jacobian; this approach allows exploiting the available Degrees of Freedom (i.e. DoFs) of the robot kinematic chain to achieve the desired end-effector pose; however, if used to operate non-redundant exoskeletons, it does not ensure that anthropomorphic criteria are satisfied in the whole human-robot workspace. This paper proposes a motion planning system, based on Learning by Demonstration, for upper-limb exoskeletons that allow successfully assisting patients during Activities of Daily Living (ADLs) in unstructured environment, while ensuring that anthropomorphic criteria are satisfied in the whole human-robot workspace. The motion planning system combines Learning by Demonstration with the computation of Dynamic Motion Primitives and machine learning techniques to construct task- and patient-specific joint trajectories based on the learnt trajectories. System validation was carried out in simulation and in a real setting with a 4-DoF upper-limb exoskeleton, a 5-DoF wrist-hand exoskeleton and four patients with Limb Girdle Muscular Dystrophy. Validation was addressed to (i) compare the performance of the proposed motion planning with traditional methods; (ii) assess the generalization capabilities of the proposed method with respect to the environment variability. Three ADLs were chosen to validate the system: drinking, pouring and lifting a light sphere. The achieved results showed a 100% success rate in the task fulfillment, with a high level of generalization with respect to the environment variability. Moreover, an anthropomorphic configuration of the exoskeleton is always ensured. PMID:29527161

  20. Learning by Demonstration for Motion Planning of Upper-Limb Exoskeletons

    Directory of Open Access Journals (Sweden)

    Clemente Lauretti

    2018-02-01

    Full Text Available The reference joint position of upper-limb exoskeletons is typically obtained by means of Cartesian motion planners and inverse kinematics algorithms with the inverse Jacobian; this approach allows exploiting the available Degrees of Freedom (i.e. DoFs of the robot kinematic chain to achieve the desired end-effector pose; however, if used to operate non-redundant exoskeletons, it does not ensure that anthropomorphic criteria are satisfied in the whole human-robot workspace. This paper proposes a motion planning system, based on Learning by Demonstration, for upper-limb exoskeletons that allow successfully assisting patients during Activities of Daily Living (ADLs in unstructured environment, while ensuring that anthropomorphic criteria are satisfied in the whole human-robot workspace. The motion planning system combines Learning by Demonstration with the computation of Dynamic Motion Primitives and machine learning techniques to construct task- and patient-specific joint trajectories based on the learnt trajectories. System validation was carried out in simulation and in a real setting with a 4-DoF upper-limb exoskeleton, a 5-DoF wrist-hand exoskeleton and four patients with Limb Girdle Muscular Dystrophy. Validation was addressed to (i compare the performance of the proposed motion planning with traditional methods; (ii assess the generalization capabilities of the proposed method with respect to the environment variability. Three ADLs were chosen to validate the system: drinking, pouring and lifting a light sphere. The achieved results showed a 100% success rate in the task fulfillment, with a high level of generalization with respect to the environment variability. Moreover, an anthropomorphic configuration of the exoskeleton is always ensured.

  1. Consumer design priorities for upper limb prosthetics.

    Science.gov (United States)

    Biddiss, Elaine; Beaton, Dorcas; Chau, Tom

    2007-11-01

    To measure consumer satisfaction with upper limb prosthetics and provide an enumerated list of design priorities for future developments. A self-administered, anonymous survey collected information on participant demographics, history of and goals for prosthesis use, satisfaction, and design priorities. The questionnaire was available online and in paper format and was distributed through healthcare providers, community support groups, and one prosthesis manufacturer; 242 participants of all ages and levels of upper limb absence completed the survey. Rates of rejection for myoelectric hands, passive hands, and body-powered hooks were 39%, 53%, and 50%, respectively. Prosthesis wearers were generally satisfied with their devices while prosthesis rejecters were dissatisfied. Reduced prosthesis weight emerged as the highest priority design concern of consumers. Lower cost ranked within the top five design priorities for adult wearers of all device types. Life-like appearance is a priority for passive/cosmetic prostheses, while improved harness comfort, wrist movement, grip control and strength are required for body-powered devices. Glove durability, lack of sensory feedback, and poor dexterity were also identified as design priorities for electric devices. Design priorities reflect consumer goals for prosthesis use and vary depending on the type of prosthesis used and age. Future design efforts should focus on the development of more light-weight, comfortable prostheses.

  2. DIAGNOSTICS OF DISORDERS AND DISEASES OF MUSCULOSKELETAL SYSTEM IN SCHOOLCHILDREN: APPROACHES, TERMINOLOGY, CLASSIFICATION

    Directory of Open Access Journals (Sweden)

    N.B. Mirskaya

    2009-01-01

    Full Text Available This article describes an information system for physicians working in general education institutes, which is named «Detection, correction and prophylaxis of musculoskeletal system disorders in students of general education institutes». This system was created for the purpose of improving diagnostics of initial stages of musculoskeletal system in schoolchildren, detecting of risk factors, and for the provision of timely prophylaxis during school education. The system was based on classification of functional disorders and initial stages of diseases of musculoskeletal system in schoolchildren, developed by authors of present article, and methods of medical examination and organization of this work.Key words: schoolchildren, musculoskeletal system, diagnostics, classification, prophylaxis.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(3:10-13

  3. A novel upper limb rehabilitation system with self-driven virtual arm illusion.

    Science.gov (United States)

    Aung, Yee Mon; Al-Jumaily, Adel; Anam, Khairul

    2014-01-01

    This paper proposes a novel upper extremity rehabilitation system with virtual arm illusion. It aims for fast recovery from lost functions of the upper limb as a result of stroke to provide a novel rehabilitation system for paralyzed patients. The system is integrated with a number of technologies that include Augmented Reality (AR) technology to develop game like exercise, computer vision technology to create the illusion scene, 3D modeling and model simulation, and signal processing to detect user intention via EMG signal. The effectiveness of the developed system has evaluated via usability study and questionnaires which is represented by graphical and analytical methods. The evaluation provides with positive results and this indicates the developed system has potential as an effective rehabilitation system for upper limb impairment.

  4. Exoskeleton-Based Robotic Platform Applied in Biomechanical Modelling of the Human Upper Limb

    Directory of Open Access Journals (Sweden)

    Andres F. Ruiz

    2009-01-01

    Full Text Available One of the approaches to study the human motor system, and specifically the motor strategies implied during postural tasks of the upper limbs, is to manipulate the mechanical conditions of each joint of the upper limbs independently. At the same time, it is essential to pick up biomechanical signals and bio-potentials generated while the human motor system adapts to the new condition. The aim of this paper is two-fold: first, to describe the design, development and validation of an experimental platform designed to modify or perturb the mechanics of human movement, and simultaneously acquire, process, display and quantify bioelectric and biomechanical signals; second, to characterise the dynamics of the elbow joint during postural control. A main goal of the study was to determine the feasibility of estimating human elbow joint dynamics using EMG-data during maintained posture. In particular, the experimental robotic platform provides data to correlate electromyographic (EMG activity, kinetics and kinematics information from the upper limb motion. The platform aims consists of an upper limb powered exoskeleton, an EMG acquisition module, a control unit and a software system. Important concerns of the platform such as dependability and safety were addressed in the development. The platform was evaluated with 4 subjects to identify, using system identification methods, the human joint dynamics, i.e. visco-elasticity. Results obtained in simulations and experimental phase are introduced.

  5. Acupotomy and venesection in Upper Limb Lymphedema and Peripheral neuropathy following Breast Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Jang Eun-ha

    2009-12-01

    Full Text Available Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

  6. Upper limb vein anatomy before hemodialysis fistula creation: cross-sectional anatomy using MR venography

    International Nuclear Information System (INIS)

    Laissy, Jean-Pierre; Fernandez, Pedro; Karila-Cohen, Pascale; Chillon, Sylvie; Schouman-Claeys, Elisabeth; Delmas, Vincent; Dupuy, Emmanuel; Mignon, Francoise

    2003-01-01

    Preoperative imaging is indicated to discriminate patent, adequate superficial veins of the upper limbs undetectable by clinical inspection that could be anastomosed for the creation of a durable and functional hemodialysis fistula. The aim of this pictorial review is to provide a venous anatomic map of the upper limbs using MR venography (MRV) which could help surgeons before creation of hemodialysis access fistulas (AVF). At the level of the forearm, the antebrachial cephalic vein is the most commonly identified as patent. At the level of the elbow and distal arm, the cephalic vein is patent in 80% of normal subjects, and less often patent (23-26%) than basilic vein (33-38%) in patients. Overall, reading transaxial MR views can help for assessing upper limb vein anatomy before creation of a hemodialysis access fistula. (orig.)

  7. Upper limb vein anatomy before hemodialysis fistula creation: cross-sectional anatomy using MR venography

    Energy Technology Data Exchange (ETDEWEB)

    Laissy, Jean-Pierre; Fernandez, Pedro; Karila-Cohen, Pascale; Chillon, Sylvie; Schouman-Claeys, Elisabeth [Department of Radiology, Hopital Bichat, 46 rue Henri Huchard, 75877 Paris Cedex 18 (France); Delmas, Vincent [Department of Urology, Hopital Bichat, 46 rue Henri Huchard, 75877 Paris Cedex 18 (France); Dupuy, Emmanuel; Mignon, Francoise [Department of Nephrology, Hopital Bichat, 46 rue Henri Huchard, 75877 Paris Cedex 18 (France)

    2003-02-01

    Preoperative imaging is indicated to discriminate patent, adequate superficial veins of the upper limbs undetectable by clinical inspection that could be anastomosed for the creation of a durable and functional hemodialysis fistula. The aim of this pictorial review is to provide a venous anatomic map of the upper limbs using MR venography (MRV) which could help surgeons before creation of hemodialysis access fistulas (AVF). At the level of the forearm, the antebrachial cephalic vein is the most commonly identified as patent. At the level of the elbow and distal arm, the cephalic vein is patent in 80% of normal subjects, and less often patent (23-26%) than basilic vein (33-38%) in patients. Overall, reading transaxial MR views can help for assessing upper limb vein anatomy before creation of a hemodialysis access fistula. (orig.)

  8. Psychosocial Factors and Work-related Musculoskeletal Disorders among Southeastern Asian Female Workers Living in Korea

    Directory of Open Access Journals (Sweden)

    Hyeonkyeong Lee

    2011-06-01

    Conclusion: Acculturation strategy and nationality were found to be significant factors associated with work-related musculoskeletal disorders. Health professionals need to accommodate acculturation contexts into risk assessment and intervention development for work-related musculoskeletal disorders separately for different nationalities.

  9. Measuring upper limb function in children with hemiparesis with 3D inertial sensors.

    Science.gov (United States)

    Newman, Christopher J; Bruchez, Roselyn; Roches, Sylvie; Jequier Gygax, Marine; Duc, Cyntia; Dadashi, Farzin; Massé, Fabien; Aminian, Kamiar

    2017-12-01

    Upper limb assessments in children with hemiparesis rely on clinical measurements, which despite standardization are prone to error. Recently, 3D movement analysis using optoelectronic setups has been used to measure upper limb movement, but generalization is hindered by time and cost. Body worn inertial sensors may provide a simple, cost-effective alternative. We instrumented a subset of 30 participants in a mirror therapy clinical trial at baseline, post-treatment, and follow-up clinical assessments, with wireless inertial sensors positioned on the arms and trunk to monitor motion during reaching tasks. Inertial sensor measurements distinguished paretic and non-paretic limbs with significant differences (P < 0.01) in movement duration, power, range of angular velocity, elevation, and smoothness (normalized jerk index and spectral arc length). Inertial sensor measurements correlated with functional clinical tests (Melbourne Assessment 2); movement duration and complexity (Higuchi fractal dimension) showed moderate to strong negative correlations with clinical measures of amplitude, accuracy, and fluency. Inertial sensor measurements reliably identify paresis and correlate with clinical measurements; they can therefore provide a complementary dimension of assessment in clinical practice and during clinical trials aimed at improving upper limb function.

  10. Cervical Spinal Cord and Dorsal Nerve Root Stimulation for Neuropathic Upper Limb Pain.

    Science.gov (United States)

    Levine, Adrian B; Parrent, Andrew G; MacDougall, Keith W

    2017-01-01

    Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic pain in the lower limbs. Upper limb pain comprises a significant proportion of neuropathic pain patients, but is often difficult to target specifically and consistently with paresthesias. We hypothesized that the use of dorsal nerve root stimulation (DNRS), as an option along with SCS, would help us better relieve pain in these patients. All 35 patients trialed with spinal stimulation for upper limb pain between July 1, 2011, and October 31, 2013, were included. We performed permanent implantation in 23/35 patients based on a visual analogue scale pain score decrease of ≥50% during trial stimulation. Both the SCS and DNRS groups had significant improvements in average visual analogue scale pain scores at 12 months compared with baseline, and the majority of patients in both groups obtained ≥50% pain relief. The majority of patients in both groups were able to reduce their opioid use, and on average had improvements in Short Form-36 quality of life scores. Complication rates did not differ significantly between the two groups. Treatment with SCS or DNRS provides meaningful long-term relief of chronic neuropathic pain in the upper limbs.

  11. Neck and Upper Limb Dysfunction in Patients following Neck Dissection: Looking beyond the Shoulder.

    Science.gov (United States)

    Gane, Elise M; O'Leary, Shaun P; Hatton, Anna L; Panizza, Benedict J; McPhail, Steven M

    2017-10-01

    Objective To measure patient-perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Study Design Cross-sectional. Setting Two tertiary hospitals in Brisbane, Australia. Subjects and Methods Inclusion criteria: patients treated with neck dissection (2009-2014). aged <18 years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self-reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self-efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self-reported function. Results Eighty-nine participants (male n = 63, 71%; median age, 62 years; median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76; 95% confidence interval [CI], 0.01-3.51), having disease within the thyroid (17.40; 2.37-32.44), postoperative radiation therapy (vs surgery only) (13.90; 6.67-21.14), and shoulder pain (0.65; 0.44-0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61; 95% CI, 1.14-12.08), shoulder pain (0.19; 0.04-0.34), neck pain (0.34; 0.21-0.47), and symptoms of neuropathic pain (0.61; 0.25-0.98). Conclusion Patients can experience upper limb and neck dysfunction following nerve-preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.

  12. What characterizes cleaners sustaining good musculoskeletal health after years with physically heavy work?

    DEFF Research Database (Denmark)

    Holtermann, A; Blangsted, A K; Christensen, H

    2009-01-01

    OBJECTIVES: The aim of this case-control study was to investigate characteristics of cleaners with good musculoskeletal health after years with physically heavy work. METHODS: One hundred and 41 female seniority cleaners participated. Twenty-five reported no musculoskeletal symptoms, whereas 83...... reported severe symptoms in the low back, neck shoulders or upper limbs. The groups were of matching age, height, body weight and seniority (19 years). Muscular strength was recorded by isometric maximal voluntary contractions on a day without pain. Exposure to physical risk factors at work, psychosocial...... work factors, and leisure time physical activity were assessed by a postal questionnaire. RESULTS: Cleaners with good musculoskeletal health were not reporting different exposure to physical risk factors at work or leisure time physical activity, but had higher muscular strength and reported higher...

  13. 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

  14. Bilateral responses of upper limb muscles to transcranial magnetic stimulation in human subjects.

    Science.gov (United States)

    Bawa, P; Hamm, J D; Dhillon, P; Gross, P A

    2004-10-01

    Anatomical and behavioural work on primates has shown bilateral innervation of axial and proximal limb muscles, and contralateral control of distal limb muscles. The following study examined if a clear boundary exists between the distal and proximal upper limb muscles that are controlled contralaterally or bilaterally. The right motor cortical area representing the upper limb was stimulated, while surface EMG was recorded bilaterally from various upper limb muscles during rest and phasic voluntary contractions. Peak-to-peak amplitude of motor evoked potential (MEP) was measured for each muscle on both sides. The ratio R = (ipsilateral MEP: contralateral MEP) was calculated for seven pairs of muscles. For each of the seven pairs, R was less than 1.0, implying that for each muscle and subject, the contralateral control is stronger. The boundary where R changed from almost zero to a clearly measurable magnitude depended on the subject. Ipsilateral MEPs from trapezius and pectoralis could be recorded with a small background contraction from almost all subjects; on the other hand, in deltoid and biceps brachii, ipsilateral MEPs were observed only with bimanual phasic contractions. The forearm and hand muscles, in general, did not show any ipsilateral MEPs. Major differences between subjects lay in the presence or the absence of ipsilateral MEPs in biceps brachii and deltoid, without defining a sharp boundary between proximal and distal muscles.

  15. Prevalence of work-related musculoskeletal disorders among hairdressers

    Directory of Open Access Journals (Sweden)

    Happiness Anulika Aweto

    2015-06-01

    Full Text Available Objectives: This study has investigated the prevalence of work-related musculoskeletal disorders (WMSDs, the most commonly affected body parts, the risk factors of WMSDs and the coping strategies adopted by hairdressers. Material and Methods: The study design was a cross-sectional descriptive survey design. Two hundred and ninety-nine hairdressers (242 females and 57 males from salons in Surulere and Mushin Local Government Areas of Lagos State completed a 27-item questionnaire. They were selected using a non-probability consecutive sampling technique. The inferential analysis was conducted using the Chi2 test. The level of significance stood at p < 0.05. Results: The 12-month prevalence of musculoskeletal disorders stood at 75.6%. Two hundred and twenty-one (91.3% participants reported gradual onset of musculoskeletal disorders. One hundred and sixteen (47.9% participants had the onset of the WMSDs at the age range of 26–35 years. The most commonly affected body parts included the low back (76.3%, shoulder (62.5% and neck (46.3%. Some of the major job risk factors of the WMSDs that were identified included: working in the same position for long periods and attending to a large number of customers in 1 day. Taking sufficient rest breaks by participants was one of the coping strategies adopted by the participants. The mean number of years of working experience was 7.85±0.4 years. One hundred and twenty-four (41.5% participants had worked for 1–5 years. The Chi2 analysis showed that the prevalence of musculoskeletal disorders were significantly associated with the age of a participant (Chi2 = 78.78, p = 0.001, years of working experience (Chi2 = 78.03, p = 0.001 and hours spent working in a standing position (Chi2 = 8.77, p = 0.01, respectively. Conclusions: The age of hairdressers, their years of working and the long hours they spent working in a standing position may be significant factors that contribute to the high prevalence of the WMSDs

  16. A Force-Feedback Exoskeleton for Upper-Limb Rehabilitation in Virtual Reality

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    Antonio Frisoli

    2009-01-01

    Full Text Available This paper presents the design and the clinical validation of an upper-limb force-feedback exoskeleton, the L-EXOS, for robotic-assisted rehabilitation in virtual reality (VR. The L-EXOS is a five degrees of freedom exoskeleton with a wearable structure and anthropomorphic workspace that can cover the full range of motion of human arm. A specific VR application focused on the reaching task was developed and evaluated on a group of eight post-stroke patients, to assess the efficacy of the system for the rehabilitation of upper limb. The evaluation showed a significant reduction of the performance error in the reaching task (paired t-test, p < 0.02

  17. Upper Limb Absence : Predictors of Work Participation and Work Productivity

    NARCIS (Netherlands)

    Postema, Sietke G; Bongers, Raoul M; Brouwers, Michael A; Burger, Helena; Norling-Hermansson, Liselotte M; Reneman, Michiel F; Dijkstra, Pieter U; van der Sluis, Corry K

    OBJECTIVES: To analyze work participation, work productivity, contributing factors, and physical work demands of individuals with upper limb absence (ULA). DESIGN: Cross-sectional study: postal survey (response rate, 45%). SETTING: Twelve rehabilitation centers and orthopedic workshops.

  18. 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.

  19. Upper extremities musculoskeletal disorders: Prevalence and associated ergonomic factors in an electronic assembly factory

    Directory of Open Access Journals (Sweden)

    Somthus Pullopdissakul

    2013-10-01

    Full Text Available Objectives:To determine the magnitude, distribution and associated ergonomic factors of upper extremities musculoskeletal disorders (UEMSD among workers of electronic assembly in Thailand. Material and Methods: This was a cross-sectional study. 591 of 853 workers in an electronic and electrical appliance assembly factory in Bangkok, Thailand, participated in this study. A self-administered questionnaire consisting of demographic data and ergonomic factors was collected from October 2010 to January 2011. Clinical examination of each worker was performed by an occupational physician. The criteria for diagnosis of UEMSD came as a result of a consensus reached by a group of orthopedists. The associated factors were analyzed using a multiple logistic regression. Results: The point prevalence of clinically diagnosed UEMSD was as follows: radial styloid tenosynovitis - 13.03% (95% CI: 10.31-15.75, trigger finger - 9.48% (95% CI: 7.11-11.84, carpal tunnel syndrome - 8.12% (95% CI: 5.91-10.33, lateral epicondylitis - 3.38% (95% CI: 1.92-4.85, and medial epicondylitis - 1.69% (95% CI: 0.65-2.73, respectively. The adjusted odds ratio with statistical significance associated with UEMSD was as follows: high force of wrist - 1.78 (95% CI: 1.06-2.99, awkward posture of wrist - 2.37 (95% CI: 1.28-4.37 and contact stress at wrists - 1.75 (95% CI: 1.02-3.00 to develop radial styloid tenosynovitis. For trigger finger, the ratios were awkward posture of fingers - 2.09 (95% CI: 1.12-3.90 and contact stress on finger - 1.86 (95% CI: 1.04-3.34. For medial epicondylitis, it was an awkward posture of using elbows - 3.14 (95% CI: 1.10-8.95. However, this study did not find any associations between repetitive motion and any UEMSD. Conclusions: UEMSD are most commonly found in electronic assembly workers. The relevant parties should provide comprehensive ergonomic resolution for these workers.

  20. MUSCULOSKELETAL PAIN TRAINEES IN PHYSICAL THERAPY OF UESB

    Directory of Open Access Journals (Sweden)

    Marta Rodrigues Barreto Neta

    2015-01-01

    Full Text Available To determine musculoskeletal disorders presented in algic way of undergraduates supervised I and II of the physiotherapy course at the State University of Southwest Bahia, Jequié campus. The study of descriptive, transversal and quantitative character, with a sample of 35 trainees of the physiotherapy course at the State University of Southwest Bahia. Data were obtained through questionnaires demographic social, Nordic and Mc Gill. Of the participants 20% were male and 80% female, aged between 20-29 years (23 ± 2. The regions most affected by musculoskeletal disorders in the current period, 7 days and 12 months were the lower back (40%, shoulder (28,6%, neck and upper back (25.7%. Regarding the classification of pain, trainees described as tiring (60%; thin (40%; sharp and stabbing (34%. This study concluded that physiotherapy graduates have high musculoskeletal pain complaints, before entering the labor market.

  1. MUSCULOSKELETAL PAIN TRAINEES IN PHYSICAL THERAPY OF UESB

    Directory of Open Access Journals (Sweden)

    Marta Rodrigues Barreto Neta

    2015-05-01

    Full Text Available To determine musculoskeletal disorders presented in algic way of undergraduates supervised I and II of the physiotherapy course at the State University of Southwest Bahia, Jequié campus. The study of descriptive, transversal and quantitative character, with a sample of 35 trainees of the physiotherapy course at the State University of Southwest Bahia. Data were obtained through questionnaires demographic social, Nordic and Mc Gill. Of the participants 20% were male and 80% female, aged between 20-29 years (23 ± 2. The regions most affected by musculoskeletal disorders in the current period, 7 days and 12 months were the lower back (40%, shoulder (28,6%, neck and upper back (25.7%. Regarding the classification of pain, trainees described as tiring (60%; thin (40%; sharp and stabbing (34%. This study concluded that physiotherapy graduates have high musculoskeletal pain complaints, before entering the labor market.

  2. Robotic assessment of the influence of age on upper-limb sensorimotor function

    Directory of Open Access Journals (Sweden)

    LLinares A

    2013-07-01

    Full Text Available Ana LLinares, Francisco Javier Badesa, Ricardo Morales, Nicolas Garcia-Aracil, JM Sabater, Eduardo Fernandez Biomedical Neuroengineering, Universidad Miguel Hernández de Elche, Elche, Spain Purpose: This paper examines the influence of age on several attributes of sensorimotor performance while performing a reaching task. Our hypothesis, based on previous studies, is that aged persons will show differences in one or more of the attributes of sensorimotor performance. Patients and methods: Fifty-one subjects (aged 20–80 years with no known neuromotor disorders of the upper limbs participated in the study. Subjects were asked to grasp the end-effector of a pneumatic robotic device with two degrees of freedom in order to reach peripheral targets (1.0 cm radius, "quickly and accurately", from a centrally located target (1.0 cm radius. Subjects began each trial by holding the hand within the central target for 2000 milliseconds. Afterwards, a peripheral target was illuminated. Then participants were given 3000 milliseconds to complete the movement. When a target was reached, the participant had to return to the central target in order to start a new trial. A total of 64 trials were completed and each peripheral target was illuminated in a random block design. Results: Subjects were divided into three groups according to age: group 1 (age 20–40 years, group 2 (age 41–60 years, and group 3 (age 61–80 years. The Kruskal–Wallis test showed significant differences (P < 0.05 between groups, except for the variables postural speed in the dominant arm, and postural speed and initial deviation in the non-dominant arm (P > 0.05. These results suggest that age introduces significant differences in upper-limb motor function. Conclusion: Our findings show that there are objective differences in sensorimotor function due to age, and that these differences are greater for the dominant arm. Therefore for the assessment of upper-limb function, we should

  3. Upper limb joint muscle/tendon injury and anthropometric adaptations in French competitive tennis players.

    Science.gov (United States)

    Rogowski, Isabelle; Creveaux, Thomas; Genevois, Cyril; Klouche, Shahnaz; Rahme, Michel; Hardy, Philippe

    2016-01-01

    The purpose of this study was to examine the relationship between the upper limb anthropometric dimensions and a history of dominant upper limb injury in tennis players. Dominant and non-dominant wrist, forearm, elbow and arm circumferences, along with a history of dominant upper limb injuries, were assessed in 147 male and female players, assigned to four groups based on location of injury: wrist (n = 9), elbow (n = 25), shoulder (n = 14) and healthy players (n = 99). From anthropometric dimensions, bilateral differences in circumferences and in proportions were calculated. The wrist group presented a significant bilateral difference in arm circumference, and asymmetrical bilateral proportions between wrist and forearm, as well as between elbow and arm, compared to the healthy group (6.6 ± 3.1% vs. 4.9 ± 4.0%, P elbow group displayed asymmetrical bilateral proportions between forearm and arm compared to the healthy group (-0.4 ± 4.3% vs. 1.5 ± 4.0%, P elbow circumference, and asymmetrical bilateral proportions between forearm and elbow when compared to the healthy group (5.8 ± 4.7% vs. 3.1 ± 4.8%, P tennis injury and asymmetry in upper limb proportions using high-tech measurements in symptomatic tennis players.

  4. Job adjustments, job satisfaction and health experience in upper and lower limb amputees

    NARCIS (Netherlands)

    van der Sluis, Corry K.; Hartman, Paul P.; Schoppen, Tanneke; Dijkstra, Pieter U.

    2009-01-01

    Objectives: To explore job adjustments, job satisfaction, and health experience among employees with an upper limb amputation and to compare the results with those of lower limb amputees and control subjects. Methods: Amputees were recruited from data files of a large European University Medical

  5. Multisite musculoskeletal pain predicts medically certified disability retirement among Finns.

    Science.gov (United States)

    Haukka, E; Kaila-Kangas, L; Ojajärvi, A; Saastamoinen, P; Holtermann, A; Jørgensen, M B; Karppinen, J; Heliövaara, M; Leino-Arjas, P

    2015-09-01

    Musculoskeletal pain at several sites (multisite pain) is more common than single-site pain. Little is known on its effects on disability pension (DP) retirement. A nationally representative sample comprised 4071 Finns in the workforce aged 30 to 63. Data (questionnaire, interview, clinical examination) were gathered in 2000-2001 and linked with national DP registers for 2000-2011. Pain during the preceding month in 18 locations was combined into four sites (neck, upper limbs, low back, lower limbs). Hazard ratios (HR) of DP were estimated by Cox regression. The HR of any DP (n = 477) was 1.6 (95% confidence interval 1.2-2.1) for one, 2.5 (1.9-3.3) for two, 3.1 (2.3-4.3) for three and 5.6 (4.0-7.8) for four pain sites, when adjusted for age and gender. When additionally adjusted for clinically assessed chronic diseases, the HRs varied from 1.4 (1.0-1.8) to 3.5 (2.5-4.9), respectively. When further adjusted for physical and psychosocial workload, education, body mass index, smoking, exercise and sleep disorders, the HRs were 1.3 (0.9-1.7), 1.6 (1.2-2.2), 1.8 (1.3-2.5) and 2.5 (1.8-3.6). The number of pain sites was especially strong in predicting DPs due to musculoskeletal diseases (HRs in the full model; 3.1 to 4.3), but it also predicted DPs due to other somatic diseases (respective HRs 1.3 to 2.3); pain in all four sites was also predictive of DPs due to mental disorders (full model HR 2.2). The number of pain sites independently predicted DP retirement. Employees with multisite pain may need specific support to maintain their work ability. © 2014 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

  6. Management of Sick Leave due to Musculoskeletal Disorders

    NARCIS (Netherlands)

    E. Faber (Elske)

    2007-01-01

    textabstractMusculoskeletal disorders are a common problem that may lead to func-Ational limitations and (work) disability. It is not clear yet how improvement in Apain or functional limitations is related to return to work after an episode of sick Aleave. Furthermore, several physicians are

  7. Effectiveness of an Ergonomics Training Program on Decreasing Work-Related Musculoskeletal Disorders Risk among Video Display Terminals Users

    Directory of Open Access Journals (Sweden)

    Yahya Rasoulzadeh

    2012-07-01

    Full Text Available loskeletaldisorders (WMSDs among the video display terminals (VDTs users, Prevention ofthese disorders among this population is a challenge for many workplaces today. ErgonomicallyImproving of VDT workstations may be an effective and applicable way to decrease the risk ofWMSDs. This study evaluated the effect of an ergonomics-training program on the risk ofWMSDs among VDT users.Methods: This study was conducted among a large group of computer users in SAPCO industrialcompany, Tehran, Iran (84 persons with 29.85±11.2 years of age and with 6.98±2.54 years ofexperience. An active ergonomics-training program was designed and implemented during 14days to empower the VDT users and involve them in improving their workstations. The directobservational RULA (Rapid Upper Limb Assessment method was used in pre and postinterventionstages to evaluate the risk of WMSDs among participants.Results: The RULA final scores showed that 18.8 % of VDT users were at action level 2, 63.5%at action level 3 and 17.6% at action level 4 before any intervention. In addition, 8.2% of userswere at action level 1, 44.7% at action level 2, 42.4% at action level 3 and 4.7% at action level 4 atthe post-intervention stage. The results of Wilcoxon statistical test indicated that RULA scoresere decreased significantly after interventions (P < 0.05 and consequently, decreased risk ofWMSDs.Conclusion: Active ergonomics training programs can be used effectively to improve the VDTworkstations and decrease the risk of musculoskeletal disorders among VDT users.

