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Sample records for shoulder joint forces

  1. Shoulder model validation and joint contact forces during wheelchair activities

    PubMed Central

    Morrow, Melissa M.B.; Kaufman, Kenton R.; An, Kai-Nan

    2010-01-01

    Chronic shoulder impingement is a common problem for manual wheelchair users. The loading associated with performing manual wheelchair activities of daily living is substantial and often at a high frequency. Musculoskeletal modeling and optimization techniques can be used to estimate the joint contact forces occurring at the shoulder to assess the soft tissue loading during an activity and to possibly identify activities and strategies that place manual wheelchair users at risk for shoulder injuries. The purpose of this study was to validate an upper extremity musculoskeletal model and apply the model to wheelchair activities for analysis of the estimated joint contact forces. Upper extremity kinematics and handrim wheelchair kinetics were measured over three conditions: level propulsion, ramp propulsion, and a weight relief lift. The experimental data were used as input to a subject-specific musculoskeletal model utilizing optimization to predict joint contact forces of the shoulder during all conditions. The model was validated using a mean absolute error calculation. Model results confirmed that ramp propulsion and weight relief lifts place the shoulder under significantly higher joint contact loading than level propulsion. In addition, they exhibit large superior contact forces that could contribute to impingement. This study highlights the potential impingement risk associated with both the ramp and weight relief lift activities. Level propulsion was shown to have a low relative risk of causing injury, but with consideration of the frequency with which propulsion is performed, this observation is not conclusive. PMID:20840833

  2. Shoulder Joint For Protective Suit

    NASA Technical Reports Server (NTRS)

    Kosmo, Joseph J.; Smallcombe, Richard D.

    1994-01-01

    Shoulder joint allows full range of natural motion: wearer senses little or no resisting force or torque. Developed for space suit, joint offers advantages in protective garments for underwater work, firefighting, or cleanup of hazardous materials.

  3. Arthritis at the shoulder joint.

    PubMed

    Sankaye, Prashant; Ostlere, Simon

    2015-07-01

    The shoulder is a complex joint with numerous structures contributing to mobility and stability. Shoulder pain is a common clinical complaint that may be due to a wide spectrum of disorders including rotator cuff disease, instability, and arthropathy. Primary osteoarthritis of the shoulder joint is uncommon because it is a non-weight-bearing joint. Significant osteoarthritis of the glenohumeral joint is unusual in the absence of trauma, and the detection of advanced degenerative changes in patients without a known history of trauma should alert the clinician to search for other disorders. This article reviews the pathogenesis, clinical manifestations, and key imaging findings of the common categories of the arthritis affecting the glenohumeral joint. PMID:26021591

  4. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... cemented prosthesis. 888.3680 Section 888.3680 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis. (a) Identification. A shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis is a device that has a glenoid (socket)...

  5. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  6. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  7. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... made of alloys, such as cobalt-chromium-molybdenum, or alloys with ultra-high molecular weight... equivalent to a shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis that was in...

  8. Biomechanical loading of the shoulder complex and lumbosacral joints during dynamic cart pushing task.

    PubMed

    Nimbarte, Ashish D; Sun, Yun; Jaridi, Majid; Hsiao, Hongwei

    2013-09-01

    The primary objective of this study was to quantify the effect of dynamic cart pushing exertions on the biomechanical loading of shoulder and low back. Ten participants performed cart pushing tasks on flat (0°), 5°, and 10° ramped walkways at 20 kg, 30 kg, and 40 kg weight conditions. An optoelectronic motion capturing system configured with two force plates was used for the kinematic and ground reaction force data collection. The experimental data was modeled using AnyBody modeling system to compute three-dimensional peak reaction forces at the shoulder complex (sternoclavicular, acromioclavicular, and glenohumeral) and low back (lumbosacral) joints. The main effect of walkway gradient and cart weight, and gradient by weight interaction on the biomechanical loading of shoulder complex and low back joints was statistically significant (all p < 0.001). At the lumbosacral joint, negligible loading in the mediolateral direction was observed compared to the anterioposterior and compression directions. Among the shoulder complex joints, the peak reaction forces at the acromioclavicular and glenohumeral joints were comparable and much higher than the sternoclavicular joint. Increased shear loading of the lumbosacral joint, distraction loading of glenohumeral joint and inferosuperior loading of the acromioclavicular joint may contribute to the risk of work-related low back and shoulder musculoskeletal disorder with prolonged and repetitive use of carts. PMID:23566675

  9. Shoulder joint loading and posture during medicine cart pushing task.

    PubMed

    Xu, Xu; Lin, Jia-Hua; Boyer, Jon

    2013-01-01

    Excessive physical loads and awkward shoulder postures during pushing and pulling are risk factors for shoulder pain. Pushing a medicine cart is a major component of a work shift for nurses and medical assistants in hospitals and other health care facilities. A laboratory experiment was conducted to examine the effects of common factors (e.g., lane congestion, cart load stability, floor surface friction) on shoulder joint moment and shoulder elevation angle of participants during cart pushing. Participants pushed a medicine cart on straight tracks and turning around right-angle corners. Peak shoulder joint moments reached 25.1 Nm, 20.3 Nm, and 26.8 Nm for initial, transition, and turning phases of the pushing tasks, indicating that shoulder joint loading while pushing a medical cart is comparable to levels previously reported from heavy manual activities encountered in industry (e.g., garbage collection). Also, except for user experience, all other main study factors, including congestion level, cart load stability, location of transition strip, shoulder tendency, surface friction, and handedness, significantly influenced shoulder joint moment and shoulder elevation angle. The findings provide a better understanding of shoulder exposures associated with medicine cart operations and may be helpful in designing and optimizing the physical environment where medicine carts are used. PMID:23767931

  10. Objective Assessment of Joint Stiffness: A Clinically Oriented Hardware and Software Device with an Application to the Shoulder Joint.

    PubMed

    McQuade, Kevin; Price, Robert; Liu, Nelson; Ciol, Marcia A

    2012-08-30

    Examination of articular joints is largely based on subjective assessment of the "end-feel" of the joint in response to manually applied forces at different joint orientations. This technical report aims to describe the development of an objective method to examine joints in general, with specific application to the shoulder, and suitable for clinical use. We adapted existing hardware and developed laptop-based software to objectively record the force/displacement behavior of the glenohumeral joint during three common manual joint examination tests with the arm in six positions. An electromagnetic tracking system recorded three-dimensional positions of sensors attached to a clinician examiner and a patient. A hand-held force transducer recorded manually applied translational forces. The force and joint displacement were time-synchronized and the joint stiffness was calculated as a quantitative representation of the joint "end-feel." A methodology and specific system checks were developed to enhance clinical testing reproducibility and precision. The device and testing protocol were tested on 31 subjects (15 with healthy shoulders, and 16 with a variety of shoulder impairments). Results describe the stiffness responses, and demonstrate the feasibility of using the device and methods in clinical settings. PMID:23641316

  11. Echographic and Kinetic Changes in the Shoulder Joint after Manual Wheelchair Propulsion Under Two Different Workload Settings

    PubMed Central

    Gil-Agudo, Ángel; Solís-Mozos, Marta; Crespo-Ruiz, Beatriz; del-Ama Eng, Antonio J.; Pérez-Rizo, Enrique; Segura-Fragoso, Antonio; Jiménez-Díaz, Fernando

    2014-01-01

    Manual wheelchair users with spinal cord injury (SCI) have a high prevalence of shoulder pain due to the use of the upper extremity for independent mobility, transfers, and other activities of daily living. Indeed, shoulder pain dramatically affects quality of life of these individuals. There is limited evidence obtained through radiographic techniques of a relationship between the forces acting on the shoulder during different propulsion conditions and shoulder pathologies. Today, ultrasound is widely accepted as a precise tool in diagnosis, displaying particularly effectiveness in screening the shoulder rotator cuff. Thus, we set out to perform an ultrasound-based study of the acute changes to the shoulder soft tissues after propelling a manual wheelchair in two workload settings. Shoulder joint kinetics was recorded from 14 manual wheelchair users with SCI while they performed high- and low-intensity wheelchair propulsion tests (constant and incremental). Shoulder joint forces and moments were obtained from inverse dynamic methods, and ultrasound screening of the shoulder was performed before and immediately after the test. Kinetic changes were more relevant after the most intensive task, showing the significance of high-intensity activity, yet no differences were found in ultrasound-related parameters before and after each propulsion task. It therefore appears that further studies will be needed to collect clinical data and correlate data regarding shoulder pain with both ultrasound images and data from shoulder kinetics. PMID:25566539

  12. Echographic and kinetic changes in the shoulder joint after manual wheelchair propulsion under two different workload settings.

    PubMed

    Gil-Agudo, Ángel; Solís-Mozos, Marta; Crespo-Ruiz, Beatriz; Del-Ama Eng, Antonio J; Pérez-Rizo, Enrique; Segura-Fragoso, Antonio; Jiménez-Díaz, Fernando

    2014-01-01

    Manual wheelchair users with spinal cord injury (SCI) have a high prevalence of shoulder pain due to the use of the upper extremity for independent mobility, transfers, and other activities of daily living. Indeed, shoulder pain dramatically affects quality of life of these individuals. There is limited evidence obtained through radiographic techniques of a relationship between the forces acting on the shoulder during different propulsion conditions and shoulder pathologies. Today, ultrasound is widely accepted as a precise tool in diagnosis, displaying particularly effectiveness in screening the shoulder rotator cuff. Thus, we set out to perform an ultrasound-based study of the acute changes to the shoulder soft tissues after propelling a manual wheelchair in two workload settings. Shoulder joint kinetics was recorded from 14 manual wheelchair users with SCI while they performed high- and low-intensity wheelchair propulsion tests (constant and incremental). Shoulder joint forces and moments were obtained from inverse dynamic methods, and ultrasound screening of the shoulder was performed before and immediately after the test. Kinetic changes were more relevant after the most intensive task, showing the significance of high-intensity activity, yet no differences were found in ultrasound-related parameters before and after each propulsion task. It therefore appears that further studies will be needed to collect clinical data and correlate data regarding shoulder pain with both ultrasound images and data from shoulder kinetics. PMID:25566539

  13. Ultrasound and operative evaluation of arthritic shoulder joints

    PubMed Central

    Alasaarela, E; Leppilahti, J; Hakala, M

    1998-01-01

    OBJECTIVE—To assess the diagnostic value of ultrasonography (US) in the evaluation of arthritic shoulder joints.
METHODS—Twenty shoulders of 20 inpatients with arthritis were evaluated by US one day before the shoulder operation. Changes in the subacromial-subdeltoid bursa, biceps tendon and tendon sheath, rotatof cuff, and glenohumeral joint were recorded and compared with findings at operation.
RESULTS—In the detection of effusion/hypertrophy in the subacromial-subdeltoid bursa, US had a sensitivity of 93% and a specificity of 83%. For a biceps tendon rupture US had a sensitivity of 70% and a specificity of 100%. US missed three intra-articular biceps tendon ruptures. For effusion/hypertrophy in the biceps tendon sheath US had a sensitivity of 100% and a specificity of 83%. For a rotator cuff tear US had a sensitivity of 83% and a specificity of 57%. US missed two small longitudinal rotator cuff tears. Three thin membranous, but intact, rotator cuff tendons were classified as full thickness tears by US. Synovial effusion/hypertrophy was detected by US and at operation in all of the 12 glenohumeral joints that were evaluable at surgery.
CONCLUSION—US is a reliable method in experienced hands for the evaluation of inflammatory changes of an arthritic shoulder. In advanced stages of rheumatoid shoulder joints, however, US is not useful, because destructive bone changes and tendon ruptures change the normal anatomy and restrict shoulder motions, limiting the visibility of US.

 Keywords: ultrasound diagnostics; shoulder; surgery; rheumatoid arthritis PMID:9771210

  14. Shoulder joint kinetics of the elite wheelchair tennis serve

    PubMed Central

    Reid, Machar; Elliott, Bruce; Alderson, Jacque

    2007-01-01

    Background The shoulder is a key joint in wheelchair locomotion and commonly implicated in injury among virtually all wheelchair populations. In tennis, quantification of the shoulder joint kinetics that characterise the wheelchair serve could enhance injury prevention and rehabilitation practices as well as assist coaches evaluate the efficacy of their current technical instruction. Methods A 12‐camera, 250 Hz Vicon motion analysis system (Oxford Metrics Inc., UK) recorded the 3D flat (WFS) and kick serve (WKS) motions of two male top 30‐ranked international wheelchair players. Mechanical comparisons between wheelchair players, as well as to the previously captured data of 12 high‐performance able‐bodied players executing the same types of serves, were undertaken. Results Without the benefit of a propulsive leg action, wheelchair players developed lower peak absolute (∼32 m/s) and horizontal (∼28 m/s) pre‐impact racquet velocities than able‐bodied players (∼42 m/s, ∼38 m/s). Wheelchair serve tactics nevertheless necessitated that higher pre‐impact horizontal and right lateral racquet velocities characterised the WFS (∼29 m/s, WKS: ∼26 m/s) and WKS (∼4 m/s, WFS: ∼11 m/s) respectively. The shoulder joint kinetics that contributed to the differential racquet velocity profiles were mostly developed independent of wheelchair serve type, but varied with and were likely related to the level and severity of spinal cord injury of the individual players. Conclusions Compared with able‐bodied players, wheelchair players experienced matching pre‐ and post‐impact shoulder joint loads, such that wheelchair and able‐bodied playing populations appear subject to similar shoulder joint injury risk. PMID:17957009

  15. The effect of an active vibration stimulus according to different shoulder joint angles on functional reach and stability of the shoulder joint

    PubMed Central

    Kim, Eun-Kyung; Kim, Seong-Gil

    2016-01-01

    [Purpose] The purpose of this study was to analyze the effect of an active vibration stimulus exercise according to shoulder joint angles on functional reach and stability of the shoulder joint. [Subjects and Methods] Thirty healthy male students participated in this study. Upper limb length of each subject was measured to obtain normalized measurement values. The exercise groups were as follows: group I (n=10, shoulder joint angle of 90°), group II (n=10, shoulder joint angle of 130°), and group III (n=10, shoulder joint angle of 180°). After warm-up, an active vibration stimulus was applied to the subjects with a Flexi-Bar. The Functional Reach Test and Y-balance test were conducted for measurement of shoulder stability. [Results] Analysis of covariance was conducted with values before the intervention as covariates to analyze the differences among the groups in the two tests. There were significant differences among the groups. According to Bonferroni post hoc comparison, group I showed greater improvement than group III in the Functional Reach Test, and group II showed greater improvement than group I and group III in the Y-balance test. [Conclusion] The effect of the exercise with different shoulder joint angles revealed that the shoulder joint has a certain effective joint angle for its functionality and stability. In addition, application of an active vibration stimulus with a Flexi-Bar can be a very effective tool for improvement of functionality and stability of the shoulder joint. PMID:27134352

  16. Generalized joint laxity and multidirectional instability of the shoulder

    PubMed Central

    SACCOMANNO, MARISTELLA F.; FODALE, MARIO; CAPASSO, LUIGI; CAZZATO, GIAMPIERO; MILANO, GIUSEPPE

    2013-01-01

    Generalized joint laxity and shoulder instability are common conditions that exhibit a wide spectrum of different clinical forms and may coexist in the same patient. Generalized joint laxity can be congenital or acquired. It is fundamental to distinguish laxity from instability. Laxity is a physiological condition that may predispose to the development of shoulder instability. A high prevalence of generalized joint laxity has been identified in patients with multidirectional instability of the shoulder. Multidirectional instability is defined as symptomatic instability in two or more directions. The diagnosis and treatment of this condition are still challenging because of complexities in its classification and etiology. These complexities are compounded when multidirectional instability and laxity exist in the same patient. With an improved understanding of the clinical symptoms and physical examination findings, a successful strategy for conservative and/or surgical treatments can be developed. Conservative treatment is the first-line option. If it fails, different surgical options are available. Historically, open capsular shift has been considered the gold standard in the surgical management of these patients. Nowadays, advanced arthroscopic techniques offer several advantages over traditional open approaches and have shown similar outcomes. The correct approach to the management of failed stabilization procedures has not been yet defined. PMID:25606530

  17. A new shoulder model with a biologically inspired glenohumeral joint.

    PubMed

    Quental, C; Folgado, J; Ambrósio, J; Monteiro, J

    2016-09-01

    Kinematically unconstrained biomechanical models of the glenohumeral (GH) joint are needed to study the GH joint function, especially the mechanisms of joint stability. The purpose of this study is to develop a large-scale multibody model of the upper limb that simulates the 6 degrees of freedom (DOF) of the GH joint and to propose a novel inverse dynamics procedure that allows the evaluation of not only the muscle and joint reaction forces of the upper limb but also the GH joint translations. The biomechanical model developed is composed of 7 rigid bodies, constrained by 6 anatomical joints, and acted upon by 21 muscles. The GH joint is described as a spherical joint with clearance. Assuming that the GH joint translates according to the muscle load distribution, the redundant muscle load sharing problem is formulated considering as design variables the 3 translational coordinates associated with the GH joint translations, the joint reaction forces associated with the remaining kinematic constraints, and the muscle activations. For the abduction motion in the frontal plane analysed, the muscle and joint reaction forces estimated by the new biomechanical model proposed are similar to those estimated by a model in which the GH joint is modeled as an ideal spherical joint. Even though this result supports the assumption of an ideal GH joint to study the muscle load sharing problem, only a 6 DOF model of the GH joint, as the one proposed here, provides information regarding the joint translations. In this study, the biomechanical model developed predicts an initial upward and posterior migration of the humeral head, followed by an inferior and anterior movement, which is in good agreement with the literature. PMID:27381499

  18. Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 2: Glenohumeral Joint

    PubMed Central

    LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; STAKER, JUSTIN L.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To compare differences in glenohumeral joint angular motion and linear translations between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Numerous clinical theories have linked abnormal glenohumeral kinematics, including decreased glenohumeral external rotation and increased superior translation, to individuals with shoulder pain and impingement diagnoses. However, relatively few studies have investigated glenohumeral joint angular motion and linear translations in this population. METHODS Transcortical bone pins were inserted into the scapula and humerus of 12 a symptomatic and 10 symptomatic participants for direct bone-fixed tracking using electromagnetic sensors. Glenohumeral joint angular positions and linear translations were calculated during active shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups in angular positions were limited to glenohumeral elevation, coinciding with a reduction in scapulothoracic upward rotation. Symptomatic participants demonstrated 1.4 mm more anterior glenohumeral translation between 90° and 120° of shoulder flexion and an average of 1 mm more inferior glenohumeral translation throughout shoulder abduction. CONCLUSION Differences in glenohumeral kinematics exist between symptomatic and a symptomatic individuals. The clinical implications of these differences are not yet understood, and more research is needed to understand the relationship between abnormal kinematics, shoulder pain, and pathoanatomy. PMID:25103132

  19. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  20. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  1. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  2. 21 CFR 888.3670 - Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint metal/polymer/metal nonconstrained... ORTHOPEDIC DEVICES Prosthetic Devices § 888.3670 Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented prosthesis. (a) Identification. A shoulder joint...

  3. 21 CFR 888.3670 - Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shoulder joint metal/polymer/metal nonconstrained... ORTHOPEDIC DEVICES Prosthetic Devices § 888.3670 Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented prosthesis. (a) Identification. A shoulder joint...

  4. Shoulder and hip joint for hard space suits

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.

    1986-01-01

    Shoulder and hip joints for hard space suits are disclosed which are comprised of three serially connected truncated spherical sections, the ends of which converge. Ball bearings between the sections permit relative rotation. The proximal end of the first section is connected to the torso covering by a ball bearing and the distal end of the outermost section is connected to the elbow or thigh covering by a ball bearing. The sections are equi-angular and this alleviates lockup, the condition where the distal end of the joint leaves the plane in which the user is attempting to flex. The axes of rotation of the bearings and the bearing mid planes are arranged to intersect in a particular manner that provides the joint with a minimum envelope. In one embodiment, the races of the bearing between the innermost section and the second section is partially within the inner race of the bearing between the torso and the innermost spherical section further to reduce bulk.

  5. Perspectives on glenohumeral joint contractures and shoulder dysfunction in children with perinatal brachial plexus palsy.

    PubMed

    Gharbaoui, Idris S; Gogola, Gloria R; Aaron, Dorit H; Kozin, Scott H

    2015-01-01

    Shoulder joint deformities continue to be a challenging aspect of treating upper plexus lesions in children with perinatal brachial plexus palsy (PBPP). It is increasingly recognized that PBPP affects the glenohumeral joint specifically, and that abnormal scapulothoracic movements are a compensatory development. The pathophysiology and assessment of glenohumeral joint contractures, the progression of scapular dyskinesia and skeletal dysplasia, and current shoulder imaging techniques are reviewed. PMID:25835253

  6. Shoulder pain

    MedlinePlus

    Pain - shoulder ... The shoulder is the most movable joint in the human body. A group of 4 muscles and their tendons, called the rotator cuff, give the shoulder its wide range of motion. Swelling, damage, or ...

  7. Shoulder arthroscopy

    MedlinePlus

    ... repair; SLAP lesion; Acromioplasty; Bankart repair; Bankart lesion; Shoulder repair; Shoulder surgery; Rotator cuff repair ... their tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm ...

  8. Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation

    PubMed Central

    Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

    2014-01-01

    Introduction: Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. Methods: A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. Results: According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). Conclusion: The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate. PMID

  9. The effect of joint instability on latency and recruitment order of the shoulder muscles.

    PubMed

    Santos, Marcio J; Belangero, William Dias; Almeida, Gil L

    2007-04-01

    Several shoulder dysfunctions are generally characterized as Shoulder Impingement Syndrome (SIS). Specifically, glenohumeral instability (GI) has been viewed as a primary cause of SIS in young individuals, mainly in overhead athletics. Past studies have associated GI with modifications in latency, recruitment order and/or EMG activity. However, it is not clear if pain and/or joint instability can account for these observed changes. The aim of this investigation was to analyze the effect of glenohumeral instability on the latencies and recruitment order of the superficial muscles of the glenohumeral and scapulothoracic joints in swimmers without pain symptom. Eight individuals with and eight without history of Shoulder Impingement Syndrome performed bilateral and simultaneous shoulder elevations at three different distances. The shoulder kinematics and EMG activities of glenohumeral and scapulothoracic muscles were registered. Results showed that subjects of both groups performed the task with similar latencies and recruitment order of the muscle activities. We conclude that shoulder instability does not necessarily affect the latencies and recruitment order of the shoulder muscles during the elevation of the shoulder in the scapular plane. Pain and other factors may be involved in the kinematics and electromyographic alterations demonstrated in other experiments. PMID:16546403

  10. Frozen shoulder

    MedlinePlus

    Frozen shoulder is a condition in which the shoulder is painful and loses motion because of inflammation. ... The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are ...

  11. Shoulder joint loading in the high performance flat and kick tennis serves

    PubMed Central

    Reid, Machar; Elliott, Bruce; Alderson, Jacque

    2007-01-01

    Objective To quantify and compare the full body kinematics and shoulder joint kinetics during the high‐performance tennis flat (FS) and kick serves (KS). Methods A 12‐camera 250 Hz, Vicon motion analysis system recorded the three‐dimensional FS and KS of 12 high‐performance male players. A total of 22 paired Student's t tests, with an accompanying partial Bonferroni correction (p<0.01), determined statistically significant differences between the variables of interest in both serves. Results Higher peak horizontal, vertical and absolute racquet velocities were developed during the FS, while higher lateral velocities characterised the KS. Similar shoulder joint kinematics and kinetics punctuated both serves, but with some variation in trunk and lower limb mechanics. Conclusions Similar shoulder joint kinetics assisted the development of varying three‐dimensional racquet velocities in the FS and KS. The comparable shoulder joint loading conditions point to the repetitive, long‐term performance of either serve as relevant in shoulder joint injury pathologies. PMID:17513331

  12. Influence of Combinations of Shoulder, Elbow and Trunk Orientation on Elbow Joint Loads in Youth Baseball Pitchers

    PubMed Central

    Tanaka, Hiroshi; Hayashi, Toyohiko; Inui, Hiroaki; Ninomiya, Hiroki; Muto, Tomoyuki; Nobuhara, Katsuya

    2016-01-01

    Objectives: Shoulder and elbow pain in youth baseball pitchers is a well-recognized phenomenon. Common problems in pitching mechanics that can lead to injury begin with stride foot contact. The purpose of this study was to address the relationships between the combinations of shoulder, elbow and trunk orientation at the instant of stride foot contact and elbow joint loads in youth baseball pitchers. Methods: A total of 143 Japanese male youth baseball pitchers participated in this study after providing written informed consents approved by the hospital’s institutional review board. The procedures to be performed were also explained to their parent(s) or legal guardian(s). Each participant was not currently injured or recovering from an injury at time of testing. For data collection of baseball pitching, a set of 14-mm spherical reflective markers was placed on the skin overlying 34 anatomical landmarks determined. Subsequently, a motion capture three-dimensional automatic digitizing system was used to collect 500-Hz from 7 charge-coupled-device synchronized cameras was set up around the regulation pitching mound in an indoor laboratory. After performing a preparation routine of stretching and warm-up pitching, each player pitch to 5 fastball pitches off the pitching mound to a catcher at the regulation distance of 16 m for youth pitchers. The best pitch thrown for a strike was chosen for kinematic and kinetic analysis. The local coordinate systems were used to calculate 3-dimesional rotation at the trunk, shoulder and elbow using the typical Eulerian sequence. Afterward, the standard inverse dynamic equation was used to estimate resultant joint forces and torques at throwing shoulder and elbow. In order to normalize data between subjects, forces and torques were expressed as percent using body weight and height. A multiple regression analysis was carried out to assess the combined effects of shoulder (external rotation, abduction and horizontal adduction), elbow

  13. [Impingement syndrome following direct injuries of the shoulder joint].

    PubMed

    Volpin, G; Stahl, S; Stein, H

    1996-02-15

    Impingement is the most common cause of pain and limitation of movement in the shoulder, with painful arc syndrome its major clinical sign. It usually becomes manifest at between 70 degrees-120 degrees of abduction, but in severe cases, this may be reduced to only 50 degrees-70 degrees. We studied 22 patients who had developed shoulder impingement following direct injuries and who had been treated by anterior acromioplasty and decompression, with an average follow-up of 32 months. 5 had sustained fractures of the greater tuberosity of the humerus at the time of injury, 14 had tears of the rotator cuff of various sizes (1 in both shoulders) and 3 had developed fibrotic scars of the subacromial bursa. Excellent or good results were achieved in 86.6%. Healing time was shorter, and there was return of full range of shoulder movement in those with subacromial scars, undisplaced fractures of the greater tuberosity, or those with a small tear of the rotator cuff. Recovery took longer in those with larger tears of the rotator cuff and in those with displaced fractures of the greater tuberosity. Recovery time was proportional to the size of the rotator cuff tear. It is concluded that direct trauma to the shoulder bears a direct relationship to the development of impingement syndrome, and that at surgery a concomitant tear in the rotator cuff is seen more than 2/3. Because of the high rate of success in surgical treatment of this syndrome, operation is indicated when a few months of physical therapy and analgesics fail to provide relief. In the presence of fractures, decompression surgery should be postponed until the fracture has united. PMID:8675117

  14. Joint Kinetics to Assess the Influence of the Racket on a Tennis Player’s Shoulder

    PubMed Central

    Creveaux, Thomas; Dumas, Raphaël; Hautier, Christophe; Macé, Pierre; Chèze, Laurence; Rogowski, Isabelle

    2013-01-01

    This study aimed at investigating the influence of three rackets on shoulder net joint moments, power and muscle activity during the flat tennis serve under field- conditions. A 6-camera Eagle® motion analysis system, operating at 256 Hz, captured racket and dominant upper limb kinematics of the serve in five tennis players under three racket conditions (A: low mass, high balance and polar moment, B: low three moments of inertia, and C: high mass, swingweight and twistweight). The electromyographic activity of six trunk and arm muscles was simultaneously recorded. Shoulder net joint moments and power were computed by 3D inverse dynamics. The results showed that greater shoulder joint power and internal/external rotation peak moments were found to accelerate and decelerate racket A in comparison with the racket C. Moreover, serving with the racket A resulted in less activity in latissimus dorsi muscle during the acceleration phase, and biceps brachii muscle during the follow-through phase when compared with racket C. These initial findings encourage studying the biomechanical measurements to quantify the loads on the body during play in order to reduce them, and then prevent shoulder injuries. Racket specifications may be a critical point for coaches who train players suffering from shoulder pain and chronic upper limb injuries should be considered in relation to the racket specifications of the players. Key Points Light racket required more joint power than heavy one to achieve similar post impact ball velocity. Serving with a light racket resulted in higher shoulder internal and external rotation moments than using a heavy one for similar performance. Chronic shoulder pain should encourage coaches to check for potentially inappropriate racket specifications of their players. PMID:24149804

  15. Reconstruction of high voltage electric burn wound with exposed shoulder joint by thoracoacromial artery perforator propeller flap

    PubMed Central

    Rout, Debesh Kumar; Nayak, Bibhuti Bhusan; Choudhury, Arun Kumar; Pati, Ajit Kumar

    2014-01-01

    We describe the reconstruction of high voltage electric burn injury with exposed shoulder joint by thoracoacromial artery perforator propeller flap based on the delto-pectoral perforators of thoracoacromial artery. The successful use of this propeller flap to cover the exposed shoulder joint in a case with limited local flap options demonstrates its use as an alternative technique. PMID:25190925

  16. Development of an Arthroscopic Joint Capsule Injury Model in the Canine Shoulder

    PubMed Central

    Kovacevic, David; Baker, Andrew R.; Staugaitis, Susan M.; Kim, Myung-Sun; Ricchetti, Eric T.; Derwin, Kathleen A.

    2016-01-01

    Background The natural history of rotator cuff tears can be unfavorable as patients develop fatty infiltration and muscle atrophy that is often associated with a loss of muscle strength and shoulder function. To facilitate study of possible biologic mechanisms involved in early degenerative changes to rotator cuff muscle and tendon tissues, the objective of this study was to develop a joint capsule injury model in the canine shoulder using arthroscopy. Methods Arthroscopic surgical methods for performing a posterior joint capsulectomy in the canine shoulder were first defined in cadavers. Subsequently, one canine subject underwent bilateral shoulder joint capsulectomy using arthroscopy, arthroscopic surveillance at 2, 4 and 8 weeks, and gross and histologic examination of the joint at 10 weeks. Results The canine subject was weight-bearing within eight hours after index and follow-up surgeries and had no significant soft tissue swelling of the shoulder girdle or gross lameness. Chronic synovitis and macroscopic and microscopic evidence of pathologic changes to the rotator cuff bony insertions, tendons, myotendinous junctions and muscles were observed. Conclusions This study demonstrates feasibility and proof-of-concept for a joint capsule injury model in the canine shoulder. Future work is needed to define the observed pathologic changes and their role in the progression of rotator cuff disease. Ultimately, better understanding of the biologic mechanisms of early progression of rotator cuff disease may lead to clinical interventions to halt or slow this process and avoid the more advanced and often irreversible conditions of large tendon tears with muscle fatty atrophy. PMID:26808837

  17. Effect of different hand positions on trunk and shoulder kinematics and reaction forces in sitting pivot transfer

    PubMed Central

    Kim, Sung Shin; Her, Jin Gan; Ko, Tae Sung

    2015-01-01

    [Purpose] The purpose of this study was to compare the changes in trunk and shoulder angles, and reaction forces under the two hands elicited by different hand base of support positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired subjects performed independent sitting pivot transfer. Subjects performed sitting pivot transfer between an initial seat to a target seat by only using their hands positioned at the same height as and lower than the seat position. Trunk and shoulder kinematics, and reaction forces on the trailing and leading hands were calculated. Mean peak joint angles and forces were compared between the hand positions using the pared t-test for the lift phase of the transfer. [Results] There were significant increases in the trunk angles of forward and lateral flexion, even though rotation decreased while transferring in the lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms lower than the seat position during sitting pivot transfer was identified as having biomechanical advantages. Therefore, the lower hand position can be recommended as an effective and safe method for sitting pivot transfer by patients with spinal cord injury and can be utilized as a reference data for considering the appropriate height of aids for a wheelchair. PMID:26310994

  18. Effect of different hand positions on trunk and shoulder kinematics and reaction forces in sitting pivot transfer.

    PubMed

    Kim, Sung Shin; Her, Jin Gan; Ko, Tae Sung

    2015-07-01

    [Purpose] The purpose of this study was to compare the changes in trunk and shoulder angles, and reaction forces under the two hands elicited by different hand base of support positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired subjects performed independent sitting pivot transfer. Subjects performed sitting pivot transfer between an initial seat to a target seat by only using their hands positioned at the same height as and lower than the seat position. Trunk and shoulder kinematics, and reaction forces on the trailing and leading hands were calculated. Mean peak joint angles and forces were compared between the hand positions using the pared t-test for the lift phase of the transfer. [Results] There were significant increases in the trunk angles of forward and lateral flexion, even though rotation decreased while transferring in the lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms lower than the seat position during sitting pivot transfer was identified as having biomechanical advantages. Therefore, the lower hand position can be recommended as an effective and safe method for sitting pivot transfer by patients with spinal cord injury and can be utilized as a reference data for considering the appropriate height of aids for a wheelchair. PMID:26310994

  19. Assessment of Correlation Between MRI and Arthroscopic Pathologic Findings in the Shoulder Joint

    PubMed Central

    Momenzadeh, Omid R; Gerami, Mohamad H; Sefidbakht, Sepideh; Dehghani, Sakineh

    2015-01-01

    Background: The objective of this study was to determine the diagnostic value of magnetic resonance imaging for shoulder joint pathologies and then compare the results with arthroscopy, the standard for joint diagnosis. Methods: In this cross-sectional study, 80 patients with shoulder joint disorders, who underwent final arthroscopy, were studied. Based on patients’ medical history and physical examinations, shoulder MRI was requested if paraclinical investigations were. If non-surgical therapies failed, arthroscopy of the affected shoulder was done and the same structures were inspected. Subsequently, sensitivity, specificity, and positive and negative predictive values (PPV) and (NPV) of MRI were determined by arthroscopy comparisons. Results: The highest sensitivity, specificity, PPV and NPV were found in MRI pathology reports that included: Hill-Sach lesion (0.910), infraspinatus tendon (0.985), supraspinatus tendon (0.930), and biceps tendon (0.954), respectively. Rotator interval (0.250), biceps labrum complex (0.805), subscapularis tendon (0.538) and anterior labrum lesions (0.604) had the lowest sensitivity, specificity, PPV and NPV, respectively. Conclusion: The results showed that MRI can be a useful tool in ruling out possible abnormalities in the shoulder and to give clues to the most probable diagnosis. Although knowing some practical skills in order to successfully perform the procedure and experience of the radiologist with suitable feedback by surgeon is necessary. PMID:26550595

  20. An analysis of acromioclavicular joint morphology as a factor for shoulder impingement syndrome

    PubMed Central

    Tavakkolizadeh, Adel; Sinha, Joydeep

    2014-01-01

    Background The present study aimed to determine whether acromioclavicular (AC) joint morphology was a factor in the development of symptomatic impingement necessitating AC joint excision. Methods We performed a prospective cohort study on all patients undergoing AC joint excision for symptomatic joint pain unresponsive to conservative treatment between 2009 and 2011. This involved 106 consecutive patients (57 women, 49 men, average age 54 years, age range 33 to 76 years). Prior to surgery, radiographic classification of the AC joint was performed producing three main groups: oblique, flat or curved. Pre- and postoperative assessment was performed using the Oxford Shoulder Score and the Disabilities of the Arm, Shoulder and Hand questionnaire. Results A significantly (p < 0.05) higher frequency of oblique AC joint morphology was seen in the AC joint excision study population compared to the normal population. Postoperative outcome demonstrated no significant difference (P > 0.05) between any of the three AC joint morphologies. Conclusions The present study demonstrates a significant association between the oblique AC joint morphology and those patients who develop AC joint pain requiring surgery. Outcomes of surgery were independent of joint morphology, gender or age, with all patient subgroups demonstrating significant improvement by the end of the study.

  1. Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 1: Sternoclavicular, Acromioclavicular, and Scapulothoracic Joints

    PubMed Central

    LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To compare sternoclavicular, acromioclavicular, and scapulothoracic joint motion between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Differences in scapulothoracic kinematics are associated with shoulder pain. Several studies have measured these differences using surface sensors, but the results of this technique may be affected by skin-motion artifact. Furthermore, previous studies have not included the simultaneous measurement of sternoclavicular and acromioclavicular joint motion. METHODS Transcortical bone pins were inserted into the clavicle, scapula, and humerus of 12 asymptomatic and 10 symptomatic individuals for direct, bone-fixed tracking using electromagnetic sensors. Angular positions for the sternoclavicular, acromioclavicular, and scapulothoracic joints were measured during shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups were found for sternoclavicular and scapulothoracic joint positions. Symptomatic individuals consistently demonstrated less sternoclavicular posterior rotation, regardless of angle, phase, or plane of shoulder motion. Symptomatic individuals also demonstrated less scapulothoracic upward rotation at 30° and 60° of humerothoracic elevation during shoulder abduction and scapular plane abduction. CONCLUSION The results of this study show that differences in shoulder complex kinematics exist between symptomatic and asymptomatic individuals. However, the magnitude of these differences was small, and the resulting clinical implications are not yet fully understood. The biomechanical coupling of the sternoclavicular and acromioclavicular joints requires further research to better understand scapulothoracic movement deviations and to improve manual therapy and exercise-based physical therapy interventions. PMID:25103135

  2. Kinematic and force data collection in biomechanics by means of sonic emitters--II: Force data collection and application to the human shoulder complex.

    PubMed

    Engin, A E; Peindl, R D; Berme, N; Kaleps, I

    1984-08-01

    In multisegmented mathematical models of the human body the most difficult and the least successful modeling of a major articulating joint has been the shoulder complex because of the lack of appropriate biomechanical data as well as the anatomical complexity of the region. In this paper, quantitative results on the variability of the stiffness of the shoulder complex dependent upon orientation of the upper arm are presented by applying the principles and theory developed in Part I. The paper starts with a description of a multiple-axis force and moment transducer and its utilization with sonic emitters in determining direction as well as location of the general force and moment vectors applied on a body segment. The numerical results which are presented for three subjects are in the form of plots showing the passive resistance of the shoulder complex as functions of drawer displacements of the upper arm along its long bone axis. Exponential and power curve fitting of the numerical results are also provided to establish intra-subject variations and similarities of the behavioral patterns of the axial stiffness characteristics of the human shoulder complex. PMID:6492766

  3. Functional Anatomy of the Shoulder

    PubMed Central

    Terry, Glenn C.; Chopp, Thomas M.

    2000-01-01

    Objective: Movements of the human shoulder represent the result of a complex dynamic interplay of structural bony anatomy and biomechanics, static ligamentous and tendinous restraints, and dynamic muscle forces. Injury to 1 or more of these components through overuse or acute trauma disrupts this complex interrelationship and places the shoulder at increased risk. A thorough understanding of the functional anatomy of the shoulder provides the clinician with a foundation for caring for athletes with shoulder injuries. Data Sources: We searched MEDLINE for the years 1980 to 1999, using the key words “shoulder,” “anatomy,” “glenohumeral joint,” “acromioclavicular joint,” “sternoclavicular joint,” “scapulothoracic joint,” and “rotator cuff.” Data Synthesis: We examine human shoulder movement by breaking it down into its structural static and dynamic components. Bony anatomy, including the humerus, scapula, and clavicle, is described, along with the associated articulations, providing the clinician with the structural foundation for understanding how the static ligamentous and dynamic muscle forces exert their effects. Commonly encountered athletic injuries are discussed from an anatomical standpoint. Conclusions/Recommendations: Shoulder injuries represent a significant proportion of athletic injuries seen by the medical provider. A functional understanding of the dynamic interplay of biomechanical forces around the shoulder girdle is necessary and allows for a more structured approach to the treatment of an athlete with a shoulder injury. PMID:16558636

  4. Shoulder surgery - discharge

    MedlinePlus

    SLAP repair - discharge; Acromioplasty - discharge; Bankart - discharge; Shoulder repair - discharge; Shoulder arthroscopy - discharge ... You had shoulder surgery to repair the tissues inside or around your shoulder joint. The surgeon may have used a tiny ...

  5. Evaluation of Three Methods for Determining EMG-Muscle Force Parameter Estimates for the Shoulder Muscles

    PubMed Central

    Gatti, Christopher J.; Doro, Lisa Case; Langenderfer, Joseph E.; Mell, Amy G.; Maratt, Joseph D.; Carpenter, James E.; Hughes, Richard E.

    2008-01-01

    Background Accurate prediction of in vivo muscle forces is essential for relevant analyses of musculoskeletal biomechanics. The purpose of this study was to evaluate three methods for predicting muscle forces of the shoulder by comparing calculated muscle parameters, which relate electromyographic activity to muscle forces. Methods Thirteen subjects performed sub-maximal, isometric contractions consisting of six actions about the shoulder and two actions about the elbow. Electromyography from 12 shoulder muscles and internal shoulder moments were used to determine muscle parameters using traditional multiple linear regression, principal-components regression, and a sequential muscle parameter determination process using principal-components regression. Muscle parameters were evaluated based on their sign (positive or negative), standard deviations, and error between the measured and predicted internal shoulder moments. Findings It was found that no method was superior with respect to all evaluation criteria. The sequential principal-components regression method most frequently produced muscle parameters that could be used to estimate muscle forces, multiple regression best predicted the measured internal shoulder moments, and the results of principal-components regression fell between those of sequential principal-components regression and multiple regression. Interpretation The selection of a muscle parameter estimation method should be based on the importance of the evaluation criteria. Sequential principal-components regression should be used if a greater number of physiologically accurate muscle forces are desired, while multiple regression should be used for a more accurate prediction of measured internal shoulder moments. However, all methods produced muscle parameters which can be used to predict in vivo muscle forces of the shoulder. PMID:17945401

  6. Shoulder replacement

    MedlinePlus

    ... the opening at the end of the shoulder blade, called the socket. This type of joint allows ... head. The socket part (glenoid) of your shoulder blade will be replaced with a smooth plastic shell ( ...

  7. Shoulder Arthroscopy

    MedlinePlus

    ... synovial fluid that lubricates the shoulder joint. Rotator cuff. Four tendons surround the shoulder capsule and help ... This thick tendon material is called the rotator cuff. The cuff covers the head of the humerus ...

  8. A proposal for a new definition of the axial rotation angle of the shoulder joint.

    PubMed

    Masuda, Tadashi; Ishida, Akimasa; Cao, Lili; Morita, Sadao

    2008-02-01

    The Euler/Cardan angles are commonly used to define the motions of the upper arm with respect to the trunk. This definition, however, has a problem in that the angles of both the horizontal flexion/extension and the axial rotation of the shoulder joint become unstable at the gimbal-lock positions. In this paper, a new definition of the axial rotation angle was proposed. The proposed angle was stable over the entire range of the shoulder motion. With the new definition, the neutral position of the axial rotation agreed with that in the conventional anatomy. The advantage of the new definition was demonstrated by measuring actual complex motions of the shoulder with a three-dimensional motion capture system. PMID:17070702

  9. Scapular dyskinesis is detrimental to shoulder tendon properties and joint mechanics in a rat model.

    PubMed

    Reuther, Katherine E; Thomas, Stephen J; Tucker, Jennica J; Yannascoli, Sarah M; Caro, Adam C; Vafa, Rameen P; Liu, Stephen S; Gordon, Joshua A; Bhatt, Pankti R; Kuntz, Andrew F; Soslowsky, Louis J

    2014-11-01

    Shoulder tendon injuries are frequently seen in the presence of abnormal scapular motion, termed scapular dyskinesis. The cause and effect relationship between scapular dyskinesis and shoulder injury has not been directly defined. We developed and used an animal model to examine the initiation and progression of pathological changes in the rotator cuff and biceps tendon. Sixty male Sprague-Dawley rats were randomized into two groups: nerve transection (to induce scapular dyskinesis, SD) or sham nerve transection (control). The animals were euthanized 4 and 8 weeks after surgery. Shoulder function and passive joint mechanics were evaluated over time. Tendon mechanical, histological, organizational, and compositional properties were evaluated at both time points. Gross observation demonstrated alterations in scapular motion, consistent with scapular "winging." Shoulder function, passive internal range of motion, and tendon mechanical properties were significantly altered. Histology results, consistent with tendon pathology (rounded cell shape and increased cell density), were observed, and protein expression of collagen III and decorin was altered. This study presents a new model of scapular dyskinesis that can rigorously evaluate cause and effect relationships in a controlled manner. Our results identify scapular dyskinesis as a causative mechanical mechanism for shoulder tendon pathology. PMID:25070580

  10. Scapular Dyskinesis is Detrimental to Shoulder Tendon Properties and Joint Mechanics in a Rat Model

    PubMed Central

    Reuther, Katherine E.; Thomas, Stephen J.; Tucker, Jennica J.; Yannascoli, Sarah M.; Caro, Adam C.; Vafa, Rameen P.; Liu, Stephen S.; Gordon, Joshua A.; Bhatt, Pankti R.; Kuntz, Andrew F.; Soslowsky, Louis J.

    2015-01-01

    Shoulder tendon injuries are frequently seen in the presence of abnormal scapular motion, termed scapular dyskinesis. The cause and effect relationship between scapular dyskinesis and shoulder injury has not been directly defined. The objective of this study was to develop and use an animal model to examine the initiation and progression of pathological changes in the rotator cuff and biceps tendon. 60 male Sprague-Dawley rats were randomized into two groups: nerve transection (to induce scapular dyskinesis, SD) or sham nerve transection (control). The animals were sacrificed 4 and 8 weeks after surgery. Shoulder function and passive joint mechanics were evaluated over time. Tendon mechanical, histological, organizational, and compositional properties were evaluated at 4 and 8 weeks. Gross observation demonstrated alterations in scapular motion, consistent with scapular “winging”. Shoulder function, passive internal range of motion, and tendon mechanical properties were significantly altered. Histology results, consistent with tendon pathology (rounded cell shape and increased cell density), were observed and protein expression of collagen III and decorin was altered. This study presents a new model of scapular dyskinesis that can rigorously evaluate cause and effect relationships in a controlled manner. These results identify scapular dyskinesis as a causative mechanical mechanism for shoulder tendon pathology. PMID:25070580

  11. Shoulder separation - aftercare

    MedlinePlus

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... Shoulder separation is not an injury to the main shoulder joint itself. It is an injury to the top ...

  12. Shoulder separation - aftercare

    MedlinePlus

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... Shoulder separation is not an injury to the main shoulder joint itself. It is an injury to ...

  13. [The Throwing Shoulder].

    PubMed

    Wieser, Karl; Gerber, Christian; Meyer, Dominik C

    2016-02-01

    Repetitive top-performance of overhead athletes induces a tremendous stress for the throwing shoulder. Throwers reach rotational speed of their arm of more than 7000°/s with joint compression and distraction forces of more than 1000 N. This performance is tributary to adaption of the shoulder muscles and the joint itself. These adaptions may, however lead to two specific problems of the throwing shoulder: 1. The posterosuperior internal impingement of the rotator cuff and labrum between glenoid and humeral head during late cooking phase; 2. A decreased internal rotation of the glenohumeral joint (GIRD) with compensatory problems of the scapula-stabilizing muscles. Precise analysis of kinematics and pathomechanics aims to improve understanding and treatment of those specific problems of the throwing shoulder. PMID:26837325

  14. Streptococcus agalactiae Septic Arthritis of the Shoulder and the Sacroiliac Joints: A Case Report

    PubMed Central

    Imam, Yahia Z.; Sarakbi, Housam Aldeen; Abdelwahab, Nagui; Mattar, Issa

    2012-01-01

    Invasive group beta-streptococcal arthritis is being increasingly diagnosed as suggested by recent data. We report a case of a middle-aged lady from Sri Lanka who developed septic arthritis of the right shoulder and the left sacroiliac joint as well as an iliopsoas collection caused by Streptococcus agalactiae shortly after labor at Hamad General Hospital in Doha, Qatar. We conclude that Streptococcus agalactiae septic arthritis is rare. It can present with invasive disease in adults. It usually targets older females and immuno compromised patients especially those with risk factors for bacteraemia. Therefore a high index of suspicion is needed. Shoulder and sacroiliac joint affection is not uncommon for unknown reasons. Utilizing imaging modalities such as ultrasonography and magnetic resonance imaging is helpful. PMID:22937455

  15. The Effects of Vibration Stimuli Applied to the Shoulder Joint on the Activity of the Muscles Around the Shoulder Joint

    PubMed Central

    Lee, Su-kyoung

    2013-01-01

    [Purpose] The present study compared the muscle activity of the upper trapezius with those of the serratus anterior and the lower trapezius when slings, unstable surfaces, were laterally vibrated, to examine the effects of vibration during sling exercises on shoulder stabilization muscles. [Methods] The subjects performed push-up exercises on a sling and maintained isometric contraction in the final stage, while vibration was manually administered to the rope of the sling during the isometric-contraction stage. Vibration within a range of 10 cm was delivered for five seconds at a frequency of 1 Hz in time with a metronome. Vibrations were applied for five seconds at 3 Hz and 3.5 Hz, respectively. [Results] The serratus anterior showed a significant differences between isometric contraction with vibration of 3 Hz and isometric contraction with vibration of 3.5 Hz. [Conclusion] The upper trapezius and the lower trapezius showed prominent changes in muscle activity at 3.5 Hz, and the serratus anterior showed prominent changes in muscle activity at 3 Hz and 3.5 Hz. Therefore, as vibration frequency increased, making the load-bearing surface more unstable, the recruitment of the upper trapezius, the lower trapezius, and the serratus anterior increased. To perform exercises that selectively strengthen the serratus anterior, the exercises should be performed at a vibration frequency of 3 Hz. PMID:24396199

  16. A Biomechanical Model of the Scapulothoracic Joint to Accurately Capture Scapular Kinematics during Shoulder Movements

    PubMed Central

    Seth, Ajay; Matias, Ricardo; Veloso, António P.; Delp, Scott L.

    2016-01-01

    The complexity of shoulder mechanics combined with the movement of skin relative to the scapula makes it difficult to measure shoulder kinematics with sufficient accuracy to distinguish between symptomatic and asymptomatic individuals. Multibody skeletal models can improve motion capture accuracy by reducing the space of possible joint movements, and models are used widely to improve measurement of lower limb kinematics. In this study, we developed a rigid-body model of a scapulothoracic joint to describe the kinematics of the scapula relative to the thorax. This model describes scapular kinematics with four degrees of freedom: 1) elevation and 2) abduction of the scapula on an ellipsoidal thoracic surface, 3) upward rotation of the scapula normal to the thoracic surface, and 4) internal rotation of the scapula to lift the medial border of the scapula off the surface of the thorax. The surface dimensions and joint axes can be customized to match an individual’s anthropometry. We compared the model to “gold standard” bone-pin kinematics collected during three shoulder tasks and found modeled scapular kinematics to be accurate to within 2mm root-mean-squared error for individual bone-pin markers across all markers and movement tasks. As an additional test, we added random and systematic noise to the bone-pin marker data and found that the model reduced kinematic variability due to noise by 65% compared to Euler angles computed without the model. Our scapulothoracic joint model can be used for inverse and forward dynamics analyses and to compute joint reaction loads. The computational performance of the scapulothoracic joint model is well suited for real-time applications; it is freely available for use with OpenSim 3.2, and is customizable and usable with other OpenSim models. PMID:26734761

  17. A Biomechanical Model of the Scapulothoracic Joint to Accurately Capture Scapular Kinematics during Shoulder Movements.

    PubMed

    Seth, Ajay; Matias, Ricardo; Veloso, António P; Delp, Scott L

    2016-01-01

    The complexity of shoulder mechanics combined with the movement of skin relative to the scapula makes it difficult to measure shoulder kinematics with sufficient accuracy to distinguish between symptomatic and asymptomatic individuals. Multibody skeletal models can improve motion capture accuracy by reducing the space of possible joint movements, and models are used widely to improve measurement of lower limb kinematics. In this study, we developed a rigid-body model of a scapulothoracic joint to describe the kinematics of the scapula relative to the thorax. This model describes scapular kinematics with four degrees of freedom: 1) elevation and 2) abduction of the scapula on an ellipsoidal thoracic surface, 3) upward rotation of the scapula normal to the thoracic surface, and 4) internal rotation of the scapula to lift the medial border of the scapula off the surface of the thorax. The surface dimensions and joint axes can be customized to match an individual's anthropometry. We compared the model to "gold standard" bone-pin kinematics collected during three shoulder tasks and found modeled scapular kinematics to be accurate to within 2 mm root-mean-squared error for individual bone-pin markers across all markers and movement tasks. As an additional test, we added random and systematic noise to the bone-pin marker data and found that the model reduced kinematic variability due to noise by 65% compared to Euler angles computed without the model. Our scapulothoracic joint model can be used for inverse and forward dynamics analyses and to compute joint reaction loads. The computational performance of the scapulothoracic joint model is well suited for real-time applications; it is freely available for use with OpenSim 3.2, and is customizable and usable with other OpenSim models. PMID:26734761

  18. Influence of anthropometry on meat-packing plant workers: an approach to the shoulder joint.

    PubMed

    Reis, Pedro Ferreira; Peres, Luis Sérgio; Tirloni, Adriana Seára; dos Reis, Diogo Cunha; Estrázulas, Jansen Atier; Rossato, Mateus; Moro, Antônio Renato Pereira

    2012-01-01

    This study was conducted with 90 poultry slaughterhouse workers, which perform the function of removing chicken parts from the conveyor belt, and sample was composed of 66 women (33.5 ± 6.5 years) and 24 men (35.7 ± 7.2 years), aiming to analyze the influence of anthropometry in the shoulder joint of these workers. Body discomfort was evaluated by a human body diagram, being applied at the end of the work shift. The anthropometric measurement of shoulder was performed by measuring the height of the acromion process, being compared with the height of the conveyor belt. Analysis of the results was performed by descriptive statistics, mean, standard deviation, percentage and percentiles 5%, 50% and 95%. It was found that the height of the conveyor belt was 1.74 meters, while the average shoulder height of workers was 1.38 meters for percentile 5%, 1.41 meters for percentile 50% and 1.65 meters for percentile 95%. The discomfort regions were shoulder 45%, neck 29%, column 26%, arms 23%, and wrists and hand 20%. The upper limb assessment was performed with percentile 5% through the Rapid Upper Limb Assessment method, resulting in a final score > 7, indicating the need for adjustments of the work organization. It was concluded that the workplace does not meet the workers' anthropometric characteristics, mainly affecting the shoulder joint, and correction ergonomics becomes necessary so that the workers involved in this study can perform their functions with health, comfort and safety. PMID:22317430

  19. A 200-m All-out Front-crawl Swim Modifies Competitive Swimmers' Shoulder Joint Position Sense.

    PubMed

    Uematsu, A; Kurita, Y; Inoue, K; Okuno, K; Hortobágyi, T; Suzuki, S

    2015-11-01

    We tested the hypothesis that an all-out-effort 200-m front-crawl swim trial affects competitive swimmers' shoulder joint position sense. On Day 1, we measured shoulder joint position sense before and after the swim trial, and on Day 2 before and after 2 min of seated rest. On both days, shoulder joint position sense was measured in the seated position using electromagnetic movement sensors in a position-matching paradigm. An investigator abducted participants' left (reference) shoulder joint in the frontal plane to test angles of 90°, 135°, and 180°. Participants then actively abducted the right (indicator) shoulder joint to match the position of the left, reference arm. After the 200-m all-out front-crawl swim trial, the indicator relative to the reference angle differed by 4.4° toward adduction at the 180° (vertical) testing position (P<0.05). Variation in absolute matching error was 3.2° or 2.2 times greater after swim compared with the no-swim control trial. An all-out 200-m front-crawl swim trial can selectively increase competitive swimmers' shoulder joint position sense error and increase variation in matching error in horizontal arm position. PMID:26252553

  20. Computational reverse shoulder prosthesis model: Experimental data and verification.

    PubMed

    Martins, A; Quental, C; Folgado, J; Ambrósio, J; Monteiro, J; Sarmento, M

    2015-09-18

    The reverse shoulder prosthesis aims to restore the stability and function of pathological shoulders, but the biomechanical aspects of the geometrical changes induced by the implant are yet to be fully understood. Considering a large-scale musculoskeletal model of the upper limb, the aim of this study is to evaluate how the Delta reverse shoulder prosthesis influences the biomechanical behavior of the shoulder joint. In this study, the kinematic data of an unloaded abduction in the frontal plane and an unloaded forward flexion in the sagittal plane were experimentally acquired through video-imaging for a control group, composed of 10 healthy shoulders, and a reverse shoulder group, composed of 3 reverse shoulders. Synchronously, the EMG data of 7 superficial muscles were also collected. The muscle force sharing problem was solved through the minimization of the metabolic energy consumption. The evaluation of the shoulder kinematics shows an increase in the lateral rotation of the scapula in the reverse shoulder group, and an increase in the contribution of the scapulothoracic joint to the shoulder joint. Regarding the muscle force sharing problem, the musculoskeletal model estimates an increased activity of the deltoid, teres minor, clavicular fibers of the pectoralis major, and coracobrachialis muscles in the reverse shoulder group. The comparison between the muscle forces predicted and the EMG data acquired revealed a good correlation, which provides further confidence in the model. Overall, the shoulder joint reaction force was lower in the reverse shoulder group than in the control group. PMID:26206550

  1. Knee joint forces: prediction, measurement, and significance

    PubMed Central

    D’Lima, Darryl D.; Fregly, Benjamin J.; Patil, Shantanu; Steklov, Nikolai; Colwell, Clifford W.

    2011-01-01

    Knee forces are highly significant in osteoarthritis and in the survival and function of knee arthroplasty. A large number of studies have attempted to estimate forces around the knee during various activities. Several approaches have been used to relate knee kinematics and external forces to internal joint contact forces, the most popular being inverse dynamics, forward dynamics, and static body analyses. Knee forces have also been measured in vivo after knee arthroplasty, which serves as valuable validation of computational predictions. This review summarizes the results of published studies that measured knee forces for various activities. The efficacy of various methods to alter knee force distribution, such as gait modification, orthotics, walking aids, and custom treadmills are analyzed. Current gaps in our knowledge are identified and directions for future research in this area are outlined. PMID:22468461

  2. Knee joint forces: prediction, measurement, and significance.

    PubMed

    D'Lima, Darryl D; Fregly, Benjamin J; Patil, Shantanu; Steklov, Nikolai; Colwell, Clifford W

    2012-02-01

    Knee forces are highly significant in osteoarthritis and in the survival and function of knee arthroplasty. A large number of studies have attempted to estimate forces around the knee during various activities. Several approaches have been used to relate knee kinematics and external forces to internal joint contact forces, the most popular being inverse dynamics, forward dynamics, and static body analyses. Knee forces have also been measured in vivo after knee arthroplasty, which serves as valuable validation of computational predictions. This review summarizes the results of published studies that measured knee forces for various activities. The efficacy of various methods to alter knee force distribution, such as gait modification, orthotics, walking aids, and custom treadmills are analyzed. Current gaps in our knowledge are identified and directions for future research in this area are outlined. PMID:22468461

  3. Towards the development of a novel experimental shoulder simulator with rotating scapula and individually controlled muscle forces simulating the rotator cuff.

    PubMed

    Baumgartner, Daniel; Tomas, Daniel; Gossweiler, Lukas; Siegl, Walter; Osterhoff, Georg; Heinlein, Bernd

    2014-03-01

    A preclinical analysis of novel implants used in shoulder surgery requires biomechanical testing conditions close to physiology. Existing shoulder experiments may only partially apply multiple cycles to simulate postoperative, repetitive loading tasks. The aim of the present study was therefore the development of an experimental shoulder simulator with rotating scapula able to perform multiple humeral movement cycles by simulating individual muscles attached to the rotator cuff. A free-hanging, metallic humerus pivoted in a polyethylene glenoid is activated by tension forces of linear electroactuators to simulate muscles of the deltoideus (DELT), supraspinatus (SSP), infraspinatus/teres minor and subscapularis. The abductors DELT and SSP apply forces with a ratio of 3:1 up to an abduction angle of 85°. The rotating scapular part driven by a rotative electro actuator provides one-third to the overall arm abduction. Resulting joint forces and moments are measured by a 6-axis load cell. A linear increase in the DELT and SSP motors is shown up to a maximum of 150 and 50 N for the DELT and SSP, respectively. The force vector in the glenoid resulted in 253 N at the maximum abduction. The present investigation shows the contribution of individual muscle forces attached to the moving humerus to perform active abduction in order to reproducibly test shoulder implants. PMID:24170552

  4. Segmentation and measurement of collagen fibers for shoulder and joint therapy studies

    SciTech Connect

    Mascio, L.

    1994-11-15

    Various shoulder instabilities are debilitating, especially in individuals who perform overhead activities. Thermal modification of soft tissues in joints may allow precise alteration of these tissues` mechanical and/or structural properties to enhance joint function without inducing cell death or an inflammatory response. Several studies have evaluated laser energy for tissue welding. The collective findings are promising, and the next step is to identify the mechanisms responsible for laser-induced capsular tissue alternation, and the short- and long-term effects of non-ablative laser energy on joint capsular tissue. One step toward this goal is to compare the effect of three laser energy densities on the histologic properties of the tissue evaluating the architecture of the collagen (including density, fibril diameter distribution, and interfibrillar space) in sheep at various time intervals after surgery. The specific computer algorithms that are being used to make these measurements will be described.

  5. Anterior Hip Joint Force Increases with Hip Extension, Decreased Gluteal Force, or Decreased Iliopsoas Force

    PubMed Central

    Lewis, Cara L.; Sahrmann, Shirley A.; Moran, Daniel W.

    2008-01-01

    Abnormal or excessive force on the anterior hip joint may cause anterior hip pain, subtle hip instability and a tear of the acetabular labrum. We propose that both the pattern of muscle force and hip joint position can affect the magnitude of anterior joint force and thus possibly lead to excessive force and injury. The purpose of this study was to determine the effect of hip joint position and of weakness of the gluteal and iliopsoas muscles on anterior hip joint force. We used a musculoskeletal model to estimate hip joint forces during simulated prone hip extension and supine hip flexion under 4 different muscle force conditions and across a range of hip extension and flexion positions. Weakness of specified muscles was simulated by decreasing the modeled maximum force value for the gluteal muscles during hip extension and the iliopsoas muscle during hip flexion. We found that decreased force contribution from the gluteal muscles during hip extension and the iliopsoas muscle during hip flexion resulted in an increase in the anterior hip joint force. The anterior hip joint force was greater when the hip was in extension than when the hip was in flexion. Further studies are warranted to determine if increased utilization of the gluteal muscles during hip extension and of the iliopsoas muscle during hip flexion, and avoidance of hip extension beyond neutral would be beneficial for people with anterior hip pain, subtle hip instability, or an anterior acetabular labral tear. PMID:17707385

  6. Effect of brief daily resistance training on rapid force development in painful neck and shoulder muscles: randomized controlled trial

    PubMed Central

    Jay, Kenneth; schraefel, mc; Andersen, Christoffer H; Ebbesen, Frederik S; Christiansen, David H; Skotte, Jørgen; Zebis, Mette K; Andersen, Lars L

    2013-01-01

    Objective: To determine the effect of small daily amounts of progressive resistance training on rapid force development of painful neck/shoulder muscles. Methods: 198 generally healthy adults with frequent neck/shoulder muscle pain (mean: age 43·1 years, computer use 93% of work time, 88% women, duration of pain 186 day during the previous year) were randomly allocated to 2- or 12 min of daily progressive resistance training with elastic tubing or to a control group receiving weekly information on general health. A blinded assessor took measures at baseline and at 10-week follow-up; participants performed maximal voluntary contractions at a static 90-degree shoulder joint angle. Rapid force development was determined as the rate of torque development and maximal muscle strength was determined as the peak torque. Results: Compared with the control group, rate of torque development increased 31·0 Nm s−1 [95% confidence interval: (1·33–11·80)] in the 2-min group and 33·2 Nm s−1 (1·66–12·33) in the 12-min group from baseline to 10-week follow-up, corresponding to an increase of 16·0% and 18·2% for the two groups, respectively. The increase was significantly different compared to controls (P<0·05) for both training groups. Maximal muscle strength increased only ∼5–6% [mean and 95% confidence interval for 2- and 12-min groups to control, respectively: 2·5 Nm (0·05–0·73) and 2·2 Nm (0·01–0·70)]. No significant differences between the 2- and 12-min groups were evident. A weak but significant relationship existed between changes in rapid force development and pain (r = 0·27, P<0·01), but not between changes in maximal muscle strength and pain. Conclusion: Small daily amounts of progressive resistance training in adults with frequent neck/shoulder pain increases rapid force development and, to a less extent, maximal force capacity. PMID:23758661

  7. Bilateral Anterior Fracture-Dislocation of Shoulder Joint- A rare case with Delayed Presentation

    PubMed Central

    Sunku, Nithin; Kalaiah, Kiran; Marulasidappa, G.; Gopinath, P.

    2012-01-01

    Introduction: The shoulder is the most frequently dislocated joint. Bilateral glenohumeral dislocations are rare and almost always posterior. Bilateral anterior fracture dislocations of humeral neck in a patient with seizure are extremely rare. We report one such case of delayed presentation of bilateral anterior fracture dislocation of shoulder after an epileptic attack. Case Report: We describe a rare case of 30 year old gentleman who presented with first episode of seizure following alcohol withdrawal. Physical examination and radiographic assessment revealed fracture dislocation of bilateral proximal humeri (4 part fracture on right side and two part fracture on left). Patient presented 20 days after injury during which he was treated by local osteopath by immobilization and massage. Open reduction and internal fixation with simple T plate was done on right side and multiple K – wires were used on left side. At one year follow up the patient had acceptable range and was able to carry out daily activities. Conclusions: Bilateral anterior fracture dislocation of shoulder behave similar to unilateral fracture dislocations and treatment needs to be planned appropriately. Even in cases with delayed presentation good results can be achieved

  8. The effect of shoulder core exercises on isometric torque of glenohumeral joint movements in healthy young females

    PubMed Central

    Moghadam, Afsun Nodehi; Mohammadi, Roghayeh; Arab, Amir Massoud; Kazamnajad, Anoshirvan

    2011-01-01

    BACKGROUND: Strength improvement of the shoulder muscles is a major goal in rehabilitation or athletic conditioning programs. The purpose of this study was to determine the effect of shoulder core exercises on the isometric torque of glenohumeral joint movements. METHODS: A total of 36 healthy females with no history of shoulder injury enrolled in this study. Subjects were randomly assigned into the control group (n = 18, 22 ± 2.19 years of age) or experimental group (n = 18, 21 ± 2.05 years of age). Subjects in experimental group performed shoulder core exercises, using progressive resistance training, three times a week for six weeks. Subjects in control group performed no exercise. The isometric torque of shoulder movements were measured with Dynatorq device in isolated test positions of glenohumeral muscles at the beginning and after six weeks in both groups. RESULTS: shoulder core exercise training led to an increase in maximal isometric torques of shoulder scaption at 0° and 90° arm elevation, external and internal rotation, horizontal adduction and extension movements (p < 0.001 in all instances). No significant difference was found between initial scores and scores after six weeks in the control group (p > 0.05). CONCLUSIONS: These findings indicated that shoulder core exercise training leads to an increase in peak torque for all glenohumeral movements that can be considered in glenohumeral muscles strengthening programs. PMID:22973363

  9. Joint Task Force on Undergraduate Physics Programs

    NASA Astrophysics Data System (ADS)

    This session will focus on the guidelines and recommendations being developed by the APS/AAPT Joint Task Force on Undergraduate Physics Programs. J-TUPP is studying how undergraduate physics programs might better prepare physics majors for diverse careers. The guidelines and recommendations will focus on curricular content, flexible tracks, pedagogical methods, research experiences and internships, the development of professional skills, and enhanced advising and mentoring for all physics majors.

  10. 3 CFR - Disestablishment of United States Joint Forces Command

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Disestablishment of United States Joint Forces... of United States Joint Forces Command Memorandum for the Secretary of Defense Pursuant to my... States Joint Forces Command, effective on a date to be determined by the Secretary of Defense. I...

  11. Using your shoulder after replacement surgery

    MedlinePlus

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made ...

  12. Shoulder and hip joints for hard space suits and the like

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.

    1986-01-01

    For use in hard space suits and the like, a joint between the torso covering and the upper arm covering (i.e., shoulder) or between the torso covering and upper leg covering (i.e., hip) is disclosed. Each joint has an outer covering and a inner covering. The outer covering has plural perferably truncated toroidal sections decreasing in size proceeding outwardly. In one embodiment at each joint there are two bearings, the first larger than the second. The outer race of the larger bearing is attached to the outer edge of the smaller end of each section and the inner race of the larger bearing is attached to the end wall. The inner race of the smaller bearing is attached to the end wall. The outer race of the smaller bearing is attached to the larger end of the next section. Each bearing hask appropriate seals. Between each section is a rubber ring for the comfort of the wearer. Such rubber rings have radial flanges attached to the inner races of two adjacent bearings. Matching semicircular grooves are formed in the abutting overlapping surfaces. Bellows-like inner walls are also provided for each section fixed at one end to an inner cylindrical flange and, at the opposite end, to an end wall. Each outer section may rotate 360 deg relative to the next outer section, whereas the bellows sections do not rotate, but rather expand or contract locally as the rigid sections rotate relative to each other.

  13. The friction coefficient of shoulder joints remains remarkably low over 24 h of loading.

    PubMed

    Jones, Brian K; Durney, Krista M; Hung, Clark T; Ateshian, Gerard A

    2015-11-01

    The frictional response of whole human joints over durations spanning activities of daily living has not been reported previously. This study measured the friction of human glenohumeral joints during 24 h of reciprocal loading in a pendulum testing device, at moderate (0.2 mm/s, 4320 cycles) and low (0.02 mm/s, 432 cycles) sliding speeds, under a 200 N load. The effect of joint congruence was also investigated by testing human humeral heads against significantly larger mature bovine glenoids. Eight human joints and six bovine joints were tested in four combinations: human joints tested at moderate (hHCMS, n=6) and low speed (hHCLS, n=3), human humeral heads tested against bovine glenoids at moderate speed (LCMS, n=3), and bovine joints tested at moderate speed (bHCMS, n=3). In the first half hour the mean±standard deviation of the friction coefficient was hHCMS: 0.0016±0.0011, hHCLS: 0.0012±0.0002, LCMS: 0.0008±0.0002 and bHCMS: 0.0024±0.0008; in the last four hours it was hHCMS: 0.0057±0.0025, hHCLS: 0.0047±0.0017, LCMS: 0.0012±0.0003 and bHCMS: 0.0056±0.0016. The initial value was lower than the final value (p<0.0001). The value in LCMS was significantly lower than in hHCMS and bHCMS (p<0.01). No visual damage was observed in any of the specimens. These are the first results to demonstrate that the friction coefficient of natural human shoulders remains remarkably low (averaging as little as 0.0015 and no greater than 0.006) for up to 24 h of continuous loading. The sustained low friction coefficients observed in incongruent joints (~0.001) likely represent rolling rather than sliding friction. PMID:26472306

  14. The validation of a human force model to predict dynamic forces resulting from multi-joint motions

    NASA Technical Reports Server (NTRS)

    Pandya, Abhilash K.; Maida, James C.; Aldridge, Ann M.; Hasson, Scott M.; Woolford, Barbara J.

    1992-01-01

    The development and validation is examined of a dynamic strength model for humans. This model is based on empirical data. The shoulder, elbow, and wrist joints were characterized in terms of maximum isolated torque, or position and velocity, in all rotational planes. This data was reduced by a least squares regression technique into a table of single variable second degree polynomial equations determining torque as a function of position and velocity. The isolated joint torque equations were then used to compute forces resulting from a composite motion, in this case, a ratchet wrench push and pull operation. A comparison of the predicted results of the model with the actual measured values for the composite motion indicates that forces derived from a composite motion of joints (ratcheting) can be predicted from isolated joint measures. Calculated T values comparing model versus measured values for 14 subjects were well within the statistically acceptable limits and regression analysis revealed coefficient of variation between actual and measured to be within 0.72 and 0.80.

  15. 76 FR 1975 - Disestablishment of United States Joint Forces Command

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ..., 2011 [FR Doc. 2011-590 Filed 1-10-11; 11:15 am] Billing code 5000-04-P ... Memorandum of January 6, 2011--Disestablishment of United States Joint Forces Command #0; #0; #0... of United States Joint Forces Command Memorandum for the Secretary of Defense Pursuant to...

  16. The lateral impaction of the shoulder.

    PubMed

    Scarlat, M M; Cuny, C; Goldberg, B A; Harryman, D T; Matsen, F A

    1999-01-01

    17 patients had radiographic demonstration of injury to the clavicle, scapula and ribs from an impact delivered to the lateral shoulder. The study included 13 males and 4 females whose ages ranged from 18 to 83 years (average 45 years). Most injuries were sustained in falls or motor vehicle accidents. Analysis of these cases suggests a biomechanical hypothesis concerning the transmission of the impact forces within the shoulder girdle. According to this hypothesis, the impaction force applied to the lateral shoulder is transmitted from outside inward following two paths. The anterior and superior path passes through the acromio-clavicular joint, the clavicle, the costo-clavicular joint and the sterno-clavicular joint. The posterior and inferior path is transmitted within the gleno-humeral joint, the scapula and the scapulo-thoracic joint. Major impacting force is required to disrupt the anterior and posterior arches of the shoulder girdle. When both of these supporting structures are damaged, the patient is at risk for more serious injuries, including disruption of the thorax, shoulder joint, brachial plexus and neck. PMID:10653299

  17. The Treatment of Fibrosis of Joint Synovium and Frozen Shoulder by Smad4 Gene Silencing in Rats

    PubMed Central

    Xue, MingFeng; Gong, SuiLiang; Dai, JiaPing; Chen, Gang; Hu, JunYu

    2016-01-01

    Soft tissue fibrosis at the joint induced by inflammation is the pathological basis of frozen shoulder. In the present study, we utilized a lentiviral approach to silence the Smad4 gene in an in vitro fibrosis model of fibroblasts and an in vivo frozen shoulder model. We observed the change in the fibrosis process and the biological indicators of frozen shoulder. The in vitro fibrosis models (Rat myoblasts L6, Rat synovial cell RSC-364 and Rat chondrocytes RCs) were established using TGF-β1 induction, and the effect of Smad4 gene silencing on fibrosis was analyzed. The method of Kanno A was employed to establish a rat model of frozen shoulder, and Smad4 in the relevant part was knocked down with the lentiviral approach. We then examined the abduction and rotation angles and the length of synovial intima and measured the inflammatory factors in effusion and the fibrotic markers of tissues. We found that Smad4 knockdown suppressed the proliferation and expression of fibrotic markers in L6, RSC-364 and RCs cells induced by TGF-β1. MMP activity measurements showed that Smad4 knockdown significantly reversed the decrease in MMP activity in these three cell lines that were induced by TGF-β1. Furthermore, using lentivirus in the rat frozen shoulder model, we found that Smad4 silencing attenuated the inflammatory response and fibrosis. It significantly inhibited the increase of the Vimentin, α-SMA, collagen I and III, Lama1 and Timp1 proteins in synovial tissue as well as the inflammatory factors of TNF-a, IL-1α/β, IL-6 and IL-10 in effusion. MMP acidity assays revealed that Smad4 silencing inhibited MMP activity in the synovial, cartilage and ligament tissues in the model animals. The assessment of the phosphorylated Smad2/3 in the nuclei isolated from the synovial tissues showed that Smad4 silencing significantly inhibited the phosphorylation and subsequent nuclear translocation of Smad2/3 proteins. Moreover, Smad4-shRNA lentivirus inhibited the decrease in both

  18. Development and evaluation of the measurement system for the human shoulder joint based on the 6 DOF kinematic modelling.

    PubMed

    Shimomura, Y; Iwanaga, K; Harada, H; Katsuura, T

    2000-01-01

    Although numerical models on the shoulder complex joint are currently available, many are impractical because of the procedural complexity coupled with limited and mere simple simulations. The present study defined the clavicle-scapula system as the "base of the humerus" in determining the position of proximal head of humerus, rendering conclusive innovation of a six degree of freedom (DOF) shoulder complex joint model. Furthermore, a complete measurement system where evaluation by calibrating the actual values via the use of an electromagnetic tracking device (ETD) was developed based on the innovated model. The special calibration method using optimizing calculation to work out the rotational center of humerus was employed and actually tested if the theoretical consideration was practically available. As a result of accuracy check experiments, the measurement error was defined within 2-3 mm, indicating sufficient accuracy in studies for human movement. Our findings strongly advocate that the benefit of this novel measurement system would contribute to studies related to shoulder movements in physiological anthropology. PMID:10979249

  19. A Rare Unusual Case Presentation of the Tuberculosis of the Shoulder Joint

    PubMed Central

    Deshmukh, Ashwin; Deo, Sanjay; Salgia, Anil Kumar; Agarwal, Tushar

    2013-01-01

    Introduction: Afflictions of shoulder by tuberculosis is rare and when it occurs its more commonly a dry lesion (caries sicca). Wet lesions in shoulder are rare and we report this case for the rarity of its occurrence. Case Report: A 55yrs old female patient presented with a painful swelling with restriction of movements of the right shoulder since six months. Patient had taken various treatments without any relief; there was no history of trauma, weight loss, recent infection in the past or any history of tuberculosis in family or contact with tubercular patient. Right shoulder revealed restricted movements with no local rise in temperature. Tenderness was present over anterior and posterior aspect of the right shoulder diffusely. External rotation and abduction movements were restricted while adduction and flexion were not restricted. Power of the muscles was unaffected with no neurological deficit. Antero-posterior and axial X-rays of the right shoulder showed no bony involvement however, ultrasonography showed lipoma. Serological investigations showed a markedly raised erythrocyte sedimentation rate (73mm / hr) and a positive C-reactive protein. Surgical excision of the mass revealed rice bodies. DNA PCR was positive for tuberculosis and patient was started on anti-tubercular treatment(Category I) for six months. Conclusion: Any patient coming with the complaints of long standing painful restriction of the movements of the shoulder associated with or without complaints swelling, shall be evaluated to rule out skeletal tuberculosis along with other differential diagnosis of periarthritis of shoulder and adhesive capsulitis. Most of the patients with skeletal tuberculosis may not necessarily present with the constitutional symptoms of fever, weight loss, etc and also because of the widespread prevalence of the organism in India. PMID:27298926

  20. Injection in the cervical facet joint for shoulder pain with myofascial trigger points in the upper trapezius muscle.

    PubMed

    Tsai, Chien-Tsung; Hsieh, Lin-Fen; Kuan, Ta-Shen; Kao, Mu-Jung; Hong, Chang-Zern

    2009-08-01

    The goal of this double-blinded, randomized, controlled study was to confirm the effectiveness of the cervical facet joint injection in treating shoulder pain with the myofascial trigger point in the upper trapezius muscle secondary to cervical facet lesion. Eighty-nine patients with chronic unilateral shoulder pain due to myofascial trigger points in the upper trapezius muscle received an injection to the C4-5 facet joint in the experimental group and to the corresponding unilateral multifidi muscle in the control group. Subjective pain intensity and pressure pain threshold of the myofascial trigger point were assessed, and the prevalence of endplate noise in the myofascial trigger point region was measured in 28 patients before, immediately after, and 1 month after the injection. Half of the patients in the experimental group, but none of the control patients, reported being completely pain free 1 month after the injection. Both the decrease in the pain intensity and the increase in pressure pain threshold were significantly more in the experimental group than in the control group either immediately or 1 month after the injection. There was no significant difference in the change of endplate noise prevalence between the 2 groups. This study demonstrates that intra-articular or peri-articular injection into the cervical facet joint region can effectively inactivate the upper trapezius myofascial trigger point secondary to the facet lesion. PMID:19708635

  1. Automatic bone segmentation and bone-cartilage interface extraction for the shoulder joint from magnetic resonance images

    NASA Astrophysics Data System (ADS)

    Yang, Zhengyi; Fripp, Jurgen; Chandra, Shekhar S.; Neubert, Aleš; Xia, Ying; Strudwick, Mark; Paproki, Anthony; Engstrom, Craig; Crozier, Stuart

    2015-02-01

    We present a statistical shape model approach for automated segmentation of the proximal humerus and scapula with subsequent bone-cartilage interface (BCI) extraction from 3D magnetic resonance (MR) images of the shoulder region. Manual and automated bone segmentations from shoulder MR examinations from 25 healthy subjects acquired using steady-state free precession sequences were compared with the Dice similarity coefficient (DSC). The mean DSC scores between the manual and automated segmentations of the humerus and scapula bone volumes surrounding the BCI region were 0.926  ±  0.050 and 0.837  ±  0.059, respectively. The mean DSC values obtained for BCI extraction were 0.806  ±  0.133 for the humerus and 0.795  ±  0.117 for the scapula. The current model-based approach successfully provided automated bone segmentation and BCI extraction from MR images of the shoulder. In future work, this framework appears to provide a promising avenue for automated segmentation and quantitative analysis of cartilage in the glenohumeral joint.

  2. Bilateral coracoclavicular joints as a rare cause of bilateral thoracic outlet syndrome and shoulder pain treated successfully by conservative means.

    PubMed

    Singh, V K; Singh, P K; Balakrishnan, S K

    2009-06-01

    The coracoclavicular joint (CCJ) is a rare anomalous joint. Symptomatic CCJ, being an exceptional rarity, makes it difficult to formulate a standard set of practice or guidelines. We report a 50-year-old Indian man, a machine operator by profession, who experienced bilateral shoulder pain and arm paraesthesia for two years, and was diagnosed with bilateral CCJ. The symptoms gradually increased, affecting his daily activities. Dynamic magnetic resonance imaging revealed the compression of the brachial plexus in extreme shoulder abduction. After a thorough search of the literature, we retrieved four similar cases, all of them treated with individualised protocols. None of the cases was bilateral. The lack of clear evidence in any particular direction and the patient's medical condition prompted us to give a conservative trial, before embarking on more invasive methods. He showed rapid response to the conservative treatment with remission of all symptoms. To the best of our knowledge, this is the first reported case of bilateral symptomatic CCJ with bilateral thoracic outlet syndrome, that was managed conservatively. PMID:19551300

  3. [Rehabilitation of the shoulder joint after acromioplasty in the subacromial pain syndrome].

    PubMed

    Vavra-Hadziahmetović, Narcisa; Hadziahmetović, Zoran; Smajlović, Fahrudin

    2002-01-01

    Diagnostic error possibility and non-adequate surgical treatment by shoulder injury lead to non-adequate rehabilitation program. Authors show the case with diagnostic error and discuss the reasons for incomplete functional answer after rehabilitation-program. It is given the recommendation for solving these problems. PMID:11917686

  4. Does surgery for instability of the shoulder truly stabilize the glenohumeral joint?

    PubMed Central

    Lädermann, Alexandre; Denard, Patrick J.; Tirefort, Jérôme; Kolo, Frank C.; Chagué, Sylvain; Cunningham, Grégory; Charbonnier, Caecilia

    2016-01-01

    Abstract Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects glenohumeral translation. The purpose of this prospective clinical study was to analyze the effect of surgical stabilization on glenohumeral translation. Glenohumeral translation was assessed in 11 patients preoperatively and 1 year postoperatively following surgical stabilization for anterior shoulder instability. Translation was measured using optical motion capture and computed tomography. Preoperatively, anterior translation of the affected shoulder was bigger in comparison to the normal contralateral side. Differences were significant for flexion and abduction movements (P < 0.001). Postoperatively, no patients demonstrated apprehension and all functional scores were improved. Despite absence of apprehension, postoperative anterior translation for the surgically stabilized shoulders was not significantly different from the preoperative values. While surgical treatment for anterior instability limits the chance of dislocation, it does not seem to restore glenohumeral translation during functional range of motion. Such persistent microinstability may explain residual pain, apprehension, inability to return to activity and even emergence of dislocation arthropathy that is seen in some patients. Further research is necessary to better understand the causes, effects, and treatment of residual microinstability following surgical stabilization of the shoulder. PMID:27495043

  5. Effect of increased pushoff during gait on hip joint forces.

    PubMed

    Lewis, Cara L; Garibay, Erin J

    2015-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to "push more with your foot when you walk". We collected motion data of markers placed on the subjects' trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data. The instruction to "push more with your foot when you walk" reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces were 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain. PMID:25468661

  6. Effect of increased pushoff during gait on hip joint forces

    PubMed Central

    Lewis, Cara L.; Garibay, Erin J.

    2014-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to “push more with your foot when you walk”. We collected motion data of markers placed on the subjects’ trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual 3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data. The instruction to “push more with your foot when you walk” reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces was 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain. PMID:25468661

  7. The effects of shoulder joint abduction angles on the muscle activity of the serratus anterior muscle and the upper trapezius muscle while vibrations are applied

    PubMed Central

    Jung, Da-eun; Moon, Dong-chul

    2015-01-01

    [Purpose] The purpose of this study was to examine the ratio between the upper trapezius and the serratus anterior muscles during diverse shoulder abduction exercises applied with vibrations in order to determine the appropriate exercise methods for recovery of scapular muscle balance. [Subjects and Methods] Twenty-four subjects voluntarily participated in this study. The subjects performed shoulder abduction at various shoulder joint abduction angles (90°, 120°, 150°, 180°) with oscillation movements. [Results] At 120°, all the subjects showed significant increases in the muscle activity of the serratus anterior muscle in comparison with the upper trapezius muscle. However, no significant difference was found at angles other than 120°. [Conclusion] To selectively strengthen the serratus anterior, applying vibration stimuli at the 120° shoulder abduction position is considered to be appropriate. PMID:25642052

  8. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    PubMed Central

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic bilateral acute anterior shoulder dislocations with associated Hill-Sachs lesions in a young, fit and well patient with no comorbidities. MRI illustrated the Hill-Sachs lesions with superior labral tear from anterior to posterior, and confirmed the acute nature of the injury by demonstrating the bone marrow oedema. The patient was treated surgically with arthroscopic anterior stabilisation. At 6 months following surgery, the patient has a pain free full range of movement of both shoulders with no further dislocations and has returned to work. PMID:24895390

  9. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type.

    PubMed

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene; Maeland, Silje; Juul-Kristensen, Birgit

    2016-07-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p < 0.001), lower HRQol on SF-36 Physical Component Scale (PCS: 28.1 versus 49.9; p < 0.001), and higher pain intensity (NRS: 6.4 versus 2.7; p < 0.001) than controls. Neck and shoulder joints were rated as primary painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain. PMID:26824670

  10. Muscular forces affect the glycosaminoglycan content of joint cartilage

    PubMed Central

    Ganse, Bergita; Zange, Jochen; Weber, Tobias; Pohle-Fröhlich, Regina; Johannes, Bernd W; Hackenbroch, Matthias; Rittweger, Jörn; Eysel, Peer; Koy, Timmo

    2015-01-01

    Background and purpose Unloading alters the thickness of joint cartilage. It is unknown, however, to what extent unloading leads to a loss of glycosaminoglycans (GAGs) in the cartilage tissue. We hypothesized that muscle forces, in addition to axial loading, are necessary to maintain the joint cartilage GAG content of the knee and the upper and lower ankle. Patients and methods The HEPHAISTOS orthosis was worn unilaterally by 11 men (mean age 31 (23–50) years old) for 56 days. The orthosis reduces activation and force production of the calf muscles while it permits full gravitational loading of the lower leg. MRI measurements of the knee and ankle were taken before the intervention, during the intervention (on day 49), and 14 days after the end of the intervention. Cartilage segmentation was conducted semiautomatically for the knee joint (4 segments) and for the upper (tibio-talar) and lower (subtalar) ankle joints (2 segments each). Linear mixed-effects (LME) models were used for statistical analysis. Results 8 volunteers completed the MRI experiment. In the lower ankle joint, differences in ΔT1 were found between the end of the intervention and 14 days after (p = 0.004), indicating a decrease in GAG content after reloading. There were no statistically significant differences in ΔT1 values in the knee and upper ankle joints. Interpretation Our findings suggest that in addition to gravitational load, muscular forces affect cartilage composition depending on the local distribution of forces in the joints affected by muscle contraction. PMID:25417835

  11. Upper limb joint position sense during shoulder flexion in healthy individuals: a pilot study to develop a new assessment method

    PubMed Central

    Hood, Victoria

    2015-01-01

    Background Altered shoulder joint position sense (JPS) following shoulder injury has been demonstrated in the literature and may increase the risk of injury. A JPS assessment targeting the shoulder will provide the clinician with an objective marker. The present study aimed to develop an assessment method of JPS using an active relocation test (ART). Methods In total, 40 healthy participants were recruited. A laser-pointer attached to the index finger during an ART allowed measurement (mm) of JPS by measuring the distance between the target and relocated position. Participants were blindfolded and stood an arm’s length (approximately 1 m) away from the wall. Whilst keeping the wrist in neutral and elbow extended, the participant actively moved to the target position (90° glenohumeral flexion), held for 5 seconds, returned their arm to their side and actively returned to the target position. A mean was calculated from three trials to provide an ART score. Results The mean (SD) dominant and nondominant ART score was 89.2 (SD 35.5) mm (95% confidence interval = 77.87 mm to 100.5 mm) and 94.1 (34.5) mm (95% confidence interval = 83.1 mm to 105.2 mm), respectively. Arm dominance did not significantly affect ART scores. Conclusions No significant difference was demonstrated between the dominant and nondominant arm using an ART assessing JPS acuity. Further studies are needed to establish inter-rater and intra-rater reliability.

  12. Joint forces and torques when walking in shallow water.

    PubMed

    Orselli, Maria Isabel Veras; Duarte, Marcos

    2011-04-01

    This study reports for the first time an estimation of the internal net joint forces and torques on adults' lower limbs and pelvis when walking in shallow water, taking into account the drag forces generated by the movement of their bodies in the water and the equivalent data when they walk on land. A force plate and a video camera were used to perform a two-dimensional gait analysis at the sagittal plane of 10 healthy young adults walking at comfortable speeds on land and in water at a chest-high level. We estimated the drag force on each body segment and the joint forces and torques at the ankle, knee, and hip of the right side of their bodies using inverse dynamics. The observed subjects' apparent weight in water was about 35% of their weight on land and they were about 2.7 times slower when walking in water. When the subjects walked in water compared with walking on land, there were no differences in the angular displacements but there was a significant reduction in the joint torques which was related to the water's depth. The greatest reduction was observed for the ankle and then the knee and no reduction was observed for the hip. All joint powers were significantly reduced in water. The compressive and shear joint forces were on average about three times lower during walking in water than on land. These quantitative results substantiate the use of water as a safe environment for practicing low-impact exercises, particularly walking. PMID:21334630

  13. Putting the shoulder to the wheel: a new biomechanical model for the shoulder girdle.

    PubMed

    Levin, S M

    1997-01-01

    The least successfully modeled joint complex has been the shoulder. In multi-segmented mathematical shoulder models rigid beams (the bones) act as a series of columns or levers to transmit forces or loads to the axial skeleton. Forces passing through the almost frictionless joints must, somehow, always be directed perfectly perpendicular to the joints as only loads directed at right angles to the surfaces could transfer across frictionless joints. Loads transmitted to the axial skeleton would have to pass through the moving ribs or the weak jointed clavicle and then through the ribs. A new model of the shoulder girdle, based on the tension icosahedron described by Buckminster Fuller, is proposed that permits the compression loads passing through the arm and shoulder to be transferred to the axial skeleton through its soft tissues. In this model the scapula 'floats' in the tension network of shoulder girdle muscles just as the hub of the wire wheel is suspended in its tension network of spokes. With this construct inefficient beams and levers are eliminated. A more energy efficient, load distributing, integrated, hierarchical system is created. PMID:9731395

  14. Intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer for geriatric and stroke patients

    PubMed Central

    Hirano, Masahiro; Katoh, Munenori; Kawaguchi, Saori; Uemura, Tomomi

    2016-01-01

    [Purpose] This study aimed to verify the appropriate number of measurements and the intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD) for geriatric and stroke patients. [Subjects and Methods] The subjects were 40 inpatients, who were divided into two groups: 20 stroke patients in the stroke group (SG), and 20 geriatric patients in the no-stroke group (N-SG). Measurements were performed three times using an HHD with a belt. The reliability was verified using Bland-Altman analysis and the intraclass correlation coefficient (ICC). [Results] ICC (1, 1) was >0.9. A systematic bias was not observed between the first and second measurement values except for the right side in N-SG. A systematic bias between the maximum value obtained during the first and second measurements and third measurement value was observed on the left side in N-SG, and on the non-paralyzed side in SG: the third measurement values were small in both cases. [Conclusion] Intrarater reliabilities were high for shoulder horizontal adductor strength measurements using an HHD with a belt for geriatric and stroke patients. Taking the systematic bias into consideration, these findings suggest that the required number of measurements is two. PMID:26957727

  15. "Floating shoulder" injuries.

    PubMed

    Heng, Kenneth

    2016-12-01

    "Floating shoulder" is a rare injury complex resulting from high-energy blunt force trauma to the shoulder, resulting in scapulothoracic dissociation. It is commonly associated with catastrophic neurovascular injury. Two cases of motorcyclists with floating shoulder injuries are described. PMID:26961729

  16. Calculation of joint reaction force and joint moments using by wearable walking analysis system.

    PubMed

    Adachi, Wataru; Tsujiuchi, Nobutaka; Koizumi, Takayuki; Shiojima, Kouzou; Tsuchiya, Youtaro; Inoue, Yoshio

    2012-01-01

    In gait analysis, which is one useful method for efficient physical rehabilitation, the ground reaction force, the center of pressure, and the body orientation data are measured during walking. In the past, these data were measured by a 3D motion analysis system consisting of high-speed cameras and force plates, which must be installed in the floor. However, a conventional 3D motion analysis system can measure the ground reaction force and the center of pressure just on force plates during a few steps. In addition, the subjects' stride lengths are limited because they have to walk on the center of the force plate. These problems can be resolved by converting conventional devices into wearable devices. We used a measuring device consisting of portable force plates and motion sensors. We developed a walking analysis system that calculates the ground reaction force, the center of pressure, and the body orientations and measured a walking subject to estimate this system. We simultaneously used a conventional 3D motion analysis system to compare with our development system and showed its validity for measurements of ground reaction force and the center of pressure. Moreover we calculated joint reactions and joint moment of each joint. PMID:23365940

  17. Relaxin Receptor RXFP1 and RXFP2 Expression in Ligament, Tendon, and Shoulder Joint Capsule of Rats.

    PubMed

    Kim, Jae Hyung; Lee, Sang Kwang; Lee, Seong Kyu; Kim, Joo Heon; Fredericson, Michael

    2016-06-01

    Numerous musculoskeletal disorders are caused by thickened ligament, tendon stiffness, or fibrosis of joint capsule. Relaxin, a peptide hormone, can exert collagenolytic effect on ligamentous and fibrotic tissues. We hypothesized that local injection of relaxin could be used to treat entrapment neuropathy and adhesive capsulitis. Because hormonal effect depends on the receptor of the hormone on the target cell, it is important to confirm the presence of such hormonal receptor at the target tissue before the hormone therapy is initiated. The aim of this study was to determine whether there were relaxin receptors in the ligament, tendon, and joint capsular tissues of rats and to identify the distribution of relaxin receptors in these tissues. Transverse carpal ligaments (TCLs), inguinal ligaments, anterior cruciate ligaments (ACLs), Achilles tendons, and shoulder joint capsules were obtained from male Wistar rats. Western blot analysis was used to identify relaxin receptor isoforms RXFP1 and RXFP2. The distribution of relaxin receptors was determined by immunohistochemical staining. The RXFP1 isoform was found in all tissues examined. The RXFP2 isoform was present in all tissues but the TCLs. Its expression in ACLs tissues was relatively weak compared to that in other tissues. Our results revealed that RXFP1 and RXFP2 were distributed in distinctly different patterns according to the type of tissue (vascular endothelial cells, fibroblast-like cells) they were identified. PMID:27247510

  18. Relaxin Receptor RXFP1 and RXFP2 Expression in Ligament, Tendon, and Shoulder Joint Capsule of Rats

    PubMed Central

    2016-01-01

    Numerous musculoskeletal disorders are caused by thickened ligament, tendon stiffness, or fibrosis of joint capsule. Relaxin, a peptide hormone, can exert collagenolytic effect on ligamentous and fibrotic tissues. We hypothesized that local injection of relaxin could be used to treat entrapment neuropathy and adhesive capsulitis. Because hormonal effect depends on the receptor of the hormone on the target cell, it is important to confirm the presence of such hormonal receptor at the target tissue before the hormone therapy is initiated. The aim of this study was to determine whether there were relaxin receptors in the ligament, tendon, and joint capsular tissues of rats and to identify the distribution of relaxin receptors in these tissues. Transverse carpal ligaments (TCLs), inguinal ligaments, anterior cruciate ligaments (ACLs), Achilles tendons, and shoulder joint capsules were obtained from male Wistar rats. Western blot analysis was used to identify relaxin receptor isoforms RXFP1 and RXFP2. The distribution of relaxin receptors was determined by immunohistochemical staining. The RXFP1 isoform was found in all tissues examined. The RXFP2 isoform was present in all tissues but the TCLs. Its expression in ACLs tissues was relatively weak compared to that in other tissues. Our results revealed that RXFP1 and RXFP2 were distributed in distinctly different patterns according to the type of tissue (vascular endothelial cells, fibroblast-like cells) they were identified. PMID:27247510

  19. Distribution of beta-endorphin and substance P in the shoulder joint of the dog before and after a low impact exercise programme.

    PubMed

    Karahan, S; Kincaid, S A; Baird, A N; Kammermann, J R

    2002-04-01

    Beta-endorphin and substance P were immunolocalized in the articular cartilage, synovial membrane and fibrous joint capsule of dogs. Twelve adult greyhounds were randomly assigned to one of three groups: control, limited exercise, or regimented exercise. On day 0, biopsies of articular cartilage and joint capsule were obtained from the left shoulder joints of dogs receiving limited and regimented exercise. On day 72, biopsies of joint capsule from right and left shoulders and articular cartilage from the right shoulder joint were analysed for the presence of glycosaminoglycans (GAG) and for immunolocalization of substance P and beta-endorphin. Regimented exercise increased the presence of GAGs and immunolocalization of substance P and beta-endorphin in articular cartilage and synovial membrane compared to day 0 biopsies and untreated controls. Localization of beta-endorphin became prominent in and around the chondrocytes. Substance P was increased in chondrocytes and extracellular matrix. Concomitant changes in localization of beta-endorphin and substance P may have a role in the modulation of the microphysiological environment, metabolism, or function of joint tissues in response to low-impact exercise. PMID:12047242

  20. Restoration of Shoulder Function.

    PubMed

    Boe, Chelsea C; Elhassan, Bassem T

    2016-08-01

    Restoration of shoulder function in patients with brachial plexus injury can be challenging. Initial reported efforts were focused on stabilizing the shoulder, improving inferior subluxation and restoring abduction and flexion of the joint. Recent advancements and improved understanding of coordinated shoulder motion and the biomechanical properties of the muscles around the shoulder applicable to tendon transfer have expanded available surgical options to improve shoulder function, specifically external rotation. Despite the advances in reconstructive options, brachial plexus injury remains a serious problem that requires complex surgical solutions, prolonged recovery, and acceptance of functional loss. PMID:27387074

  1. Effect of core muscle thickness and static or dynamic balance on prone bridge exercise with sling by shoulder joint angle in healthy adults

    PubMed Central

    Park, Mi Hwa; Yu, Jae Ho; Hong, Ji Heon; Kim, Jin Seop; Jung, Sang Woo; Lee, Dong Yeop

    2016-01-01

    [Purpose] To date, core muscle activity detected using ultrasonography during prone bridge exercises has not been reported. Here we investigated the effects of core muscle thickness and balance on sling exercise efficacy by shoulder joint angle in healthy individuals. [Subjects and Methods] Forty-three healthy university students were enrolled in this study. Ultrasonography thickness of external oblique, internal oblique, and transversus abdominis during sling workouts was investigated. Muscle thickness was measured on ultrasonography imaging before and after the experiment. Dynamic balance was tested using a functional reaching test. Static balance was tested using a Tetrax Interactive Balance System. [Results] Different muscle thicknesses were observed during the prone bridge exercise with the shoulder flexed at 60°, 90° or 120°. Shoulder flexion at 60° and 90° in the prone bridge exercise with a sling generated the greatest thickness of most transversus abdominis muscles. Shoulder flexion at 120° in the prone bridge exercise with a sling generated the greatest thickness of most external oblique muscles. [Conclusion] The results suggest that the prone bridge exercise with shoulder joint angle is an effective method of increasing global and local muscle strength. PMID:27134390

  2. Shoulder injuries from attacking motion

    NASA Astrophysics Data System (ADS)

    Yanagi, Shigeru; Nishimura, Tetsu; Itoh, Masaru; Wada, Yuhei; Watanabe, Naoki

    1997-03-01

    Sports injuries have bothered professional players. Although many medical doctors try to treat injured players, to prevent sports injuries is more important. Hence, it is required to clear a kinematic mechanism of the sport injuries. A shoulder of volleyball attacker or baseball pitcher is often inured by playing motion. The injuries are mainly caused at the end of long head tendon, which is located in the upper side of scapula. Generally, a muscle and tendon have enough strength against tensile force, however, it seems that they are sometimes defeated by the lateral force. It is imagined that the effect of the lateral force has a possibility of injuring the tendon. If we find the influence of the lateral force on the injured portion, the mechanism of injuries must be cleared. In our research, volleyball attacking motion is taken by high speed video cameras. We analyze the motion as links system and obtain an acceleration of an arm and a shoulder from video image data. The generated force at a shoulder joint is calculated and resolved into the lateral and longitudinal forces. Our final goal is to discuss a possibility that the lateral force causes the injuries.

  3. Test-retest reliability of an active range of motion test for the shoulder and hip joints by unskilled examiners using a manual goniometer

    PubMed Central

    Kim, Seong-Gil; Kim, Eun-Kyung

    2016-01-01

    [Purpose] The purpose of this study was to analyze test-retest reliability of an active range of motion test using a manual goniometer by unskilled examiners. [Subjects and Methods] Active range of motion was measured in 30 students attending U university (4 males, 26 females). Range of motion during flexion and extension of the shoulder and hip joints were measured using a manual goniometer. [Results] Flexion and extension of the shoulder joint (ICC=0.906 and ICC=0.808) and (ICC=0.946 and ICC=0. 955) of the hip joint showed excellent reliabilities. [Conclusion] The active range of motion test using a manual goniometer showed very high test-retest reliability in unskilled examiners. When examiners are aware of the method of the test, an objective assessment can be conducted. PMID:27134347

  4. Differences Regarding Branded HA in Italy, Part 2: Data from Clinical Studies on Knee, Hip, Shoulder, Ankle, Temporomandibular Joint, Vertebral Facets, and Carpometacarpal Joint

    PubMed Central

    Migliore, A.; Bizzi, E.; De Lucia, O.; Delle Sedie, A.; Tropea, S.; Bentivegna, M.; Mahmoud, A.; Foti, C.

    2016-01-01

    OBJECTIVES The aim of the current study is to collect scientific data on all branded hyaluronic acid (HA) products in Italy that are in use for intra-articular (IA) injection in osteoarthritis (OA) compared with that reported in the leaflet. METHODS An extensive literature research was performed for all articles reporting data on the IA use of HA in OA. Selected studies were taken into consideration only if they are related to products based on HAs that are currently marketed in Italy with the specific joint indication for IA use in patients affected by OA. RESULTS Sixty-two HA products are marketed in Italy: 30 products are indicated for the knee but only 8 were proved with some efficacy; 9 products were effective for the hip but only 6 had hip indication; 7 products proved to be effective for the shoulder but only 3 had the indication; 5 products proved effective for the ankle but only one had the indication; 6 products were effective for the temporomandibular joint but only 2 had the indication; only 2 proved effective for vertebral facet joints but only 1 had the indication; and 5 products proved effective for the carpometacarpal joint but only 2 had the indication. CONCLUSIONS There are only a few products with some evidences, while the majority of products remain without proof. Clinicians and regulators should request postmarketing studies from pharmaceuticals to corroborate with that reported in the leaflet and to gather more data, allowing the clinicians to choose the adequate product for the patient. PMID:27279754

  5. Effect of pain scrambler therapy on shoulder joint pain and range of motion in patients who had undergone arthroscopic rotator cuff repair for the first time

    PubMed Central

    Lee, Dong-Kyu; Kim, Eun-Kyung

    2016-01-01

    [Purpose] This study aimed to determine the effect of pain scrambler therapy on shoulder joint pain and range of motion in patients who had undergone arthroscopic rotator cuff repair for the first time. [Subjects and Methods] Pain scrambler therapy was administered once a day every 40 minutes for 10 days to patients that had undergone arthroscopic rotator cuff repair for the first time. The visual analog scale was used to measure pain, and a goniometer was used to measure shoulder range of motion. [Results] After 10 sessions of pain scrambler therapy, pain was significantly reduced from that before the treatment. In addition, shoulder range of motion was increased after 10 treatment sessions. [Conclusion] Thus, pain scrambler therapy greatly reduced pain and increased should range of motion in the patients who had undergone arthroscopic rotator cuff repair for the first time. PMID:27512291

  6. [Orthopedic treatment of the shoulder joint impairment in patients with rheumatoid arthritis].

    PubMed

    Herasymenko, S I; Babko, A M; Poluliakh, M V; Huzhevs'kyĭ, I V; Herasymenko, A S

    2014-12-01

    Brachial joint affection in patients, suffering rheumatoid arthritis, occupies a third place after such of the elbow and the hand. Due to significant reduction of a freedom degree, caused by inflammation, the upper extremity looses function of active instrument for the items transposition. Volume of surgical treatment of such patients depends on stage of the process. On early stages arthroscopic synovectomy of brachial joint is performed and on the late--endoprosthesis. Late results of the treatment are mainly positive. Satisfactory results are based, predominantly, on raising of activity of general rheumatoid inflammation. PMID:25842886

  7. Shoulder replacement - discharge

    MedlinePlus

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; ...

  8. Shoulder Instability

    MedlinePlus

    ... Risk Factors Is shoulder instability the same as shoulder dislocation? No. The signs of dislocation and instability might ... the same to you--weakness and pain. However, dislocation occurs when your shoulder goes completely out of place. The shoulder ligaments ...

  9. Effect of Resistance Training Maintaining the Joint Angle-torque Profile Using a Haptic-based Machine on Shoulder Internal and External Rotation

    PubMed Central

    Kim, Yeonghun; Lee, Kunwoo; Moon, Jeheon; Koo, Dohoon; Park, Jaewoo; Kim, Kyengnam; Hong, Daehie; Shin, Inshik

    2014-01-01

    [Purpose] The aim of this study was to present an individualized resistance training method to enable exercise while maintaining an exercise load that is set according to an individual’s joint angle-torque using a haptic-based resistance training machine. [Methods] Five participants (machine group) performed individualized shoulder internal and external rotation training with a haptic resistance training machine, while another five participants performed general dumbbell-based shoulder internal and external rotation training for eight weeks. Internal and external rotation powers of subjects were measured using an isokinetic machine before and after training. [Results] The average powers of both shoulder internal and external rotation has been improved after training (25.72%, 13.62%). The improvement in power of external rotation in the machine group was significantly higher than that in the control group. [Conclusion] This study proposes a haptic-based individualized rotator cuff muscle training method. The training protocol maintaining the joint angle-torque profile showed better improvement of shoulder internal/external rotation than dumbbell training. PMID:24764626

  10. Investigating shoulder muscle loading and exerted forces during wall painting tasks: influence of gender, work height and paint tool design.

    PubMed

    Rosati, Patricia M; Chopp, Jaclyn N; Dickerson, Clark R

    2014-07-01

    The task of wall painting produces considerable risk to the workers, both male and female, primarily in the development of upper extremity musculoskeletal disorders. Insufficient information is currently available regarding the potential benefits of using different paint roller designs or the possible adverse effects of painting at different work heights. The aim of this study was to investigate the influence of gender, work height, and paint tool design on shoulder muscle activity and exerted forces during wall painting. Ten young adults, five male and five female, were recruited to perform simulated wall painting at three different work heights with three different paint roller designs while upper extremity muscle activity and horizontal push force were recorded. Results demonstrated that for female participants, significantly greater total average (p = 0.007) and integrated (p = 0.047) muscle activity was present while using the conventional and curly flex paint roller designs compared to the proposed design in which the load was distributed between both hands. Additionally, for both genders, the high working height imposed greater muscular demands compared to middle and low heights. These findings suggest that, if possible, avoid painting at extreme heights (low or high) and that for female painters, consider a roller that requires the use of two hands; this will reduce fatigue onset and subsequently mitigate potential musculoskeletal shoulder injury risks. PMID:24636728

  11. Adhesively-Bonded Structural Composite Joint Utilizing Shoulder-Centered Sleeves

    NASA Technical Reports Server (NTRS)

    Lukowski, Florian P., Jr. (Inventor)

    2015-01-01

    A composite joint includes a first member having a groove therein, a second member adjacent to the first member, and a connector member disposed between the second member and the first member. The connector member is received in the groove so as to bias a load path between the first member and the second member from a peripheral portion to a central portion of the connector member.

  12. Revisiting the Force-Joint Angle Relationship After Eccentric Exercise.

    PubMed

    Welsh, Molly C; Allen, David L; Batliner, Matthew E; Byrnes, William C

    2015-12-01

    The purpose of this study was to evaluate force-angle curve fitting techniques pre-eccentric exercise, quantify changes in curve characteristics postexercise, and examine the relationship between curve changes and markers of muscle damage. Fourteen males unaccustomed to eccentric exercise performed 60 eccentric muscle actions of the elbow flexors. Maximal voluntary isometric force was measured throughout a range of angles pre- (Pre1 and Pre2), immediately post (IP), and 1, 2, 4, and 7 days postexercise. Force-angle curves for each visit were constructed using second-order polynomials. Changes in curve characteristics (optimal angle, peak force, curve height), range of motion, soreness, and creatine kinase activity were quantified. Optimal joint angle and force at optimal angle were significantly correlated from Pre1 to Pre2 (ICC = 0.821 and 0.979, respectively). Optimal angle was significantly right shifted (p = 0.035) by 10.4 ± 12.9° from Pre2 to IP and was restored by 1 day post exercise. Interestingly, the r value for curve fit was significantly decreased (p < 0.001) from Pre2 (r = 0.896) to IP (r = 0.802) and 1 day post exercise (r = 0.750). Curve height was significantly decreased (39%) IP and restored to pre-exercise height by 4 days postexercise. There was no correlation between optimal angle or curve height and other damage markers. In conclusion, force-angle relationships can be accurately described using second-order polynomials. After eccentric exercise, the force-angle curve is flattened and shifted (downward and rightward), but these changes are not correlated to other markers of muscle damage. Changes in the force-angle relationship are multifaceted, but determining the physiological significance of these changes requires further investigation. PMID:25970492

  13. Passive Joint Forces Are Tuned to Limb Use in Insects and Drive Movements without Motor Activity

    PubMed Central

    Ache, Jan M.; Matheson, Thomas

    2013-01-01

    Summary Background Limb movements are generally driven by active muscular contractions working with and against passive forces arising in muscles and other structures. In relatively heavy limbs, the effects of gravity and inertia predominate, whereas in lighter limbs, passive forces intrinsic to the limb are of greater consequence. The roles of passive forces generated by muscles and tendons are well understood, but there has been little recognition that forces originating within joints themselves may also be important, and less still that these joint forces may be adapted through evolution to complement active muscle forces acting at the same joint. Results We examined the roles of passive joint forces in insect legs with different arrangements of antagonist muscles. We first show that passive forces modify actively generated movements of a joint across its working range, and that they can be sufficiently strong to generate completely passive movements that are faster than active movements observed in natural behaviors. We further demonstrate that some of these forces originate within the joint itself. In legs of different species adapted to different uses (walking, jumping), these passive joint forces complement the balance of strength of the antagonist muscles acting on the joint. We show that passive joint forces are stronger where they assist the weaker of two antagonist muscles. Conclusions In limbs where the dictates of a key behavior produce asymmetry in muscle forces, passive joint forces can be coadapted to provide the balance needed for the effective generation of other behaviors. PMID:23871240

  14. Multibody system of the upper limb including a reverse shoulder prosthesis.

    PubMed

    Quental, C; Folgado, J; Ambrósio, J; Monteiro, J

    2013-11-01

    The reverse shoulder replacement, recommended for the treatment of several shoulder pathologies such as cuff tear arthropathy and fractures in elderly people, changes the biomechanics of the shoulder when compared to the normal anatomy. Although several musculoskeletal models of the upper limb have been presented to study the shoulder joint, only a few of them focus on the biomechanics of the reverse shoulder. This work presents a biomechanical model of the upper limb, including a reverse shoulder prosthesis, to evaluate the impact of the variation of the joint geometry and position on the biomechanical function of the shoulder. The biomechanical model of the reverse shoulder is based on a musculoskeletal model of the upper limb, which is modified to account for the properties of the DELTA® reverse prosthesis. Considering two biomechanical models, which simulate the anatomical and reverse shoulder joints, the changes in muscle lengths, muscle moment arms, and muscle and joint reaction forces are evaluated. The muscle force sharing problem is solved for motions of unloaded abduction in the coronal plane and unloaded anterior flexion in the sagittal plane, acquired using video-imaging, through the minimization of an objective function related to muscle metabolic energy consumption. After the replacement of the shoulder joint, significant changes in the length of the pectoralis major, latissimus dorsi, deltoid, teres major, teres minor, coracobrachialis, and biceps brachii muscles are observed for a reference position considered for the upper limb. The shortening of the teres major and teres minor is the most critical since they become unable to produce active force in this position. Substantial changes of muscle moment arms are also observed, which are consistent with the literature. As expected, there is a significant increase of the deltoid moment arms and more fibers are able to elevate the arm. The solutions to the muscle force sharing problem support the

  15. Shoulder proprioception in baseball pitchers.

    PubMed

    Safran, M R; Borsa, P A; Lephart, S M; Fu, F H; Warner, J J

    2001-01-01

    We examined proprioceptive differences between the dominant and nondominant shoulders of 21 collegiate baseball pitchers without a history of shoulder instability or surgery. A proprioceptive testing device was used to measure kinesthesia and joint position sense. Joint position sense was significantly (P =.05) more accurate in the nondominant shoulder than in the dominant shoulder when starting at 75% of maximal external rotation and moving into internal rotation. There were no significant differences for proprioception in the other measured positions or with kinesthesia testing. Six pitchers with recent shoulder pain had a significant (P =.04) kinesthetic deficit in the symptomatic dominant shoulder compared with the asymptomatic shoulder, as measured in neutral rotation moving into internal rotation. The net effect of training, exercise-induced laxity, and increased external rotation in baseball pitchers does not affect proprioception, although shoulder pain, possibly due to rotator cuff inflammation or tendinitis, is associated with reduced kinesthetic sensation. PMID:11641701

  16. Traction-drive force transmission for telerobotic joints

    NASA Technical Reports Server (NTRS)

    Kuban, D. P.; Williams, D. M.

    1989-01-01

    The U.S. Space Station Program is providing many technological developments to meet the increasing demands of designing such a facility. One of the key areas of research is that of telerobotics for space station assembly and maintenance. Initial implementation will be teleoperated, but long-term plans call for autonomous robotics. One of the essential components for making this transition successful is the manipulator joints mechanism. Historically, teleoperated manipulators and industrial robotics have had very different mechanisms for force transmission. This is because the design objectives are almost mutually exclusive. A teleoperator must have very low friction and inertia to minimize operator fatigue; backlash and stiffness are of secondary concern. A robot, however, must have minimum backlash, and high stiffness for accurate and rapid positioning. A joint mechanism has yet to be developed that can optimize these divergent performance objectives. A joint mechanism that approaches this optimal performance was developed for NASA Langley, Automation Technology Branch. It is a traction-drive differential that uses variable preload mechanisms. The differential provides compact, dexterous motion range with a torque density similar to geared systems. The traction drive offers high stiffness and zero backlash, for good robotic performance, and the variable loading mechanism (VLM) minimizes the drive-train friction, for improved teleoperation.

  17. A Thickened Coracohumeral Ligament and Superomedial Capsule Limit Internal Rotation of the Shoulder Joint: Report of Three Cases

    PubMed Central

    Koide, Masashi; Hamada, Junichiro; Hagiwara, Yoshihiro; Kanazawa, Kenji; Suzuki, Kazuaki

    2016-01-01

    Adhesive capsulitis of the shoulder (also known as frozen shoulder) is a painful and disabling disorder with an estimated prevalence ranging from 2% to 5% in the general population. Although the precise pathogenesis of frozen shoulder is unclear, thickened capsule and coracohumeral ligament (CHL) have been documented to be one of the most specific manifestations. The thickened CHL has been understood to limit external rotation of the shoulder, and restriction of internal rotation of the shoulder has been believed to be related to posterior capsular tightness. In this paper, three cases of refractory frozen shoulder treated through arthroscopic release of a contracted capsule including CHL were reported. Two cases in which there is recalcitrant severe restriction of internal rotation after manipulation under anesthesia (MUA) were finally treated with arthroscopic surgery. Although MUA could release the posterior capsule, internal rotation did not improve in our cases. After release of the thickened CHL, range of motion of internal rotation was significantly improved. This report demonstrates the role of the thickened CHL in limiting the internal rotation of the shoulder. We highlight the importance of release of thickened CHL in addition to the pancapsular release, in case of severe limitation of internal rotation of shoulder. PMID:27123353

  18. How well do the muscular synergies extracted via non-negative matrix factorisation explain the variation of torque at shoulder joint?