  8. TRANSIT DISORDERS OF THE GASTRIC REMNANT AND ROUX LIMB AFTER ROUX-EN-Y GASTROJEJUNOSTOMY - RELATION TO SYMPTOMATOLOGY AND VAGOTOMY

    NARCIS (Netherlands)

    VANDERMIJLE, HCJ; BEEKHUIS, H; BLEICHRODT, RP; KLEIBEUKER, JH

    Patients after Roux-en-Y gastrojejunostomy frequently complain of upper abdominal pain, fullness, nausea and vomiting. This study was performed to clarify the relationship of this Roux-en-Y syndrome to transit disorders in the gastric remnant and Roux limb, and to vagal status. Using a

  9. [The epidemiological study of work-related musculoskeletal disorders and related factors among automobile assembly workers].

    Science.gov (United States)

    Wang, Zhong-Xu; Qin, Ru-Li; Li, Yu-Zhen; Zhang, Xue-Yan; Jia, Ning; Zhang, Qiu-Ling; Li, Gang; Zhao, Jie; Li, Huan-Huan; Jiang, Hai-Qiang

    2011-08-01

    To investigate the work-related musculoskeletal disorders among automobile assembly workers, to discusses the related risk factors and their relationship. The selected 1508 automobile assembly workers from a north car manufacturing company were regarded as the study object. The hazard zone jobs checklist, Nordic musculoskeletal symptom questionnaire (NMQ) and pain questionnaire were used to perform the epidemiological cross-sectional and retrospective survey and study for the General status, awkward ergonomics factors and related influencing factors, and musculoskeletal disorders of workers. The predominant body sites of occurring WMSDs among automobile assembly workers were mainly low back, wrist, neck and shoulders, the predominant workshop section of occurring WMSDs were mostly concentrated in engine compartment, interior ornament, door cover, chassis and debugging section. The predominant body site of WMSDs among engine compartment and chassis section workers was low back, interior ornament workers were low back and wrist, door cover workers was wrist, chassis workers was low back, debugging workers were neck and low back. Neck musculoskeletal disorders had the trend with the increase of a body height; Smoking may increase the occurrence of musculoskeletal disorders. The WMSDs appears to be a serious ergonomic proble assem among automobile assembly workers, predominant occurring site of WMSDs is with different workshop section, its characteristics is quite obvious, probably related to its existing awkward work position or activities. The worker height and smoking habits may be important factors which affect musculoskeletal disorders happen.

  10. Considerations for designing robotic upper limb rehabilitation devices

    Science.gov (United States)

    Nadas, I.; Vaida, C.; Gherman, B.; Pisla, D.; Carbone, G.

    2017-12-01

    The present study highlights the advantages of robotic systems for post-stroke rehabilitation of the upper limb. The latest demographic studies illustrate a continuous increase of the average life span, which leads to a continuous increase of stroke incidents and patients requiring rehabilitation. Some studies estimate that by 2030 the number of physical therapists will be insufficient for the patients requiring physical rehabilitation, imposing a shift in the current methodologies. A viable option is the implementation of robotic systems that assist the patient in performing rehabilitation exercises, the physical therapist role being to establish the therapeutic program for each patient and monitor their individual progress. Using a set of clinical measurements for the upper limb motions, the analysis of rehabilitation robotic systems provides a comparative study between the motions required by clinicians and the ones that robotic systems perform for different therapeutic exercises. A critical analysis of existing robots is performed using several classifications: mechanical design, assistance type, actuation and power transmission, control systems and human robot interaction (HRI) strategies. This classification will determine a set of pre-requirements for the definition of new concepts and efficient solutions for robotic assisted rehabilitation therapy.

  11. Physiologically Relevant Prosthetic Limb Movement Feedback for Upper and Lower Extremity Amputees

    Science.gov (United States)

    2016-10-01

    upper arm (elbow movement), Upper leg (knee movement) and lower leg ( ankle movement) to provide a physiologically relevant sense of limb movement...Additionally a BOA cable tensioning system is passed through these plates and anchored to the external surface of the socket. When tension is applied the

  12. Music Upper Limb Therapy – Integrated: an Enriched Collaborative Approach for Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Preeti Raghavan

    2016-10-01

    Full Text Available Stroke is a leading cause of disability worldwide. It leads to a sudden and overwhelming disruption in one’s physical body, and alters the stroke survivors’ sense of self. Long-term recovery requires that bodily perception, social participation and sense of self are restored; this is challenging to achieve, particularly with a single intervention. However, rhythmic synchronization of movement to external stimuli facilitates sensorimotor coupling for movement recovery, enhances emotional engagement, and has positive effects on interpersonal relationships. In this proof-of-concept study, we designed a group music-making intervention, Music Upper Limb Therapy-Integrated (MULT-I, to address the physical, psychological and social domains of rehabilitation simultaneously, and investigated its effects on long-term post-stroke upper limb recovery. The study used a mixed-method pre-post design with one-year follow up. Thirteen subjects completed the 45-minute intervention twice a week for six weeks. The primary outcome was reduced upper limb motor impairment on the Fugl-Meyer Scale. Secondary outcomes included sensory impairment (two-point discrimination test, activity limitation (Modified Rankin scale, well-being (WHO well-being index, and participation (Stroke Impact Scale. Repeated measures ANOVA was used to test for differences between pre- and post-intervention, and one-year follow up scores. Significant improvement was found in upper limb motor impairment, sensory impairment, activity limitation, and well-being immediately post-intervention that persisted at 1 year. Activities of daily living and social participation improved only from post-intervention to one-year follow up. The improvement in upper limb motor impairment was more pronounced in a subset of lower functioning individuals as determined by their pre-intervention wrist range of motion. Qualitatively, subjects reported new feelings of ownership of their impaired limb, more

  13. Achievement report for fiscal 1999 on research and development of technologies for medical welfare equipment. Rehabilitation system for upper limbs and lower limbs; 1999 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Shintai kino rihabiri shien system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-05-01

    This project aims to develop physical function measuring and training systems equipped with a variety of feedback utilities and widely applicable to the prevention of the elderly from physical function degradation, to the preservation of physical functions, and to their recovery from mild physical difficulties, thereby helping the elderly enjoy independence and participation in social activities. Possibilities will be studied of providing them with engineering support in the field of exercise therapy through the analysis of the characteristics of old people's movement, and the findings will be applied to the designing and assessment of welfare and nursing equipment and also fed back to their development environment. In the gait training system, the suspension force is adjusted according to data from the force plate and various position sensors, and the system produces an effect similar to that of walking in the water. The lower limb rehabilitation system facilitates the treatment of the aged or handicapped people, and patients suffering from cerebral disorders, at any of their physical positions from lying to standing. The upper limb training support system is to provide motivation for the aged or handicapped people suffering from mild difficulties in their upper limbs. In this fiscal year, basic designs have been prepared for the gait training system and the lower limb rehabilitation system, and a preparatory survey is conducted for the upper limb training support system. (NEDO)

  14. Unvealing the Principal Modes of Human Upper Limb Movements through Functional Analysis

    Directory of Open Access Journals (Sweden)

    Giuseppe Averta

    2017-08-01

    Full Text Available The rich variety of human upper limb movements requires an extraordinary coordination of different joints according to specific spatio-temporal patterns. However, unvealing these motor schemes is a challenging task. Principal components have been often used for analogous purposes, but such an approach relies on hypothesis of temporal uncorrelation of upper limb poses in time. To overcome these limitations, in this work, we leverage on functional principal component analysis (fPCA. We carried out experiments with 7 subjects performing a set of most significant human actions, selected considering state-of-the-art grasp taxonomies and human kinematic workspace. fPCA results show that human upper limb trajectories can be reconstructed by a linear combination of few principal time-dependent functions, with a first component alone explaining around 60/70% of the observed behaviors. This allows to infer that in daily living activities humans reduce the complexity of movement by modulating their motions through a reduced set of few principal patterns. Finally, we discuss how this approach could be profitably applied in robotics and bioengineering, opening fascinating perspectives to advance the state of the art of artificial systems, as it was the case of hand synergies.

  15. [Quality of professional life and musculoskeletal disorders in nurses].

    Science.gov (United States)

    Rodarte-Cuevas, Lilia; Araujo-Espino, Roxana; Trejo-Ortiz, Perla María; González-Tovar, José

    To characterize the conditions of quality of working life, the presence of muscle- skeletal disorders and the association between these variables in nursing staff of a public hospital in Zacatecas, Mexico. A cross-sectional study with descriptive-correlational scope was designed. A stratified random sampling per shift was used in 107 cases. The Questionnaire Professional Quality of Life (CVP-35) was applied as well as the Nordic Questionnaire Standardized for musculoskeletal pain and work-related risk factors questionnaire. The quality of working life gained an average of 55.62 (SD=13.57), the intrinsic motivation was the best rated component with (M=75.06, SD=18.44), contrary to managerial support that got the lowest scores with (M=43.74, SD=21.71). The presence of risk factors in the development work of musculoskeletal problems obtained a mean of 50.10 (SD=26.69). The main musculoskeletal disorders occurred in the neck region, lumbar spine and knees with 42.1% for each one. The quality of working life decreased in the presence of muscle-skeletal problems in the lumbar region with (-0.188, p≤.050), dorsal (-0.206, p≤.050), neck (-0.175, p≤.050) and knees (-0.220, p≤.010). It is necessary to improve the working conditions of nurses to reduce the presence of musculoskeletal problems and improve their quality of working life. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. Musculoskeletal disorders among first-year Ghanaian students in a ...

    African Journals Online (AJOL)

    Keywords: Musculoskeletal disorders, nursing students, functional impairment. ... female sex6,7,14,17, lack of regular exer- cise13,18 and psychosocial stress and mental pressure6,15 .... students in China and Malaysia respectively. There is.

  17. Mirror therapy for upper limb rehabilitation in chronic patients after stroke

    OpenAIRE

    Mota, Dreyzialle Vila Nova; Meireles, André Luís Ferreira de; Viana, Marcelo Tavares; Almeida, Rita de Cássia de Albuquerque

    2016-01-01

    Abstract Introduction: Individuals with stroke sequelae present changes in the postural alignment and muscle strength associated with hemiplegia or hemiparesis. Mirror therapy is a technique that aims to improve the motor function of the paretic limb. Objective: The aim of this study was to evaluate the effect of mirror therapy, associated with conventional physiotherapy, for range of motion (ROM), degree of spasticity of the affected upper limb, and the level of independence in the activ...

  18. Rehabilitation of Upper Limb in Children with Acquired Brain Injury: A Preliminary Comparative Study

    Directory of Open Access Journals (Sweden)

    Elena Beretta

    2018-01-01

    Full Text Available Acquired brain injuries (ABIs can lead to a wide range of impairments, including weakness or paralysis on one side of the body known as hemiplegia. In hemiplegic patients, the rehabilitation of the upper limb skills is crucial, because the recovery has an immediate impact on patient quality of life. For this reason, several treatments were developed to flank physical therapy (PT and improve functional recovery of the upper limbs. Among them, Constraint-Induced Movement Therapy (CIMT and robot-aided therapy have shown interesting potentialities in the rehabilitation of the hemiplegic upper limb. Nevertheless, there is a lack of quantitative evaluations of effectiveness in a standard clinical setting, especially in children, as well as a lack of direct comparative studies between these therapeutic techniques. In this study, a group of 18 children and adolescents with hemiplegia was enrolled and underwent intensive rehabilitation treatment including PT and CIMT or Armeo®Spring therapy. The effects of the treatments were assessed using clinical functional scales and upper limb kinematic analysis during horizontal and vertical motor tasks. Results showed CIMT to be the most effective in terms of improved functional scales, while PT seemed to be the most significant in terms of kinematic variations. Specifically, PT resulted to have positive influence on distal movements while CIMT conveyed more changes in the proximal kinematics. Armeo treatment delivered improvements mainly in the vertical motor task, showing trends of progresses of the movement efficiency and reduction of compensatory movements of the shoulder with respect to other treatments. Therefore, every treatment gave advantages in a specific and different upper limb district. Therefore, results of this preliminary study may be of help to define the best rehabilitation treatment for each patient, depending on the goal, and may thus support clinical decision.

  19. Rehabilitation of Upper Limb in Children with Acquired Brain Injury: A Preliminary Comparative Study.

    Science.gov (United States)

    Beretta, Elena; Cesareo, Ambra; Biffi, Emilia; Schafer, Carolyn; Galbiati, Sara; Strazzer, Sandra

    2018-01-01

    Acquired brain injuries (ABIs) can lead to a wide range of impairments, including weakness or paralysis on one side of the body known as hemiplegia. In hemiplegic patients, the rehabilitation of the upper limb skills is crucial, because the recovery has an immediate impact on patient quality of life. For this reason, several treatments were developed to flank physical therapy (PT) and improve functional recovery of the upper limbs. Among them, Constraint-Induced Movement Therapy (CIMT) and robot-aided therapy have shown interesting potentialities in the rehabilitation of the hemiplegic upper limb. Nevertheless, there is a lack of quantitative evaluations of effectiveness in a standard clinical setting, especially in children, as well as a lack of direct comparative studies between these therapeutic techniques. In this study, a group of 18 children and adolescents with hemiplegia was enrolled and underwent intensive rehabilitation treatment including PT and CIMT or Armeo®Spring therapy. The effects of the treatments were assessed using clinical functional scales and upper limb kinematic analysis during horizontal and vertical motor tasks. Results showed CIMT to be the most effective in terms of improved functional scales, while PT seemed to be the most significant in terms of kinematic variations. Specifically, PT resulted to have positive influence on distal movements while CIMT conveyed more changes in the proximal kinematics. Armeo treatment delivered improvements mainly in the vertical motor task, showing trends of progresses of the movement efficiency and reduction of compensatory movements of the shoulder with respect to other treatments. Therefore, every treatment gave advantages in a specific and different upper limb district. Therefore, results of this preliminary study may be of help to define the best rehabilitation treatment for each patient, depending on the goal, and may thus support clinical decision.

  20. Effectiveness of Occupational Therapy Interventions for Lower-Extremity Musculoskeletal Disorders: A Systematic Review.

    Science.gov (United States)

    Dorsey, Julie; Bradshaw, Michelle

    Lower-extremity (LE) musculoskeletal disorders (MSDs) can have a major impact on the ability to carry out daily activities. The effectiveness of interventions must be examined to enable occupational therapy practitioners to deliver the most appropriate services. This systematic review examined the literature published between 1995 and July 2014 that investigated the effectiveness of occupational therapy interventions for LE MSDs. Forty-three articles met the criteria and were reviewed. Occupational therapy interventions varied on the basis of population subgroup: hip fracture, LE joint replacement, LE amputation or limb loss, and nonsurgical osteoarthritis and pain. The results indicate an overall strong role for occupational therapy in treating clients with LE MSDs. Activity pacing is an effective intervention for nonsurgical LE MSDs, and multidisciplinary rehabilitation is effective for LE joint replacement and amputation. Further research on specific occupational therapy interventions in this important area is needed. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  1. Physical and psychosocial indicators among office workers from public sector with and without musculoskeletal symptoms.

    Science.gov (United States)

    Barbieri, Dechristian França; Nogueira, Helen Cristina; Bergamin, Letícia Januário; Oliveira, Ana Beatriz

    2012-01-01

    Work-related musculoskeletal disorders (WRMD) are the result of the combination of different risk factors. They are very common among computer workers, mainly when neck and upper limbs are considered. Forty-two office workers from a public university participated in this study. They were divided into two groups: Symptomatic Subjects (SS, n=20) and Asymptomatic Subjects (AS, n=22), according to the Nordic Musculoskeletal Questionnaire (NMQ). Psychosocial indicators were assessed using the Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES). Workplaces were evaluated according to the Ergonomic Workplace Analysis (EWA), proposed by the Finnish Institute of Occupational Health. The NMQ showed higher weekly prevalence of complaints on neck, shoulders and wrist/hands (p=0.00) among SS. The annual prevalence of symptoms on wrist/hands was also higher among SS (p=0.02). The JCQ did not show any difference between groups (p>0.05). Higher proportion of servers with 'high level' of engagement, dedication and absorption, according to UWES, was identified among SS (p<0.01). EWA showed worse scores for 'Work Site', 'Job Content' and 'Repetitiveness of the Work' among SS (p<0.05). Servers are exposed to physical and psychosocial risk factors that can contribute to the development of WRMD. Work conditions need to be change in order to improve musculoskeletal health.

  2. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    Science.gov (United States)

    Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F.; Cuesta-Gómez, A.; Ruiz, Oscar E.

    2014-01-01

    New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation. PMID:25110698

  3. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    Directory of Open Access Journals (Sweden)

    Camilo Cortés

    2014-01-01

    Full Text Available New motor rehabilitation therapies include virtual reality (VR and robotic technologies. In limb rehabilitation, limb posture is required to (1 provide a limb realistic representation in VR games and (2 assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a the mathematical formulation and solution to the problem, (b the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c its integration into a rehabilitation VR game platform, and (d the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i animate avatars that represent the patient in VR games and (ii obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.

  4. Using commercial video games for upper limb stroke rehabilitation: is this the way of the future?

    Science.gov (United States)

    Pietrzak, Eva; Cotea, Cristina; Pullman, Stephen

    2014-01-01

    The increasing number of people living with poststroke sequelae has stimulated the search for novel ways of providing poststroke rehabilitation without putting additional stress on overburdened health care systems. One of them is the use of commercially available technology and off-the-shelf video games for hemiparetic upper limb rehabilitation. The MEDLINE, EMBASE, and Cochrane Library databases were searched using key word synonyms for stroke, upper limb, and video games. Included studies investigated upper limb stroke rehabilitation using commercially available consoles and video games, reported outcomes that included measures of upper limb functionality, and were published in a peer-reviewed journal written in English. Thirteen studies were identified - 6 published as full articles and 7 as abstracts. Studies were generally small and only 3 were randomized. The gaming systems investigated were the Nintendo Wii (n = 10), EyeToy PlayStation (n = 2), and CyWee Z (n = 1). The Nintendo Wii appears to provide the greatest benefits to patients, with improvements seen in upper extremity function measures such as joint range of motion, hand motor function, grip strength, and dexterity. Three studies indicate that video therapy appears to be safe and that long-term improvements continue at follow-up. At present, the evidence that the use of commercial video games in rehabilitation improves upper limb functionality after stroke is very limited. However, this approach has the potential to provide easily available and affordable stroke rehabilitation therapy in settings where access to therapy is limited by geographical or financial constraints.

  5. Short-Term Upper Limb Immobilization Affects Action-Word Understanding

    Science.gov (United States)

    Bidet-Ildei, Christel; Meugnot, Aurore; Beauprez, Sophie-Anne; Gimenes, Manuel; Toussaint, Lucette

    2017-01-01

    The present study aimed to investigate whether well-established associations between action and language can be altered by short-term upper limb immobilization. The dominant arm of right-handed participants was immobilized for 24 hours with a rigid splint fixed on the hand and an immobilization vest restraining the shoulder, arm, and forearm. The…

  6. Active unicameral bone cysts in the upper limb are at greater risk of fracture.

    Science.gov (United States)

    Tey, Inn Kuang; Mahadev, Arjandas; Lim, Kevin Boon Leong; Lee, Eng Hin; Nathan, Saminathan Suresh

    2009-08-01

    To elucidate the natural history of unicameral bone cyst (UBC) and risk factors for pathological fracture. 14 males and 8 females (mean age, 9 years) diagnosed with UBC were reviewed. Cyst location, symptoms, and whether there was any fracture or surgery were recorded. Cyst parameters were measured on radiographs, and included (1) the cyst index, (2) the ratio of the widest cyst diameter to the growth plate diameter, and (3) the adjusted distance of the cyst border from the growth plate. There were 11 upper- and 11 lower-limb cysts. 13 patients had pathological fractures and 9 did not. 20 patients were treated conservatively with limb immobilisation; 2 underwent curettage and bone grafting (one resolved and one did not). Seven cysts resolved (5 had fractures and 2 did not). The risk of fracture was higher in the upper than lower limbs (100% vs 18%, pFractured cysts were larger than unfractured cysts (mean cyst index, 4.5 vs. 2.2, p=0.07). Active cysts were more likely to fracture. Conservative management had a 30% resolution rate. Surgery should be considered for large active cysts in the upper limbs in order to minimise the fracture risk.

  7. Ergonomics intervention to reduce musculoskeletal disorders: case study in cement company production

    Directory of Open Access Journals (Sweden)

    Abbas Moradi

    2016-09-01

    Full Text Available Introduction:Musculoskeletal Disorders (MSDs are one of the most important factors occupational injuries and disabilities in workplaces. The aim of the persent study was ergonomics intervention to reducemusculoskeletal disorders. Methods: This interventional study was conduct on 126 preservation and maintenance  workers in cement company by classfication sampling. The Nordic Musculoskeletal Disorders Questionnaire, QEC and Ergonomics Checkpoint methods were used to collected data before and after the interventions. The interventional program include practical and easy to implment solutions for improvement safety,health and work conditions, workers trainig, selective and corrective exer Data  were analyzed by Mcnemar test using SPSS_22 software. Result: Data analysis showed  significant differences(P_value<0.001 between prevalnce of disorders during one week before interventions.  for lower back,back and were 62.70%, 60.32% and after intervention were reduce  to 46.03% and 43.65%. Conclusion: Acoording  to QEC method, 83 maintenance  workers ( 65.87% were at high risk  and prevalence  of lower back and knee was high that applying of  simple  and inexpensive solutions, participatory solutions of Ergonomics Checkpoint andselective corrective exerciselead to  musculoskeletal disorders reduction.

  8. [The role of psychosocial work factors in the development of musculoskeletal disorders in workers].

    Science.gov (United States)

    Bugajska, Joanna; Zołnierczyk-Zreda, Dorota; Jedryka-Góral, Anna

    2011-01-01

    The aim of the study was to determine the role of psychosocial work factors in the development of musculoskeletal disorders in workers. It should be stressed that over a decade these disorders have been the subject of studies because of complaints reported not only by workers performing heavy physical work or working in awkward, forced body posture. It has also been acknowledged that stress at work caused by various psychosocial work factors can significantly influence their development. One of the models, most popular nowadays, was used in the study. It takes into account various risk factors in the etiology of cervical spine disorders. Based on this model it was shown that certain psychosocial and cultural variables (e.g., work demands and control, individual variables, individual values, work group's culture) may constitute occupational stressors and, when combined with physical load factors, may lead to stress and musculoskeletal disorders. It was also indicated that such psychosocial work factors as excessive work demands (quantitative or qualitative), inadequate control at work or lack of social support are the most frequent sources of work-related stress. The article presents the results of some prospective studies in which the role of these factors in the development of musculoskeletal disorders has been considered. Apart from work properties (factors), the role of other psychological variables was shown; these include: work involvement, perfectionism, negative affectivity or work style, which in numerous studies turned out to be important risk factors in the development of musculoskeletal disorders. Finally, potential mechanisms underlying the relationships between psychosocial factors and musculoskeletal disorders were indicated. However, it was stressed that the majority of them still require to be confirmed in future descriptive or experimental studies.

  9. The Study of the Burnout and its Relationship with Musculoskeletal Disorders among Librarians Working in Public Libraries

    Directory of Open Access Journals (Sweden)

    Fatemeh Rastgari

    2015-08-01

    Full Text Available Background and objectives : In the 1960s, psychologists began to investigate the relationship between the work environment and individuals’ tolerance. Since the first harm of burnout is suffering from physical exhaustion, people who suffer from this disorder feel severe fatigue. There are several ways to confront burnout syndrome and try to reduce work-related musculoskeletal disorders: educational planning to the principles of working properly, job rotation, resting and information exchanging related to burnout and musculoskeletal injuries among employees. This study investigated the correlation of musculoskeletal disorders and burnout of librarians working in public libraries in Hamadan. Material and Methods: This is a descriptive - analytical study. The study population consisted of librarians working in public libraries in Hamadan. The census number was 112. Data collecting tools included two Nordic and burnout questionnaires. The validity of questionnaire was confirmed by the opinions of subject specialists. The questionnaire was distributed among librarians. SPSS13 software was used for statistical analysis. P Results: A significant correlations between burnout and musculoskeletal disorders (74% has been observed. The relationship between burnout dimensions and musculoskeletal areas were examined. Conclusion : Given the apparent relationship between burnout and musculoskeletal disorders, organization managers need to improve working conditions, reduce stress, working tools and training to work properly.

  10. Liminality and decision making for upper limb surgery in tetraplegia: a grounded theory.

    Science.gov (United States)

    Dunn, Jennifer A; Hay-Smith, E Jean C; Whitehead, Lisa C; Keeling, Sally

    2013-07-01

    To explore, from the perspective of the person with tetraplegia, the issues that influenced decision making about upper limb surgery and develop a conceptual framework describing the decision making process. Purposive and theoretical sampling of 22 people with tetraplegia, followed by interviews. Ten people had upper limb surgery and 12 had not. Verbatim transcripts were analyzed with constructivist grounded theory. Participants responded to the offer of surgery in one of three ways: yes, let me have it; no thanks; or possibly. Many influences on the decision about surgery had a temporal element, such as hope for the cure or recovery from SCI, inadequate physical or social supports while rehabilitating, life roles and goals, and the avoidance of re-hospitalization. The conceptual framework illustrated that many participants entered a liminal state within which they required a stimulus to review their decision about upper limb surgery. Decision making is a temporal process, and for some the process was a prolonged and liminal one. Therefore, multiple offers for surgery are required to allow for changing thoughts and circumstances throughout an individual's lifetime. Flexibility with regard to timing for surgery and type of rehabilitation may increase the uptake, especially for women. • Multiple offers for upper limb surgery are required throughout an individual's lifetime to account for changing thoughts and priorities. • Identification of the type of support required (informational, emotional) may assist in decreasing the time taken to make the decision about surgery. • Flexibility in surgical and rehabilitation options, especially for women, may increase the uptake of surgery.

  11. Origin of directionally tuned responses in lower limb muscles to unpredictable upper limb disturbances.

    Directory of Open Access Journals (Sweden)

    Ali Forghani

    Full Text Available Unpredictable forces which perturb balance are frequently applied to the body through interaction between the upper limb and the environment. Lower limb muscles respond rapidly to these postural disturbances in a highly specific manner. We have shown that the muscle activation patterns of lower limb muscles are organized in a direction specific manner which changes with lower limb stability. Ankle muscles change their activity within 80 ms of the onset of a force perturbation applied to the hand which is earlier than the onset of changes in ground reaction force, ankle angle or head motion. The latency of the response is sensitive to the perturbation direction. However, neither the latency nor the magnitude of the response is affected by stiffening the arm even though this alters the magnitude and timing of motion of the body segments. Based on the short latency, insensitivity of the change in ankle muscle activation to motion of the body segments but sensitivity to perturbation direction we reason that changes in ankle muscle activation are most likely triggered by sensory signals originating from cutaneous receptors in the hand. Furthermore, evidence that the latency of changes in ankle muscle activation depends on the number of perturbation directions suggests that the neural pathway is not confined to the spinal cord.

  12. Biomechanical Constraints Underlying Motor Primitives Derived from the Musculoskeletal Anatomy of the Human Arm.

    Science.gov (United States)

    Gritsenko, Valeriya; Hardesty, Russell L; Boots, Mathew T; Yakovenko, Sergiy

    2016-01-01

    Neural control of movement can only be realized though the interaction between the mechanical properties of the limb and the environment. Thus, a fundamental question is whether anatomy has evolved to simplify neural control by shaping these interactions in a beneficial way. This inductive data-driven study analyzed the patterns of muscle actions across multiple joints using the musculoskeletal model of the human upper limb. This model was used to calculate muscle lengths across the full range of motion of the arm and examined the correlations between these values between all pairs of muscles. Musculoskeletal coupling was quantified using hierarchical clustering analysis. Muscle lengths between multiple pairs of muscles across multiple postures were highly correlated. These correlations broadly formed two proximal and distal groups, where proximal muscles of the arm were correlated with each other and distal muscles of the arm and hand were correlated with each other, but not between groups. Using hierarchical clustering, between 11 and 14 reliable muscle groups were identified. This shows that musculoskeletal anatomy does indeed shape the mechanical interactions by grouping muscles into functional clusters that generally match the functional repertoire of the human arm. Together, these results support the idea that the structure of the musculoskeletal system is tuned to solve movement complexity problem by reducing the dimensionality of available solutions.

  13. Self-reported musculoskeletal disorder pain: The role of job hazards and work-life interaction.

    Science.gov (United States)

    Weale, Victoria P; Wells, Yvonne; Oakman, Jodi

    2018-02-01

    Previous research identified an association between work-family conflict and musculoskeletal pain. This study explores how the work-life interface might affect pain experienced by residential aged care staff. A cross-sectional survey of 426 employees in residential aged care was analyzed to assess the impacts of workplace hazards, work-family conflict, and work-life balance on self-reported musculoskeletal pain. Work-family conflict acts as a mediator of the relationships between workplace hazards and the total number of body regions at which musculoskeletal pain was experienced. Work-life balance only acts as a mediator for particular hazards and only if work-family conflict is not taken into account. Addressing work-life interaction, and in particular work-family conflict, warrants further investigation as a legitimate means through which musculoskeletal disorder risk can be reduced. Policies and practices to improve work-life interaction and reduce work-family conflict should be considered as integral components of musculoskeletal disorder risk management strategies. © 2017 Wiley Periodicals, Inc.

  14. Extracorporeal shockwave therapy in musculoskeletal disorders.

    Science.gov (United States)

    Wang, Ching-Jen

    2012-03-20

    The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy) is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy) is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave therapy (ESWT) in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65% to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneficial effects. FDA (USA) first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.

  15. Extracorporeal shockwave therapy in musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Wang Ching-Jen

    2012-03-01

    Full Text Available Abstract The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave therapy (ESWT in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65% to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneficial effects. FDA (USA first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.

  16. Design and Interaction Control of a New Bilateral Upper-Limb Rehabilitation Device

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    Qing Miao

    2017-01-01

    Full Text Available This paper proposed a bilateral upper-limb rehabilitation device (BULReD with two degrees of freedom (DOFs. The BULReD is portable for both hospital and home environment, easy to use for therapists and patients, and safer with respect to upper-limb robotic exoskeletons. It was implemented to be able to conduct both passive and interactive training, based on system kinematics and dynamics, as well as the identification of real-time movement intention of human users. Preliminary results demonstrate the potential of the BULReD for clinical applications, with satisfactory position and interaction force tracking performance. Future work will focus on the clinical evaluation of the BULReD on a large sample of poststroke patients.

  17. 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.

  18. Serum dehydroepiandrosterone sulphate, psychosocial factors and musculoskeletal pain in workers.

    Science.gov (United States)

    Marinelli, A; Prodi, A; Pesel, G; Ronchese, F; Bovenzi, M; Negro, C; Larese Filon, F

    2017-12-30

    The serum level of dehydroepiandrosterone sulphate (DHEA-S) has been suggested as a biological marker of stress. To assess the association between serum DHEA-S, psychosocial factors and musculoskeletal (MS) pain in university workers. The study population included voluntary workers at the scientific departments of the University of Trieste (Italy) who underwent periodical health surveillance from January 2011 to June 2012. DHEA-S level was analysed in serum. The assessment tools included the General Health Questionnaire (GHQ) and a modified Nordic musculoskeletal symptoms questionnaire. The relation between DHEA-S, individual characteristics, pain perception and psychological factors was assessed by means of multivariable linear regression analysis. There were 189 study participants. The study population was characterized by high reward and low effort. Pain perception in the neck, shoulder, upper limbs, upper back and lower back was reported by 42, 32, 19, 29 and 43% of people, respectively. In multivariable regression analysis, gender, age and pain perception in the shoulder and upper limbs were significantly related to serum DHEA-S. Effort and overcommitment were related to shoulder and neck pain but not to DHEA-S. The GHQ score was associated with pain perception in different body sites and inversely to DHEA-S but significance was lost in multivariable regression analysis. DHEA-S was associated with age, gender and perception of MS pain, while effort-reward imbalance dimensions and GHQ score failed to reach the statistical significance in multivariable regression analysis. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  19. Smartphone supported upper limb prosthesis

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    Hepp D.

    2015-09-01

    Full Text Available State of the art upper limb prostheses offer up to six active DoFs (degrees of freedom and are controlled using different grip patterns. This low number of DoFs combined with a machine-human-interface which does not provide control over all DoFs separately result in a lack of usability for the patient. The aim of this novel upper limb prosthesis is both offering simplified control possibilities for changing grip patterns depending on the patients’ priorities and the improvement of grasp capability. Design development followed the design process requirements given by the European Medical Device Directive 93/42 ECC and was structured into the topics mechanics, software and drive technology. First user needs were identified by literature research and by patient feedback. Consequently, concepts were evaluated against technical and usability requirements. A first evaluation prototype with one active DoF per finger was manufactured. In a second step a test setup with two active DoF per finger was designed. The prototype is connected to an Android based smartphone application. Two main grip patterns can be preselected in the software application and afterwards changed and used by the EMG signal. Three different control algorithms can be selected: “all-day”, “fine” and “tired muscle”. Further parameters can be adjusted to customize the prosthesis to the patients’ needs. First patient feedback certified the prosthesis an improved level of handling compared to the existing devices. Using the two DoF test setup, the possibilities of finger control with a neural network are evaluated at the moment. In a first user feedback test, the smartphone based software application increased the device usability, e.g. the change within preselected grip patterns and the “tired muscle” algorithm. Although the overall software application was positively rated, the handling of the prosthesis itself needs to be proven within a patient study to be

  20. Use of complementary and alternative medicine for work related musculoskeletal disorders associated with job contentment in dental professionals: Indian outlook.

    Science.gov (United States)

    Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha

    2014-04-01

    High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional therapy (CT) as a treatment modality for WRMSD. Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (PComplementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders.

  1. Evaluation of upper limb muscle fatigue based on surface electromyography.

    Science.gov (United States)

    Zhou, Qianxiang; Chen, Yuhong; Ma, Chao; Zheng, Xiaohui

    2011-10-01

    Fatigue is believed to be a major contributory factor to occupational injuries in machine operators. The development of accurate and usable techniques to measure operator fatigue is therefore important. In this study, we used a novel method based on surface electromyography (sEMG) of the biceps brachii and the Borg scale to evaluate local muscle fatigue in the upper limb after isometric muscle action. Thirteen young males performed isometric actions with the upper limb at different force levels. sEMG activities of the biceps brachii were recorded during the actions. Borg scales were used to evaluate the subjective sensation of local fatigue of the biceps brachii after the actions. sEMG activities were analyzed using the one-third band octave method, and an equation to determine the degree of fatigue was derived based on the relationship between the variable and the Borg scale. The results showed that the relationship could be expressed by a conic curve, and could be used to evaluate muscle fatigue during machine operation.

  2. Impact of early applied upper limb stimulation: The EXPLICIT-stroke programme design

    Directory of Open Access Journals (Sweden)

    Lindeman Eline

    2008-12-01

    Full Text Available Abstract Background Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS in patients with respectively a favourable or poor probability for recovery of dexterity. Methods/design 180 participants suffering from an acute, first-ever ischemic stroke will be recruited. Functional prognosis at the end of the first week post stroke is used to stratify patient into a poor prognosis group for upper limb recovery (N = 120, A2 project and a group with a favourable prognosis (N = 60, A1 project. Both groups will be randomized to an experimental arm receiving respectively modified CIMT (favourable prognosis or EMG-NMS (poor prognosis for 3 weeks or to a control arm receiving usual care. Primary outcome variable will be the Action Research Arm Test (ARAT, assessed at 1,2,3,4,5, 8, 12 and 26 weeks post stroke. To study the impact of modified CIMT or EMG-NMS on stroke recovery mechanisms i.e. neuroplasticity, compensatory movements and upper limb neuromechanics, 60 patients randomly selected from projects A1 and A2 will undergo TMS, kinematical and haptic robotic measurements within a repeated measurement design. Additionally, 30 patients from the A1 project will undergo fMRI at baseline, 5 and 26 weeks post stroke. Conclusion EXPLICIT stroke is a 5 year translational research programme which main aim is to investigate the effects of early applied intensive intervention for regaining dexterity

  3. A randomised controlled trial on whether a participatory ergonomics intervention could prevent musculoskeletal disorders.

    Science.gov (United States)

    Haukka, E; Leino-Arjas, P; Viikari-Juntura, E; Takala, E-P; Malmivaara, A; Hopsu, L; Mutanen, P; Ketola, R; Virtanen, T; Pehkonen, I; Holtari-Leino, M; Nykänen, J; Stenholm, S; Nykyri, E; Riihimäki, H

    2008-12-01

    To examine the efficacy of a participatory ergonomics intervention in preventing musculoskeletal disorders among kitchen workers. Participatory ergonomics is commonly recommended to reduce musculoskeletal disorders, but evidence for its effectiveness is sparse. A cluster randomised controlled trial among the 504 workers of 119 kitchens in Finland was conducted during 2002-2005. Kitchens were randomised to an intervention (n = 59) and control (n = 60) group. The duration of the intervention that guided the workers to identify strenuous work tasks and to seek solutions for decreasing physical and mental workload, was 11 to 14 months. In total, 402 ergonomic changes were implemented. The main outcome measures were the occurrence of and trouble caused by musculoskeletal pain in seven anatomical sites, local fatigue after work, and sick leave due to musculoskeletal disorders. Individual level data were collected by a questionnaire at baseline and every 3 months during the intervention and 1-year follow-up period. All response rates exceeded 92%. No systematic differences in any outcome variable were found between the intervention and control groups during the intervention or during the 1-year follow-up. The intervention did not reduce perceived physical work load and no evidence was found for the efficacy of the intervention in preventing musculoskeletal disorders among kitchen workers. It may be that a more comprehensive redesign of work organisation and processes is needed, taking more account of workers' physical and mental resources.

  4. [The effect of neurorehabilitation on the functional state and muscle tone of upper limb in patients after ischaemic stroke].

    Science.gov (United States)

    Klimkiewicz, Paulina; Kubsik, Anna; Jankowska, Agnieszka; Woldańska-Okońska, Marta

    2014-03-01

    Rehabilitation of upper limb in patients after ischemic stroke is a major challenge for modern neurorehabilitation. Function of upper limb of patients after ischemic stroke returns on the end of the rehabilitation comparing with another parts of the body. Below presents two groups of patients after ischemic stroke who were rehabilitated with use of the following methods: kinesiotherapy combined with NDT- Bobath method and kinesiotherapy only. The aim of this study was to assess the impact of kinesiotherapy only and NDT- Bobath method combined with kinesiotherapy on the functional state and muscle tone of upper limb in patients after ischemic stroke. The study involved a group of 40 patients after ischemic stroke with motor control and muscle tone problems of upper limb. Patients were divided into two groups, each of them included 20 people. Upper limb in group I was rehabilitated with the use of kinesiotherapy exercise however group II with the use of kinesiotherapy exercise combined with NDT- Bobath method (Neurodevelopmental Treatment Bobath). To evaluate the patients before and after rehabilitation muscle tone Asworth scale was used and to assess functional status Rivermead Motor Assessment (RMAIII) scale was used. After 5 weeks of rehabilitation in group II in majority patients were observed decrease of muscle tone and improvement in upper limb functional status. In group I the muscle tone were also decreased and functional status were better but in smaller impact than in II group. Classical kinesiotherapy combined with the NDT-Bobath method gives better results in neurorehabilitation of upper limb than the use of kinesiotherapy exercises only in patients after ischemic stroke.

  5. Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS Trial

    Directory of Open Access Journals (Sweden)

    Nick Steen

    2012-11-01

    Full Text Available Stroke imposes significant burdens on health services and society, and as such there is a growing need to assess the cost-effectiveness of stroke treatment to ensure maximum benefit is derived from limited resources. This study compared the cost-effectiveness of treating post-stroke upper limb spasticity with botulinum toxin type A plus an upper limb therapy programme against the therapy programme alone. Data on resource use and health outcomes were prospectively collected for 333 patients with post-stroke upper limb spasticity taking part in a randomized trial and combined to estimate the incremental cost per quality adjusted life year (QALY gained of botulinum toxin type A plus therapy relative to therapy alone. The base case incremental cost-effectiveness ratio (ICER of botulinum toxin type A plus therapy was £93,500 per QALY gained. The probability of botulinum toxin type A plus therapy being cost-effective at the England and Wales cost-effectiveness threshold value of £20,000 per QALY was 0.36. The point estimates of the ICER remained above £20,000 per QALY for a range of sensitivity analyses, and the probability of botulinum toxin type A plus therapy being cost-effective at the threshold value did not exceed 0.39, regardless of the assumptions made.

  6. Investigation of Factors Affecting Musculoskeletal Disorders among Hospital Emergency Nurses of Qom University of Medical Sciences, Iran

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    Mohsen Farahabadi

    2016-11-01

    Full Text Available Abstract Background and Objectives: Musculoskeletal disorders are one of the most common and costly occupational injuries, because they account for one-third of work-related injuries per year. In this study, the factors affecting musculoskeletal disorders, were investigated among hospital emergency nurses of Qom University of Medical Sciences. Methods: This study was performed as a descriptive cross-sectional study using census method on 127 nurses in the Emergency Department of hospitals affiliated to Qom University of Medical Sciences in 2014. The participants completed the Nordic musculoskeletal disorders questionnaire. Data analysis was carried out using Mann-Whitney and the Chi-square Statistical tests. The significance level was considered to be 0.05. Results: In this study, 46 (36.2% participants were men and the remaining were women. The mean age was 33.87±8.892 and the mean work hours per week was 57.71±17.675. The overall prevalence of musculoskeletal disorder was reported to be 82.7%, which had significant relationships with weight, interference with daily work, and pain per day (p0.05. Also, only 16 subjects had participated in ergonomics workshops and 118 subjects were aware of the occupational risks. Conclusion: According to the results of this study and high prevalence of musculoskeletal disorders among nurses, it is suggested that given the type of disorder, change in the way of job performance, adjustment of working hours, holding ergonomics workshops, and preventive measures be placed on the agenda. Keywords: Musculoskeletal disorder; Emergency nurses; Occupational injuries.

  7. The influence of upper limb position on the effect of a contrast agent in chest CT enhancement

    International Nuclear Information System (INIS)

    Feng, Shi-Ting; Wang, Meng; Gao, Zhenhua; Tan, Guosheng; Cai, Huasong; Hu, Xiaoshu; Yang, Jianyong; Li, Zi-Ping

    2013-01-01

    Purpose: To compare the influence of two different upper limb positions on contrast agent effects in chest CT enhancement. Materials and methods: In 142 patients undergoing contrast-enhanced CT chest scanning, an indwelling venous catheter was placed in the right hand and iodinated contrast agent was injected through a high-pressure single syringe pump. The patients were divided into three age groups (<40 years; 40–60 years; and >60 years) and randomly assigned to one of two upper limb position groups: (1) supine position, both upper limbs extended and raised above head in the same horizontal plane as the body; and (2) supine position, both upper limbs raised and crossed on the forehead, with the right arm on top. Differences in mean CT values on the two sides of the thoracic inlet along the right subclavian vein were used to evaluate the effects of the contrast agent. Results: Although contrast agent effects were not significantly different among the three age groups with either limb position, there was a significant difference between patients adopting the second limb positions (Chi-square value was 5.936, P < 0.05). An excellent or good contrast agent effect was observed in 63.08% of patients assuming the first limb position, as compared with 81.69% assuming the second position. Conclusion: For contrast-enhanced CT chest scans, use of the second limb position can reduce retention of the contrast agent in the right axillary vein and the right subclavian vein outside the thorax, increase contrast agent utilization, and decrease artifacts caused by high-density, local retention of the contrast agent

  8. Adaptive control based on an on-line parameter estimation of an upper limb exoskeleton.

    Science.gov (United States)

    Riani, Akram; Madani, Tarek; Hadri, Abdelhafid El; Benallegue, Abdelaziz

    2017-07-01

    This paper presents an adaptive control strategy for an upper-limb exoskeleton based on an on-line dynamic parameter estimator. The objective is to improve the control performance of this system that plays a critical role in assisting patients for shoulder, elbow and wrist joint movements. In general, the dynamic parameters of the human limb are unknown and differ from a person to another, which degrade the performances of the exoskeleton-human control system. For this reason, the proposed control scheme contains a supplementary loop based on a new efficient on-line estimator of the dynamic parameters. Indeed, the latter is acting upon the parameter adaptation of the controller to ensure the performances of the system in the presence of parameter uncertainties and perturbations. The exoskeleton used in this work is presented and a physical model of the exoskeleton interacting with a 7 Degree of Freedom (DoF) upper limb model is generated using the SimMechanics library of MatLab/Simulink. To illustrate the effectiveness of the proposed approach, an example of passive rehabilitation movements is performed using multi-body dynamic simulation. The aims is to maneuver the exoskeleton that drive the upper limb to track desired trajectories in the case of the passive arm movements.

  9. Effect of STS space suit on astronaut dominant upper limb EVA work performance

    Science.gov (United States)

    Greenisen, Michael C.

    1987-01-01

    The STS Space Suited and unsuited dominant upper limb performance was evaluated in order to quantify future EVA astronaut skeletal muscle upper limb performance expectations. Testing was performed with subjects standing in EVA STS foot restraints. Data was collected with a CYBEX Dynamometer enclosed in a waterproof container. Control data was taken in one g. During one g testing, weight of the Space Suit was relieved from the subject via an overhead crane with a special connection to the PLSS of the suit. Experimental data was acquired during simulated zero g, accomplished by neutral buoyancy in the Weightless Environment Training Facility. Unsuited subjects became neutrally buoyant via SCUBA BC vests. Actual zero g experimental data was collected during parabolic arc flights on board NASA's modified KC-135 aircraft. During all test conditions, subjects performed five EVA work tasks requiring dominant upper limb performance and ten individual joint articulation movements. Dynamometer velocities for each tested movement were 0 deg/sec, 30 or 60 deg/sec and 120 or 180 deg/sec, depending on the test, with three repetitions per test. Performance was measured in foot pounds of torque.

  10. Application of ultrasonography in the diagnosis of bovine musculo-skeletal disorders

    International Nuclear Information System (INIS)

    Kofler, J.

    1995-01-01

    Besides classical orthopedic examination techniques including radiography and centesis of diseased synovial cavities, for the first time ultrasonography was applied in the examination of proximal bovine limb disorders in 18 bovine patients. The clinical and radiographic findings and the results of centesis were compared with the sonographic findings. Where only soft tissues and joints were affected, the sonographic findings provided more information than radiography. This new, complementary examination technique for limb disorders in cattle offers a number of advantages. Therefore, sonography is the method of choice for differentiating affections of the soft tissue in the limbs of cattle

  11. Phantom Sensations, Supernumerary Phantom Limbs and Apotemnophilia: Three Body Representation Disorders.

    Science.gov (United States)

    Tatu, Laurent; Bogousslavsky, Julien

    2018-01-01

    Body representation disorders continue to be mysterious and involve the anatomical substrate that underlies the mental representation of the body. These disorders sit on the boundaries of neurological and psychiatric diseases. We present the main characteristics of 3 examples of body representation disorders: phantom sensations, supernumerary phantom limb, and apotemnophilia. The dysfunction of anatomical circuits that regulate body representation can sometimes have paradoxical features. In the case of phantom sensations, the patient feels the painful subjective sensation of the existence of the lost part of the body after amputation, surgery or trauma. In case of apotemnophilia, now named body integrity identity disorder, the subject wishes for the disappearance of the existing and normal limb, which can occasionally lead to self-amputation. More rarely, a brain-damaged patient with 4 existing limbs can report the existence of a supernumerary phantom limb. © 2018 S. Karger AG, Basel.

  12. Cervical Epidural Anaesthesia for Radical Mastectomy and Chronic Regional Pain Syndrome of Upper Limb - A Case Report

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    Ashok Jadon

    2009-01-01

    Full Text Available A 47-yrs-female patient presented with carcinoma right breast, swelling and allodynia of right upper limb. radical mastectomy with axillary clearance and skin grafting was done under cervical epidural anaesthesia through 18G epidural catheter placed at C6/C7 level. Postoperative analgesia and rehabilitation of affected right upper limb was managed by continuous epidural infusion of 0.125% bupivacaine and 2.5 µg/ml -1 clonidine solution through epidu-ral catheter for 5 days and physiotherapy. This case report highlights the usefulness of cervical epidural analgesia in managing a complex situation of carcinoma breast with associated periarthitis of shoulder joint and chronic regional pain syndrome (CRPS of right upper limb.

  13. The prevalence of musculoskeletal disorders and its contributing factors in farmers of Zarand in 2010-2011

    Directory of Open Access Journals (Sweden)

    Akram Jafari roodbandi

    2015-09-01

    Full Text Available Background & objective: Farmers are exposed to numerous risk factors for musculoskeletal disorders, such as awkward postures, highly repetitive movements and carrying heavy loads. The prevalence of these symptoms is therefore predicted to be significant in this group of workers. The present study was conducted to determine the prevalence of musculoskeletal disorders among farmers in Zarand county in Iran. Methods: The present descriptive, analytical, cross-sectional study was conducted on 350 farmers in Zarand. Participants were selected through simple random sampling. Data were collected by community health workers at health houses of the region using the Nordic Questionnaire. The data obtained were then analyzed in SPSS-18. Results: A total of 98% of the farmers were male, 98.9% were married and 62.9% had a normal BMI. The highest prevalence of musculoskeletal disorders was perceived in the knees (58.3 and the lowest in the elbows (8.19 over the last 12 months. The results of statistical tests showed a significant relationship between age and the prevalence of musculoskeletal disorders in all the 9 body parts examined. A significant relationship also existed between the frequency of these disorders and variables including weight and height. Work experience and good exercise habits reduced the likelihood of developing these disorders. Conclusion: The prevalence of musculoskeletal disorders was significant among the farmers examined. Performing ergonomic interventions aimed at modifying body posture at work, designing useful tools and performing exercises at set intervals are measures that should be taken to help farmers keep healthy.

  14. 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.

  15. Musculoskeletal disorders as a fatigue failure process: evidence, implications and research needs.

    Science.gov (United States)

    Gallagher, Sean; Schall, Mark C

    2017-02-01

    Mounting evidence suggests that musculoskeletal disorders (MSDs) may be the result of a fatigue failure process in musculoskeletal tissues. Evaluations of MSD risk in epidemiological studies and current MSD risk assessment tools, however, have not yet incorporated important principles of fatigue failure analysis in their appraisals of MSD risk. This article examines the evidence suggesting that fatigue failure may play an important role in the aetiology of MSDs, assesses important implications with respect to MSD risk assessment and discusses research needs that may be required to advance the scientific community's ability to more effectively prevent the development of MSDs. Practitioner Summary: Evidence suggests that musculoskeletal disorders (MSDs) may result from a fatigue failure process. This article proposes a unifying framework that aims to explain why exposure to physical risk factors contributes to the development of work-related MSDs. Implications of that framework are discussed.

  16. Sensory feedback in upper limb prosthetics.

    Science.gov (United States)

    Antfolk, Christian; D'Alonzo, Marco; Rosén, Birgitta; Lundborg, Göran; Sebelius, Fredrik; Cipriani, Christian

    2013-01-01

    One of the challenges facing prosthetic designers and engineers is to restore the missing sensory function inherit to hand amputation. Several different techniques can be employed to provide amputees with sensory feedback: sensory substitution methods where the recorded stimulus is not only transferred to the amputee, but also translated to a different modality (modality-matched feedback), which transfers the stimulus without translation and direct neural stimulation, which interacts directly with peripheral afferent nerves. This paper presents an overview of the principal works and devices employed to provide upper limb amputees with sensory feedback. The focus is on sensory substitution and modality matched feedback; the principal features, advantages and disadvantages of the different methods are presented.

  17. Factors that affect the quality of life of community-dwelling elderly women with musculoskeletal disorders.

    Science.gov (United States)

    Takemasa, Seiichi; Nakagoshi, Ryoma; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Koeda, Hideki; Naruse, Susumu

    2015-11-01

    [Purpose] This study aimed to examine the quality of life (QOL) of community-dwelling elderly women with musculoskeletal disorders and factors that affect it. [Subjects] The subjects were 27 community-dwelling elderly women with musculoskeletal disorders (mean age: 76.3 ± 7.4 years). Their physical and psychological conditions, QOL, and other characteristics were researched. [Methods] The Japanese version of Life-Space Assessment was used to assess the subjects' daily life activities; the Japanese version of Fall Efficacy Scale (FES), to assess their fear of falling; the Geriatric Depression Scale (GDS 15), to assess their depression status; and the Life Satisfaction Index K (LSIK), to assess their QOL. [Results] The results indicated that the number of family members living together, degree of pain, fear of falling, and depression affect the LSIK scores of the community-dwelling elderly women with musculoskeletal disorders. [Conclusion] The study results suggest that the LSIK scores of community-dwelling elderly women with musculoskeletal disorders can be improved by easing their pain, improving their physical abilities to prevent falls, and improving their mobility. The results also suggest that continuing rehabilitation treatment is required.

  18. Prevalence of work-related musculoskeletal disorders among physical therapists

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    Zaheen Iqbal

    2015-08-01

    Full Text Available Background: Health professions like dentistry, nursing and physical therapy have been reported at high risk for developing workrelated musculoskeletal disorders. Results of studies conducted in these occupational groups may help formulate prevention strategies. However, no such data among physical therapists has been reported in India. Material and Methods: We conducted an online survey among 100 physiotherapists in Delhi. Results: The response rate was 75%. The prevalence of work-related musculoskeletal disorders is found to be high since 92% of them reported to feel some pain after joining physical therapy which affects daily activities and even sometimes forces them to change their work. Physical therapists specialty, gender, furniture used in clinic and duration of patient contact are found to be related to the pain development (p < 0.05. Conclusions: We need to emphasize the role of ergonomics and techniques of patient handling in development of work-related pain symptoms. Med Pr 2015;66(4:459–469

  19. Ergonomic Intervention Effect in Reducing Musculoskeletal Disorders in Staff of Shiraz Medical School

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    Keyvan Pakshir

    2012-05-01

    Full Text Available Background and aims: High percentage of musculoskeletal disorders occurs due to awkward working posture and poor workstation design. So this study was conducted to determine the prevalence rate of musculoskeletal disorders , evaluate workstations and investigate the effectiveness of ergonomic interventional measures among medical school staff of Shiraz University of Medical Sciences (SUMS.   Methods: In this interventional study, 200 employees of different units of medical school of SUMS participated. They were randomly divided into experimental and control groups. Data were collected via anonymous questionnaire, RULA and QEC techniques as well as an ergonomic workstation checklist that was used to evaluate working conditions.   Results: The results showed that after conducting interventional program for the experimental group there was a significant relationship between employees' increased awareness of ergonomics and workstation improvement (p≤0.05. Additionally, the prevalence rate of reported musculoskeletal disorders in experimental group was significantly reduced following intervention (p≤0.05. After corrective measures, level of risk was decreased and working postures were improved. A significant relationship was observed between risk levels and neck and shoulder pain in the experimental group (p≤0.05 . Following the intervention, workstations scores were increased significantly. Conclusion: On the basis of the findings of this study, it could be noted that the ergonomic interventional program was effective to improve working posture and workstations as well as to reduce the prevalence of musculoskeletal disorders among the staff.

  20. Working aspects and musculoskeletal disorders of workers in a school’s lactary

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    Maria do Carmo Baracho de Alencar

    2017-03-01

    Full Text Available Objective: To investigate the working conditions and the occurrence of musculoskeletal disorders in cooks from a Primary Public School. Method: This is an ergonomic study and a case study. General data about the school and the workplace were surveyed. A questionnaire was applied to cooks to collect information on personal and work aspects and musculoskeletal symptoms. Tasks and work processes, systematic observations and records of work activities were noted in paper, as based on the methodological approach of Ergonomic Work Analysis (EWA. Results: Two cooks participated in the study. They were 43 and 49 years old. They reported musculoskeletal symptoms in the region of wrist, hands, and low back in the last 12 months; and in the cervical and low back in the last seven days. Several inappropriate working conditions were found, including some related to the physical space and thermal environment, as well as aspects of work organization (undersized team, time for delivery of foods, etc.. Conclusion: Precarious working conditions tend to favor the emergence and/or worsening of musculoskeletal disorders in cooks of Primary Public Schools, and further research aimed at prevention and health promotion are necessary

  1. Upper limb lymphedema after breast cancer treatment

    International Nuclear Information System (INIS)

    Ben Salah, H.; Bahri, M.; Jbali, B.; Daoud, J.; Guermazi, M.; Frikha, M.

    2012-01-01

    Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120). Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. (authors)

  2. Epidural electrocorticography of phantom hand movement following long-term upper-limb amputation

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    Alireza eGharabaghi

    2014-05-01

    Full Text Available Introduction: Prostheses for upper-limb amputees are currently controlled by either myoelectric or peripheral neural signals. Performance and dexterity of these devices is still limited, particularly when it comes to controlling hand function. Movement-related brain activity might serve as a complementary bio-signal for motor control of hand prosthesis. Methods: We introduced a methodology to implant a cortical interface without direct exposure of the brain surface in an upper-limb amputee. This bi-directional interface enabled us to explore the cortical physiology following long-term transhumeral amputation. In addition, we investigated neurofeedback of electrocorticographic brain activity related to the patient’s motor imagery to open his missing hand, i.e. phantom hand movement, for real-time control of a virtual hand prosthesis.Results: Both event-related brain potentials and cortical stimulation revealed mutually overlapping cortical representations of the phantom hand. Phantom hand movements could be robustly classified and the patient required only three training sessions to gain reliable control of the virtual hand prosthesis in an online closed-loop paradigm that discriminated between hand opening and rest. Conclusion: Epidural implants may constitute a powerful and safe alternative communication pathway between the brain and external devices for upper-limb amputees, thereby facilitating the integrated use of different signal sources for more intuitive and specific control of multi-functional devices in clinical use.

  3. Upper-limb biomechanical analysis of wheelchair transfer techniques in two toilet configurations.

    Science.gov (United States)

    Tsai, Chung-Ying; Boninger, Michael L; Bass, Sarah R; Koontz, Alicia M

    2018-06-01

    Using proper technique is important for minimizing upper limb kinetics during wheelchair transfers. The objective of the study was to 1) evaluate the transfer techniques used during toilet transfers and 2) determine the impact of technique on upper limb joint loading for two different toilet configurations. Twenty-six manual wheelchair users (23 men and 3 women) performed transfers in a side and front wheelchair-toilet orientation while their habitual transfer techniques were evaluated using the Transfer Assessment Instrument. A motion analysis system and force sensors were used to record biomechanical data during the transfers. More than 20% of the participants failed to complete five transfer skills in the side setup compared to three skills in the front setup. Higher quality skills overall were associated with lower peak forces and moments in both toilet configurations (-0.68 perform these skills correctly (p ≤ 0.04). In the front setup, positioning the wheelchair within three inches of the transfer target was associated with reduced peak trailing forces and moments across all three upper limb joints (p = 0.02). Transfer skills training, making toilet seats level with the wheelchair seat, positioning the wheelchair closer to the toilet and mounting grab bars in a more ideal location for persons who do sitting pivot transfers may facilitate better quality toilet transfers. Published by Elsevier Ltd.

  4. Psychosocial factors, musculoskeletal disorders and work-related fatigue amongst nurses in Brunei: structural equation model approach.

    Science.gov (United States)

    Abdul Rahman, Hanif; Abdul-Mumin, Khadizah; Naing, Lin

    2017-09-01

    Psychosocial factors, musculoskeletal disorders and work-related fatigue have adverse effects on individual nurses and place a substantial financial burden on health care. Evidence of an association has been reported in the literature, but no theoretical explanation has been published to date. To explore and develop a structural model to provide a theoretical explanation for this relationship. A cross-sectional study using data from 201 valid samples of emergency and critical care nurses across public hospitals in Brunei was performed via self-administered questionnaire. The structural equation model was assessed using partial least squares analysis. A valid and robust structural model was constructed. This revealed that 61.5% of the variance in chronic fatigue could be explained by psychosocial factors and musculoskeletal disorders pathways. Among the psychosocial factors, work-family conflict was identified as a key mediator for progression of musculoskeletal problems and subsequent fatigue through stress and burnout. This report provides a novel theoretical contribution to understanding the relationship between psychosocial factors, musculoskeletal disorders and work-related fatigue. These preliminary results may be useful for future studies on the development of work-related fatigue and musculoskeletal disorders, particularly the central role of work-family conflict. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Predictive value of upper-limb accelerometry in acute stroke with hemiparesis

    NARCIS (Netherlands)

    Gebruers, Nick; Truijen, Steven; Engelborghs, Sebastiaan; De Deyn, Peter P.

    2013-01-01

    Few studies have investigated how well early activity measurements by accelerometers predict recovery after stroke. First, we assessed the predictive value of accelerometer-based measurements of upper-limb activity in patients with acute stroke with a hemiplegic arm. Second, we established the

  6. An enquiry into the prevalence of musculoskeletal disorders and ergonomic risk factors among Hamadan-based bakers in 2017

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    Majid Motamedzade Torghabeh

    2018-01-01

    Conclusion: Musculoskeletal disorders of the knees, the middle and lower back, shoulders and wrists are of a high prevalence among bakers of traditional bread. Therefore, both engineering and management interventions are recommended to eliminate musculoskeletal disorders.

  7. Musculoskeletal pain in Dentistry students

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    Rosane Batista e Silva

    2010-06-01

    Full Text Available Objective: To investigate the frequency of musculoskeletal pain in dental students. Methods: A descriptive study of observational and cross-sectional approach in which was used an Ergonomics and Posture Questionnaire for Dentists adapted by the researchers, associated with the Cooler Quiz. The sample comprised 43 students who attended between the 6th, 8th and 10th academic periods. The data were submitted to descriptive analysis and expressed as percentages, means and standard deviations, also maximum and minimum. For the comparative analysis between the variables, we used the chi-square test, chi-square test with Yates correction or Fisher exact test, when necessary, considering the significance level of 5%. Results: Among the students surveyed 20 (46.51% were men and 23 (53.5% women with a mean age of 23.14 ± 10.24 years, maximum of 35 years and minimum of 19. It was found that 40 (93.02% reported pain in some part of the body, 23 (53.5% in the upper limbs, 20 (46.5% in the lower limbs and 37 (86% in axial skeleton, with no difference between genders (p = 0.59. Pain intensity was classified as mild 10 (25%, moderate 21(52.5% and severe 7 (17.5%. In the assessment we evidenced the direct correlation between the hours of trainning and the intensity of pain. Conclusions: The results of the survey showed that the students assessed developed high frequency of musculoskeletal pain and that pain was associated with hours of daily training held during graduation at the dental clinic.