    PubMed

    Moghadam, M Nassajian; Aminian, K; Asghari, M; Parnianpour, M

    2013-01-01

    The way central nervous system manages the excess degrees of freedom to solve kinetic redundancy of musculoskeletal system remains an open question. In this study, we utilise the concept of synergy formation as a simplifying control strategy to find the muscle recruitment based on summation of identified muscle synergies to balance the biomechanical demands (biaxial external torque) during an isometric shoulder task. A numerical optimisation-based shoulder model was used to obtain muscle activation levels when a biaxial external isometric torque is imposed at the shoulder glenohumeral joint. In the numerical simulations, 12 different shoulder torque vectors in the transverse plane are considered. For each selected direction for the torque vector, the resulting muscle activation data are calculated. The predicted muscle activation data are used for grouping muscles in some fixed element synergies by the non-negative matrix factorisation method. Next, torque produced by these synergies are computed and projected in the 2D torque space to investigate the magnitude and direction of torques that each muscle synergy generated. The results confirmed our expectation that few dominant synergies are sufficient to reconstruct the torque vectors and each muscle contributed to more than one synergy. Decomposition of the concatenated data, combining the activation and external torque, provided functional muscle synergies that produced torques in the four principal directions. Four muscle synergies were able to account for more than 95% of variation of the original data. PMID:21970618

  19. Functional Analysis of the Primate Shoulder

    PubMed Central

    Hohn, Bianca; Scherf, Heike; Schmidt, Manuela; Krause, Cornelia; Witzel, Ulrich

    2010-01-01

    Studies of the shoulder girdle are in most cases restricted to morphological comparisons and rarely aim at elucidating function in a strictly biomechanical sense. To fill this gap, we investigated the basic functional conditions that occur in the shoulder joint and shoulder girdle of primates by means of mechanics. Because most of nonhuman primate locomotion is essentially quadrupedal walking—although on very variable substrates—our analysis started with quadrupedal postures. We identified the mechanical situation at the beginning, middle, and end of the load-bearing stance phase by constructing force parallelograms in the shoulder joint and the scapulo-thoracal connection. The resulting postulates concerning muscle activities are in agreement with electromyographical data in the literature. We determined the magnitude and directions of the internal forces and explored mechanically optimal shapes of proximal humerus, scapula, and clavicula using the Finite Element Method. Next we considered mechanical functions other than quadrupedal walking, such as suspension and brachiation. Quadrupedal walking entails muscle activities and joint forces that require a long scapula, the cranial margin of which has about the same length as the axillary margin. Loading of the hand in positions above the head and suspensory behaviors lead to force flows along the axillary margin and so necessitate a scapula with an extended axillary and a shorter cranial margin. In all cases, the facies glenoidalis is nearly normal to the calculated joint forces. In anterior view, terrestrial monkeys chose a direction of the ground reaction force requiring (moderate) activity of the abductors of the shoulder joint, whereas more arboreal monkeys prefer postures that necessitate activity of the adductors of the forelimb even when walking along branches. The same adducting and retracting muscles are recruited in various forms of suspension. As a mechanical consequence, the scapula is in a more

  20. Unusual lesions mimicking impingement syndrome in the shoulder joint - Think medially.

    PubMed

    Singh, Rohit; Malhotra, Akshay; Cribb, Gillian; Cool, Paul; Hay, Stuart

    2016-09-01

    Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromio-clavicular joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires left from previous surgery can cause similar symptoms. We present a series of four cases mimicking "classical" impingement symptoms/signs in which the causal pathology was identified outside the sub-acromial space. Magnetic Resonance Imaging (MRI) showed lesions that were present in the supra-spinatus fossa but were causing pressure effects on the sub-acromial space, namely - a ganglion cyst in one case, lipomata in two other cases, and a glomus tumour. A ganglion cyst and glomus tumour mimicking impingement syndrome is a rare reported case to our knowledge. These are unusual causes that should be considered when investigating classical impingement syndrome and particularly those who may have failed to respond to decompression surgery. They highlight the potential value of looking beyond the sub-acromial space for causal lesions and in these cases, at a time when limited ultrasound investigation has become increasingly popular; MRI has clearly played an important and was essential in planning surgery as these lesions would not have been identified on USS. Even though the symptoms were classical. PMID:27594993

  1. A correlation study of the American Shoulder and Elbow Society Score and the Oxford Shoulder Score with the use of regression analysis to predict one score from the other in patients undergoing reverse shoulder joint arthroplasty for cuff tear arthropathy

    PubMed Central

    Poon, Peter C

    2014-01-01

    Background More than 30 different scoring systems are available for evaluating outcomes of shoulder surgery. Unfortunately, given the multitude of scoring systems, there is no objective method to compare results between studies when different scoring systems are utilized. Methods We compared the American Shoulder and Elbow Society score (ASES) and the Oxford Shoulder Score (OSS) in patients undergoing reverse shoulder arthroplasty for cuff tear arthropathy. Twenty-nine patients had the ASES and OSS recorded pre-operatively, and at 6 and 12 months follow-up. The paired scores were assessed for their degree of correlation and sensitivity to change over time. Linear regression analysis was used to formulate a regression equation to predict one score from the other. Results The ASES and OSS correlated well with a Pearson’s correlation coefficient of 0.91 (p < 0.0001, n = 87). Both scores were sensitive to change. Regression analysis yielded a formula to predict the ASES from the OSS and vice versa with good accuracy (r2 = 0.83, F1,85 = 422.6, p < 0.0001). Conclusions Where good correlation exists, regression formulae can be used to accurately predict one score from the other in a specific population that it has been validated for. This can be of benefit when objectively comparing outcomes between studies using these two scoring systems.

  2. Shoulder arthroscopy

    MedlinePlus

    ... Surgery for shoulder instability: If you have a torn labrum, the surgeon will repair it. The labrum ... may be recommended for these shoulder problems: A torn or damaged cartilage ring (labrum) or ligaments Shoulder ...

  3. Prosthesis design and placement in reverse total shoulder arthroplasty.

    PubMed

    Ackland, David C; Patel, Minoo; Knox, David

    2015-01-01

    The management of irreparable rotator cuff tears associated with osteoarthritis of the glenohumeral joint has long been challenging. Reverse total shoulder arthroplasty (RSA) was designed to provide pain relief and improve shoulder function in patients with severe rotator cuff tear arthropathy. While this procedure has been known to reduce pain, improve strength and increase range of motion in shoulder elevation, scapular notching, rotation deficiency, early implant loosening and dislocation have attributed to complication rates as high as 62%. Patient selection, surgical approach and post-operative management are factors vital to successful outcome of RSA, with implant design and component positioning having a significant influence on the ability of the shoulder muscles to elevate, axially rotate and stabilise the humerus. Clinical and biomechanical studies have revealed that component design and placement affects the location of the joint centre of rotation and therefore the force-generating capacity of the muscles and overall joint mobility and stability. Furthermore, surgical technique has also been shown to have an important influence on clinical outcome of RSA, as it can affect intra-operative joint exposure as well as post-operative muscle function. This review discusses the behaviour of the shoulder after RSA and the influence of implant design, component positioning and surgical technique on post-operative joint function and clinical outcome. PMID:26135298

  4. Improving anterior deltoid activity in a musculoskeletal shoulder model - an analysis of the torque-feasible space at the sternoclavicular joint.

    PubMed

    Ingram, David; Engelhardt, Christoph; Farron, Alain; Terrier, Alexandre; Müllhaupt, Philippe

    2016-01-01

    Modelling the shoulder's musculature is challenging given its mechanical and geometric complexity. The use of the ideal fibre model to represent a muscle's line of action cannot always faithfully represent the mechanical effect of each muscle, leading to considerable differences between model-estimated and in vivo measured muscle activity. While the musculo-tendon force coordination problem has been extensively analysed in terms of the cost function, only few works have investigated the existence and sensitivity of solutions to fibre topology. The goal of this paper is to present an analysis of the solution set using the concepts of torque-feasible space (TFS) and wrench-feasible space (WFS) from cable-driven robotics. A shoulder model is presented and a simple musculo-tendon force coordination problem is defined. The ideal fibre model for representing muscles is reviewed and the TFS and WFS are defined, leading to the necessary and sufficient conditions for the existence of a solution. The shoulder model's TFS is analysed to explain the lack of anterior deltoid (DLTa) activity. Based on the analysis, a modification of the model's muscle fibre geometry is proposed. The performance with and without the modification is assessed by solving the musculo-tendon force coordination problem for quasi-static abduction in the scapular plane. After the proposed modification, the DLTa reaches 20% of activation. PMID:26158646

  5. Shoulder Injuries in US Astronauts Related to EVA Suit Design

    NASA Technical Reports Server (NTRS)

    Scheuring, R. A.; McCulloch, P.; Van Baalen, Mary; Minard, Charles; Watson, Richard; Blatt, T.

    2011-01-01

    Introduction: For every one hour spent performing extravehicular activity (EVA) in space, astronauts in the US space program spend approximately six to ten hours training in the EVA spacesuit at NASA-Johnson Space Center's Neutral Buoyancy Lab (NBL). In 1997, NASA introduced the planar hard upper torso (HUT) EVA spacesuit which subsequently replaced the existing pivoted HUT. An extra joint in the pivoted shoulder allows increased mobility but also increased complexity. Over the next decade a number of astronauts developed shoulder problems requiring surgical intervention, many of whom performed EVA training in the NBL. This study investigated whether changing HUT designs led to shoulder injuries requiring surgical repair. Methods: US astronaut EVA training data and spacesuit design employed were analyzed from the NBL data. Shoulder surgery data was acquired from the medical record database, and causal mechanisms were obtained from personal interviews Analysis of the individual HUT designs was performed as it related to normal shoulder biomechanics. Results: To date, 23 US astronauts have required 25 shoulder surgeries. Approximately 48% (11/23) directly attributed their injury to training in the planar HUT, whereas none attributed their injury to training in the pivoted HUT. The planar HUT design limits shoulder abduction to 90 degrees compared to approximately 120 degrees in the pivoted HUT. The planar HUT also forces the shoulder into a forward flexed position requiring active retraction and extension to increase abduction beyond 90 degrees. Discussion: Multiple factors are associated with mechanisms leading to shoulder injury requiring surgical repair. Limitations to normal shoulder mechanics, suit fit, donning/doffing, body position, pre-existing injury, tool weight and configuration, age, in-suit activity, and HUT design have all been identified as potential sources of injury. Conclusion: Crewmembers with pre-existing or current shoulder injuries or certain

  6. Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain

    PubMed Central

    2013-01-01

    Background Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. Methods Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. Following a standardised clinical examination and diagnostic injection into the subacromial bursa, all participants received a fluoroscopically guided diagnostic block of 1% lidocaine hydrochloride (XylocaineTM) into the ACJ. Diagnostic accuracy statistics including sensitivity, specificity, predictive values, positive and negative likelihood ratios (LR+ and LR-) were calculated for traditional ACJ tests (Active Compression/O’Brien’s test, cross-body adduction, localised ACJ tenderness and Hawkins-Kennedy test), and for individual and combinations of clinical examination variables that were associated with a positive anaesthetic response (PAR) (P≤0.05) defined as 80% or more reduction in post-injection pain intensity during provocative clinical tests. Results Twenty two of 153 participants (14%) reported an 80% PAR. None of the traditional ACJ tests were associated with an 80% PAR (P<0.05) and combinations of traditional tests were not able to discriminate between a PAR and a negative anaesthetic response (AUC 0.507; 95% CI: 0.366, 0.647; P>0.05). Five clinical examination variables (repetitive mechanism of pain onset, no referred pain below the elbow, thickened or swollen ACJ, no symptom provocation during passive glenohumeral abduction and external rotation) were associated with an 80% PAR (P<0.05) and demonstrated an ability to accurately discriminate between an PAR and NAR

  7. Motor control hierarchy in joint action that involves bimanual force production

    PubMed Central

    Masumoto, Junya

    2015-01-01

    The concept of hierarchical motor control has been viewed as a means of progressively decreasing the number of variables manipulated by each higher control level. We tested the hypothesis that turning an individual bimanual force-production task into a joint (two-participant) force-production task would lead to positive correlation between forces produced by the two hands of the individual participant (symmetric strategy) to enable negative correlation between forces produced by two participants (complementary strategy). The present study consisted of individual and joint tasks that involved both unimanual and bimanual conditions. In the joint task, 10 pairs of participants produced periodic isometric forces, such that the sum of forces that they produced matched a target force cycling between 5% and 10% of maximum voluntary contraction at 1 Hz. In the individual task, individuals attempted to match the same target force. In the joint bimanual condition, the two hands of each participant adopted a symmetric strategy of force, whereas the two participants adopted a complementary strategy of force, highlighting that the bimanual action behaved as a low level of a hierarchy, whereas the joint action behaved as an upper level. The complementary force production was greater interpersonally than intrapersonally. However, whereas the coherence was highest at 1 Hz in all conditions, the frequency synchrony was stronger intrapersonally than interpersonally. Moreover, whereas the bimanual action exhibited a smaller error and variability of force than the unimanual action, the joint action exhibited a less-variable interval and force than the individual action. PMID:25904710

  8. Dual-Energy Computed Tomography Arthrography of the Shoulder Joint Using Virtual Monochromatic Spectral Imaging: Optimal Dose of Contrast Agent and Monochromatic Energy Level

    PubMed Central

    An, Chansik; Chun, Yong-Min; Kim, Sungjun; Lee, Young Han; Yun, Min Jeong; Suh, Jin-Suck

    2014-01-01

    Objective To optimize the dose of contrast agent and the level of energy for dual-energy computed tomography (DECT) arthrography of the shoulder joint and to evaluate the benefits of the optimized imaging protocol. Materials and Methods Dual-energy scans with monochromatic spectral imaging mode and conventional single energy scans were performed on a shoulder phantom with 10 concentrations from 0 to 210 mg/mL of iodinated contrast medium at intervals of 15 or 30 mg/mL. Image noise, tissue contrast, and beam hardening artifacts were assessed to determine the optimum dose of contrast agent and the level of monochromatic energy for DECT shoulder arthrography in terms of the lowest image noise and the least beam hardening artifacts while good tissue contrast was maintained. Material decomposition (MD) imaging for bone-iodine differentiation was qualitatively assessed. The optimized protocol was applied and evaluated in 23 patients. Results The optimal contrast dose and energy level were determined by the phantom study at 60 mg/mL and 72 keV, respectively. This optimized protocol for human study reduced the image noise and the beam-hardening artifacts by 35.9% and 44.5%, respectively. Bone-iodine differentiation by MD imaging was not affected by the iodine concentration or level of energy. Conclusion Dual-energy scan with monochromatic spectral imaging mode results in reduced image noise and beam hardening artifacts. PMID:25469086

  9. Shoulder Joint Replacement

    MedlinePlus

    ... such as anti-inflammatory medications, cortisone injections, or physical therapy. Orthopaedic Evaluation Your family physician may refer you ... your function. Other treatment options — including medications, injections, physical therapy, or other types of surgery — will also be ...

  10. Lower limb joint forces during walking on the level and slopes at different inclinations.

    PubMed

    Alexander, Nathalie; Schwameder, Hermann

    2016-03-01

    Sloped walking is associated with an increase of lower extremity joint loading compared to level walking. Therefore, the aim of this study was to analyse lower limb joint compression forces as well as tibiofemoral joint shear forces during sloped walking at different inclinations. Eighteen healthy male participants (age: 27.0±4.7 years, height: 1.80±0.05m, mass: 74.5±8.2kg) were asked to walk at a pre-set speed of 1.1m/s on a ramp (6m×1.5m) at the slopes of -18°, -12°, -6°, 0°, 6°, 12° and 18°. Kinematic data were captured with a twelve-camera motion capture system (Vicon). Kinetic data were recorded with two force plates (AMTI) imbedded into a ramp. A musculoskeletal model (AnyBody) was used to compute lower limb joint forces. Results showed that downhill walking led to significantly increased hip, tibiofemoral and patellofemoral joint compression forces (p<0.05) and to significantly decreased ankle joint compression forces (p<0.05). Uphill walking significantly increased all lower limb joint compression forces with increasing inclination (p<0.05). Findings that downhill walking is a stressful task for the anterior cruciate ligament could not be supported in the current study, since anterior tibiofemoral joint shear forces did not increase with the gradient. Due to diverse tibiofemoral joint shear force patterns in the literature, results should be treated with caution in general. Finally, lower limb joint force analyses provided more insight in the structure loading conditions during sloped walking than joint moment analyses. PMID:26979896

  11. Desulfovibrio legallii Prosthetic Shoulder Joint Infection and Review of Antimicrobial Susceptibility and Clinical Characteristics of Desulfovibrio Infections

    PubMed Central

    Mason, Erin L.; Gustafson, Daniel R.; Cunningham, Scott A.; Cole, Nicolynn C.; Vetter, Emily A.; Steinmann, Scott P.; Wilson, Walter R.; Patel, Robin; Berbari, Elie F.

    2014-01-01

    We describe a case of shoulder hemiarthroplasty infection with Desulfovibrio legallii. Antimicrobial susceptibilities of 36 Desulfovibrio isolates are presented. Metronidazole and carbapenems exhibited reliable activity, although piperacillin-tazobactam did not. Eleven previous cases of Desulfovibrio infection are reviewed; most arose from a gastrointestinal tract-related source. PMID:24850351

  12. Does surgery for instability of the shoulder truly stabilize the glenohumeral joint?: A prospective comparative cohort study.

    PubMed

    Lädermann, Alexandre; Denard, Patrick J; Tirefort, Jérôme; Kolo, Frank C; Chagué, Sylvain; Cunningham, Grégory; Charbonnier, Caecilia

    2016-08-01

    Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects glenohumeral translation. The purpose of this prospective clinical study was to analyze the effect of surgical stabilization on glenohumeral translation.Glenohumeral translation was assessed in 11 patients preoperatively and 1 year postoperatively following surgical stabilization for anterior shoulder instability. Translation was measured using optical motion capture and computed tomography.Preoperatively, anterior translation of the affected shoulder was bigger in comparison to the normal contralateral side. Differences were significant for flexion and abduction movements (P < 0.001). Postoperatively, no patients demonstrated apprehension and all functional scores were improved. Despite absence of apprehension, postoperative anterior translation for the surgically stabilized shoulders was not significantly different from the preoperative values.While surgical treatment for anterior instability limits the chance of dislocation, it does not seem to restore glenohumeral translation during functional range of motion. Such persistent microinstability may explain residual pain, apprehension, inability to return to activity and even emergence of dislocation arthropathy that is seen in some patients. Further research is necessary to better understand the causes, effects, and treatment of residual microinstability following surgical stabilization of the shoulder. PMID:27495043

  13. Intra-Articular Knee Contact Force Estimation During Walking Using Force-Reaction Elements and Subject-Specific Joint Model.

    PubMed

    Jung, Yihwan; Phan, Cong-Bo; Koo, Seungbum

    2016-02-01

    Joint contact forces measured with instrumented knee implants have not only revealed general patterns of joint loading but also showed individual variations that could be due to differences in anatomy and joint kinematics. Musculoskeletal human models for dynamic simulation have been utilized to understand body kinetics including joint moments, muscle tension, and knee contact forces. The objectives of this study were to develop a knee contact model which can predict knee contact forces using an inverse dynamics-based optimization solver and to investigate the effect of joint constraints on knee contact force prediction. A knee contact model was developed to include 32 reaction force elements on the surface of a tibial insert of a total knee replacement (TKR), which was embedded in a full-body musculoskeletal model. Various external measurements including motion data and external force data during walking trials of a subject with an instrumented knee implant were provided from the Sixth Grand Challenge Competition to Predict in vivo Knee Loads. Knee contact forces in the medial and lateral portions of the instrumented knee implant were also provided for the same walking trials. A knee contact model with a hinge joint and normal alignment could predict knee contact forces with root mean square errors (RMSEs) of 165 N and 288 N for the medial and lateral portions of the knee, respectively, and coefficients of determination (R2) of 0.70 and -0.63. When the degrees-of-freedom (DOF) of the knee and locations of leg markers were adjusted to account for the valgus lower-limb alignment of the subject, RMSE values improved to 144 N and 179 N, and R2 values improved to 0.77 and 0.37, respectively. The proposed knee contact model with subject-specific joint model could predict in vivo knee contact forces with reasonable accuracy. This model may contribute to the development and improvement of knee arthroplasty. PMID:26720762

  14. Comparison of mechanical energy expenditure of joint moments and muscle forces during human locomotion.

    PubMed

    Prilutsky, B I; Petrova, L N; Raitsin, L M

    1996-04-01

    The mechanical energy expenditures (MEEs) of two human lower extremity models with different sources of mechanical energy - (1) muscles and (2) joint moments - were compared theoretically. Sources of mechanical energy producing movement of Model 1 were eight muscle, three of which were two-joint muscles. Sources of mechanical energy producing movement of Model 2 were net moments at its joints. These sources of mechanical energy were substituted by 11 one-joint muscles, with the assumption that antagonistic muscles did not produce force. Because of this assumption, summed MEE of all joint moments and all one-joint muscles of Model 2 were the same. It was shown that during the same movement the model with two-joint muscles could spend less mechanical energy than the model without two-joint muscles. This economy of mechanical energy realized by two-joint muscles was possible if (i) signs of the muscle powers which were produced by the two-joint muscle at both joints were opposite, (ii) moments produced by that muscle at each of the two joints had the same direction as the net joint moments at these joints, and (iii) muscles crossing these two joints from the opposite side did not produce force. Realization of these three conditions during human locomotion was checked experimentally. Electrical activity of eight lower extremity muscles of ten subjects was measured during treadmill walking and running. Based on this information, the periods where the muscles produce force were estimated. Moments and their power at joints of the lower extremity of two subjects performing walking and running were calculated using kinematics and ground reaction force measurements, and an inverse dynamics approach. It was shown that MEE of models with different sources of mechanical energy appeared to be different during certain periods of the swing phase. However, the magnitude of this difference was probably relatively small. PMID:8964770

  15. Effect of Hip Angle on Anterior Hip Joint Force during Gait

    PubMed Central

    Lewis, Cara L.; Sahrmann, Shirley A.; Moran, Daniel W.

    2010-01-01

    Anterior hip or groin pain is a common complaint for which people are referred for physical therapy. We have observed that people with anterior hip pain often walk in greater hip extension than people without anterior hip pain, and that the pain is reduced when they walk in less hip extension. Therefore, we investigated anterior hip joint forces which may contribute to anterior hip pain and examined the effect of end range hip extension on the anterior hip joint force during gait. To do this, we used a 6 degree of freedom, 3-dimensional musculoskeletal model to estimate hip joint forces during gait. Within subjects, the maximum anterior hip joint force for gait trials with the most hip extension was compared to the anterior hip joint force for gait trials with the least hip extension. The musculoskeletal model indicated that increasing the maximum end range hip extension when walking results in an increase in the anterior hip joint force when compared to walking in less hip extension. Walking in greater hip extension may result in an increase in the anterior hip joint force, and thereby contribute to anterior hip pain. The findings of this study provide some evidence supporting the use of gait modification to reduce anterior hip force when treating people with anterior hip pain. PMID:20934338

  16. Elbow and wrist joint contact forces during occupational pick and place activities.

    PubMed

    Chadwick, E K; Nicol, A C

    2000-05-01

    A three-dimensional, mathematical model of the elbow and wrist joints, including 15 muscle units, 3 ligaments and 4 joint forces, has been developed. A new strain gauge transducer has been developed to measure functional grip forces. The device measures radial forces divided into six components and forces of up to 250N per segment can be measured with an accuracy of +/-1%. Ten normal volunteers were asked to complete four tasks representing occupational activities, during which time their grip force was monitored. Together with kinematic information from the six-camera Vicon data, the moment effect of these loads at the joints was calculated. These external moments are assumed to be balanced by the internal moments, generated by the muscles, passive soft tissue and bone contact. The effectiveness of the body's internal structures in generating joint moments was assessed by studying the geometry of a simplified model of the structures, where information about the lines of action and moment arms of muscles, tendons and ligaments is contained. The assumption of equilibrium between these external and internal joint moments allows formulation of a set of equations from which muscle and joint forces can be calculated. A two stage, linear optimisation routine minimising the overall muscle stress and the sum of the joint forces has been used to overcome the force-sharing problem. Humero-ulnar forces of up to 1600N, humero-radial forces of up to 800N and wrist joint forces of up to 2800N were found for moderate level activity. The model was validated by comparison with other studies. PMID:10708780

  17. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sach’s lesions: A rare case

    PubMed Central

    Sachit, Malhan; Shekhar, Agarwal; Shekhar, Srivastav; joban, Singh Har

    2015-01-01

    Introduction: Late diagnoses of orthopedic injuries after epileptic crisis are a matter of concern. The rarity of correlation between seizure and specific trauma incidences such as bilateral anterior shoulder dislocation, may lead to improper estimation of the patient’s clinical state, wrong treatment and unpleasant complications. Case Report: We report a rare case of bilateral anterior shoulder dislocation associated with coracoid processes fracture after a seizure episode, in a young lady of 29 years. This is a rare event, however as patient is often disoriented after seizures, frequently this can be missed diagnosis. So this article puts emphasis on possibilities of rare diagnosis, which if treated promptly can lead to early restoration of complete movement. Conclusion: Although it is not a common problem, but one should have a high degree of suspicion and should always opt for further radiological examination if there is any doubt. PMID:27299022

  18. A History of Shoulder Surgery

    PubMed Central

    Iqbal, S; Jacobs, U; Akhtar, A; Macfarlane, R.J; Waseem, M

    2013-01-01

    Shoulder surgery has emerged from being a marginalised sub-speciality to being an area of much research and advancement within the last seventy years. This has been despite the complexity of the joint, and success majorly rests on parallel development of biomedical technology. This article looks at the past and present of shoulder surgery and discusses future directions in the speciality. PMID:24082968

  19. Shoulder pain

    MedlinePlus

    ... 4 muscles and their tendons, called the rotator cuff, give the shoulder its wide range of motion. Swelling, damage, or bone changes around the rotator cuff can cause shoulder pain. You may have pain ...

  20. Well pipe joint

    SciTech Connect

    Ortloff, D.J.; Landriault, L.S.

    1987-08-25

    For use in forming a pipe joint, a threaded tubular member adapted for connecting to another threaded member to form a threaded connection between the two members is described comprising a tubular body, a projecting helical rib on the body forming screw threads having load flanks shaped to have clearance between the flanks of the thread and the load flanks of the threads of the threaded member to which the member is adapted to be connected and a torque shoulder on the body to engage a torque shoulder on the other threaded member as the connection is being made up to limit the distance one of the members can enter the other for a given make-up torque. The threads are formed on the body so that selected threads away from the torque shoulder will have less clearance between them and the mating threads on the other member than do the threads on the member adjacent the torque shoulder and the mating threads on the other member when the torque shoulders engage so that the selected threads will engage the mating threads on the other member before the other threads adjacent the torque shoulder and the mating threads on the other member engage to cause the selected threads to be loaded initially to provide the initial force between the torque shoulders and to more uniformly load all of the threads when the connection is made-up and additional external loads are applied.

  1. Evidence of rapid Cenozoic uplift of the shoulder escarpment of the Cenozoic West Antarctic rift system and a speculation on possible climate forcing

    USGS Publications Warehouse

    Behrendt, John C.; Cooper, A.

    1991-01-01

    The Cenozoic West Antarctic rift system, characterized by Cenozoic bimodal alkalic volcanic rocks, extends over a largely ice-covered area, from the Ross Sea nearly to the Bellingshausen Sea. Various lines of evidence lead to the following interpretation: the transantarctic Mountains part of the rift shoulder (and probably the entire shoulder) has been rising since about 60 Ma, at episodic rates of ~1 km/m.y., most recently since mid-Pliocene Time, rather than continuously at the mean rate of 100 m/m.y. Uplift rates vary along the scarp, which is cut by transverse faults. It is speculated that this uplift may have climatically forced the advance of the Antarctic ice sheet since the most recent warm period. A possible synergistic relation is suggested between episodic tectonism, mountain uplift, and volcanism in the Cenozoic West Antarctic rift system and waxing and waning of the Antarctic ice sheet beginning about earliest Oligocene time. -from Authors

  2. Joint force protection advanced security system (JFPASS) "the future of force protection: integrate and automate"

    NASA Astrophysics Data System (ADS)

    Lama, Carlos E.; Fagan, Joe E.

    2009-09-01

    The United States Department of Defense (DoD) defines 'force protection' as "preventive measures taken to mitigate hostile actions against DoD personnel (to include family members), resources, facilities, and critical information." Advanced technologies enable significant improvements in automating and distributing situation awareness, optimizing operator time, and improving sustainability, which enhance protection and lower costs. The JFPASS Joint Capability Technology Demonstration (JCTD) demonstrates a force protection environment that combines physical security and Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) defense through the application of integrated command and control and data fusion. The JFPASS JCTD provides a layered approach to force protection by integrating traditional sensors used in physical security, such as video cameras, battlefield surveillance radars, unmanned and unattended ground sensors. The optimization of human participation and automation of processes is achieved by employment of unmanned ground vehicles, along with remotely operated lethal and less-than-lethal weapon systems. These capabilities are integrated via a tailorable, user-defined common operational picture display through a data fusion engine operating in the background. The combined systems automate the screening of alarms, manage the information displays, and provide assessment and response measures. The data fusion engine links disparate sensors and systems, and applies tailored logic to focus the assessment of events. It enables timely responses by providing the user with automated and semi-automated decision support tools. The JFPASS JCTD uses standard communication/data exchange protocols, which allow the system to incorporate future sensor technologies or communication networks, while maintaining the ability to communicate with legacy or existing systems.

  3. The medial-lateral force distribution in the ovine stifle joint during walking.

    PubMed

    Taylor, William R; Poepplau, Berry M; König, Christian; Ehrig, Rainald M; Zachow, Stefan; Duda, Georg N; Heller, Markus O

    2011-04-01

    Knowledge of the load distribution in the knee is essential for understanding the interaction between mechanics and biology in both the healthy and diseased joint. While the sheep stifle joint is a predominant model for better understanding regeneration after injury, little is known about the compartmental force distribution between the medial and lateral condyles. By including sheep specific anatomy and gait analyses, we used computational musculoskeletal analyses to estimate the medial-lateral joint contact force distribution in ovine stifle joints during walking by simplifying the system of equations into a 2D problem that was solved directly. Gait analysis was conducted using bone markers in three female Merino-mix sheep. Joint contact forces were computed with respect to the specific anatomy of the ovine tibia, resulting in low (<0.13 bodyweight) mean anteroposterior shear forces throughout the gait cycle, with mean peak contact forces perpendicular to the tibial plateau of 2.2 times bodyweight. The medial-lateral compartmental load distribution across the tibial condyles was determined and revealed loading predominantly on the medial condyle, bearing approximately 75% of the total load during phases of peak loading. By considering the anatomical characteristics of the ovine stifle joint, together with the dynamic forces during gait, this study provides evidence for predominantly medial loading in sheep, somewhat similar to the distribution reported in man. However, the exact conditions under which the loading in the ovine stifle joint is representative of the human situation will need to be elucidated in further studies. PMID:20957731

  4. Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: A cadaveric study.

    PubMed

    Kim, Hyun-Min Mike; Chacon, Alexander C; Andrews, Seth H; Roush, Evan P; Cho, Edward; Conaway, William K; Kunselman, Allen R; Lewis, Gregory S

    2016-04-01

    Restoration of joint stability during total shoulder arthroplasty can be challenging in the face of severe glenoid retroversion. A novel technique of humeral head component anterior-offsetting has been proposed to address posterior instability. We evaluated the biomechanical benefits of this technique in cadaveric specimens. Total shoulder arthroplasty was performed in 14 cadaveric shoulders from 7 donors. Complementary shoulders were assigned to either 10° or 20° glenoid retroversion, with retroversion created by eccentric reaming. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. The force and energy required to displace the humeral head posteriorly increased significantly with the anterior offset position compared to the anatomic offset position. The joint contact pressures were significantly shifted anteriorly, and the joint contact area significantly increased with the anterior offset position. Anterior offsetting of the humeral head component increased the resistance to posterior humeral head translation, shifted joint contact pressures anteriorly, and increased joint contact area, thus, potentially increasing the joint stability in total shoulder arthroplasty with simulated glenoid retroversion. PMID:26356804

  5. Hemiarthroplasty of the shoulder joint using a custom-designed high-density nano-hydroxyapatite/polyamide prosthesis with a polyvinyl alcohol hydrogel humeral head surface in rabbits.

    PubMed

    Guo, Yongwen; Guo, Jun; Bai, Ding; Wang, Hang; Zheng, Xiaohui; Guo, Weihua; Tian, Weidong

    2014-07-01

    In this study, a novel custom-designed high-density nano-hydroxyapatite/polyamide (n-HA/PA) prosthesis with a polyvinyl alcohol (PVA) hydrogel humeral head surface was employed to repair the shoulder joint head for hemiarthroplasty in rabbits. The prosthesis was fabricated using three-dimensional computed tomography and computer-aided design and computer-aided manufacturing systems for perfect fitting. Sixteen New Zealand white rabbits underwent humeral head excision, and received the composite prostheses for hemiarthroplasty. The implant sites were free from suppuration and necrosis at all periods. The X-ray results showed that there was a clear space between the prosthesis head and the glenoid surface, and the joint capsules and surfaces of the glenoid and PVA were well preserved without any damage during the whole inspection period. A high density of bone was observed around the firmware part of the prosthesis. Histological results revealed that significant osteogenesis was surrounding the firmware part, and the joint space was clear and the cartilage of the upper joint surface was basically intact. There was no visible absorption of the joint surfaces even after 3 months of continuous functional motions. The maximum tensile strength between the prosthesis and host bone reached 2.63 MPa at the 12th week postimplantation. In conclusion, the customized prosthesis by combination of PVA and high-density n-HA/PA has excellent biocompatibility and biological fixation, and offers a promising substitute for both the cartilage and the bone of the humeral head in a rabbit model as level V evidence. PMID:24404998

  6. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces.

    PubMed

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F; Fregly, Benjamin J; Delp, Scott L; Banks, Scott A; Pandy, Marcus G; D'Lima, Darryl D; Lloyd, David G

    2013-11-15

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941

  7. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

    PubMed Central

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F.; Fregly, Benjamin J.; Delp, Scott L.; Banks, Scott A.; Pandy, Marcus G.; D’Lima, Darryl D.; Lloyd, David G.

    2013-01-01

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941

  8. Shoulder manifestations of diabetes mellitus.

    PubMed

    Garcilazo, Cintia; Cavallasca, Javier A; Musuruana, Jorge L

    2010-09-01

    The musculoskeletal system can be affected by diabetes in a number of ways. The shoulder is one of the frequently affected sites. One of the rheumatic conditions caused by diabetes is frozen shoulder (adhesive capsulitis), which is characterized by pain and severe limited active and passive range of motion of the glenohumeral joint, particularly external rotation. This disorder has a clinical diagnosis and the treatment is based on physiotherapy, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections and, in refractory cases, surgical resolution. As with adhesive capsulitis, calcific periarthritis of the shoulder causes pain and limited joint mobility, although usually it has a better prognosis than frozen shoulder. Reflex sympathetic dystrophy, also known as shoulder-hand syndrome, is a painful syndrome associated with vasomotor and sudomotor changes in the affected member. Diabetic amyotrophy usually affects the peripheral nerves of lower limbs. However, when symptoms involve the shoulder girdle, it must be considered in the differential diagnosis of shoulder painful conditions. Osteoarthritis is the most common rheumatic condition. There are many risk factors for shoulder osteoarthritis including age, genetics, sex, weight, joint infection, history of shoulder dislocation, and previous injury, in older age patients, diabetes is a risk factor for shoulder OA. Treatment options include acetaminophen, NSAIDs, short term opiate, glucosamine and chondroitin. Corticosteroid injections and/or injections of hyaluronans could also be considered. Patients with continued disabling pain that is not responsive to conservative measures may require surgical referral. The present review will focus on practice points of view about shoulder manifestations in patients with diabetes. PMID:20701586

  9. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement

    PubMed Central

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A.; Cates, Harold E.

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05). No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups. PMID:27258086

  10. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement.

    PubMed

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A; Cates, Harold E; Zhang, Songning

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05). No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups. PMID:27258086

  11. Relative importance of gait vs. joint positioning on hip contact forces after total hip replacement.

    PubMed

    Foucher, Kharma C; Hurwitz, Debra E; Wimmer, Markus A

    2009-12-01

    Implant loosening is a common indication for total hip replacement (THR) revision. High contact forces and implant twisting moments are thought to be associated with implant loosening. Relationships between joint positioning and hip forces, or outcomes, have been investigated through in vivo and in vitro modalities. Relationships between hip forces and gait are less understood, despite repeated findings that gait following a THR does not fully return to normal. We tested the hypothesis that gait parameters would be better predictors of implant force (peak contact forces and peak twisting moment during walking) than joint positioning parameters. Subjects underwent gait analysis, hip force modeling, and measurement of clinical radiographs 1 year after successful THR surgery. Gait parameters were consistently more influential in determining hip forces. Alone, gait explained as much as 67% of the variation in force, compared to a maximum of 33% by joint geometry. Combinations of gait and joint positioning parameters together explained up to 86% of the variation in hip force parameters. Results suggest that gait may provide a valuable postoperatively modifiable target to improve hip loads and potentially reduce the risk for implant loosening. PMID:19514072

  12. Evidence of rapid Cenozoic uplift of the shoulder escarpment of the Cenozoic West Antarctic rift system and a speculation on possible climate forcing

    SciTech Connect

    Behrendt, J.C. ); Cooper, A. )

    1991-04-01

    The Cenzoic West Antarctic rift system, characterized by Cenozoic bimodal alkalic volcanic rocks, extends over a largely ice-covered area, from the Ross Sea nearly to the Bellingshausen Sea. It is bounded on one side by a spectacular 4-to 5-km-high rift-shoulder scarp (maximum bedrock relief 5 to 7 km) from northern Victoria Land-Queen Maud Mountains to the Ellsworth-Whitmore-Horlick Mountains. Jurassic tholeiites crop out with the late Cenozoic volcanic rocks along the section of the Transantarctic Mountains from northern Victoria Land to the Horlick Mountains. The Cenozoic rift shoulder diverges here from the Jurassic tholeiite trend, and the tholeiites are exposed discontinuously along the lower elevation (1-2 km) section of the Transantarctic Mountains to the Weddell Sea. Various lines of evidence, no one of which is independently conclusive, lead the authors (as others have also suggested) to interpret the following. The Transantarctic Mountains part of the rift shoulder (and probably the entire shoulder) has been rising since about 60 Ma, at episodic rates of {approximately}1 km/m.y., most recently since mid-Pliocene time, rather than continuously at the mean rate of 100m/m.y. Uplift rates vary along the scarp, which is cut by transverse faults. The authors speculate that this uplift may have climatically forced the advance of the Antarctic ice sheet since the most recent warm period. They suggest a possible synergistic relation between episodic tectonism, mountain uplift, and volcanism in the Cenozoic West Antarctic rift system and waxing and waning of the Antarctic ice sheet beginning about earliest Oligocene time.

  13. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA... joint metal/metal or metal/polymer constrained cemented prosthesis shall have an approved PMA or...

  14. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA... joint metal/metal or metal/polymer constrained cemented prosthesis shall have an approved PMA or...

  15. [Subacromial pain syndromes as a possible results of errors in the initial diagnosis and therapy of the shoulder joint].

    PubMed

    Hadziahmetović, Z

    1999-01-01

    The author in this paper shows possible diagnostic mistakes in the development of subacromial painful arc syndrome (cases with inadequate diagnostics). A hundred cases with acute shoulder's injury (without fractures and luxationes) who were admitted at the Clinic for bone surgery and Emergency Department of Clinical Centre, CUC Sarajevo in period between 1 January 1998-30 June 1998. Only clinical and X-ray examination in part were performed. A very interesting case with subacromial impingement as a consequence of such kind of treatment is presented in this paper. It can be concluded that it is necessary to use as a routine a comparative advantages of Echosonography, CT, MRI, as non invasive diagnostic methods at clinically suspected intra or extra articular lesions. PMID:10386045

  16. American Indian Policy Review Commission Special Joint Task Force Report on Alaskan Native Issues.

    ERIC Educational Resources Information Center

    Congress of the U.S. Washington, DC. American Indian Policy Review Commission.

    Impact of the Alaskan Native Claims Settlement Act (ANCSA) on Alaskan Natives, particularly at village levels, is the focus of a joint task force report on Alaskan Native issues. Prepared for the American Indian Policy Review Commission, the report is the work of representatives from task forces on tribal government, federal, state, and tribal…

  17. An in-fiber Bragg grating sensor for contact force and stress measurements in articular joints

    NASA Astrophysics Data System (ADS)

    Dennison, Christopher R.; Wild, Peter M.; Wilson, David R.; Gilbart, Michael K.

    2010-11-01

    We present an in-fiber Bragg grating-based sensor (240 µm diameter) for contact force/stress measurements in articular joints. The contact force sensor and another Bragg grating-based pressure sensor (400 µm diameter) are used to conduct the first simultaneous measurements of contact force/stress and fluid pressure in intact cadaveric human hips. The contact force/stress sensor addresses limitations associated with stress-sensitive films, the current standard tools for contact measurements in joints, including cartilage modulus-dependent sensitivity of films and the necessity to remove biomechanically relevant anatomy to implant the films. Because stress-sensitive films require removal of anatomy, it has been impossible to validate the mechanical rationale underlying preventive or corrective surgeries, which repair these anatomies, by conducting simultaneous stress and pressure measurements in intact hips. Methods are presented to insert the Bragg grating-based sensors into the joint, while relevant anatomy is left largely intact. Sensor performance is predicted using numerical models and the predicted sensitivity is verified through experimental calibrations. Contact force/stress and pressure measurements in cadaveric joints exhibited repeatability. With further validation, the Bragg grating-based sensors could be used to study the currently unknown relationships between contact forces and pressures in both healthy and degenerated joints.

  18. Traction-drive force transmission for telerobotic joints

    NASA Technical Reports Server (NTRS)

    Williams, D. M.; Kuban, D. P.

    1989-01-01

    A mechanism which meets the requirements of a teleoperated manipulator and those of an autonomous robot is discussed. The mechanism is a traction-drive differential that uses variable preload mechanisms. The differential provides compact design, with dextrous motion range and torque density similar to geared systems. The traction drive offers high stiffness to backlash for good robotic performance. The variable-loading mechanism (VLM) minimizes the drive-train friction for improved teleoperation. This combination provides a mechanism to allow advanced manipulation with either teleoperated control or autonomous robotic operation. The design principles of both major components of the joint mechanism are described.

  19. The Business of Bundling: Joining Forces on Joint Replacement.

    PubMed

    Kaldy, Joanne

    2016-03-01

    A mandated bundled-payment program for joint replacement is in place in several regions across the country, and practitioners such as pharmacists are still sorting out their roles in this federal initiative. To get involved, pharmacists need to establish connections with area hospitals and physician groups to promote and document their ability to manage medications, reduce and eliminate medication-related problems and rehospitalizations, and work with patients to maximize adherence and improve communication for those undergoing hip and knee replacement. PMID:26975592

  20. A clamping force measurement system for monitoring the condition of bolted joints on railway track joints and points

    NASA Astrophysics Data System (ADS)

    Tesfa, B.; Horler, G.; Thobiani, F. Al; Gu, F.; Ball, A. D.

    2012-05-01

    Many industrial structures associated with railway infrastructures rely on a large number of bolted joint connections to ensure safe and reliable operation of the track and trackside furniture. Significant sums of money are spent annually to repair the damage caused by bolt failures and to maintain the integrity of bolted structures. In the UK, Network Rail (the organization responsible for rail network maintenance and safety) conducts corrective and preventive maintenance manually on 26,000 sets of points (each having approximately 30 bolted joints per set), in order to ensure operational success and safety for the travelling public. Such manual maintenance is costly, disruptive, unreliable and prone to human error. The aim of this work is to provide a means of automatically measuring the clamping force of each individual bolted joint, by means of an instrumented washer. This paper describes the development of a sensor means to be used in the washer, which satisfies the following criteria. Sense changes in the clamping force of the joint and report this fact. Provide compatibility with the large dynamic range of clamping force. Satisfy the limitations in terms of physical size. Provide the means to electronically interface with the washer. Provide a means of powering the washer in situ. Provide a solution at an acceptable cost. Specifically the paper focuses on requirements 1, 2 and 3 and presents the results that support further development of the proposed design and the realization of a pre-prototype system. In the paper, various options for the force sensing element (strain gage, capacitor, piezo-resistive) have been compared, using design optimization techniques. As a result of the evaluation, piezo-resistive sensors in concert with a proprietary force attenuation method, have been found to offer the best performance and cost trade-off The performance of the novel clamping force sensor has been evaluated experimentally and the results show that a smart washer

  1. Canine intersegmental hip joint forces and moments before and after cemented total hip replacement.

    PubMed

    Dogan, S; Manley, P A; Vanderby, R; Kohles, S S; Hartman, L M; McBeath, A A

    1991-01-01

    Intersegmental forces and moments (i.e. resultant free body forces and moments computed at the joint centers) were studied in canine hindlimbs before and after cemented total hip replacement (THR). Five large, adult, mixed-breed dogs were selected. Their gait was recorded (while leash-walked) before surgery using high-speed cinematography and a force plate. Cemented total hip replacement was unilaterally performed on each dog. Gait was again recorded at one and four months after surgery. Segmental properties (mass, center of mass, and mass moment of inertia) of the hindlimbs were experimentally determined, and an inverse dynamics approach was used to compute intersegmental forces and moments in the sagittal plane. Significant reductions in intersegmental joint forces and moments were observed in the operated hindlimb one month after surgery, although kinematic gait parameters were unaltered. Decreases of 77.0% for vertical forces, 61.9% for craniocaudal forces, and 66.2% for extension moments were determined. Four months after surgery, the joint forces and moments had returned to their preoperative values. This experiment demonstrates that the dynamics of normal walking can be restored in a canine model by four months after THR. It also shows that kinetic (rather than kinematic) parameters are more descriptive of antalgic gait in the canine. PMID:1856240

  2. Ground reaction force estimation using an insole-type pressure mat and joint kinematics during walking.

    PubMed

    Jung, Yihwan; Jung, Moonki; Lee, Kunwoo; Koo, Seungbum

    2014-08-22

    Kinetic analysis of walking requires joint kinematics and ground reaction force (GRF) measurement, which are typically obtained from a force plate. GRF is difficult to measure in certain cases such as slope walking, stair climbing, and track running. Nevertheless, estimating GRF continues to be of great interest for simulating human walking. The purpose of the study was to develop reaction force models placed on the sole of the foot to estimate full GRF when only joint kinematics are provided (Type-I), and to estimate ground contact shear forces when both joint kinematics and foot pressure are provided (Type-II and Type-II-val). The GRF estimation models were attached to a commercial full body skeletal model using the AnyBody Modeling System, which has an inverse dynamics-based optimization solver. The anterior-posterior shear force and medial-lateral shear force could be estimated with approximate accuracies of 6% BW and 2% BW in all three methods, respectively. Vertical force could be estimated in the Type-I model with an accuracy of 13.75% BW. The accuracy of the force estimation was the highest during the mid-single-stance period with an average RMS for errors of 3.10% BW, 1.48% BW, and 7.48% BW for anterior-posterior force, medial-lateral force, and vertical force, respectively. The proposed GRF estimation models could predict full and partial GRF with high accuracy. The design of the contact elements of the proposed model should make it applicable to various activities where installation of a force measurement system is difficult, including track running and treadmill walking. PMID:24917473

  3. Biomechanics of reverse total shoulder arthroplasty.

    PubMed

    Berliner, Jonathan L; Regalado-Magdos, Ashton; Ma, C Benjamin; Feeley, Brian T

    2015-01-01

    Reverse total shoulder arthroplasty is an effective procedure for treatment of glenohumeral joint disease among patients with severe rotator cuff deficiency. Improvements in prosthetic design are the result of an evolved understanding of both shoulder and joint replacement biomechanics. Although modern generations of the reverse shoulder prosthesis vary in specific design details, they continue to adhere to Grammont's core principles demonstrated by his original Delta III prosthesis. This review article discusses the biomechanics of reverse total shoulder arthroplasty with a focus on elements of implant design and surgical technique that may affect stability, postoperative complications, and functional outcomes. PMID:25441574

  4. A feasibility study for experimentally determining dynamic force distribution in a lap joint.

    SciTech Connect

    Mayes, Randall Lee

    2013-11-01

    Developing constitutive models of the physics in mechanical joints is currently stymied by inability to measure forces and displacements within the joint. The current state of the art estimates whole joint stiffness and energy loss per cycle from external measured force input and one or two acceleration responses. To validate constitutive models beyond this state requires a measurement of the distributed forces and displacements at the joint interface. Unfortunately, introducing measurement devices at the interface completely disrupts the desired physics. A feasibility study is presented for a non-intrusive method of solving for the interface dynamic forces from an inverse problem using full field measured responses. The responses come from the viewable surface of a beam. The noise levels associated with digital image correlation and continuous scanning laser Doppler velocimetry are evaluated from typical beam experiments. Two inverse problems are simulated. One utilizes the extended Sum of Weighted Accelerations Technique (SWAT). The second is a new approach dubbed the method of truncated orthogonal forces. These methods are much more robust if the contact patch geometry is well identified. Various approaches to identifying the contact patch are investigated, including ion marker tracking, Prussian blue and ultrasonic measurements. A typical experiment is conceived for a beam which has a lap joint at one end with a single bolt connecting it to another identical beam. In a virtual test using the beam finite element analysis, it appears that the SWAT inverse method requires evaluation of too many coefficients to adequately identify the force distribution to be viable. However, the method of truncated orthogonal forces appears viable with current digital image correlation (and probably other) imaging techniques.

  5. SHOULDER DISORDERS AND OCCUPATION

    PubMed Central

    Linaker, CH; Walker-Bone, K

    2016-01-01

    Shoulder pain is very common and causes substantial morbidity. Standardised classification systems based upon presumed patho-anatomical origins have proved poorly reproducible and hampered epidemiological research. Despite this, there is evidence that exposure to combinations of physical workplace strains such as overhead working, heavy lifting and forceful work as well as working in an awkward posture increase the risk of shoulder disorders. Psychosocial risk factors are also associated. There is currently little evidence to suggest that either primary prevention or treatment strategies in the workplace are very effective and more research is required, particularly around the cost-effectiveness of different strategies. PMID:26612238

  6. Shoulder motor performance assessment in the sagittal plane in children with hemiplegia during single joint pointing tasks

    PubMed Central

    2014-01-01

    Background Pointing is a motor task extensively used during daily life activities and it requires complex visuo-motor transformation to select the appropriate movement strategy. The study of invariant characteristics of human movements has led to several theories on how the brain solves the redundancy problem, but the application of these theories on children affected by hemiplegia is limited. This study aims at giving a quantitative assessment of the shoulder motor behaviour in children with hemiplegia during pointing tasks. Methods Eight children with hemiplegia were involved in the study and were asked to perform movements on the sagittal plane with both arms, at low and high speed. Subject movements were recorded using an optoelectronic system; a 4-DOF model of children arm has been developed to calculate kinematic and dynamic variables. A set of evaluation indexes has been extracted in order to quantitatively assess whether and how children modify their motor control strategies when perform movements with the more affected or less affected arm. Results In low speed movements, no differences can be seen in terms of movement duration and peak velocity between the More Affected arm (MA) and the Less Affected arm (LA), as well as in the main characteristics of movement kinematics and dynamics. As regards fast movements, remarkable differences in terms of strategies of motor control can be observed: while movements with LA did not show any significant difference in Dimensionless Jerk Index (JI) and Dimensionless Torque-change Cost index (TC) between the elevation and lowering phases, suggesting that motor control optimization is similar for movements performed with or against gravity, movements with MA showed a statistically significant increase of both JI and TC during lowering phase. Conclusions Results suggest the presence of a different control strategy for fast movements in particular during lowering phase. Results suggest that motor control is not able to

  7. Changes in muscle and joint coordination in learning to direct forces.

    PubMed

    Hasson, Christopher J; Caldwell, Graham E; van Emmerik, Richard E A

    2008-08-01

    While it has been suggested that bi-articular muscles have a specialized role in directing external reaction forces, it is unclear how humans learn to coordinate mono- and bi-articular muscles to perform force-directing tasks. Participants were asked to direct pedal forces in a specified target direction during one-legged cycling. We expected that with practice, performance improvement would be associated with specific changes in joint torque patterns and mono- and bi-articular muscular coordination. Nine male participants practiced pedaling an ergometer with only their left leg, and were instructed to always direct their applied pedal force perpendicular to the crank arm (target direction) and to maintain a constant pedaling speed. After a single practice session, the mean error between the applied and target pedal force directions decreased significantly. This improved performance was accompanied by a significant decrease in the amount of ankle angular motion and a smaller increase in knee and hip angular motion. This coincided with a re-organization of lower extremity joint torques, with a decrease in ankle plantarflexor torque and an increase in knee and hip flexor torques. Changes were seen in both mono- and bi-articular muscle activity patterns. The mono-articular muscles exhibited greater alterations, and appeared to contribute to both mechanical work and force-directing. With practice, a loosening of the coupling between bi-articular thigh muscle activation and joint torque co-regulation was observed. The results demonstrated that participants were able to learn a complex and dynamic force-directing task by changing the direction of their applied pedal forces through re-organization of joint torque patterns and mono- and bi-articular muscle coordination. PMID:18405988

  8. Changes in Muscle and Joint Coordination in Learning to Direct Forces

    PubMed Central

    Hasson, Christopher J.; Caldwell, Graham E.; van Emmerik, Richard E.A.

    2008-01-01

    While it has been suggested that biarticular muscles have a specialized role in directing external reaction forces, it is unclear how humans learn to coordinate mono- and bi-articular muscles to perform force-directing tasks. Subjects were asked to direct pedal forces in a specified target direction during one-legged cycling. We expected that with practice, performance improvement would be associated with specific changes in joint torque patterns and mono- and bi-articular muscular coordination. Nine male subjects practiced pedaling an ergometer with only their left leg, and were instructed to always direct their applied pedal force perpendicular to the crank arm (target direction) and to maintain a constant pedaling speed. After a single practice session, the mean error between the applied and target pedal force directions decreased significantly. This improved performance was accompanied by a significant decrease in the amount of ankle angular motion and a smaller increase in knee and hip angular motion. This coincided with a re-organization of lower extremity joint torques, with a decrease in ankle plantarflexor torque and an increase in knee and hip flexor torques. Changes were seen in both mono- and bi-articular muscle activity patterns. The monoarticular muscles exhibited greater alterations, and appeared to contribute to both mechanical work and force directing. With practice, a loosening of the coupling between biarticular thigh muscle activation and joint torque co-regulation was observed. The results demonstrated that subjects were able to learn a complex and dynamic force-directing task by changing the direction of their applied pedal forces through re-organization of joint torque patterns and mono- and bi-articular muscle coordination. PMID:18405988

  9. Shoulder replacement

    MedlinePlus

    ... are able to return to sports such as golf, swimming, gardening, bowling, and others. Your new shoulder ... important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy , ...

  10. Frozen shoulder

    MedlinePlus

    ... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: Elsevier ... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

  11. Shoulder Problems

    MedlinePlus

    ... weak? Yes You may have a TORN ROTATOR CUFF or SHOULDER INSTABILITY. See your doctor. No *7. ... redness? Yes You may have BURSITIS or ROTATOR CUFF SYNDROME. Use an anti-inflammatory medicine, such as ...

  12. Minimum detectable change for knee joint contact force estimates using an EMG-driven model

    PubMed Central

    Gardinier, Emily S.; Manal, Kurt; Buchanan, Thomas S.; Snyder-Mackler, Lynn

    2013-01-01

    Adequate test–retest reliability of model estimates is a necessary precursor to examining treatment effects or longitudinal changes in individuals. Purpose The purpose of this study was to establish thresholds for minimal detectable change (MDC) for joint contact forces obtained using a patient specific EMG-driven musculoskeletal model of the knee. Design A sample of young, active individuals was selected for this study, and subjects were tested on 2 separate days. Three-dimensional motion analysis with electromyography (EMG) was used to obtain data from each subject during gait for model input. An EMG-driven modeling approach was used to estimate joint contact forces at each session. Results MDC’s for contact force variables ranged from 0.30 to 0.66 BW. The lowest MDC was for peak medial compartment force (0.30 BW) and the highest was for peak tibiofemoral contact force (0.66 BW). Test–retest reliability coefficients were also reported for comparison with previous work. Conclusions Using the present model, changes in joint contact forces between baseline and subsequent measurements that are greater than these MDCs are greater than typical day-to-day variation and can be identified as real change. PMID:23601782

  13. Management of acromioclavicular joint injuries.

    PubMed

    Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

    2014-01-01

    Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

  14. Management of Shoulder Problems Following Obstetric Brachial Plexus Injury

    PubMed Central

    Nixon, Matthew; Trail, Ian

    2013-01-01

    Obstetric brachial plexus injuries are common, with an incidence of 0.42 per 1000 live births in the UK, and with 25% of patients being left with permanent disability without intervention. The shoulder is the most commonly affected joint and, as a result of the subsequent imbalance of musculature, the abnormal deforming forces cause dysplasia of the glenohumeral joint. In the growing child, this presents with changing pattern of pathology, which requires a multidisciplinary approach and a broad range of treatment modalities to optimize function.

  15. Bilateral ground reaction forces and joint moments for lateral sidestepping and crossover stepping tasks

    PubMed Central

    Kuntze, Gregor; Sellers, William I.; Mansfield, Neil

    2009-01-01

    Racquet sports have high levels of joint injuries suggesting the joint loads during play may be excessive. Sports such as badminton employ lateral sidestepping (SS) and crossover stepping (XS) movements which so far have not been described in terms of biomechanics. This study examined bilateral ground reaction forces and three dimensional joint kinetics for both these gaits in order to determine the demands of the movements on the leading and trailing limb and predict the contribution of these movements to the occurrence of overuse injury of the lower limbs. A force platform and motion-analysis system were used to record ground reaction forces and track marker trajectories of 9 experienced male badminton players performing lateral SS, XS and forward running tasks at a controlled speed of 3 m·s-1 using their normal technique. Ground reaction force and kinetic data for the hip, knee and ankle were analyzed, averaged across the group and the biomechanical variables compared. In all cases the ground reaction forces and joint moments were less than those experienced during moderate running suggesting that in normal play SS and XS gaits do not lead to high forces that could contribute to increased injury risk. Ground reaction forces during SS and XS do not appear to contribute to the development of overuse injury. The distinct roles of the leading and trailing limb, acting as a generator of vertical force and shock absorber respectively, during the SS and XS may however contribute to the development of muscular imbalances which may ultimately contribute to the development of overuse injury. However it is still possible that faulty use of these gaits might lead to high loads and this should be the subject of future work. Key pointsGround reaction forces and joint moments during lateral stepping are smaller in magnitude than those experienced during moderate running.Force exposure in SS and XS gaits in normal play does not appear to contribute to the development of

  16. Graduate Education in Physics. Report of the Joint AAPT-APS Task Force. Revised

    ERIC Educational Resources Information Center

    American Association of Physics Teachers (NJ1), 2006

    2006-01-01

    The Task Force on Graduate Education in Physics (TFGE), an ad hoc committee convened jointly by the American Association of Physics Teachers (AAPT) and the American Physical Society (APS), has studied the current status of graduate education in physics Ph.D. programs, and has made recommendations based on what was found. The findings indicate that…

  17. Preserving the Illustrated Text. Report of the Joint Task Force on Text and Image.

    ERIC Educational Resources Information Center

    Commission on Preservation and Access, Washington, DC.

    The mission of the Joint Task Force on Text and Image was to inquire into the problems, needs, and methods for preserving images in text that are important for scholarship in a wide range of disciplines and to draw from that exploration a set of principles, guidelines, and recommendations for a comprehensive national strategy for image…

  18. Effects of Initial Graft Tension on the Tibiofemoral Compressive Forces and Joint Position Following ACL Reconstruction

    PubMed Central

    Brady, Mark F.; Bradley, Michael P.; Fleming, Braden C.; Fadale, Paul D.; Hulstyn, Michael J.; Banerjee, Rahul

    2007-01-01

    Background The initial tension applied to an ACL graft at the time of fixation modulates knee motion and the tibiofemoral compressive loads. Purpose To establish the relationships between initial graft tension, tibiofemoral compressive force, and the neutral tibiofemoral position in the cadaver knee. Study Design Controlled Laboratory Study. Methods The tibiofemoral compressive forces and joint positions were determined in the ACL-intact knee at 0°, 20° and 90° knee flexion. The ACL was excised and reconstructed with a patellar tendon graft using graft tensions of 1, 15, 30, 60 and 90 N applied at 0°, 20° and 90° knee flexion. The compressive forces and neutral positions were compared between initial tension conditions and the ACL-intact knee. Results Increasing initial graft tension increased the tibiofemoral compressive forces. The forces in the medial compartment were 1.8 times those in the lateral compartment. The compressive forces were dependent on the knee angle at which the tension was applied. The greatest compressive forces occurred when the graft was tensioned with the knee in extension. An increase in initial graft tension caused the tibia to rotate externally compared to the ACL-intact knee. Increases in initial graft tension also caused a significant posterior translation of the tibia relative to the femur. Conclusions Different initial graft tension protocols produced predictable changes in the tibiofemoral compressive forces and joint positions. Clinical Relevance The tibiofemoral compressive force and neutral joint position were best replicated with a low graft tension (1–15 N) when using a patellar tendon graft. PMID:17218659

  19. Shoulder CT scan

    MedlinePlus

    CAT scan - shoulder; Computed axial tomography scan - shoulder; Computed tomography scan - shoulder; CT scan - shoulder ... Mosby; 2012:chap 57. Shaw AS, Prokop M. Computed tomography. In: Adam A, Dixon AK, Gillard JH, Schaefer- ...

  20. Dislocated shoulder - aftercare

    MedlinePlus

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... You most likely dislocated your shoulder from a sports injury or accident, such as a fall. You have likely injured (stretched or torn) some of the muscles, ...

  1. Biomechanics of first ray hypermobility: an investigation on joint force during walking using finite element analysis.

    PubMed

    Wong, Duo Wai-Chi; Zhang, Ming; Yu, Jia; Leung, Aaron Kam-Lun

    2014-11-01

    Hypermobility of the first ray is suggested to contribute to hallux valgus. The investigation of first ray hypermobility focused on the mobility and range of motion that based on manual examination. The load transfer mechanism of the first ray is important to understand the development and pathomechanism of hallux valgus. In this study, we investigated the immediate effect of the joint hypermobility on the metatarsocuneiform and metatarsophalangeal joint loading through a reduction of the stiffness of the foot ligaments. A three-dimensional foot model was constructed from a female aged 28 via MRI. All foot and ankle bones, including two sesamoids and the encapsulated bulk tissue were modeled as 3D solid parts, linking with ligaments of shell elements and muscles connectors. The stance phase of walking was simulated by the boundary and loading conditions obtained from gait analysis of the same subject. Compared with the normal foot, the hypermobile foot had higher resultant metatarsocuneiform and metatarsophalangeal joint forces. The increases accounted for 18.6% and 3.9% body weight. There was also an abrupt change of metatarsocuneiform joint force in the medial-lateral direction. The predicted results represented possible risk of joint problems and metatarsus primus varus. PMID:24726375

  2. A Biomechanical Model Correlating Shoulder Kinetics to Pain in Young Baseball Pitchers

    PubMed Central

    Keeley, David W.; Oliver, Gretchen D.; Dougherty, Christopher P.

    2012-01-01

    Previous work has postulated that shoulder pain may be associated with increases in both peak shoulder anterior force and peak shoulder proximal force. Unfortunately these relationships have yet to be quantified. Thus, the purpose of this study was to associate these kinetic values with reported shoulder pain in youth baseball pitchers. Nineteen healthy baseball pitchers participated in this study. Segment based reference systems and established calculations were utilized to identify peak shoulder anterior force and peak shoulder proximal force. A medical history questionnaire was utilized to identify shoulder pain. Following collection of these data, the strength of the relationships between both peak shoulder anterior force and peak shoulder proximal force and shoulder pain were analyzed. Although peak anterior force was not significantly correlated to shoulder pain, peak proximal force was. These results lead to the development of a single variable logistic regression model able to accurately predict 84.2% of all cases and 71.4% of shoulder pain cases. This model indicated that for every 1 N increase in peak proximal force, there was a corresponding 4.6% increase in the likelihood of shoulder pain. The magnitude of peak proximal force is both correlated to reported shoulder pain and capable of being used to accurately predict the likelihood of experiencing shoulder pain. It appears that those pitchers exhibiting high magnitudes of peak proximal force are significantly more likely to report experiencing shoulder pain than those who generate lower magnitudes of peak proximal force. PMID:23486209

  3. Measurement of force sense reproduction in the knee joint: application of a new dynamometric device

    PubMed Central

    Zavieh,, Minoo Khalkhali; Amirshakeri,, Bahram; Rezasoltani,, Asghar; Talebi,, Ghadam Ali; Kalantari,, Khosro Khademi; Nedaey,, Vahab; Baghban,, Alireza Akbarzadeh

    2016-01-01

    [Purpose] The aim of this study was to determine the reliability of a newly designed dynamometric device for use in frequent force producing/reproducing tasks on the knee joint. [Subjects and Methods] In this cross-sectional study (Development & Reliability), 30 young healthy males and females (age 23.4 ± 2.48 years) were selected among students of Tabriz University of Medical Sciences by simple randomized selection. The study instrument was designed to measure any isometric contraction force exerted by the knee joint flexor/extensor muscles, known as the ipsilateral and contralateral methods. Participant knees were fixed in 60° flexion, and each participant completed the entire set of measurements twice, 72 hours apart. [Results] The findings showed a good intraclass correlation coefficient of 0.73 to 0.81 for all muscle groups. The standard error of measurement and smallest detectable difference for flexor muscle groups were 0.37 and 1.02, respectively, while the values increased to standard error of measurement=0.38 and smallest detectable difference=1.05 for extensor muscle groups. [Conclusion] The device designed could quantify the forces producing/reproducing tasks on the knee joint with a high rate of reliability, and can probably be applied for outcome measurements in proprioceptive assessment of the knee joint.

  4. Relationship Between Hand Contact Angle and Shoulder Loading During Manual Wheelchair Propulsion by Individuals with Paraplegia

    PubMed Central

    Mulroy, Sara J.; Ruparel, Puja; Hatchett, Patricia E.; Haubert, Lisa Lighthall; Eberly, Valerie J.; Gronley, JoAnne K.

    2015-01-01

    Background: Shoulder loading during manual wheelchair propulsion (WCP) contributes to the development of shoulder pain in individuals with spinal cord injury (SCI). Objective: To use regression analysis to investigate the relationships between the hand contact angle (location of the hand on the pushrim at initial contact and release during the push phase of the WCP cycle) with propulsion characteristics, pushrim forces, and shoulder kinetics during WCP in individuals with paraplegia. Methods: Biomechanical data were collected from 222 individuals (198 men and 24 women) with paraplegia from SCI during WCP on a stationary ergometer at a self-selected speed. The average age of participants was 34.7 years (±9.3), mean time since SCI was 9.3 years (±6.1), and average body weight was 74.4 kg (±15.9). The majority (n = 127; 56%) of participants had lower level paraplegia (T8 to L5) and 95 (42%) had high paraplegia (T2 to T7). Results: Increased push arc (mean = 75.3°) was associated with greater velocity (R = 0.384, P < .001) and cycle distance (R = 0.658, P < .001) and reduced cadence (R = -0.419, P < .001). Initial contact angle and hand release angles were equally associated with cycle distance and cadence, whereas a more anterior release angle was associated with greater velocity (R = 0.372, P < .001). When controlling for body weight, a more posterior initial contact angle was associated with greater posterior shoulder net joint force (R = 0.229, P = .001) and greater flexor net joint moment (R = 0.204, P = .002), whereas a more anterior hand release angle was significantly associated with increased vertical (R = 0.270, P < .001) and greater lateral (R = .293, P < .001) pushrim forces; greater shoulder net joint forces in all 3 planes — posterior (R = 0.164, P = .015), superior (R = 0.176, P = .009), and medial (R = 0.284, P < .001); and greater external rotator (R = 0.176, P = .009) and adductor (R = 0.259, P = .001) net joint moments. Conclusions: Current

  5. Avoiding Shoulder Injury from Resistance Training.

    ERIC Educational Resources Information Center

    Durall, Chris J.; Manske, Robert C.; Davies, George J.

    2001-01-01

    Identifies shoulder exercises commonly performed in fitness centers that may contribute to or exacerbate glenohumeral joint (shoulder) injury, describing alternative exercises that may be substituted and a offering rationale for the variations. The article focuses on anterior and posterior glenohumeral instability, subacromial impingement (primary…

  6. Joint Disorders

    MedlinePlus

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  7. [Stability versus mobility of the shoulder. Biomechanical aspects in athletes].

    PubMed

    Pastor, M F; Smith, T; Struck, M; Wellmann, M

    2014-03-01

    The demand profile of athletes shoulders is high. On the one hand the shoulder has to provide a maximum active range of motion that allows rapid movements of the arm and on the other hand it has to be sufficiently stabilized to decelerate rapid movements and to neutralize the resulting translational forces. Two general types of instability can be differentiated in athletes shoulders: the macroinstability typically occurring in athletes involved in contact sports and the microinstability occurring in athletes involved in overhead sports.Repetitive abduction and external rotation movements of athletes involved in overhead sports lead to adaptation of the glenohumeral joint capsule and ligaments. The anterior capsule becomes stretched while the posterior capsule develops tightness. These adaptations can result in an anterior microinstability as well as posterosuperior impingement (PSI) which implicates a pathological contact of the posterosuperior rotator cuff with the posterior glenoid and which is also associated with SLAP lesions. In contrast the shoulders of swimmers are prone to anterosuperior impingement because the arm stroke involves a forceful combined anteflexion, adduction and internal rotation of the arm.The macroinstability of contact athletes is caused by sufficient trauma and characterized by a structural lesion of capsulolabral or bony lesion. While the empirical recurrence risk of young contact athletes is already high, it can be further impaired by bony defects of the glenoid. In suspected cases, critical glenoid defects should be quantified by computed tomography (CT) scans and treated by bony augmentation of the glenoid. PMID:24604155

  8. Correlation of Shoulder and Elbow Kinetics With Ball Velocity in Collegiate Baseball Pitchers

    PubMed Central

    Post, Eric G.; Laudner, Kevin G.; McLoda, Todd A.; Wong, Regan; Meister, Keith

    2015-01-01

    Context Throwing a baseball is a dynamic and violent act that places large magnitudes of stress on the shoulder and elbow. Specific injuries at the elbow and glenohumeral joints have been linked to several kinetic variables throughout the throwing motion. However, very little research has directly examined the relationship between these kinetic variables and ball velocity. Objective To examine the correlation of peak ball velocity with elbow-valgus torque, shoulder external-rotation torque, and shoulder-distraction force in a group of collegiate baseball pitchers. Design Cross-sectional study. Setting Motion-analysis laboratory. Patients or Other Participants Sixty-seven asymptomatic National Collegiate Athletic Association Division I baseball pitchers (age = 19.5 ± 1.2 years, height = 186.2 ± 5.7 cm, mass = 86.7 ± 7.0 kg; 48 right handed, 19 left handed). Main Outcome Measure(s) We measured peak ball velocity using a radar gun and shoulder and elbow kinetics of the throwing arm using 8 electronically synchronized, high-speed digital cameras. We placed 26 reflective markers on anatomical landmarks of each participant to track 3-dimensional coordinate data. The average data from the 3 highest-velocity fastballs thrown for strikes were used for data analysis. We calculated a Pearson correlation coefficient to determine the associations between ball velocity and peak elbow-valgus torque, shoulder-distraction force, and shoulder external-rotation torque (P < .05). Results A weak positive correlation was found between ball velocity and shoulder-distraction force (r = 0.257; 95% confidence interval [CI] = 0.02, 0.47; r2 = 0.066; P = .018). However, no significant correlations were noted between ball velocity and elbow-valgus torque (r = 0.199; 95% CI = −0.043, 0.419; r2 = 0.040; P = .053) or shoulder external-rotation torque (r = 0.097; 95% CI = −0.147, 0.329; r2 = 0.009; P = .217). Conclusions Although a weak positive correlation was present between ball velocity

  9. Frozen Shoulder

    MedlinePlus

    ... to control pain and restore motion. Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain ... Surgeons, 2010. Steroid injections. Cortisone is a powerful anti-inflammatory medicine that is injected directly into your shoulder ...

  10. Normalization of ground reaction forces, joint moments, and free moments in human locomotion.

    PubMed

    Wannop, John W; Worobets, Jay T; Stefanyshyn, Darren J

    2012-12-01

    Authors who report ground reaction force (GRF), free moment (FM), and resultant joint moments usually normalize these variables by division normalization. Normalization parameters include body weight (BW), body weight x height (BWH), and body weight x leg length (BWL). The purpose of this study was to explore the appropriateness of division normalization, power curve normalization, and offset normalization on peak GRF, FM, and resultant joint moments. Kinematic and kinetic data were collected on 98 subjects who walked at 1.2 and 1.8 m/s and ran at 3.4 and 4.0 m/s. Linear curves were best fit to the data, and regression analyses performed to test the significance of the correlations. It was found that the relationship between peak force and BW, as well as joint moments and BW, BWH, and BWL, were not always linear. After division normalization, significant correlations were still found. Power curve and offset normalization, however, were effective at normalizing all variables; therefore, when attempting to normalize GRF and joint moments, perhaps nonlinear or offset methods should be implemented. PMID:23348130

  11. Summary of the 19th Joint EU-US Transport Task Force Workshop

    NASA Astrophysics Data System (ADS)

    Angioni, C.; Mantica, P.; Naulin, V.; Bourdelle, C.; Hidalgo, C.; Maggi, C. F.; Rice, J. E.; Sharapov, S. E.; 19th Joint EU-US Transport Task Force Workshop, the Participants to the

    2015-06-01

    This conference report summarizes the contributions to, and discussions at, the 19th Joint EU-US Transport Task Force workshop, held in Culham, UK, during 8-11 September 2014. The workshop was organized under six topics: momentum transport, energetic particles, challenges in modelling transport in ITER and JT60-SA, L-H transition, impurity transport and SOL transport. This report follows the same structure.

  12. Analysis of applied forces and electromyography of back and shoulders muscles when performing a simulated hand scaling task.

    PubMed

    Porter, William; Gallagher, Sean; Torma-Krajewski, Janet

    2010-05-01

    Hand scaling is a physically demanding task responsible for numerous overexertion injuries in underground mining. Scaling requires the miner to use a long pry bar to remove loose rock, reducing the likelihood of rock fall injuries. The experiments described in this article simulated "rib" scaling (scaling a mine wall) from an elevated bucket to examine force generation and electromyographic responses using two types of scaling bars (steel and fiberglass-reinforced aluminum) at five target heights ranging from floor level to 176 cm. Ten male and six female subjects were tested in separate experiments. Peak and average force applied at the scaling bar tip and normalized electromyography (EMG) of the left and right pairs of the deltoid and erectores spinae muscles were obtained. Work height significantly affected peak prying force during scaling activities with highest force capacity at the lower levels. Bar type did not affect force generation. However, use of the lighter fiberglass bar required significantly more muscle activity to achieve the same force. Results of these studies suggest that miners scale points on the rock face that are below their knees, and reposition the bucket as often as necessary to do so. PMID:19800050

  13. The primer for sports medicine professionals on imaging: the shoulder.

    PubMed

    Farshad-Amacker, Nadja A; Jain Palrecha, Sapna; Farshad, Mazda

    2013-01-01

    Because of its inherent superior soft tissue contrast and lack of ionizing radiation, magnetic resonance imaging (MRI) is highly suited to study the complex anatomy of the shoulder joint, particularly when assessing the relatively high incidence of shoulder injuries in young, athletic patients. This review aims to serve as a primer for understanding shoulder MRI in an algorithmical approach, including MRI protocol and technique, normal anatomy and anatomical variations of the shoulder, pathologic conditions of the rotator cuff tendons and muscles, the long head of the biceps tendon, shoulder impingement, labral and glenohumeral ligament pathology, MR findings in shoulder instability, adhesive capsulitis, and osteoarthritis. PMID:24381700

  14. Kinematics of chiropteran shoulder girdle in flight.

    PubMed

    Panyutina, A A; Kuznetsov, A N; Korzun, L P

    2013-03-01

    New data on the mechanisms of movements of the shoulder girdle and humerus of bats are described; potential mobility is compared to the movements actually used in flight. The study was performed on the basis of morphological and functional analysis of anatomical specimens of 15 species, high speed and high definition filming of two species and X-ray survey of Rousettus aegyptiacus flight. Our observations indicate that any excursions of the shoulder girdle in bats have relatively small input in the wing amplitude. Shoulder girdle movements resemble kinematics of a crank mechanism: clavicle plays the role of crank, and scapula-the role of connecting rod. Previously described osseous "locking mechanisms" in shoulder joint of advanced bats do not affect the movements, actually used in flight. The wing beats in bats are performed predominantly by movements of humerus relative to shoulder girdle, although these movements occupy the caudal-most sector of available shoulder mobility. PMID:23381941

  15. Upper limb joint kinetic analysis during tennis serve: Assessment of competitive level on efficiency and injury risks.

    PubMed

    Martin, C; Bideau, B; Ropars, M; Delamarche, P; Kulpa, R

    2014-08-01

    The aim of this work was to compare the joint kinetics and stroke production efficiency for the shoulder, elbow, and wrist during the serve between professionals and advanced tennis players and to discuss their potential relationship with given overuse injuries. Eleven professional and seven advanced tennis players were studied with an optoelectronic motion analysis system while performing serves. Normalized peak kinetic values of the shoulder, elbow, and wrist joints were calculated using inverse dynamics. To measure serve efficiency, all normalized peak kinetic values were divided by ball velocity. t-tests were used to determine significant differences between the resultant joint kinetics and efficiency values in both groups (advanced vs professional). Shoulder inferior force, shoulder anterior force, shoulder horizontal abduction torque, and elbow medial force were significantly higher in advanced players. Professional players were more efficient than advanced players, as they maximize ball velocity with lower joint kinetics. Since advanced players are subjected to higher joint kinetics, the results suggest that they appeared more susceptible to high risk of shoulder and elbow injuries than professionals, especially during the cocking and deceleration phases of the serve. PMID:23293868

  16. [A DESTRUCTIVE SHOULDER ARTHROPATHY].

    PubMed

    Ouhadi, L; Gaudreault, M; Mottard, S; Gillet, Ph

    2016-02-01

    Charcot arthropathy is a progressive, chronic and degenerative destruction of one or several joints caused by a central or peripheral neurological disorder. Approximately 25 % of the patients with syringomyelia develop this arthropathy located in the upper limb in 80 % of the cases. An early etiological diagnosis is essential to begin the treatment of the underlying neurological disorder. Afterwards, a conservative treatment of the arthropathy is preferred. We report the story of a patient with an arthropathy of the left shoulder due to Arnold-Chiari's malformation of type I with syringomyelia. PMID:27141649

  17. Compressive and shear hip joint contact forces are affected by pediatric obesity during walking.

    PubMed

    Lerner, Zachary F; Browning, Raymond C

    2016-06-14

    Obese children exhibit altered gait mechanics compared to healthy-weight children and have an increased prevalence of hip pain and pathology. This study sought to determine the relationships between body mass and compressive and shear hip joint contact forces during walking. Kinematic and kinetic data were collected during treadmill walking at 1ms(-1) in 10 obese and 10 healthy-weight 8-12 year-olds. We estimated body composition, segment masses, lower-extremity alignment, and femoral neck angle via radiographic images, created personalized musculoskeletal models in OpenSim, and computed muscle forces and hip joint contact forces. Hip extension at mid-stance was 9° less, on average, in the obese children (p<0.001). Hip abduction, knee flexion, and body-weight normalized peak hip moments were similar between groups. Normalized to body-weight, peak contact forces were similar at the first peak and slightly lower at the second peak between the obese and healthy-weight participants. Total body mass explained a greater proportion of contact force variance compared to lean body mass in the compressive (r(2)=0.89) and vertical shear (perpendicular to the physis acting superior-to-inferior) (r(2)=0.84) directions; lean body mass explained a greater proportion in the posterior shear direction (r(2)=0.54). Stance-average contact forces in the compressive and vertical shear directions increased by 41N and 48N, respectively, for every kilogram of body mass. Age explained less than 27% of the hip loading variance. No effect of sex was found. The proportionality between hip loads and body-weight may be implicated in an obese child׳s increased risk of hip pain and pathology. PMID:27040390

  18. Practical approach to subject-specific estimation of knee joint contact force.

    PubMed

    Knarr, Brian A; Higginson, Jill S

    2015-08-20

    Compressive forces experienced at the knee can significantly contribute to cartilage degeneration. Musculoskeletal models enable predictions of the internal forces experienced at the knee, but validation is often not possible, as experimental data detailing loading at the knee joint is limited. Recently available data reporting compressive knee force through direct measurement using instrumented total knee replacements offer a unique opportunity to evaluate the accuracy of models. Previous studies have highlighted the importance of subject-specificity in increasing the accuracy of model predictions; however, these techniques may be unrealistic outside of a research setting. Therefore, the goal of our work was to identify a practical approach for accurate prediction of tibiofemoral knee contact force (KCF). Four methods for prediction of knee contact force were compared: (1) standard static optimization, (2) uniform muscle coordination weighting, (3) subject-specific muscle coordination weighting and (4) subject-specific strength adjustments. Walking trials for three subjects with instrumented knee replacements were used to evaluate the accuracy of model predictions. Predictions utilizing subject-specific muscle coordination weighting yielded the best agreement with experimental data; however this method required in vivo data for weighting factor calibration. Including subject-specific strength adjustments improved models' predictions compared to standard static optimization, with errors in peak KCF less than 0.5 body weight for all subjects. Overall, combining clinical assessments of muscle strength with standard tools available in the OpenSim software package, such as inverse kinematics and static optimization, appears to be a practical method for predicting joint contact force that can be implemented for many applications. PMID:25952546

  19. Effect of asymmetric force on the condylar cartilage, subchondral bone and collagens in the temporomandibular joints.

    PubMed

    Zhang, Caixia; Xu, Yue; Cheng, Yangxi; Wu, Tuojiang; Li, Huang

    2015-04-01

    This study aimed to define the effects of asymmetric force on rat temporomandibular joints (TMJs). A total of 232 10-week-old rats were used in the experiment. Their left TMJs were kept forward and upward with 40g or 120g. The histological and osteogenic changes, as well as the expression of type I, II and III collagens were observed. Our results showed that the curve of the cartilage thickness changes in the anterior part of the treated side in the heavy force group (HS) decreased first and increased later during the strength and the recovery periods, while the reverse changes were shown in the middle and posterior parts. The cartilage thickness change on the other side in the heavy force group (HO) was the opposite. Additionally, the cartilage thickness change on the treated side and the other side of the light force group (LS and LO) were similar to but not as significantly changed as HS and HO. There were significant differences among the experimental groups. The subchondral bone trabecula also decreased after the pressure loading and removing, then recovered, without significant differences among these groups. Furthermore, more pathological changes such as fractures, bone cysts, the degradation of type II collagen and the increased expression of type III collagen were observed on the treated sides following the application of heavy force. In contrast, more osteogenesis and more active changes were found in the light force group. In conclusion, our study demonstrated that asymmetric force exerted different effects on the cartilage, subchondral bone and collagens of TMJs. Greater changes occurred in the heavy force group, and light force provided more benefits for TMJs remodelling. PMID:25703817

  20. The influence of the spine on the shoulder in the throwing athlete.

    PubMed

    Young, J L; Herring, S A; Press, J M; Casazza, B A

    1996-01-01

    Analysis of shoulder dysfunction in throwing and overhead athletes can no longer be restricted to evaluation of the glenohumeral joint alone. The isolated shoulder is incapable of generating the force necessary to hurl a baseball at velocities of 90-100 miles per hour or serve a tennis ball in excess of 120 miles per hour. The purpose of this paper is to provide a literature based theoretical framework for the role of the spine during these activities. The spine is a pivotal component of the kinematic chain which functions as a transfer link between the lower and upper limbs, a force generator capable of accelerating the arm, and a force attenuator which dampens shear forces at the glenohumeral joint during the deceleration phase of the pitching motion. Side bending and rotation of the cervical spine facilitates visual acquisition of the intended target. Inflexibility of the hip musculature and weakness of the muscles which attach to the thoracolumbar fascia have profound effects upon spine function which secondarily places greater stress upon the glenohumeral joint and rotator cuff. Shoulder rehabilitation and injury prevention programs should include evaluation of and exercise regimens for the lumbar, thoracic and cervical spine. PMID:24572551

  1. An EMG-driven Model to Estimate Muscle Forces and Joint Moments in Stroke Patients

    PubMed Central

    Shao, Qi; Bassett, Daniel N.; Manal, Kurt; Buchanan, Thomas S.

    2009-01-01

    Individuals following stroke exhibit altered muscle activation and movement patterns. Improving the efficiency of gait can be facilitated by knowing which muscles are affected and how they contribute to the pathological pattern. In this paper we present an electromyographically (EMG) driven musculoskeletal model to estimate muscle forces and joint moments. Subject specific EMG for the primary ankle plantar and dorsiflexor muscles, and joint kinematics during walking for four subjects following stroke were used as inputs to the model to predict ankle joint moments during stance. The model’s ability to predict the joint moment was evaluated by comparing the model output with the moment computed using inverse dynamics. The model did predict the ankle moment with acceptable accuracy, exhibiting an average R2 value ranging between 0.87 and 0.92, with RMS errors between 9.7% and 14.7%. The values are in line with previous results for healthy subjects, suggesting that EMG-driven modeling in this population of patients is feasible. It is our hope that such models can provide clinical insight into developing more effective rehabilitation therapies and to assess the effects of an intervention. PMID:19818436

  2. Density of muscle spindles in prosimian shoulder muscles reflects locomotor adaptation.

    PubMed

    Higurashi, Yasuo; Taniguchi, Yuki; Kumakura, Hiroo

    2006-01-01

    We examined the correlation between the density of muscle spindles in shoulder muscles and the locomotor mode in three species of prosimian primates: the slow loris (Nycticebus coucang), Garnett's galago (Otolemur garnettii), and the ring-tailed lemur (Lemur catta). The shoulder muscles (supraspinatus, infraspinatus, teres major, teres minor, and subscapularis) were embedded in celloidin and cut into transverse serial thin sections (40 microm); then, every tenth section was stained using the Azan staining technique. The relative muscle weights and the density of the muscle spindles were determined. The slow loris muscles were heavier and had sparser muscle spindles, as compared to Garnett's galago. These features suggest that the shoulder muscles of the slow loris are more adapted to generating propulsive force and stabilizing the shoulder joint during locomotion and play a less controlling role in forelimb movements. In contrast, Garnett's galago possessed smaller shoulder muscles with denser spindles that are suitable for the control of more rapid locomotor movements. The mean relative weight and the mean spindle density in the shoulder muscles of the ring-tailed lemur were between those of the other primates, suggesting that the spindle density is not simply a consequence of taxonomic status. PMID:17361082

  3. Ground reaction forces and lower-limb joint kinetics of turning gait in typically developing children.

    PubMed

    Dixon, Philippe C; Stebbins, Julie; Theologis, Tim; Zavatsky, Amy B

    2014-11-28

    Turning is a common locomotor task essential to daily activity; however, very little is known about the forces and moments responsible for the kinematic adaptations occurring relative to straight-line gait in typically developing children. Thus, the aims of this study were to analyse ground reaction forces (GRFs), ground reaction free vertical torque (TZ), and the lower-limb joint kinetics of 90° outside (step) and inside (spin) limb turns. Step, spin, and straight walking trials from fifty-four typically developing children were analysed. All children were fit with the Plug-in Gait and Oxford Foot Model marker sets while walking over force plates embedded in the walkway. Net internal joint moments and power were computed via a standard inverse dynamics approach. All dependent variables were statistically analysed over the entire curves using the mean difference 95% bootstrap confidence band approach. GRFs were directed medially for step turns and laterally for spin turns during the turning phase. Directions were reversed and magnitudes decreased during the approach phase. Step turns showed reduced ankle power generation, while spin turns showed large TZ. Both strategies required large knee and hip coronal and transverse plane moments during swing. These kinetic differences highlight adaptations required to maintain stability and reorient the body towards the new walking direction during turning. From a clinical perspective, turning gait may better reveal weaknesses and motor control deficits than straight walking in pathological populations, such as children with cerebral palsy, and could potentially be implemented in standard gait analysis sessions. PMID:25311452

  4. "In vivo" determination of hip joint separation and the forces generated due to impact loading conditions.

    PubMed

    Dennis, D A; Komistek, R D; Northcut, E J; Ochoa, J A; Ritchie, A

    2001-05-01

    Numerous supporting structures assist in the retention of the femoral head within the acetabulum of the normal hip joint including the capsule, labrum, and ligament of the femoral head (LHF). During total hip arthroplasty (THA), the LHF is often disrupted or degenerative and is surgically removed. In addition, a portion of the remaining supporting structures is transected or resected to facilitate surgical exposure. The present study analyzes the effects of LHF absence and surgical dissection in THA patients. Twenty subjects (5 normal hip joints, 10 nonconstrained THA, and 5 constrained THA) were evaluated using fluoroscopy while performing active hip abduction. All THA subjects were considered clinically successful. Fluoroscopic videos of the normal hips were analyzed using digitization, while those with THA were assessed using a computerized interactive model-fitting technique. The distance between the femoral head and acetabulum was measured to determine if femoral head separation occurred. Error analysis revealed measurements to be accurate within 0.75mm. No separation was observed in normal hips or those subjects implanted with constrained THA, while all 10 (100%) with unconstrained THA demonstrated femoral head separation, averaging 3.3mm (range 1.9-5.2mm). This study has shown that separation of the prosthetic femoral head from the acetabular component can occur. The normal hip joint has surrounding capsuloligamentous structures and a ligament attaching the femoral head to the acetabulum. We hypothesize that these soft tissue supports create a passive, resistant force at the hip, preventing femoral head separation. The absence of these supporting structures after THA may allow increased hip joint forces, which may play a role in premature polyethylene wear or prosthetic loosening. PMID:11311703

  5. A Cervico-Thoraco-Lumbar Multibody Dynamic Model for the Estimation of Joint Loads and Muscle Forces.

    PubMed

    Khurelbaatar, Tsolmonbaatar; Kim, Kyungsoo; Hyuk Kim, Yoon

    2015-11-01

    Computational musculoskeletal models have been developed to predict mechanical joint loads on the human spine, such as the forces and moments applied to vertebral and facet joints and the forces that act on ligaments and muscles because of difficulties in the direct measurement of joint loads. However, many whole-spine models lack certain elements. For example, the detailed facet joints in the cervical region or the whole spine region may not be implemented. In this study, a detailed cervico-thoraco-lumbar multibody musculoskeletal model with all major ligaments, separated structures of facet contact and intervertebral disk joints, and the rib cage was developed. The model was validated by comparing the intersegmental rotations, ligament tensile forces, facet joint contact forces, compressive and shear forces on disks, and muscle forces were to those reported in previous experimental and computational studies both by region (cervical, thoracic, or lumbar regions) and for the whole model. The comparisons demonstrated that our whole spine model is consistent with in vitro and in vivo experimental studies and with computational studies. The model developed in this study can be used in further studies to better understand spine structures and injury mechanisms of spinal disorders. PMID:26292160

  6. 49 CFR 572.184 - Shoulder assembly.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 100 ±5 mm. The length of the elastic shoulder cord (175-3015) shall be adjusted so that a force... shoulder at 4.3±0.1 m/s. (c) Performance criteria. The peak acceleration of the impactor is between 7.5...

  7. 49 CFR 572.184 - Shoulder assembly.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ±5 mm. The length of the elastic shoulder cord (175-3015) shall be adjusted so that a force between... shoulder at 4.3±0.1 m/s. (c) Performance criteria. The peak acceleration of the impactor is between 7.5...

  8. 49 CFR 572.184 - Shoulder assembly.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 100 ±5 mm. The length of the elastic shoulder cord (175-3015) shall be adjusted so that a force... shoulder at 4.3±0.1 m/s. (c) Performance criteria. The peak acceleration of the impactor is between 7.5...

  9. 49 CFR 572.184 - Shoulder assembly.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... the plane of motion of the impactor at contact with the shoulder. The arms are oriented forward at 50... ±5 mm. The length of the elastic shoulder cord (175-3015) shall be adjusted so that a force between... clavicle in the same plane as the clavicle movement, is required to initiate a forward motion of 1 to 5...

  10. Dislocated shoulder - aftercare

    MedlinePlus

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  11. Modeling of muscle forces in humans with and without temporomandibular joint disorders

    PubMed Central

    Iwasaki, LR; Liu, H; Gonzalez, YM; Marx, DB; Nickel, JC

    2015-01-01

    Objectives Subjects with/without temporomandibular joint disorders (TMJD) were tested for differences in muscle forces. Setting and Sample Population School of Dental Medicine, University at Buffalo. Ninety-one subjects were classified in 4 groups based on presence/absence (+/-) of chronic myofascial and/or TMJ pain (P) and bilateral disc displacement (DD). Material & Methods Validated numerical models employed an organizational objective and subjects’ anatomy to calculate masticatory muscle forces during static biting. ANOVA and Holm step-down procedure post-hoc tests assessed group differences. Theoretical geometries, representing the range of subjects’ muscle orientations, were surveyed via numerical models to identify key combinations resulting in high muscle forces. Effect-size (Cohen’s d) and ANOVA/post-hoc tests assessed group differences in key muscle orientations. Results +P-DD subjects had significantly higher muscle forces, especially for lateral pterygoid muscles, compared to the other groups (P<0.01) for bite-forces that were directed posteromedially or posterolaterally on mandibular molars and posteriorly and slightly medially on mandibular incisors. Key muscle orientations for peak lateral pterygoid muscle forces were identified and group comparisons showed mean orientation in +P-DD compared to other diagnostic groups was ≥5° more upright for masseter and ≥3° more posteriorly-directed for temporalis muscles (all Cohen’s d ≥0.8). Conclusion Predicted lateral pterygoid muscle forces were significantly higher in +P-DD compared to other groups for specific biting conditions and were attributable, in part, to differences in masseter and temporalis muscle orientations. PMID:25865546

  12. Shoulder Injuries and Disorders

    MedlinePlus

    ... of many common problems. They include sprains, strains, dislocations, separations, tendinitis, bursitis, torn rotator cuffs, frozen shoulder, fractures and arthritis. Usually shoulder problems are treated ...

  13. Simultaneous shoulder and elbow dislocation

    PubMed Central

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; Karataş, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to emergency service but she was diagnosed with simultaneous ipsilateral shoulder and elbow injury and treated conservatively. As a more painful pathology may mask the additional ones, one should hasten to help before performing a complete evaluation. Any harm caused to the patient due to this reason would not be a complication but a malpractice. PMID:24859563

  14. Gimballed Shoulders for Friction Stir Welding

    NASA Technical Reports Server (NTRS)

    Carter, Robert; Lawless, Kirby

    2008-01-01

    In a proposed improvement of tooling for friction stir welding, gimballed shoulders would supplant shoulders that, heretofore, have been fixedly aligned with pins. The proposal is especially relevant to self-reacting friction stir welding. Some definitions of terms, recapitulated from related prior NASA Tech Briefs articles, are prerequisite to a meaningful description of the proposed improvement. In friction stir welding, one uses a tool that includes (1) a rotating shoulder on top (or front) of the workpiece and (2) a pin that rotates with the shoulder and protrudes from the shoulder into the depth of the workpiece. In conventional friction stir welding, the main axial force exerted by the tool on the workpiece is reacted through a ridged backing anvil under (behind) the workpiece. When conventional friction stir welding is augmented with an auto-adjustable pin-tool (APT) capability, the depth of penetration of the pin into the workpiece is varied in real time by a position- or forcecontrol system that extends or retracts the pin as needed to obtain the desired effect. In self-reacting (also known as self-reacted) friction stir welding as practiced heretofore, there are two shoulders: one on top (or front) and one on the bottom (or back) of the workpiece. In this case, a threaded shaft protrudes from the tip of the pin to beyond the back surface of the workpiece. The back shoulder is held axially in place against tension by a nut on the threaded shaft. Both shoulders rotate with the pin and remain aligned coaxially with the pin. The main axial force exerted on the workpiece by the tool and front shoulder is reacted through the back shoulder and the threaded shaft into the friction-stir-welding machine head, so that a backing anvil is no longer needed. A key transmits torque between the bottom shoulder and the threaded shaft, so that the bottom shoulder rotates with the shaft. This concludes the prerequisite definitions of terms.

  15. Joint strength measurements of individual fiber-fiber bonds: An atomic force microscopy based method

    NASA Astrophysics Data System (ADS)

    Schmied, Franz J.; Teichert, Christian; Kappel, Lisbeth; Hirn, Ulrich; Schennach, Robert

    2012-07-01

    We are introducing a method to measure tensile strength of individual fiber-fiber bonds within a breaking force range of 0.01 mN-1 mN as well as the energy consumed during breaking. Until now, such a method was not available. Using a conventional atomic force microscope and a specifically designed sample holder, the desired force and the breaking behavior can be analyzed by two different approaches. First, dynamic loading can be applied, where force-versus-distance curves are employed to determine the proportions of elastic energy and energy dissipated in the bond. Second, static loading is utilized to study viscoelastic behavior and calculate viscoelastic energy contributions. To demonstrate the capability of the proposed method, we are presenting results for breaking strength of kraft pulp fiber-fiber bonds in tensile opening mode. The procedure is by no means restricted to cellulose fibers, it has the potential to quantify joint strength of micrometer-sized fibers in general.

  16. Data Fusion Engine (DFE) for the Force Protection Joint Experiment (FPJE)

    NASA Astrophysics Data System (ADS)

    Barngrover, C. M.; Laird, R. T.; Kramer, T. A.; Cruickshanks, J. R.; Cutler, S. H.

    2009-04-01

    The FPJE was an experiment to consider the best way to create a system of systems in the realm of Force Protection. It was sponsored by Physical Security Equipment Action Group (PSEAG) and Joint Program Manager - Guardian (JPMG), and was managed by the Product Manager - Force Protection Systems (PM-FPS). The experiment attempted to understand the challenges associated with integrating disparate systems into a cohesive unit, and then the compounding challenge of handling the flow of data into the system and its dispersion to all subscribed Command and Control (C2) nodes. To handle this data flow we created the DFE based on the framework of the Joint Battlespace Command and Control System for Manned and Unmanned Assets (JBC2S). The DFE is a data server that receives information from the network of systems via the Security Equipment Integration Working Group (SEIWG) ICD-0100 protocol, processes the data through static fusion algorithms, and then publishes the fused data to the C2 nodes, in this case JBC2S and the Tactical Automated Security System (TASS). The DFE uses only known concepts and algorithms for its fusion efforts. This paper discusses the analyzed impact of the fusion on C2 nodes displays and in turn on the operators. Also, this paper discusses the lessons learned about networked control combined with DFE generated automatic response. Finally, this paper discusses possible future efforts and their benefits for providing the useful operational picture to the operator.

  17. Strength Training and Shoulder Proprioception

    PubMed Central

    Salles, José Inácio; Velasques, Bruna; Cossich, Victor; Nicoliche, Eduardo; Ribeiro, Pedro; Amaral, Marcus Vinicius; Motta, Geraldo

    2015-01-01

    Context: Proprioception is essential to motor control and joint stability during daily and sport activities. Recent studies demonstrated that athletes have better joint position sense (JPS) when compared with controls matched for age, suggesting that physical training could have an effect on proprioception. Objective: To evaluate the result of an 8-week strength-training program on shoulder JPS and to verify whether using training intensities that are the same or divergent for the shoulder's dynamic-stabilizer muscles promote different effects on JPS. Design: Randomized controlled clinical trial. Setting: We evaluated JPS in a research laboratory and conducted training in a gymnasium. Patients or Other Participants: A total of 90 men, right handed and asymptomatic, with no history of any type of injury or shoulder instability. Intervention(s): For 8 weeks, the participants performed the strength-training program 3 sessions per week. We used 4 exercises (bench press, lat pull down, shoulder press, and seated row), with 2 sets each. Main Outcome Measure(s): We measured shoulder JPS acuity by calculating the absolute error. Results: We found an interaction between group and time. To examine the interaction, we conducted two 1-way analyses of variance comparing groups at each time. The groups did not differ at pretraining; however, a difference among groups was noted posttraining. Conclusions: Strength training using exercises at the same intensity produced an improvement in JPS compared with exercises of varying intensity, suggesting that the former resulted in improvements in the sensitivity of muscle spindles and, hence, better neuromuscular control in the shoulder. PMID:25594912

  18. Static torque-angle relation of human elbow joint estimated with artificial neural network technique.

    PubMed

    Uchiyama, T; Bessho, T; Akazawa, K

    1998-06-01

    Static relations between elbow joint angle and torque at constant muscle activity in normal volunteers were investigated with the aid of an artificial neural network technique. A subject sat on a chair and moved his upper- and forearm in a horizontal plane at the height of his shoulder. The subject was instructed to maintain the elbow joint at a pre-determined angle. The wrist was then pulled to extend the elbow joint by the gravitational force of a weight hanging from a pulley. Integrated electromyograms (IEMGs), elbow and shoulder joint angles and elbow joint torque were measured. Then the relation among IEMGs, joint angles and torque was modeled with the aid of the artificial neural network, where IEMGs and joint angles were the inputs and torque was the output. After back propagation learning, we presented various combinations of IEMGs, shoulder and elbow joint angles to the model and estimated the elbow joint torque to obtain the torque-angle relation for constant muscle activation. The elbow joint torque increased and then decreased with extension of the elbow joint. This suggests that if the forearm is displaced from an equilibrium point, the torque angle relation would not act like a simple spring. In a view of the musculoskeletal structure of the elbow joint, the relation between the elbow joint angle and the moment arm of the elbow flexor muscles seems to have a dominant effect on the torque-angle relation. PMID:9755039

  19. Shoulder Ultrasonography: Performance and Common Findings

    PubMed Central

    Gaitini, Diana

    2012-01-01

    Ultrasound (US) of the shoulder is the most commonly requested examination in musculoskeletal US diagnosis. Sports injuries and degenerative and inflammatory processes are the main sources of shoulder pain and functional limitations. Because of its availability, low cost, dynamic examination process, absence of radiation exposure, and ease of patient compliance, US is the preferred mode for shoulder imaging over other, more sophisticated, and expensive methods. Operator dependence is the main disadvantage of US examinations. Use of high range equipment with high resolution transducers, adhering to a strict examination protocol, good knowledge of normal anatomy and pathological processes and an awareness of common pitfalls are essential for the optimal performance and interpretation of shoulder US. This article addresses examination techniques, the normal sonographic appearance of tendons, bursae and joints, and the main pathological conditions found in shoulder ultrasonography. PMID:22919552

  20. Arthroscopic Management of Anterior, Posterior, and Multidirectional Shoulder Instabilities.

    PubMed

    Field, Larry D; Ryu, Richard K N; Abrams, Jeffrey S; Provencher, Matthew

    2016-01-01

    Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability. The treating physician also must be familiar with diagnostic imaging and physical examination maneuvers that are required to accurately diagnose shoulder instability. PMID:27049209

  1. Shoulder arthroplasty in osteoarthritis: current concepts in biomechanics and surgical technique

    PubMed Central

    Merolla, G; Nastrucci, G; Porcellini, G

    Shoulder arthroplasty is a technically demanding procedure to restore shoulder function in patients with severe osteoarthritis of the glenohumeral joint. The modern prosthetic system exploit the benefits of modularity and the availibility of additional sizes of the prosthetic components. In this paper we describe the biomechanics of shoulder arthroplasty and the technique for shoulder replacement including total shoulder arthroplasty (TSA) with all-polyethylene and metal-backed glenoid component, humeral head resurfacing and stemless humeral replacement. PMID:24251240

  2. Joint Task Force on Undergraduate Physics Programs (J-TUPP): Overview and Major Findings

    NASA Astrophysics Data System (ADS)

    Heron, Paula

    2016-03-01

    The Joint Task Force on Undergraduate Physics Programs (JTUPP) was formed in response to growing awareness in the physics community that physics majors pursue a wide range of careers after graduation, with very few ending up in academia. The task force is charged with identifying the skills and knowledge that undergraduate physics degree holders should possess to be well prepared for a diverse set of careers, and providing guidance for physicists considering revising the undergraduate curriculum to improve the education of a diverse student population. Task force members represent large and small universities, professional societies, and industry, and have expertise in a broad range of areas including entrepreneurship, physics education research and systemic change in education. We reviewed employment data, surveys of employers, and reports generated by other disciplines. We also met with physicists in selected industries to get their views on the strengths and weaknesses of physics graduates, commissioned a series of interviews with recent physics graduates employed in the private sector, and identified exemplary programs that ensure that all of their students are well prepared to pursue a wide range of career paths. The findings and recommendations will be summarized.

  3. Throwing, the Shoulder, and Human Evolution.

    PubMed

    Kuhn, John E

    2016-01-01

    Throwing with accuracy and speed is a skill unique to humans. Throwing has many advantages and the ability to throw has likely been promoted through natural selection in the evolution of humans. There are many unsolved questions regarding the anatomy of the human shoulder. The purpose of this article is to review many of these mysteries and propose that the answer to these questions can be understood if one views the shoulder as a joint that has evolved to throw. PMID:26991561

  4. Inter-clinician and intra-clinician reliability of force application during joint mobilization: a systematic review.

    PubMed

    Gorgos, Kara S; Wasylyk, Nicole T; Van Lunen, Bonnie L; Hoch, Matthew C

    2014-04-01

    Joint mobilizations are commonly used by clinicians to decrease pain and restore joint arthrokinematics following musculoskeletal injury. The force applied during a joint mobilization treatment is subjective to the individual clinician but may have an effect on patient outcomes. The purpose of this systematic review was to critically appraise and synthesize the studies which examined the reliability of clinicians' force application during joint mobilization. A systematic search of PubMed and EBSCO Host databases from inception to March 1, 2013 was conducted to identify studies assessing the reliability of force application during joint mobilizations. Two reviewers utilized the Quality Appraisal of Reliability Studies (QAREL) assessment tool to determine the quality of included studies. The relative reliability of the included studies was examined through intraclass correlation coefficients (ICC) to synthesize study findings. All results were collated qualitatively with a level of evidence approach. A total of seven studies met the eligibility and were included. Five studies were included that assessed inter-clinician reliability, and six studies were included that assessed intra-clinician reliability. The overall level of evidence for inter-clinician reliability was strong for poor-to-moderate reliability (ICC = -0.04 to 0.70). The overall level of evidence for intra-clinician reliability was strong for good reliability (ICC = 0.75-0.99). This systematic review indicates there is variability in force application between clinicians but individual clinicians apply forces consistently. The results of this systematic review suggest innovative instructional methods are needed to improve consistency and validate the forces applied during of joint mobilization treatments. This is particularly evident for improving the consistency of force application across clinicians. PMID:24405786

  5. Total hip joint prosthesis for in vivo measurement of forces and moments.

    PubMed

    Damm, Philipp; Graichen, Friedmar; Rohlmann, Antonius; Bender, Alwina; Bergmann, Georg

    2010-01-01

    A new instrumented hip joint prosthesis was developed which allows the in vivo measurement of the complete contact loads in the joint, i.e. 3 force and 3 moment components. A clinically proven standard implant was modified. Inside the hollow neck, 6 semiconductor strain gauges are applied to measure the deformation of the neck. Also integrated are a small coil for the inductive power supply and a 9-channel telemetry transmitter. The neck cavity is closed by a titanium plate and hermetically sealed by electron beam welding. The sensor signals are pulse interval modulated (PIM) with a sampling rate of about 120 Hz. The pulses are transmitted at radio frequencies via a small antenna loop inside the ceramic head, which is connected to the electronic circuit by a two-pin feedthrough. Inductive power supply, calculation of the loads from the measured deformations and real time load display are carried out by the external equipment. The maximum error of the load components is 2% including crosstalk. PMID:19889565

  6. Comparison of joint kinematics and pedaling force in the young and the elderly

    PubMed Central

    Seo, Jeong-Woo; Kim, Dae-Hyeok; Yang, Seung-Tae; Kang, Dong-Won; Choi, Jin-Seung; Tack, Gye-Rae

    2016-01-01

    [Purpose] Proper pedaling posture can improve muscle strength and cardiopulmonary function. To investigate proper pedaling posture for the elderly, this study compared the pedaling efficiency of the elderly with that of the young by using an index of effectiveness (IE) and kinematic results. [Subjects and Methods] Eight adults in their twenties and eight in their seventies participated in 3-min, 40 rpm cycle pedaling tests, with the same load and cadence. The joint angle, range of motion (ROM), and IE were compared by measuring 3-dimensional motion and 3-axis pedal-reaction force during 4 pedaling phases (Phase 1: 330–30°, Phase 2: 30–150°, Phase 3: 150–210°, and Phase 4: 210–330°). [Results] The knee and ankle ROM, maximum knee extension, and maximum ankle dorsiflexion in the elderly were significantly decreased compared with those in the young. Moreover, there were significant differences in IE for the total phase, Phase 1, and Phase 4 between the elderly and young. IE of the young was greater than that of the elderly, except in Phase 3. [Conclusion] Joint movement in the elderly during pedaling was limited. This study provides information that will facilitate the proposal of an efficient pedaling method for the elderly.

  7. Estimation of the superconducting joint for the forced-cooled superconducting poloidal coil for the Large Helical Device

    SciTech Connect

    Hanawa, S.; Wachi, Y.; Shibayama, K.

    1996-07-01

    The authors applied a new solid state bonding technique to the joints of the forced-cooled superconducting poloidal coils for LHD. The NbTi/Cu wires of the cable-in-conduit (CIC) conductors were joined superconductively by this technique to realize the low electrical resistance and compactness. They make several joint samples and study the joint condition among the NbTi filaments. By the Scanning Electron Microscope (SEM) they make sure that the filaments are joined with very narrow gaps. They measure the magnetization of the joint using Superconducting Quantum Interference Device and estimate the effective diameter of the filaments to be about 90 {micro}m. This value shows that the joint is magnetically stable by the adiabatic theory.

  8. The effect of toe marker placement error on joint kinematics and muscle forces using OpenSim gait simulation.

    PubMed

    Xu, Hang; Merryweather, Andrew; Bloswick, Donald; Mao, Qi; Wang, Tong

    2015-01-01

    Marker placement can be a significant source of error in biomechanical studies of human movement. The toe marker placement error is amplified by footwear since the toe marker placement on the shoe only relies on an approximation of underlying anatomical landmarks. Three total knee replacement subjects were recruited and three self-speed gait trials per subject were collected. The height variation between toe and heel markers of four types of footwear was evaluated from the results of joint kinematics and muscle forces using OpenSim. The reference condition was considered as the same vertical height of toe and heel markers. The results showed that the residual variances for joint kinematics had an approximately linear relationship with toe marker placement error for lower limb joints. Ankle dorsiflexion/plantarflexion is most sensitive to toe marker placement error. The influence of toe marker placement error is generally larger for hip flexion/extension and rotation than hip abduction/adduction and knee flexion/extension. The muscle forces responded to the residual variance of joint kinematics to various degrees based on the muscle function for specific joint kinematics. This study demonstrates the importance of evaluating marker error for joint kinematics and muscle forces when explaining relative clinical gait analysis and treatment intervention. PMID:26406064

  9. [The effect of the motion of forefoot joint at the force exerted upon the floor during walking exercise].

    PubMed

    Maeda, A; Nishizono, H; Ebashi, H; Shibayama, H

    1993-11-01

    In walking exercise the human body is exposed to external forces. Some of them are produced by constraints such as surface, shoes or opponent. In kick action of walking, the ground reaction force (GRF) is the most important external force. The magnitude of the GRF, its direction, and point of application have an influence on the load on the human body. The purpose of this study is to clarify the role of forefoot joint (artt. metatarsophalangeae) at the force exerted upon the floor during kick action of walking. The device used in this study to analyze the GRF and its three components consists of Kistler's force platform. Output from force transducer was collected online with a TEAC data recorder and MEM-4101 minicomputer. The impact force measurements were taken from the anterior-posterior force time curves at the take-off for 1 subject walking 10 trials at 2 m/sec with 2 different pairs of shoes (Shoes 1: thin sole of 4mm, and Shoes 2: thick sole of 40mm) and without shoes. High speed (200f/sec) cinematography was also used to analyze the angular displacement of forefoot joint at the take-off of walking exercise. The force acting at the forefoot joint may produce the anterior-posterior force of the GRF which is defined as the propelling power acting on the human body during walking exercise. The result showed that the impact force peak occurred 40-60 msec before take-off and the propelling part of kick action accounted for only about 6% of the external force.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8123187

  10. Are the mediolateral joint forces in the lower limbs different between scoliotic and healthy subjects during gait?

    PubMed Central

    2015-01-01

    Introduction The quantification of internal joint efforts could be essential in the development of rehabilitation tools for patients with musculo-skeletal pathologies, such as scoliosis. In this context, the aim of this study was to compare the hips joint mediolateral forces during gait, between healthy subjects and adolescents with left lumbar or thoracolumbar scoliosis (AIS), categorized by their Cobb angle (CA). Material and methods Twelve healthy subjects, 12 AIS with CA between 20° and 40° and 16 AIS in pre-operative condition (CA : > 40°) walked at 4 km/h on an instrumented treadmill. The experimental set-up include six infrared cameras allow the computation of the tridimensional (3D) angular displacement and strain gauges located under the motor-driven treadmill allow the computation of ground reaction forces (GRF). The hips joint mediolateral forces were calculated using a 3D inverse dynamic of human body. One-way ANOVA was performed for the maximum, the minimum and the range of medio-lateral forces at each joint of the lower limbs. When appropriate, a Tukey's post hoc was performed to determine the differences. Results The mediolateral forces were significantly lower at the right hip for AIS with CA between 20° and 40° compared to healthy subject. Conclusion The spinal deformation leads to a reduced medio-lateral force at the right hip, which could gradually change the scheme of postural adjustments for AIS during gait. Further research on the quantification of the joint lower limb efforts should include the knee and ankle joints to evaluate the impact of spinal deformation on the lower limb dynamic behaviour in AIS patients. PMID:25810755

  11. Injury patterns to other body regions and load vectors in nearside impact occupants with and without shoulder injuries

    PubMed Central

    Yoganandan, Narayan; Stadter, Gregory W.; Halloway, Dale E.; Pintar, Frank A.

    2013-01-01

    CIREN and NASS-CDS databases were used to analyze nearside impact injuries. Front seat occupants with and without shoulder injuries were examined on an individual basis in both databases. All vehicles were from model year 2000 or newer. Variables such as the type of collision, change in velocity, principal direction force, demographics, injuries scored by the MAIS and ISS metrics, and injuries to the head, thorax, abdomen and pelvis were included. Shoulder injuries included fractures to the humerus, scapula and clavicle, and associated joint traumas. The median changes in velocities for occupants with and without shoulder injuries were 36 and 32 km/h in CIREN and 29 and 32 km/h in NASS databases. Approximately two-thirds of all cases occurred below 40 km/h. In both databases, the clavicle, scapula and humerus fractures, and AC joint dislocations were found, and the scapula fracture was associated with the clavicle, AC joint, acromion and humerus injuries in few occupants. The clavicle fracture was associated with AC joint and humerus injuries only in the NASS database. Thorax, abdomen and pelvic injuries and skull fractures increased with the presence of shoulder injuries in both databases, albeit not at the same rate. Anterior oblique loading was more frequent than pure lateral loading in both databases suggesting the importance of the oblique vector in side impact trauma. These findings underscore a need for detailed examinations of shoulder load-sharing using biomechanical studies to better understand its role in side impact traumas, shoulder biofidelity and injury assessments in dummies. PMID:24406953

  12. Injury patterns to other body regions and load vectors in nearside impact occupants with and without shoulder injuries.

    PubMed

    Yoganandan, Narayan; Stadter, Gregory W; Halloway, Dale E; Pintar, Frank A

    2013-01-01

    CIREN and NASS-CDS databases were used to analyze nearside impact injuries. Front seat occupants with and without shoulder injuries were examined on an individual basis in both databases. All vehicles were from model year 2000 or newer. Variables such as the type of collision, change in velocity, principal direction force, demographics, injuries scored by the MAIS and ISS metrics, and injuries to the head, thorax, abdomen and pelvis were included. Shoulder injuries included fractures to the humerus, scapula and clavicle, and associated joint traumas. The median changes in velocities for occupants with and without shoulder injuries were 36 and 32 km/h in CIREN and 29 and 32 km/h in NASS databases. Approximately two-thirds of all cases occurred below 40 km/h. In both databases, the clavicle, scapula and humerus fractures, and AC joint dislocations were found, and the scapula fracture was associated with the clavicle, AC joint, acromion and humerus injuries in few occupants. The clavicle fracture was associated with AC joint and humerus injuries only in the NASS database. Thorax, abdomen and pelvic injuries and skull fractures increased with the presence of shoulder injuries in both databases, albeit not at the same rate. Anterior oblique loading was more frequent than pure lateral loading in both databases suggesting the importance of the oblique vector in side impact trauma. These findings underscore a need for detailed examinations of shoulder load-sharing using biomechanical studies to better understand its role in side impact traumas, shoulder biofidelity and injury assessments in dummies. PMID:24406953

  13. Excitability of the infraspinatus, but not the middle deltoid, is affected by shoulder elevation angle.

    PubMed

    Lin, Yin-Liang; Christie, Anita; Karduna, Andrew

    2015-06-01

    Although both the rotator cuff and deltoid muscle serve as shoulder abductors, they play different roles in shoulder movement. While the deltoid is a primary abductor, the rotator cuff is a stabilizer. They have different anatomic structures for force production and demonstrate different neuromuscular control at different shoulder angles, as measured by electromyographic activity. Corticospinal excitability may be associated with different neuromuscular control of the deltoid and rotator cuff at different angles. The purpose of this study was to investigate how shoulder joint position influences the corticospinal excitability of the deltoid and rotator cuff muscles. Transcranial magnetic stimulation was used to measure the corticospinal excitability of the middle deltoid and infraspinatus at 0° and 90° of arm elevation. Three parameters, a plateau value, exponential parameter, and threshold, were calculated from the input-output curve of the corticospinal pathway. The plateau value of the infraspinatus was significantly higher at 90° of arm elevation, while there is no difference in the excitability in the middle deltoid between elevation angles. The plateau value of the middle deltoid at 90° was 5 % lower than that at 0°, but the plateau value of infraspinatus at 90° was 55 % higher than that at 0°. This suggests that the modulation of excitability varies with shoulder angle and reveals different neurological mechanism for the roles of the deltoid and rotator cuff. PMID:25814379

  14. Acute Shoulder Injuries in Adults.

    PubMed

    Monica, James; Vredenburgh, Zachary; Korsh, Jeremy; Gatt, Charles

    2016-07-15

    Acute shoulder injuries in adults are often initially managed by family physicians. Common acute shoulder injuries include acromioclavicular joint injuries, clavicle fractures, glenohumeral dislocations, proximal humerus fractures, and rotator cuff tears. Acromioclavicular joint injuries and clavicle fractures mostly occur in young adults as the result of a sports injury or direct trauma. Most nondisplaced or minimally displaced injuries can be treated conservatively. Treatment includes pain management, short-term use of a sling for comfort, and physical therapy as needed. Glenohumeral dislocations can result from contact sports, falls, bicycle accidents, and similar high-impact trauma. Patients will usually hold the affected arm in their contralateral hand and have pain with motion and decreased motion at the shoulder. Physical findings may include a palpable humeral head in the axilla or a dimple inferior to the acromion laterally. Reduction maneuvers usually require intra-articular lidocaine or intravenous analgesia. Proximal humerus fractures often occur in older patients after a low-energy fall. Radiography of the shoulder should include a true anteroposterior view of the glenoid, scapular Y view, and axillary view. Most of these fractures can be managed nonoperatively, using a sling, early range-of-motion exercises, and strength training. Rotator cuff tears can cause difficulty with overhead activities or pain that awakens the patient from sleep. On physical examination, patients may be unable to hold the affected arm in an elevated position. It is important to recognize the sometimes subtle signs and symptoms of acute shoulder injuries to ensure proper management and timely referral if necessary. PMID:27419328

  15. Reductions in knee joint forces with weight loss are attenuated by gait adaptations in class III obesity.

    PubMed

    DeVita, Paul; Rider, Patrick; Hortobágyi, Tibor

    2016-03-01

    A consensus exists that high knee joint forces are a precursor to knee osteoarthritis and weight loss reduces these forces. Because large weight loss also leads to increased step length and walking velocity, knee contact forces may be reduced less than predicted by the magnitude of weight loss. The purpose was to determine the effects of weight loss on knee muscle and joint loads during walking in Class III obese adults. We determined through motion capture, force platform measures and biomechanical modeling the effects of weight loss produced by gastric bypass surgery over one year on knee muscle and joint loads during walking at a standard, controlled velocity and at self-selected walking velocities. Weight loss equaling 412N or 34% of initial body weight reduced maximum knee compressive force by 824N or 67% of initial body weight when walking at the controlled velocity. These changes represent a 2:1 reduction in knee force relative to weight loss when walking velocity is constrained to the baseline value. However, behavioral adaptations including increased stride length and walking velocity in the self-selected velocity condition attenuated this effect by ∼50% leading to a 392N or 32% initial body weight reduction in compressive force in the knee joint. Thus, unconstrained walking elicited approximately 1:1 ratio of reduction in knee force relative to weight loss and is more indicative of walking behavior than the standard velocity condition. In conclusion, massive weight loss produces dramatic reductions in knee forces during walking but when patients stride out and walk faster, these favorable reductions become substantially attenuated. PMID:26979878

  16. Mathematical Model and Calibration Experiment of a Large Measurement Range Flexible Joints 6-UPUR Six-Axis Force Sensor.