  8. THE PREVALENCE OF MUSCULOSKELETAL DISORDERS AND THEIR ASSOCIATION WITH RISK FACTORS IN AUTO RICKSHAW DRIVERS - A SURVEY IN GUNTUR CITY

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    Rahul Shaik

    2014-09-01

    Full Text Available Background and Purpose: Musculoskeletal disorders represent largest category of work related illness in India. Variety of internal and external factors leads to postural stress in vehicle drivers that affects the functioning of musculoskeletal system. Vibration, studied extensively among various risk factors causing musculoskeletal disorders. Hence, the current study focused on various risk factors. Objectives: To know the prevalence of musculoskeletal disorders and their association with possible risk factors in auto rickshaw drivers. Investigation Tools: Nordic musculoskeletal questionnaire (NMSQ, inch tape, vibrometer. Methodology: NMSQ has been used to document prevalence of musculoskeletal disorders in 300 subjects. Vibrometer and inch tape were used to measure risk factors like driver’s seat vibration and work space envelope (shoulder to handle distance, lower cabin space. Associations with risk factors were analyzed by logistic regression. Results: Work experience and working hours per week showed a significant positive association with knee problems (p=0.009, p=0.006 respectively. Shoulder to handle distance on right side showed significant negative association with knee problems (p=0.013. Driver’s seat vibration showed strong significant positive association with low backache (p=0.000. No variable showed significant association with neck troubles. Working experience and lower cabin space are significantly associated with ankle problems (p=0.012, p=0.045 respectively.Age, work experience and shoulder to handle distance on left side showed significant positive association with general musculoskeletal troubles (p=0.029, p= 0.005, p=0.045 respectively. Conclusion: Lower back, knee, neck and ankle troubles are more prevalent in auto rickshaw drivers. Increasing age, work experience, maximum working hours per week, increased left shoulder to handle distance and greater driver’s seat vibrations are increasing the risk of musculoskeletal

  9. Upper limb muscle activation during sports video gaming of persons with spinal cord injury.

    Science.gov (United States)

    Jaramillo, Jeffrey P; Johanson, M Elise; Kiratli, B Jenny

    2018-04-04

    Video gaming as a therapeutic tool has largely been studied within the stroke population with some benefits reported in upper limb motor performance, balance, coordination, and cardiovascular status. To date, muscle activation of upper limb muscles in persons with spinal cord injuries (SCI) has not been studied during video game play. In this paper, we provide descriptive and comparative data for muscle activation and strength during gaming for players with tetraplegia and paraplegia, as well as, compare these results with data from traditional arm exercises (ie, biceps curl and shoulder press) with light weights which are commonly prescribed for a home program. Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia). We measured upper limb muscle activation with surface electromyography (EMG) during Wii Sports video game play. Muscle activation was recorded from the playing arm during 4 selected games and normalized to a maximum voluntary contraction (MVC). Heart rate and upper limb motion were recorded simultaneously with EMG. Wilcoxon signed rank tests were used to analyze differences in muscle activation between participants with paraplegia versus tetraplegia and compare gaming with traditional arm exercises with light weights. A Friedman 2-way analysis of variance identified key muscle groups active during game play. Overall muscle activation across the games was not different between those with paraplegia and tetraplegia. Heart rate during video game play for tennis and boxing were on average 10 to 20 beats/minute above resting heart rate. The magnitude of EMG was relatively greater for traditional arm exercises with light weights compared with game play. The selected Wii games were able to elicit upper extremity muscle activation and elevated heart rates for individuals with SCI that may be used to target therapeutic outcomes.

  10. Using upper limb kinematics to assess cognitive deficits in people living with both HIV and stroke.

    Science.gov (United States)

    Bui, Kevin D; Rai, Roshan; Johnson, Michelle J

    2017-07-01

    In this study, we aim to explore ways to objectively assess cognitive deficits in the stroke and HIV/stroke populations, where cognitive and motor impairments can be hard to separate. Using an upper limb rehabilitation robot called the Haptic TheraDrive, we collect performance error scores and motor learning data on the impaired and unimpaired limb during a trajectory tracking task. We compare these data to clinical cognitive scores. The preliminary results suggest a possible relationship between unimpaired upper limb performance error and visuospatial/executive function cognitive domains, but more work needs to be done to further investigate this. The potential of using robot-assisted technologies to measure unimpaired limb kinematics as a tool to assess cognitive deficits would be useful to inform more effective rehabilitation strategies for HIV, stroke, and HIV/stroke populations.

  11. Assessing the impact of upper limb disability following stroke: a qualitative enquiry using internet-based personal accounts of stroke survivors.

    Science.gov (United States)

    Poltawski, Leon; Allison, Rhoda; Briscoe, Simon; Freeman, Jennifer; Kilbride, Cherry; Neal, Debbie; Turton, Ailie J; Dean, Sarah

    2016-01-01

    Upper limb disability following stroke may have multiple effects on the individual. Existing assessment instruments tend to focus on impairment and function and may miss other changes that are personally important. This study aimed to identify personally significant impacts of upper limb disability following stroke. Accounts by stroke survivors, in the form of web-based diaries (blogs) and stories, were sought using a blog search engine and in stroke-related web-sites. Thematic analysis using the World Health Organisation's International Classification of Functioning Disability and Health (ICF) was used to identify personal impacts of upper limb disability following stroke. Ninety-nine sources from at least four countries were analysed. Many impacts were classifiable using the ICF, but a number of additional themes emerged, including emotional, cognitive and behavioural changes. Blogs and other web-based accounts were easily accessible and rich sources of data, although using them raised several methodological issues, including potential sample bias. A range of impacts was identified, some of which (such as use of information technology and alienation from the upper limb) are not addressed in current assessment instruments. They should be considered in post-stroke assessments. Blogs may help in the development of more comprehensive assessments. A comprehensive assessment of the upper limb following stroke should include the impact of upper limb problems on social participation, as well as associated emotional, cognitive and behavioural changes. Using personalised assessment instruments alongside standardised measures may help ensure that these broader domains are considered in discussions between clinicians and patients. Rehabilitation researchers should investigate whether and how these domains could be addressed and operationalised in standard upper limb assessment instruments.

  12. How work impairments and reduced work ability are associated with health care use in workers with musculoskeletal disorders, cardiovascular disorders or mental disorders

    NARCIS (Netherlands)

    K.G. Reeuwijk (Kerstin); S.J.W. Robroek (Suzan); L. van Hakkaart-van Roijen (Leona); A. Burdorf (Alex)

    2014-01-01

    markdownabstract__Abstract__ The aim of this study was to explore how work impairments and work ability are associated with health care use by workers with musculoskeletal disorders (MSD), cardiovascular disorders (CVD), or mental disorders (MD). Methods in this cross-sectional study,

  13. 6-REXOS: Upper Limb Exoskeleton Robot with Improved pHRI

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    Malin Gunasekara

    2015-04-01

    Full Text Available Close interaction can be observed between an exoskeleton robot and its wearer. Therefore, appropriate physical human-robot interaction (pHRI should be considered when designing an exoskeleton robot to provide safe and comfortable motion assistance. Different features have been used in recent studies to enhance the pHRI in upper-limb exoskeleton robots. However, less attention has been given to integrating kinematic redundancy into upper-limb exoskeleton robots to improve the pHRI. In this context, this paper proposes a six-degrees-of-freedom (DoF upper-limb exoskeleton robot (6-REXOS for the motion assistance of physically weak individuals. The 6-REXOS uses a kinematically different structure to that of the human lower arm, where the exoskeleton robot is worn. The 6-REXOS has four active DoFs to generate the motion of the human lower arm. Furthermore, two flexible bellow couplings are attached to the wrist and elbow joints to generate two passive DoFs. These couplings not only allow translational motion in wrist and elbow joints but also a redundancy in the robot. Furthermore, the compliance of the flexible coupling contributes to avoiding misalignments between human and robot joint axes. The redundancy in the 6-REXOS is verified based on manipulability index, minimum singular value, condition number and manipulability ellipsoids. The 6-REXOS and a four-DoF exoskeleton robot are compared to verify the manipulation advantage due to the redundancy. The four-DoF exoskeleton robot is designed by excluding the two passive DoFs of the 6-REXOS. In addition, a kinematic model is proposed for the human lower arm to validate the performance of the 6-REXOS. Kinematic analysis and simulations are carried out to validate the 6-REXOS and human-lower-arm model.

  14. Correlation of physical factors with musculoskeletal pain among physiotherapists

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    Vidhi Rajen Kalyani

    2017-01-01

    Full Text Available Introduction: The etiology of musculoskeletal work related disorders remains largely unclear, pain being the predominant complaint. The prevalence of neck pain, shoulder pain, upper and lower back pain increases drastically during professional practice in Physiotherapy. This study evaluated the prevalence of musculoskeletal pain. Also, the study determined the role of modifiable risk factors for physiotherapists (physical activity, psychological status and quantity and quality of sleep for pain. Method: The study population includes 60 physiotherapists with atleast work experience of 1 year and work duration of 6 hours per day. Outcome measures used were Nordic Musculoskeletal Questionnaire as a screening tool, Orebro Musculoskeletal Pain Questionnaire, The Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH, University of Cambridge sleep questionnaire and Internet Mental Health Quality of Life (IMHQOL scale. Results: Comparatively, pain was more concentrated at spinal regions than peripheral locations among physiotherapists. Surprisingly, many physiotherapists reported multiple sites of musculoskeletal pains. Conclusion: A weak correlation was established between physical activity and musculoskeletal pain among physiotherapists.

  15. Biomedical research on the International Space Station postural and manipulation problems of the human upper limb in weightlessness

    Science.gov (United States)

    Neri, Gianluca; Zolesi, Valfredo

    2000-01-01

    Accumulated evidence, based on information gathered on space flight missions and ground based models involving both humans and animals, clearly suggests that exposure to states of microgravity conditions for varying duration induces certain physiological changes; they involve cardiovascular deconditioning, balance disorders, bone weakening, muscle hypertrophy, disturbed sleep patterns and depressed immune responses. The effects of the microgravity on the astronauts' movement and attitude have been studied during different space missions, increasing the knowledge of the human physiology in weightlessness. The purpose of the research addressed in the present paper is to understand and to assess the performances of the upper limb, especially during grasp. Objects of the research are the physiological changes related to the long-term duration spaceflight environment. Specifically, the changes concerning the upper limb are investigated, with particular regard to the performances of the hand in zero-g environments. This research presents also effects on the Earth, improving the studies on a number of pathological states, on the health care and the rehabilitation. In this perspective, a set of experiments are proposed, aimed at the evaluation of the effects of the zero-g environments on neurophysiology of grasping movements, fatigue assessment, precision grip. .

  16. Use of Complementary and Alternative Medicine for Work Related Musculoskeletal Disorders Associated With Job Contentment in Dental Professionals: Indian Outlook

    OpenAIRE

    Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha

    2014-01-01

    Background High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional ther...

  17. Concomitant upper limb fractures and short-term functional recovery in hip fracture patients: does the site of upper limb injury matter?

    Science.gov (United States)

    Di Monaco, Marco; Castiglioni, Carlotta; Vallero, Fulvia; Di Monaco, Roberto; Tappero, Rosa

    2015-05-01

    The aim of this study was to evaluate functional recovery in a subgroup of hip fracture patients who sustained a simultaneous fracture at the upper limb, taking into account the site of upper limb injury. Of 760 patients admitted consecutively to the authors' rehabilitation hospital because of a fall-related hip fracture, 700 were retrospectively investigated. Functional outcome was assessed using Barthel Index scores. In 49 of the 700 patients, a single fall resulted in both a hip fracture and a fracture of either wrist (n = 34) or proximal humerus (n = 15). The patients with concomitant shoulder fractures had lower median Barthel Index scores after rehabilitation (70 vs. 90, P = 0.003), lower median Barthel Index effectiveness (57.1 vs. 76.9, P = 0.018), and prolonged median length of stay (42 vs. 36 days, P = 0.011) than did the patients with isolated hip fractures. Significant differences persisted after adjustment for six potential confounders. The adjusted odds ratio for achieving a Barthel Index score lower than 85 was 6.71 (95% confidence interval, 1.68-26.81; P = 0.007) for the patients with concomitant shoulder fractures. Conversely, no prognostic disadvantages were associated with concomitant wrist fractures. Data show a worse functional recovery and a prolonged length of stay in the subgroup of hip fracture patients who sustained a concomitant fracture at the proximal humerus, but not at the wrist.

  18. Can We Achieve Intuitive Prosthetic Elbow Control Based on Healthy Upper Limb Motor Strategies?

    Directory of Open Access Journals (Sweden)

    Manelle Merad

    2018-02-01

    Full Text Available Most transhumeral amputees report that their prosthetic device lacks functionality, citing the control strategy as a major limitation. Indeed, they are required to control several degrees of freedom with muscle groups primarily used for elbow actuation. As a result, most of them choose to have a one-degree-of-freedom myoelectric hand for grasping objects, a myoelectric wrist for pronation/supination, and a body-powered elbow. Unlike healthy upper limb movements, the prosthetic elbow joint angle, adjusted prior to the motion, is not involved in the overall upper limb movements, causing the rest of the body to compensate for the lack of mobility of the prosthesis. A promising solution to improve upper limb prosthesis control exploits the residual limb mobility: like in healthy movements, shoulder and prosthetic elbow motions are coupled using inter-joint coordination models. The present study aims to test this approach. A transhumeral amputated individual used a prosthesis with a residual limb motion-driven elbow to point at targets. The prosthetic elbow motion was derived from IMU-based shoulder measurements and a generic model of inter-joint coordinations built from healthy individuals data. For comparison, the participant also performed the task while the prosthetic elbow was implemented with his own myoelectric control strategy. The results show that although the transhumeral amputated participant achieved the pointing task with a better precision when the elbow was myoelectrically-controlled, he had to develop large compensatory trunk movements. Automatic elbow control reduced trunk displacements, and enabled a more natural body behavior with synchronous shoulder and elbow motions. However, due to socket impairments, the residual limb amplitudes were not as large as those of healthy shoulder movements. Therefore, this work also investigates if a control strategy whereby prosthetic joints are automatized according to healthy individuals

  19. Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC).

    Science.gov (United States)

    Abdullah, B J J; Mohammad, N; Sangkar, J V; Abd Aziz, Y F; Gan, G G; Goh, K Y; Benedict, I

    2005-07-01

    The objective of this study was to prospectively determine the incidence of venous thrombosis (VT) in the upper limbs in patients with peripherally inserted central catheters (PICC). We prospectively investigated the incidence of VT in the upper limbs of 26 patients who had PICC inserted. The inclusion criteria were all patients who had a PICC inserted, whilst the exclusion criterion was the inability to perform a venogram (allergies, previous contrast medium reaction and inability of gaining venous access). Both valved and non-valved catheters were evaluated. Prior to removal of the PICC, an upper limb venogram was performed. The number of segments involved with VT were determined. The duration of central venous catheterization was classified as; less than 6 days, between 6 days and 14 days and more than 14 days. VT was confirmed in 38.5% (10/26) of the patients. The majority 85.7% (12/14) were complete occlusive thrombi and the majority of VT only involved one segment. There was no statistical correlation between the site of insertion of the PICC and the location of VT. Neither was there any observed correlation between the occurrence of VT with the patient's history of hypertension, hypercholesterolaemia, coronary artery disease, diabetes mellitus, cardiac insufficiency, smoking or cancer. There was also no statistical correlation with the size of the catheter. In conclusion, PICCs are associated with a significant risk of upper extremity deep vein thrombosis (UEVT).

  20. Musculoskeletal disorders among first-year Ghanaian students in a ...

    African Journals Online (AJOL)

    Musculoskeletal disorders among first-year Ghanaian students in a nursing college. Jubilant Kwame ... Abstract: Objective: To estimate the prevalence and extent of MSDs among a sample of freshmen in a nursing college in Ghana. Methods: A ... cise13,18 and psychosocial stress and mental pressure6,15 have been ...

  1. Upper Limb Muscle and Brain Activity in Light Assembly Task on Different Load Levels

    Science.gov (United States)

    Zadry, Hilma Raimona; Dawal, Siti Zawiah Md.; Taha, Zahari

    2010-10-01

    A study was conducted to investigate the effect of load on upper limb muscles and brain activities in light assembly task. The task was conducted at two levels of load (Low and high). Surface electromyography (EMG) was used to measure upper limb muscle activities of twenty subjects. Electroencephalography (EEG) was simultaneously recorded with EMG to record brain activities from Fz, Pz, O1 and O2 channels. The EMG Mean Power Frequency (MPF) of the right brachioradialis and the left upper trapezius activities were higher on the high-load task compared to low-load task. The EMG MPF values also decrease as time increases, that reflects muscle fatigue. Mean power of the EEG alpha bands for the Fz-Pz channels were found to be higher on the high-load task compared to low-load task, while for the O1-O2 channels, they were higher on the low-load task than on the high-load task. These results indicated that the load levels effect the upper limb muscle and brain activities. The high-load task will increase muscle activities on the right brachioradialis and the left upper tapezius muscles, and will increase the awareness and motivation of the subjects. Whilst the low-load task can generate drowsiness earlier. It signified that the longer the time and the more heavy of the task, the subjects will be more fatigue physically and mentally.

  2. Upper limb stroke rehabilitation: the effectiveness of Stimulation Assistance through Iterative Learning (SAIL).

    Science.gov (United States)

    Meadmore, Katie L; Cai, Zhonglun; Tong, Daisy; Hughes, Ann-Marie; Freeman, Chris T; Rogers, Eric; Burridge, Jane H

    2011-01-01

    A novel system has been developed which combines robotic therapy with electrical stimulation (ES) for upper limb stroke rehabilitation. This technology, termed SAIL: Stimulation Assistance through Iterative Learning, employs advanced model-based iterative learning control (ILC) algorithms to precisely assist participant's completion of 3D tracking tasks with their impaired arm. Data is reported from a preliminary study with unimpaired participants, and also from a single hemiparetic stroke participant with reduced upper limb function who has used the system in a clinical trial. All participants completed tasks which involved moving their (impaired) arm to follow an image of a slowing moving sphere along a trajectory. The participants' arm was supported by a robot and ES was applied to the triceps brachii and anterior deltoid muscles. During each task, the same tracking trajectory was repeated 6 times and ILC was used to compute the stimulation signals to be applied on the next iteration. Unimpaired participants took part in a single, one hour training session and the stroke participant undertook 18, 1 hour treatment sessions composed of tracking tasks varying in length, orientation and speed. The results reported describe changes in tracking ability and demonstrate feasibility of the SAIL system for upper limb rehabilitation. © 2011 IEEE

  3. Musculoskeletal Disorders among Iranian Coal Miners at 2014

    Directory of Open Access Journals (Sweden)

    Mashallah Aghillinejad

    2016-02-01

    Full Text Available Some factors such as stooping posture and frequent kneeling in miners can increase prevalence of their musculoskeletal disorders Present study was performed for assessment of MSDs prevalence among Iranian coal miners and finds its relationships with some their characters including age, work experience and body mass index. Participants in the persent cross sectional study, were 505 coal miners which selected among Iranian coal miners by simple random method. Data of musculoskeletal disorders (MSDs gathered by Standardized Nordic self-reporting questionnaire. Demographic and work related data were collected into the check list. Findings of persent study showed that 56.1% and 66.5% of study miners claimed one of the MSDs complaints during last week and in the last year respectively. Lumbar, Knee(s and Back had most common MSDs prevalence at last week and year. MSDs prevalence had significant association with age (P≤0.02 and non-significant association with BMI (P≥0.8 of workers. MSDs in Iranian coal miners were happened in high rate. Ergonomic interventions strategies in the workplaces must be focussed for elimination of environmental hazards such as apposition at the time of work, manual handling of heavy loads.

  4. Hybrid robotic systems for upper limb rehabilitation after stroke: A review.

    Science.gov (United States)

    Resquín, Francisco; Cuesta Gómez, Alicia; Gonzalez-Vargas, Jose; Brunetti, Fernando; Torricelli, Diego; Molina Rueda, Francisco; Cano de la Cuerda, Roberto; Miangolarra, Juan Carlos; Pons, José Luis

    2016-11-01

    In recent years the combined use of functional electrical stimulation (FES) and robotic devices, called hybrid robotic rehabilitation systems, has emerged as a promising approach for rehabilitation of lower and upper limb motor functions. This paper presents a review of the state of the art of current hybrid robotic solutions for upper limb rehabilitation after stroke. For this aim, studies have been selected through a search using web databases: IEEE-Xplore, Scopus and PubMed. A total of 10 different hybrid robotic systems were identified, and they are presented in this paper. Selected systems are critically compared considering their technological components and aspects that form part of the hybrid robotic solution, the proposed control strategies that have been implemented, as well as the current technological challenges in this topic. Additionally, we will present and discuss the corresponding evidences on the effectiveness of these hybrid robotic therapies. The review also discusses the future trends in this field. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  5. Assessing the impact of upper limb disability following stroke: a qualitative enquiry using internet-based personal accounts of stroke survivors

    Science.gov (United States)

    Poltawski, Leon; Allison, Rhoda; Briscoe, Simon; Freeman, Jennifer; Kilbride, Cherry; Neal, Debbie; Turton, Ailie J.; Dean, Sarah

    2016-01-01

    Abstract Purpose: Upper limb disability following stroke may have multiple effects on the individual. Existing assessment instruments tend to focus on impairment and function and may miss other changes that are personally important. This study aimed to identify personally significant impacts of upper limb disability following stroke. Methods: Accounts by stroke survivors, in the form of web-based diaries (blogs) and stories, were sought using a blog search engine and in stroke-related web-sites. Thematic analysis using the World Health Organisation’s International Classification of Functioning Disability and Health (ICF) was used to identify personal impacts of upper limb disability following stroke. Results: Ninety-nine sources from at least four countries were analysed. Many impacts were classifiable using the ICF, but a number of additional themes emerged, including emotional, cognitive and behavioural changes. Blogs and other web-based accounts were easily accessible and rich sources of data, although using them raised several methodological issues, including potential sample bias. Conclusions: A range of impacts was identified, some of which (such as use of information technology and alienation from the upper limb) are not addressed in current assessment instruments. They should be considered in post-stroke assessments. Blogs may help in the development of more comprehensive assessments.Implications for RehabilitationA comprehensive assessment of the upper limb following stroke should include the impact of upper limb problems on social participation, as well as associated emotional, cognitive and behavioural changes.Using personalised assessment instruments alongside standardised measures may help ensure that these broader domains are considered in discussions between clinicians and patients.Rehabilitation researchers should investigate whether and how these domains could be addressed and operationalised in standard upper limb assessment instruments. PMID

  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. [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.

  8. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: A systematic review

    NARCIS (Netherlands)

    D.C. Bervoets (Diederik C.); P.A.J. Luijsterburg (Pim); J.J.N. Alessie (Jeroen J.N.); M.J. Buijs (Martijn J.); A.P. Verhagen (Arianne)

    2015-01-01

    textabstractQuestion: Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? Design: Systematic review of randomised clinical trials. Participants: People with musculoskeletal disorders. Interventions: Massage therapy (manual

  9. Relationship between Musculoskeletal Disorders and Quality of Life in Employees of Selected Hospitals in Golestan Province

    Directory of Open Access Journals (Sweden)

    Shahnaz Tabatabaei

    2017-06-01

    Full Text Available Introduction and purpose: In this study, we attempted to investigate the relationship between musculoskeletal disorders and quality of life in staff of selected hospitals in Golestan Province, Iran. Methods: In this descriptive-analytic study, the study population included all the employees (n=770 of Kordkuy Heart Hospital and Khatam al-Anbia Hospital of Gonbad Kavus, Golestan Province, Iran. The standard sample size was estimated at 256 based on Morgan Table. Considering the probability of subject attrition and to bolster the validity of the study, 300 employees (150 Kurdkuy and 150 Gonbad Kavus from different occupational groups were randomly selected by stratified sampling. To collect the data, a demographic information form, the Nordic Musculoskeletal Questionnaire, and the Lancashire quality of life profile were used. Independent t-test was run in SPSS, version 22. Results: During the past year, the neck and knee were the most problematic areas, and the elbows and thighs caused the least amount of pain or discomfort among the employees. There was a significant difference between different dimensions of quality of life with consideration of musculoskeletal disorders in different areas of the body. Musculoskeletal disorders in various areas significantly diminished different aspects of quality of life. In the physical aspect of quality of life, the employees suffering from musculoskeletal disorders in all areas were significantly different from those without any problems. Conclusion: According to the results of this study, musculoskeletal disorders are one of the workplace damages that affect employees’ quality of life. Indeed, in addition to high costs, it undermines physical, mental, and social health, hence low productivity of employees.

  10. Ultrasonography for the diagnosis of tendinitis and electromyography for the diagnosis of peripheral neuropathy and upper limb radiculopathy: rheumatologists' perspectives.

    Science.gov (United States)

    Helfenstein, Milton; Ferreira, Mario Soares; Maia, Anna Beatriz Assad; Siena, César Augusto Fávaro; Techy, Antonio

    2013-01-01

    To ascertain the value ascribed by Brazilian rheumatologists to ultrasonography (US) for diagnosing tendinitis and to electromyography (EMG) for diagnosing peripheral neuropathy and upper limb radiculopathy. In total, 165 rheumatologists answered an anonymous survey (sent via the internet) concerning the two exams, with respect to the following characteristics: reliability, diagnostic accuracy, the importance and necessity of these tests for diagnostic The study revealed that most of the rheumatologists recognised that these exams are operator-dependent, that clinicians do not rely entirely on the results, that these exams are not mandatory for the diagnoses listed, and that professionals who perform these exams should be better trained to provide reliable results. The Brazilian rheumatologists believe the following: the results of these exams should be interpreted with caution and are not definitive for diagnosis; musculoskeletal US and EMG should be performed by trained professionals; and there must be better preparation of the professionals who perform these exams.

  11. A robot hand testbed designed for enhancing embodiment and functional neurorehabilitation of body schema in subjects with upper limb impairment or loss.

    Science.gov (United States)

    Hellman, Randall B; Chang, Eric; Tanner, Justin; Helms Tillery, Stephen I; Santos, Veronica J

    2015-01-01

    Many upper limb amputees experience an incessant, post-amputation "phantom limb pain" and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF), rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech "rubber hand" illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the "BairClaw" presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger-object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced cognitive burden.

  12. A robot hand testbed designed for enhancing embodiment and functional neurorehabilitation of body schema in subjects with upper limb impairment or loss

    Directory of Open Access Journals (Sweden)

    Randall B. Hellman

    2015-02-01

    Full Text Available Many upper limb amputees experience an incessant, post-amputation phantom limb pain and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF, rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech rubber hand illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the BairClaw presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger-object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced

  13. Impact of virtual reality games on psychological well-being and upper limb performance in adults with physical disabilities: A pilot study.

    Science.gov (United States)

    Singh, D K A; Rahman, N N A; Seffiyah, R; Chang, S Y; Zainura, A K; Aida, S R; Rajwinder, K H S

    2017-04-01

    There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities. Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test. Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention. There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.

  14. The Pilates method in the rehabilitation of musculoskeletal disorders: a systematic review

    Directory of Open Access Journals (Sweden)

    Josiane Cristiane Cruz

    Full Text Available Abstract Introduction: Joseph Pilates created an authentic method of physical and mental conditioning, which he called Contrology and defined as the complete coordination of body, mind and spirit. Recent studies indicate that the Pilates Method is a useful tool in rehabilitation can improve overall health, sports performance and help in the prevention and attenuation of injuries and disorders of the musculoskeletal system. Musculoskeletal disorders are prevalent and costly conditions that develop gradually, presenting a chronic course and often remain untreated. Objective: This study aimed to identify the effects of the Pilates Method in the rehabilitation of musculoskeletal disorders through a systematic review. Methods: An active search was performed in the PubMed, PEDro, Scielo and Bireme databases. A total of 24 studies were pre-selected and their methodological quality was evaluated based on the PEDro scale. Of these, 14 fulfilled the selection criteria. Results: The studies analyzed indicate that Pilates can be effective both for the treatment of conditions such as scoliosis, back pain, ankylosing spondylitis and breast cancer, and for preventing injuries in adults, elderly people and athletes. Conclusion: The high methodological variability requires that these studies be viewed with caution. It indicates the need for the performance of new studies with high methodological quality and standardization of evaluation instruments.

  15. Review on Upper Limb Continuous Passive Motion Devices

    Directory of Open Access Journals (Sweden)

    Ragazzo Francesco

    2016-01-01

    Full Text Available The paper is devoted to a survey on the state of the art of elements and parts for the upper limb rehabilitation. As a matter of fact, the use of technological, and specifically of robotic, devices is entering in the habits of clinical approaches, due to their ability to work efficiently and to be able to obtain, at least, the same rehabilitation results of manual therapy. At the same time, the therapists can change his/her role in rehabilitation activity from a physical contribution to an intellectual/motivational one.

  16. 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.

  17. [Characteristics of pain syndrome in patients with upper limbs occupational polyneuropathies].

    Science.gov (United States)

    Kochetova, O A; Mal'kova, N Yu

    2015-01-01

    Pain syndrome accompanies various diseases of central and peripheral nervous system--that is one of the most important problems in contemporary neurology. Many scientists are in search for effective diagnostic and therapeutic tools. The article covers characteristics of the pain syndrome and its mechanisms in patients with upper limbs occupational polyneuropathies.

  18. [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.

  19. Using Data From the Microsoft Kinect 2 to Quantify Upper Limb Behavior: A Feasibility Study.

    Science.gov (United States)

    Dehbandi, Behdad; Barachant, Alexandre; Harary, David; Long, John Davis; Tsagaris, K Zoe; Bumanlag, Silverio Joseph; He, Victor; Putrino, David

    2017-09-01

    The objective of this study was to assess whether the novel application of a machine learning approach to data collected from the Microsoft Kinect 2 (MK2) could be used to classify differing levels of upper limb impairment. Twenty-four healthy subjects completed items of the Wolf Motor Function Test (WMFT), which is a clinically validated metric of upper limb function for stroke survivors. Subjects completed the WMFT three times: 1) as a healthy individual; 2) emulating mild impairment; and 3) emulating moderate impairment. A MK2 was positioned in front of participants, and collected kinematic data as they completed the WMFT. A classification framework, based on Riemannian geometry and the use of covariance matrices as feature representation of the MK2 data, was developed for these data, and its ability to successfully classify subjects as either "healthy," "mildly impaired," or "moderately impaired" was assessed. Mean accuracy for our classifier was 91.7%, with a specific accuracy breakdown of 100%, 83.3%, and 91.7% for the "healthy," "mildly impaired," and "moderately impaired" conditions, respectively. We conclude that data from the MK2 is of sufficient quality to perform objective motor behavior classification in individuals with upper limb impairment. The data collection and analysis framework that we have developed has the potential to disrupt the field of clinical assessment. Future studies will focus on validating this protocol on large populations of individuals with actual upper limb impairments in order to create a toolkit that is clinically validated and available to the clinical community.

  20. Eponyms in imaging of the upper limb: A historical review

    International Nuclear Information System (INIS)

    Murphy, Frederick; Gunn, Heather

    2012-01-01

    This paper provides an initial debate on the use of eponyms used in trauma imaging. This is followed by a review of common and interesting eponyms associated with upper limb trauma. The origin of these eponyms, which are still used in clinical practice, is often unclear or not actually attributed to the originator of the fracture type. Trauma eponyms are considered within this paper from the distal to the proximal aspect of the upper limb. A brief biography of famous eponymous surgeons gives insight and background to their work and professional achievements. Each fracture is then described briefly, supported by the relevant image and a concise summary of a radiological report. Since accuracy and conciseness are essential elements of any medical communication, the use of terms that are well understood further facilitate clarity. For this reason some knowledge of the originator and a full description of the eponymic fracture, plus its etymology, is still an essential part of clinical and radiographic teaching. This paper also argues that the radiographic report should always describe soft tissue and bony injuries with the concise use of standard anatomic radiographic terminology.