    PubMed

    Zhao, Yanzhi; Zhang, Caifeng; Zhang, Dan; Shi, Zhongpan; Zhao, Tieshi

    2016-01-01

    Nowadays improving the accuracy and enlarging the measuring range of six-axis force sensors for wider applications in aircraft landing, rocket thrust, and spacecraft docking testing experiments has become an urgent objective. However, it is still difficult to achieve high accuracy and large measuring range with traditional parallel six-axis force sensors due to the influence of the gap and friction of the joints. Therefore, to overcome the mentioned limitations, this paper proposed a 6-Universal-Prismatic-Universal-Revolute (UPUR) joints parallel mechanism with flexible joints to develop a large measurement range six-axis force sensor. The structural characteristics of the sensor are analyzed in comparison with traditional parallel sensor based on the Stewart platform. The force transfer relation of the sensor is deduced, and the force Jacobian matrix is obtained using screw theory in two cases of the ideal state and the state of flexibility of each flexible joint is considered. The prototype and loading calibration system are designed and developed. The K value method and least squares method are used to process experimental data, and in errors of kind Ι and kind II linearity are obtained. The experimental results show that the calibration error of the K value method is more than 13.4%, and the calibration error of the least squares method is 2.67%. The experimental results prove the feasibility of the sensor and the correctness of the theoretical analysis which are expected to be adopted in practical applications. PMID:27529244

  17. Validation of Shoulder Response of Human Body Finite-Element Model (GHBMC) Under Whole Body Lateral Impact Condition.

    PubMed

    Park, Gwansik; Kim, Taewung; Panzer, Matthew B; Crandall, Jeff R

    2016-08-01

    In previous shoulder impact studies, the 50th-percentile male GHBMC human body finite-element model was shown to have good biofidelity regarding impact force, but under-predicted shoulder deflection by 80% compared to those observed in the experiment. The goal of this study was to validate the response of the GHBMC M50 model by focusing on three-dimensional shoulder kinematics under a whole-body lateral impact condition. Five modifications, focused on material properties and modeling techniques, were introduced into the model and a supplementary sensitivity analysis was done to determine the influence of each modification to the biomechanical response of the body. The modified model predicted substantially improved shoulder response and peak shoulder deflection within 10% of the observed experimental data, and showed good correlation in the scapula kinematics on sagittal and transverse planes. The improvement in the biofidelity of the shoulder region was mainly due to the modifications of material properties of muscle, the acromioclavicular joint, and the attachment region between the pectoralis major and ribs. Predictions of rib fracture and chest deflection were also improved because of these modifications. PMID:26753830

  18. Spacecraft environmental interactions: A joint Air Force and NASA research and technology program

    NASA Technical Reports Server (NTRS)

    Pike, C. P.; Purvis, C. K.; Hudson, W. R.

    1985-01-01

    A joint Air Force/NASA comprehensive research and technology program on spacecraft environmental interactions to develop technology to control interactions between large spacecraft systems and the charged-particle environment of space is described. This technology will support NASA/Department of Defense operations of the shuttle/IUS, shuttle/Centaur, and the force application and surveillance and detection missions, planning for transatmospheric vehicles and the NASA space station, and the AFSC military space system technology model. The program consists of combined contractual and in-house efforts aimed at understanding spacecraft environmental interaction phenomena and relating results of ground-based tests to space conditions. A concerted effort is being made to identify project-related environmental interactions of concern. The basic properties of materials are being investigated to develop or modify the materials as needed. A group simulation investigation is evaluating basic plasma interaction phenomena to provide inputs to the analytical modeling investigation. Systems performance is being evaluated by both groundbased tests and analysis.

  19. Shoulder Kinematics and Spatial Pattern of Trapezius Electromyographic Activity in Real and Virtual Environments

    PubMed Central

    Samani, Afshin; Pontonnier, Charles; Dumont, Georges; Madeleine, Pascal

    2015-01-01

    The design of an industrial workstation tends to include ergonomic assessment steps based on a digital mock-up and a virtual reality setup. Lack of interaction and system fidelity is often reported as a main issue in such virtual reality applications. This limitation is a crucial issue as thorough ergonomic analysis is required for an investigation of the biomechanics. In the current study, we investigated the biomechanical responses of the shoulder joint in a simulated assembly task for comparison with the biomechanical responses in virtual environments. Sixteen male healthy novice subjects performed the task on three different platforms: real (RE), virtual (VE), and virtual environment with force feedback (VEF) with low and high precision demands. The subjects repeated the task 12 times (i.e., 12 cycles). High density electromyography from the upper trapezius and rotation angles of the shoulder joint were recorded and split into the cycles. The angular trajectories and velocity profiles of the shoulder joint angles over a cycle were computed in 3D. The inter-subject similarity in terms of normalized mutual information on kinematics and electromyography was investigated. Compared with RE the task in VE and VEF was characterized by lower kinematic maxima. The inter-subject similarity in RE compared with intra-subject similarity across the platforms was lower in terms of movement trajectories and greater in terms of trapezius muscle activation. The precision demand resulted in lower inter- and intra-subject similarity across platforms. The proposed approach identifies biomechanical differences in the shoulder joint in both VE and VEF compared with the RE platform, but these differences are less marked in VE mostly due to technical limitations of co-localizing the force feedback system in the VEF platform. PMID:25768123

  20. Verification of joint input-state estimation for force identification by means of in situ measurements on a footbridge

    NASA Astrophysics Data System (ADS)

    Maes, K.; Nimmen, K. Van; Lourens, E.; Rezayat, A.; Guillaume, P.; Roeck, G. De; Lombaert, G.

    2016-06-01

    This paper presents a verification of a joint input-state estimation algorithm using data obtained from in situ experiments on a footbridge. The estimation of the input and the system states is performed in a minimum-variance unbiased way, based on a limited number of response measurements and a system model. A dynamic model of the footbridge is obtained using a detailed finite element model that is updated using a set of experimental modal characteristics. The joint input-state estimation algorithm is used for the identification of two impact, harmonic, and swept sine forces applied to the bridge deck. In addition to these forces, unknown stochastic forces, such as wind loads, are acting on the structure. These forces, as well as measurement errors, give rise to uncertainty in the estimated forces and system states. Quantification of the uncertainty requires determination of the power spectral density of the unknown stochastic excitation, which is identified from the structural response under ambient loading. The verification involves comparing the estimated forces with the actual, measured forces. Although a good overall agreement is obtained between the estimated and measured forces, modeling errors prohibit a proper distinction between multiple forces applied to the structure for the case of harmonic and swept sine excitation.

  1. Trunk and Shoulder Kinematic and Kinetic and Electromyographic Adaptations to Slope Increase during Motorized Treadmill Propulsion among Manual Wheelchair Users with a Spinal Cord Injury

    PubMed Central

    Champagne, Audrey

    2015-01-01

    The main objective was to quantify the effects of five different slopes on trunk and shoulder kinematics as well as shoulder kinetic and muscular demands during manual wheelchair (MWC) propulsion on a motorized treadmill. Eighteen participants with spinal cord injury propelled their MWC at a self-selected constant speed on a motorized treadmill set at different slopes (0°, 2.7°, 3.6°, 4.8°, and 7.1°). Trunk and upper limb movements were recorded with a motion analysis system. Net shoulder joint moments were computed with the forces applied to the handrims measured with an instrumented wheel. To quantify muscular demand, the electromyographic activity (EMG) of the pectoralis major (clavicular and sternal portions) and deltoid (anterior and posterior fibers) was recorded during the experimental tasks and normalized against maximum EMG values obtained during static contractions. Overall, forward trunk flexion and shoulder flexion increased as the slope became steeper, whereas shoulder flexion, adduction, and internal rotation moments along with the muscular demand also increased as the slope became steeper. The results confirm that forward trunk flexion and shoulder flexion movement amplitudes, along with shoulder mechanical and muscular demands, generally increase when the slope of the treadmill increases despite some similarities between the 2.7° to 3.6° and 3.6° to 4.8° slope increments. PMID:25793200

  2. Using your shoulder after surgery

    MedlinePlus

    Shoulder surgery - using your shoulder; Shoulder surgery - after ... You had surgery on your shoulder to repair a muscle, tendon, or cartilage tear. The surgeon may have removed damaged tissue. You will need to know how ...

  3. Evaluation of the effect of joint constraints on the in situ force distribution in the anterior cruciate ligament.

    PubMed

    Livesay, G A; Rudy, T W; Woo, S L; Runco, T J; Sakane, M; Li, G; Fu, F H

    1997-03-01

    The function of the anterior cruciate ligament was investigated for different conditions of kinematic constraint placed on the intact knee using a six-degree-of-freedom robotic manipulator combined with a universal force-moment sensor. To do this, the in situ forces and force distribution within the porcine anterior cruciate ligament during anterior tibial loading up to 100 N were compared at 30, 60, and 90 degrees of flexion under: (a) unconstrained, five-degree-of-freedom knee motion, and (b) constrained, one-degree-of-freedom motion (i.e., anterior translations only). The robotic/universal force-moment sensor testing system was used to both apply the specified external loading to the intact joint and measure the resulting kinematics. After tests of the intact knee were completed, all soft tissues except the anterior cruciate ligament were removed, and these motions were reproduced such that the in situ force and force distribution could be determined. No significant differences in the magnitude of in situ forces in the anterior cruciate ligament were found between the unconstrained and constrained testing conditions. In contrast, the direction of in situ force changed significantly; the force vector in the unconstrained case was more parallel with the direction of the applied tibial load. In addition, the distribution of in situ force between the anteromedial and posterolateral bundles of the ligament was nearly equal for all flexion angles for the unconstrained case, whereas the anteromedial bundle carried higher forces than the posterolateral bundle at both 60 and 90 degrees of flexion for the constrained case. This demonstrates that the constraint conditions placed on the joint have a significant effect on the apparent role of the anterior cruciate ligament. Specifically, constraining joint motion to one degree of freedom significantly alters both the direction and distribution of the in situ force in the ligament from that observed for unconstrained joint

  4. Control strategy for stabilizing force with goal-equivalent joint torques is frequency-dependent during human hopping.

    PubMed

    Yen, Jasper T; Chang, Young-Hui

    2009-01-01

    Normal human locomotion requires the ability to control a complex, redundant neuromechanical system to repetitively cycle the legs in a stable manner. In a reduced paradigm of locomotion, hopping, we investigated the ability of human subjects to exploit motor redundancy in the legs to coordinate joint torques fluctuations to minimize force fluctuations generated against the ground. Although we saw invariant performance in terms of force stabilization across frequencies, we found that the role of joint torque coordination in stabilizing force was most important at slow hopping frequencies. Notably, the role of this coordinated variation strategy decreased as hopping frequency increased, giving way to an independent joint variation strategy. At high frequencies, the control strategy to stabilize force was more dependent on a direct reduction in ankle torque fluctuations. Through the systematic study of how joint-level variances affect task-level end-point function, we can gain insight into the underlying control strategies in place for automatically counteracting cycle-to-cycle deviations during normal human locomotion. PMID:19964783

  5. A neural network approach for determining gait modifications to reduce the contact force in knee joint implant.

    PubMed

    Ardestani, Marzieh Mostafavizadeh; Chen, Zhenxian; Wang, Ling; Lian, Qin; Liu, Yaxiong; He, Jiankang; Li, Dichen; Jin, Zhongmin

    2014-10-01

    There is a growing interest in non-surgical gait rehabilitation treatments to reduce the loading in the knee joint. In particular, synergetic kinematic changes required for joint offloading should be determined individually for each subject. Previous studies for gait rehabilitation designs are typically relied on a "trial-and-error" approach, using multi-body dynamic (MBD) analysis. However MBD is fairly time demanding which prevents it to be used iteratively for each subject. This study employed an artificial neural network to develop a cost-effective computational framework for designing gait rehabilitation patterns. A feed forward artificial neural network (FFANN) was trained based on a number of experimental gait trials obtained from literature. The trained network was then hired to calculate the appropriate kinematic waveforms (output) needed to achieve desired knee joint loading patterns (input). An auxiliary neural network was also developed to update the ground reaction force and moment profiles with respect to the predicted kinematic waveforms. The feasibility and efficiency of the predicted kinematic patterns were then evaluated through MBD analysis. Results showed that FFANN-based predicted kinematics could effectively decrease the total knee joint reaction forces. Peak values of the resultant knee joint forces, with respect to the bodyweight (BW), were reduced by 20% BW and 25% BW in the midstance and the terminal stance phases. Impulse values of the knee joint loading patterns were also decreased by 17% BW*s and 24%BW*s in the corresponding phases. The FFANN-based framework suggested a cost-effective forward solution which directly calculated the kinematic variations needed to implement a given desired knee joint loading pattern. It is therefore expected that this approach provides potential advantages and further insights into knee rehabilitation designs. PMID:25066584

  6. Assessing Finger Joint Biomechanics by Applying Equal Force to Flexor Tendons In Vitro Using a Novel Simultaneous Approach

    PubMed Central

    Yang, Tai-Hua; Lu, Szu-Ching; Lin, Wei-Jr; Zhao, Kristin; Zhao, Chunfeng; An, Kai-Nan; Jou, I-Ming; Lee, Pei-Yuan

    2016-01-01

    Background The flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) are critical for finger flexion. Although research has recently focused on these tendons’ coactivity, their contributions in different tasks remain unclear. This study created a novel simultaneous approach to investigate the coactivity between the tendons and to clarify their contributions in different tasks. Methods Ten human cadaveric hands were mounted on our custom frame with the FDS and FDP of the third finger looped through a mechanical pulley connected to a force transducer. Joint range of motion, tendon excursion and loading force were recorded during individual joint motion and free joint movement from rest to maximal flexion. Each flexor tendon’s moment arm was then calculated. Results In individual motions, we found that the FDP contributed more than the FDS in proximal interphalangeal (PIP) joint motion, with an overall slope of 1.34 and all FDP-to-FDS excursion (P/S) ratios greater than 1.0 with force increase. However, the FDP contributed less than the FDS in metacarpophalangeal (MCP) joint motion, with an overall slope of 0.95 and P/S ratios smaller than 1.0 throughout the whole motion except between 1.9% and 13.1% force. In free joint movement, the FDP played a greater role than the FDS, with an overall ratio of 1.37 and all P/S ratios greater than 1.0. Conclusions The new findings include differences in finger performance and excursion amounts between the FDS and FDP throughout flexion. Such findings may provide the basis for new hand models and treatments. PMID:27513744

  7. Design and evaluation of prosthetic shoulder controller

    PubMed Central

    Barton, Joseph E.; Sorkin, John D.

    2015-01-01

    We developed a 2-degree-of-freedom (DOF) shoulder position transducer (sensing shoulder protraction-retraction and elevation-depression) that can be used to control two of a powered prosthetic humerus' DOFs. We also developed an evaluation protocol based on Fitts' law to assess the performance of our device. The primary motivation for this work was to support development of powered prosthetic shoulder joints of a new generation of prosthetic arms for people with shoulder disarticulation and very high-level transhumeral amputation. We found that transducers that provided resistance to shoulder movement performed better than those providing no resistance. We also found that a position control scheme, where effector position is proportional to shoulder position, performed better than a velocity control scheme, where effector velocity is proportional to shoulder position. More generally, our transducer can be used to control motion along any two DOFs. It can also be used in a more general 4-DOF control scheme by sequentially controlling two DOFs at a time. The evaluation protocol has general applicability for researchers and practitioners. Researchers can employ it to compare different prosthesis designs and control schemes, while practitioners may find the evaluation protocol useful in evaluating and training people with amputation in the use of prostheses. PMID:25357185

  8. Inflamed shoulder tendons (image)

    MedlinePlus

    Tearing and inflammation of the tendons of the shoulder muscles can occur in sports which require the ... pitching, swimming, and lifting weights. Most often the shoulder will heal if a break is taken from ...

  9. Ultrasound-Guided Interventional Procedures About the Shoulder: Anatomy, Indications, and Techniques.

    PubMed

    Pourcho, Adam M; Colio, Sean W; Hall, Mederic M

    2016-08-01

    Chronic and acute shoulder pain and dysfunction are common complaints among patients. Shoulder pain may be the result of abnormality involving the rotator cuff, subacromial-subdeltoid bursa, biceps tendon, glenoid labrum, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, or glenohumeral joint capsule. Ultrasound-guided (USG) procedures of the shoulder are well established for interventional management. Ultrasound provides the advantages of excellent soft tissue resolution, injection accuracy, low cost, accessibility, portability, lack of ionizing radiation, and the ability to perform real-time image-guided procedures. The purpose of this article is to review common indications and effective techniques for USG injections about the shoulder. PMID:27468666

  10. [Shoulder impingement].

    PubMed

    Wurnig, C

    2000-10-01

    The impingement syndrome is a common disorder of the shoulder girdle. The causes for this syndrome may be anatomic changes in the coracoacromial arch, also within the ultrastructural regions, on the one hand, or changes in the biomechanics which have developed for various reasons, on the other. Diagnosis is based on roentgenograms using the appropriate technique. In large-scale-studies, sonography has proved to be an extremely sensitive screening method for differential diagnosis of rupture of the rotator cuff. Magnetic resonance imaging might gain in value in the diagnosis of impingement as regards differential diagnosis of rupture of the rotator cuff because this technique--when employed appropriately--allows exact viewing of the soft tissue and the anterior part of the acromion. In the majority of cases conservative treatment is the method of choice. Methods of treatment are sonography, galvanization, and application of heat. Physiotherapy should not be initiated until pain relief has been achieved by other measures. Infiltration therapy is of considerable value in the management of pain due to impingement. Application of cortisone into the subacromial space must also be considered critically. As regards conservative therapy, only few evidence-based publications provide information on the effectiveness of different treatment regimens. Surgical therapy is only indicated in cases of pain resistant to the conservative therapy for a certain period. Furthermore, only an outlet impingement can be treated successfully by surgical decompression. The surgeon decides on the surgical method--open surgery or arthroscopy. Of course, arthroscopic methods are less invasive; however, up to now the superiority of one of the surgical methods over the other could not yet be proven by mid-term clinical results. Other surgical methods such as wedge osteotomy in the region of the spina scapulae are still in the experimental stage. By surgical and conservatives methods, good and even

  11. Rehabilitation of the shoulder in tennis players.

    PubMed

    Plancher, K D; Litchfield, R; Hawkins, R J

    1995-01-01

    The tennis player places unique demands on the shoulder by creating a high risk for overuse and overloading of the soft tissues. Tennis requires concentric work to position and move the arm, eccentric work to stabilize the shoulder, effective depression of the humeral head to avoid impingement in the overhead position, and normal stability to prevent secondary impingement. The tennis serve produces enormous angular velocities about the shoulder joint. A comprehensive rehabilitation program has been described in which the therapist, trainer, player, and physician alike need to have an understanding of the basic biomechanics of this sport. This program can be used to treat the painful shoulder, prevent injury, and enhance performance. PMID:7712546

  12. Nonfatal air embolism during shoulder arthroscopy.

    PubMed

    Pandey, Vivek; Varghese, Elsa; Rao, Madhu; Srinivasan, Nataraj M; Mathew, Neethu; Acharya, Kiran K V; Rao, P Sripathi

    2013-06-01

    An air embolism is a rare but potentially fatal complication of shoulder arthroscopy. In this article, we report the case of a patient who developed a nonfatal air embolism during shoulder arthroscopy for an acute bony Bankart lesion and a greater tuberosity avulsion fracture. The venous air embolism occurred immediately after the joint was insufflated with air for diagnostic air arthroscopy. The diagnosis was based on a drop in end-tidal carbon dioxide and blood pressure and presence of mill wheel (waterwheel) murmur over the right heart. Supportive treatment was initiated immediately. The patient recovered fully and had no further complications of air embolism. This patient's case emphasizes the importance of being aware that air embolisms can occur during shoulder arthroscopy performed for acute intra-articular fractures of the shoulder. Monitoring end tidal carbon dioxide can be very useful in early detection of air embolisms. PMID:23805421

  13. Evaluation of regression-based 3-D shoulder rhythms.

    PubMed

    Xu, Xu; Dickerson, Clark R; Lin, Jia-Hua; McGorry, Raymond W

    2016-08-01

    The movements of the humerus, the clavicle, and the scapula are not completely independent. The coupled pattern of movement of these bones is called the shoulder rhythm. To date, multiple studies have focused on providing regression-based 3-D shoulder rhythms, in which the orientations of the clavicle and the scapula are estimated by the orientation of the humerus. In this study, six existing regression-based shoulder rhythms were evaluated by an independent dataset in terms of their predictability. The datasets include the measured orientations of the humerus, the clavicle, and the scapula of 14 participants over 118 different upper arm postures. The predicted orientations of the clavicle and the scapula were derived from applying those regression-based shoulder rhythms to the humerus orientation. The results indicated that none of those regression-based shoulder rhythms provides consistently more accurate results than the others. For all the joint angles and all the shoulder rhythms, the RMSE are all greater than 5°. Among those shoulder rhythms, the scapula lateral/medial rotation has the strongest correlation between the predicted and the measured angles, while the other thoracoclavicular and thoracoscapular bone orientation angles only showed a weak to moderate correlation. Since the regression-based shoulder rhythm has been adopted for shoulder biomechanical models to estimate shoulder muscle activities and structure loads, there needs to be further investigation on how the predicted error from the shoulder rhythm affects the output of the biomechanical model. PMID:26253991

  14. Shoulder Problems in Athletes.

    ERIC Educational Resources Information Center

    Clancy, William G., Jr.

    A description is given of typical sport-related injuries to the shoulder area. These include: (1) brachial plexus injuries; (2) peripheral nerve injuries about the shoulder; (3) acromioclavicular injuries; (4) sternoclavicular injuries; (5) shoulder dislocations; (6) recurrent traumatic subluxation/dislocations; and (7) overuse injuries.…

  15. Assessment of a three-point restraint system with a pre-tensioned lap belt and an inflatable, force-limited shoulder belt.

    PubMed

    Kent, Richard; Lopez-Valdes, Francisco J; Dennis, Nate J; Lessley, David; Forman, Jason; Higuchi, Kazuo; Tanji, Hiromasa; Ato, Tadayuki; Kameyoshi, Hikaru; Arbogast, Kristy

    2011-11-01

    This study investigates the performance of a 3-point restraint system incorporating an inflatable shoulder belt with a nominal 2.5-kN load limiter and a non-inflatable lap belt with a pretensioner (the "Airbelt"). Frontal impacts with PMHS in a rear seat environment are presented and the Airbelt system is contrasted with an earlier 3-point system with inflatable lap and shoulder belts but no load-limiter or pretensioners, which was evaluated with human volunteers in the 1970s but not fully reported in the open literature (the "Inflataband"). Key differences between the systems include downward pelvic motion and torso recline with the Inflataband, while the pelvis moved almost horizontally and the torso pitched forward with the Airbelt. One result of these kinematic differences was an overall more biomechanically favorable restraint loading but greater maximum forward head excursion with the Airbelt. The Airbelt is shown to generate generally lower head, neck, and thoracic injury metrics and PMHS trauma than other, non-inflatable rear-seat restraint concepts (viz., a standard 3-point belt and a pre-tensioned shoulder belt with a progressive load limiter). Further study is needed to evaluate the Airbelt system for different size occupants (e.g., children), non-frontal impact vectors, and for out-of-position occupants and to allow the results with this particular system to be generalized to a broader range of Airbelt designs. PMID:22869308

  16. Operational Stress and Correlates of Mental Health Among Joint Task Force Guantanamo Bay Military Personnel.

    PubMed

    Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L

    2015-12-01

    Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample. PMID:26595460

  17. On the organizing role of nonmuscular forces during performance of a giant circle in gymnastics.

    PubMed

    Sevrez, Violaine; Rao, Guillaume; Berton, Eric; Bootsma, Reinoud J

    2012-02-01

    Five elite gymnasts performed giant circles on the high bar under different conditions of loading (without and with 6-kg loads attached to the shoulders, waist or ankles). Comparing the gymnasts' kinematic pattern of movement with that of a triple-pendulum moving under the sole influence of nonmuscular forces revealed qualitative similarities, including the adoption of an arched position during the downswing and a piked position during the upswing. The structuring role of nonmuscular forces in the organization of movement was further reinforced by the results of an inverse dynamics analysis, assessing the contributions of gravitational, inertial and muscular components to the net joint torques. Adding loads at the level of the shoulders, waist or ankles systematically influenced movement kinematics and net joint torques. However, with the loads attached at the level of the shoulders or waist, the load-induced changes in gravitational and inertial torques provided the required increase in net joint torque, thereby allowing the muscular torques to remain unchanged. With the loads attached at the level of the ankles, this was no longer the case and the gymnasts increased the muscular torques at the shoulder and hip joints. Together, these results demonstrate that expert gymnasts skillfully exploit the operative nonmuscular forces, employing muscle force only in the capacity of complementary forces needed to perform the task. PMID:21975422

  18. Like Father, Like Son: Assessment of the Morphological Affinities of A.L. 288–1 (A. afarensis), Sts 7 (A. africanus) and Omo 119–73–2718 (Australopithecus sp.) through a Three-Dimensional Shape Analysis of the Shoulder Joint

    PubMed Central

    Arias-Martorell, Julia; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-01-01

    The postcranial evidence for the Australopithecus genus indicates that australopiths were able bipeds; however, the morphology of the forelimbs and particularly that of the shoulder girdle suggests that they were partially adapted to an arboreal lifestyle. The nature of such arboreal adaptations is still unclear, as are the kind of arboreal behaviors in which australopiths might have engaged. In this study we analyzed the shape of the shoulder joint (proximal humerus and glenoid cavity of the scapula) of three australopith specimens: A.L. 288–1 (A. afarensis), Sts 7 (A. africanus) and Omo 119–73–2718 (Australopithecus sp.) with three-dimensional geometric morphometrics. The morphology of the specimens was compared with that of a wide array of living anthropoid taxa and some additional fossil hominins (the Homo erectus specimen KNM-WT 15000 and the H. neanderthalensis specimen Tabun 1). Our results indicate that A.L. 288–1 shows mosaic traits resembling H. sapiens and Pongo, whereas the Sts 7 shoulder is most similar to the arboreal apes and does not present affinities with H. sapiens. Omo 119–73–2718 exhibits morphological affinities with the more arboreal and partially suspensory New World monkey Lagothrix. The shoulder of the australopith specimens thus shows a combination of primitive and derived traits (humeral globularity, enhancement of internal and external rotation of the joint), related to use of the arm in overhead positions. The genus Homo specimens show overall affinities with H. sapiens at the shoulder, indicating full correspondence of these hominin shoulders with the modern human morphotype. PMID:25651542

  19. Like father, like son: assessment of the morphological affinities of A.L. 288-1 (A. afarensis), Sts 7 (A. africanus) and Omo 119-73-2718 (Australopithecus sp.) through a three-dimensional shape analysis of the shoulder joint.

    PubMed

    Arias-Martorell, Julia; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-01-01

    The postcranial evidence for the Australopithecus genus indicates that australopiths were able bipeds; however, the morphology of the forelimbs and particularly that of the shoulder girdle suggests that they were partially adapted to an arboreal lifestyle. The nature of such arboreal adaptations is still unclear, as are the kind of arboreal behaviors in which australopiths might have engaged. In this study we analyzed the shape of the shoulder joint (proximal humerus and glenoid cavity of the scapula) of three australopith specimens: A.L. 288-1 (A. afarensis), Sts 7 (A. africanus) and Omo 119-73-2718 (Australopithecus sp.) with three-dimensional geometric morphometrics. The morphology of the specimens was compared with that of a wide array of living anthropoid taxa and some additional fossil hominins (the Homo erectus specimen KNM-WT 15000 and the H. neanderthalensis specimen Tabun 1). Our results indicate that A.L. 288-1 shows mosaic traits resembling H. sapiens and Pongo, whereas the Sts 7 shoulder is most similar to the arboreal apes and does not present affinities with H. sapiens. Omo 119-73-2718 exhibits morphological affinities with the more arboreal and partially suspensory New World monkey Lagothrix. The shoulder of the australopith specimens thus shows a combination of primitive and derived traits (humeral globularity, enhancement of internal and external rotation of the joint), related to use of the arm in overhead positions. The genus Homo specimens show overall affinities with H. sapiens at the shoulder, indicating full correspondence of these hominin shoulders with the modern human morphotype. PMID:25651542

  20. Fatigue Damage Evaluation of Friction Stir Spot Welded Cross-Tension Joints Under Repeated Two-Step Force Amplitudes

    NASA Astrophysics Data System (ADS)

    Joy-A-Ka, Sutep; Ogawa, Yuki; Akebono, Hiroyuki; Kato, Masahiko; Sugeta, Atsushi; Sun, Yufeng; Fujii, Hidetoshi

    2015-06-01

    This paper investigates an approach to evaluate the fatigue damage of FSSW cross-tension specimens under two-step force amplitude conditions. In fatigue tests with repeated two-step force amplitude, the fatigue limit of the welded joint disappeared. However, the fatigue damage evaluation using the modified Miner's rule erred too much on the side of safety, as the modified Miner's rule tends to overestimate the damage by applied forces below the fatigue limit. Thus, it was determined that, within the testing conditions used in this study, the fatigue damage evaluation using Haibach's method yielded an accurate evaluation. In the case where significant plastic deformation caused by the applied force occurred near the welded zone, the cumulative fatigue damage value based on Miner's rule was often larger than unity. Therefore, it is important to consider a cumulative damage estimation that takes into account the effect of pre-strain from the high force amplitude.

  1. Joint positioning sense, perceived force level and two-point discrimination tests of young and active elderly adults

    PubMed Central

    Franco, Priscila G.; Santos, Karini B.; Rodacki, André L. F.

    2015-01-01

    Background: Changes in the proprioceptive system are associated with aging. Proprioception is important to maintaining and/or recovering balance and to reducing the risk of falls. Objective: To compare the performance of young and active elderly adults in three proprioceptive tests. Method: Twenty-one active elderly participants (66.9±5.5 years) and 21 healthy young participants (24.6±3.9 years) were evaluated in the following tests: perception of position of the ankle and hip joints, perceived force level of the ankle joint, and two-point discrimination of the sole of the foot. Results: No differences (p>0.05) were found between groups for the joint position and perceived force level. On the other hand, the elderly participants showed lower sensitivity in the two-point discrimination (higher threshold) when compared to the young participants (p < 0.01). Conclusion: Except for the cutaneous plantar sensitivity, the active elderly participants had maintained proprioception. Their physical activity status may explain similarities between groups for the joint position sense and perceived force level, however it may not be sufficient to prevent sensory degeneration with aging. PMID:26443978

  2. Shoulder and elbow injuries in the adolescent athlete.

    PubMed

    Krabak, Brian J; Alexander, Eric; Henning, Troy

    2008-05-01

    The shoulder and elbow represent two of the most commonly injured joints in the adolescent population. Specific injuries vary by sport and can involve various structures, depending on the mechanism of injury. Unlike the adult shoulder, the immature skeletal structure of the adolescent athlete can lead to several unique injuries. By understanding the special demands placed on the immature shoulder, the sports physician can more effectively treat the resultant injury. This article reviews the diagnosis and management of unique injuries to the shoulder and elbow in the adolescent athlete. PMID:18395648

  3. MRI of the shoulder

    SciTech Connect

    Zlatkin, M.B.; Iannotti, J.P.; Schnall, M.D.

    1991-01-01

    This book reports on the use of magnetic resonance imaging (MRI) in evaluating shoulder disorders. The book gives detailed information on MRI techniques and shoulder anatomy, describes and illustrates MRI findings for a wide range of shoulder disorders, and explains how abnormalities seen on MIR images relate to pathophysiology and clinical signs. Special attention is given to imaging of rotator cuff disease and shoulder instability conditions for which MRI is the imaging procedure of choice. Complementing the text are 365 high-quality scans depicting normal shoulder anatomy and showing the wide variety of pathologic findings encountered in practice.

  4. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis.

    PubMed

    Prinold, Joe A I; Mazzà, Claudia; Di Marco, Roberto; Hannah, Iain; Malattia, Clara; Magni-Manzoni, Silvia; Petrarca, Maurizio; Ronchetti, Anna B; Tanturri de Horatio, Laura; van Dijkhuizen, E H Pieter; Wesarg, Stefan; Viceconti, Marco

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients' joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural damage progression. A number of lower-limb musculoskeletal models have been proposed to analyse the hip and knee joints, but juvenile models of the foot are still lacking. This paper presents a modelling pipeline that allows the creation of juvenile patient-specific models starting from lower limb kinematics and foot and ankle MRI data. This pipeline has been applied to data from three children with JIA and the importance of patient-specific parameters and modelling assumptions has been tested in a sensitivity analysis focused on the variation of the joint reaction forces. This analysis highlighted the criticality of patient-specific definition of the ankle joint axes and location of the Achilles tendon insertions. Patient-specific detection of the Tibialis Anterior, Tibialis Posterior, and Peroneus Longus origins and insertions were also shown to be important. PMID:26374518

  5. Specific Shoulder Pathoanatomy in Semiprofessional Water Polo Players

    PubMed Central

    Klein, Maria; Tarantino, Ignazio; Warschkow, René; Berger, Claus Joachim; Zdravkovic, Vilijam; Jost, Bernhard; Badulescu, Michael

    2014-01-01

    Background: Shoulders of throwing and swimming athletes are highly stressed joints that often show structural abnormalities on magnetic resonance imaging (MRI). However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described. Purpose: To assess specific MRI abnormalities in shoulders of elite water polo players and to compare these findings with a healthy control group. Study Design: Cross-sectional study; Level of evidence, 3. Methods: After performing a power analysis, volunteers were recruited for this study. Both shoulders of 28 semiprofessional water polo players and 15 healthy volunteers were assessed clinically (based on the Constant score) and had bilateral shoulder MRIs. The shoulders were clustered into 3 groups: 28 throwing and 28 nonthrowing shoulders of water polo athletes and 30 shoulders of healthy control subjects. Results: Twenty-eight male water polo players with an average age of 24 years and 15 healthy subjects (30 shoulders) with an average age of 31 years were examined. Compared with controls, significantly more MRI abnormalities in the water polo players' throwing shoulders could be found in the subscapularis, infraspinatus, and posterior labrum (P = .001, P = .024, and P = .041, respectively). Other structures showed no statistical differences between the 3 groups, including the supraspinatus tendon, which had abnormalities in 36% of throwing versus 32% of nonthrowing shoulders and 33% of control shoulders. All throwing shoulders showed abnormal findings in the MRI, but only 8 (29%) were symptomatic. Conclusion: The shoulders of semiprofessional water polo players demonstrated abnormalities in subscapularis and infraspinatus tendons that were not typical abnormalities for swimmers or throwing athletes. Clinical Relevance: The throwing shoulders of water polo players have specific MRI changes. Clinical symptoms do not correlate with the MRI findings

  6. [Biomechanics of the shoulder and therapeutic applications].

    PubMed

    Weinstabl, R; Huber, G; Kropik, K; Khakpour, Z; Barisani, G R; Fialka, C; Krösel, P

    1996-12-01

    The influence of biomechanics in surgery of the locomotor apparatus has been constantly increasing over the last few decades. The purpose of this study was to determine wether biomechanical studies can significantly influence therapy and treatment of shoulder injuries, especially shoulder instability. The investigation was performed on 23 fresh human specimens with intact capsular ligaments of the glenohumeral joint. A Bankart lesion from 3 o'clock to 6 o'clock was repaired, and a Bankart repair and anterior inferior capsular shift, as described by Neer, were performed. The measurement was done on six clinically relevant positions of instability: superior, anterior, anterior-inferior, inferior, posterior-inferior, posterior. Measurement was done using a specially developed strain-gauge system. It was demonstrated that both instability and too much stability of the shoulder joint lead to a significant change in shoulder biomechanics. The anatomical O-position of the glenohumeral joint in 110 degrees of abduction is a position of about 60 degrees of external rotation compared to the O-position for clinical measurement. From the therapy point of view, one has to ask for anatomical reconstruction instead of tight repair in soft-tissue repair in the glenohumeral joint. Immediate post-operative rehabilitation in a 60 degrees range of motion is possible. PMID:9082480

  7. Prediction of medial and lateral contact force of the knee joint during normal and turning gait after total knee replacement.

    PubMed

    Purevsuren, Tserenchimed; Dorj, Ariunzaya; Kim, Kyungsoo; Kim, Yoon Hyuk

    2016-04-01

    The computational modeling approach has commonly been used to predict knee joint contact forces, muscle forces, and ligament loads during activities of daily living. Knowledge of these forces has several potential applications, for example, within design of equipment to protect the knee joint from injury and to plan adequate rehabilitation protocols, although clinical applications of computational models are still evolving and one of the limiting factors is model validation. The objective of this study was to extend previous modeling technique and to improve the validity of the model prediction using publicly available data set of the fifth "Grand Challenge Competition to Predict In Vivo Knee Loads." A two-stage modeling approach, which combines conventional inverse dynamic analysis (the first stage) with a multi-body subject-specific lower limb model (the second stage), was used to calculate medial and lateral compartment contact forces. The validation was performed by direct comparison of model predictions and experimental measurement of medial and lateral compartment contact forces during normal and turning gait. The model predictions of both medial and lateral contact forces showed strong correlations with experimental measurements in normal gait (r = 0.75 and 0.71) and in turning gait trials (r = 0.86 and 0.72), even though the current technique over-estimated medial compartment contact forces in swing phase. The correlation coefficient, Sprague and Geers metrics, and root mean squared error indicated that the lateral contact forces were predicted better than medial contact forces in comparison with the experimental measurements during both normal and turning gait trials. PMID:26908641

  8. Improved orthopedic arm joint

    NASA Technical Reports Server (NTRS)

    Dane, D. H.

    1971-01-01

    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  9. A symptomatic coracoclavicular joint.

    PubMed

    Cheung, T F S; Boerboom, A L; Wolf, R F E; Diercks, R L

    2006-11-01

    Bilateral coracoclavicular joints were found in a 44-year-old male patient following a fall. He had an Indonesian mother and a Dutch father. Prior to the injury he was asymptomatic and had full range of movement in both shoulders but the trauma resulted in pain and limitation of movement in the left shoulder which required resection of the anomalous joint, after which full pain-free movement was restored. PMID:17075101

  10. Shoulder Pain and Common Shoulder Problems

    MedlinePlus

    ... and muscles around the shoulder become loose or torn, dislocations can occur repeatedly. Recurring dislocations, which may ... involve arthroscopy to remove scar tissue or repair torn tissues, or traditional, open procedures for larger reconstructions ...

  11. Managing shoulder dystocia.

    PubMed

    Brew, J

    1993-01-01

    In midwifery textbooks not much has been written about the management of shoulder dystocia, although it sometimes occurs, and midwives conducting the delivery have to know how to manage it. Should dystocia occurs when the shoulders are stuck in the antero-posterior diameter of the outlet. Sometimes the shoulders fail to rotate into the antero-posterior diameter; in this situation the shoulders are in the oblique diameter of the outlet. This usually happens when the baby is big, weighing more than 4 kilograms. In such cases, the head is big, and it is difficult to deliver the face and the chin. The woman should be in lithotomy position, with the buttocks slightly beyond the end of the bed. The baby's air passages should be sucked of mucus and liquid, so that respiration is initiated. A wide episiotomy should be performed to enlarge the outlet. If the shoulders are in the oblique diameter of the outlet, the midwife should correct the position by hooking a finger into the anterior axilla and rotate the shoulders forward to the antero-posterior diameter of the outlet, before attempting to deliver the shoulders. The next step is the delivery of the posterior shoulder. The midwife puts a finger into the axilla of the posterior shoulder, and by gentle traction downwards, the posterior shoulder is freed. After this, the anterior shoulder is delivered the normal way. This can be aided by applying pressure on the anterior shoulder above the pubic. If the above management fails, then the assistance of the obstetrician must be sought. It is important to recognize large babies before birth in order to initiate appropriate measures before the woman goes into labor. During delivery, the shoulders must be rotated into the antero-posterior diameter of the outlet before attempting to deliver them. PMID:12179356

  12. Motion of the Shoulder Complex During Multiplanar Humeral Elevation

    PubMed Central

    Ludewig, Paula M.; Phadke, Vandana; Braman, Jonathan P.; Hassett, Daniel R.; Cieminski, Cort J.; LaPrade, Robert F.

    2009-01-01

    Background: Many prior studies have evaluated shoulder motion, yet no three-dimensional analysis comparing the combined clavicular, scapular, and humeral motion during arm elevation has been done. We aimed to describe and compare dynamic three-dimensional motion of the shoulder complex during raising and lowering the arm across three distinct elevation planes (flexion, scapular plane abduction, and coronal plane abduction). Methods: Twelve subjects without a shoulder abnormality were enrolled. Transcortical pin placement into the clavicle, scapula, and humerus allowed electromagnetic motion sensors to be rigidly fixed. The subjects completed two repetitions of raising and lowering the arm in flexion, scapular, and abduction planes. Three-dimensional angles were calculated for sternoclavicular, acromioclavicular, scapulothoracic, and glenohumeral joint motions. Joint angles between humeral elevation planes and between raising and lowering of the arm were compared. Results: General patterns of shoulder motion observed during humeral elevation were clavicular elevation, retraction, and posterior axial rotation; scapular internal rotation, upward rotation, and posterior tilting relative to the clavicle; and glenohumeral elevation and external rotation. Clavicular posterior rotation predominated at the sternoclavicular joint (average, 31°). Scapular posterior tilting predominated at the acromioclavicular joint (average, 19°). Differences between flexion and abduction planes of humerothoracic elevation were largest for the glenohumeral joint plane of elevation (average, 46°). Conclusions: Overall shoulder motion consists of substantial angular rotations at each of the four shoulder joints, enabling the multiple-joint interaction required to elevate the arm overhead. Clinical Relevance: Improved knowledge of the normal motion of the shoulder during humeral elevation will improve the assessment of patients with shoulder motion abnormalities, planning for rehabilitation

  13. Integration of marker and force data to compute three-dimensional joint moments of the thumb and index finger digits during pinch

    PubMed Central

    Nataraj, Raviraj; Li, Zong-Ming

    2014-01-01

    This study presents methodology to determine joint moments of the digits of the hand during pinch function. This methodology incorporates steps to identify marker-based kinematic data defining aligned coordinate systems for individual digit segments and joint center locations. The kinematic data are then transformed to a common reference frame along with the force data collected at pinch contact of a customized apparatus in three-dimensions (3-D). These methods were demonstrated with a pilot investigation to examine the static joint moments occurring during two-digit oppositional precision pinch at a particular endpoint force level applied at the digit pads. Notable abduction joint moments at the proximal joints of both digits were observed, which implicate the role of respective intrinsic and extrinsic muscles in maintaining pinch grasp. Examining differences in joint moment results when substituting select steps of this methodological approach suggested greater relative importance for joint center identification and segment coordinate system alignment. PMID:23947659

  14. Shoulder pain in primary care: frozen shoulder.

    PubMed

    Cadogan, Angela; Mohammed, Khalid D

    2016-03-01

    BACKGROUND AND CONTEXT Frozen shoulder is a painful condition that follows a protracted clinical course. We aim to review the management of patients with a diagnosis of frozen shoulder who are referred for specialist orthopaedic evaluation against existing guidelines in primary care. ASSESSMENT OF PROBLEM Referrals and clinical records were reviewed for all patients referred for orthopaedic specialist assessment who received a specialist diagnosis of frozen shoulder. Diagnostic, investigation and management practices from a regional primary health care setting in New Zealand were compared with guideline-recommended management. RESULTS Eighty patients with frozen shoulder were referred for orthopaedic evaluation in the 13 month study period, mostly from general practice. Fifteen patients (19%) were identified as having a frozen shoulder in their medical referral. Most (99%) had received previous imaging. Seven patients (12%) had received guideline recommended treatment. STRATEGIES FOR IMPROVEMENT Education of all clinicians involved in patient management is important to ensure an understanding of the long natural history of frozen shoulder and provide reassurance that outcomes are generally excellent. HealthPathways now include more information regarding diagnosis, imaging and evidence-based management for frozen shoulder. LESSONS Frozen shoulder may be under-diagnosed among patients referred for orthopaedic review. Ultrasound imaging is commonly used and may identify occult and unrelated pathology in this age-group. When managed according to clinical guidelines, patients report significant clinical and functional improvement with most reporting 80% function compared with normal after 1 year. KEYWORDS Adhesive capsulitis; bursitis; injections; practice guideline; primary health care; ultrasound. PMID:27477374

  15. Septic Arthritis of the Shoulder Complicating Pregnancy

    PubMed Central

    Raiser, Sara; Davidson, Kathryn; Walsh, Ashley; Egerman, Robert

    2014-01-01

    Septic arthropathy leads to rapid joint destruction, impairment, and disability. Staphylococcus can be particularly virulent to bone and joints leading to adverse obstetric events. At 28 of weeks gestation, a patient presented with pyelonephritis and progressive left shoulder pain. Magnetic resonance imaging indicated early clavicular destruction and acromial involvement. Glenohumeral joint aspiration produced Staphylococcus aureus. The patient then had premature rupture of membranes and progressed rapidly to preterm delivery. Placental pathology revealed chorioamnionitis and microabscesses. Treatment of the infected joint required further surgical drainage and bone resection as well as extended antibiotics. It is important to remember that joint pain in pregnancy may indicate infective arthritis, and pyelonephritis can be a source of such an infection. Evaluation includes magnetic resonance imaging and consultation for joint aspiration. Prompt recognition and treatment are necessary to prevent joint destruction. PMID:24959364

  16. Relation between isometric muscle force and surface EMG in intrinsic hand muscles as function of the arm geometry.

    PubMed

    Del Santo, Francesco; Gelli, Francesca; Ginanneschi, Federica; Popa, Traian; Rossi, Alessandro

    2007-08-13

    Evidence exists that shoulder joint geometry influences recruitment efficiency and force-generating capacity of hand muscles [Ginanneschi, F., Del Santo, F., Dominici, F., Gelli, F., Mazzocchio, R., Rossi, A., 2005. Changes in corticomotor excitability of hand muscles in relation to static shoulder positions. Exp. Brain Res. 161 (3), 374-382; Dominici, F., Popa, T., Ginanneschi, F., Mazzocchio, R., Rossi, A., 2005. Cortico-motoneural output to intrinsic hand muscles is differentially influenced by static changes in shoulder positions. Exp. Brain Res. 164 (4), 500-504]. The present study was designed to examine the impact of changing shoulder joint position on the relation between surface EMG amplitude and isometric force production of the abductor digiti minimi muscle (ADM). EMG-force relation of ADM was examined in two shoulder positions: 30 degrees adduction (ANT) and 30 degrees abduction (POST) on the horizontal plane, i.e. under higher and lower force-generating capacity, respectively. The relation was studied over the full range isometric force (10-100% of maximum force in 10% increments, 3 s duration) by analysing root mean square (RMS), median frequency (Mf) of the power spectrum and non-linear recurrence quantification analysis (percentage of determinism: %DET) of the surface EMG signals. We found that in POST, the slope of the RMS-force relation was significantly higher than in ANT, while its general shape (strictly linear) was preserved. Averaged Mf of the EMG power spectrum was significantly higher in POST that in ANT, while no difference in %DET was observed between the two shoulder positions. The higher slope of the EMG-force relation in POST than in ANT is interpreted in terms of increased gain of the excitatory drive-firing rate relation. It is concluded that discharge from sensory receptors signalling shoulder position may act to regulate the gain of the excitatory drive-firing rate relation of motoneurones in order to compensate for reduced

  17. Inter-joint coupling strategy during adaptation to novel viscous loads in human arm movement.

    PubMed

    Debicki, D B; Gribble, P L

    2004-08-01

    When arm movements are perturbed by a load, how does the nervous system adjust control signals to reduce error? While it has been shown that the nervous system is capable of compensating for the effects of limb dynamics and external forces, the strategies used to adapt to novel loads are not well understood. We used a robotic exoskeleton [kinesiological instrument for normal and altered reaching movements (KINARM)] to apply novel loads to the arm during single-joint elbow flexions in the horizontal plane (shoulder rotation was allowed). Loads varied in magnitude with the instantaneous velocity of elbow flexion, and were applied to the shoulder in experiment 1 (interaction loads) and the elbow in experiment 2 (direct loads). Initial exposure to both interaction and direct loads resulted in perturbations at both joints, even though the load was applied to only a single joint. Subjects tended to correct for the kinematics of the elbow joint while perturbations at the shoulder persisted. Electromyograms (EMGs) and computed muscle torque showed that subjects modified muscle activity at the elbow to reduce elbow positional deviations. Shoulder muscle activity was also modified; however, these changes were always in the same direction as those at the elbow. Current models of motor control based on inverse-dynamics calculations and force-control, as well as models based on positional control, predict an uncoupling of shoulder and elbow muscle torques for adaptation to these loads. In contrast, subjects in this study adopted a simple strategy of modulating the natural coupling that exists between elbow and shoulder muscle torque during single-joint elbow movements. PMID:15056688

  18. Development and performance evaluation of a multi-PID muscle loading driven in vitro active-motion shoulder simulator and application to assessing reverse total shoulder arthroplasty.

    PubMed

    Giles, Joshua William; Ferreira, Louis Miguel; Athwal, George Singh; Johnson, James Andrew

    2014-12-01

    In vitro active shoulder motion simulation can provide improved understanding of shoulder biomechanics; however, accurate simulators using advanced control theory have not been developed. Therefore, our objective was to develop and evaluate a simulator which uses real-time kinematic feedback and closed loop proportional integral differential (PID) control to produce motion. The simulator's ability to investigate a clinically relevant variable-namely muscle loading changes resulting from reverse total shoulder arthroplasty (RTSA)-was evaluated and compared to previous findings to further demonstrate its efficacy. Motion control of cadaveric shoulders was achieved by applying continuously variable forces to seven muscle groups. Muscle forces controlling each of the three glenohumeral rotational degrees of freedom (DOF) were modulated using three independent PID controllers running in parallel, each using measured Euler angles as their process variable. Each PID controller was configured and tuned to control the loading of a set of muscles which, from previous in vivo investigations, were found to be primarily responsible for movement in the PID's DOF. The simulator's ability to follow setpoint profiles for abduction, axial rotation, and horizontal extension was assessed using root mean squared error (RMSE) and average standard deviation (ASD) for multiple levels of arm mass replacement. A specimen was then implanted with an RTSA, and the effect of joint lateralization (0, 5, 10 mm) on the total deltoid force required to produce motion was assessed. Maximum profiling error was <2.1 deg for abduction and 2.2 deg for horizontal extension with RMSE of <1 deg. The nonprofiled DOF were maintained to within 5.0 deg with RMSE <1.0 deg. Repeatability was high, with ASDs of <0.31 deg. RMSE and ASD were similar for all levels of arm mass replacement (0.73-1.04 and 0.14-0.22 deg). Lateralizing the joint's center of rotation (CoR) increased total deltoid force by up to 8.5% body

  19. The developing shoulder has a limited capacity to recover after a short duration of neonatal paralysis

    PubMed Central

    Potter, Ryan; Havlioglu, Necat; Thomopoulos, Stavros

    2014-01-01

    Mechanical stimuli are required for the proper development of the musculoskeletal system. Removal of muscle forces during fetal or early post-natal timepoints impairs the formation of bone, tendon, and their attachment (the enthesis). The goal of the current study was to examine the capacity of the shoulder to recover after a short duration of neonatal rotator cuff paralysis, a condition mimicking the clinical condition neonatal brachial plexus palsy. We asked if reapplication of muscle load to a transiently paralyzed muscle would allow for full recovery of tissue properties. CD-1 mice were injected with botulinum toxin A to paralyze the supraspinatus muscle from birth through 2 weeks and subsequently allowed to recover. The biomechanics of the enthesis was determined using tensile testing and the morphology of the shoulder joint was determined using micro computed tomography and histology. A recovery period of at least 10 weeks was required to achieve control properties, demonstrating a limited capacity of the shoulder to recover after only two weeks of muscle paralysis. Although care must be taken when extrapolating results from an animal model to the human condition, the results of the current study imply that treatment of neonatal brachial plexus palsy should be aggressive, as even short periods of paralysis could lead to long-term deficiencies in enthesis biomechanics and shoulder morphology. PMID:24831237

  20. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  1. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  2. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  3. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened... the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle...

  4. Bilateral Traumatic Anterior Dislocation of Shoulder - A Rare Entity

    PubMed Central

    Kumar, Yashavantha C; Nalini, K B; Maini, Lalit; Nagaraj, Prashanth

    2013-01-01

    Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy. Case report: A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted. There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks. Conclusion: Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored. PMID:27298892

  5. Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking

    PubMed Central

    Nha, Kyung Wook; Shin, Jun Ho; Kim, Jong In; Kwon, Jae Ho; Kim, Yoon Hyuk

    2013-01-01

    Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments. PMID:24302973

  6. Pharmacy Faculty Workplace Issues: Findings From the 2009-2010 COD-COF Joint Task Force on Faculty Workforce

    PubMed Central

    Peirce, Gretchen L.; Crabtree, Brian L.; Acosta, Daniel; Early, Johnnie L.; Kishi, Donald T.; Nobles-Knight, Dolores; Webster, Andrew A.

    2011-01-01

    Many factors contribute to the vitality of an individual faculty member, a department, and an entire academic organization. Some of the relationships among these factors are well understood, but many questions remain unanswered. The Joint Task Force on Faculty Workforce examined the literature on faculty workforce issues, including the work of previous task forces charged by the American Association of Colleges of Pharmacy (AACP). We identified and focused on 4 unique but interrelated concepts: organizational culture/climate, role of the department chair, faculty recruitment and retention, and mentoring. Among all 4 resides the need to consider issues of intergenerational, intercultural, and gender dynamics. This paper reports the findings of the task force and proffers specific recommendations to AACP and to colleges and schools of pharmacy. PMID:21769139

  7. Acromion-fixation of glenoid components in total shoulder arthroplasty.

    PubMed

    Murphy, Linda A; Prendergast, Patrick J

    2005-08-01

    Successful design of components for total shoulder arthroplasty has proven to be challenging. This is because of the difficulties in maintaining fixation of the component that inserts into the scapula; i.e., the glenoid component. Glenoid components that are fixated to both the glenoid and acromion (a long process extending medially on the dorsal aspect of the scapula) have the possible advantage of greater stability over those that are fixated to the glenoid alone. In this study, a finite element analysis is used to investigate whether or not acromion fixation is advantageous for glenoid components. Full muscle loading and joint reaction forces are included in the finite element model. Reflective photoelasticity of five scapulae is used to obtain experimental data to compare with results from the finite element analysis, and it confirms the structural behaviour of the finite element model. When implanted with an acromion-fixated prosthesis, it is found that high unphysiological stresses occur in the scapula bone, and that stresses in the fixation are not reduced. Very high stresses are predicted in that part of the prosthesis which connects the acromion to the glenoid. It is found that the very high stresses are partly in response to the muscle and joint reaction forces acting at the acromion. It is concluded that, because of the relatively high forces acting at the acromion, fixation to it may not be the way forward in glenoid component design. PMID:15958228

  8. A Comparative Study on Shoulder Rotational Strength, Range of Motion and Proprioception between the Throwing Athletes and Non-athletic Persons

    PubMed Central

    Nodehi-Moghadam, Afsun; Nasrin, Nasrin; Kharazmi, Aleeyehsadat; Eskandari, Zahra

    2012-01-01

    Purpose The repetitive micro traumatic stresses placed on the athletes shoulder joint complex during the throwing motion challenge the surrounding tissues. The purpose of this study was to compare shoulder rotational strength, range of motion and proprioception between the throwing athletes and non-athletic persons. Methods Fifteen throwing athletes and 15 non-athletes participated in a nonrandom case – control study. Strength of shoulder rotational movements was tested with a hand held dynamometer. The ranges of internal and external rotation of shoulder were measured by a standard goniometer. The ability of subjects to replicate the target position and kinesthetic sense was examined on the subjects’ right shoulder by using a continuous passive motion device. Independent and paired t tests were used to statistically analyze between and within group differences. Results No significant difference was detected on the range of internal rotation between throwing athletes and non-athletic candidates (P=0.3). The range of external rotation was significantly more in athletic subjects (P=0.03). The results also showed that throwing athletes demonstrated a significantly higher isometric strength of shoulder external and internal rotation than the non-athletic group (P<0.05). However, the comparison of the internal and external rotation strength of dominant side in each group showed that throwing athletes showed a significant lower isometric strength of shoulder external rotation than internal rotation (P<0.001). It was also demonstrated higher joint position acuity in the throwing athletes than non athlete subjects (P=0.01). Conclusion The repetitive nature of overhead throwing and the high forces that it causes result in adaptive changes of the dominant extremity. Throwing can lead to mobility, strength and neural adaptation. PMID:23785574

  9. Increase in joint stability at the expense of energy efficiency correlates with force variability during a fatiguing task.

    PubMed

    Cashaback, Joshua G A; Cluff, Tyler

    2015-02-26

    Empirical evidence suggests that our nervous system considers many objectives when performing various tasks. With the progression of fatigue, researchers have noted increase in both joint moment variability and muscular cocontraction during isometric force production tasks. Muscular cocontraction increases joint stability, but is metabolically costly. Thus, our nervous system must select a compromise between joint stability and energy efficiency. Interestingly, the continuous increase in cocontraction with fatigue suggests there may be a shift in the relative weighting of these objectives. Here we test the notion of dynamic objective weightings. Using multi-objective optimization, we found a shift in objective weighting that favoured joint stability at the expense of energy efficiency during fatigue. This shift was highly correlated with muscular cocontraction (R(2)=0.78, p<0.001) and elbow moment variability in the time (R(2)=0.56, p<0.01) and frequency (R(2)=0.57, p<0.01) domains. By considering a dynamic objective weighting we obtained strong correlations with predicted and collected muscle activity (R(2)=0.94, p<0.001). PMID:25597814

  10. Ten questions on prosthetic shoulder infection.

    PubMed

    Pinder, Elizabeth M; Ong, Joshua Cy; Bale, R Stephen; Trail, Ian A

    2016-07-01

    Prosthetic shoulder infection can cause significant morbidity secondary to pain and stiffness. Symptoms may be present for years before diagnosis because clinical signs are often absent and inflammatory markers may be normal. An emerging common culprit, Propionibacterium acnes, is hard to culture and so prolonged incubation is necessary. A negative culture result does not always exclude infection and new synovial fluid biochemical markers such as α defensin are less sensitive than for lower limb arthroplasty. A structured approach is necessary when assessing patients for prosthetic shoulder joint infection. This includes history, examination, serum inflammatory markers, plain radiology and aspiration and/or biopsy. A classification for the likelihood of prosthetic shoulder infection has been described based on culture, pre-operative and intra-operative findings. Treatment options include antibiotic suppression, debridement with component retention, one-stage revision, two-stage revision and excision arthroplasty. Revision arthroplasty is associated with the best outcomes. PMID:27583013

  11. Ten questions on prosthetic shoulder infection

    PubMed Central

    Pinder, Elizabeth M; Ong, Joshua CY; Bale, R Stephen

    2016-01-01

    Prosthetic shoulder infection can cause significant morbidity secondary to pain and stiffness. Symptoms may be present for years before diagnosis because clinical signs are often absent and inflammatory markers may be normal. An emerging common culprit, Propionibacterium acnes, is hard to culture and so prolonged incubation is necessary. A negative culture result does not always exclude infection and new synovial fluid biochemical markers such as α defensin are less sensitive than for lower limb arthroplasty. A structured approach is necessary when assessing patients for prosthetic shoulder joint infection. This includes history, examination, serum inflammatory markers, plain radiology and aspiration and/or biopsy. A classification for the likelihood of prosthetic shoulder infection has been described based on culture, pre-operative and intra-operative findings. Treatment options include antibiotic suppression, debridement with component retention, one-stage revision, two-stage revision and excision arthroplasty. Revision arthroplasty is associated with the best outcomes. PMID:27583013

  12. Total Shoulder Arthroplasty

    PubMed Central

    Sanchez-Sotelo, Joaquin

    2011-01-01

    Shoulder arthroplasty has been the subject of marked advances over the last few years. Modern implants provide a wide range of options, including resurfacing of the humeral head, anatomic hemiarthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty and trauma-specific implants for fractures and nonunions. Most humeral components achieve successful long-term fixation without bone cement. Cemented all-polyethylene glenoid components remain the standard for anatomic total shoulder arthroplasty. The results of shoulder arthroplasty vary depending on the underlying diagnosis, the condition of the soft-tissues, and the type of reconstruction. Total shoulder arthroplasty seems to provide the best outcome for patients with osteoarthritis and inflammatory arthropathy. The outcome of hemiarthroplasty for proximal humerus fractures is somewhat unpredictable, though it seems to have improved with the use of fracture-specific designs, more attention to tuberosity repair, and the selective use of reverse arthroplasty, as well as a shift in indications towards internal fixation. Reverse shoulder arthroplasty has become extremely popular for patients with cuff-tear arthropathy, and its indications have been expanded to the field of revision surgery. Overall, shoulder arthroplasty is a very successful procedure with predictable pain relief and substantial improvements in motion and function. PMID:21584206

  13. Biomechanics of Reverse Shoulder Arthroplasty: 
Current Concepts.

    PubMed

    Lorenzetti, Adam J; Stone, Geoffrey P; Simon, Peter; Frankle, Mark A

    2016-01-01

    The evolution of reverse shoulder arthroplasty has provided surgeons with new solutions for many complex shoulder problems. A primary goal of orthopaedics is the restoration or re-creation of functional anatomy to reduce pain and improve function, which can be accomplished by either repairing injured structures or replacing them as anatomically as possible. If reconstructible tissue is lacking or not available, which is seen in patients who have complex shoulder conditions such as an irreparable rotator cuff-deficient shoulder, cuff tear arthropathy, or severe glenoid bone loss, substantial problems may arise. Historically, hemiarthroplasty or glenoid grafting with total shoulder arthroplasty yielded inconsistent and unsatisfactory results. Underlying pathologies in patients who have an irreparable rotator cuff-deficient shoulder, cuff tear arthropathy, or severe glenoid bone loss can considerably alter the mechanical function of the shoulder and create treatment dilemmas that are difficult to overcome. A better biomechanical understanding of these pathologic adaptations has improved treatment options. In the past three decades, reverse total shoulder arthroplasty was developed to treat these complex shoulder conditions not by specifically re-creating the anatomy but by using the remaining functional tissue to improve shoulder balance. Reverse total shoulder arthroplasty has achieved reliable improvements in both pain and function. Initial implant designs lacked scientific evidence to support the design rationale, and many implants failed because surgeons did not completely understand the forces involved or the pathology being treated. Implant function and clinical results will continue to improve as surgeons' biomechanical understanding of shoulder disease and reverse shoulder arthroplasty implants increases. PMID:27049186

  14. CURRENT CONCEPTS IN SHOULDER EXAMINATION OF THE OVERHEAD ATHLETE

    PubMed Central

    Ellenbecker, Todd

    2013-01-01

    Examination of the shoulder complex has long been described as challenging. This is particularly true in the examination of the overhead athlete who has structural differences when compared to a shoulder patient who is a non‐athlete. Complexity with the examination is due to unique biomechanical and structural changes, multiple joint articulations, multiple pain patterns, and the potential of injury to structures both inside (intra‐articular) and outside (extra‐articular) the glenohumeral joint. Repetitive stresses placed on the shoulders of overhead athletes may affect range of motion, strength, scapular position, and ultimately, the integrity of soft tissue and bony structures in any of the joints that comprise the shoulder complex. Furthermore, many shoulder examination tests thought to be unique to a single structure, joint, or condition can be positive in multiple conditions. The examination of the overhead athletes shoulder, coupled with a thorough medical history will provide a solid foundation to allow a functional physical therapy diagnosis and provide clues as to the presence of the lesion (s) causing disability. The purpose of this clinical commentary is to assist the reader to understand the unique physical characteristics of the overhead athlete, which will lead to a more accurate and reproducible evaluation of athletes who sustain injuries while participating in overhead sports. Level of Evidence: 5 PMID:24175138

  15. Effect of clenching on biomechanical response of human mandible and temporomandibular joint to traumatic force analyzed by finite element method

    PubMed Central

    Yamamoto, Kazuhiko; Sugiura, Tsutomu; Kawakami, Masayoshi; Kang, Yu B.; Tsutsumi, Sadami; Kirita, Tadaaki

    2013-01-01

    Purpose: The purpose of the present study was to analyze the effect of clenching on the biomechanical response of human mandible and temporomandibular joint (TMJ) to traumatic force by the finite element (FE) method. Material and Methods: FE models of the mandible and the TMJ in resting and clenching positions were prepared. Distribution and magnitude of von Mises stress were analyzed by applying force as a point load in the symphyseal, canine, body and angle regions of the mandible. In addition, strain energy density (SED) at the articular disc and in posterior connective tissue of TMJ was analyzed. Results: In the resting position, von Mises stress was mainly concentrated at the condylar neck and in the retromolar region of the mandible. In the clenching position, the stress at the condylar neck decreased in all loadings. The stress in the retromolar region similary decreased in the symphyseal, canine and body loading, respectively; however, higher stress was observed in the retromolar region on the loading side in the angle loading. High SED was generated at the articular disc and in posterior connective tissues of TMJ in the resting position. The SED in these tissues decreased in all loadings in the clenching position. Conclusions: Clenching generally reduces stress at the condylar neck and in the retromolar region of the mandible, and strain energy at the articular disc and in posterior connective tissue of TMJ by traumatic forces on the mandible; however, clenching induces greater stress in the retromolar region on the loading side by traumatic force to the angle region. Key words:Mandibular, temporomandibular joint, traumatic force, clenching, finite element analysis. PMID:23524422

  16. Psychophysical testing of visual prosthetic devices: a call to establish a multi-national joint task force

    NASA Astrophysics Data System (ADS)

    Rizzo, Joseph F., III; Ayton, Lauren N.

    2014-04-01

    Recent advances in the field of visual prostheses, as showcased in this special feature of Journal of Neural Engineering , have led to promising results from clinical trials of a number of devices. However, as noted by these groups there are many challenges involved in assessing vision of people with profound vision loss. As such, it is important that there is consistency in the methodology and reporting standards for clinical trials of visual prostheses and, indeed, the broader vision restoration research field. Two visual prosthesis research groups, the Boston Retinal Implant Project (BRIP) and Bionic Vision Australia (BVA), have agreed to work cooperatively to establish a multi-national Joint Task Force. The aim of this Task Force will be to develop a consensus statement to guide the methods used to conduct and report psychophysical and clinical results of humans who receive visual prosthetic devices. The overarching goal is to ensure maximum benefit to the implant recipients, not only in the outcomes of the visual prosthesis itself, but also in enabling them to obtain accurate information about this research with ease. The aspiration to develop a Joint Task Force was first promulgated at the inaugural 'The Eye and the Chip' meeting in September 2000. This meeting was established to promote the development of the visual prosthetic field by applying the principles of inclusiveness, openness, and collegiality among the growing body of researchers in this field. These same principles underlie the intent of this Joint Task Force to enhance the quality of psychophysical research within our community. Despite prior efforts, a critical mass of interested parties could not congeal. Renewed interest for developing joint guidelines has developed recently because of a growing awareness of the challenges of obtaining reliable measurements of visual function in patients who are severely visually impaired (in whom testing is inherently noisy), and of the importance of

  17. Functional outcomes assessment in shoulder surgery

    PubMed Central

    Wylie, James D; Beckmann, James T; Granger, Erin; Tashjian, Robert Z

    2014-01-01

    The effective evaluation and management of orthopaedic conditions including shoulder disorders relies upon understanding the level of disability created by the disease process. Validated outcome measures are critical to the evaluation process. Traditionally, outcome measures have been physician derived objective evaluations including range of motion and radiologic evaluations. However, these measures can marginalize a patient’s perception of their disability or outcome. As a result of these limitations, patient self-reported outcomes measures have become popular over the last quarter century and are currently primary tools to evaluate outcomes of treatment. Patient reported outcomes measures can be general health related quality of life measures, health utility measures, region specific health related quality of life measures or condition specific measures. Several patients self-reported outcomes measures have been developed and validated for evaluating patients with shoulder disorders. Computer adaptive testing will likely play an important role in the arsenal of measures used to evaluate shoulder patients in the future. The purpose of this article is to review the general health related quality-of-life measures as well as the joint-specific and condition specific measures utilized in evaluating patients with shoulder conditions. Advances in computer adaptive testing as it relates to assessing dysfunction in shoulder conditions will also be reviewed. PMID:25405091

  18. Active Vibration Control of a Large Flexible Manipulator by Inertial Force and Joint Torque. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Lee, Soo Han

    1988-01-01

    The efficiency and positional accuracy of a lightweight flexible manipulator are limited by its flexural vibrations, which last after a gross motion is completed. The vibration delays subsequent operations. In the proposed work, the vibration is suppressed by inertial force of a small arm in addition to the joint actuators and passive damping treatment. The proposed approach is: (1) Dynamic modeling of a combined system, a large flexible manipulator and a small arm, (2) Determination of optimal sensor location and controller algorithm, and (3) Verification of the fitness of model and the performance of controller.

  19. Epinephrine-enhanced computed tomographic arthrography of the canine shoulder.

    PubMed

    De Rycke, Lieve; van Bree, Henri; Van Caelenberg, Annemie; Polis, Ingeborgh; Duchateau, Luc; Gielen, Ingrid

    2015-10-01

    The aim of this study was to investigate the effect of epinephrine-enhanced computed tomographic arthrography (CTA) on the image sharpness of the lateral and medial glenohumeral ligaments (LGHL and MGHL, respectively), biceps tendon (BT) and joint cartilage (JC) in the canine shoulder. The shoulders of eight normal dogs were examined using a 4-slice helical CT scanner. The right shoulders were injected with Iohexol and the left shoulders with a mixture of Iohexol and epinephrine. CTA images were obtained after 1, 3, 5, 9, 13, 20 and 30 min and the image sharpness of the intra-articular structures in both shoulders was graded for visibility. The attenuation values were measured to examine the persistence of contrast appearance. Admixture of epinephrine and Iohexol significantly improved the image sharpness of the LGHL and the BT, especially on delayed CTA images. The use of epinephrine did not negatively affect post-CTA recovery. PMID:26412512

  20. Calculation of joint moments following foot contact across two force plates.

    PubMed

    Wong, Andrew Y C; Sangeux, Morgan; Baker, Richard

    2010-02-01

    This study aimed to quantify the effect of combining the measurements from force plates when a subject's foot comes in contact with more than one force plate. A 3-Dimensional Gait Analysis (3DGA) was performed on a subject walking barefoot. Ten gait trials (good both) were captured where both subject's feet hit a single force plate. Then 20 gait trials (two force plates) were captured where either the right or left subject's foot was in contact with two force plates at a time. Kinematics were computed with VICON Plugin Gait and kinetics with a BodyLanguage (VICON, Oxford, UK) model that allowed the combination of force plate measurements. The kinetics traces from both sets of data were compared using variance component analysis. Results suggest that effects of how the moments were calculated were at most a third of those arising from stride to stride variability. This suggests that development of automated systems for determining foot contact coupled with arrays of more and smaller force plates than are commonly used might be useful to ensure the capture of good quality kinetic data in a wide range of patients. PMID:20005718

  1. Psychophysical testing of visual prosthetic devices: a call to establish a multi-national joint task force

    NASA Astrophysics Data System (ADS)

    Rizzo, Joseph F., III; Ayton, Lauren N.

    2014-04-01

    Recent advances in the field of visual prostheses, as showcased in this special feature of Journal of Neural Engineering , have led to promising results from clinical trials of a number of devices. However, as noted by these groups there are many challenges involved in assessing vision of people with profound vision loss. As such, it is important that there is consistency in the methodology and reporting standards for clinical trials of visual prostheses and, indeed, the broader vision restoration research field. Two visual prosthesis research groups, the Boston Retinal Implant Project (BRIP) and Bionic Vision Australia (BVA), have agreed to work cooperatively to establish a multi-national Joint Task Force. The aim of this Task Force will be to develop a consensus statement to guide the methods used to conduct and report psychophysical and clinical results of humans who receive visual prosthetic devices. The overarching goal is to ensure maximum benefit to the implant recipients, not only in the outcomes of the visual prosthesis itself, but also in enabling them to obtain accurate information about this research with ease. The aspiration to develop a Joint Task Force was first promulgated at the inaugural 'The Eye and the Chip' meeting in September 2000. This meeting was established to promote the development of the visual prosthetic field by applying the principles of inclusiveness, openness, and collegiality among the growing body of researchers in this field. These same principles underlie the intent of this Joint Task Force to enhance the quality of psychophysical research within our community. Despite prior efforts, a critical mass of interested parties could not congeal. Renewed interest for developing joint guidelines has developed recently because of a growing awareness of the challenges of obtaining reliable measurements of visual function in patients who are severely visually impaired (in whom testing is inherently noisy), and of the importance of

  2. Joint instability and osteoarthritis.

    PubMed

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  3. Joint Instability and Osteoarthritis

    PubMed Central

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  4. Experimental Validation of a Tibiofemoral Model for Analyzing Joint Force Distribution

    PubMed Central

    Miller, Emily J.; Riemer, Rose F.; Haut Donahue, Tammy L.; Kaufman, Kenton R.

    2009-01-01

    A computational model of the tibiofemoral joint utilizing the discrete element analysis method has been developed and validated with human cadaveric knees. The computational method can predict load distributions to within a Root Mean Square Error (RMSE) of 3.6%. The model incorporates subject-specific joint geometry and the health of the subjects’ articular cartilage to determine the cartilage stiffness. It also includes the collateral and cruciate ligaments and utilizes stiffness values derived from literature for these elements. Comparisons of the total load, peak load, and peak load location for axial, varus, and valgus loading conditions confirmed that there was less than 4% RMSE between the analytical and experimental results. The model presented in this paper can generate results with minimal computational time and it can be used as a non-invasive method for characterizing and monitoring subject-specific knee loading patterns. PMID:19389677

  5. An unusual presentation of thoracoacromial artery pseudoaneurysm following shoulder arthroplasty

    PubMed Central

    Wright, Anna Elizabeth; Wall, Michael; Slaney, Penny; Downing, Richard

    2014-01-01

    Pseudoaneurysms of peripheral arteries are not an uncommon condition presenting to vascular surgeons. Perioperative injury and infection are two of the commonest causes. We describe a case of an 82-year-old lady, who presented 10 years following right shoulder joint replacement, with a sharply marginated erythematous cutaneous eruption over the right shoulder. Subsequent angiography revealed a pseudoaneurysm of the acromial branch of the thoracoacromial artery. Planned intervention was superseded by a further embolic episode, which prompted immediate percutaneous translumninal embolisation of the aneurysm. The aetiology of a pseudoaneurysm 10 years following shoulder arthroplasty is discussed. PMID:24973348

  6. Development of a Finite Element Model of the Human Shoulder to Investigate the Mechanical Responses and Injuries in Side Impact

    NASA Astrophysics Data System (ADS)

    Iwamoto, Masami; Miki, Kazuo; Yang, King H.

    Previous studies in both fields of automotive safety and orthopedic surgery have hypothesized that immobilization of the shoulder caused by the shoulder injury could be related to multiple rib fractures, which are frequently life threatening. Therefore, for more effective occupant protection, it is important to understand the relationship between shoulder injury and multiple rib fractures in side impact. The purpose of this study is to develop a finite element model of the human shoulder in order to understand this relationship. The shoulder model included three bones (the humerus, scapula and clavicle) and major ligaments and muscles around the shoulder. The model also included approaches to represent bone fractures and joint dislocations. The relationships between shoulder injury and immobilization of the shoulder are discussed using model responses for lateral shoulder impact. It is also discussed how the injury can be related to multiple rib fractures.

  7. Secondary synovial chondromatosis of the shoulder.

    PubMed

    Ji, Jong-Hun; Shafi, Mohamed; Jeong, Dong-Seok

    2015-09-01

    Synovial chondromatosis is classified as either primary or secondary. Primary synovial chondromatosis results from a proliferation of chondrocytes in the synovial membrane leading to the formation of cartilaginous loose bodies. Secondary synovial chondromatosis is a rare condition characterized by the growth of separated particles from the articular cartilage or osteophytes in joint diseases. The present article aims to report the secondary chondromatosis of the shoulder and to discuss the clinical manifestations, pathogenesis, diagnosis, histological findings and management of this condition. PMID:24803015

  8. SHOULDER ARTHROPLASTY RECORDS

    PubMed Central

    Filho, Geraldo Motta; Galvão, Marcus Vinicius; Monteiro, Martim; Cohen, Marcio; Brandão, Bruno

    2015-01-01

    The study's objective is to evaluate the characteristics and problems of patients who underwent shoulder arthroplasties between July 2004 and November 2006. Methodology: During the period of the study, 145 shoulder arthroplasties were performed. A prospective protocol was used for every patient; demographic, clinical and surgical procedure data were collected. All gathered data were included in the data base. The patients were divided in three major groups: fractures, degenerative diseases and trauma sequels. Information obtained from the data base was correlated in order to determine patients' epidemiologic, injuries, and surgical procedure profiles. Results: Of the 145 shoulder arthroplasties performed, 37% presented trauma sequels, 30% degenerative diseases, and 33% proximal humerus fracture. 12% of the cases required total arthroplasties and 88% partial arthroplasties. Five major complications were observed on early postoperative period. Conclusion: Shoulder arthroplasties have become a common procedure in orthopaedic practice. Surgical records are important in evidencing progressive evolution and in enabling future clinical outcomes evaluation. PMID:26998463

  9. Shoulder MRI scan

    MedlinePlus

    ... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

  10. What Are Shoulder Problems?

    MedlinePlus

    ... between the collarbone and the shoulder blade are torn. The injury is most often caused by a ... others can be very painful. Treatment for a torn rotator cuff depends on age, health, how severe ...

  11. Exercise and Shoulder Pain

    MedlinePlus

    ... of four small muscles (known as the rotator cuff) and another five muscles that stabilize the scapula ( ... Adequate strength and endurance of both the rotator cuff and shoulder blade stabilizing muscles (trapezius, levator scapula, ...

  12. Shoulder MRI scan

    MedlinePlus

    ... an imaging test that uses energy from powerful magnets and to create pictures of the shoulder area. ... in your eyes) Because the MRI contains strong magnets, metal objects are not allowed in the room ...

  13. Frozen shoulder - aftercare

    MedlinePlus

    Adhesive capsulitis - aftercare; Frozen shoulder syndrome - aftercare ... Krabak BJ, Banks NL. Adhesive capsulitis. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation . 2nd ed. Philadelphia, PA: Elsevier Saunders;2008: ...

  14. Force.

    ERIC Educational Resources Information Center

    Gamble, Reed

    1989-01-01

    Discusses pupil misconceptions concerning forces. Summarizes some of Assessment of Performance Unit's findings on meaning of (1) force, (2) force and motion in one dimension and two dimensions, and (3) Newton's second law. (YP)

  15. Kinetic chain abnormalities in the athletic shoulder.

    PubMed

    Sciascia, Aaron; Thigpen, Charles; Namdari, Surena; Baldwin, Keith

    2012-03-01

    Overhead activities require the shoulder to be exposed to and sustain repetitive loads. The segmental activation of the body's links, known as the kinetic chain, allows this to occur effectively. Proper muscle activation is achieved through generation of energy from the central segment or core, which then transfers the energy to the terminal links of the shoulder, elbow, and hand. The kinetic chain is best characterized by 3 components: optimized anatomy, reproducible efficient motor patterns, and the sequential generation of forces. However, tissue injury and anatomic deficits such as weakness and/or tightness in the leg, pelvic core, or scapular musculature can lead to overuse shoulder injuries. These injuries can be prevented and maladaptations can be detected with a thorough understanding of biomechanics of the kinetic chain as it relates to overhead activity. PMID:22311288

  16. Conference-EC-US Task Force Joint US-EU Workshop on Metabolomics and Environmental Biotechnology

    SciTech Connect

    PI: Lily Y. Young Co-PI: Gerben J. Zylstra

    2009-06-04

    Since 1990, the EC-US Task Force on Biotechnology Research has been coordinating transatlantic efforts to guide and exploit the ongoing revolution in biotechnology and the life sciences. The Task Force was established in June 1990 by the European Commission and the White House Office of Science and Technology Policy. The Task Force has acted as an effective forum for discussion, coordination, and development of new ideas for the last 18 years. Task Force members are European Commission and US Government science and technology administrators who meet annually to enhance communication across the Atlantic, and to encourage collaborative research. Through sponsoring workshops, and other activities, the Task Force also brings together scientific leaders and early career researchers from both sides of the Atlantic to forecast research challenges and opportunities and to promote better links between researchers. Over the years, by keeping a focus on the future of science, the Task Force has played a key role in establishing a diverse range of emerging scientific fields, including biodiversity research, neuroinformatics, genomics, nanobiotechnology, neonatal immunology, transkingdom molecular biology, biologically-based fuels, and environmental biotechnology. The EC-US Task Force has sponsored a number of Working Groups on topics of mutual transatlantic interest. The idea to create a Working Group on Environmental Biotechnology research was discussed in the Task Force meeting of October 1993. The EC-US Working Group on Environmental Biotechnology set as its mission 'To train the next generation of leaders in environmental biotechnology in the United States and the European Union to work collaboratively across the Atlantic.' Since 1995, the Working Group supported three kinds of activities, all of which focus one early career scientists: (1) Workshops on the use of molecular methods and genomics in environmental biotechnology; (2) Short courses with theoretical, laboratory

  17. Posterior instability caused by batter's shoulder.

    PubMed

    Kang, Richard W; Mahony, Gregory T; Harris, Thomas C; Dines, Joshua S

    2013-10-01

    In summary, batter’s shoulder is a rare and only recently recognized entity. This condition is posterior shoulder instability caused by a missed attempt at hitting a pitch, especially with an outside pitch. The lack of counterforce from hitting a ball produces increased forces imparted on the posterior capsulolabral complex of the lead shoulder during batting. If the player fails conservative management, she or he can undergo an arthroscopic posterior labral repair instead of debridement. After treatment, the player can expect to return to play after approximately 6 to 7 months. Initial results from a small, retrospective series demonstrate greater than 90% excellent results. These findings are similar to current literature for arthroscopic treatment of posterior instability, which reports success rates that range from 75% to 91%. Longer-term follow-up will be needed to determine the natural history and prognosis or batter’s shoulder. Based on initial results, the authors predict good to excellent results for most players with batter’s shoulder who undergo proper treatment. Additionally, with the exception of switch hitters, the nonthrowing arm is affected. This can also improve the athlete’s return to play. PMID:24079435

  18. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release.

    PubMed

    Arce, Guillermo

    2015-12-01

    Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery. PMID:26870652

  19. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release

    PubMed Central

    Arce, Guillermo

    2015-01-01

    Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery. PMID:26870652

  20. Education for the World of Work. Report of the Joint Task Force.

    ERIC Educational Resources Information Center

    Colorado State Board for Community Colleges and Occupational Education, Denver. Div. of Occupational Education.

    A task force convened by the Colorado State Board for Community Colleges and Occupational Education and the Colorado Department of Education met in 1984-85 to seek ways to bring vocational education, industrial arts education, and general education closer together in the preparation of students for entry into the world of work. This report…

  1. Natural Gas Deliverability Task Force report: A joint FERC/DOE project. [Contains glossary

    SciTech Connect

    Not Available

    1992-09-01

    The purpose of the FERC/DOE Natural Gas Deliverability Task Force Report was threefold: (1) to review current deliverability data for utility, accuracy, and timeliness; (2) to identify mechanisms for closing significant gaps in information resulting from changing market structures; and (3) to ensure that technologies are available to meet the needs of the emerging, competitive natural gas industry.

  2. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty.

    PubMed

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-03-18

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  3. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

    PubMed Central

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-01-01

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  4. Analysis of joint force and torque for the human and non-human ape foot during bipedal walking with implications for the evolution of the foot.

    PubMed

    Wang, Weijie; Abboud, Rami J; Günther, Michael M; Crompton, Robin H

    2014-08-01

    The feet of apes have a different morphology from those of humans. Until now, it has merely been assumed that the morphology seen in humans must be adaptive for habitual bipedal walking, as the habitual use of bipedal walking is generally regarded as one of the most clear-cut differences between humans and apes. This study asks simply whether human skeletal proportions do actually enhance foot performance during human-like bipedalism, by examining the influence of foot proportions on force, torque and work in the foot joints during simulated bipedal walking. Skeletons of the common chimpanzee, orangutan, gorilla and human were represented by multi-rigid-body models, where the components of the foot make external contact via finite element surfaces. The models were driven by identical joint motion functions collected from experiments on human walking. Simulated contact forces between the ground and the foot were found to be reasonably comparable with measurements made during human walking using pressure- and force-platforms. Joint force, torque and work in the foot were then predicted. Within the limitations of our model, the results show that during simulated human-like bipedal walking, (1) the human and non-human ape (NHA) feet carry similar joint forces, although the distributions of the forces differ; (2) the NHA foot incurs larger joint torques than does the human foot, although the human foot has higher values in the first tarso-metatarsal and metatarso-phalangeal joints, whereas the NHA foot incurs higher values in the lateral digits; and (3) total work in the metatarso-phalangeal joints is lower in the human foot than in the NHA foot. The results indicate that human foot proportions are indeed well suited to performance in normal human walking. PMID:24925580

  5. Analysis of joint force and torque for the human and non-human ape foot during bipedal walking with implications for the evolution of the foot

    PubMed Central

    Wang, Weijie; Abboud, Rami J; Günther, Michael M; Crompton, Robin H

    2014-01-01

    The feet of apes have a different morphology from those of humans. Until now, it has merely been assumed that the morphology seen in humans must be adaptive for habitual bipedal walking, as the habitual use of bipedal walking is generally regarded as one of the most clear-cut differences between humans and apes. This study asks simply whether human skeletal proportions do actually enhance foot performance during human-like bipedalism, by examining the influence of foot proportions on force, torque and work in the foot joints during simulated bipedal walking. Skeletons of the common chimpanzee, orangutan, gorilla and human were represented by multi-rigid-body models, where the components of the foot make external contact via finite element surfaces. The models were driven by identical joint motion functions collected from experiments on human walking. Simulated contact forces between the ground and the foot were found to be reasonably comparable with measurements made during human walking using pressure- and force-platforms. Joint force, torque and work in the foot were then predicted. Within the limitations of our model, the results show that during simulated human-like bipedal walking, (1) the human and non-human ape (NHA) feet carry similar joint forces, although the distributions of the forces differ; (2) the NHA foot incurs larger joint torques than does the human foot, although the human foot has higher values in the first tarso-metatarsal and metatarso-phalangeal joints, whereas the NHA foot incurs higher values in the lateral digits; and (3) total work in the metatarso-phalangeal joints is lower in the human foot than in the NHA foot. The results indicate that human foot proportions are indeed well suited to performance in normal human walking. PMID:24925580

  6. Shouldering the load, maximising value.

    PubMed

    Baillie, Jonathan

    2015-02-01

    In mid-November last year Ryhurst signed what it dubbed 'a ground-breaking strategic estates partnership' agreement with the Isle of Wight NHS Trust (HEJ - January 2015). Under the Wight Life Partnership, the two organisations will work in partnership 'to comprehensively review the estate across all the Trust's sites to ensure that buildings and grounds are being fully utilised, and suitable for modern healthcare'. This is Ryhurst's third such 'whole estate' joint-venture agreement with the NHS, and the first with a non-Foundation Trust, harnessing an approach that sees the company shoulder a considerable part of the burden of making optimum use of, and deriving 'maximum value' from, large healthcare estates. HEJ editor, Jonathan Baillie, reports. PMID:26268015

  7. Distribution of joint local and total size and of extension for avalanches in the Brownian force model.

    PubMed

    Delorme, Mathieu; Le Doussal, Pierre; Wiese, Kay Jörg

    2016-05-01

    The Brownian force model is a mean-field model for local velocities during avalanches in elastic interfaces of internal space dimension d, driven in a random medium. It is exactly solvable via a nonlinear differential equation. We study avalanches following a kick, i.e., a step in the driving force. We first recall the calculation of the distributions of the global size (total swept area) and of the local jump size for an arbitrary kick amplitude. We extend this calculation to the joint density of local and global sizes within a single avalanche in the limit of an infinitesimal kick. When the interface is driven by a single point, we find new exponents τ_{0}=5/3 and τ=7/4, depending on whether the force or the displacement is imposed. We show that the extension of a "single avalanche" along one internal direction (i.e., the total length in d=1) is finite, and we calculate its distribution following either a local or a global kick. In all cases, it exhibits a divergence P(ℓ)∼ℓ^{-3} at small ℓ. Most of our results are tested in a numerical simulation in dimension d=1. PMID:27300864

  8. Distribution of joint local and total size and of extension for avalanches in the Brownian force model

    NASA Astrophysics Data System (ADS)

    Delorme, Mathieu; Le Doussal, Pierre; Wiese, Kay Jörg

    2016-05-01

    The Brownian force model is a mean-field model for local velocities during avalanches in elastic interfaces of internal space dimension d , driven in a random medium. It is exactly solvable via a nonlinear differential equation. We study avalanches following a kick, i.e., a step in the driving force. We first recall the calculation of the distributions of the global size (total swept area) and of the local jump size for an arbitrary kick amplitude. We extend this calculation to the joint density of local and global sizes within a single avalanche in the limit of an infinitesimal kick. When the interface is driven by a single point, we find new exponents τ0=5 /3 and τ =7 /4 , depending on whether the force or the displacement is imposed. We show that the extension of a "single avalanche" along one internal direction (i.e., the total length in d =1 ) is finite, and we calculate its distribution following either a local or a global kick. In all cases, it exhibits a divergence P (ℓ ) ˜ℓ-3 at small ℓ . Most of our results are tested in a numerical simulation in dimension d =1 .

  9. Implantable sensor technology: measuring bone and joint biomechanics of daily life in vivo

    PubMed Central

    2013-01-01

    Stresses and strains are major factors influencing growth, remodeling and repair of musculoskeletal tissues. Therefore, knowledge of forces and deformation within bones and joints is critical to gain insight into the complex behavior of these tissues during development, aging, and response to injury and disease. Sensors have been used in vivo to measure strains in bone, intraarticular cartilage contact pressures, and forces in the spine, shoulder, hip, and knee. Implantable sensors have a high impact on several clinical applications, including fracture fixation, spine fixation, and joint arthroplasty. This review summarizes the developments in strain-measurement-based implantable sensor technology for musculoskeletal research. PMID:23369655

  10. Directional variability of the isometric force vector produced by the human hand in multijoint planar tasks.

    PubMed

    Friedman, Jason; Latash, Mark L; Zatsiorsky, Vladimir M

    2011-01-01

    Numerous studies have examined control of force magnitude, but relatively little research has considered force direction control. The subjects applied isometric forces to a handle and the authors compared within-trial variability when force is produced in different directions. The standard deviation of the force parallel to the prescribed direction of force production increased linearly with the targeted force level, as did the standard deviation of the force perpendicular to the instructed direction. In contrast, the standard deviation of the angle of force production decreased with increased force level. In the 4 (of 8) instructed force directions where the endpoint force was generated due to a joint torque in only 1 joint (either the shoulder or elbow) the principal component axes in force space were well aligned with the prescribed direction of force production. In the other directions, the variance was approximately equal along the 2 force axes. The variance explained by the first principal component was significantly larger in torque space compared to the force space, and mostly corresponded to positive correlation between the joint torques. Such coordinated changes suggest that the torque variability was mainly due to the variability of the common drive to the muscles serving 2 joints, although this statement needs to be supported by direct studies of muscle activation in the future. PMID:22017526

  11. Problems With Large Joints: Shoulder Conditions.

    PubMed

    Campbell, Michael

    2016-07-01

    Age-related macular degeneration (AMD) causes a progressive loss of photoreceptors in the macula. It is the most common cause of legal blindness in the United States, and some form of AMD is thought to affect more than 9 million individuals. Risk factors include older age, smoking, dyslipidemia, obesity, white race, female sex, and a family history of AMD. There are two types of advanced AMD: nonexudative (dry or geographic atrophy) and exudative (wet or neovascular). Both cause progressive central vision loss with intact peripheral vision. Nonexudative AMD accounts for 80% to 90% of all advanced cases, and more than 90% of patients with severe vision loss have exudative AMD. On ophthalmoscopic examination, early findings include drusen (ie, yellow deposits in the retina). Prominent choroidal vessels, subretinal edema, and/or hemorrhage are seen in wet AMD. Regular eye examinations, visual field testing, fluorescein angiography, and optical coherence tomography are used for diagnosis and to guide management. There is no specific therapy for dry AMD, but antioxidant supplementation may be helpful. Intravitreal injection of a vascular endothelial growth factor inhibitor is the treatment of choice for wet AMD. Optical aids and devices can help to maximize function for patients with AMD. PMID:27403865

  12. Micro- and nanodomain imaging in uniaxial ferroelectrics: Joint application of optical, confocal Raman, and piezoelectric force microscopy

    SciTech Connect

    Shur, V. Ya. Zelenovskiy, P. S.

    2014-08-14

    The application of the most effective methods of the domain visualization in model uniaxial ferroelectrics of lithium niobate (LN) and lithium tantalate (LT) family, and relaxor strontium-barium niobate (SBN) have been reviewed in this paper. We have demonstrated the synergetic effect of joint usage of optical, confocal Raman, and piezoelectric force microscopies which provide extracting of the unique information about formation of the micro- and nanodomain structures. The methods have been applied for investigation of various types of domain structures with increasing complexity: (1) periodical domain structure in LN and LT, (2) nanodomain structures in LN, LT, and SBN, (3) nanodomain structures in LN with modified surface layer, (4) dendrite domain structure in LN. The self-assembled appearance of quasi-regular nanodomain structures in highly non-equilibrium switching conditions has been considered.

  13. Impact of the Joint Task Force on Undergraduate Physics Programs for Innovation and Entrepreneurship Education in Physics

    NASA Astrophysics Data System (ADS)

    Arion, Douglas

    The Joint Task Force on Undergraduate Physics Programs has worked diligently to develop recommendations for what physics programs could and should be doing to prepare graduates for 21st century careers. While the `traditional' physics curriculum has served for many years, the demands of the new workforce, and the recognition that only a few percent of physics students actually become faculty - the vast majority entering the workforce and applying their skills to a very diverse range of problems, projects, and products - implies that a review of the education undergraduates receives is in order. The outcomes of this study point to the need to provide greater connection between the education process and the actual skills, knowledge, and abilities that the workplace demands. This presentation will summarize these considerations, and show how entrepreneurship and innovation programs and curricula are a particularly effective means of bringing these elements to physics students.

  14. Estimation of Human Arm Joints Using Two Wireless Sensors in Robotic Rehabilitation Tasks.

    PubMed

    Bertomeu-Motos, Arturo; Lledó, Luis D; Díez, Jorge A; Catalan, Jose M; Ezquerro, Santiago; Badesa, Francisco J; Garcia-Aracil, Nicolas

    2015-01-01

    This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG) device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM) of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints' estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster. PMID:26690160

  15. Force Protection Joint Experiment (FPJE) Battlefield Anti-Intrusion System (BAIS) sensors data analysis and filtering metrics

    NASA Astrophysics Data System (ADS)

    Barngrover, C. M.; Laird, R. T.; Kramer, T. A.; Cruickshanks, J. R.; Cutler, S. H.

    2009-04-01

    The FPJE was an experiment to consider the best way to develop and evaluate a system of systems approach to Force Protection. It was sponsored by Physical Security Equipment Action Group (PSEAG) and Joint Program Manager - Guardian (JPM-G), and was managed by the Product Manager - Force Protection Systems (PM-FPS). The experiment was an effort to utilize existing technical solutions from all branches of the military in order to provide more efficient and effective force protection. The FPJE consisted of four separate Integration Assessments (IA), which were intended as opportunities to assess the status of integration, automation and fusion efforts, and the effectiveness of the current configuration and "system" components. The underlying goal of the FPJE was to increase integration, automation, and fusion of the many different sensors and their data to provide enhanced situational awareness and a common operational picture. One such sensor system is the Battlefield Anti-Intrusion System (BAIS), which is a system of seismic and acoustic unmanned ground sensors. These sensors were originally designed for employment by infantry soldiers at the platoon level to provide early warning of personnel and vehicle intrusion in austere environments. However, when employed around airfields and high traffic areas, the sensitivity of these sensors can cause an excessive number of detections. During the second FPJE-IA all of the BAIS detections and the locations of all Opposing Forces were logged and analyzed to determine the accuracy rate of the sensors. This analysis revealed that with minimal filtering of detections, the number of false positives and false negatives could be reduced substantially to manageable levels while using the sensors within extreme operational acoustic and seismic noise conditions that are beyond the design requirements.

  16. Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities

    PubMed Central

    Trepczynski, Adam; Kutzner, Ines; Bergmann, Georg; Taylor, William R; Heller, Markus O

    2014-01-01

    Objective The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed) in a sample of subjects across a spectrum of activities. Methods The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors “subject” and “activity” on the relationships between Fmed and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression. Results Across subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R2 value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed, the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW. Conclusion The relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue–related mechanisms that modulate the internal forces at the knee. PMID:24470261

  17. Frozen shoulder and other shoulder disturbances in Parkinson's disease.

    PubMed

    Riley, D; Lang, A E; Blair, R D; Birnbaum, A; Reid, B

    1989-01-01

    The frequency of shoulder disturbances, particularly frozen shoulder, has not been assessed previously in Parkinson's disease. In a survey of 150 patients compared with 60 matched control subjects a significantly higher incidence of both a history of shoulder complaints (43% vs. 23%) and frozen shoulder (12.7% vs. 1.7%) was found in the Parkinson's disease population. Those developing a frozen shoulder had initial disease symptoms indicative of akinesia twice as frequently as tremor while the ratio was reversed in those without frozen shoulder. In at least 8% of the patients frozen shoulder was the first symptom of disease, occurring 0-2 years prior to the onset of more commonly recognised features. Parkinson's disease should be added to the list of causes of frozen shoulder, and clinicians must be aware that the latter is often the presenting symptom of Parkinson's disease. PMID:2709037

  18. Thromboembolism Following Shoulder Arthroscopy

    PubMed Central

    Schick, Cameron W.; Westermann, Robert W.; Gao, Yubo; Abboud, Joseph A.; Wolf, Brian R.

    2014-01-01

    Background: Thromboembolism following shoulder arthroscopy is considered an uncommon complication, with fewer than 50 cases reported in the literature. Arthroscopy of the shoulder is one of the most commonly performed orthopaedic procedures, with low associated risks. Purpose: To identify potential risk factors for the development of venous thromboembolism (VTE) following shoulder arthroscopy and to determine the overall incidence of this complication. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective case-control review was performed of patients who developed symptomatic deep venous thrombosis (DVT) or pulmonary embolism (PE) following shoulder arthroscopy. Multiple surgeons from across North America were queried. For every case of DVT or PE identified, 2 control cases of shoulder arthroscopy were analyzed. The incidence of DVT/PE following shoulder arthroscopy was determined. A univariate analysis and a multivariate logistic regression model were conducted to identify any potential risk factors for the development of VTE following shoulder arthroscopy. Results: A total of 17 surgeons participated in this study and had performed a total of 15,033 cases of shoulder arthroscopy from September 2002 through August 2011. Eleven of the 17 participating surgeons had had a patient with a VTE complication during this time frame. The incidence of VTE in the 15,033 cases was 0.15%; 22 patients of the 15,033 patients had a DVT (n = 15) and/or PE (n = 8). Forty-four control cases were also analyzed. Univariate and multivariate analyses were performed. No significant risk factors were identified other than patient positioning. All cases and controls were positioned in the beach-chair position for surgery. Conclusion: The results of this study show that although rare, VTE occurs following shoulder arthroscopy at a rate of 0.15%. The variables analyzed in the cases of VTE compared with the control cases did not show any significant risk factors. All

  19. Testing thread compounds for rotary-shouldered connections

    SciTech Connect

    Bailey, E.I. ); Smith, J.E. )

    1993-09-01

    Trouble-free rotary-shouldered-connection performance depends on proper joint makeup. Joints must be tight enough to prevent shoulder separation under bending and tensile loads but not so tight that their tensile capacity decreases or the pin or box is damaged. The preload in a connection from tightening depends on the makeup torque and frictional properties of the thread compound. In 1957, Farr developed and published a simplified torque formula to calculate makeup torque: T[sub mu] = ([sigma]A/12)[(p/2[pi])+(r[sub t]K[sub f]/cos [Theta])+r[sub s]K[sub f

  20. The Joint Commission has provided a tool to change your work force: are you paying attention?

    PubMed

    Decker, P J; Strader, M K

    1998-03-01

    Most health care managers wonder how to change employee "attitudes" so that their staff will be more accountable for patient satisfaction, cost reduction, and quality of care. Employees were trained to function in an industry where the power players were the physician and the administrator and now it is exceedingly difficult to get them to switch their attention to the patient and the payer in a market-driven economy. For hospital managers, the answer may be right at their fingertips: The Joint Commission on Accreditation of Healthcare Organizations' standards demanding that employee competence be objectively measured, proven, tracked & trended, improved, and age specific. A comprehensive competence assessment system can save the health care manager enormous work in measuring fewer things, focusing performance assessment on the 20 percent of things that are true problems, and helping to specifically define certain competencies such as customer focus and cost consciousness so that coaching, training, and giving performance feedback is easier. Developing a comprehensive competence assessment system is a powerful tool to change the culture of organizations. Consequently, it is important that managers be aware of those possibilities before they embark on developing "competencies" or before their organizations get too carried away on redesigning systems to satisfy standards. PMID:10177390

  1. Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill.

    PubMed

    Jensen, Bente R; Hovgaard-Hansen, Line; Cappelen, Katrine L

    2016-08-01

    Running on a lower-body positive-pressure (LBPP) treadmill allows effects of weight support on leg muscle activation to be assessed systematically, and has the potential to facilitate rehabilitation and prevent overloading. The aim was to study the effect of running with weight support on leg muscle activation and to estimate relative knee and ankle joint forces. Runners performed 6-min running sessions at 2.22 m/s and 3.33 m/s, at 100%, 80%, 60%, 40%, and 20% body weight (BW). Surface electromyography, ground reaction force, and running characteristics were measured. Relative knee and ankle joint forces were estimated. Leg muscles responded differently to unweighting during running, reflecting different relative contribution to propulsion and antigravity forces. At 20% BW, knee extensor EMGpeak decreased to 22% at 2.22 m/s and 28% at 3.33 m/s of 100% BW values. Plantar flexors decreased to 52% and 58% at 20% BW, while activity of biceps femoris muscle remained unchanged. Unweighting with LBPP reduced estimated joint force significantly although less than proportional to the degree of weight support (ankle). It was concluded that leg muscle activation adapted to the new biomechanical environment, and the effect of unweighting on estimated knee force was more pronounced than on ankle force. PMID:26957520

  2. Platelet-Rich Plasma for Frozen Shoulder: A Case Report

    PubMed Central

    Aslani, Hamidreza; Nourbakhsh, Seyed Taghi; Zafarani, Zohreh; Ahmadi-Bani, Monireh; Ananloo, Mohammad Ebrahim Shahsavand; Beigy, Maani; Salehi, Shahin

    2016-01-01

    Frozen shoulder is a glenohumeral joint disorder that movement because of adhesion and the existence of fibrosis in the shoulder capsule. Platelet-rich plasma can produce collagen and growth factors, which increases stem cells and consequently enhances the healing. To date, there is no evidence regarding the effectiveness of platelet-rich plasma in frozen shoulder. A 45-year-old man with shoulder adhesive capsulitis volunteered for this treatment. He underwent two consecutive platelet-rich plasma injections at the seventh and eighth month after initiation of symptoms. We measured pain, function, ROM by the visual analogue scale (VAS), scores from the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and goniometer; respectively. After first injection, the patient reported 60% improvement regarding diurnal shoulder pain, and no night pain. Also, two-fold improvement for ROM and more than 70% improvement for function were reported. This study suggests the use of platelet-rich plasma in frozen shoulder to be tested in randomized trials. PMID:26894228

  3. Association between Propionibacterium acnes and frozen shoulder: a pilot study

    PubMed Central

    Bunker, Tim D; Gallacher, Sian; Auckland, Cressida R; Kitson, Jeff; Smith, Chris D

    2014-01-01

    Background Frozen shoulder has not previously been shown to be associated with infection. The present study set out to confirm the null hypothesis that there is no relationship between infection and frozen shoulder using two modern scientific methods, extended culture and polymerase chain reaction (PCR) for bacterial nucleic acids. Methods A prospective cohort of 10 patients undergoing arthroscopic release for stage II idiopathic frozen shoulder had two biopsies of tissue taken from the affected shoulder joint capsule at the time of surgery, along with control biopsies of subdermal fat. The biopsies and controls were examined with extended culture and PCR for microbial nucleic acid. Results Eight of the 10 patients had positive findings on extended culture in their shoulder capsule and, in six of these, Propionibacterium acnes was present. Conclusions The findings mean that we must reject the null hypothesis that there is no relationship between infection and frozen shoulder. More studies are urgently needed to confirm or refute these findings. If they are confirmed, this could potentially lead to new and effective treatments for this common, painful and disabling condition. Could P. acnes be the Helicobacter of frozen shoulder?

  4. Joint Task Force on Undergraduate Physics Programs: Implications for physics programs and why you should care

    NASA Astrophysics Data System (ADS)

    Hodapp, Theodore

    2016-03-01

    The content of undergraduate physics programs has not changed appreciably in 50 years, however, the jobs our students take have changed dramatically. Preparing students for careers they are likely to encounter requires physics programs to rethink and in some cases retool to provide an education that will not only educate an individual in the habits of mind and keen sense of how to solve complex technical problems, but also what related skills they will need to be effective in those careers. Do you teach your student how to read or create a budget? How about dealing with a low-performing member of an R&D team? This talk will explore driving forces behind this report, potential implications for physics departments, and practical steps faculty members can take to continue to consider improvements in experiences for our students. This work is supported in part by the National Science Foundation (NSF-1540570).

  5. Shoulder Problems Motivate Innovative Solutions.

    PubMed

    Lubowitz, James H; Brand, Jefferson C; Rossi, Michael J; Provencher, Matthew T

    2016-09-01

    Shoulder arthroscopic and related surgeons may require expertise in use of the 70° arthroscope, biologic patch augmentation, repair of massive rotator cuff tears, the Latarjet procedure and related glenoid bone augmentation, and reverse total shoulder arthroplasty. PMID:27594323

  6. Using your shoulder after surgery

    MedlinePlus

    ... you it is ok. If you had rotator cuff surgery or other ligament or labral surgery, you ... Saunders; 2009:chap 20. Read More Osteoarthritis Rotator cuff problems Rotator cuff repair Shoulder arthroscopy Shoulder pain ...

  7. The forces generated at the human elbow joint in response to imposed sinusoidal movements of the forearm

    PubMed Central

    Joyce, G. C.; Rack, Peter M. H.; Ross, H. F.

    1974-01-01

    1. The mechanical resistance of the human forearm has been measured during imposed sinusoidal flexion-extension movements of the elbow joint. 2. The force required to move the limb can be divided into components required to move the mass, and components required to overcome the resistance offered by elastic and frictional properties of the muscles and other soft tissues. 3. When during a vigorous flexing effort the limb was subjected to a small amplitude sinusoidal movement each extension was followed by a considerable reflex contraction of the flexor muscles. At low frequencies of movement this reflex provided an added resistance to extension, but at 8-12 Hz the delay in the reflex pathway was such that the reflex response to extension occurred after the extension phase of the movement was over and during the subsequent flexion movement. The reflex activity then assisted the movement whereas at other frequencies it impeded it. 4. The reflex response to movement increased as the subject exerted a greater flexing force. 5. Small movements generated a relatively larger reflex response than big ones. 6. Even with large amplitudes of movement when the reflex activity was relatively small, the limb resisted extension with a high level of stiffness; this was comparable with the short range stiffness of muscles in experimental animals. 7. The fact that at some frequencies the reflex response assisted the movement implies that with appropriate loading the limb could undergo a self-sustaining oscillation at those frequencies. PMID:4420490

  8. Robotics in shoulder rehabilitation

    PubMed Central

    Sicuri, Chiara; Porcellini, Giuseppe; Merolla, Giovanni

    2014-01-01

    Summary In the last few decades, several researches have been conducted in the field of robotic rehabilitation to meet the intensive, repetitive and task-oriented training, with the goal to recover the motor function. Up to now, robotic rehabilitation studies of the upper extremity have generally focused on stroke survivors leaving less explored the field of orthopaedic shoulder rehabilitation. In this review we analyse the present status of robotic technologies, in order to understand which are the current indications and which may be the future perspective for their application in both neurological and orthopaedic shoulder rehabilitation. PMID:25332937

  9. The Painful Shoulder: Shoulder Impingement Syndrome

    PubMed Central

    Khan, Yousaf; Nagy, Mathias Thomas; Malal, Joby; Waseem, Mohammad

    2013-01-01

    Rotator cuff disorders are considered to be among the most common causes of shoulder pain and disability encountered in both primary and secondary care. The general pathology of subacromial impingment generally relates to a chronic repetitive process in which the conjoint tendon of the rotator cuff undergoes repetitive compression and micro trauma as it passes under the coracoacromial arch. However acute traumatic injuries may also lead to this condition. Diagnosis remains a clinical one, however advances in imaging modalities have enabled clinicians to have an increased understanding of the pathological process. Ultrasound scanning appears to be a justifiable and cost effective assessment tool following plain radiographs in the assessment of shoulder impingment, with MRI scans being reserved for more complex cases. A period of observed conservative management including the use of NSAIDs, physiotherapy with or without the use of subacromial steroid injections is a well-established and accepted practice. However, in young patients or following any traumatic injury to the rotator cuff, surgery should be considered early. If surgery is to be performed this should be done arthroscopically and in the case of complete rotator cuff rupture the tendon should be repaired where possible. PMID:24082973

  10. A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings.

    PubMed

    Mokhtarzadeh, Hossein; Perraton, Luke; Fok, Laurence; Muñoz, Mario A; Clark, Ross; Pivonka, Peter; Bryant, Adam L

    2014-09-22

    The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies. PMID:25129166

  11. Ultrasound features of shoulder involvement in patients with ankylosing spondylitis: a case–control study

    PubMed Central

    2013-01-01

    Background During Ankylosing spondylitis (AS) courses, shoulder involvement is common. However, etiologies of shoulder pain in patients with AS remain to be defined. The aim of this study was to investigate the prevalence of ultrasound (US) abnormalities in shoulders of patients with ankylosing spondylitis (AS), and to determine predictive factors of ultrasound shoulder enthesitis. Methods 38 patients with AS were included with 38 age and sex-matched healthy controls. All patients fulfilled the modified New York criteria for ankylosing spondylitis. Clinical and demographical data were recorded. US examination of bilateral shoulders was performed by a musculoskeletal sonographer according to a defined protocol that included imaging of the insertions of supraspinatus, subscapularis and infraspinatus tendons, rotator cuff tendons, subacromial-subdeltoid bursa, acromioclavicular joint, and glenohumeral joint. Results The mean age of patients and controls was 36 years, each group of patients and controls comprised 22 men (57.9%) and 16 women (42.1%). Disease duration was 9.6 ± 7.2 years. Among 38 patients with AS, 21 had coxitis (55%) and 19 had previous or current shoulder pain (50%). AS shoulders presented significantly more ultrasound enthesitis than controls shoulders (43 shoulders (56.6%) versus 8 shoulders (10.5%) respectively). Involvement of rotator cuff tendons was significantly higher in patients with AS compared with control subjects (16/38 (42.1%) versus 6 (15.2%) respectively). However, involvement of gleno-humeral and acromio-clavicular joints was infrequent in both groups. In patients with AS, we found that the presence of coxitis was the only significant predictive factors of shoulder enthesitis (Odds Ratio (OR) = 9.4; Confidence interval (CI) 95% (1.10; 81.9), p = 0.04). Conclusions Ultrasound abnormalities of shoulders are common in patients with AS, and the most frequent abnormalitie was enthesitis, which was associated with the

  12. Estimation of Joint Forces and Moments for the In-Run and Take-Off in Ski Jumping Based on Measurements with Wearable Inertial Sensors

    PubMed Central

    Logar, Grega; Munih, Marko

    2015-01-01

    This study uses inertial sensors to measure ski jumper kinematics and joint dynamics, which was until now only a part of simulation studies. For subsequent calculation of dynamics in the joints, a link-segment model was developed. The model relies on the recursive Newton–Euler inverse dynamics. This approach allowed the calculation of the ground reaction force at take-off. For the model validation, four ski jumpers from the National Nordic center performed a simulated jump in a laboratory environment on a force platform; in total, 20 jumps were recorded. The results fit well to the reference system, presenting small errors in the mean and standard deviation and small root-mean-square errors. The error is under 12% of the reference value. For field tests, six jumpers participated in the study; in total, 28 jumps were recorded. All of the measured forces and moments were within the range of prior simulated studies. The proposed system was able to indirectly provide the values of forces and moments in the joints of the ski-jumpers' body segments, as well as the ground reaction force during the in-run and take-off phases in comparison to the force platform installed on the table. Kinematics assessment and estimation of dynamics parameters can be applied to jumps from any ski jumping hill. PMID:25985167

  13. Estimation of joint forces and moments for the in-run and take-off in ski jumping based on measurements with wearable inertial sensors.

    PubMed

    Logar, Grega; Munih, Marko

    2015-01-01

    This study uses inertial sensors to measure ski jumper kinematics and joint dynamics, which was until now only a part of simulation studies. For subsequent calculation of dynamics in the joints, a link-segment model was developed. The model relies on the recursive Newton-Euler inverse dynamics. This approach allowed the calculation of the ground reaction force at take-off. For the model validation, four ski jumpers from the National Nordic center performed a simulated jump in a laboratory environment on a force platform; in total, 20 jumps were recorded. The results fit well to the reference system, presenting small errors in the mean and standard deviation and small root-mean-square errors. The error is under 12% of the reference value. For field tests, six jumpers participated in the study; in total, 28 jumps were recorded. All of the measured forces and moments were within the range of prior simulated studies. The proposed system was able to indirectly provide the values of forces and moments in the joints of the ski-jumpers' body segments, as well as the ground reaction force during the in-run and take-off phases in comparison to the force platform installed on the table. Kinematics assessment and estimation of dynamics parameters can be applied to jumps from any ski jumping hill. PMID:25985167

  14. The Rotator Interval of the Shoulder

    PubMed Central

    Frank, Rachel M.; Taylor, Dean; Verma, Nikhil N.; Romeo, Anthony A.; Mologne, Timothy S.; Provencher, Matthew T.

    2015-01-01

    Biomechanical studies have shown that repair or plication of rotator interval (RI) ligamentous and capsular structures decreases glenohumeral joint laxity in various directions. Clinical outcomes studies have reported successful outcomes after repair or plication of these structures in patients undergoing shoulder stabilization procedures. Recent studies describing arthroscopic techniques to address these structures have intensified the debate over the potential benefit of these procedures as well as highlighted the differences between open and arthroscopic RI procedures. The purposes of this study were to review the structures of the RI and their contribution to shoulder instability, to discuss the biomechanical and clinical effects of repair or plication of rotator interval structures, and to describe the various surgical techniques used for these procedures and outcomes. PMID:26779554

  15. Common Shoulder Injuries in American Football Athletes.

    PubMed

    Gibbs, Daniel B; Lynch, T Sean; Nuber, Erika D; Nuber, Gordon W

    2015-01-01

    American football is a collision sport played by athletes at high speeds. Despite the padding and conditioning in these athletes, the shoulder is a vulnerable joint, and injuries to the shoulder girdle are common at all levels of competitive football. Some of the most common injuries in these athletes include anterior and posterior glenohumeral instability, acromioclavicular pathology (including separation, osteolysis, and osteoarthritis), rotator cuff pathology (including contusions, partial thickness, and full thickness tears), and pectoralis major and minor tears. In this article, we will review the epidemiology and clinical and radiographic workup of these injuries. We also will evaluate the effectiveness of surgical and nonsurgical management specifically related to high school, collegiate, and professional football athletes. PMID:26359844

  16. Comparisons of knee and ankle joint angles and ground reaction force according to functional differences during single-leg drop landing

    PubMed Central

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-01-01

    [Purpose] The purpose of this study was to determine potential predictors of functional instability of the knee and ankle joints during single-leg drop landing based on the prior history of injury. [Subjects and Methods] The subjects were 24 collegiate soccer players without pain or dysfunction. To compare the differences between the stable and unstable sides during single-leg drop landing, 8 motion analysis cameras and a force plate were used. The Cortex 4 software was used for a biomechanical analysis of 3 events. An independent t-test was used for statistical comparison between both sides; p<0.05 indicated significance. [Results] The knee joint movements showed gradual flexion in the sagittal plane. The unstable-side ankle joint showed plantar flexion of approximately 2° relative to the stable side. In the coronal plane, the unstable-side knee joint differed from the stable side in its tendency for valgus movement. The unstable-side ankle joint showed contrasting movement compared with the stable side, and the difference was significant. Regarding the vertical ground reaction force, the stable side showed maximum knee flexion that was approximately 0.1 BW lower than that of the unstable side. [Conclusion] Increasing the flexion angle of the knee joint can help prevent injury during landing. PMID:27190444

  17. Adhesive Capsulitis (Frozen Shoulder)

    MedlinePlus

    ... Reaching: Put things you use every day (shoes, coffee cup, toothbrush) on a high shelf. This way you have to reach up for things more often. The reaching is a good stretch for your shoulder. Do the exercises once or twice a day even after your ...

  18. Preliminary Assessment of Education and Human Resources in Thailand. Volume I, Report of the Joint Task Force; Volume II, Working Papers.

    ERIC Educational Resources Information Center

    Palakawongsa, Nai Nob; And Others

    This report was prepared by the Joint Thai-US Task Force on Human Resource Development in Thailand. Volume I of the Report includes: Human Resources Development in Thailand--A Preliminary Assessment; The Educational System and Human Resource Development in Thailand; Manpower Demand; Adjusting Educational Supply to Manpower Demand; Education…

  19. A Kinetic Chain Approach for Shoulder Rehabilitation

    PubMed Central

    McMullen, John; Uhl, Timothy L.

    2000-01-01

    Objective: To introduce an approach to shoulder rehabilitation that integrates the kinetic chain throughout the rehabilitation program while providing the theoretical rationale for this program. Background: The focus of a typical rehabilitation program is to identify and treat the involved structures. However, in activities of sport and daily life, the body does not operate in isolated segments but rather works as a dynamic unit. Recently, rehabilitation programs have emphasized closed kinetic chain exercises, core-stabilization exercises, and functional programs. These components are implemented as distinct entities and are used toward the end of the rehabilitation program. Description: Kinetic chain shoulder rehabilitation incorporates the kinetic link biomechanical model and proximal-to-distal motor-activation patterns with proprioceptive neuromuscular facilitation and closed kinetic chain exercise techniques. This approach focuses on movement patterns rather than isolated muscle exercises. Patterns sequentially use the leg, trunk, and scapular musculature to activate weakened shoulder musculature, gain active range of motion, and increase strength. The paradigm of kinetic chain shoulder rehabilitation suggests that functional movement patterns and closed kinetic chain exercises should be incorporated throughout the rehabilitation process. Clinical Advantages: The exercises in this approach are consistent with biomechanical models, apply biomechanical and motor control theory, and work toward sport specificity. The exercises are designed to stimulate weakened tissue by motion and force production in the adjacent kinetic link segments. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8. PMID:16558646

  20. Consistent accuracy in whole-body joint kinetics during gait using wearable inertial motion sensors and in-shoe pressure sensors.