  1. Civil engineering airman at increased risk for injuries and injury-related musculoskeletal disorders.

    Science.gov (United States)

    Webb, Timothy S; Wells, Timothy S

    2011-03-01

    With the advent of electronic records, the opportunity to conduct research on workplace-related injuries and musculoskeletal disorders has increased dramatically. The purpose of this study was to examine the United States Air Force Civil Engineering career field to determine if they are negatively impacted by their work environment. Specifically, the objective of this study was to determine if enlisted Civil Engineering Airmen (n = 25,385) were at increased risk for injury or injury-related musculoskeletal disorders compared to enlisted Information Management/Communications Airmen (n = 28,947). Using an historical prospective design, electronic data were assembled and analyzed using Cox's proportional hazards modeling. Models were stratified by gender and adjusted for race/ethnicity, marital status, birth year, and deployment status. Male Civil Engineers were observed to be at greater risk for both inpatient injury-related musculoskeletal disorders (HR = 1.86; 95% CI = 1.54-2.26) and injuries (HR = 1.77; 95% CI = 1.48-2.11), while female Civil Engineers were more than double the risk for both inpatient injury-related musculoskeletal disorders (HR = 2.18; 95% CI = 1.28-3.73) and injuries (HR = 2.22; 95% CI = 1.27-3.88) compared to Information Management/Communications Airmen. Although analyses do not allow exploration of specific causes, they highlight the utility of using electronic data to identify occupations for further evaluation. Based on these results, additional resources were allocated to survey Civil Engineers on their physical work demands and job requirements to identify key problem areas for further study and mitigation. Copyright © 2010 Wiley-Liss, Inc.

  2. A practical description and student perspective of the integration of radiology into lower limb musculoskeletal anatomy.

    Science.gov (United States)

    Davy, S; O'Keeffe, G W; Mahony, N; Phelan, N; Barry, D S

    2017-05-01

    Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.

  3. 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.

  4. 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

  5. Musculoskeletal symptoms and ergonomic hazards among material handlers in grocery retail industries

    Science.gov (United States)

    Nasrull Abdol Rahman, Mohd; Zuhaidi, Muhammad Fareez Ahmad

    2017-08-01

    Grocery retail work can be physically demanding as material handler’s tasks involve manual lifting, lowering, carrying, pushing and pulling loads. The nature of this work puts them at a risk for serious low back pain, shoulder pain and other musculoskeletal injuries. This study was conducted by using two different types of tools which were Nordic Musculoskeletal Questionnaire (NMQ) as a survey and Washington Industrial Safety and Health Act (WISHA) Checklist as a direct observation method. Among 46 males and 14 females material handlers were involved throughout this study. For NMQ, the highest body part trouble in the last 12 months was low back pain (88.3%), followed by upper back (68.3%), neck (55.3%) and shoulder (36.7%). While for WISHA Checklist, most of them experienced hazard level involving awkward posture and high hand force. From the research conducted, musculoskeletal disorders (MSDs) and ergonomic risk factors (ERFs) do related as it showed that musculoskeletal disorders may arise if the workers ignored the safety in ergonomic hazards.

  6. Psychosocial Work Stressors, Work Fatigue, and Musculoskeletal Disorders: Comparison between Emergency and Critical Care Nurses in Brunei Public Hospitals.

    Science.gov (United States)

    Abdul Rahman, Hanif; Abdul-Mumin, Khadizah; Naing, Lin

    2017-03-01

    Little evidence estimated the exposure of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders for nurses working in South-East Asian region, and research on this subject is almost nonexistent in Brunei. The main aim of our study was to provide a comprehensive exploration and estimate exposure of the study variables amongst emergency (ER) and critical care (CC) nurses in Brunei. The study also aims to compare whether experiences of ER nurses differ from those of CC nurses. This cross-sectional study was implemented in the ER and CC departments across Brunei public hospitals from February to April 2016 by using Copenhagen Psychosocial Questionnaire II, Occupational Fatigue Exhaustion Recovery scale, and Cornell Musculoskeletal Discomfort Questionnaire. In total, 201 ER and CC nurses (82.0% response rate) participated in the study. Quantitative demands of CC nurses were significantly higher than ER nurses. Even so, ER nurses were 4.0 times more likely [95% confidence interval (2.21, 7.35)] to experience threats of violence, and 2.8 times more likely [95% confidence interval: (1.50, 5.29)] to experience chronic fatigue. The results revealed that nurses experienced high quantitative demands, work pace, stress, and burnout. High prevalence of chronic and persistent fatigue, threats of violence and bullying, and musculoskeletal pain at the neck, shoulder, upper and lower back, and foot region, was also reported. This study has provided good estimates for the exposure rate of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders among nurses in Brunei. It provided important initial insight for nursing management and policymakers to make informed decisions on current and future planning to provide nurses with a conducive work environment. Copyright © 2017. Published by Elsevier B.V.

  7. Epidemiological profile of workers with musculoskeletal disorders of a supermarket company

    Directory of Open Access Journals (Sweden)

    Marcia Benites da Silva

    Full Text Available AbstractIntroduction The epidemiological profile is considered a sensitive indicator of living conditions and the disease process. The musculoskeletal disorders are the most common causes of pain and can lead to disability or restriction of daily activities. These disorders take the name of RCT/OWRD when they are associated with work activities and may be associated with risk conditions at work.Objectives To describe the epidemiological profile of supermarket workers with musculoskeletal disorders under treatment at a physiotherapy clinic in the city of Porto Alegre, Brazil.Methods This was a cross-sectional, observational study which used retrospective data collected from 360 records of patients treated from January 2010 to December 2011 in a physiotherapy clinic that provides health services for a supermarket chain.Results There was a predominance of females (73.9%, aged 30–39 years (35.1%; 63.0% reported being single and 73.4% lived in Porto Alegre. The most commonly reported occupation was cashier (31.2%. The main reasons for referral to physiotherapy treatment were low back pain (21.4%, neck pain (19.7%, pain (16.1%, subacromial bursitis (13.9% and back pain (12.2%. Among the signs and symptoms 95.8% of the sample reported pain in chronic phase.Conclusion The prevalence of musculoskeletal pain was high in this group. The presence of pain can disable the worker for daily activities and physiotherapy becomes the therapeutic procedure of choice for their rehabilitation.

  8. Combined mirror visual and auditory feedback therapy for upper limb phantom pain: a case report

    Directory of Open Access Journals (Sweden)

    Yan Kun

    2011-01-01

    Full Text Available Abstract Introduction Phantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain. Case presentation We present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated with mirror visual feedback combined with auditory feedback with improved pain relief. Conclusion This case may suggest that auditory feedback might enhance the effectiveness of mirror visual feedback and serve as a valuable addition to the complex multi-sensory processing of body perception in patients who are amputees.

  9. Efficacy of a Virtual Reality Commercial Gaming Device in Upper Limb Recovery after Stroke: A Randomized, Controlled Study.

    Science.gov (United States)

    Kong, Keng-He; Loh, Yong-Joo; Thia, Ernest; Chai, Audrey; Ng, Chwee-Yin; Soh, Yan-Ming; Toh, Shirlene; Tjan, Soon-Yin

    2016-10-01

    To compare the efficacy of a virtual reality commercial gaming device, Nintendo wii (NW) with conventional therapy and customary care in facilitating upper limb recovery after stroke. Randomized, controlled, single-blinded study. Tertiary rehabilitation center. 105 subjects admitted to in inpatient rehabilitation program within 6 weeks of stroke onset. Subjects were randomly assigned to one of three groups of upper limb exercises: (1) NW gaming; (2) conventional therapy; (3) control. NW gaming and conventional therapy were provided fourtimes a week for 3 weeks. The main outcome measure was Fugl-Meyer assessment (FMA) of upper limb function. Secondary outcome measures included Action Research Arm Test, Functional Independence Measure, and Stroke Impact Scale. These measures were assessed at baseline, completion of intervention (week 3) and at 4 weeks and 8 weeks after completion of intervention. The primary outcome measure was the change in FMA scores at completion of intervention. The mean age was 57.5±9.8 years, and subjects were enrolled at a mean of 13.7±8.9 days after stroke. The mean baseline FMA score was 16.4±14.2. There was no difference in FMA scores between all 3 groups at the end of intervention, and at 4 and 8 weeks after completion of intervention. Similar findings were also noted for the secondary outcome measures. Twelve sessions of augmented upper limb exercises via NW gaming or conventional therapy over a 3-week period was not effective in enhancing upper limb motor recovery compared to control.

  10. Treatment of chikungunya musculoskeletal disorders: a systematic review.

    Science.gov (United States)

    Guaraldo, Lusiele; Wakimoto, Mayumi Duarte; Ferreira, Heloisa; Bressan, Clarisse; Calvet, Guilherme Amaral; Pinheiro, Geraldo Castelar; Siqueira, Andre Machado; Brasil, Patrícia

    2018-04-01

    Chikungunya virus is amongst the fastest expanding vector transmissible diseases in recent years and has been causing massive epidemics in Africa, Asia, Latin America and the Caribbean. Despite human infection by this virus being first described in the 1950s, there is a lack of adequate therapeutic evaluations to guide evidence-based recommendations. The current guidelines rely heavily in specialists' opinion and experience instead of using higher rated evidence. Areas covered: A systematic review of the literature was performed- not restricted to clinical trials - reporting the therapeutic response against this infection with the intent to gather the best evidence of the treatment options against musculoskeletal disorders following chikungunya fever. The 15 studies included in the analysis were categorized considering the initiation of treatment during the acute, subacute and chronic phase. Expert commentary: This review demonstrates the complexity of chikungunya fever and difficulty of therapeutic management. This review found no current evidence-based treatment recommendations for the musculoskeletal disorders following chikungunya fever. To provide an optimal treatment that prevents perpetuation or progression of chikungunya infection to a potentially destructive and permanent condition without causing more harm is an aim that must be pursued by researchers and health professionals working with this disease.

  11. Pneumatic Muscle Actuated Rehabilitation Equipment of the Upper Limb Joints

    Science.gov (United States)

    Deaconescu dr. eng. habil., Andrea, Prof.

    2017-06-01

    Rehabilitation equipment of the upper limb joints holds a key role in passive physical therapy. Within this framework, the paper presents two such pieces of equipment developed for the rehabilitation of elbow and of wrist and knuckles, respectively. The presented and discussed equipment is actuated by pneumatic muscles, its benefits being a low cost, simple and robust construction, as well as short response time to commands.

  12. 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

  13. The prevalence of musculoskeletal disorders and occupational risk factors in Kashan SAIPA automobile industry workers by key indicator method (KIM), 1390

    OpenAIRE

    2012-01-01

    Introduction: work related musculoskeletal disorders are the most wide spread type of occupational diseases among workers. Awkward body postures during work and manual material handling are among the most important risk factors of musculoskeletal disorders in different jobs. Due to importance of recognizing these factors prevalence and risk factor of work related musculoskeletal disorders, this research was aimed to study the among employees of Kashan City’s Saipa automobile industry in 2...

  14. Claw and limb disorders in 12 Norwegian beef-cow herds.

    Science.gov (United States)

    Fjeldaas, Terje; Nafstad, Ola; Fredriksen, Bente; Ringdal, Grethe; Sogstad, Ase M

    2007-09-24

    The main aim of the study was to assess the prevalence of claw and limb disorders in Norwegian beef-cow herds. Twenty-six herds with >or=15 cow-years were selected by computerized systematic assignment from the three most beef cattle-dense regions of Norway. The study population consisted of 12 herds with 28 heifers and 334 cows. The animals were trimmed and examined once by claw trimmers during the late winter and spring of 2003. The seven claw trimmers had been taught diagnosing and recording of claw lesions. Environment, feeding and management routines, age and breed, culling and carcass characteristics were also recorded. Lameness was recorded in 1.1% of the animals, and only in hind claws. Pericarpal swellings were recorded in one animal and peritarsal lesions in none. In total, claw and limb disorders including lameness were recorded in 29.6% of the animals, 4.1% with front and 28.2% with hind limb disorders, respectively. Most lesions were mild. Laminitis-related claw lesions were recorded in 18.0% of the animals and infectious lesions in 16.6%. The average claw length was 84 mm in front claws and 89 mm in hind claw. Both laminitis-related and infectious claw lesions were more prevalent with increasing age. Carcasses from animals with claw and limb disorders were on average 34 kg heavier than carcasses from animals without such disorders (p = 0.02). Our results also indicate association between some management factors and claw lesions. The study shows that the prevalence of lameness was low in 12 Norwegian beef-cow herds compared to beef-cattle herds in other countries and also that there were less claw and limb disorders in these herds compared to foreign dairy-cattle herds. The prevalence of lameness and white-line fissures was approximately the same as in Norwegian dairy herds whereas less dermatitis, heel-horn erosions, haemorrhages of the sole and the white line and sole ulcers were recorded.

  15. Claw and limb disorders in 12 Norwegian beef-cow herds

    Directory of Open Access Journals (Sweden)

    Ringdal Grethe

    2007-09-01

    Full Text Available Abstract Background The main aim of the study was to assess the prevalence of claw and limb disorders in Norwegian beef-cow herds. Methods Twenty-six herds with ≥15 cow-years were selected by computerized systematic assignment from the three most beef cattle-dense regions of Norway. The study population consisted of 12 herds with 28 heifers and 334 cows. The animals were trimmed and examined once by claw trimmers during the late winter and spring of 2003. The seven claw trimmers had been taught diagnosing and recording of claw lesions. Environment, feeding and management routines, age and breed, culling and carcass characteristics were also recorded. Results Lameness was recorded in 1.1% of the animals, and only in hind claws. Pericarpal swellings were recorded in one animal and peritarsal lesions in none. In total, claw and limb disorders including lameness were recorded in 29.6% of the animals, 4.1% with front and 28.2% with hind limb disorders, respectively. Most lesions were mild. Laminitis-related claw lesions were recorded in 18.0% of the animals and infectious lesions in 16.6%. The average claw length was 84 mm in front claws and 89 mm in hind claw. Both laminitis-related and infectious claw lesions were more prevalent with increasing age. Carcasses from animals with claw and limb disorders were on average 34 kg heavier than carcasses from animals without such disorders (p = 0.02. Our results also indicate association between some management factors and claw lesions. Conclusion The study shows that the prevalence of lameness was low in 12 Norwegian beef-cow herds compared to beef-cattle herds in other countries and also that there were less claw and limb disorders in these herds compared to foreign dairy-cattle herds. The prevalence of lameness and white-line fissures was approximately the same as in Norwegian dairy herds whereas less dermatitis, heel-horn erosions, haemorrhages of the sole and the white line and sole ulcers were

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

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    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.

  17. DIAGNOSTICS OF DISORDERS AND DISEASES OF MUSCULOSKELETAL SYSTEM IN SCHOOLCHILDREN: APPROACHES, TERMINOLOGY, CLASSIFICATION

    OpenAIRE

    N.B. Mirskaya; A.N. Kolomenskaya

    2009-01-01

    This article describes an information system for physicians working in general education institutes, which is named «Detection, correction and prophylaxis of musculoskeletal system disorders in students of general education institutes». This system was created for the purpose of improving diagnostics of initial stages of musculoskeletal system in schoolchildren, detecting of risk factors, and for the provision of timely prophylaxis during school education. The system was based on classificati...

  18. Effectiveness of Aquatic Exercise in Improving Lower Limb Strength in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Heywood, Sophie; McClelland, Jodie; Mentiplay, Benjamin; Geigle, Paula; Rahmann, Ann; Clark, Ross

    2017-01-01

    To investigate the effectiveness of aquatic exercise in improving lower limb strength in people with musculoskeletal conditions. A systematic search used 5 databases, including MEDLINE, CINAHL, Embase, SPORTDiscus, and The Cochrane Library. Randomized controlled trials evaluating aquatic exercise with a resistance training component for adults with musculoskeletal conditions compared with no intervention or land-based exercise were identified. Fifteen studies from the initial yield of 1214 met these criteria. Data related to participant demographics, study design, and methods, interventions, and outcomes, including numerical means and SDs, were extracted independently by 2 reviewers. Nine of the 15 studies were of high quality, scoring at least 6 on the Physiotherapy Evidence Database Scale. Limited consideration of the prescription of resistance in the aquatic exercise and application of resistance training principles existed. Low- or very low-quality evidence indicates there was no difference in average effect between aquatic exercise and no exercise in improving hip abductor strength (standardized mean difference [SMD], .28; 95% confidence interval [CI], -.04 to .59), knee extensor strength (SMD, .18; 95% CI, -.03 to .40), knee flexor strength (SMD, .13; 95% CI, -.20 to .45), or lower limb endurance (SMD, .35; 95% CI, -.06 to .77). Low-quality evidence indicates no difference in average effect between aquatic and land exercise for knee extensor (SMD, -.24; 95% CI, -.49 to .02) or flexor strength (SMD, -.15; 95% CI, -.53 to .22). It is likely that the inadequate application of resistance in water is a significant contributor to the limited effectiveness of aquatic exercise interventions in improving hip and knee muscle strength in people with musculoskeletal conditions. Future research is needed to quantify resistance with aquatic exercises and to determine if using opportunities for greater resistance in aquatic rehabilitation and appropriate resistance

  19. Effect of Pilates Exercise on Range of Motion and Edema of Upper Limb in Mastectomy Side

    Directory of Open Access Journals (Sweden)

    Maryam Ghorbani

    2013-09-01

    Full Text Available Background & objectives : The surgery of breast cancer like any other surgeries may bring about some problems and complications, which the knowledge of these problems may be an effective way for prevention or dealing with the complications. The motor and sensory impairments in the upper limb of the surgery side necessitate the utilization of the rehabilitation methods. The main purpose of this research was to show the effect of Pilates exercise on range of motion and edema of upper limb in females suffering from breast cancer after going through surgery.   Methods: This quasi- experimental study was conducted on 25 patients randomly chosen among the patients referring to Cancer Institute. The designed exercise included five "Mat Pilates" moves which were done for 15 sessions until the patient reached fatigue borderlines. Meantime, the control group was doing routine active exercises in physiotherapy center. The range of motion and edema of upper limb was measured before and after applying the designed exercise. For describing the data, the mean and standard deviation, and for inferential analysis, the correlated T-tests and one way analysis of variance were used in level of significance of 5%, to compare the variants before and after applying the designed exercise.   Results: The results showed a significant difference between the flexion, extension, and internal, external rotation of shoulder, flexion and extension of elbow, flexion, extension, supination deviation and pronation deviation of the wrist and forearm before and after experiment in Pilates group. While in the control group, flexion, extension, internal and external rotation of shoulder, flexion and extension of elbow, and flexion of wrist showed a significant difference before and after the experiment.   Conclusion: The use of Pilates exercise after mastectomy surgery can increase the range of motion of the upper limb in the involved side of the patients, and decrease the edema

  20. Maintained physical activity and physiotherapy in the management of distal upper limb pain - a protocol for a randomised controlled trial (the arm pain trial).

    Science.gov (United States)

    Jones, Gareth T; Mertens, Kathrin; Macfarlane, Gary J; Palmer, Keith T; Coggon, David; Walker-Bone, Karen; Burton, Kim; Heine, Peter J; McCabe, Candy; McNamee, Paul; McConnachie, Alex

    2014-03-10

    Distal upper limb pain (pain affecting the elbow, forearm, wrist, or hand) can be non-specific, or can arise from specific musculoskeletal disorders. It is clinically important and costly, the best approach to clinical management is unclear. Physiotherapy is the standard treatment and, while awaiting treatment, advice is often given to rest and avoid strenuous activities, but there is no evidence base to support these strategies. This paper describes the protocol of a randomised controlled trial to determine, among patients awaiting physiotherapy for distal arm pain, (a) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability, compared with advice to rest; and (b) whether immediate physiotherapy results in a long-term reduction in arm pain and disability, compared with physiotherapy delivered after a seven week waiting list period. Between January 2012 and January 2014, new referrals to 14 out-patient physiotherapy departments were screened for potential eligibility. Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers: 1) advice to remain active, 2) advice to rest, 3) immediate physiotherapy. Patients were and followed up at 6, 13, and 26 weeks post-randomisation by self-complete postal questionnaire and, at six weeks, patients who had not received physiotherapy were offered it at this time. The primary outcome is the proportion of patients free of disability at 26 weeks, as determined by the modified DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire.We hypothesise (a) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm; and (b) that fast-track physiotherapy will be superior to normal (waiting list) physiotherapy. These hypotheses will be examined using an intention-to-treat analysis. Results from this trial will contribute to the evidence base underpinning the

  1. Wheelchair propulsion kinematics in beginners and expert users: influence of wheelchair settings.

    Science.gov (United States)

    Gorce, P; Louis, N

    2012-01-01

    Biomechanical studies have linked the handrim wheelchair propulsion with a prevalence of upper limb musculoskeletal disorders. The purpose of this study was to examine the influence of the wheelchair settings on upper limb kinematics during wheelchair propulsion. Recordings were made under various wheelchair configuration conditions to understand the effect of wheelchair settings on kinematics parameters such shoulder, elbow and wrist angles. Ten experts and ten beginners' subjects propelled an experimental wheelchair on a roller ergometer system at a comfortable speed. Twelve wheelchair configurations were tested. Kinematics were recorded for each configuration. Based on the hand position relatively to the handrim, the main kinematic parameters of wheelchair propulsion were investigated on the whole propulsion cycle and a key event such as handrim contact and release. Compared to the beginner subjects, all the experts' subjects generally present higher joint amplitude and propulsion speeds. Seat height and antero-posterior axle position influence usage of the hand-rim, timing parameters and configurations of upper limb joints. Results seem to confirm that low and backward seat position allow a greater efficiency. Nevertheless, according that proximity of joint limit is a well known factor of musculoskeletal disorders, our results let us think that too low and backward seat position, increasing joints positions and amplitudes, could increase the risk of upper limb injuries in relation with manual wheelchair propulsion. Kinematic differences highlight that future studies on wheelchair propulsion should only be done with impaired experienced subjects. Furthermore, this study provides indications on how wheelchair settings can be used for upper limb injury prevention. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Impact of Computer Related Posture on the Occurrence of Musculoskeletal Discomfort among Secondary School Students in Lagos, Nigeria.

    Science.gov (United States)

    Odebiyi, D O; Olawale, O A; Adeniji, Y M

    2013-01-01

    Computers have become an essential part of life particularly in industrially advanced countries of the world. Children now have greater accessibility to computers both at school and at home. Recent studies suggest that with this increased exposure, there are associated musculoskeletal disorders (MSDs) in both school-aged children and adults. To assess the posture assumed by secondary school students during computer use and its impact on the occurrence and severity of reported musculoskeletal discomforts. Posture assumed during normal computer class, occurrence of discomforts, body parts involved and the intensity of discomforts were evaluated in 235 school aged children using Rapid Upper Limb Assessment (RULA) scale, Body Discomfort Chart (BDC) and Visual Analogue Scale (VAS) before and after normal computer class. Inferential statistics of t-test and chi-square were used to determine significance difference between variables, with level of significant set at p Computer use produced significant discomforts on the neck, shoulder and low back. There was a significant relationship between participants height and posture assumed. Two hundred and eleven (89.8%) participants reported discomforts/pain during the use of computer. Weight and height were contributory factors to the occurrence of musculoskeletal discomfort/pain (p computer use. Weight and height were implicated as factors that influenced the form of posture and the nature of the reported discomfort. Creating awareness about the knowledge of ergonomics and safety for promotion of good posture was therefore recommended.

  3. Risks of musculoskeletal disorders among betel quid preparers in Taiwan.

    Science.gov (United States)

    Chang, Jer-Hao; Wu, Jyun-De; Chen, Chih-Yong; Sumd, Shih-Bin; Yin, Hsin-I; Hsu, Der-Jen

    2014-04-01

    Betel quid chewing is common in Taiwan. The work of betel quid preparers is characterized by long hours of static work, awkward working posture and highly repetitive hand/wrist motion. However, the musculoskeletal health of betel quid preparers receives very little attention. The Chinese version of the Standardized Nordic Musculoskeletal Questionnaire (NMQ) was administered, and electrogoniometers and electromyography were used in this cross-sectional study to characterize the hand/wrist motion of the subjects. Physical examinations on the thumbs and wrists of the subjects were conducted by means of Phalen's test and Finkelstein's test, respectively. Among the 225 participants, more than 95% attributed their musculoskeletal complaints to their work, and shoulder, neck, hand/wrist, and lower back discomfort were most frequently reported. More than 70% of the preparers did not seek medical treatment for their musculoskeletal problems. Based on the physical examination, 24% of the participants had suspected symptom of either carpal tunnel syndrome (CTS) or DeQuervain's tenosynovitis. The instrumental measurements indicated that betel quid preparation is characterized by extreme angle ranges and moderate repetition of wrist motion as well as low forceful exertion. This study concludes that betel quid preparers are a high risk group of developing musculoskeletal disorders (MSDs). Future studies by electrogoniometers and detailed physical examination on betel quid preparers are needed to determine the predisposing factors for CTS. Some intervention measures to prevent MSDs and to lessen psychological stress for this group of workers are strongly suggested. © 2014 Wiley Periodicals, Inc.

  4. The use of Virtual Reality for upper limb rehabilitation of hemiparetic Stroke patients

    Directory of Open Access Journals (Sweden)

    Antonio Vinicius Soares

    Full Text Available Introduction The Stroke is a neurologic disturbs that leads to a serious impact to the functionality and the quality of life of the survivors. It is necessary to develop new tools with rehabilitation objectives, where the Virtual Reality (VR is introduced as a useful therapeutic resource to the motor recovery, in an attractive and efficient way, restoring functions through adapted games. Objective Analyzing the therapeutic effects of the Virtual Reality (Serious Game in the recovery of the upper limb in hemiparetic Stroke patients. Methods Quasi-experimental research type time series, there are three pre and three post-tests already accomplished around 20 VR sessions. In the assessments the following measurement instruments were used: Fugl-Meyer Scale – session of the upper limb (FMS - UL; Range of Motion (ROM for flexion and abduction shoulder; Box and Block Test (BBT; Nine Holes and Peg Test (9HPT; the Nottingham Health Profile (NHP; and the Modified Ashworth Scale (MAS. Results Significant gains were observed in the FMS-UL tests, with increase of 25.6%; increase ROM of shoulder with 34.0% for abduction and 19% for flexion; BBT 25.0%; also reported improvement in quality of life by NHP; it did not occurred significant alterations for 9HPT nor in MAS. Conclusion Although the results found in this research are preliminary, they are indicative that the VR can contribute for the recovery of the upper limb in hemiparetic Stroke patients.

  5. Understanding decision-making towards housework among women with upper limb repetitive strain injury.

    Science.gov (United States)

    Cheung, Therma W C; Clemson, Lindy; O'Loughlin, Kate; Shuttleworth, Russell

    2016-02-01

    Among women with upper limb repetitive strain injury (RSI), occupational therapy interventions include education to facilitate ergonomic practices in housework. From a client-centred perspective, an understanding of women's decision-making about housework is needed to design effective occupational therapy programmes. This study addresses a gap in research in this area by exploring women's views about changing housework habits. The aim was to construct a conceptual representation to explain decision-making in housework by drawing on experiences of a sample of Singapore Chinese women with upper limb RSI from one hand therapy clinic. Based on a constructivist grounded theory methodology, data were collected through in-depth interviewing with 15 women. Interviews were audiotaped and transcribed. Data were analysed with line by line coding, focussed coding and axial coding with constant comparison throughout data collection. Decision-making in housework among these women involved three main themes: (i) emotional attachment to housework; (ii) cognitively informed decision; and (iii) emotionally influenced decision. Women with upper limb RSI had to make cognitive decisions for or against a change in housework to manage their condition. However, the women's cognitively informed decisions were shaped by their emotional attachment to housework. As such, they experienced strong emotional barriers to changing their housework practices even when they had cognitively accepted the necessity and possibility of making a change. Therapists need to be aware that counselling to address the emotional barriers experienced by women is important during ergonomic education. © 2016 Occupational Therapy Australia.

  6. 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,

  7. Musculoskeletal problems among workers in a garment industry, at Tirupur, Tamil Nadu

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    Sreesupria Purushothaman Ravichandran

    2016-09-01

    Full Text Available Background: Every occupation has its own ill effects on health. Garment workers are denied of their basic rights and less importance is given to their health. Their health status also depends on their access to treatment and availability of healthcare facilities. Aims & Objectives: To estimate the prevalence, health seeking pattern and associated factors for musculoskeletal problems among garment workers and to assess the level of exposure of individual workers to upper limb musculoskeletal loads. Materials and methods: A cross sectional study was conducted among 380 workers in a garment industry, at Tirupur over a period of two months. Interview was conducted using a structured pretested questionnaire including Nordic Musculoskeletal Questionnaire and Numerical Pain Rating Scale. Level of exposure to musculoskeletal load was assessed using RULA tool. Statistical analysis was done using SPSS 19 version. Results: 77.6% of the workers had musculoskeletal problems. The most common sites affected were neck (32.1%, knee (28.7% and low back (26.6%. More than half of the workers experienced moderate pain in all body parts. 54.2% sought health care and 40% among them preferred government hospital. Only 8.7% workers had acceptable posture. Conclusion: Health problems among garment workers are one of the areas of public health concern in our country. Reducing the work strain and providing a supportive workplace environment will have a favorable impact on work productivity

  8. Musculoskeletal Disorders as Common Problems among Iranian Nurses: A Systematic Review and Meta-analysis Study.

    Science.gov (United States)

    Soroush, Ali; Shamsi, Mohammadbagher; Izadi, Neda; Heydarpour, Behzad; Samadzadeh, Soheila; Shahmohammadi, Afshar

    2018-01-01

    Considering the importance of musculoskeletal disorders (MSDs) as one of the health consequences of job stress among nurses and significant contradictions in prevalence in different parts of the body, this study was carried out to determine the prevalence of MSDs among Iranian nurses. All published studies from June 2000 until June 2015 were considered in reliable databases such as PubMed, Google Scholar, Google search, Scopus, ScienceDirect, and Persian databases such as SID, Iran Medex, and Magiran. These studies, after quality control, were entered into meta-analysis using the random effects model, a total of 41 papers were assessed between 2004 and 2015. The prevalence rate of these disorders was 60.98%, 47.76%, 46.53%, 44.64%, 42.8%, 36.8%, 24.61%, and 17.5%, respectively, obtained for the back, neck, knees, upper back, ankles, shoulders, hands, hips, thighs, and elbows. Prevalence of MSDs will lead to high costs of medical, absenteeism from work, or even unemployment. Due to high prevalence of these disorders among Iranian nurses, providing effective training in the field of ergonomics and undergoing appropriate exercises are necessary to control it.

  9. Incidence rate of mild traumatic brain injury among patients who have suffered from an isolated limb fracture: Upper limb fracture patients are more at risk.