    PubMed

    Khurelbaatar, Tsolmonbaatar; Kim, Kyungsoo; Lee, SuKyoung; Kim, Yoon Hyuk

    2015-06-01

    To analyze human motion such as daily activities or sports outside of the laboratory, wearable motion analysis systems have been recently developed. In this study, the joint forces and moments in whole-body joints during gait were evaluated using a wearable motion analysis system consisting of an inertial motion measurement system and an in-shoe pressure sensor system. The magnitudes of the joint forces and the moments in nine joints (cervical, thoracic, lumbar, right shoulder, right elbow, right wrist, right hip, right knee, and right ankle) during gait were calculated using the wearable system and the conventional system, respectively, based on a standard inverse dynamics analysis. The averaged magnitudes of the joint forces and moments of five subjects were compared between the wearable and conventional systems in terms of the Pearson's correlation coefficient and the normalized root mean squared error to the maximum value from the conventional system. The results indicated that both the joint forces and joint moments in human whole body joints using wearable inertial motion sensors and in-shoe pressure sensors were feasible for normal motions with a low speed such as walking, although the lower extremity joints showed the strongest correlation and overall the joint moments were associated with relatively smaller correlation coefficients and larger normalized root mean squared errors in comparison with the joint forces. The portability and mobility of this wearable system can provide wide applicability in both clinical and sports motion analyses. PMID:25957652

  1. The management of bilateral posterior fracture dislocations of the shoulder: a case series illustrating management options

    PubMed Central

    Robinson, Peter W; Packham, Iain; Crowther, Mark

    2016-01-01

    Background Although dislocation of the shoulder is a relatively common event, the overwhelming majority of injuries are anterior. Posterior shoulder dislocation is more uncommon, comprising between 3% and 5% of all shoulder dislocations. One percent of shoulder dislocations involve a fracture, whereas only 0.9% of the 1500 cases reported by Neer (J Bone Joint Surg Am 1970; 52:1077–89; J Bone Joint Surg Am 1970; 52:1090–103) concerned posterior fracture dislocations. Bilateral posterior fracture dislocation is an even rarer event, comprising just 5% of all posterior fracture dislocations. Given the rarity and relative poor outcome often observed after these severe injuries, it is important that upper limb function is optimized. Methods Bilateral posterior fracture dislocations of the shoulder pose a difficult clinical challenge that requires careful management planning. To date, there have been three isolated case reports of using contralateral osteochondral humeral autograft and hemiarthroplasty. We report our experiences and clinical outcomes in managing four such cases using a variety and combination of treatments, including the first reported use of reverse shoulder arthroplasty with contralateral osteochondral humeral autografting. Results Shoulders reconstructed with humeral autograft demonstrated superior Oxford Shoulder Scores and an improved range of motion, as measured by a markerless machine vision system, compared to hemiarthroplasty. Conclusions Our results support the use of a contralateral humeral autograft in bilateral posterior shoulder fracture dislocation.

  2. Bilateral posterior shoulder dislocation after electrical shock: A case report

    PubMed Central

    Ketenci, Ismail Emre; Duymus, Tahir Mutlu; Ulusoy, Ayhan; Yanik, Hakan Serhat; Mutlu, Serhat; Durakbasa, Mehmet Oguz

    2015-01-01

    Introduction Posterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction. Presentation of case This report presents a case of bilateral posterior shoulder dislocation after electrical shock. We were able to find a few individual case reports describing this condition. The case was acute and humeral head impression defects were minor. Our treatment in this case consisted of closed reduction under general anesthesia and applying of orthoses which kept the shoulders in abduction and external rotation. A rehabilitation program was begun after 3 weeks of immobilization. After 6 months of injury the patient has returned to work. 20 months postoperatively, at final follow-up, he was painless and capable of performing all of his daily activities. Discussion The amount of bilateral shoulder dislocations after electrical injury is not reported but is known to be very rare. The aim of this case presentation is to report an example for this rare entity, highlight the difficulties in diagnosis and review the treatment options. Conclusion Physical examination and radiographic evaluation are important for quick and accurate diagnosis. PMID:26904192

  3. A healthy patient with bilateral frozen hips preceding bilateral frozen shoulders: a cautionary tale.

    PubMed

    Miller, Abigail R; Arnot, Dean; Wake, Melissa

    2015-01-01

    Adhesive capsulitis of the shoulder (frozen shoulder) is a common disease characterised by spontaneous onset of pain and restriction of movement, followed by 'thawing', with complete or near-complete resolution. Adhesive capsulitis of the hip has been reported in around a dozen patients. This report describes an otherwise-healthy middle-aged woman with apparent sequential resolving adhesive capsulitis of all four ball-and-socket joints over a 9-year period, initially affecting each hip and then each shoulder sequentially. The likely hip diagnosis became clear only retrospectively with development of the second frozen shoulder, 5 years after the first pain. All joints subsequently resolved within the expected timeframe and the patient remains healthy, other than having mild hypertension. This case illustrates that, when hip precedes shoulder involvement, there is the potential for the frozen hip to receive alternate diagnoses for which invasive open hip surgery could unnecessarily be recommended. PMID:26564111

  4. Alterations in intermediate filaments expression in disc cells from the rat temporomandibular joint following exposure to continuous compressive force

    PubMed Central

    Magara, Jin; Nozawa-Inoue, Kayoko; Suzuki, Akiko; Kawano, Yoshiro; Ono, Kazuhiro; Nomura, Shuichi; Maeda, Takeyasu

    2012-01-01

    The articular disc in the temporomandibular joint (TMJ) that serves in load relief and stabilizing in jaw movements is a dense collagenous tissue consisting of extracellular matrices and disc cells. The various morphological configurations of the disc cells have given us diverse names, such as fibroblasts, chondrocyte-like cells and fibrochondrocytes; however, the characteristics of these cells have remained to be elucidated in detail. The disc cells have been reported to exhibit heterogeneous immunoreaction patterns for intermediate filaments including glial fibrillary acidic protein (GFAP), nestin and vimentin in the adult rat TMJ. Because these intermediate filaments accumulate in the disc cells as tooth eruption proceeds during postnatal development, it might be surmised that the expression of these intermediate filaments in the disc cells closely relates to mechanical stress. The present study was therefore undertaken to examine the effect of a continuous compressive force on the immunoexpression of these intermediate filaments and an additional intermediate filament – muscle-specific desmin – in the disc cells of the TMJ disc using a rat experimental model. The rats wore an appliance that exerts a continuous compressive load on the TMJ. The experimental period with the appliance was 5 days as determined by previous studies, after which some experimental animals were allowed to survive another 5 days after removal of the appliance. Histological observations demonstrated that the compressive force provoked a remarkable acellular region and a decrease in the thickness of the condylar cartilage of the mandible, and a sparse collagen fiber distribution in the articular disc. The articular disc showed a significant increase in the number of desmin-positive cells as compared with the controls. In contrast, immunopositive cells for GFAP, nestin and vimentin remained unchanged in number as well as intensity. At 5 days after removal of the appliance, both the disc

  5. Neglected Anterior Dislocation of Shoulder: is surgery necessary? A Rare Case with review of literature

    PubMed Central

    Shah, Kunal; Ubale, Tushar; Ugrappa, Harish; Pilankar, Samir; Bhaskar, Atul; Kale, Satishchandra

    2015-01-01

    Introduction: Shoulder joint is the most frequently dislocated joint. However, it is rarely neglected and treatment is sought immediately. Delayed or neglected shoulder dislocations are difficult to manage and require extensive procedures to obtain good functional outcome. Very few cases are described in literature showing neglected shoulder dislocation with good functional range of movement. We report a case with 3 years of neglected anterior shoulder dislocation with preserved joint function. Case Report: A 40 years old gentleman presented withfracture distal end of the radius (left). On clinical examination we observed that he had anterior dislocation of his left shoulder which was confirmed on radiographic evaluation. He had history of seizures 3 years back, which may be the cause of dislocation which went unnoticed. On examination he had good range of motion without any pain. Patient could perform all routine activities with no major functional limitation. At three years after dislocation CT Scan showed neocavity formation. Conclusion: Neglected shoulder dislocation with preserved joint function without major functional limitation is a rare presentation. This condition should be kept in mind in patients with history of seizures. Proper evaluation and counseling of patients avoids extensive procedures and avoids complications of surgery. Observation can be a treatment option in patients with preserved range of movement especially involving non dominant handand having low functional demand. This report presents rare presentation of neglected shoulder dislocation highlighting its natural history and its outcome following conservative treatment. PMID:27299102

  6. Swimmer's Shoulder: Painful Shoulder in the Competitive Swimmer.

    PubMed

    Matzkin, Elizabeth; Suslavich, Kaytelin; Wes, David

    2016-08-01

    Swimmer's shoulder is a broad term often used to diagnose shoulder injury in swimmers. However, research has elucidated several specific shoulder injuries that often are incurred by the competitive swimmer. Hyperlaxity, scapular dyskinesis, subacromial impingement, labral damage, os acromiale, suprascapular nerve entrapment, and glenohumeral rotational imbalances all may be included within a differential diagnosis for shoulder pain in the competitive swimmer. An understanding of the mechanics of the swim stroke, in combination with the complex static and dynamic properties of the shoulder, is essential to the comprehension and identification of the painful swimmer's shoulder. It is important for the athlete, coach, and clinician to be aware of the discerning characteristics among these different injuries to ensure a proper diagnosis and treatment plan to aid the swimmer in his or her return to competition. PMID:27355281

  7. Short stem shoulder replacement

    PubMed Central

    Bell, Simon N.; Coghlan, Jennifer A.

    2014-01-01

    Context: It is agreed that it is important to anatomically reproduce the proximal humeral anatomy when performing a prosthetic shoulder replacement. This can be difficult with a long stemmed prosthesis, in particular if there is little relationship of the metaphysis to the humeral shaft. The ‘short stem’ prosthesis can deal with this problem. Aims: A prospective study assessed the results of total shoulder arthroplasty using a short stem humeral prosthesis, a ceramic humeral head, and a pegged cemented polyethylene glenoid. Materials and methods: Patients with primary shoulder osteoarthritis were recruited into this prospective trial and pre-operatively had the ASES, Constant, SPADI, and DASH scores recorded. The patients were clinically reviewed at the two weeks, eight weeks, one year, and two year mark with completion of a data form. Radiological evaluation was at the eight week, one year and two year follow-up. At the one and two year follow-up the satisfaction rating, the range of passive and active motion, Constant, ASES, SPADI, DASH and pain results were recorded and analysed with SPPS 20. Results: During the study period 97 short stem, ceramic head total shoulder replacements were carried out. At the time of follow-up 12 were two years from operation and 38 one year from operation. Active elevation was overall mean 160 degrees. Constant scores were 76 at 1 year, and 86 at 2 years, ASES 88 and 93, and satisfaction 96% and 98% respectively at one and 2 year follow up. There were no problems during insertion of the humeral prosthesis, or any radiolucent lines or movement of the prosthesis on later radiographs. Conclusion: The short stem prosthesis had no complications, and on follow up radiographs good bone fixation. These fairly short term clinical results were overall good. PMID:25258497

  8. Ultrasound-guided interventional procedures around the shoulder.

    PubMed

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo; Sconfienza, Luca Maria

    2016-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial-subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of degenerative tendinopathy, is a common and mostly asymptomatic ultrasound finding; dry needling has been proposed in symptomatic patients. An alternative is represented by autologous platelet-rich plasma injections. Intra-articular injections of the shoulder can be performed in the treatment of a variety of inflammatory and degenerative diseases with corticosteroids or hyaluronic acid respectively. Steroid injections around the long head of the biceps brachii tendon are indicated in patients with biceps tendinopathy, reducing pain and humeral tenderness. The most common indication for acromion-clavicular joint injection is degenerative osteoarthritis, with ultrasound representing a useful tool in localizing the joint space and properly injecting various types of drugs (steroids, lidocaine or hyaluronic acid). Suprascapular nerve block is an approved treatment for chronic shoulder pain non-responsive to conventional treatments as well as candidate patients for shoulder arthroscopy. This review provides an overview of these different ultrasonography-guided procedures that can be performed around the shoulder. PMID:26313499

  9. Enhancement of antidepressant-like activity by joint administration of imipramine and magnesium in the forced swim test: Behavioral and pharmacokinetic studies in mice.

    PubMed

    Poleszak, Ewa; Wlaź, Piotr; Szewczyk, Bernadeta; Kedzierska, Ewa; Wyska, Elzbieta; Librowski, Tadeusz; Szymura-Oleksiak, Joanna; Fidecka, Sylwia; Pilc, Andrzej; Nowak, Gabriel

    2005-07-01

    The effect of joint administration of imipramine (IMI) and magnesium (Mg) on antidepressant-like activity was studied in mice using forced swim test (FST). Mg doses ineffective per se (5 and 10 mg/kg) given jointly with IMI also at ineffective doses (10 and 15 mg/kg) resulted in a potent reduction in the immobility time. Since these combined treatments did not influence locomotor activity, the antidepressant-like activity was not due to non-specific behavioral activation. Moreover, we estimated the effect of joint administration of magnesium and IMI in FST on serum and brain magnesium, IMI and its active metabolite desipramine (DMI) concentrations in mice. Swim stress (mice subjected to FST) increased the magnesium concentration in serum and decreased it in the brain compared to naive animals. Moreover administration of IMI increased (normalized) magnesium brain concentration, without influence on the serum level. Joint administration of IMI and magnesium did not influence magnesium (compared with FST) or IMI and DMI (compared with IMI treatment alone) concentrations in both examined tissues. The present data demonstrated an enhancement of the antidepressant-like effect by joint administration of IMI and magnesium in the FST, and further indicate the particular role of magnesium in the antidepressant action. Since there was no increase in IMI, DMI or magnesium concentration after joint administration of magnesium and IMI, the data suggest that pharmacodynamic rather than pharmacokinetic interaction between magnesium and IMI is accountable for behavioral effect in the FST. PMID:15936065

  10. Anatomy and biomechanics of the shoulder in throwing, swimming, gymnastics, and tennis.

    PubMed

    Perry, J

    1983-07-01

    As the most mobile joint in the body, the shoulder is structurally insecure. The ball-shaped humeral head rotates and glides on a shallow scapular cup. A limited amount of passive stability is provided by the glenoid labrum, which slightly deepens the scapular cup, and by ligaments reinforcing the capsule on its superior and anterior surfaces. At peak maturity ligamentous restraint equals 50 to 80 kg. These structural limitations indicate that the primary source of joint stability must be balanced muscle control. Joint compression is the major factor. This is supplemented by active tangential restraint, which selectively opposes anterior, posterior, or superior displacement. The large external muscles used for purposeful motion and speed often create subluxating shear forces in addition to the desired actions. Impingement and attrition syndromes are common consequences. To counter this, as well as to provide selective rotation, there are the four muscles that constitute the rotator cuff. Joint compression is the major force generated by the supraspinatus and infraspinatus. The latter (accompanied by the teres minor) also provides a downward pull to oppose the upward displacement of early deltoid action. Anterior protection against excessive external rotation or extension is offered by the subscapularis. Athletic who use the arm for a propelling force strain the extremes of joint range in their drive for maximum performance. The threat of injury can be minimized by two actions, namely, modifying motion patterns, which may avoid impingement or make it a less frequent experience, and active protection, which is gained through specific strengthening of the rotator cuff muscles. PMID:9697636

  11. Understanding Multidirectional Instability of the Shoulder

    PubMed Central

    Cordasco, Frank A.

    2000-01-01

    Objective: To provide an overview of the evaluation and treatment of the patient with multidirectional shoulder instability. Data Sources: I searched MEDLINE for the years from 1980 to 2000 using the key words “shoulder joint,” “instability,” “dislocation,” “multidirectional shoulder instability,” and “inferior capsular shift.” Data Synthesis: Multidirectional instability is symptomatic glenohumeral subluxation or dislocation in more than 1 direction: anterior, inferior, or posterior. The primary pathology is a loose and patulous capsule, and the entity is more common than previously recognized. Multidirectional instability affects young, sedentary patients with generalized ligamentous laxity, often with bilateral symptoms and an atraumatic history, but it also affects athletes, many of whom have sustained injuries. Patients with multidirectional instability may also have Bankart lesions and humeral head impression defects. Conclusions/Recommendations: Patients with multidirectional instability must be identified before appropriate treatment can be initiated. If a course of rehabilitation fails to improve the patient's symptoms, an inferior capsular shift procedure has been demonstrated to be an effective surgical option. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8.Figure 9.Figure 10. PMID:16558641

  12. Incidence of joint replacement among active component service members, U.S. Armed Forces, 2004-2014.

    PubMed

    Daniele, Denise O; Taubman, Stephen B; Clark, Leslie L

    2015-05-01

    In the U.S., joint replacements have become more common and the average age of individuals who undergo joint replacements has decreased. Joint replacements among active component service members increased 10.5% during 2004-2009, then 61.9% during 2009-2014. Knees and hips were the most frequently replaced joints among service members. During the surveillance period (and particularly after 2009), incidence rates increased in each age group of service members 30 years or older. Relative to their respective counterparts, rates of joint replacement overall--and of the hip and knee specifically--were higher among service members who were black, non-Hispanic; officers; and healthcare workers. One year after joint replacement, 18.2% had retired; 5.2% had been medically disqualified from service; 6.3% had otherwise left service; and 70.3% were still in service. By 2 years post-joint replacement, 30.2% had retired; 13.0% had been medically disqualified; 10.0% had otherwise left service; and 46.8% were still in service. Service members aged 30-44 years were the most likely to remain in service post-joint replacement. Given the increases in the frequency of joint replacement among younger service members, the number of service members who remain in service post-joint replacement may continue to increase. PMID:25996170

  13. MR evaluation of synovial injury in shoulder trauma.

    PubMed

    Chalian, Majid; Soldatos, Theodoros; Faridian-Aragh, Neda; Andreisek, Gustav; McFarland, Edward G; Carrino, John A; Chhabra, Avneesh

    2011-10-01

    The purpose of this study was to determine magnetic resonance imaging (MRI) findings relevant to synovial injury of the shoulder in patients with and without acute shoulder trauma. Three hundred and nine consecutive shoulder MRI studies (185-male, 124-female, 50 ± 15 years old) were retrospectively evaluated for findings suggestive of synovial injury including rupture and/or diverticulum of the joint capsule, bursa, and biceps tendon sheath (BTS), ganglion/synovial cyst, geyser phenomenon, and sequel of previous shoulder dislocation (Hill-Sachs deformity). Patients with one or more of these findings were included in the MR-positive group, whereas the remaining subjects were used as MR negatives. Based on their medical records, patients were also divided into trauma and non-trauma groups, and statistical analysis was performed to evaluate the association between the aforementioned MRI findings and history of shoulder trauma. Fifty-six patients were included in the MR-positive group and 253 in the MR-negative group. In MR-positive group, the incidence of capsular rupture (CR) and subacromial/subdeltoid (SASD) bursal rupture was higher in trauma patients, whereas the incidence of BTS diverticulum and ganglion cyst was higher in subjects without trauma. Significant association was found between the history of acute trauma and CR, SASD bursal rupture, BTS rupture, and Hill-Sachs deformity. In shoulder MR examination, presence of CR and/or SASD bursal rupture is strongly suggestive of acute shoulder trauma. In addition, BTS rupture and Hill-Sachs deformity are more prevalent in patients with acute shoulder trauma. The presence of these features should alert MRI readers to assess for additional trauma-related internal derangements, if a respective history has not been provided. PMID:21735271

  14. Total shoulder replacement by magnetic arthroplasty.

    PubMed

    Doursounian, L; Honiger, J; Pujade-Lauraine, E; Apoil, A

    1998-01-01

    Permanent magnets offer a novel solution to the problem of shoulder implant instability when the rotator cuff has been destroyed. We report a case of their use in a 66-year-old patient with a large proximal humerol breast cancer metastasis. Humerol resection was below the deltoid insertion. The polyacetal device had samarium-cobalt magnets in the humeral head. The glenoid component (the keeper in the magnetic circuit) was made of titanium nitride-coated F17 stainless steel. The system's breakaway force was ca. 40 N. At 24 months the shoulder was free of pain and stable, with an active range of movement of 30 degrees flexion, 45 degrees external rotation, and internal rotation to T8. The patient could perform household tasks and drive an automatic car. Radiography showed no implant loosening or upward humeral head dislocation. Subsequently, the patient's condition deteriorated; at 33 months she was bedridden, and radiography showed dislocation of the humeral component. PMID:9524336

  15. Estimation of Human Arm Joints Using Two Wireless Sensors in Robotic Rehabilitation Tasks

    PubMed Central

    Bertomeu-Motos, Arturo; Lledó, Luis D.; Díez, Jorge A.; Catalan, Jose M.; Ezquerro, Santiago; Badesa, Francisco J.; Garcia-Aracil, Nicolas

    2015-01-01

    This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG) device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM) of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints’ estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster. PMID:26690160

  16. Unilateral neuropathic arthropathy of the shoulder secondary to syringomyelia: Diagnostic challenges

    PubMed Central

    Chakraborty, Partha Pratim; Datta, Saumik; Ray, Sayantan; Bhattacharjee, Rana; Chowdhury, Subhankar

    2015-01-01

    Neuropathic arthropathy of the shoulder is a rare disorder characterized by joint degeneration, and is associated with loss of sensory innervation. Syringomyelia is a disease in which fluid-containing cavities (syrinxes) form within the spinal cord. Here, we report a case of neuropathic arthropathy of the shoulder secondary to syringomyelia in a 40-year-old woman. X-rays of the left shoulder revealed damage to bone and joint architecture. Blood tests indicated vitamin D deficiency and secondary hyperparathyroidism. Magnetic resonance imaging of the cervical spine showed a large syrinx from the second cervical spine to the second dorsal spine. Although neuropathic arthropathy is uncommon, it should be considered in cases of unexplained pain, discomfort, or limited range of motion of the affected joint. Symptoms related to the affected joint may precede or overshadow neurological deficits. Appropriate radiological examinations and diagnoses are imperative to prevent misdiagnosis or undetected bone and joint disorders. PMID:26677453

  17. Shoulder Injuries in English Community Rugby Union.

    PubMed

    Singh, V R; Trewartha, G; Roberts, S P; England, M; Stokes, K A

    2016-07-01

    The aim of this study was to describe the incidence, severity and type of shoulder injuries resulting from match play in adult community rugby union between 2009-2013. A total of 254 time-loss shoulder injuries were reported, an overall incidence of 2.2 per 1 000 h (95% CI: 1.9 to 2.4), and a mean injury severity of 9.5 weeks missed (95% CI: 8.2 to 10.8). The semi-professional group had an incidence of 2.8 injuries per 1 000 h (95% CI: 2.2 to 3.5), which was higher than the recreational group at 1.8 injuries per 1 000 h (95% CI: 1.4 to 2.2, p=0.004). The incidence of acromioclavicular joint injury for semi-professional players was 1.2 per 1 000 h (95% CI: 0.8 to 1.6); which was significantly higher than the incidence of this injury type in recreational players (0.5 per 1 000 h 95% CI: 0.3 to 0.7, p=0.002). Overall, back row players sustained the highest incidence of all shoulder injuries for a given playing position, 2.9 injuries per 1 000 h (95% CI: 2.2 to 3.6). The tackle was the main event associated with injury. Injury prevention programs and coaching strategies that consider tackle technique and physical conditioning of the shoulder region are therefore considered important. PMID:27176887

  18. The anterior approach to the shoulder from the lateral position.

    PubMed

    Steingard, M A

    1996-11-01

    An alternative method of operating on the anterior structures of the shoulder is presented. With the patient in the decubitus lateral position, the joint is readily accessible without cutting the conjoined tendon or performing an osteotomy of the coracoid process. The lateral decubitus positioning of the patient allows the surgeon to reinsert the arthroscope into the shoulder after open surgery to check the repair. This approach eliminates repositioning the patient to the supine position. It can be performed without a surgical assistant if the scrub technician is able to rotate the arm at certain times during the operation. PMID:8959262

  19. Editorial Commentary: Multidirectional Shoulder Instability.

    PubMed

    Lubowitz, James H

    2015-12-01

    Multidirectional shoulder instability responds to physical therapy and rehabilitation. For patients who fail rehabilitation, arthroscopic capsular plication seems the treatment of choice. PMID:26652151

  20. Unsteady hydrodynamic forces acting on a robotic hand and its flow field.

    PubMed

    Takagi, Hideki; Nakashima, Motomu; Ozaki, Takashi; Matsuuchi, Kazuo

    2013-07-26

    This study aims to clarify the mechanism of generating unsteady hydrodynamic forces acting on a hand during swimming in order to directly measure the forces, pressure distribution, and flow field around the hand by using a robotic arm and particle image velocimetry (PIV). The robotic arm consisted of the trunk, shoulder, upper arm, forearm, and hand, and it was independently computer controllable in five degrees of freedom. The elbow-joint angle of the robotic arm was fixed at 90°, and the arm was moved in semicircles around the shoulder joint in a plane perpendicular to the water surface. Two-component PIV was used for flow visualization around the hand. The data of the forces and pressure acting on the hand were sampled at 200Hz and stored on a PC. When the maximum resultant force acting on the hand was observed, a pair of counter-rotating vortices appeared on the dorsal surface of the hand. A vortex attached to the hand increased the flow velocity, which led to decreased surface pressure, increasing the hydrodynamic forces. This phenomenon is known as the unsteady mechanism of force generation. We found that the drag force was 72% greater and the lift force was 4.8 times greater than the values estimated under steady flow conditions. Therefore, it is presumable that swimmers receive the benefits of this unsteady hydrodynamic force. PMID:23764175

  1. Posterior dislocation of the sternoclavicular joint leading to mediastinal compression.

    PubMed

    Jougon, J B; Lepront, D J; Dromer, C E

    1996-02-01

    Dislocations of the sternoclavicular joint are uncommon, and the posterior variety have a potential for considerable morbidity. We report a case with compression of the vital structures within the superior mediastinum. It was a rugby player getting run over by the scrum. The mechanism was an indirect force exerted forward and laterally against the shoulder. The patient complained of pain and dysphagia. A systolic right cervical murmur was heard. Angiography was normal and esophagography showed extrinsic esophageal compression. Surgical reduction was performed because there was a slight pneumomediastinum on the computed tomography. This case report demonstrates the mechanism, complications, and treatment of such a lesion. PMID:8572795

  2. Enhanced crosslimb transfer of force-field learning for dynamics that are identical in extrinsic and joint-based coordinates for both limbs

    PubMed Central

    de Rugy, Aymar; Howard, Ian S.; Ingram, James N.; Wolpert, Daniel M.

    2015-01-01

    Humans are able to adapt their motor commands to make accurate movements in novel sensorimotor environments, such as when wielding tools that alter limb dynamics. However, it is unclear to what extent sensorimotor representations, obtained through experience with one limb, are available to the opposite, untrained limb and in which form they are available. Here, we compared crosslimb transfer of force-field compensation after participants adapted to a velocity-dependent curl field, oriented either in the sagittal or the transverse plane. Due to the mirror symmetry of the limbs, the force field had identical effects for both limbs in joint and extrinsic coordinates in the sagittal plane but conflicting joint-based effects in the transverse plane. The degree of force-field compensation exhibited by the opposite arm in probe trials immediately after initial learning was significantly greater after sagittal (26 ± 5%) than transverse plane adaptation (9 ± 4%; P < 0.001), irrespective of whether participants learned initially with the left or the right arm or via abrupt or gradual exposure to the force field. Thus transfer was impaired when the orientation of imposed dynamics conflicted in intrinsic coordinates for the two limbs. The data reveal that neural representations of novel dynamics are only partially available to the opposite limb, since transfer is incomplete even when force-field perturbation is spatially compatible for the two limbs, according to both intrinsic and extrinsic coordinates. PMID:26581867

  3. On the mechanical power of joint extensions as affected by the change in muscle force (or cross-sectional area), ceteris paribus.

    PubMed

    Minetti, Alberto E

    2002-02-01

    This paper offers a reference prediction for the changes of mechanical power generated during a maximal (vertical, horizontal or inclined) joint extension, as a consequence of just the changes of muscle force or cross-sectional area (CSA). Ceteris paribus (all other things being equal), for a given joint, the exponents at which the force changes have to be raised to predict the duration, final speed and power of the maximal extension are -0.5, 0.5, and 1.5, respectively, for horizontal movements. For example, a force decrease of 30% leads to an increase of 19.5% of the duration of the extension and to a decrease of 16.3% and of 41.4% of its final speed and power. The equations for vertical or inclined extension performances are subject to the same exponents. However, the actual prediction is dependent upon the ratio between muscle strength and body weight, reflecting the fraction of the muscle strength (or CSA) acting against gravity during the manoeuvre. For instance, during a vertical extension, a force decrease of 30% leads to an increase of 30.9% of the duration of the extension and to a decrease of 29.3% and of 50.5% of its final speed and power. Based on the proposed model, a methodology is also described to detect the effects on the extension power of other determinants, in addition to CSA, of the useful force change (e.g. neuromuscular factors, motor control). PMID:11990751

  4. Comparison between ultrasound and plain X-ray in evaluating the cause of shoulder pain.

    PubMed

    Salek, K M; Mannan, M; Chowdhury, A Z; Haque, M A; Kaiser, M S; Nabi, S; Ferdousee, R A; Paul, B K; Ahmed, S M; Khan, M; Begum, M

    2011-01-01

    Painful shoulder is a common painful condition among patients. Apart from acute traumatic lesions such as fractures, dislocations, contusions, sprains and ruptured tendons, 85 to 90% of painful shoulders are due to adhesive capsulitis, acute or chronic calcific tendinitis, bursitis, bicipital tendinitis and lesions of the musculotendinous cuff. Arthritis is the cause of less than 5% of painful shoulders. For evaluating conditions of shoulder joint, X-ray has been regarded as only method of choice for long time. Magnetic resonance imaging (MRI) is an alternative procedure but the cost limits its utilization especially in Bangladesh. Ultrasonography is an effective imaging modality in the evaluation of both rotator and non-rotator cuff disorders. Because of low cost and availability, it can be an alternative procedure for the diagnosis of painful shoulder. The present study was conducted to assess ultrasonography as a useful modality in evaluating cases of shoulder pain and to compare the findings with X-ray findings. Thirty two patients with shoulder pain were evaluated by X-ray and Ultrasonography (USG). Clinical diagnosis was done for correlation. To identify the cause of shoulder pain, 100% patients were found normal in plain X-ray. On Ultrasonography (USG) 12.5% patients had displaced long head of biceps, 21.9% had biceps tendinitis, and 3.1% had bursitis. In the assessment of shoulder pathology, USG had a sensitivity of 73.3%, specificity of 88.2%, Positive predictive value (PPV) of 84.6%, Negative predictive value (NPV) of 78.9% and an accuracy of 81.3%. USG is a useful modality for evaluation the shoulder joint in case of painful shoulder even plain X-ray is non conclusive. PMID:21240157

  5. Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: Single case study

    PubMed Central

    Lee, Byung-Ki

    2015-01-01

    This study was conducted to examine the influence of combined exercise using proprioceptive neuromuscular facilitation (PNF) and deep breathing exercise on range of motion (ROM) and visual analog scale (VAS) score in acute frozen shoulder patient. The subject of this study was woman complained disabilities in daily routine due as a frozen left shoulder. The exercise program was composed of 11 sessions and continued four weeks. The program was composed of PNF and deep breathing exercise, and the subject was compared by passive ROM (shoulder flexion, abduction, and internal and external rotation) test and VAS score in shoulder movement before and after the exercise. The results showed that patient who practiced this program, the ROM of the shoulder joint increased and the VAS score decreased. Thus, this program was shown to be effective in suppressing pain and increasing the ROM of the shoulder joint in acute frozen shoulder patient. PMID:26535219

  6. Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: Single case study.

    PubMed

    Lee, Byung-Ki

    2015-10-01

    This study was conducted to examine the influence of combined exercise using proprioceptive neuromuscular facilitation (PNF) and deep breathing exercise on range of motion (ROM) and visual analog scale (VAS) score in acute frozen shoulder patient. The subject of this study was woman complained disabilities in daily routine due as a frozen left shoulder. The exercise program was composed of 11 sessions and continued four weeks. The program was composed of PNF and deep breathing exercise, and the subject was compared by passive ROM (shoulder flexion, abduction, and internal and external rotation) test and VAS score in shoulder movement before and after the exercise. The results showed that patient who practiced this program, the ROM of the shoulder joint increased and the VAS score decreased. Thus, this program was shown to be effective in suppressing pain and increasing the ROM of the shoulder joint in acute frozen shoulder patient. PMID:26535219

  7. The thrower's shoulder.

    PubMed

    Kinsella, Stuart D; Thomas, Stephen J; Huffman, G Russell; Kelly, John D

    2014-07-01

    Throwers, or athletes who engage in repetitive overhead motions, are a unique subset of athletes that experience distinct shoulder injuries. Athletes engaged in baseball comprise the majority of patients seeking orthopedic care for throwing related injuries. Injuries specific to throwers most commonly involve the labrum and the undersurface of the rotator cuff. In addition, tissue changes in both the anterior and posterior glenohumeral capsule are common with repetitive overhead motions. These capsular changes alter. This article will examine the pathomechanics of injuries to throwers, elaborate means of diagnoses of cuff and labral injury and discuss recent advances in both non-operative and operative interventions, including preventative principles. PMID:24975765

  8. Effect of shoulder taping on maximum shoulder external and internal rotation range in uninjured and previously injured overhead athletes during a seated throw.

    PubMed

    McConnell, Jenny; Donnelly, Cyril; Hamner, Samuel; Dunne, James; Besier, Thor

    2011-09-01

    The purpose of our study was to investigate whether shoulder taping affects shoulder kinematics in injured and previously injured overhead athletes during a seated throw. Twenty-six overhead college athletes threw a handball three times with and without tape, while seated on a chair. An 8-camera Vicon Motion Capture system recorded markers placed on the upper limb and trunk during each of the throwing conditions. Scaled musculoskeletal models of the upper limb were created using OpenSim and inverse kinematics used to obtain relevant joint angles. Shoulder taping had no main effect on external (ER) and internal (IR) rotation range (ROM) of the shoulder, but a significant interaction effect was found (p = 0.003 and 0.02, respectively), depending on previous injury status, whereby both the ER and IR ROM of the shoulder in the group of previously injured athletes decreased when taped (143-138° and 54-51°, respectively), but increased in the group who had never been injured (131-135° and 42-44°, respectively). Maximum abduction range and ball velocity were not affected by the application of shoulder taping, regardless of previous injury status. Thus, application of shoulder taping has a differential effect on maximum shoulder ER and IR ROM during throwing depending on previous injury status. These findings have implications for returning athletes to sport after injury and for screening athletes at risk of injury. PMID:21437968

  9. Reverse Total Shoulder Replacement with Minimal ACJ Excision Arthroplasty for Management of Massive ACJ Cyst - A Case Report

    PubMed Central

    Shaarani, Shahril R; Mullett, Hannan

    2014-01-01

    Massive acromioclavicular joint (ACJ) cysts are an extremely rare cause of shoulder impairment and with limited consensus in its management. We present the first published case report of a patient with a massive ACJ cyst treated with a reverse total shoulder replacement with minimal ACJ excision arthroplasty. PMID:25279019

  10. The use of computed tomography to diagnose chronic shoulder arthritis in an American white pelican (Pelecanus erythrorhynchos)

    PubMed Central

    Whitehead, Michelle C.; Parker, Dennilyn L.

    2015-01-01

    An American white pelican was presented with a complete left wing droop and no abnormal findings on conventional radiography. Computed tomography was used to diagnose chronic shoulder arthritis as a sequela to a suspected traumatic compressive fracture. This is the first case report to describe use of computed tomography to evaluate the avian shoulder joint. PMID:25750446

  11. EMG-Driven Forward-Dynamic Estimation of Muscle Force and Joint Moment about Multiple Degrees of Freedom in the Human Lower Extremity

    PubMed Central

    Sartori, Massimo; Reggiani, Monica; Farina, Dario; Lloyd, David G.

    2012-01-01

    This work examined if currently available electromyography (EMG) driven models, that are calibrated to satisfy joint moments about one single degree of freedom (DOF), could provide the same musculotendon unit (MTU) force solution, when driven by the same input data, but calibrated about a different DOF. We then developed a novel and comprehensive EMG-driven model of the human lower extremity that used EMG signals from 16 muscle groups to drive 34 MTUs and satisfy the resulting joint moments simultaneously produced about four DOFs during different motor tasks. This also led to the development of a calibration procedure that allowed identifying a set of subject-specific parameters that ensured physiological behavior for the 34 MTUs. Results showed that currently available single-DOF models did not provide the same unique MTU force solution for the same input data. On the other hand, the MTU force solution predicted by our proposed multi-DOF model satisfied joint moments about multiple DOFs without loss of accuracy compared to single-DOF models corresponding to each of the four DOFs. The predicted MTU force solution was (1) a function of experimentally measured EMGs, (2) the result of physiological MTU excitation, (3) reflected different MTU contraction strategies associated to different motor tasks, (4) coordinated a greater number of MTUs with respect to currently available single-DOF models, and (5) was not specific to an individual DOF dynamics. Therefore, our proposed methodology has the potential of producing a more dynamically consistent and generalizable MTU force solution than was possible using single-DOF EMG-driven models. This will help better address the important scientific questions previously approached using single-DOF EMG-driven modeling. Furthermore, it might have applications in the development of human-machine interfaces for assistive devices. PMID:23300725

  12. An Overview of Shoulder Instability and its Management

    PubMed Central

    Farrar, Nicholas Greville; Malal, Joby Jacob George; Fischer, Jochen; Waseem, Mohammed

    2013-01-01

    The assessment and management of patients with instability of the shoulder joint can be challenging, due to the varying ways patients present, the array of different classification systems, the confusing terminology used and the differing potential management strategies. This review article aims to provide a clear explanation of the common concepts in shoulder instability and how they relate to the assessment and management of patients. There are sections covering the mechanisms of shoulder stability, the clinical assessment of patients and imaging techniques. Beyond that there is a discussion on the common classifications systems used and the typical management options. Some patients fall into reasonably well defined categories of classification and in these cases, the management plan is relatively easy to define. Unfortunately, other patients can elude simple classification and in these instances their management requires very careful consideration. Further research may help to facilitate a better understanding of management of the patients in this latter group. PMID:24082972

  13. SHOULDER POSTERIOR INTERNAL IMPINGEMENT IN THE OVERHEAD ATHLETE

    PubMed Central

    Grant‐Nierman, Meggan; Lucas, Brennen

    2013-01-01

    Posterior internal impingement (PII) of the glenohumeral joint is a common cause of shoulder complex pain in the overhead athlete. This impingement is very different from standard outlet impingement seen in shoulder patients. Internal impingement is characterized by posterior shoulder pain when the athlete places the humerus in extreme external rotation and abduction as in the cocking phase of pitching or throwing. Impingement in this position occurs between the supraspinatus and or infraspinatus and the glenoid rim. Understanding regarding this pathology continues to evolve. Definitive understanding of precipitating factors, causes, presentation and methods of treatment have yet to be determined. A high index of suspicion should be used when attempting to make this diagnosis. This current concepts review presents the current thinking regarding pathophysiology, evaluation, and treatment of this condition. Level of Evidence: 5 PMID:23593557

  14. Congenital Rhabdomyosarcoma of Shoulder

    PubMed Central

    Khaleghnejad-Tabari, Ahmad; Mirshemirani, Alireza; Rouzrokh, Mohsen; Nariman, Shahin; Hassas-Yeganeh, Shaghayegh; Gharib, Atoosa; Khaleghnejad-Tabari, Nasibeh

    2012-01-01

    A 16-day-old female was referred with congenital swelling on her right shoulder. On examination, there was a hard, round, ecchymotic, nontender, slightly movable, warm and shiny 10x15 cm mass on the right axillary pits which was extended to the right side of neck and chest wall. The mass separated the shoulder from the chest wall causing paralysis of right hand. Chest X-ray, ultrasound and MRI with contrast demonstrated a soft tissue mass suspected to be a hemangioma. The mass rapidly increased in size despite aggressive steroid therapy with rupture and bleeding. On the 45th post natal day the baby was taken to operating room to control the bleeding and if possible total excision of the mass. The mass was separated easily from the surrounding tissue and was excised along with right upper extremity. At the end of surgery the baby had cardiac arrest, and apparently died of Disseminated Intravascular Coagulation (DIC). The final pathology report was Rhabdomyosarcoma (RMS). PMID:25628836

  15. Study of an upper arm exoskeleton for gravity balancing and minimization of transmitted forces.

    PubMed

    Dubey, V N; Agrawal, S K

    2011-11-01

    An upper-arm wearable exoskeleton has been designed for the assistance and functional training of humans. One of the goals of this design is to provide passive assistance to a user by gravity balancing, while keeping the transmitted forces to the shoulder joints at a minimum. Consistent with this goal, this paper discusses: analytical gravity balancing design conditions for the structure of the exoskeleton; a possible implementation of these conditions into practical designs; the minimization of transmitted joint forces to the shoulder while satisfying the gravity balancing conditions; the numerical optimization of the system for gravity balancing and minimization of transmitted forces; and the effect of parameter variation on joint moments and joint forces via numerical optimization. An implementation of the design was undertaken using zero-free-length springs. The design idea presented in this paper may be useful in relieving the actuators effort of exoskeletons to support the weight of the arm and therefore the possibility of using small actuators and making the system light and portable or even a stand-alone passive support device can be developed based on these gravity balancing conditions. PMID:22292201

  16. Wear simulation strategies for reverse shoulder arthroplasty implants.

    PubMed

    Langohr, G Daniel G; Athwal, George S; Johnson, James A; Medley, John B

    2016-05-01

    Reverse total shoulder arthroplasty is a clinically accepted surgical procedure; however, its long-term wear performance is not known. The purpose of this work is to review wear simulator testing of reverse total shoulder arthroplasty, to develop a wear simulator protocol for reverse total shoulder arthroplasty, and to test it by performing a pilot study. The review of wear simulator testing in the literature revealed considerable variation in protocols. A combination of our own cadaveric testing and those of other research groups helped in determining the magnitude and direction of joint loading for the development of the present protocol. A MATCO orbital-bearing simulator was adapted using custom fixtures to simulate a circumduction motion of the shoulder under mildly adverse conditions, and a pilot study gave wear rates within the wide range found in the literature. Arguments were presented in support of the currently developed protocol, but it was also suggested that, rather than rely on one protocol, a series of simulator wear protocols should be developed to fully test the implant wear performance in reverse total shoulder arthroplasty. PMID:27160563

  17. Clinical assessment and magnetic resonance imaging of the shoulder of patients with spinal cord injury

    PubMed Central

    Alves, Alex Pereira; Terrabuio Junior, Alberto Antonio; Pimenta, Ciro Jabur; Medina, Giovanna Ignácio Subirá; Rimkus, Carolina de Medeiros; Cliquet Júnior, Alberto

    2012-01-01

    Objective To study the shoulder of this group of patients using magnetic resonance imaging to detect clinical and subclinical disorders and establish a rehabilitation program. Methods Nine patients with spinal cord injury followed in the Laboratory of Biomechanics and Rehabilitation of the Locomotive System at HC/UNICAMP were divided into two groups according to the presence of paraplegia and tetraplegia and were clinically assessed for correlation with the imaging exams. Results Normal results were found in 41% of the shoulders. Most common injuries were tendinopathy of the supraspinatus and acromioclavicular joint degeneration. Eighty percent of injured shoulders had combined lesions. Conclusion A great variety of causes of shoulder pain was identified in paraplegic and tetraplegic subjects. Routine clinical assessment and imaging studies of the shoulder may contribute to the evolution of rehabilitation and reduction of pain and musculoskeletal disorders. Level of Evidence II, Development of Diagnostic Criteria on Consecutive Patients, With Universally Applied Reference "Gold" Standard. PMID:24453620

  18. Optimal management of shoulder impingement syndrome

    PubMed Central

    Escamilla, Rafael F; Hooks, Todd R; Wilk, Kevin E

    2014-01-01

    Shoulder impingement is a progressive orthopedic condition that occurs as a result of altered biomechanics and/or structural abnormalities. An effective nonoperative treatment for impingement syndrome is aimed at addressing the underlying causative factor or factors that are identified after a complete and thorough evaluation. The clinician devises an effective rehabilitation program to regain full glenohumeral range of motion, reestablish dynamic rotator cuff stability, and implement a progression of resistive exercises to fully restore strength and local muscular endurance in the rotator cuff and scapular stabilizers. The clinician can introduce stresses and forces via sport-specific drills and functional activities to allow a return to activity. PMID:24648778

  19. Overhead throwing injuries of the shoulder and elbow.

    PubMed

    Anderson, Mark W; Alford, Bennett A

    2010-11-01

    Injuries to the shoulder and elbow are common in athletes involved in sporting activities that require overhead motion of the arm. An understanding of the forces involved in the throwing motion, the anatomic structures most at risk, and the magnetic resonance imaging appearances of the most common associated injuries can help to improve diagnostic accuracy when interpreting imaging studies in these patients. PMID:21094403

  20. How much does inferior capsular shift reduce shoulder volume?

    PubMed

    Lubowitz, J; Bartolozzi, A; Rubinstein, D; Ciccotti, M; Schweitzer, M; Nazarian, L; Lombardi, J; Dellose, S; Landsdorf, A; Miller, L

    1996-07-01

    The purpose of this study was to quantitate the effect of inferior capsular shift on shoulder volume. Four fresh frozen cadaveric shoulders were analyzed. Volume before and after shift was determined using 3 techniques: (1) Magnetic resonance imaging sequences were digitized to computer and analyzed for volume via a 35-mm camera using Cue 2 software. The capsule was delineated by contrast between light and dark regions. Volume was calculated by summing the total area of respective slices. (2) Ultrasound images, obtained after surgical exposure of the capsule, were digitized. Volume was calculated using the formula for a prolate ellipsoid. (3) An 18-gauge needle was used to inject and evacuate saline via an anterior approach. Quantity of aspirated fluid provided a direct measure of volume. Inferior capsular shift was performed. After the operation, measurements were repeated. Inferior capsular shift reduced volume in all shoulders with each technique. On average, inferior capsular shift reduced joint volume by 57 %). A measurable reduction in shoulder joint volume is an effect of capsular shift. This measurement may have clinical application if volume is an indicator of instability or laxity. PMID:8653983

  1. Effect of gender and stroke rate on joint power characteristics of the upper extremity during simulated rowing.

    PubMed

    Attenborough, Alison S; Smith, Richard M; Sinclair, Peter J

    2012-01-01

    Males typically have greater upper body strength than do females, which is likely to impact on the rowing techniques adopted by each sex. The aim of this study was to quantify energy contributions and compare the joint power production of upper extremity joints between the sexes. Seven males and eight females performed 60 s trials at five different stroke rates. External forces were measured at the handle and stretcher, while kinematics were recorded by motion analysis. Joint moments were derived by inverse dynamic calculations, followed by the calculation of joint powers and gross mechanical energy expenditure. Male rowers expended more total external energy per stroke and made a larger percentage contribution of angular shoulder energy to their total external energy expenditure. As stroke rate increased, the contribution from elbow and angular shoulder energy contributions decreased for both males and females. Female rowers decreased their angular shoulder contribution at a slower rate than did males as stroke rate increased. The overall percentage of work done on the stretcher was higher for male rowers, and this difference further increased at higher stroke rates. The results of this study suggest that specific upper body conditioning may be particularly important for female rowers. PMID:22296106

  2. Repetitive arm motion-induced fatigue affects shoulder but not endpoint position sense.

    PubMed

    Emery, Kim; Côté, Julie N

    2012-02-01

    Neck/shoulder pain has previously been linked to repetitive work and muscle fatigue. We have shown that asymptomatic people performing repetitive upper limb tasks display signs of shoulder fatigue and of whole-body compensatory strategies. However, the role played by the proprioceptive system in the production of these compensatory strategies has not been studied. A group of asymptomatic adults (n = 18) performed a repetitive pointing task at shoulder height to fatigue. Before and after fatigue, they performed two position sense tasks, eyes closed: a single-joint task where they abducted their shoulder to the perceived horizontal and a multi-joint task, where they stood and placed their finger at the perceived location of a target in front of them at shoulder height. After fatigue, subjects made larger shoulder errors by raising their elbow higher above the horizontal (~ +1.3 cm) than before fatigue; however, their finger position accuracy was not changed, despite all subjects performing the movement in less time (~ -0.18 s) while fatigued. There were no gender differences in shoulder or finger position accuracy before or after fatigue; however, there were gender differences in the perceived finger-target location and in the temporal characteristics of the finger movement toward the target. Results suggest that healthy individuals are able to develop strategies to compensate for fatigue-induced deficits at one joint to maintain the endpoint accuracy of a multi-joint task constant. Gender differences in movement strategies and perception of endpoint location may play parts in the previously reported gender differences in work-related neck/shoulder symptoms. PMID:22124803

  3. A method for shoulder range-of-motion estimation using a single wireless sensor node.

    PubMed

    Thiemjarus, Surapa; Marukatat, Sanparith; Poomchoompol, Pongwat

    2013-01-01

    This study proposes a method for range-of-motion (ROM) estimation based on the acceleration and geomagnetic data acquired using a single miniaturized wireless sensor node. An experiment on eight shoulder rehabilitation protocols in real human subjects has been conducted, with a sensor placed on user's left and right upper arms and wrists. The experimental results demonstrate the limitations of estimation methods that use sensors placed on skin surface and that, despite being a different body segment, the wrist is a better placement position for sensor-based shoulder joint ROM measurement than the shoulder itself. PMID:24111083

  4. Generalized Ligamentous Laxity: An Important Predisposing Factor for Shoulder Injuries in Athletes

    PubMed Central

    Saremi, Hossein; Yavarikia, Alireza; Jafari, Nasibeh

    2016-01-01

    Background Generalized ligamentous laxity is defined as an increased range of joint motion compared to that of the general population. It is a predisposing factor for sports injuries, especially in the lower extremities. Nevertheless, there is little evidence about the relationship between generalized ligamentous laxity and sports injuries in the upper extremities. Objectives To evaluate the relationship of generalized ligamentous laxity with acute and chronic shoulder injuries in athletes. Patients and Methods Our study comprised 118 volunteer athletes with a history of at least six months of sports activities and a shoulder injury in the three years prior to participation in our study. The athletes were divided into two groups: those with or without generalized ligamentous laxity. Acute and chronic shoulder injuries, shoulder pain, shoulder instability, and functional status assessed via the QuickDASH measure were determined and compared between the two groups. A P value of less than 0.05 was considered significant. Results Group A (with ligamentous laxity) consisted of 43 participants (36.4%) and group B (without ligamentous laxity) consisted of 75 participants (63.6%). The athletes in group A had more shoulder pain (P = 0.016), chronic shoulder injuries (P = 0.032), and shoulder instability (P = 0.004), and less functionality (P = 0.030) than those in group B. If fracture were not considered an acute injury in both groups, the athletes with generalized ligamentous laxity would have had more acute shoulder injuries. Conclusions Generalized ligamentous laxity is an important predisposing factor for acute and chronic shoulder injuries in athletes. Prescreening programs for beginners and rehabilitation shoulder programs for sports athletes at high risk are strongly recommended. PMID:27621940

  5. A new autoreduction method for anterior shoulder dislocation: the GONAIS method.

    PubMed

    Gonai, Shiro; Kamio, Yoshito; Matsuoka, Tomoyuki; Harunari, Manabu; Saito, Yutaka; Takuma, Kiyotsugu

    2016-01-01

    Although techniques for autoreduction of anterior shoulder dislocation have been developed, no reports have detailed an autoreduction method using the zero position and traction on the affected arm. Therefore, we developed a new autoreduction technique using the zero position and gentle autotraction. The objective of this study is to present our experience with a new method for autoreduction of anterior shoulder dislocation called the GONAIS (a backronym for “Grasp a waist-high object, Opposite arm assists, Nonsedated, Autoreduction/autotraction, Immobilize the grasped object, and Squatting and stooping”) method. A 41-year-old healthy woman with a history of left shoulder dislocation presented to the emergency department with left shoulder pain while attaching her seatbelt. The X-ray examination revealed subcoracoid dislocation of the left shoulder. The patient tried the GONAIS method after simple guidance and demonstration. Although she felt pain once when weakening traction, she achieved autoreduction successfully in only 2 min and 50 s. Clinical examination after autoreduction revealed normal neurovascular findings and appearance of the shoulder. The X-ray revealed glenohumeral joint reduction and no fracture. Here, our patient using the GONAIS method achieved shoulder autoreduction in a short time. The GONAIS method does not require lying down or sitting on the ground, does not necessarily require the opposite arm, and is minimally invasive. This method would likely be helpful for those who cannot quickly reach a hospital for treatment of anterior shoulder dislocation. PMID:26168697

  6. An unusual presentation of metastatic melanoma in the shoulder.

    PubMed

    Branford White, Harriet A; Mourant, Philipa; Woods, David A

    2016-07-01

    A 72-year-old lady underwent a Copeland hemiarthoplasty of the shoulder for rotator cuff arthropathy with a good functional outcome. Her past medical history included previous management of a malignant melanoma. Several years following arthroplasty surgery, she acutely developed signs and symptoms of prosthetic joint infection. The present case report describes the metastatic spread of malignant melanoma mimicking that of prosthetic sepsis. PMID:27583015

  7. An unusual presentation of metastatic melanoma in the shoulder

    PubMed Central

    Mourant, Philipa; Woods, David A

    2016-01-01

    A 72-year-old lady underwent a Copeland hemiarthoplasty of the shoulder for rotator cuff arthropathy with a good functional outcome. Her past medical history included previous management of a malignant melanoma. Several years following arthroplasty surgery, she acutely developed signs and symptoms of prosthetic joint infection. The present case report describes the metastatic spread of malignant melanoma mimicking that of prosthetic sepsis. PMID:27583015

  8. Frozen shoulder: a sympathetic dystrophy?

    PubMed

    Müller, L P; Müller, L A; Happ, J; Kerschbaumer, F

    2000-01-01

    Diagnostic and clinical features of the frozen shoulder syndrome and the Sudeck syndrome are similar in many aspects. Radioisotope bone scan shows an increased uptake in affected areas in both diseases, while native radiographs show a progressive demineralisation. Measurement of bone mineral density (BMD) by quantitative digital radiography objectified these local decalcification processes in an early stage of the frozen shoulder syndrome; 10 of 12 patients with primary frozen shoulder had BMD decreases greater 21% in the humeral head of the affected shoulder compared to the non-affected side. In the immobilised control group with degenerative changes of the rotator cuff, calcifying tendinitis and shoulder instability (n = 12) and in the group of healthy probands (n = 20), the difference between the affected and non-affected side (left and right humerus of the healthy probands) was only more than 21% in one case each. There are several references in the literature that assume frozen shoulder to be an algoneurodystrophic process; our observations support this hypothesis, possibly leading to earlier diagnoses and extended therapeutic management. PMID:10653111

  9. Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction

    PubMed Central

    DeAngelis, Joseph P.; Hertz, Benjamin; Wexler, Michael T.; Patel, Nehal; Walley, Kempland C.; Harlow, Ethan R.; Manoukian, Ohan S.; Masoudi, Aidin; Vaziri, Ashkan; Ramappa, Arun J.; Nazarian, Ara

    2015-01-01

    Background: Shoulder pain is a common problem, with 30% to 50% of the American population affected annually. While the majority of these shoulder problems improve, there is a high rate of recurrence, as 54% of patients experience persistent symptoms 3 years after onset. Purpose: Posterior shoulder tightness has been shown to alter glenohumeral (GH) kinematics. Clinically, posterior shoulder contractures result in a significant loss of internal rotation and abduction (ABD). In this study, the effect of a posterior capsular contracture on GH kinematics was investigated using an intact cadaveric shoulder without violating the joint capsule or the rotator cuff. Study Design: Controlled laboratory study. Methods: Glenohumeral motion, humeral load, and subacromial contact pressure were measured in 6 fresh-frozen left shoulders during passive ABD from 60° to 100° using an automated robotic upper extremity testing system. Baseline values were compared with the experimental condition in which the full thickness of posterior tissues was plicated without decompressing the joint capsule. Results: Posterior soft tissue plication resulted in increased compression between the humeral head and the glenoid (axial load) at 90° of ABD. Throughout ABD, the posterior contracture increased the anterior and superior moment on the humeral head, but it did not change the GH kinematics in this intact model. As a result, there was no increase in the subacromial contact pressure during ABD with posterior plication. Conclusion: In an intact cadaveric shoulder, posterior contracture does not alter GH motion or subacromial contact pressure during passive ABD. By tightening the soft tissue envelope posteriorly, there is an increase in compressive load on the articular cartilage and anterior/superior force on the humeral head. These findings suggest that subacromial impingement in the setting of a posterior soft tissue contracture may result from alterations in scapulothoracic motion, not

  10. Counterrotating-Shoulder Mechanism for Friction Stir Welding

    NASA Technical Reports Server (NTRS)

    Nunes, Arthur C., Jr.

    2007-01-01

    A counterrotating-shoulder mechanism has been proposed as an alternative to the mechanism and fixtures used in conventional friction stir welding. The mechanism would internally react most or all of the forces and torques exerted on the workpiece, making it unnecessary to react the forces and torques through massive external fixtures. In conventional friction stir welding, a rotating pin tool is inserted into, and moved along, a weld seam. As the pin tool moves, it stirs together material from the opposite sides of the seam to form the weld. A large axial plunge force must be exerted upon the workpiece through and by the pin tool and a shoulder attached above the pin tool in order to maintain the pressure necessary for the process. The workpiece is secured on top of an anvil, which supports the workpiece against the axial plunge force and against the torque exerted by the pin tool and shoulder. The anvil and associated fixtures must be made heavy (and, therefore, are expensive) to keep the workpiece stationary. In addition, workpiece geometries must be limited to those that can be accommodated by the fixtures. The predecessor of the proposed counterrotating-shoulder mechanism is a second-generation, self-reacting tool, resembling a bobbin, that makes it possible to dispense with the heavy anvil. This tool consists essentially of a rotating pin tool with opposing shoulders. Although the opposing shoulders maintain the necessary pressure without need to externally apply or react a large plunge force, the torque exerted on the workpiece remains unreacted in the absence of a substantial external fixture. Depending on the RPM and the thickness of the workpiece, the torque can be large. The proposed mechanism (see figure) would include a spindle attached to a pin tool with a lower shoulder. The spindle would be coupled via splines to the upper one of three bevel gears in a differential drive. The middle bevel gear would be the power-input gear and would be coupled to the

  11. Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit

    PubMed Central

    Chung, Hoejeong; Yoon, Yeo-Seung; Shin, Ji-Soo; Shin, John Junghun

    2016-01-01

    Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment. PMID:27583119

  12. Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit.

    PubMed

    Chung, Hoejeong; Yoon, Yeo-Seung; Shin, Ji-Soo; Shin, John Junghun; Kim, Doosup

    2016-09-01

    Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment. PMID:27583119

  13. Elbow and Shoulder Lesions of Baseball Players*

    PubMed Central

    2008-01-01

    plays a part in the disability and should be the first thought in the mind of the examiner” [2]. Dr. George Bennett is shown. Photograph is reproduced with permission and ©American Academy of Orthopaedic Surgeons. Fifty Years of Progress, 1983. References Bennett GE. Shoulder and elbow lesions of the professional baseball player. JAMA. 1941;117:510–514. Bennett GE. Elbow and shoulder lesions of baseball players. Am J Surg. 1959;98:484–492. George Eli Bennett. J Bone Joint Surg Am. 1962;44:1711–1713. Scorecard. Mender of immortals. Sports Illustrated. July 30,1962:7. PMID:18196375

  14. Upper limb joint motion of two different user groups during manual wheelchair propulsion

    NASA Astrophysics Data System (ADS)

    Hwang, Seonhong; Kim, Seunghyeon; Son, Jongsang; Lee, Jinbok; Kim, Youngho

    2013-02-01

    Manual wheelchair users have a high risk of injury to the upper extremities. Recent studies have focused on kinematic and kinetic analyses of manual wheelchair propulsion in order to understand the physical demands on wheelchair users. The purpose of this study was to investigate upper limb joint motion by using a motion capture system and a dynamometer with two different groups of wheelchair users propelling their wheelchairs at different speeds under different load conditions. The variations in the contact time, release time, and linear velocity of the experienced group were all larger than they were in the novice group. The propulsion angles of the experienced users were larger than those of the novices under all conditions. The variances in the propulsion force (both radial and tangential) of the experienced users were larger than those of the novices. The shoulder joint moment had the largest variance with the conditions, followed by the wrist joint moment and the elbow joint moment. The variance of the maximum shoulder joint moment was over four times the variance of the maximum wrist joint moment and eight times the maximum elbow joint moment. The maximum joint moments increased significantly as the speed and load increased in both groups. Quick and significant manipulation ability based on environmental changes is considered an important factor in efficient propulsion. This efficiency was confirmed from the propulsion power results. Sophisticated strategies for efficient manual wheelchair propulsion could be understood by observation of the physical responses of each upper limb joint to changes in load and speed. We expect that the findings of this study will be utilized for designing a rehabilitation program to reduce injuries.