    Science.gov (United States)

    Jodoin, Marianne; Rouleau, Dominique M; Charlebois-Plante, Camille; Benoit, Benoit; Leduc, Stéphane; Laflamme, G-Yves; Gosselin, Nadia; Larson-Dupuis, Camille; De Beaumont, Louis

    2016-08-01

    This study compares the incidence rate of mild traumatic brain injury (mild TBI) detected at follow-up visits (retrospective diagnosis) in patients suffering from an isolated limb trauma, with the incidence rate held by the hospital records (prospective diagnosis) of the sampled cohort. This study also seeks to determine which types of fractures present with the highest incidence of mild TBI. Retrospective assessment of mild TBI among orthopaedic monotrauma patients, randomly selected for participation in an Orthopaedic clinic of a Level I Trauma Hospital. Patients in the remission phase of a limb fracture were recruited between August 2014 and May 2015. No intervention was done (observational study). Standardized semi-structured interviews were conducted with all patients to retrospectively assess for mild TBI at the time of the fracture. Emergency room related medical records of all patients were carefully analyzed to determine whether a prospective mild TBI diagnosis was made following the accident. A total of 251 patients were recruited (54% females, Mean age=49). Study interview revealed a 23.5% incidence rate of mild TBI compared to an incidence rate of 8.8% for prospective diagnosis (χ(2)=78.47; plimb monotrauma (29.6%; n=42/142) are significantly more at risk of sustaining a mild TBI compared to lower limb fractures (15.6%; n=17/109) (χ(2)=6.70; p=0.010). More specifically, patients with a proximal upper limb injury were significantly more at risk of sustaining concomitant mild TBI (40.6%; 26/64) compared to distal upper limb fractures (20.25%; 16/79) (χ(2)=7.07; p=0.008). Results suggest an important concomitance of mild TBI among orthopaedic trauma patients, the majority of which go undetected during acute care. Patients treated for an upper limb fracture are particularly at risk of sustaining concomitant mild TBI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Human upper limb manipulator mass center motion and mass moments of inertia variation

    Directory of Open Access Journals (Sweden)

    Nikolova Gergana

    2018-01-01

    Full Text Available Motion control is complicated for people having traumas or neurological diseases. An underlying assumption in our work is that the motion of healthy people is optimal with respect to positioning accuracy, movement response, and energy expenditure. In this paper, a new approach for determination of the human upper limb mass-inertial characteristics is presented by using the 3D geometrical mathematical modeling analysis approach. Two examples will be given to illustrate the main features and advantages of the proposed design concepts. The objective of the work presented in this paper is a determination of the mass properties of a two joints human upper limb manipulator. Results are aimed to have application in an exoskeleton design, the design of manipulation system and external manipulation system, serving people with some motion difficulties, as well as in sport and rehabilitation.

  11. Comparison between Flail Arm Syndrome and Upper Limb Onset Amyotrophic Lateral Sclerosis: Clinical Features and Electromyographic Findings.

    Science.gov (United States)

    Yoon, Byung-Nam; Choi, Seong Hye; Rha, Joung-Ho; Kang, Sa-Yoon; Lee, Kwang-Woo; Sung, Jung-Joon

    2014-09-01

    Flail arm syndrome (FAS), an atypical presentation of amyotrophic lateral sclerosis (ALS), is characterized by progressive, predominantly proximal, weakness of upper limbs, without involvement of the lower limb, bulbar, or respiratory muscles. When encountering a patient who presents with this symptomatic profile, possible diagnoses include upper limb onset ALS (UL-ALS), and FAS. The lack of information regarding FAS may make differential diagnosis between FAS and UL-ALS difficult in clinical settings. The aim of this study was to compare clinical and electromyographic findings from patients diagnosed with FAS with those from patients diagnosed with UL-ALS. To accomplish this, 18 patients with FAS and 56 patients with UL-ALS were examined. Significant differences were observed between the 2 groups pertaining to the rate of fasciculation, patterns of predominantly affected muscles, and the Medical Research Council scale of the weakest muscle. The presence of upper motor neuron signs and lower motor neuron involvement evidenced through electromyography showed no significant between-group differences.

  12. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    International Nuclear Information System (INIS)

    Ryu, Jung-Kyu; Cho, Jeong-Yeon; Choi, Jong-Sun

    2003-01-01

    Focal musculoskeletal anomalies vary, and can manifest as part of a syndrome or be accompanied by numerous other conditions such as genetic disorders, karyotype abnormalities, central nervous system anomalies and other skeletal anomalies, lsolated focal musculoskeletal anomaly does, however, also occur; its early prenatal diagnosis is important in deciding prenatal care, and also helps in counseling parents about the postnatal effects of numerous possible associated anomalies. We have encountered 50 cases involving focal musculoskeletal anomalies, including total limb dysplasia [radial ray abnormality (n=3), mesomelic dysplasia (n=1)]; anomalies of the hand [polydactyly (n=8), syndactyly (n=3), ectrodactyly (n=1), clinodactyly (n=6), clenched hand (n=5)]; anomalies of the foot [clubfoot (n=10), rockerbottom foot (n=5), sandal gap deformity (n=1), curly toe (n=2)]; amniotic band syndrome (n=3); and anomalies of the focal spine [block vertebra (n=1), hemivertebra (n=1)]. Among these 50 cases, five [polydactyly (n=1), syndactyly (n=2) and curly toe (n=2) were confirmed by postnatal physical evaluation, two (focal spine anomalies) were diagnosed after postnatal radiologic examination, and the remaining 43 were proven at autopsy. For each condition, we describe the prenatal sonographic findings, and include a brief review

  13. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jung-Kyu; Cho, Jeong-Yeon; Choi, Jong-Sun [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2003-12-15

    Focal musculoskeletal anomalies vary, and can manifest as part of a syndrome or be accompanied by numerous other conditions such as genetic disorders, karyotype abnormalities, central nervous system anomalies and other skeletal anomalies, lsolated focal musculoskeletal anomaly does, however, also occur; its early prenatal diagnosis is important in deciding prenatal care, and also helps in counseling parents about the postnatal effects of numerous possible associated anomalies. We have encountered 50 cases involving focal musculoskeletal anomalies, including total limb dysplasia [radial ray abnormality (n=3), mesomelic dysplasia (n=1)]; anomalies of the hand [polydactyly (n=8), syndactyly (n=3), ectrodactyly (n=1), clinodactyly (n=6), clenched hand (n=5)]; anomalies of the foot [clubfoot (n=10), rockerbottom foot (n=5), sandal gap deformity (n=1), curly toe (n=2)]; amniotic band syndrome (n=3); and anomalies of the focal spine [block vertebra (n=1), hemivertebra (n=1)]. Among these 50 cases, five [polydactyly (n=1), syndactyly (n=2) and curly toe (n=2) were confirmed by postnatal physical evaluation, two (focal spine anomalies) were diagnosed after postnatal radiologic examination, and the remaining 43 were proven at autopsy. For each condition, we describe the prenatal sonographic findings, and include a brief review.

  14. Sirenomelia: four further cases with discussion of associated upper limb defects.

    Science.gov (United States)

    Moosa, Shahida; Lambie, Lindsay Ann; Krause, Amanda

    2012-07-01

    Sirenomelia, also known as the 'mermaid malformation/syndrome', is a rare, serious congenital anomaly characterized by variable degrees of fusion of the lower limbs and associated severe malformations of the lower vertebral and genitourinary systems. In this report, we describe a series of African patients with sirenomelia. We present the clinical and radiological features of four black South African patients and illustrate some of the rarer associated abnormalities, which include asymmetrical upper limb defects, not confined to the radial ray. The clinical phenotypic overlap between caudal dysgenesis, VACTERL association and sirenomelia in our patients is highlighted, lending support to the theory that these entities may be different manifestations of a single pathogenic process.

  15. Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kai-Hua Chen

    2013-01-01

    Full Text Available Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40 and Yanglingquan (GB34 points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side versus sham needling on the contralateral lower limb (control side in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P=0.03 in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P=0.036. Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle.

  16. Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

    Science.gov (United States)

    Chen, Kai-Hua; Hsiao, Kuang-Yu; Lin, Chu-Hsu; Chang, Wen-Ming; Hsu, Hung-Chih; Hsieh, Wei-Chi

    2013-01-01

    Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs) of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40) and Yanglingquan (GB34) points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side) versus sham needling on the contralateral lower limb (control side) in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM) upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P = 0.03) in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P = 0.036). Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle. PMID:23710218

  17. Age Effects on Upper Limb Kinematics Assessed by the REAplan Robot in Healthy Subjects Aged 3 to 93 Years.

    Science.gov (United States)

    Gilliaux, Maxime; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine

    2016-04-01

    Kinematics is recommended for the quantitative assessment of upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish normative values in healthy subjects. Three hundred and seventy healthy subjects, aged 3-93 years, participated in the study. They performed two unidirectional and two geometrical tasks ten consecutive times with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-six kinematic indices were computed for the four tasks. For the four tasks, nineteen of the computed kinematic indices showed an age effect. Seventeen indices (the accuracy, speed and smoothness indices and the reproducibility of the accuracy, speed and smoothness) improved in young subjects aged 3-30 years, showed stabilization in adults aged 30-60 years and declined in elderly subjects aged 60-93 years. Additionally, for both geometrical tasks, the speed index exhibited a decrease throughout life. Finally, a principal component analysis provided the relations between the kinematic indices, tasks and subjects' age. This study is the first to assess age effects on upper limb kinematics and establish normative values in subjects aged 3-93 years.

  18. Postural reconfiguration and cycle-to-cycle variability in patients with work-related musculoskeletal disorders compared to healthy controls and in relation to pain emerging during a repetitive movement task.

    Science.gov (United States)

    Longo, Alessia; Meulenbroek, Ruud; Haid, Thomas; Federolf, Peter

    2018-05-01

    Movement variability in sustained repetitive tasks is an important factor in the context of work-related musculoskeletal disorders. While a popular hypothesis suggests that movement variability can prevent overuse injuries, pain evolving during task execution may also cause variability. The aim of the current study was to investigate, first, differences in movement behavior between volunteers with and without work-related pain and, second, the influence of emerging pain on movement variability. Upper-body 3D kinematics were collected as 22 subjects with musculoskeletal disorders and 19 healthy volunteers performed a bimanual repetitive tapping task with a self-chosen and a given rhythm. Three subgroups were formed within the patient group according to the level of pain the participants experienced during the task. Principal component analysis was applied to 30 joint angle coordinates to characterize in a combined analysis the movement variability associated with reconfigurations of the volunteers' postures and the cycle-to-cycle variability that occurred during the execution of the task. Patients with no task-related pain showed lower cycle-to-cycle variability compared to healthy controls. Findings also indicated an increase in movement variability as pain emerged, manifesting both as frequent postural changes and large cycle-to-cycle variability. The findings suggested a relationship between work-related musculoskeletal disorders and movement variability but further investigation is needed on this issue. Additionally, the findings provided clear evidence that pain increased motor variability. Postural reconfigurations and cycle-to-cycle variability should be considered jointly when investigating movement variability and musculoskeletal disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Assessing musculoskeletal disorders among municipal waste loaders of Mumbai, India.

    Science.gov (United States)

    Salve, Pradeep; Chokhandre, Praveen; Bansod, Dhananjay

    2017-10-06

    The study aims to assess the impact of municipal waste loading occupation upon developing musculoskeletal disorders (MSDs) and thereby disabilities among waste loaders. Additionally, the study has identified the potential risk factors raising MSDs and disabilities. A cross-sectional case-control design survey was conducted in 6 out of 24 municipal wards of Mumbai during March-September 2015. The study population consisted of municipal waste loaders (N = 180) and a control group (N = 180). The Standardized Modified Nordic questionnaire was adopted to measures the MSDs and thereby disabilities in the past 12 months. A Propensity Score Matching (PSM) method was applied to assess the impact of waste loading occupation on developing MSDs and disabilities. Waste loaders had a significantly higher risk of developing MSDs as well as disabilities than the control group particularly for low back, hip/ thigh upper back and shoulder. Propensity Score Matching results revealed that the MSDs were significantly higher among waste loaders for hip/thigh (22%), low back (19%), shoulder (18%), and upper back (15%) than matched control group. Likewise, MSDs-related disabilities were found to be significantly higher among waste loaders for low back (20%), hip/ thigh (18%) upper back (13%) and shoulder (8%) than the control group. Duration of work, substance use and mental health were found to be the potential psychosocial factors for developing the risk of MSDs and disabilities. The municipal waste loading occupation raised the risk of MSDs and related disabilities among waste loaders compared to the control group. The preventive and curative measures are strongly recommended to minimize the burden of MSDs and disabilities. Int J Occup Med Environ Health 2017;30(6):875-886. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  20. 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.

  1. Transcutaneous Auricular Vagus Nerve Stimulation with Concurrent Upper Limb Repetitive Task Practice for Poststroke Motor Recovery: A Pilot Study.

    Science.gov (United States)

    Redgrave, Jessica N; Moore, Lucy; Oyekunle, Tosin; Ebrahim, Maryam; Falidas, Konstantinos; Snowdon, Nicola; Ali, Ali; Majid, Arshad

    2018-03-23

    Invasive vagus nerve stimulation (VNS) has the potential to enhance the effects of physiotherapy for upper limb motor recovery after stroke. Noninvasive, transcutaneous auricular branch VNS (taVNS) may have similar benefits, but this has not been evaluated in stroke recovery. We sought to determine the feasibility of taVNS delivered alongside upper limb repetitive task-specific practice after stroke and its effects on a range of outcome measures evaluating limb function. Thirteen participants at more than 3 months postischemic stroke with residual upper limb dysfunction were recruited from the community of Sheffield, United Kingdom (October-December 2016). Participants underwent 18 × 1-hour sessions over 6 weeks in which they made 30-50 repetitions of 8-10 arm movements concurrently with taVNS (NEMOS; Cerbomed, Erlangen, Germany, 25 Hz, .1-millisecond pulse width) at maximum tolerated intensity (mA). An electrocardiogram and rehabilitation outcome scores were obtained at each visit. Qualitative interviews determined the acceptability of taVNS to participants. Median time after stroke was 1.16 years, and baseline median/interquartile range upper limb Fugl-Meyer (UFM) score was 63 (54.5-99.5). Participants attended 92% of the planned treatment sessions. Three participants reported side effects, mainly fatigue, but all performed mean of more than 300 arm repetitions per session with no serious adverse events. There was a significant change in the UFM score with a mean increase per participant of 17.1 points (standard deviation 7.8). taVNS is feasible and well-tolerated alongside upper limb repetitive movements in poststroke rehabilitation. The motor improvements observed justify a phase 2 trial in patients with residual arm weakness. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Functional influence of botulinum neurotoxin type A treatment (Xeomin® of multifocal upper and lower limb spasticity on chronic hemiparetic gait

    Directory of Open Access Journals (Sweden)

    Maurizio Falso

    2012-05-01

    Full Text Available This report describes the modification of hemiplegic shoulder pain and walking velocity through injections of Xeomin®, a new botulinum neurotoxin type A formulation, in a 67-year-old woman with chronic residual left hemiparesis and hemiparetic gait attributable to stroke. Clinical evaluation included upper and lower limb spasticity, upper and lower limb pain, trunk control, upper and lower limb motricity index, visual gait analysis, and gait velocity. Assessments were performed before, 1 week after, and 1 month after treatment. Improvement was observed in all clinical parameters assessed. Amelioration of spasticity of the upper and lower limbs and shoulder pain was observed after 1 month. Trunk postural attitude and paraxial muscle recruitment recovered. No adverse events were observed and the patient shows significant improvement of functional impairment derived from chronic spasticity after treatment with Xeomin®. We also provide a simple and useful protocol for clinical evaluation of the treatment.

  3. An ergonomic intervention to reduce musculoskeletal discomfort among semiconductor assembly workers.

    Science.gov (United States)

    Aghilinejad, Mashallah; Azar, Neda Soleimanvandy; Ghasemi, Mohammad Sadegh; Dehghan, Naser; Mokamelkhah, Elahe Kabir

    2016-06-14

    Work-related musculoskeletal disorders (MSDs) and ergonomics-related injuries are the single largest category of workplace injuries and are responsible for almost 30% of all worker's compensation costs. Awkward working posture refers to positions of the body that deviate significantly from the neutral position while job tasks are being performed and it is the primary ergonomic risk factor for developing musculoskeletal discomfort. This study was conducted among assembly workers of a semiconductor in Tehran province with the objective of implementing an interventional ergonomic program to minimize musculoskeletal discomfort. This study that was conducted on 105 male assembly workers of a semiconductor industry based on a census method. The standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to determine the prevalence of MSDs. Corlett and Bishop's body part discomfort scale (BPD) was applied to evaluate body discomfort before and after the intervention (using a magnifying loupes to improve visibility of the parts). The results of NMQ showed the highest rate of MSDs were in neck, shoulder, upper arm and lower back regions (more than 75%). After ergonomic intervention, significant decrements of discomfort was observed in neck, shoulder, upper arm, elbows, lower arm, lower back and whole body discomfort (p ergonomic interventions can decrease MSDs of at risk body regions in the long term.

  4. Design and Evaluation of Ergonomic Interventions for the Prevention of Musculoskeletal Disorders in India

    Science.gov (United States)

    2014-01-01

    Background Improper workstation, work procedures and tools are found to be the risk factors for the development of musculoskeletal disorders among the informal sector workers of the developing countries. Low cost ergonomic interventions can effectively improve such adverse conditions. Case presentation In the present article some studies related to design interventions in different informal and agricultural sectors were discussed and their efficacies were analyzed. It was observed that with the help of appropriate interventions musculoskeletal disorders were reduced, adverse physiological conditions were improved when awkward postures were corrected and ultimately the organisational productivity was increased. Conclusion Proper implementation of ergonomic interventions can ultimately improve the economy of the nation. PMID:25009740

  5. Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury.

    Science.gov (United States)

    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Abe, Tetsuya; Ueno, Tomoyuki; Soma, Yuichiro; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2017-01-01

    Patients with complete paraplegia after spinal cord injury (SCI) are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL) in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman) were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20-67) years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS) grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60-90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG) was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad) in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs) score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention. These findings

  6. Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Yukiyo Shimizu

    2017-11-01

    Full Text Available Patients with complete paraplegia after spinal cord injury (SCI are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20–67 years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60–90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention

  7. Musculoskeletal disorders in shipyard industry: Prevalence, health care use, and absenteeism

    NARCIS (Netherlands)

    E.C. Alexopoulos (Evangelos); D. Tanagra (Dimitra); E.C. Konstantinou (Eleni); A. Burdorf (Alex)

    2006-01-01

    textabstractBackground: It is unclear whether the well-known risk factors for the occurrence of musculoskeletal disorders (MSD) also play an important role in the determining consequences of MSD in terms of sickness absence and health care use. Methods: A cross-sectional study was conducted among

  8. Proximal weakness of lower limbs as the sole presentation of hyperthyroidism: report of one case.

    Science.gov (United States)

    Chen, Chu-Chin; Chiu, Pao-Chin; Shih, Chen-Houng; Hsieh, Kai-Sheng

    2005-01-01

    Most children with acute or chronic flaccid limb weakness have a disorder of motor unit. However, it is very important to exclude cerebral or other upper motor neuron disorders before we approach such patients as pure muscle disorders. In general, neuropathy results in distal limb weakness, myopathy manifests with proximal weakness. There are exceptions, however. Accurate diagnosis in this wide array of disorders is dependent on a careful clinical assessment followed by the appropriate investigations. Here we report a 14-year-old girl who presented with progressive difficulty in rising up from the floor for one month. Neurological examination revealed an obese, clumsy but clear girl with stable vital signs. The muscle power of neck and upper limbs was normal. There was positive Gower sign, but the toe and heel gaits were acceptable. The initial blood work and motor/sensory nerve conduction velocity were unremarkable. Further study for thyroid function showed a hyperthyroid state. The proximal myopathy recovered soon after medical treatment. There were no other symptoms, and signs indicating hyperthyroidism and proximal myopathy of lower limbs was the isolated clinical feature. Hyperthyroid myopathy is common in hyperthyroidism, but is unusual as the sole presenting symptom.

  9. Rare muscular variations identified in a single cadaveric upper limb: a four-headed biceps brachii and muscular elevator of the latissimus dorsi tendon.

    Science.gov (United States)

    Moore, Colin W; Rice, Charles L

    2018-03-01

    Supernumerary or accessory heads of the biceps brachii are persistent muscular structures which can vary in number and location in the arm. Variations in other arm muscles, such as the coracobrachialis, can accompany supernumerary biceps brachii musculature in the upper limb. In this case report, we describe two rare muscular variants in a single adult male: a four-headed biceps brachii and the muscular elevator of the latissimus dorsi tendon. Additionally, accessory muscles of the brachialis and flexor digiti minimi brevis were identified in the upper limb. To our knowledge, the muscular variants identified here are considered rare, and their co-occurrence in a single upper limb has not been described previously. Also, a four-headed biceps brachii consisting of both the infero-medial and infero-lateral humeral heads has not been described previously to our knowledge. We postulate that the simultaneous appearance of several muscular variations may indicate a signaling disruption in embryogenesis during muscle patterning of the ventral limb bud. Knowledge of variant musculature in the arm is important for surgeons and clinicians as these muscles and their aberrant innervation patterns can complicate surgical procedures and may compress arteries and nerves producing upper limb pain and paresthesia. The clinical, functional and embryological implications of the upper limb variants are discussed.

  10. Musculoskeletal Disorders Assessment and Posture Analysis by LUBA among Female Hairdressers in Tehran, 2015

    Directory of Open Access Journals (Sweden)

    Mohammad Khandan

    2017-01-01

    Full Text Available Background & Aims of the Study: Musculoskeletal disorders (MSDs are part of the main occupational diseases in the workplace. Occupations such as hairdressers are exposed to multiple risk factors of these problems. The study was conducted to assess MSDs and posture analysis among female hairdressers in Tehran, 2015. Materials and Methods: In this cross-sectional research, 114 participants were studied. To collect data, demographic questionnaire, body map for assessment of MSDs and Postural Loading on the Upper Body Assessment (LUBA method to evaluate postures was used. Also, data were analyzed by Mann-Whitney, Kruskal Wallis and Spearman correlation tests through SPSS-V20. Results: The mean and standard deviation of age and experience of the participants were5.34±8.9 and 10±8 years, respectively. In addition, they worked 9.8 hours per day on average. One hundred and thirteen (99.12% persons have experienced the pain at least in one member of their musculoskeletal system. Most of hairdressers had reported leg, lower back, as well as neck and shoulder pain. According to the posture assessment, 94.2% of people experienced high risk of exposure to risk factors for MSDs. Conclusion: Findings showed MSDs are high among barbers. Also, the work situations require immediate correction. Correction of workstations and tools design, work rest cycle and reduction in repetitive motions can help to improve working conditions.

  11. Work-related musculoskeletal injuries in Prosthetists and Orthotists in Australia.

    Science.gov (United States)

    Anderson, S; Stuckey, R; Oakman, J

    2018-06-12

    This study aims to determine the prevalence of work-related musculoskeletal disorders in prosthetists/orthotists working in Australia. Secondary to this, the relationship between work-related hazards and work-related musculoskeletal disorders will be examined. In 2012 a self-report survey was conducted with the prosthetist/orthotist workforce in Australia (N=139, 56% response rate). Data on workplace physical and psychosocial hazards, job satisfaction, work life balance and musculoskeletal discomfort were collected. Predictors of work-related musculoskeletal disorders were assessed using logistic regression analysis. Prevalence of work-related musculoskeletal disorders was 80%. Gender (β= 1.31, p=0.03), total weekly hours (β=0.9, pwork-related musculoskeletal disorders. Females reported higher levels of work-related musculoskeletal disorder discomfort than males in all body areas. Work-related musculoskeletal disorders prevalence is high in prosthetists/orthotists. This suggests that focus on work place injury prevention is required. Targeted prevention requires systematic identification and then control of all relevant workplace hazards.

  12. The relationship of unions to prevalence and claim filing for work-related upper-extremity musculoskeletal disorders.

    Science.gov (United States)

    Morse, Tim; Punnett, Laura; Warren, Nicholas; Dillon, Charles; Warren, Andrew

    2003-07-01

    Unionization has been found to be related to higher filing of workers' compensation (WC) claims, but the extent of the relationship and the relationships to other variables have not been previously reported. Telephone interviews were conducted with both a population-based and WC-based samples of musculoskeletal disorder (MSD) cases. Workers at unionized facilities were 5.7 times (95% CI 2.5-13.1) more likely to file a claim for WC, despite a comparable rate of MSD cases. Higher filing was also associated with several measures of MSD severity (1.8-14.1 odds ratios), economic sector (OR = 10.1 for manufacturing), hourly (vs. salary) wages (OR = 2.6), and for having a personal physician (OR = 2.5). Unions appeared to have a protective effect on social effects of work-related MSD. Unions appear to improve filing of work-related MSD, particularly for less severe conditions. The higher filing does not appear to be a case of "moral hazard," but rather improved and earlier reporting, as is advocated by early intervention approaches to reducing MSD. Copyright 2003 Wiley-Liss, Inc.

  13. Is patient responsibility for managing musculoskeletal disorders related to self-reported better outcome of physiotherapy treatment?

    Science.gov (United States)

    Larsson, Maria E H; Kreuter, Margareta; Nordholm, Lena

    2010-07-01

    Musculoskeletal disorders are prevalent and a major burden on individuals and society. Information on relationships of patient involvement and responsibility to outcome is limited. This study aimed to explore relationships between self-reported outcome of physiotherapy treatment and attitudes toward responsibility for musculoskeletal disorders. A cross-sectional postal survey design was used. Patients (n=615) from an outpatient physiotherapy clinic, who had finished their physiotherapy treatment within the last 6 months were sent a questionnaire that included the Attitudes regarding Responsibility for Musculoskeletal disorders instrument (ARM), self-reported outcome of treatment and sociodemographic data. A total of 279 (45%) completed forms were returned. Multiple logistic regression analysis was used. The patients' scores on the four dimensions of ARM ("responsibility self active," "responsibility out of my hands," "responsibility employer," and "responsibility medical professionals"), controlled for age, sex, education, and physical activity as well as for number of treatments, main treatment, and physiotherapist, were associated with the patients' self-reported treatment outcome. Patients who attributed responsibility more to themselves were more likely (OR 2.37 and over) to report considerable improvement as the outcome of physiotherapy treatment. Because this study was conducted at only one physiotherapy outpatient clinic and had a cross-sectional design, the results should be replicated in other settings. Because patients' attitudes regarding responsibility for musculoskeletal disorders can possibly affect the outcome of physiotherapy treatment, it might be useful to decide whether to systematically try to influence the person's attitude toward responsibility for the management of the disorder or to match treatment to attitude.

  14. The clinical profile of musculoskeletal injuries in children attending a major hospital in Delhi, India.

    Science.gov (United States)

    Sural, Sumit; Verma, Anu

    2015-03-01

    Children are vulnerable to musculoskeletal injuries both at home and on the street for various reasons. Morbidity and disabilities resulting from these, mostly preventable, injuries, make them a burden to their families and society. The role of various factors associated with injuries is often not documented. This prospective study, done on 100 children aged up to 12 years with musculoskeletal trauma, analysed in details, the various modes of injuries. One in every five patient was a child below 12 years of age. Boys were injured more than girls. Injuries, especially fractures, were most common in the extremities, the upper limb more commonly injured than the lower limb. Most of the injuries occurred at home. The most common mode of injuries was falls that happened while playing both within and outside the home, followed by road traffic accidents. Most injuries occurred during daytime. Injuries in children were found to be preventable. Small interventions while constructing homes can contribute tremendously to injury prevention and control in children. Parental awareness about the various modes of injury, role of supervised playing and their responsibility towards injury prevention can play a key role in reducing the morbidity associated with childhood fractures.

  15. Deviations in upper limb function of the less-affected side in congenital hemiparesis

    NARCIS (Netherlands)

    Steenbergen, B.; Meulenbroek, R.G.J.

    2006-01-01

    In the present study we examined upper-limb function of the less-affected side in young adolescents with congenital hemiparesis (cerebral palsy: CP). Five participants with hemiparetic CP and five control participants performed a cyclical reach-and-grasp task with the less-affected hand towards

  16. Combined pharmacological and motor training interventions for recovery of upper limb function in subacute ischemic stroke

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    Ioana Stanescu

    2017-05-01

    Full Text Available Motor deficit, especially in the upper limb, is the primary contributor in post-stroke disability. Recovery of motor function relies on neural plasticity – cortical plastic reorganization – a spontaneous process, which could be enhanced from early phases by rehabilitative strategies. The subacute stage after stroke is the critical period during which the brain is most receptive to rehabilitation strategies. Based on the recent results of 2 trials in stroke rehabilitation using pharmacological intervention with Cerebrolysin in combination with standardized kinesitherapy, we conducted a pilot study of 4 consecutive patients with acute ischemic stroke, treated with Cerebrolysin for 28 days after stroke, and with intensive task-specific kinesitherapy from day 7 to day 28 after stroke. We assessed stroke severity with NIHSS score, upper limb function with ARAT (Action Research Arm Test score, disability with modified Rankin scale and patient’s autonomy with Barthel Index, at day 0 and day 30 after stroke. After 28 days of combined therapy all 4 patients improved, most significant improvement was seen in upper limb function, measured by ARAT score and in autonomy measured by Barthel Index.

  17. An upper limb robot model of children limb for cerebral palsy neurorehabilitation.

    Science.gov (United States)

    Pathak, Yagna; Johnson, Michelle

    2012-01-01

    Robot therapy has emerged in the last few decades as a tool to help patients with neurological injuries relearn motor tasks and improve their quality of life. The main goal of this study was to develop a simple model of the human arm for children affected with cerebral palsy (CP). The Simulink based model presented here shows a comparison for children with and without disabilities (ages 6-15) with normal and reduced range of motion in the upper limb. The model incorporates kinematic and dynamic considerations required for activities of daily living. The simulation was conducted using Matlab/Simulink and will eventually be integrated with a robotic counterpart to develop a physical robot that will provide assistance in activities of daily life (ADLs) to children with CP while also aiming to improve motor recovery.

  18. Robot-Mediated Upper Limb Physiotherapy: Review and Recommendations for Future Clinical Trials

    Science.gov (United States)

    Peter, Orsolya; Fazekas, Gabor; Zsiga, Katalin; Denes, Zoltan

    2011-01-01

    Robot-mediated physiotherapy provides a new possibility for improving the outcome of rehabilitation of patients who are recovering from stroke. This study is a review of robot-supported upper limb physiotherapy focusing on the shoulder, elbow, and wrist. A literature search was carried out in PubMed, OVID, and EBSCO for clinical trials with robots…

  19. Emergence of Virtual Reality as a Tool for Upper Limb Rehabilitation: Incorporation of Motor Control and Motor Learning Principles

    Science.gov (United States)

    Weiss, Patrice L.; Keshner, Emily A.

    2015-01-01

    The primary focus of rehabilitation for individuals with loss of upper limb movement as a result of acquired brain injury is the relearning of specific motor skills and daily tasks. This relearning is essential because the loss of upper limb movement often results in a reduced quality of life. Although rehabilitation strives to take advantage of neuroplastic processes during recovery, results of traditional approaches to upper limb rehabilitation have not entirely met this goal. In contrast, enriched training tasks, simulated with a wide range of low- to high-end virtual reality–based simulations, can be used to provide meaningful, repetitive practice together with salient feedback, thereby maximizing neuroplastic processes via motor learning and motor recovery. Such enriched virtual environments have the potential to optimize motor learning by manipulating practice conditions that explicitly engage motivational, cognitive, motor control, and sensory feedback–based learning mechanisms. The objectives of this article are to review motor control and motor learning principles, to discuss how they can be exploited by virtual reality training environments, and to provide evidence concerning current applications for upper limb motor recovery. The limitations of the current technologies with respect to their effectiveness and transfer of learning to daily life tasks also are discussed. PMID:25212522

  20. Parental Assessment of Status of Congenital Upper Limb Differences: Analysis of the Pediatric Outcomes Data Collection Instrument.

    Science.gov (United States)

    Wall, Lindley B; Shen, Tony; Roberts, Summer; Goldfarb, Charles A

    2016-03-01

    To determine the range of the Pediatric Outcomes Collection Instrument (PODCI) scores for children with a wide variety of congenital upper limb differences and to examine the scoring effect of the patient's surgical history, family history, severity of involvement, and syndromic associations. We reviewed the PODCI scores for 109 patients, aged 2-18 years, treated for nontraumatic upper extremity conditions. Charts were reviewed for sex, age, extent of limb involvement, laterality, family history, surgical history, and syndrome association. All patients were classified based on the Oberg, Manske, Tonkin classification with general categories of malformation, deformation, or dysplasia. Of 109 patients, 80 (73%) had a malformation, 12 (11%) had a deformation, and 17 (16%) had a dysplasia. The cohort as a whole had a happiness PODCI score that was similar to the normal population, yet a lower (worse) PODCI score for upper extremity and global function. Patients with a dysplasia had a higher upper extremity function scores than those with malformations or deformations, but they had similar happiness and global function scores. Complete upper limb involvement and lower extremity involvement statistically lowered the PODCI score within our study cohort, whereas a positive family history and syndromic association increased PODCI scores. This study showed that there was a similar level of perceived happiness between children/adolescents with congenital upper extremity conditions compared with the normal pediatric population based on PODCI scores. In contrast, the perceived upper extremity and global function was significantly decreased in patients with congenital differences compared with normal individuals. This investigation also revealed that the extent of upper extremity involvement, lower extremity involvement, family history, and syndromic association may affect PODCI scores as independent variables and should be taken into consideration in studies of upper extremity

  1. Musculoskeletal growth in the upper arm in infants after obstetric brachial plexus lesions partial denervation and its relation with residual muscle function

    NARCIS (Netherlands)

    Ruoff, J.M.; van der Sluijs, J.A.; van Ouwerkerk, W.J.R.; Jaspers, R.T.

    2012-01-01

    Aim Denervation after obstetric brachial plexus lesion (OBPL) is associated with reduced musculoskeletal growth in the upper arm. The aim of this study was to investigate whether reduced growth of upper arm flexor and extensor muscles is related to active elbow function and humeral length. Method In

  2. Predictive value of upper limb muscles and grasp patterns on functional outcome in cervical spinal cord injury

    NARCIS (Netherlands)

    Velstra, Inge-Marie; Bolliger, M.; Krebs, J.; Rietman, Johan Swanik; Curt, A.

    2015-01-01

    Objective: To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP),

  3. Safety, Feasibility, and Efficacy of Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Ischemic Stroke.

    Science.gov (United States)

    Dawson, Jesse; Pierce, David; Dixit, Anand; Kimberley, Teresa J; Robertson, Michele; Tarver, Brent; Hilmi, Omar; McLean, John; Forbes, Kirsten; Kilgard, Michael P; Rennaker, Robert L; Cramer, Steven C; Walters, Matthew; Engineer, Navzer

    2016-01-01

    Recent animal studies demonstrate that vagus nerve stimulation (VNS) paired with movement induces movement-specific plasticity in motor cortex and improves forelimb function after stroke. We conducted a randomized controlled clinical pilot study of VNS paired with rehabilitation on upper-limb function after ischemic stroke. Twenty-one participants with ischemic stroke >6 months before and moderate to severe upper-limb impairment were randomized to VNS plus rehabilitation or rehabilitation alone. Rehabilitation consisted of three 2-hour sessions per week for 6 weeks, each involving >400 movement trials. In the VNS group, movements were paired with 0.5-second VNS. The primary objective was to assess safety and feasibility. Secondary end points included change in upper-limb measures (including the Fugl-Meyer Assessment-Upper Extremity). Nine participants were randomized to VNS plus rehabilitation and 11 to rehabilitation alone. There were no serious adverse device effects. One patient had transient vocal cord palsy and dysphagia after implantation. Five had minor adverse device effects including nausea and taste disturbance on the evening of therapy. In the intention-to-treat analysis, the change in Fugl-Meyer Assessment-Upper Extremity scores was not significantly different (between-group difference, 5.7 points; 95% confidence interval, -0.4 to 11.8). In the per-protocol analysis, there was a significant difference in change in Fugl-Meyer Assessment-Upper Extremity score (between-group difference, 6.5 points; 95% confidence interval, 0.4 to 12.6). This study suggests that VNS paired with rehabilitation is feasible and has not raised safety concerns. Additional studies of VNS in adults with chronic stroke will now be performed. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01669161. © 2015 The Authors.

  4. Limb amputations in fixed dystonia: a form of body integrity identity disorder?

    Science.gov (United States)

    Edwards, Mark J; Alonso-Canovas, Araceli; Schrag, Arnette; Bloem, Bastiaan R; Thompson, Philip D; Bhatia, Kailash

    2011-07-01

    Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases, combined with recent data regarding disorders of mental rotation in patients with fixed dystonia, as well as previous data regarding body integrity identity disorder and amputations sought by patients with chronic regional pain syndrome, raise the possibility that patients with fixed dystonia might have a deficit in body schema that predisposes them to developing fixed dystonia and drives some to seek amputation. The outcome of amputation in fixed dystonia is invariably unfavorable. Copyright © 2011 Movement Disorder Society.

  5. Subjective Mental Workload and Its Correlation With Musculoskeletal Disorders in Bank Staff.

    Science.gov (United States)

    Darvishi, Ebrahim; Maleki, Afshin; Giahi, Omid; Akbarzadeh, Arash

    2016-01-01

    The purpose of this study was to evaluate the rate of subjective mental workload (SMWL) and its correlation with musculoskeletal disorders among bank staff members in Kurdistan Province located in western Iran. This cross-sectional study was conducted among 200 bank staff members in Kurdistan Province, Iran. The mental workload was assessed using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) computerized version. NASA-TLX is a multidimensional rating procedure that derives an overall workload score based on a weighted average of ratings on 6 subscales. These subscales include Mental Demands, Physical Demands, Temporal Demands, Performance, Effort, Effectiveness, and Frustration. The musculoskeletal disorders (MSDs) were documented with the Nordic Musculoskeletal Questionnaire and generic body diagram. Of the staff members, 78.5% experienced pain at least once during the past year in 1 of their 9 musculoskeletal body regions. The highest frequencies of pain were in the neck and lower back. The NASA-TLX estimated the Effort and Performance scales with mean ± SD of 72.8 ± 25.2 and 36 ± 22.6, respectively, as the maximal and minimal scores among the 6 subscales of SMWL. The statistical analysis of the data revealed that there was a significant correlation between the overall mental workload score and also among the 6 subscales of SMWL separately with MSDs (P < .05). SMWL appears to be a risk factor in the incidence of MSDs, so that the odds of MSDs increased by 11% with each additional 1-point increase in SMWL score. Copyright © 2016. Published by Elsevier Inc.

  6. Lower limb vascular dysfunction in cyclists

    Directory of Open Access Journals (Sweden)

    Thiago Ayala Melo Di Alencar

    2013-06-01

    Full Text Available Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.

  7. Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report.

    Science.gov (United States)

    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Saotome, Kousaku; Ueno, Tomoyuki; Abe, Tetsuya; Marushima, Aiki; Watanabe, Hiroki; Endo, Ayumu; Tsurumi, Kazue; Ishimoto, Ryu; Matsushita, Akira; Koda, Masao; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2018-01-19

    We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury. A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient's manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees. Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.

  8. Work-Related Musculoskeletal Disorders in Iranian Dentists: A Systematic Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Hamid Reza ZakerJafari

    2018-03-01

    Full Text Available Background: Work-related musculoskeletal disorders are the most important problems among professions particularly, dentists. This study was conducted to determine the prevalence of musculoskeletal disorders in various parts of the body in Iranian dentists by using systematic review and meta-analysis. Methods: This systematic review and meta-analysis was based on preferred reporting items for systematic reviews and meta-analyses (PRISMA guidelines and searching in national databases such as SID, Magiran, Irandoc, IranMedex, and Medlib, and international databases such as MedLine, Web of Sciences, Scopus, PubMed, ScienceDirect, Cochrane, Embase, Springer, Wiley Online Library, Ebsco, CEBM, and Google Scholar search engine which were published by January 1, 2017. Researched keywords were in Persian and their standard English equivalents were in accordance with their MeSH. The obtained documents were analyzed using Comprehensive Meta-analysis version 2. Results: According to 23 studies through 2,531 Iranian dentists which took part in this study, prevalence of skeletal disorders in Iranian dentists has been 17.6% [confidence interval (CI 95%:11.7–25.5] in knees, 33.2% (CI 95%:24.1–43.8 in shoulders, 33.4% (CI 95%: 26.8–40.8 in the thorax, 51.9% (CI 95%:46.7–57.2 in necks, 33.7% (CI 95%:28.2–39.6 in wrists/hands, 12.9% (CI 95%:7.7–20.6 in elbows, 37.3% (CI 95%: 31.5–43.5 in lower back, 11.9% (CI 95%:8.7–16.1 in thighs, 12.9% (CI 95%:3.8–36 in the foot, and 10.5% (CI 95%:7–15.4 in legs. Conclusion: Considering the high prevalence of musculoskeletal disorders in Iranian dentists, ergonomics should be included as a lesson in preclinic and also, reeducation courses for ergonomics basics should be executed for graduate dentists. Keywords: discomforts, Iran, musculoskeletal diseases, occupational dentists, prevalence

  9. Transcranial direct current stimulation for motor recovery of upper limb function after stroke.

    Science.gov (United States)

    Lüdemann-Podubecká, Jitka; Bösl, Kathrin; Rothhardt, Sandra; Verheyden, Geert; Nowak, Dennis Alexander

    2014-11-01

    Changes in neural processing after stroke have been postulated to impede recovery from stroke. Transcranial direct current stimulation has the potential to alter cortico-spinal excitability and thereby might be beneficial in stroke recovery. We review the pertinent literature prior to 30/09/2013 on transcranial direct current stimulation in promoting motor recovery of the affected upper limb after stroke. We found overall 23 trials (they included 523 participants). All stimulation protocols pride on interhemispheric imbalance model. In a comparative approach, methodology and effectiveness of (a) facilitation of the affected hemisphere, (b) inhibition of the unaffected hemisphere and (c) combined application of transcranial direct current stimulation over the affected and unaffected hemispheres to treat impaired hand function after stroke are presented. Transcranial direct current stimulation is associated with improvement of the affected upper limb after stroke, but current evidence does not support its routine use. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke

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    Thais Botossi Scalha

    2011-08-01

    Full Text Available OBJECTIVE: Describe the somatosensory function of the affected upper limb of hemiparetic stroke patients and investigate the correlations between measurements of motor and sensory functions in tasks with and without visual deprivation. METHOD: We applied the Fugl-Meyer Assessment (FMA, Nottingham Sensory Assessment (NSA, and several motor and sensory tests: Paper manipulation (PM, Motor Sequences (MS, Reaching and grasping (RG Tests Functional (TF, Tactile Discrimination (TD, Weight Discrimination (WD and Tactile Recognition of Objects (RO. RESULTS: We found moderate correlations between the FMA motor subscale and the tactile sensation score of the NSA. Additionally, the FMA sensitivity was correlated with the NSA total; and performance on the WD test items correlated with the NSA. CONCLUSION: There was a correlation between the sensory and motor functions of the upper limb in chronic hemiparetic stroke patients. Additionally, there was a greater reliance on visual information to compensate for lost sensory-motor skills.

  11. Neural Basis of Limb Ownership in Individuals with Body Integrity Identity Disorder

    OpenAIRE

    van Dijk, Milenna T.; van Wingen, Guido A.; van Lammeren, Anouk; Blom, Rianne M.; de Kwaasteniet, Bart P.; Scholte, H. Steven; Denys, Damiaan

    2013-01-01

    Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs ...

  12. Evaluation of musculoskeletal disorders in sewing machine operators of a shoe manufacturing factory in Iran.

    Science.gov (United States)

    Aghili, Mir Masih Moslemi; Asilian, Hasan; Poursafa, Parinaz

    2012-03-01

    A 15-year research conducted in USA showed that compensation expenses paid to workers for musculoskeletal disorders (MSDs) of back exceeded 128 million Dollars calculated on the basis of 0.97 Dollars per hour of work. In addition, according to the latest studies carried out in relation with disease burdens with risk factors in Iran, DALYs indices for low back pain, knee arthrosis and other musculoskeletal disorders have been reported to be 307772, 291305 and 872633 respectively, which have caused the work related diseases to occupy the second position in the country, after cardiovascular diseases. On the other hand, in accordance with occupational health indices of Iranian health ministry, 37% of all working population had had poor work postures with 15% of all working population had been working with inappropriate working tools in the year 2009. This was a case study comparing exposed workers with control group using Standard Nordic Questionnair in sewing machine operators of a shoe manufacturing factory in Iran. In this study, the mentioned questionnaires were filled out for the exposed group (25 sewing machine operators with average age of 43.5 years with work records of 16.8 years) and control group (15 employees from administrative department with average age of 39.8 years with work records of 13.4 years) which both were selected through simple random method. There were statistically significant differences in age between musculoskeletal disorders of right elbow (p = 0.033), thigh (p = 0.044), both knees (p = 0.019) and ankles (p = 0.039). There were also statistically significant association between gender and musculoskeletal disorders of right elbow (p = 0.028), thigh (p = 0.026) both knees (p = 0.011); right shoulder disorders (p = 0.018) and work records; disorders of both knees (p = 0.031) and number of cigarettes smoked. In general, prevalence of disorders of cervical area, shoulders with hands, vertebral column, back, knees, thigh with feet were higher

  13. Assessment of Medical Students’ Posture When Using the Existing Best-Selling Laptop Tables Using Rapid Upper Limb Assessment Method

    Directory of Open Access Journals (Sweden)

    mojtaba jafarvand

    2017-06-01

    Full Text Available Introduction and purpose: Improper posture while working is one of the most important risk factors for musculoskeletal disorders. Regarding this, the aim of this study was to assess the posture of students studying at Qazvin University of Medical Sciences when using the existing best-selling laptop tables using rapid upper limb assessment (RULA method. Methods: This analytic, cross-sectional study was conducted on 50 male and female dormitory students in 2017. The study population was selected through stratified random sampling technique. The participants’ postures in two different work stations (tables number one and two were evaluated by means of RULA method. Data analysis was performed in SPSS version 16 using the independent sample t-test and ANOVA test. Results: According to the results, 36% and 46% of the students obtained scores of 3 and 4, respectively in case of table number one. Furthermore, regarding table number two, scores 3 and 4 were recorded for 48% and 44% of the participants, respectively. Therefore, tables number one and two were found to have 82% and 92% of level two corrective measure, respectively. In addition, a significant relationship was obtained between the demographic variables and RULA score (P<0.05. Conclusion: As the findings of the present study indicated, table number one was a better case than table number two for fitting with different body structures since it allowed for the adjustment of the height and inclination of the work surface. However, corrective measures were necessary for both tables to provide the users with comfort, convenience, health, and productivity when using these laptop tables.

  14. Rehabilitation plus OnabotulinumtoxinA Improves Motor Function over OnabotulinumtoxinA Alone in Post-Stroke Upper Limb Spasticity: A Single-Blind, Randomized Trial.

    Science.gov (United States)

    Devier, Deidre; Harnar, JoAnn; Lopez, Leandro; Brashear, Allison; Graham, Glenn

    2017-07-11

    OnabotulinumtoxinA (BoNT-A) can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl-Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. The 'rehab' group significantly improved on the Fugl-Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67) while the 'no rehab' group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006). This improvement was largely driven by the upper extremity "movement" subscale, which showed that the 'rehab' group was improving (Visit 1 = 33, Visit 5 = 37) while the 'no rehab' group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034). Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.

  15. Towards a short questionnaire for stepwise assessment of upper limb function, pain and stiffness in Duchenne muscular dystrophy.

    Science.gov (United States)

    Janssen, Mariska M H P; Geurts, Alexander C H; de Groot, Imelda J M

    2018-04-01

    Duchenne muscular dystrophy can lead to upper extremity limitations, pain and stiffness. In a previous study, these domains have been investigated using extensive questionnaires, which are too time-consuming for clinical practice. This study aimed at gaining insight into the underlying dimensions of these questionnaires, and to construct a short questionnaire that can be used for clinical assessment. Exploratory factor analysis was performed on the responses of 213 participants to a web-based survey to find the underlying dimensions in the Capabilities of Upper Extremity questionnaire, the ABILHAND questionnaire, and questionnaires regarding pain and stiffness. Based on these underlying dimensions, a stepwise approach was formulated. In addition, construct validity of the factors was investigated. In total, 14 factors were identified. All had high internal consistency (Cronbach's alpha >0.89) and explained 80-88% of the variance of the original questionnaires. Construct validity was supported, because participants in the early ambulatory stage performed significantly better (pDuchenne muscular dystrophy. Based on the factor commonalities, the Upper Limb Short Questionnaire was formulated. Implications for Rehabilitation New insights into the underlying dimensions of upper extremity function, pain and stiffness in Duchenne muscular dystrophy are gained. Fourteen factors, with good internal consistency and construct validity, are identified regarding upper extremity function, pain and stiffness in Duchenne muscular dystrophy. Based on these factors, the Upper Limb Short Questionnaire is presented. The Upper Limb Short Questionnaire can be used as an identifier of arm-hand limitations and the start of more thorough clinical investigation.

  16. How do low/high height and weight variation affect upper limb movements during manual material handling of industrial boxes?

    Directory of Open Access Journals (Sweden)

    Ana B. Oliveira

    Full Text Available OBJECTIVES: To evaluate the effect of surface height and load weight on upper limb movements and electromyographic (EMG recordings during manual handling performed by both experienced and inexperienced lifter subjects. METHODS: Sixteen experienced and sixteen inexperienced lifters handled a box (both 7 and 15 kg from an intermediate height (waist level to either a high or low surface. Electromyography and video images were recorded during the tasks. The 10th, 50th and 90th percentiles were calculated for the deltoid and biceps muscles, shoulder flexion, shoulder abduction, and elbow flexion movements. Groups, right/left sides, weights and heights were compared. There were no differences between either groups or sides. RESULTS: Weight and height variations affected EMG and posture, although weight had more impact on EMG. Shoulder abduction and flexion movements higher than 60º occurred, particularly for the higher surface. Shoulder flexion was also higher when the box was moved to the low height. This study provides new evidence as shoulder postures during boxes handling on low surfaces had not previously been evaluated. CONCLUSIONS: The high demand of upper limb in manual material handling tasks is clear, particularly for the shoulder. This knowledge can be used by physical therapists to plan better rehabilitation programs for manual material handling-related disorders, particularly focusing on return to work.

  17. Prevalence of Musculoskeletal Disorders Among Surgeons Performing Minimally Invasive Surgery: A Systematic Review

    NARCIS (Netherlands)

    Alleblas, C.C.J.; Man, A.M. de; Haak, L. van den; Vierhout, M.E.; Jansen, F.W.; Nieboer, T.E.

    2017-01-01

    OBJECTIVE: The aim of this study was to review musculoskeletal disorder (MSD) prevalence among surgeons performing minimally invasive surgery. BACKGROUND: Advancements in laparoscopic surgery have primarily focused on enhancing patient benefits. However, compared with open surgery, laparoscopic

  18. A REVIEW ON LOWER APPENDICULAR MUSCULOSKELETAL SYSTEM OF HUMAN BODY

    Directory of Open Access Journals (Sweden)

    M. Akhtaruzzaman

    2016-04-01

    Full Text Available Rehabilitation engineering plays an important role in designing various autonomous robots to provide better therapeutic exercise to disabled patients. Hence it is necessary to study human musculoskeletal system and also needs to be presented in scientific manner in order to describe and analyze the biomechanics of human body motion. This review focuses on lower appendicular musculoskeletal structure of human body to represent joints and links architectures; to identify muscle attachments and functions; and to illustrate muscle groups which are responsible for a particular joint movement. Firstly, human lower skeletal structure, linking systems, joint mechanisms, and their functions are described with a conceptual representation of joint architecture of human skeleton. This section also represents joints and limbs by comparing with mechanical systems. Characteristics of ligaments and their functions to construct skeletal joints are also discussed briefly in this part. Secondly, the study focuses on muscular system of human lower limbs where muscle structure, functions, roles in moving endoskeleton structure, and supporting mechanisms are presented ellaborately. Thirdly, muscle groups are tabulated based on functions that provide mobility to different joints of lower limbs. Finally, for a particular movement action of lower extremity, muscles are also grouped and tabulated to have a better understanding on functions of individual muscle. Basically the study presents an overview of the structure of human lower limbs by characterizing and classifying skeletal and muscular systems.KEYWORDS:   Musculoskeletal system; Human lower limbs; Muscle groups; Joint motion; Biomechatronics; Rehabilitation.

  19. Cross-cultural adaptation, reliability and validity of the Turkish version of the Lower Limb Functional Index.

    Science.gov (United States)

    Duruturk, Neslihan; Tonga, Eda; Gabel, Charles Philip; Acar, Manolya; Tekindal, Agah

    2015-07-26

    This study aims to adapt culturally a Turkish version of the Lower Limb Functional Index (LLFI) and to determine its validity, reliability, internal consistency, measurement sensitivity and factor structure in lower limb problems. The LLFI was translated into Turkish and cross-culturally adapted with a double forward-backward protocol that determined face and content validity. Individuals (n = 120) with lower limb musculoskeletal disorders completed the LLFI and Short Form-36 questionnaires and the Timed Up and Go physical test. The psychometric properties were evaluated for the all participants from patient-reported outcome measures made at baseline and repeated at day 3 to determine criterion between scores (Pearson's r), internal consistency (Cronbachs α) and test-retest reliability (intraclass correlation coefficient - ICC 2.1 ). Error was determined using standard error of the measurement (SEM) and minimal detectable change at the 90% level (MDC 90 ), while factor structure was determined using exploratory factor analysis with maximum likelihood extraction and Varimax rotation. The psychometric characteristics showed strong criterion validity (r = 0.74-0.76), high internal consistency (α = 0.82) and high test-retest reability (ICC 2.1  = 0.97). The SEM of 3.2% gave an MDC 90  = 5.8%. The factor structure was uni-dimensional. Turkish version of LLFI was found to be valid and reliable for the measurement of lower limb function in a Turkish population. Implications for Rehabilitation Lower extremity musculoskeletal disorders are common and greatly impact activities among the affected individuals pertaining to daily living, work, leisure and quality of life. Patient-reported outcome (PRO) measures have advantages as they are practical, cost-effective and clinically convenient for use in patient-centered care. The Lower Limb Functional Index is a recently validated PRO measure shown to have strong clinimetric properties.

  20. A comparison of passive hindlimb cycling and active upper-limb exercise provides new insights into systolic dysfunction after spinal cord injury.

    Science.gov (United States)

    DeVeau, Kathryn M; Harman, Kathryn A; Squair, Jordan W; Krassioukov, Andrei V; Magnuson, David S K; West, Christopher R

    2017-11-01

    Active upper-limb and passive lower-limb exercise are two interventions used in the spinal cord injury (SCI) population. Although the global cardiac responses have been previously studied, it is unclear how either exercise influences contractile cardiac function. Here, the cardiac contractile and volumetric responses to upper-limb (swim) and passive lower-limb exercise were investigated in rodents with a severe high-thoracic SCI. Animals were divided into control (CON), SCI no exercise (NO-EX), SCI passive hindlimb cycling (PHLC), or SCI swim (SWIM) groups. Severe contusion SCI was administered at the T2 level. PHLC and SWIM interventions began on day 8 postinjury and lasted 25 days. Echocardiography and dobutamine stress echocardiography were performed before and after injury. Cardiac contractile indexes were assessed in vivo at study termination via a left ventricular pressure-volume conductance catheter. Stroke volume was reduced after SCI (91 µl in the NO-EX group vs. 188 µl in the CON group, P spinal cord injury. Here, we demonstrate that lower-limb exercise positively influences flow-derived cardiac indexes, whereas upper-limb exercise does not. Furthermore, neither intervention corrects the cardiac contractile dysfunction associated with spinal cord injury. Copyright © 2017 the American Physiological Society.

  1. [Kinematics Modeling and Analysis of Central-driven Robot for Upper Limb Rehabilitation after Stroke].

    Science.gov (United States)

    Yi, Jinhua; Yu, Hongliu; Zhang, Ying; Hu, Xin; Shi, Ping

    2015-12-01

    The present paper proposed a central-driven structure of upper limb rehabilitation robot in order to reduce the volume of the robotic arm in the structure, and also to reduce the influence of motor noise, radiation and other adverse factors on upper limb dysfunction patient. The forward and inverse kinematics equations have been obtained with using the Denavit-Hartenberg (D-H) parameter method. The motion simulation has been done to obtain the angle-time curve of each joint and the position-time curve of handle under setting rehabilitation path by using Solid Works software. Experimental results showed that the rationality with the central-driven structure design had been verified by the fact that the handle could move under setting rehabilitation path. The effectiveness of kinematics equations had been proved, and the error was less than 3° by comparing the angle-time curves obtained from calculation with those from motion simulation.

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

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    Maria SW

    2015-07-01

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

  3. 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.

  4. Posição socioeconômica e duração do benefício por incapacidade devido a doenças musculoesqueléticas relacionadas ao trabalho Socioeconomic position and duration of disability benefit due to work-related musculoskeletal disorders

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    Norma Suely Souto Souza

    2012-02-01

    Full Text Available Neste estudo, estima-se o efeito da posição socioeconômica sobre a duração dos benefícios por incapacidade devido a doenças musculoesqueléticas. Dados de um inquérito conduzido pela Auditoria Regional do Instituto Nacional do Seguro Social, com todos os segurados que receberam benefício por incapacidade temporária por doenças musculoesqueléticas da região cervical e membros superiores, em 2008, juntamente com os registros administrativos, foram utilizados para formar uma coorte de 563 trabalhadores. Todos eram residentes em Salvador, Bahia. Entre os trabalhadores sindicalizados e com alta demanda psicossocial no trabalho, a posição socioeconômica se associava positivamente com a duração do benefício (RR = 1,89; IC95%: 1,25-2,87. Esses resultados correspondem ou a uma situação de iniquidade ou ao uso desnecessário do seguro pelos trabalhadores com posição socioeconômica alta. Investigações futuras que visem a elucidar as diferenças na utilização dos benefícios são necessárias para subsidiar a abordagem apropriada dessa questão pelos gestores do seguro social.This study estimated the effect of socioeconomic position on the duration of disability benefits due to musculoskeletal disorders affecting the neck and/or upper limbs. A cohort study including 563 insured workers from the city of Salvador, Bahia, Brazil, registered inthe General Social Security System and who received temporary disability benefits due to musculoskeletal disorders affecting the neck and/or upper limbs, , was performedin 2008 using data from the National Social Security Institute. The results show that among union member workers with high psychosocial demands at work, those with low socioeconomic status are almost twice as likely to receive benefit for a shorter period of time compared to those with a higher socioeconomic position (RR = 1.89; 95%CI: 1.25-2.87. These results reveal aninequitable situation or unnecessary use of insurance for

  5. Sirenomelia with upper limb malformation: a case report and review of the literature.

    Science.gov (United States)

    Su, D; Yao, Q

    2015-01-01

    Sirenomelia sequence is a rare lethal pattern of congenital anomalies characterized by fusion of the legs and a variable combination of visceral abnormalities. Some cases accompanied with rare malformations have been reported. In this article, the authors report a case of sirenomelia with upper limb malformations and a review of the literature.

  6. Participant perceptions of use of CyWee Z as adjunct to rehabilitation of upper-limb function following stroke.

    Science.gov (United States)

    Hale, Leigh A; Satherley, Jessica A; McMillan, Nicole J; Milosavljevic, Stephan; Hijmans, Juha M; King, Marcus J

    2012-01-01

    This article reports on the perceptions of 14 adults with chronic stroke who participated in a pilot study to determine the utility, acceptability, and potential efficacy of using an adapted CyWee Z handheld game controller to play a variety of computer games aimed at improving upper-limb function. Four qualitative in-depth interviews and two focus groups explored participant perceptions. Data were thematically analyzed with the general inductive approach. Participants enjoyed playing the computer games with the technology. The perceived benefits included improved upper-limb function, concentration, and balance; however, six participants reported shoulder and/or arm pain or discomfort, which presented while they were engaged in play but appeared to ease during rest. Participants suggested changes to the games and provided opinions on the use of computer games in rehabilitation. Using an adapted CyWee Z controller and computer games in upper-limb rehabilitation for people with chronic stroke is an acceptable and potentially beneficial adjunct to rehabilitation. The development of shoulder pain was a negative side effect for some participants and requires further investigation.

  7. [Work-related musculoskeletal disorders and their association with occupational nursing].

    Science.gov (United States)

    Barboza, Michele Cristiene Nachtigall; Milbrath, Viviane Marten; Bielemann, Valquíria Machado; de Siqueira, Hedi Crecencia Heckler

    2008-12-01

    Work-related musculoskeletal diseases (MSD) are disorders in the musculoskeletal structures caused by chronic occupational processes. The objective of this study was to get to know scientific papers on MSD related to the nursing profession. A bibliographic research of the last ten years was conducted at Health Virtual Library using the main data bases. Twenty-one summaries were found. Among them, thirteen were selected because they specifically focused on the subject. Three main areas were identified: occupational health nurses in relation to MSDs--their importance in health prevention and promotion; Ergonomics as MSDs prevention method: performed as changes on work consider risk factors; Vulnerability of Nursing staff to MSDs--predisposing factors to disease caused by inappropriate working conditions. The conclusion was that an occupational and ergonomic health service is important to prevent MSDs, especially among the nursing staff.

  8. The role of order of practice in learning to handle an upper-limb prosthesis

    NARCIS (Netherlands)

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

    Objective: To determine which Order of presentation of practice tasks had the highest effect oil using an upper-limb prosthetic simulator. Design: A cohort analytic Study. Setting: University laboratory. Participants: Healthy, able-bodied participants (N=72) randomly assigned to I Of 8 groups, each

  9. Pushing and pulling in relation to musculoskeletal disorders : a review of risk factors

    NARCIS (Netherlands)

    Hoozemans, M J; Van Der Beek, Allard J.; Frings-Dresen, M. H. W.; Dijk, F.J.H.; van der Woude, L H

    The objective was to review the literature on risk factors for musculoskeletal disorders related to pushing and pulling. The risk factors have been described and evaluated from four perspectives: epidemiology, psychophysics, physiology, and biomechanics. Epidemiological studies have shown, based on

  10. Pushing and pulling in relation to musculoskeletal disorders: a review of risk factors

    NARCIS (Netherlands)

    Hoozemans, Marco; van der Beek, A.J.; Frings-Dresen, M.H.W.; Dijk, F.J.H.

    1998-01-01

    The objective was to review the literature on risk factors for musculoskeletal disorders related to pushing and pulling. The risk factors have been described and evaluated from four perspectives: epidemiology, psychophysics, physiology, and biomechanics. Epidemiological studies have shown, based on

  11. [Clinical study of post-stroke upper limb spasmodic hemiplegia treated with jingou diaoyu needling technique and Bobath therapy].

    Science.gov (United States)

    Sun, Runjie; Tian, Liang; Fang, Xiaoli; Du, Xiaozheng; Zhu, Bowen; Song, Zhongyang; Xu, Xuan; Qin, Xiaoguang

    2017-04-12

    To compare the difference in the clinical efficacy on post-stroke upper limb spasmodic hemiplegia between the combined therapy of jingou diaoyu needling technique and Bobath technology and simple Bobath technology. Sixty patients were randomized into an observation group and a control group, 30 cases in each one. The usual medication of neurological internal medicine was used in the two groups. In the control group, Bobath facilitation technology was applied to the rehabilitation training. In the observation group, on the basis of the treatment as the control group, jingou diaoyu needling technique was used to stimulate Zhongfu (LU 1), Tianfu (LU 3), Chize (LU 5), Quchi (LI 11), Jianshi (PC 5) and Daling (PC 7). The treatment was given once a day; 5 treatments made one session and totally 4-week treatment was required in the two groups. The modified Ashworth scale, the modified Fugle-Meyer assessment (FMA) and the Barthel index (BI) were adopted to evaluate the muscular tension, the upper limb motor function and the activities of daily living (ADL) before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared with those before treatment, the modified Ashworth scale, Fugl-Meyer score and BI score were all improved after treatment in the two groups (all P Bobath therapy achieve the superior efficacy on post-stroke upper limb spasmodic hemiplegia as compared with the simple application Bobath therapy. This combined treatment effectively relieve spasmodic state and improve the upper limb motor function and the activities of daily living.

  12. Is complementary and alternative medicine effective in job satisfaction among dentists with musculoskeletal disorders? A cross sectional study.

    Science.gov (United States)

    Gupta, Devanand; Bhaskar, Dara John; Gupta, Rajendra Kumar; Jain, Ankita; Yadav, Priyanka; Dalai, Deepak Ranjan; Singh, Rajeshwar; Singh, Nisha; Chaudhary, Varunjeet; Singh, Ankit; Yadav, Ankit; Karim, Bushra

    2014-01-01

    Musculoskeletal disorders have serious impact on the profession of dentistry. There is common occurrence of pain due to incorrect posture in dental professionals. Complementary and alternative medicine (CAM) therapies may cast a new light on preventing and intercepting musculoskeletal disorders (MSD). An epidemiological study was conducted in an effort to contribute to the prevention of musculoskeletal disorders in dentistry. The purpose of this study was to determine the prevalence of MSD at dentists using CAM as a treatment and preventive modality for MSD and to compare job/career satisfaction between dentists who use CAM and conventional therapy (CT). Dentists registered in Uttrakhand state, India, under the Dental Council of India and registered members of the Indian Dental Association, Uttrakhand branch (N = 1496) were surveyed. Statistical analysis was conducted using SPSS 17. A response rate of 84% (N = 1257) was obtained, revealing that 90% (N = 1131) had the problem of MSD. Seventy three percentage (N = 826) of dentists with MSD reported the use of CAM and CT. Complementary and alternative medicine users reported greater overall health (72.7% vs. 51%, p alternative medicine therapies may improve quality of life, reduce work interruption and enhance job satisfaction for dentists who suffers from MSD. Through the course of their studies, dentists should be equipped with knowledge on ergonomics and CAM therapies, such as yoga and others, to help them prevent musculoskeletal disorders more effectively.

  13. Severe form of streptococcal necrotizing fasciitis of the upper limb - diagnostic and therapeutic challenge: A case report

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    Mikić Dragan

    2015-01-01

    Full Text Available Introduction. Since delay in recognition and effective treatment of necrotizing fasciitis (NF caused by invasive group A streptococcus increases the mortality and disability, the early diagnosis and management of this disease are essential for a better outcome. We presented a patient with a severe form of streptococcal NF of the left upper limb in whom amputation was performed as a life saving procedure. Case report. A 65-year-old man, previously healthy, suffered an injury to his left hand by sting on a fish bone. Two days after that the patient got fever, redness, swelling and pain in his left hand. Clinical examination of the patient after admission indicated NF that spread quickly to the entire left upper limb, left armpit, and the left side of the chest and abdomen. Despite the use of aggressive antibiotic and surgical therapy severe destruction of the skin and subcutaneous tissues developed with the development of gangrene of the left upper limb. In this situation, the team of specialists decided that the patient must be operated on submited to amputation of the left arm, at the shoulder. After amputation and aggressive debridement of soft tissue on the left side of the trunk, the patient completely recovered. β-hemolytic streptococcus group A was isolated from the skin and tissue obtained during the surgery. Conclusion. In the most severe forms of streptococcal NF of the extremities, adequate multidisciplinary treatment, including limb amputation, can save the life of a patient.

  14. Focal Dystonia in Hemiplegic Upper Limb: Favorable Effect of Cervical Microsurgical DREZotomy Involving the Ventral Horn - A Report of 3 Patients.

    Science.gov (United States)

    Sindou, Marc; Georgoulis, George

    2016-01-01

    Focal dystonia in hemiplegic upper limbs is poorly responsive to medications or classical neurosurgical treatments. Only repeated botulinum toxin injections show efficacy, but in most severe cases effects are transient. Cervical DREZ lesioning, which has proven efficacious in hyperspasticity when done deeply (3-5 mm) in the dorsal horn, may have favorable effects on the dystonic component when performed down to, and including, the base of the ventral horn (5-6 mm in depth). Three patients underwent deep cervical microsurgical DREZotomy (MDT) for focal dystonia in the upper limb. Hypertonia was reduced, and sustained dystonic postures were suppressed. Residual motor function (hidden behind hypertonia) came to the surface. Cervical MDT may be a useful armamentarium for treating refractory focal dystonia in the upper limb. © 2016 S. Karger AG, Basel.

  15. Rehabilitation plus OnabotulinumtoxinA Improves Motor Function over OnabotulinumtoxinA Alone in Post-Stroke Upper Limb Spasticity: A Single-Blind, Randomized Trial

    Directory of Open Access Journals (Sweden)

    Deidre Devier

    2017-07-01

    Full Text Available Background: OnabotulinumtoxinA (BoNT-A can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. Methods: This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl–Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. Results: The ‘rehab’ group significantly improved on the Fugl–Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67 while the ‘no rehab’ group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006. This improvement was largely driven by the upper extremity “movement” subscale, which showed that the ‘rehab’ group was improving (Visit 1 = 33, Visit 5 = 37 while the ‘no rehab’ group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034. Conclusions: Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.

  16. The Impact of Upper Tropospheric Humidity from Microwave Limb Sounder on the Midlatitude Greenhouse Effect

    Science.gov (United States)

    Hu, Hua; Liu, W. Timothy

    1998-01-01

    This paper presents an analysis of upper tropospheric humidity, as measured by the Microwave Limb Sounder, and the impact of the humidity on the greenhouse effect in the midlatitudes. Enhanced upper tropospheric humidity and an enhanced greenhouse effect occur over the storm tracks in the North Pacific and North Atlantic. In these areas, strong baroclinic activity and the large number of deep convective clouds transport more water vapor to the upper troposphere, and hence increase greenhouse trapping. The greenhouse effect increases with upper tropospheric humidity in areas with a moist upper troposphere (such as areas over storm tracks), but it is not sensitive to changes in upper tropospheric humidity in regions with a dry upper troposphere, clearly demonstrating that there are different mechanisms controlling the geographical distribution of the greenhouse effect in the midlatitudes.

  17. Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Forouzanfar, Mohammad H; Vollset, Stein Emil; El Bcheraoui, Charbel; Daoud, Farah; Afshin, Ashkan; Charara, Raghid; Khalil, Ibrahim; Higashi, Hideki; Abd El Razek, Mohamed Magdy; Kiadaliri, Aliasghar Ahmad; Alam, Khurshid; Akseer, Nadia; Al-Hamad, Nawal; Ali, Raghib; AlMazroa, Mohammad AbdulAziz; Alomari, Mahmoud A; Al-Rabeeah, Abdullah A; Alsharif, Ubai; Altirkawi, Khalid A; Atique, Suleman; Badawi, Alaa; Barrero, Lope H; Basulaiman, Mohammed; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Bensenor, Isabela M; Buchbinder, Rachelle; Danawi, Hadi; Dharmaratne, Samath D; Zannad, Faiez; Farvid, Maryam S; Fereshtehnejad, Seyed-Mohammad; Farzadfar, Farshad; Fischer, Florian; Gupta, Rahul; Hamadeh, Randah Ribhi; Hamidi, Samer; Horino, Masako; Hoy, Damian G; Hsairi, Mohamed; Husseini, Abdullatif; Javanbakht, Mehdi; Jonas, Jost B; Kasaeian, Amir; Khan, Ejaz Ahmad; Khubchandani, Jagdish; Knudsen, Ann Kristin; Kopec, Jacek A; Lunevicius, Raimundas; Abd El Razek, Hassan Magdy; Majeed, Azeem; Malekzadeh, Reza; Mate, Kedar; Mehari, Alem; Meltzer, Michele; Memish, Ziad A; Mirarefin, Mojde; Mohammed, Shafiu; Naheed, Aliya; Obermeyer, Carla Makhlouf; Oh, In-Hwan; Park, Eun-Kee; Peprah, Emmanuel Kwame; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Shiri, Rahman; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rana, Saleem M; Sepanlou, Sadaf G; Shaikh, Masood Ali; Shiue, Ivy; Sibai, Abla Mehio; Silva, Diego Augusto Santos; Singh, Jasvinder A; Skogen, Jens Christoffer; Terkawi, Abdullah Sulieman; Ukwaja, Kingsley N; Westerman, Ronny; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Lim, Stephen S; Wang, Haidong; Vos, Theo; Naghavi, Mohsen; Lopez, Alan D; Murray, Christopher J L; Mokdad, Ali H

    2017-01-01

    Objectives We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR). Methods The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs). Results For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3–1703.4) in 1990 to 1606.0 (95% UI 1141.2–2130.4) in 2013. During 1990–2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7–3.0) in 1990 to 4.7% (95% UI 3.6–5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2–136.0 for low back pain, 27.3–49.7 for neck pain, 9.7–37.3 for osteoarthritis (OA), 0.6–2.2 for rheumatoid arthritis and 0.1–0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries. Conclusions This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness. PMID:28209629

  18. 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...

  19. A functional MRI study of the brain in stroke patients with upper-limb paralysis treated with constraint-induced movement therapy

    International Nuclear Information System (INIS)

    Wen Bo; Ma Lin; Weng Changshui; Zheng Zhixin; Sun Tong

    2009-01-01

    Objective: To investigate and compare the activation patterns of stroke patients with upper-limb paralysis using functional MRI before and after treatment with constraint-induced movement therapy (CIMT) so as to explore the mechanism of CIMT. Methods: Six patients in chronic stage of brain infarction who have functional disturbance in right upper-limb and 9 normal controls were entered into the study. All of the patients were asked to perform the thumb-to-index finger tapping task and underwent functional MRI before and two weeks after CIMT. The controls underwent fMRI of same protocol once. The patients' upper-limb function scores before and after CIMT were analyzed with SPSS 11.5 by paired t test. The fMRI data were analyzed with analysis of functional neurolmages (AFNI) software. The percentage of blood oxygenation level dependent (BOLD) signal change for the normal control was analyzed by one-sample t test to indentify the activated brain regions. The percentage change of BOLD signal for the patients before and after CIMT was compared to control's data by independent-samples t test. The percentage change of BOLD signal for the patients before and after CIMT was analyzed by paired-samples t test. The significant difference level was set P<0.05. Results: The fMRI showed the patients' activated brain regions before CIMT were similar to that of the controls', while the activation level was lower. There were wide areas activated to compensate the impaired function especially for the fight upper-limb. Before CIMT, the patients' score for fight upper-limb on the action research arm test was 27±4. After CIMT, the patients' score was 40±3, and the difference was significant (t=14.626, P<0.05), which indicated the improved function. These subjects also displayed cortical reorganization after CIMT on fMRI. The areas responsible for the right hand movement showed increased activation and the activation level at bilateral corpora striata thalami, and cerebella increased

  20. Physician practicing preferences for conventional or homeopathic medicines in elderly subjects with musculoskeletal disorders in the EPI3-MSD cohort

    Directory of Open Access Journals (Sweden)

    Danno K

    2014-09-01

    Full Text Available Karine Danno,1 Clementine Joubert,1 Gerard Duru,2 Jean-Marie Vetel31Laboratoires Boiron, Messimy, France; 2Cyklad Group, Lyon, France; 3Centre Hospitalier du Mans, Le Mans, FranceBackground: Musculoskeletal pain is common in elderly persons. Analgesic use is high in the elderly and may involve unacceptable risk in individuals with chronic pain. Our aim was to compare the socio-demographic characteristics of elderly subjects with musculoskeletal disorders (MSD and to assess medication use and clinical evolution of musculoskeletal pain according to physician prescribing preference: homeopathy (Ho group, conventional medicine (CM group, or mixed prescription (MX group.Methods: The EPI3 study was a 1 year observational survey carried out among general practitioners in France between March 2007 and July 2008. This sub-analysis was carried out on elderly subjects aged ≥70 years from the original EPI3 cohort. Socio-demographic data were collected at inclusion using a self-administered patient questionnaire and medical data were recorded for each patient. Quality of life was measured using the Short Form-12 questionnaire. Patients completed a structured telephone interview on their functional status (evaluated with the QuickDash questionnaire, EIFEL scale or Lequesne index within 72 hours of inclusion. This telephone interview was repeated at 1, 3, and 12 months. Drug exposure was also assessed during these interviews.Results: 146 patients (mean age ± standard deviation: 75.8±4.8 years were analyzed (80.1% female, 74.7% MSD of the spine or lower limbs, 64.4% chronic MSD. Patients in the CM and MX groups were 3.7 times or 2.5 times more likely (odds ratio [OR] =3.71, 95% confidence interval [CI]: 1.12-12.30; OR =2.52, 95% CI: 1.05-6.05; respectively to have used non-steroidal anti-inflammatory drugs (NSAIDs than those in the Ho group. In contrast, analgesic use was comparable in the three groups (OR =1.06 [CM versus Ho], 95% CI: 0.09-12.11; OR =0

  1. A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb

    Directory of Open Access Journals (Sweden)

    E. D. Oña

    2018-01-01

    Full Text Available Robot-mediated neurorehabilitation is a growing field that seeks to incorporate advances in robotics combined with neuroscience and rehabilitation to define new methods for treating problems related with neurological diseases. In this paper, a systematic literature review is conducted to identify the contribution of robotics for upper limb neurorehabilitation, highlighting its relation with the rehabilitation cycle, and to clarify the prospective research directions in the development of more autonomous rehabilitation processes. With this aim, first, a study and definition of a general rehabilitation process are made, and then, it is particularized for the case of neurorehabilitation, identifying the components involved in the cycle and their degree of interaction between them. Next, this generic process is compared with the current literature in robotics focused on upper limb treatment, analyzing which components of this rehabilitation cycle are being investigated. Finally, the challenges and opportunities to obtain more autonomous rehabilitation processes are discussed. In addition, based on this study, a series of technical requirements that should be taken into account when designing and implementing autonomous robotic systems for rehabilitation is presented and discussed.

  2. A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb

    Science.gov (United States)

    Sánchez-Herrera, P.; Balaguer, C.; Jardón, A.

    2018-01-01

    Robot-mediated neurorehabilitation is a growing field that seeks to incorporate advances in robotics combined with neuroscience and rehabilitation to define new methods for treating problems related with neurological diseases. In this paper, a systematic literature review is conducted to identify the contribution of robotics for upper limb neurorehabilitation, highlighting its relation with the rehabilitation cycle, and to clarify the prospective research directions in the development of more autonomous rehabilitation processes. With this aim, first, a study and definition of a general rehabilitation process are made, and then, it is particularized for the case of neurorehabilitation, identifying the components involved in the cycle and their degree of interaction between them. Next, this generic process is compared with the current literature in robotics focused on upper limb treatment, analyzing which components of this rehabilitation cycle are being investigated. Finally, the challenges and opportunities to obtain more autonomous rehabilitation processes are discussed. In addition, based on this study, a series of technical requirements that should be taken into account when designing and implementing autonomous robotic systems for rehabilitation is presented and discussed. PMID:29707189

  3. A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb.

    Science.gov (United States)

    Oña, E D; Cano-de la Cuerda, R; Sánchez-Herrera, P; Balaguer, C; Jardón, A

    2018-01-01

    Robot-mediated neurorehabilitation is a growing field that seeks to incorporate advances in robotics combined with neuroscience and rehabilitation to define new methods for treating problems related with neurological diseases. In this paper, a systematic literature review is conducted to identify the contribution of robotics for upper limb neurorehabilitation, highlighting its relation with the rehabilitation cycle, and to clarify the prospective research directions in the development of more autonomous rehabilitation processes. With this aim, first, a study and definition of a general rehabilitation process are made, and then, it is particularized for the case of neurorehabilitation, identifying the components involved in the cycle and their degree of interaction between them. Next, this generic process is compared with the current literature in robotics focused on upper limb treatment, analyzing which components of this rehabilitation cycle are being investigated. Finally, the challenges and opportunities to obtain more autonomous rehabilitation processes are discussed. In addition, based on this study, a series of technical requirements that should be taken into account when designing and implementing autonomous robotic systems for rehabilitation is presented and discussed.

  4. Pain and Prejudice: Does Collecting Information From the Standpoint of Exposed Workers Improve Scientific Examination of Work-Related Musculoskeletal Disorders?

    Science.gov (United States)

    Messing, Karen

    2016-07-01

    The meaning, feasibility, and importance of scientific objectivity have been debated among public health scientists. The debate is particularly relevant to occupational health, because of frequent opposition between employer and worker interests. This article suggests that the concept of standpoint (J. Eakin) may be more useful than that of objectivity in framing discussion of work-related musculoskeletal disorders. Studies done from a "worker" standpoint can, for example, investigate and characterize environmental risk factors for work-related musculoskeletal disorders, while studies from an "employer" standpoint may concentrate on identifying individual workers likely to report work-related musculoskeletal disorders or those for whom consequences of work-related musculoskeletal disorders are more severe. Within "worker" standpoints, a distinction between "high-prestige worker" and "lower-prestige worker" standpoints can be identified in the current scientific debate about the health costs and benefits of prolonged standing vs prolonged sitting at work. Contact with workers, particularly lower-prestige workers, is critical to developing and sustaining a worker-based standpoint among researchers in occupational health. This contact can be facilitated by formal collaborations between universities and unions or other community groups. © The Author(s) 2015.

  5. Musculoskeletal Pain and Occupational Variables in Teachers With Voice Disorders and in Those With Healthy Voices-A Pilot Study.

    Science.gov (United States)

    da Silva Vitor, Jhonatan; Siqueira, Larissa Thaís Donalonso; Ribeiro, Vanessa Veis; Ramos, Janine Santos; Brasolotto, Alcione Ghedini; Silverio, Kelly Cristina Alves

    2017-07-01

    This study aimed to compare musculoskeletal pain perception in teachers with voice disorders and in those with healthy voices, and to investigate the relationship between musculoskeletal pain and occupational variables (ie, work journey per week and working period). Forty-three classroom teachers were divided into two groups: dysphonic group (DG), 32 classroom teachers with voice complaints and voice disorders; and non-DG, 11 classroom teachers without voice complaints and who are vocally healthy. The musculoskeletal pain investigation survey was used to investigate the frequency and intensity of the pain. Occupational variables, such as work journey per week and working period, were investigated by the Voice Production Condition-Teacher questionnaire. The statistical tests used were the Spearman correlation (P ≤ 0.05) and the Mann-Whitney U test (P ≤ 0.05). There was no difference between the frequency and the intensity of musculoskeletal pain regarding dysphonia. Work journey per week was positively related to the frequency and the intensity of laryngeal pain in the DG. The working period had a negative relationship to the frequency and the intensity of musculoskeletal pain in the submandibular region in the DG. Classroom teachers with voice disorders and those with healthy voices do not have differences regarding the frequency and the intensity of musculoskeletal pain. Besides dysphonia the pain is an important symptom to be considered in classroom teachers. The occupational variables contributed to the presence of musculoskeletal pain in the region near the larynx, which appears to be directly proportional to work journey per week and inversely proportional to the working period. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  6. The effect of physical activity in leisure time on neck and upper limb symptoms

    NARCIS (Netherlands)

    Heuvel, S.G. van den; Heinrich, J.; Jans, M.P.; Beek, A.J. van der; Bongers, P.M.

    2005-01-01

    Background. Little is known of the preventive effects of physical activity in leisure time on neck and upper limb symptoms. Methods. A cohort of 1742 employees was selected from a prospective cohort study with a follow-up period of 3 years. Independent variables were sporting activities and

  7. THE RELATION BETWEEN PSYCHOSOCIAL WORK FACTORS AND MUSCULOSKELETAL SYMPTOMS AMONG COMPUTER WORKERS

    OpenAIRE

    Viktorija Prodanovska-Stojcevska; Jovica Jovanovic; Tanja Jovanovska; Domnika Rajchanovska; Izabela Filov; Biljana Bogdanova

    2016-01-01

    INTRODUCTION: Several epidemiological studies have shown that intensive computer work and other factors of work organization, involving physical and psychosocial exposure to computer work, are associated with increased risk of neck and upper extremity disorders.OBJECTIVES:The aim of this study is to present psychosocial work factors and their relationship to musculoskeletal symptoms among computer workers.MATERIAL AND METHODS: The Copenhagen Psychosocial Questionnaire (COPSOQ) for assessing p...

  8. Musculoskeletal disorder (MSD) among agricultural workers.

    Science.gov (United States)

    Basher, A; Nath, P; Siddique, Z S; Rahman, M H; Rubel, M A; Sayed, M S; Ahmad, S A; Mondol, G D; Bhuiyan, M R

    2015-01-01

    Farming is a large and main industry in Bangladesh. Large numbers of people are directly involved in farming and have very unique exposure compare to other sectors. Musculoskeletal problems among farmer population are not infrequent. This study was carried out among 200 farmers in one selected district. The study revealed that musculoskeletal problems were common among the farmers working in a traditional way. All the respondents were male. The age of all respondents lie between 20-60 years. Among them 22.5% farmers were illiterate, about 45.5% below Class V. About half (42%) of the respondents had reported pain in different parts of the body at least one or more times during working in land. And about two third (65.5%) of the farmers had history of joint pain and stiffness in last 12 month. Most of the farmers who suffered from musculoskeletal symptoms were 41-60 years. Specially who worked more then 20 years (82.6%) and average 6 hours per day (66.7%). The occurrence of musculoskeletal problems in various part of the body included Knee pain - 48.1%, Back pain (back ache) - 22.9%, Waist pain (low back ache) - 13.3%, Neck pain - 18.3% and shoulder pain - 10.7%. Length of work in year and daily average working hours were found significant association with musculoskeletal pain. It was found that musculoskeletal pain were more common among the farmers when they worked in squatting position (52%) and specially during weeding of plants (31%). Among them only 22% also engaged in other business. Most of the farmers complained dull aching pain (40.6%), only 2.3% noticed severe acute pain, but about 86% farmers' temporary stop their work for pain and 80% get relief after discontinue of work. About 75% respondents visited doctors for their pain which was statistically significant (p=0.001). It was found that the rates of musculoskeletal complaints are more among those individuals who worked relatively bad ergonomic condition, such as body position probably play an important

  9. Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles

    Directory of Open Access Journals (Sweden)

    Heidi Haavik

    2016-12-01

    Full Text Available This study investigates whether spinal manipulation leads to changes in motor control by measuring the recruitment pattern of motor units in both an upper and lower limb muscle and to see whether such changes may at least in part occur at the cortical level by recording movement related cortical potential (MRCP amplitudes. In experiment one, transcranial magnetic stimulation input–output (TMS I/O curves for an upper limb muscle (abductor pollicus brevis; APB were recorded, along with F waves before and after either spinal manipulation or a control intervention for the same subjects on two different days. During two separate days, lower limb TMS I/O curves and MRCPs were recorded from tibialis anterior muscle (TA pre and post spinal manipulation. Dependent measures were compared with repeated measures analysis of variance, with p set at 0.05. Spinal manipulation resulted in a 54.5% ± 93.1% increase in maximum motor evoked potential (MEPmax for APB and a 44.6% ± 69.6% increase in MEPmax for TA. For the MRCP data following spinal manipulation there were significant difference for amplitude of early bereitschafts-potential (EBP, late bereitschafts potential (LBP and also for peak negativity (PN. The results of this study show that spinal manipulation leads to changes in cortical excitability, as measured by significantly larger MEPmax for TMS induced input–output curves for both an upper and lower limb muscle, and with larger amplitudes of MRCP component post manipulation. No changes in spinal measures (i.e., F wave amplitudes or persistence were observed, and no changes were shown following the control condition. These results are consistent with previous findings that have suggested increases in strength following spinal manipulation were due to descending cortical drive and could not be explained by changes at the level of the spinal cord. Spinal manipulation may therefore be indicated for the patients who have lost tonus of their muscle

  10. Technologically-advanced assessment of upper-limb spasticity

    DEFF Research Database (Denmark)

    Posteraro, Federico; Crea, Simona; Mazzoleni, Stefano

    2018-01-01

    post stroke patients. METHODS: A new robotic device able to automatically assess upper-limb spasticity during passive and active mobilization has been developed. The elbow spasticity of five post stroke patients has been assessed by using the new device and by means of the Modified Ashworth Scale (MAS......). After the first assessment, subjects were treated with botulin toxin injections, and then underwent 10 sessions of robotic treatments. After the treatment, subjects spasticity was assessed by using the robotic device and the MAS score. RESULTS: In four out of five patients, the botulin toxin injection...... and robotic treatment resulted in the improvement of the MAS score; in three patients the robotic measures were able to detect the MAS changes. In one subject botulin toxin was not effective and the robotic device was able to detect the lack of effectiveness. CONCLUSIONS: By using the robotic device some...

  11. Incidence of upper limb oedema in patients with acute hemiparetic stroke.

    Science.gov (United States)

    Gebruers, Nick; Truijen, Steven; Engelborghs, Sebastiaan; De Deyn, Peter Paul

    2011-01-01

     Assessment of the incidence of upper limb oedema in an acute care setting by means of clinical and volumetric evaluation.  Patients with acute hemiparetic stroke were recruited from 2006 until 2009 (n = 125). Baseline measurements consisted of the National Institute of Health Stroke Scale, Fugl-Meyer Assessment Arm Section and demographic characteristics. Oedema assessment was performed at 7 days after inclusion and at 1 month and 3 months follow-up. A standardised water displacement method (objective measurement) was used to define oedema and was compared to data from visual inspection and palpation (subjective measurement).  In literature, the incidence of upper limb oedema ranges from 16-83%, defined by a variety of definitions. Oedema incidence in this study was defined by strict criteria using water displacement and ranged from 9-13.9%, while the incidence of oedema defined by visual inspection and palpation ranged from 6-18.5% during the different stages of follow-up. The agreement (Kappa) between both measurements ranged from 0.23-0.38, which is not more than 'moderate' but comparable to the agreement of 0.34 found in literature.  An objective and subjective assessment of oedema was used; the agreement between both methods was only moderate. The incidence of oedema found in this study is lower than the incidences found in literature.

  12. Work–Life Imbalance and Musculoskeletal Disorders among South Korean Workers

    OpenAIRE

    Young-Mee Kim; Sung-il Cho

    2017-01-01

    Employed workers often have family responsibilities such as childcare or homemaking. This dual burden may increase work-related health problems, particularly if there are conflicts between work and family responsibilities. This study assessed whether difficulty in work–life balance is associated with musculoskeletal disorders (MSD) among Korean employees. Data from the population-based Korean Working Conditions Survey of 2011, including 28,640 male and 21,392 female workers, were used. Men an...

  13. 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

  14. [Improving diagnosis and treatment of tunnel upper limb neuropathies in miners with vibration disease].

    Science.gov (United States)

    Kir'ianov, V A; Zheglova, A V; Aliev, A F; Krylova, I V; Sukhova, A V

    2011-01-01

    The article presents results of research aimed to diagnosis and treatment of tunnel upper limb neuropathies in mining industry workers subjected to vibration factor. The authors specified diagnostic criteria for early diagnosis of tunnel neuropathies affecting median, ulnar and radial nerves, with the severity evaluation for further adequate treatment.

  15. 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

  16. 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

  17. The Impact of an Ergonomics Intervention on Psychosocial Factors and Musculoskeletal Symptoms among Thai Hospital Orderlies.

    Science.gov (United States)

    Chanchai, Withaya; Songkham, Wanpen; Ketsomporn, Pranom; Sappakitchanchai, Punnarat; Siriwong, Wattasit; Robson, Mark Gregory

    2016-05-03

    (1) BACKGROUND: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2) OBJECTIVE: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3) MATERIAL AND METHODS: This study took a participatory ergonomic (PE) approach with a randomized controlled trial (RCT) conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for data collection before and after the intervention program; (4) RESULTS: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%). The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5) CONCLUSIONS: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment.

  18. The Impact of an Ergonomics Intervention on Psychosocial Factors and Musculoskeletal Symptoms among Thai Hospital Orderlies

    Directory of Open Access Journals (Sweden)

    Withaya Chanchai

    2016-05-01

    Full Text Available (1 Background: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2 Objective: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3 Material and Methods: This study took a participatory ergonomic (PE approach with a randomized controlled trial (RCT conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ and the Copenhagen Psychosocial Questionnaire (COPSOQ were used for data collection before and after the intervention program; (4 Results: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%. The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5 Conclusions: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment.

  19. [Deep venous thrombosis of the upper limb in a violin player: The "bow syndrome"].

    Science.gov (United States)

    Sanson, H; Gautier, V; Stansal, A; Sfeir, D; Franceschi, C; Priollet, P

    2016-12-01

    Exercise-induced thrombosis is a rare cause of deep venous thrombosis (DVT) of the upper limb and usually affects young subjects without comorbid conditions. The diagnosis may be challenging. A 23-year-old female right-handed French teacher and amateur violin player presented with edema of the root of the right arm associated with erythrocyanosis of the extremity and collateral circulation of the shoulder. History taking revealed oral contraception and recent change in violin playing habits. D-dimers were negative. A second duplex-Doppler was required before visualization of a DVT in the right subclavian vein. The patient was given low-molecular-weight heparin alone, followed by rivaroxaban. The outcome was very favorable at 48h. The patient was seen at 4 months and had not had a recurrent episode. The diagnosis of DVT of the upper limb is basically clinical. There is a clinical probability score for the introduction of anticoagulation even if the duplex-Doppler fails to visualize DVT, a situation that can occur due to the clavicular superposition in this region. Exercise-induced DVT should be suspected in patients with minimally intense but repeated exercise (hyper-abduction), e.g. as here playing the violin. Anticoagulation is the treatment of choice. The role for surgery and pharmacomechanical strategies remains to be defined. Exercise-induced thrombosis (Paget-Schroetter syndrome) should be suspected in young patients free of any comorbidity who develop a thrombosis of the upper limb. Studies comparing different therapeutic options would be useful to achieve more homogeneous management practices despite the heterogeneous clinical presentations. Copyright © 2016. Published by Elsevier Masson SAS.

  20. 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.