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

    NASA Astrophysics Data System (ADS)

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

    2016-02-01

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

  16. Development of a mathematical model for predicting electrically elicited quadriceps femoris muscle forces during isovelocity knee joint motion

    PubMed Central

    Perumal, Ramu; Wexler, Anthony S; Binder-Macleod, Stuart A

    2008-01-01

    Background Direct electrical activation of skeletal muscles of patients with upper motor neuron lesions can restore functional movements, such as standing or walking. Because responses to electrical stimulation are highly nonlinear and time varying, accurate control of muscles to produce functional movements is very difficult. Accurate and predictive mathematical models can facilitate the design of stimulation patterns and control strategies that will produce the desired force and motion. In the present study, we build upon our previous isometric model to capture the effects of constant angular velocity on the forces produced during electrically elicited concentric contractions of healthy human quadriceps femoris muscle. Modelling the isovelocity condition is important because it will enable us to understand how our model behaves under the relatively simple condition of constant velocity and will enable us to better understand the interactions of muscle length, limb velocity, and stimulation pattern on the force produced by the muscle. Methods An additional term was introduced into our previous isometric model to predict the force responses during constant velocity limb motion. Ten healthy subjects were recruited for the study. Using a KinCom dynamometer, isometric and isovelocity force data were collected from the human quadriceps femoris muscle in response to a wide range of stimulation frequencies and patterns. % error, linear regression trend lines, and paired t-tests were used to test how well the model predicted the experimental forces. In addition, sensitivity analysis was performed using Fourier Amplitude Sensitivity Test to obtain a measure of the sensitivity of our model's output to changes in model parameters. Results Percentage RMS errors between modelled and experimental forces determined for each subject at each stimulation pattern and velocity showed that the errors were in general less than 20%. The coefficients of determination between the measured

  17. Does Subacromial Osteolysis Affect Shoulder Function after Clavicle Hook Plating?

    PubMed Central

    Sun, Siwei; Gan, Minfeng; Sun, Han; Wu, Guizhong; Yang, Huilin; Zhou, Feng

    2016-01-01

    Purpose. To evaluate whether subacromial osteolysis, one of the major complications of the clavicle hook plate procedure, affects shoulder function. Methods. We had performed a retrospective study of 72 patients diagnosed with a Neer II lateral clavicle fracture or Degree-III acromioclavicular joint dislocation in our hospital from July 2012 to December 2013. All these patients had undergone surgery with clavicle hook plate and were divided into two groups based on the occurrence of subacromial osteolysis. By using the Constant-Murley at the first follow-up visit after plates removal, we evaluated patients' shoulder function to judge if it has been affected by subacromial osteolysis. Results. We have analyzed clinical data for these 72 patients, which shows that there is no significant difference between group A (39 patients) and group B (33 patients) in age, gender, injury types or side, and shoulder function (the Constant-Murley scores are 93.38 ± 3.56 versus 94.24 ± 3.60, P > 0.05). Conclusion. The occurrence of subacromial osteolysis is not rare, and also it does not significantly affect shoulder function. PMID:27034937

  18. Efficacy of a trunk orthosis with joints providing resistive force on low-back load in elderly persons during static standing

    PubMed Central

    Katsuhira, Junji; Matsudaira, Ko; Yasui, Tadashi; Iijima, Shinno; Ito, Akihiro

    2015-01-01

    Purpose Postural alignment of elderly people becomes poor due to aging, possibly leading to low-back pain and spinal deformity. Although there are several interventions for treating these conditions, no previous study has reported the effectiveness of a spinal orthosis or lumbosacral orthosis (LSO) in healthy elderly people without specific spinal deformity. We therefore developed a trunk orthosis to decrease low-back muscle activity while training good postural alignment through resistive force provided by joints with springs (here, called the ORF, which stands for orthosis with joints providing resistive force) as a preventive method against abnormal posture and low-back pain in healthy elderly persons. Patients and methods Fifteen community-dwelling elderly men participated in this study. Participants stood freely for 10 seconds in a laboratory setting under three conditions: without an orthosis, with the ORF, and with an LSO. The Damen corset LSO was selected as it is frequently prescribed for patients with low-back pain. Postural alignment during static standing was recorded using a three-dimensional motion capture system employing infrared cameras. Two force plates were used to record center of pressure. Electromyograms were obtained for bilateral erector spinae (ES), left internal abdominal oblique, and right gluteus medius muscles. Results Pelvis forward tilt angle tended to increase while wearing the ORF and decrease while wearing the LSO, but these results were not significant compared to no orthosis. Thorax extension angle and thorax angle on pelvis coordinate system significantly increased while wearing the ORF compared to the other two conditions. ES activity significantly decreased while wearing the ORF compared to the other two conditions. Internal oblique activity was significantly smaller while wearing the LSO than with no orthosis. Center of pressure did not significantly differ among the conditions. Conclusion The ORF significantly improved trunk

  19. Return to Sport Following Shoulder Surgery in the Elite Pitcher

    PubMed Central

    Harris, Joshua D.; Frank, Jonathan M.; Jordan, Mark A.; Bush-Joseph, Charles A.; Romeo, Anthony A.; Gupta, Anil K.; Abrams, Geoffrey D.; McCormick, Frank M.; Bach, Bernard R.

    2013-01-01

    Context: The ability to return to elite pitching, performance, and clinical outcomes of shoulder surgery in elite baseball pitchers are not definitively established. Objective: To determine (1) the rate of return to sport (RTS) in elite pitchers following shoulder surgery, (2) postoperative clinical outcomes upon RTS, and (3) performance upon RTS and to compare RTS rates in different types of shoulder surgery. Data Sources: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched. Study Selection: Levels I-IV evidence were eligible for inclusion if performance-based (eg, RTS) and/or clinical outcome–based reporting of outcomes were reported following surgical treatment of shoulder pathology in elite pitchers (major or minor league or collegiate). Data Extraction: Subject, shoulder, and pre- and postoperative performance-based variables of interest were extracted. All shoulder surgery types were potentially inclusive (eg, open, arthroscopic, rotator cuff, labrum, biceps, acromioclavicular joint, fracture). Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS). Results: Six studies were analyzed (287 elite male pitchers [mean age, 27 years] who underwent shoulder surgery, with 99% on the dominant, throwing shoulder). MCMS was 38 (poor). Most pitchers were professional, with a mean career length of 6.58 years and postoperative clinical follow-up of 3.62 years. In 5 of 6 studies, multiple diagnoses were addressed concomitantly at surgery. Rate of RTS was 68% at mean 12 months following surgery. Twenty-two percent of Major League Baseball (MLB) pitchers never RTS in MLB. Overall performance did improve following surgery; however, this did not improve to pre-injury levels. Conclusion: In this systematic review, the rate of return to elite baseball pitching following surgery was

  20. Shoulder Injuries in US Astronauts Related to EVA Suit Design

    NASA Technical Reports Server (NTRS)

    Scheuring, Rick; McCulloch, Pat; Van Baalen, Mary; Watson, Richard; Bowen, Steve; Blatt, Terri

    2012-01-01

    There are multiple factors associated with the mechanism of injury that leads to shoulder injury requiring surgical repair. Despite the injury prevention measures taken from the 2003 Shoulder Tiger Team recommendations, shoulder injuries and subsequent shoulder surgeries remain relatively unchanged.

  1. Planning a Family Policy for California: First Year Report of the Joint Select Task Force on the Changing Family.

    ERIC Educational Resources Information Center

    Novick, Sherry; And Others

    This publication presents the findings of a California State Legislature task force on the changing needs of that state's families. An introduction summarizes the report's findings and lists five principles to guide the development of public policy. The next section, "Work and Family: The Contemporary Balancing Act," explores contemporary…

  2. Use of robotic technology for diathrodial joint research.

    PubMed

    Woo, S L; Debski, R E; Wong, E K; Yagi, M; Tarinelli, D

    1999-12-01

    Knowledge of diarthrodial joint mechanics and specific function of the ligaments are needed in order to understand injury mechanisms, improve surgical procedures and design better post-surgical rehabilitation protocols. To facilitate these needs, a robotic/universal force-moment sensor (UFS) testing system was developed to measure joint kinematics in multiple degree-of-freedom and the in situ forces in the ligaments. When operated in the position control mode, the testing system applies a known load to the intact joint while the motion and force data are recorded. After transection of a ligament, the recorded motion for the intact joint is repeated and new force and moment data is recorded by the UFS. Since the robot reproduces the identical initial position as well as path of joint motion before and after a ligament is transected, the in situ force in the ligament is the difference between the two sets of force and moment data. In force control mode, a known force is applied to the intact knee while the kinematics are recorded. After ligament transection, the same force is applied while the changes in kinematics are again recorded. Testing in this mode is similar to a clinical examination that diagnoses ligament injury. To date, this testing system has been used for experimental studies that examine the anterior cruciate ligament & posterior cruciate ligament of the knee and ligaments of the shoulder. A three-dimensional finite element model has also been constructed based on CT/MRI scans of a knee specimen and validated using data obtained with the testing system. Once in vivo kinematics (such as during gait analysis or throwing activities) are available, the robotic/UFS testing system can be programmed to reproduce these joint kinematics on young human cadaveric specimens in order to generate a database for in situ forces in the ligaments, or Ligament replacement grafts. With appropriate computational models, the stresses and strains in these tissues in vivo can

  3. Geodatabase of environmental information for Air Force Plant 4 and Naval Air Station-Joint Reserve Base Carswell Field, Fort Worth, Texas, 1990-2004

    USGS Publications Warehouse

    Shah, Sachin D.; Quigley, Sean M.

    2005-01-01

    Air Force Plant 4 (AFP4) and adjacent Naval Air Station-Joint Reserve Base (NAS-JRB) at Fort Worth, Tex., constitute a government-owned, contractor-operated (GOCO) facility that has been in operation since 1942. Contaminants from the facility, primarily volatile organic compounds (VOCs) and metals, have entered the groundwater-flow system through leakage from waste-disposal sites (landfills and pits) and from manufacturing processes (U.S. Air Force, Aeronautical Systems Center, 1995). The U.S. Geological Survey (USGS), in cooperation with the U.S. Air Force (USAF), Aeronautical Systems Center, Environmental Management Directorate (ASC/ENVR), developed a comprehensive database (or geodatabase) of temporal and spatial environmental information associated with the geology, hydrology, and water quality at AFP4 and NAS-JRB. The database of this report provides information about the AFP4 and NAS-JRB study area including sample location names, identification numbers, locations, historical dates, and various measured hydrologic data. This database does not include every sample location at the site, but is limited to an aggregation of selected digital and hardcopy data of the USAF, USGS, and various consultants who have previously or are currently working at the site.

  4. Characterization of the tensile properties of friction stir welded aluminum alloy joints based on axial force, traverse speed, and rotational speed

    NASA Astrophysics Data System (ADS)

    Panda, Biranchi; Garg, A.; Jian, Zhang; Heidarzadeh, Akbar; Gao, Liang

    2016-06-01

    Friction stir welding (FSW) process has gained attention in recent years because of its advantages over the conventional fusion welding process. These advantages include the absence of heat formation in the affected zone and the absence of large distortion, porosity, oxidation, and cracking. Experimental investigations are necessary to understand the physical behavior that causes the high tensile strength of welded joints of different metals and alloys. Existing literature indicates that tensile properties exhibit strong dependence on the rotational speed, traverse speed, and axial force of the tool that was used. Therefore, this study introduces the experimental procedure for measuring tensile properties, namely, ultimate tensile strength (UTS) and tensile elongation of the welded AA 7020 Al alloy. Experimental findings suggest that a welded part with high UTS can be achieved at a lower heat input compared with the high heat input condition. A numerical approach based on genetic programming is employed to produce the functional relationships between tensile properties and the three inputs (rotational speed, traverse speed, and axial force) of the FSW process. The formulated models were validated based on the experimental data, using the statistical metrics. The effect of the three inputs on the tensile properties was investigated using 2D and 3D analyses. A high UTS was achieved, including a rotational speed of 1050 r/min and traverse speed of 95 mm/min. The results also indicate that 8 kN axial force should be set prior to the FSW process.

  5. Shoulder biomechanics and the success of translational research.

    PubMed

    Cutti, Andrea Giovanni; Chadwick, Edward K

    2014-03-01

    In 2009, the International Shoulder Group (ISG) had the opportunity to propose to the readers of Medical and Biological Engineering and Computing a Special Issue on shoulder biomechanics. At that time, we pointed out that the field was evolving to include more applied research. After 4 years, we can confirm that impression: 10 out of 12 papers included in this second Special Issue deal with clinical related questions, through theoretical and experimental methodologies. This demonstrates that the translational research at the base of ISG foundation in 1989 is effective. We think that the papers of this issue will have an impact on clinics in general and on the treatment of work-related injuries and diseases in particular. Based on the statistics of the Italian Workers' Compensation Authority (INAIL), injuries at the shoulder are first in terms of average duration of "temporary total disability to work". Moreover, occupational diseases at the shoulder in the industrial and services sector represented 16 % of all occupational diseases in 2012, i.e., 46 % of those related to the upper limb. These data stress the need for specific interventions, with the contribution of both researchers and policy makers. Starting from the papers included here, we would encourage additional efforts on: (1) quantitative analysis of shoulder loading during tasks associated with musculoskeletal injuries, and ways to reduce that loading, (2) simple and effective tools to improve the diagnosis and outcome assessment of motion-related shoulder diseases, and (3) the development of rehabilitation treatments focused on occupational tasks, taking advantage of state-of-the-art biofeedback technologies, and exploiting the power of biomechanical models for muscle force prediction. PMID:24567068

  6. Painful Shoulder in Swimmers: A Diagnostic Challenge.

    ERIC Educational Resources Information Center

    McMaster, William C.

    1986-01-01

    This article discusses the incidence, diagnosis, and treatment of painful shoulder in swimmers, including: regional problems that can cause shoulder pain; physical, clinical, and laboratory tests for diagnostic use; and approaches to management of the problem. (Author/CB)

  7. Shoulder complex linkage mechanism for humanlike musculoskeletal robot arms.

    PubMed

    Ikemoto, Shuhei; Kimoto, Yuya; Hosoda, Koh

    2015-12-01

    The shoulder complex in the human body consists of the scapula, clavicle, humerus, and thorax and bears the load imposed by arm movements while at the same time realizing a wide range of motions. To mimic and exploit its role, several musculoskeletal robot arms with shoulder complex mechanisms have been developed. However, although many research groups have tried to design the structures using links and joints that faithfully correspond to the bones and joints in the human shoulder complex, its function has not been successfully reproduced because biologically plausible designs seriously compromise engineering plausibility. In this paper, we propose a linkage mechanism that can reproduce complex three-dimensional scapulo movements and considers the trade-off between biological and engineering plausibilities. Subsequently, the design was validated by driving the mechanism using pneumatic artificial muscles (PAMs) placed similarly to muscles in humans. Further, we present experiments in which the robot was controlled by surface electromyographic signals from a human. We show that the proposed design, due to its kinematic similarity with human musculoskeletal systems, eases the conversion between the surface electromyogram signals and the PAMs control inputs. PMID:26539726

  8. Homo floresiensis and the evolution of the hominin shoulder.

    PubMed

    Larson, Susan G; Jungers, William L; Morwood, Michael J; Sutikna, Thomas; Jatmiko; Saptomo, E Wahyu; Due, Rokus Awe; Djubiantono, Tony

    2007-12-01

    The holotype of Homo floresiensis, diminutive hominins with tiny brains living until 12,000 years ago on the island of Flores, is a partial skeleton (LB1) that includes a partial clavicle (LB1/5) and a nearly complete right humerus (LB1/50). Although the humerus appears fairly modern in most regards, it is remarkable in displaying only 110 degrees of humeral torsion, well below modern human average values. Assuming a modern human shoulder configuration, such a low degree of humeral torsion would result in a lateral set to the elbow. Such an elbow joint would function more nearly in a frontal than in a sagittal plane, and this is certainly not what anyone would have predicted for a tool-making Pleistocene hominin. We argue that Homo floresiensis probably did not have a modern human shoulder configuration: the clavicle was relatively short, and we suggest that the scapula was more protracted, resulting in a glenoid fossa that faced anteriorly rather than laterally. A posteriorly directed humeral head was therefore appropriate for maintaining a normally functioning elbow joint. Similar morphology in the Homo erectus Nariokotome boy (KNM-WT 15000) suggests that this shoulder configuration may represent a transitional stage in pectoral girdle evolution in the human lineage. PMID:17692894

  9. A Complexity Science-Based Framework for Global Joint Operations Analysis to Support Force Projection: LDRD Final Report.

    SciTech Connect

    Lawton, Craig R.

    2015-01-01

    The military is undergoing a significant transformation as it modernizes for the information age and adapts to address an emerging asymmetric threat beyond traditional cold war era adversaries. Techniques such as traditional large-scale, joint services war gaming analysis are no longer adequate to support program evaluation activities and mission planning analysis at the enterprise level because the operating environment is evolving too quickly. New analytical capabilities are necessary to address modernization of the Department of Defense (DoD) enterprise. This presents significant opportunity to Sandia in supporting the nation at this transformational enterprise scale. Although Sandia has significant experience with engineering system of systems (SoS) and Complex Adaptive System of Systems (CASoS), significant fundamental research is required to develop modeling, simulation and analysis capabilities at the enterprise scale. This report documents an enterprise modeling framework which will enable senior level decision makers to better understand their enterprise and required future investments.

  10. Clinical pathology testing recommendations for nonclinical toxicity and safety studies. AACC-DACC/ASVCP Joint Task Force.

    PubMed

    Weingand, K; Bloom, J; Carakostas, M; Hall, R; Helfrich, M; Latimer, K; Levine, B; Neptun, D; Rebar, A; Stitzel, K

    1992-01-01

    Clinical pathology testing in nonclinical toxicity and safety studies is an important part of safety assessment. In recent years, clinical laboratory testing has rapidly expanded and improved. Some government regulatory agencies provide guidelines for clinical pathology testing in nonclinical toxicity and safety studies. To improve these testing guidelines and the resultant safety assessments, the American Association for Clinical Chemistry's Division of Animal Clinical Chemistry and the American Society for Veterinary Clinical Pathology formed a joint committee to provide expert recommendations for clinical pathology testing of laboratory species involved in subchronic and chronic nonclinical toxicity and safety studies. These recommendations include technical recommendations on blood collection techniques and hematology, serum chemistry, and urinalysis tests. PMID:1296288

  11. The Evolution of Male-Biased Dispersal under the Joint Selective Forces of Inbreeding Load and Demographic and Environmental Stochasticity.

    PubMed

    Henry, Roslyn C; Coulon, Aurélie; Travis, Justin M J

    2016-10-01

    Sex-biased natal dispersal is widespread, and its significance remains a central question in evolutionary biology. However, theory so far fails to predict some of the most common patterns found in nature. To address this, we present novel results from an individual-based model investigating the joint roles of inbreeding load, demographic stochasticity, environmental stochasticity, and dispersal costs for the evolution of sex-biased dispersal. Most strikingly, we found that male-biased natal dispersal evolved in polygynous systems as a result of the interplay between inbreeding avoidance and stochasticity, whereas previous theory, in contrast to empirical observations, predicted male philopatry and female-biased natal dispersal under inbreeding load alone. Furthermore, the direction of the bias varied according to the nature of stochasticity. Our results therefore provide a unification of previous theory, yielding a much better qualitative match with empirical observations of male-biased dispersal in mate defense mating systems. PMID:27622876

  12. A comparison of the effects of concentric versus eccentric exercise on force and position sense at the human elbow joint.

    PubMed

    Brockett, C; Warren, N; Gregory, J E; Morgan, D L; Proske, U

    1997-10-17

    It is generally accepted that our sense of limb position and movement is provided, in part, by signals from muscle spindles, while the sense of muscle force derives from signals in tendon organs. Experiments are described here, using human subjects, in which the effects of eccentric and concentric exercise of elbow flexor muscles are compared on the sense of forearm position and the sense of tension in elbow flexors. Subjects were required to compress a preloaded spring with one arm, carrying out a concentric contraction in elbow flexors, then flexors of the other arm released the spring from compression and thereby carried out an eccentric contraction. The force of the spring was adjusted to be 20% maximum voluntary contraction (MVC), and each subject carried out a minimum of 120 contractions. Position sense was measured in blindfolded subjects by placing one forearm at a set angle and asking subjects to match it by positioning the other arm. Over 4 days postexercise, subjects placed the eccentrically exercised arms in a more extended position than the concentrically exercised arm suggesting that they thought the muscle was shorter than it actually was. In a force-matching task, subjects systematically undershot the target 10% MVC with their eccentrically exercised arm. Since it is known that eccentric exercise is associated with damage to muscle fibres, it is postulated that this leads to a disturbance of muscle receptors, the muscle spindles and tendon organs. PMID:9401745

  13. Gimbaled-shoulder friction stir welding tool

    NASA Technical Reports Server (NTRS)

    Carter, Robert W. (Inventor); Lawless, Kirby G. (Inventor)

    2010-01-01

    A gimbaled-shoulder friction stir welding tool includes a pin and first and second annular shoulders coupled to the pin. At least one of the annular shoulders is coupled to the pin for gimbaled motion with respect thereto as the tool is rotated by a friction stir welding apparatus.

  14. Shoulder Impingement/Rotator Cuff Tendinitis

    MedlinePlus

    .org Shoulder Impingement/Rotator Cuff Tendinitis Page ( 1 ) One of the most common physical complaints is shoulder pain. Your shoulder is made up of several ... is vulnerable to many different problems. The rotator cuff is a frequent source of pain in the ...

  15. Forces and moments generated by the human arm: Variability and control

    PubMed Central

    Xu, Y; Terekhov, AV; Latash, ML; Zatsiorsky, VM

    2012-01-01

    This is an exploratory study of the accurate endpoint force vector production by the human arm in isometric conditions. We formulated three common-sense hypotheses and falsified them in the experiment. The subjects (n=10) exerted static forces on the handle in eight directions in a horizontal plane for 25 seconds. The forces were of 4 magnitude levels (10 %, 20%, 30% and 40% of individual MVC). The torsion moment on the handle (grasp moment) was not specified in the instruction. The two force components and the grasp moment were recorded, and the shoulder, elbow, and wrist joint torques were computed. The following main facts were observed: (a) While the grasp moment was not prescribed by the instruction, it was always produced. The moment magnitude and direction depended on the instructed force magnitude and direction. (b) The within-trial angular variability of the exerted force vector (angular precision) did not depend on the target force magnitude (a small negative correlation was observed). (c) Across the target force directions, the variability of the exerted force magnitude and directional variability exhibited opposite trends: In the directions where the variability of force magnitude was maximal, the directional variability was minimal and vice versa. (d) The time profiles of joint torques in the trials were always positively correlated, even for the force directions where flexion torque was produced at one joint and extension torque was produced at the other joint. (e) The correlations between the grasp moment and the wrist torque were negative across the tasks and positive within the individual trials. (f) In static serial kinematic chains, the pattern of the joint torques distribution could not be explained by an optimization cost function additive with respect to the torques. Plans for several future experiments have been suggested. PMID:23080084

  16. MICROINSTABILITY OF THE SHOULDER IN THE OVERHEAD ATHLETE

    PubMed Central

    Curtis, Alan S.

    2013-01-01

    The overhead throwing athlete is an extremely challenging patient in sports medicine. The repetitive microtraumatic stresses and extreme ranges of motion observed within the athlete’s shoulder joint complex during the throwing motion constantly place the athlete at risk for injury. While gross instability of the shoulder is possible, microinstability is seen far more frequently and is associated with a variety of different pathologies, including rotator cuff tendonitis, internal impingement, and labral lesions. Treatment of the overhead athlete requires the understanding of several principles based on the unique physical characteristics of this type of athlete and the demands placed upon the static stabilizing structures during the act of throwing. The purpose of this paper is to describe these principles and incorporate them into in a multi‐phase progressive rehabilitation program designed to prevent injuries and rehabilitate the injured athlete, both non‐operatively and postoperatively. PMID:24175140

  17. Porous metals and alternate bearing surfaces in shoulder arthroplasty.

    PubMed

    Carpenter, Shannon R; Urits, Ivan; Murthi, Anand M

    2016-03-01

    Total shoulder arthroplasty (TSA) provides an effective solution for the treatment of glenohumeral arthritis. However, long-term outcomes have been limited by glenoid component aseptic loosening and polyethylene (PE) wear. Previous attempts to improve glenoid fixation with metal-backed glenoids resulted in inferior results. Newer component designs that contain porous metal allow for biological ingrowth of the prosthesis, potentially improving longevity and overall outcomes. Porous metal can also improve humeral component fixation, obviating the need for cement and simplifying revision surgery. Advances such as highly cross-linked polyethylene (HXLPE), vitamin E-doped HXLPE, and alternate bearing surfaces like ceramics and pyrolytic carbon have proven to provide superior wear characteristics in other joint replacements and may prove beneficial in the shoulder as well. PMID:26797775

  18. Intratendinous supraspinatus cyst as a cause of shoulder impingement

    PubMed Central

    Garg, Akshay; Karuppaiah, Karthik; Elias, David; Tavakkolizadeh, Adel

    2014-01-01

    We report the case of a 29-year-old gentleman with shoulder impingement. An articular-sided intratendinous supraspinatus cyst was identified as the cause of his symptoms. Arthroscopic cyst debridement resulted in a good outcome at 1-year follow-up. Cysts around the shoulder are a well described pathological entity. They consist of different categories, including intraosseus cysts of the humeral head and glenoid, paralabral cysts and cysts associated with the acromioclavicular joint. Although paralabral cysts that lie intramuscularly or between the muscle bellies have frequently been reported, this is the first report of an intratendinous supraspinatus cyst with an intact rotator cuff. We describe the case, its management and the postsurgical outcome. PMID:27582975

  19. Surgical Treatment of Pediatric Upper Limb Spasticity: The Shoulder.

    PubMed

    Seruya, Mitchel; Johnson, Joshua D

    2016-02-01

    The shoulder joint is essential for placing the hand in a functional position for reach and overhead activities. This depends on the delicate balance between abductor/adductor and internal/external rotator muscles. Spasticity alters this equilibrium, limiting the interaction of the upper limb with the environment. Classically, pediatric patients with upper limb spasticity present with an adduction and internal rotation contracture of the shoulder. These contractures are typically secondary to spasticity of the pectoralis major and subscapularis muscles and sometimes attributed to the latissimus dorsi muscle. Fractional lengthening, Z-step lengthening, or tendon release of the contributing muscle groups may help correct the adduction and internal rotation contractures. With proper diagnosis, a well-executed surgical plan, and a consistent hand rehabilitation regimen, successful surgical outcomes can be achieved. PMID:26869863

  20. Mycobacterium intracellulare infection of the shoulder and spine in a patient with steroid-treated systemic Lupus erythematosus

    SciTech Connect

    Zvetina, J.R.; Rubinstein, H.; Demos, T.C.

    1982-05-01

    Atypical mycobacterial infections of bone are rare. A patient with systemic lupus erythematosus treated with steroids developed an M. intracellulare infection of the shoulder and spine. These infections are insidious and diagnosis is difficult. Marked involvement of one joint, large effusion, or aspirated small synovial fragments suggest an atypical tuberculous joint infection.

  1. Kinetics of throwing arm joints and the trunk motion during an overarm distance throw by skilled Japanese elementary school boys.

    PubMed

    Kobayashi, Yasuto; Ae, Michiyoshi; Miyazaki, Akiyo; Fujii, Norihisa; Iiboshi, Akira; Nakatani, Hideki

    2016-09-01

    The purpose of this study was to investigate joint kinetics of the throwing arms and role of trunk motion in skilled elementary school boys during an overarm distance throw. Throwing motions of 42 boys from second, fourth, and sixth grade were videotaped with three high-speed cameras operating at 300 fps. Seven skilled boys from each grade were selected on the basis of throwing distance for three-dimensional kinetic analysis. Joint forces, torques, and torque powers of the throwing arm joints were calculated from reconstructed three-dimensional coordinate data smoothed at cut-off frequencies of 10.5-15 Hz and by the inverse dynamics method. Throwing distance and ball velocity significantly increased with school grade. The angular velocity of elbow extension before ball release increased with school grade, although no significant increase between the grades was observed in peak extension torque of elbow joint. The joint torque power of shoulder internal/external rotation tended to increase with school grade. When teaching the overarm throw, elementary school teachers should observe large backward twisting of trunk during the striding phase and should keep in mind that young children, such as second graders (age 8 years), will be unable to effectively utilise shoulder external/internal rotation during the throwing phase. PMID:27125238

  2. Throwing Injuries of the Shoulder.

    ERIC Educational Resources Information Center

    McCue, Frank C., III; and Others

    The majority of shoulder injuries occurring in throwing sports involve the soft tissue structures. Injuries often occur when the unit is overstretched to a point near its greatest length, involving the elastic tissues. The other injury mechanism involves the contractural unit of the muscle, which occurs near the midpoint of contractions, involving…

  3. [Shoulder dystocia: an obstetrical emergency].

    PubMed

    Marques, Joana Borges; Reynolds, Ana

    2011-01-01

    Shoulder dystocia is one of the most feared obstetric emergencies due to related maternal and neonatal complications and therefore, the growing of medico-legal litigation that it entails. Although associated with risk factors such as fetal macrossomia, gestacional diabetes and instrumented delivery, the majority of cases are unpredictable. The lack of a consensus on shoulder dystocia diagnosis causes variations on its incidence and hampers a more comprehensive analysis. Management guidelines described for its resolution include several manoeuvres but the ideal sequence of procedures is not clearly defined in more severe cases. Hands-on and team training, through simulation-based techniques applied to medicine, seems to be a promising method to learn how to deal with shoulder dystocia having in mind a reduction in related maternal or neonatal morbidity and mortality. The main goal of this paper is to provide a comprehensive revision of shoulder dystocia highlighting its relevance as an obstetric emergency. A reflection on the management is presented emphasising the importance of simulation-based training. PMID:22521019

  4. Addition of Lidocaine Injection Immediately before Physiotherapy for Frozen Shoulder: A Randomized Controlled Trial

    PubMed Central

    Hsu, Wei-Chun; Wang, Tao-Liang; Lin, Yi-Jia; Hsieh, Lin-Fen; Tsai, Chun-Mei; Huang, Kuang-Hui

    2015-01-01

    The intraarticular injection of lidocaine immediately before a physiotherapy session may relieve pain during the stretching and mobilization of the affected joint in patients with a frozen shoulder, thus enhancing the treatment effect. To compare the effects of intraarticular injection of lidocaine plus physiotherapy to that of physiotherapy alone in the treatment of a frozen shoulder, a prospective randomized controlled trial was conducted in the rehabilitation department of a private teaching hospital. Patients with a frozen shoulder were randomized into the physiotherapy group or the lidocaine injection plus physiotherapy (INJPT) group. The subjects in the INJPT group underwent injection of 3 ml of 1% lidocaine into the affected shoulder 10 to 20 minutes before each physiotherapy session. In each group, the treatment lasted 3 months. The primary outcome measures were the active and passive range of motion of the affected shoulder. The secondary outcome measures were the results of the Shoulder Disability Questionnaire, the Shoulder Pain and Disability Index, and the 36-item Short-Form Health Survey (SF-36). The outcome measures were evaluated before treatment and 1, 2, 3, 4, and 6 months after the start of treatment. The group comparisons showed significantly greater improvement in the INJPT group, mainly in active and passive shoulder range of motion in flexion and external rotation and improvements in pain and disability (P < 0.05); however, no significant group difference was seen in the SF-36 results. The intraarticular injection of lidocaine immediately before a physiotherapy session might be superior to physiotherapy alone in the treatment of a frozen shoulder. Trial Registration ClinicalTrials.gov NCT01817348 PMID:25714415

  5. Limitation of motion and shoulder disabilities in patients with cardiac implantable electronic devices.

    PubMed

    Findikoglu, Gulin; Yildiz, Bekir S; Sanlialp, Musa; Alihanoglu, Yusuf I; Kilic, Ismail D; Evregul, Harun; Senol, Hande

    2015-12-01

    The aim of this study is to investigate the presence of limitations in the shoulder range of motion (ROM) or the loss of upper extremity function on the affected side in patients with cardiac implantable electronic devices (CIEDs) with respect to the implantation time. Forty-nine patients (30 men and 19 women), mean age 64.84±11.18 years, who had been living with a CIED for less than 3 months were included in the short-term recipient (STR) group and 127 patients (85 men and 42 women), mean age 64.91±14.70 years, and with the device for longer than 3 months were included in the long-term recipients group. Shoulder ROMs were measured using a digital goniometer. The other arm was used as the control. The Constant-Murler Score, Shoulder Pain Disability Index, and Shoulder Disability Questionnaire were used to assess the functional status. Limitations of ROM for flexion, abduction, and internal rotation were found to be significantly lower in the arm on the side of CIED compared with the control arm. Significant differences in shoulder flexion, abduction, and external rotation in STRs were found compared with long-term recipient (P<0.05). However, the functional comparison of groups by the Constant-Murler Score was not significant. A low to moderate amount of shoulder disability measured by Shoulder Pain Disability Index and Shoulder Disability Questionnaire was found in patients with CIEDs, which was more prominent in STRs (P<0.05). Pain, association of CIED with pectoral muscles, a possible subtle ongoing capsular pathology, and avoidance behaviors of patients to minimize the risk of lead dislodgement might be related to restriction of motion and function in the shoulder joint in patients with CIEDs. PMID:26164799

  6. The development of goal-directed reaching in infants: hand trajectory formation and joint torque control.

    PubMed

    Konczak, J; Borutta, M; Topka, H; Dichgans, J

    1995-01-01

    Nine young infants were followed longitudinally from 4 to 15 months of age. We recorded early spontaneous movements and reaching movements to a stationary target. Time-position data of the hand (endpoint), shoulder, and elbow were collected using an optoelectronic measurement system (ELITE). We analyzed the endpoint kinematics and the intersegmental dynamics of the shoulder and elbow joint to investigate how changes in proximal torque control determined the development of hand trajectory formation. Two developmental phases of hand trajectory formation were identified: a first phase of rapid improvements between 16 and 24 weeks of age, the time of reaching onset for all infants. During that time period the number of movement units per reach and movement time decreased dramatically. In a second phase (28-64 weeks), a period of "fine-tuning" of the sensorimotor system, we saw slower, more gradual changes in the endpoint kinematics. The analysis of the underlying intersegmental joint torques revealed the following results: first, the range of muscular and motion-dependent torques (relative to body weight) did not change significantly with age. That is, early reaching was not confined by limitations in producing task-adequate levels of muscular torque. Second, improvements in the endpoint kinematics were not accomplished by minimizing amplitude of muscle and reactive torques. Third, the relative timing of muscular and motion-dependent torque peaks showed a systematic development toward an adult timing profile with increasing age. In conclusion, the development toward invariant characteristics of the hand trajectory is mirrored by concurrent changes in the control of joint forces. The acquisition of stable patterns of intersegmental coordination is not achieved by simply regulating force amplitude, but more so by modulating the correct timing of joint force production and by the system's use of reactive forces. Our findings support the view that development of reaching

  7. Dust Aerosol Optical Properties Retrieval and Radiative Forcing over Northwestern China during 2008 China-US Joint Field Experiment

    NASA Astrophysics Data System (ADS)

    Ge, J.; Su, J.; Ackerman, T. P.; Fu, Q.; Huang, J.; Shi, J.

    2009-12-01

    The Atmosphere Radiation Measurements (ARM) Program’s Ancillary Facility (AAF/SMART-COMMIT) was deployed to Zhangye (39.082° N, 100.276° E), which is located in a semi-desert area of Northwest China, during the period of late April to mid June in 2008. We selected 11 cases to retrieve dust aerosol optical depth (AOD), Angstrom exponent, size distribution, single-scattering albedo (SSA) and asymmetry parameter (ASY) from Multi-filter Rotating Shadowband Radiometer (MFRSR) measurements. These cases are dominated by large particles with Angstrom exponent values ranging from 0.34 to 0.93. The values of AOD at 0.67 µm range from 0.074 to 0.249. The mean SSA value increases with wavelength from 0.76±0.02 at 0.415 µm to 0.86±0.01 at 0.867 µm, while the mean ASY value decreases from 0.74±0.04 to 0.70±0.02. Before estimating dust aerosol direct radiative forcing, a radiative closure experiment was performed to verify that the retrieved aerosol optical properties and other input parameters to the radiative transfer model appropriately represent atmospheric conditions. The daytime-averaged differences between model simulations and ground observations are -8.5, -2.9, and -2.1 Wm-2 for the total, diffuse, and direct normal fluxes, respectively. The mean difference in the instantaneous reflected solar fluxes at the top of atmosphere (TOA) between the model and CERES observations is 8.0 Wm-2. The solar aerosol direct radiative forcing (ARF), averaged over a 24-hour period, at the surface is-22.4±8.9 Wm-2, while the TOA ARF is small and has an average value of only 0.52±1.69 Wm-2. The daily-average surface aerosol radiative forcing efficiency (ARFE) at 0.5 µm is -95.1±10.3 Wm-2τ-1. Our results illustrate that the primary role of dust aerosol is to alter the distribution of solar radiation within the climate system, rather than reflecting solar energy to space. We assess the satellite aerosol optical depth products from MISR and MODIS observations by comparing them

  8. [Classification of periprosthetic shoulder fractures].

    PubMed

    Kirchhoff, C; Kirchhoff, S; Biberthaler, P

    2016-04-01

    The key targets in the treatment of periprosthetic humeral fractures (PHF) are the preservation of bone, successful bony consolidation and provision of a stable anchoring of the prosthesis with the major goal of restoring the shoulder-arm function. A substantial problem of periprosthetic shoulder fractures is the fact that treatment is determined not only by the fracture itself but also by the implanted prosthesis and its function. Consequently, the exact preoperative shoulder function and, in the case of an implanted anatomical prosthesis, the status and function of the rotator cuff need to be assessed in order to clarify the possibility of a secondarily occurring malfunction. Of equal importance in this context is the type of implanted prosthesis. The existing classification systems of Wright and Cofield, Campbell et al., Groh et al. and Worland et al. have several drawbacks from a shoulder surgeon's point of view, such as a missing reference to the great variability of the available prostheses and the lack of an evaluation of rotator cuff function. The presented 6‑stage classification for the evaluation of periprosthetic fractures of the shoulder can be considered just as simple or complex to understand as the classification of the working group for osteosynthesis problems (AO, Arbeitsgemeinschaft für Osteosynthesefragen), depending on the viewpoint. From our point of view the classification presented here encompasses the essential points of the existing classification systems and also covers the otherwise missing points, which should be considered in the assessment of such periprosthetic fractures. The classification presented here should provide helpful assistance in the daily routine to find the most convenient form of therapy. PMID:26992712

  9. Shoulder instability surgery in Norway

    PubMed Central

    2012-01-01

    Background and purpose In January 2008, we established the Norwegian Register for Shoulder Instability Surgery. We report on the establishment, the baseline data, and the results at 1-year follow-up. Methods Primary and revision shoulder stabilization is reported by the surgeon on a 1-page paper form containing the patient's history of shoulder injury, clinical findings, and perioperative findings. The WOSI questionnaire for self-assessment of shoulder function is completed at baseline and at follow-up after 1, 2, and 5 years. To evaluate the completeness of registration, we compared our data with those in the Norwegian Patient Registry (NPR). Results The NPR reported 39 hospitals performing shoulder stabilizations. 20 of these started to report to our register during 2009, and 464 procedures (404 primary, 59 revisions) were included up to December 31, 2009, which represented 54% of the procedures reported to NPR. Of the 404 primary procedures, 83% were operations due to anterior instability, 10% were operations due to posterior instability, and 7% were operations due to multidirectional instability. Arthroscopic soft tissue techniques were used in 88% of the patients treated for primary anterior instability and open coracoid transfer was used in 10% of such patients. At 1-year follow-up of 213 patients, we found a statistically significantly improved WOSI score in all types of instability. 10% of the patients treated with arthroscopic anterior labral repair and 16% treated with arthroscopic posterior labral repair reported recurrent instability. No statistically significant difference in functional improvement or rate of recurrence was found between these groups. Interpretation The functional results are in accordance with those in previous studies. However, the incidence of recurrent instability 1 year after arthroscopic labral repair is higher than expected. PMID:22112155

  10. Stemless shoulder arthroplasty: a literature review

    PubMed Central

    PETRICCIOLI, DARIO; BERTONE, CELESTE; MARCHI, GIACOMO

    2015-01-01

    The design of humeral implants for shoulder arthroplasty has evolved over the years. The new-generation modular shoulder prostheses have an anatomical humeral stem that replicates the three-dimensional parameters of the proximal humerus. An anatomical reconstruction is the best way to restore stability and mobility of the prosthetic shoulder and improve implant durability. However, a perfect anatomical match is not always possible in, for example, patients with post-traumatic osteoarthritis of the shoulder and deformities in the metaphyseal region. To avoid stem-related complications while retaining the advantages of the fourth generation of shoulder implants, different stemless implants have been developed. The stemless shoulder prosthesis is a new concept in shoulder arthroplasty. The authors review the indications, surgical technique, clinical and radiological midterm results, and complications of these humeral implants. PMID:26151038

  11. Current Concepts in the Evaluation and Treatment of the Shoulder in Overhead-Throwing Athletes, Part 1

    PubMed Central

    Reinold, Michael M.; Gill, Thomas J.

    2010-01-01

    The overhead-throwing athlete is a challenging sports medicine patient. The repetitive microtraumatic stresses imposed on the athlete’s shoulder joint complex during the throwing motion constantly places the athlete at risk for injury. These stresses may effect several adaptations to normal shoulder range of motion, strength, and scapula position. The clinician should therefore appreciate the unique physical characteristics of the overhead-throwing athlete to accurately evaluate and treat throwing-related injuries. PMID:23015922

  12. Deformations in the Shoulder Tissues During Load Carriage: A Computational Model.

    PubMed

    Hadid, Amir; Belzer, Noa; Shabshin, Nogah; Epstein, Yoram; Gefen, Amit

    2015-11-01

    Shoulder soft tissue deformations seem to be one of the limiting factors of load carriage among soldiers and recreational backpackers that are required to carry heavy loads. Yet, there are no loading limits related to the forces borne by the shoulders, and the backpacks designs are not consistent with providing pressure relief from this sensitive anatomical region. The aim of this study was to develop a model that will enable to study the biomechanical loads that develop in the shoulder under heavy loads and to help in optimizing load carriage systems design. A 3-dimensional, anatomically accurate finite element model of a human shoulder was constructed based on MRI scans. The model was developed to calculate the effective stresses on the skin below the shoulder strap (superficial loads) and the effective strain in the brachial plexus region (inner tissue deformation) for loads of up to 35 kg. The model successfully predicted deformations in the soft tissue surrounding the brachial plexus when compared with deformations measured from load-bearing MRI scans. The model yielded a skin pressure mapping, which showed pressure hotspots in the clavicle region. Inner tissue deformations mapping, as assessed by brachial plexus envelop strains, were found to peak at 30% effective strain at the lateral aspect below the pectoralis muscle. The newly developed model successfully predicted soft tissue deformations in the shoulder related to backpacks. This model can be used to optimize load carriage systems for better distribution of pressure over the shoulders and lower inner tissue deformations. PMID:26506178

  13. Assessment of Multi-Joint Coordination and Adaptation in Standing Balance: A Novel Device and System Identification Technique.

    PubMed

    Engelhart, Denise; Schouten, Alfred C; Aarts, Ronald G K M; van der Kooij, Herman

    2015-11-01

    The ankles and hips play an important role in maintaining standing balance and the coordination between joints adapts with task and conditions, like the disturbance magnitude and type, and changes with age. Assessment of multi-joint coordination requires the application of multiple continuous and independent disturbances and closed loop system identification techniques (CLSIT). This paper presents a novel device, the double inverted pendulum perturbator (DIPP), which can apply disturbing forces at the hip level and between the shoulder blades. In addition to the disturbances, the device can provide force fields to study adaptation of multi-joint coordination. The performance of the DIPP and a novel CLSIT was assessed by identifying a system with known mechanical properties and model simulations. A double inverted pendulum was successfully identified, while force fields were able to keep the pendulum upright. The estimated dynamics were similar as the theoretical derived dynamics. The DIPP has a sufficient bandwidth of 7 Hz to identify multi-joint coordination dynamics. An experiment with human subjects where a stabilizing force field was rendered at the hip (1500 N/m), showed that subjects adapt by lowering their control actions around the ankles. The stiffness from upper and lower segment motion to ankle torque dropped with 30% and 48%, respectively. Our methods allow to study (pathological) changes in multi-joint coordination as well as adaptive capacity to maintain standing balance. PMID:25423654

  14. Bedside Washout of a Septic Shoulder in the Emergency Department: A Case Report.

    PubMed

    Bunting, Leonard; Kuper, Kenneth

    2016-07-01

    We present a case of successful bedside irrigation of a septic joint in the emergency department. Complicating factors prevented the patient from undergoing operative management. With a simple 2 catheter technique the authors irrigated the patient's septic shoulder at the bedside. The patient's pain and range of motion improved immediately following the technique. The patient had complete recovery without open drainage. With further investigation, definitive management of septic joints could begin in the emergency department. PMID:26875059

  15. Examination of Inertial Sensor-Based Estimation Methods of Lower Limb Joint Moments and Ground Reaction Force: Results for Squat and Sit-to-Stand Movements in the Sagittal Plane.

    PubMed

    Kodama, Jun; Watanabe, Takashi

    2016-01-01

    Joint moment estimation by a camera-based motion measurement system and a force plate has a limitation of measurement environment and is costly. The purpose of this paper is to evaluate quantitatively inertial sensor-based joint moment estimation methods with five-link, four-link and three-link rigid body models using different trunk segmented models. Joint moments, ground reaction forces (GRF) and center of pressure (CoP) were estimated for squat and sit-to-stand movements in the sagittal plane measured with six healthy subjects. The five-link model and the four-link model that the trunk was divided at the highest point of the iliac crest (four-link-IC model) were appropriate for joint moment estimation with inertial sensors, which showed average RMS values of about 0.1 Nm/kg for all lower limb joints and average correlation coefficients of about 0.98 for hip and knee joints and about 0.80 for ankle joint. Average root mean square (RMS) errors of horizontal and vertical GRFs and CoP were about 10 N, 15 N and 2 cm, respectively. Inertial sensor-based method was suggested to be an option for estimating joint moments of the trunk segments. Inertial sensors were also shown to be useful for the bottom-up estimation method using measured GRFs, in which average RMS values and average correlation coefficients were about 0.06 Nm/kg and larger than about 0.98 for all joints. PMID:27490544

  16. Chinrest pressure in violin playing: type of music, chin rest, and shoulder pad as possible mediators.

    PubMed

    Okner, M; Kernozek, T

    1997-04-01

    INTRODUCTION:: This study was conducted to determine if there are differences in pressure on a violin chin rest during performance due to changes in shoulder pads, chin rests, or pieces of music performed. It was also hypothesized that these differences would correlate with anthropometric measurements made of the subjects' necks and shoulders. METHODS::: A Novel EMED pad was used over the chin rest, containing 120 sensors, each one centimetre squared. The sampling rate was 50 Hz. A total of ten subjects, all professional violinists, performed excerpts from a Bruch violin concerto and a Handel sonata. Anthropometric measurements were made of the subjects' necks and shoulders. Each subject began by using his own violin with his usual shoulder pad and chin rest set-up, and then with the author's violin. Two different shoulder pads and three different chin rests were placed on the violin, in all possible combinations, for both pieces of music. This resulted in a total of fourteen conditions given in randomized order for each subject. Subjects were asked to give verbal feedback regarding the comfort and ease of playing of each shoulder pad and chin rest. Data was collected for three trials of each condition, and a mean for the three trials was obtained for each dependent variable. The five dependent variables were: peak pressure, maximum force, pressure/time integral and force/time integral, and total contact area. Intraclass coefficients of reliability were calculated for the dependent variables. Pearson's correlation coefficients were computed to determine if there were significant relationships between the five dependent variables and violin height, shoulder width, and neck length. RESULTS:: Pressure/time integral achieved the highest reliability with a coefficient of 0.9310, followed by peak pressure at 0.9152, force/time integral at 0.8817, maximum force at 0.8685, and total area at 0.8571. Multivariate analysis of variance detected significant differences in

  17. Central Hypersensitivity in Chronic Hemiplegic Shoulder Pain

    PubMed Central

    Hoo, Jennifer Soo; Paul, Tracy; Chae, John; Wilson, Richard

    2013-01-01

    Objective This study aimed to examine the association of hemiplegic shoulder pain with central hypersensitivity through pressure-pain thresholds (PPT) at healthy, distant tissues. Design This study is a cross-sectional study. A total of 40 patients (n=20 hemiplegic shoulder pain (HSP), n=20 stroke without HSP) were enrolled in this study. Pressure-pain thresholds were measured at the affected deltoid and contralateral deltoid and tibialis anterior using a handheld algometer. Differences in PPTs were analyzed by Wilcoxon Rank Sum test and with linear regression analysis controlling for gender, a known confounder of PPTs. Results Subjects with hemiplegic shoulder pain had lower local PPTs than stroke control subjects when comparing the painful to dominant shoulders and comparing the non-painful shoulder and tibialis anterior to the non-dominant side controls. Similarly, those with hemiplegic shoulder pain had lower PPTs when comparing to controls in contralesional-to-contralesional comparisons as well as ipsilesional-to-ipsilesional comparisons. Conclusions Subjects with hemiplegic shoulder pain have lower local and distal PPTs than subjects without hemiplegic shoulder pain. Our study suggests that chronic shoulder pain may be associated with widespread central hypersensitivity, which has been previously found to be associated with other chronic pain syndromes. This further understanding can then help develop better treatment options for those with this hemiplegic shoulder pain. PMID:23255268

  18. Mechanics unloading analysis and experimentation of a new type of parallel biomimetic shoulder complex

    NASA Astrophysics Data System (ADS)

    Hou, Yulei; Li, Zhisen; Wang, Yi; Zhang, Wenwen; Zeng, Daxing; Zhou, Yulin

    2016-06-01

    The structure design for high ratio of carrying capacity to deadweight is one of the challenges for the bionic mechanism, while the problem concerning high carrying capacity has not yet be solved for the existing shoulder complex. A new type biomimetic shoulder complex, which adopts 3-PSS/S(P for prismatic pair, S for spherical pair) spherical parallel mechanism (SPM), is proposed. The static equilibrium equations of each component are established by using the vector method and the equations for constrain forces with certain load are solved. Then the constrain force on the middle limb and that on the side limbs are compared in order to verify the unloading performance of the mechanism. In addition, the prototype mechanism of the shoulder complex is developed, and the force feedback experiment is conducted to verify the static analysis, which indicates that the middle limb suffers most of the external force and the effect of mechanics unloading is achieved. The 3-PSS/S spherical parallel mechanism is presented for the shoulder complex, and the realization of mechanics unloading is benefit for the improvement of the carrying capacity of the shoulder complex.

  19. Locations and monitoring well completion logs of wells surveyed by U.S. Geological Survey at Air Force Plant 4 and Naval Air Station, Joint Reserve Base, Carswell Field, Fort Worth area, Texas

    USGS Publications Warehouse

    Williams, M.D.; Kuniansky, E.L.

    1996-01-01

    Completion logs are presented for 16 monitoring wells installed by the U.S. Geological Survey at Air Force Plant 4 and Naval Air Station, Joint Reserve Base, Carswell Field, in the Fort Worth area, Texas. Natural gamma-ray logs are presented for selected monitoring wells. Also included are survey data for eight wells installed by Geo-Marine, Inc.

  20. Beta2-microglobuline plasma level and painful shoulder in haemodialysed patients.

    PubMed

    Barisić, Igor; Ljutić, Dragan; Vlak, Tonko; Bekavac, Josip; Perić, Irena; Mise, Kornelija; Klancnik, Marisa; Janković, Stipan

    2010-03-01

    Painful shoulder in patients on chronic haemodialyis is most often associated with dialysis arthropathy or accumulation of deposits containing modified fibrils of beta2- microglobuline especially in bones and joints due to insufficient elimination during the therapy. The aim of this study is to investigate whether there is connection between painful shoulder and plasma level of beta2-microglobuline and to corroborate that with morphologic parameters found in proved amyloidosis. It has to be emphasized that even other causes may contribute the development of painful shoulder. Real time sonography and conventional plain radiographs of the 108 shoulders were performed in 54 patients receiving chronic haemodialysis as a treatment of terminal renal failure (without previous history of rheumatoid arthritis), 27 symptomatic with persistent pain and stiffness in both shoulders and lasting for more than 6 weeks and restriction of movements in various degree and 27 asymptomatic. Plasma level of beta2-microglobuline, CRP and uric acid were taken periodically as routine procedure during a one year prospective trial, as well as plasma level of calcium, phosphor and alkaline phosphatase. Plasmatic level of beta2-microglobuline is strongly connected with painful shoulder in dialyzed patients, as well as CRP as sign of acute inflammation. That is proved by morphologic parameters associated with histological proved amyloidosis in patients on long term dialysis, more then 10 years. PMID:20402341

  1. Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder. A controlled radiological study.

    PubMed

    Beyeler, C; Lehmann, T; Schlapbach, P; Gerber, N J; Fuchs, W A

    1995-01-01

    The prevalence of hyperostotic spurs (HS) in different areas of the shoulder was studied in 36 probands with and 58 probands without thoracospinal hyperostosis on lateral chest radiographs. Bilateral shoulder radiographs in three projections were analysed blindly, recording the presence of HS at six separate sites (glenoid, greater tuberculum, acromion, acromioclavicular joint, coracoid and humeral shaft) and applying defined grading criteria. The prevalence of HS ranged from 11.7% of the shoulders at the coracoid to 50.0% at the glenoid. The prevalence of HS was similar on both sides [right, 30.1% of the sites versus left, 27.0%, relative risk (RR) 1.12 (95% confidence interval [Cl] 0.93-1.35)] and was not related to sex and history of work. Classification for the presence of shoulder hyperostosis was identical on both sides with the exception of one individual. In probands with thoracospinal and shoulder hyperostosis all areas analysed contributed to the classification. However, this was particularly prominent at the humeral shaft [RR 5.3 (95% Cl 2.1-13.0)] and the coracoid [RR 8.4 (95% Cl 1.9-36.4)]. These results indicated that the prevalence of HS and the specificity for the presence of diffuse idiopathic skeletal hyperostosis (DISH) vary between different sites. We suggest that future grading criteria for shoulder hyperostosis take into account the localization of HS, in addition to their number and size. PMID:8588119

  2. Infection Prevention in Shoulder Surgery.

    PubMed

    Hackett, Daniel J; Crosby, Lynn A

    2015-12-01

    The microbiome of the shoulder demonstrates distinctive differences to other orthopaedic surgical sites. Recent studies have demonstrated that the most common organisms found in deep shoulder infections are coagulase-negative staph lococcal species and Propionibacterium acnes . Many studies support diligent hand washing, decreasing operative time, routine glove changing, minimizing operating room traffic, and covering instruments as means for decreasing the risk of deep infection. On the other hand, hair clipping and the use of adhesive drapes may have little effect on decreasing the incidence of deep infection. Although generally considered the most efficacious skin preparation solution, chlorhexidine gluconate has minimal effect on eradication of P. acnes from the surgical site; however, the addition of preoperative topical applications of benzoyl peroxide to standard surgical preparation has shown promise in decreasing the rate of P . acnes culture positivity. Additionally, the use of local antibiotic formulations seems to be an effective means of preventing deep infection. PMID:26631211

  3. Does Repair of a Hill-Sachs Defect Increase Stability at the Glenohumeral Joint?

    PubMed Central

    Bakshi, Neil K.; Jolly, John T.; Debski, Richard E.; Sekiya, Jon K.

    2016-01-01

    Background: The effect of osteoallograft repair of a Hill-Sachs lesion and the effect of allograft fit on glenohumeral translations in response to applied force are poorly understood. Purpose: To compare the impact of a 25% Hill-Sachs lesion, a perfect osteoallograft repair (PAR) of a 25% Hill-Sachs lesion, and an “imperfect” osteoallograft repair (IAR) of a 25% Hill-Sachs lesion on glenohumeral translations in response to a compressive load and either an anterior or posterior load in 3 clinically relevant arm positions. Study Design: Controlled laboratory study. Methods: A robotic/universal force-moment sensor testing system was used to apply joint compression (22 N) and an anterior or posterior load (44 N) to cadaveric shoulders (n = 9) with the skin and deltoid removed (intact) at 3 glenohumeral joint positions (abduction/external rotation): 0°/0°, 30°/30°, and 60°/60°. The 25% bony defect state, PAR state, and IAR state were created and the loading protocol was performed. Translational motion was measured in each position for each shoulder state. A nonparametric repeated-measures Friedman test with a Wilcoxon signed-rank post hoc test was performed to compare the biomechanical parameters (P < .05). Results: Compared with the defect shoulder, the PAR shoulder had significantly less anterior translation with an anterior load in the 0°/0° (15.3 ± 8.2 vs 16.6 ± 9.0 mm, P = .008) and 30°/30° (13.6 ± 7.1 vs 14.2 ± 7.0 mm, P = .021) positions. Compared with IAR, the PAR shoulder had significantly less anterior translation with an anterior load in the 0°/0° (15.3 ± 8.2 vs 16.6 ± 9.0 mm, P = .008) and 30°/30° (13.6 ± 7.1 vs 14.4 ± 7.1 mm, P = .011) positions, and the defect shoulder had significantly less anterior translation with an anterior load in the 30°/30° (14.2 ± 7.0 vs 14.4 ± 7.0 mm, P = .038) position. Conclusion: PAR resulted in the least translational motion at the glenohumeral joint. The defect shoulder had significantly less

  4. The Driving Forces of the Large-Scale Deformation in the India-Eurasia Collision Region: Joint Modeling of Lithosphere and Mantle Dynamics

    NASA Astrophysics Data System (ADS)

    Wang, X.; Holt, W. E.; Ghosh, A.

    2014-12-01

    The origin of the large-scale deformation of the India-Eurasia collision zone has been pursued for more than 4 decades. However, the driving forces for the largest area of continental deformation zone on earth have not been entirely resolved; the source of such driving forces remains enigmatic. One reason could be that the driving forces have to be sufficiently large to overcome the resistance of the Tibetan Plateau, created by excess gravitational potential energy (GPE) over a long time span. Another reason is that seismic experiments carried out in the Tibetan Plateau, due to the harsh natural conditions, are fewer, making it challenging to resolve high-resolution seismic structure beneath Tibet. We address this issue of driving forces in this deformation zone by quantifying the primary contributions to the lithospheric stress field. We take into account effects of topography and shallow lithosphere structure, as well as tractions originating from deeper mantle convection, in order to calculate model estimates of the total lithosphere stresses. We evaluate recent published global seismic tomographic models (P-wave, S-wave, and geodynamic models) and select a tomographic model which, when used in the semi-analytical mantle circulation model HC (Hager and O'Connell, 1981; Milner et al., 2009), provides a best fit to observations of geoid, surface motions, strain rates, and stress orientations. We use the joint modeling of lithosphere and mantle dynamics approach of Ghosh and Holt (2012) to compute the full lithosphere stresses, except that we use HC for the circulation model, which can only handle radial viscosity variations. After using the selected seismic tomographic model of SAW642AN (Panning and Romanowicz, 2006) to compute the global lithosphere stresses, we refine the calculated stresses in the India-Eurasia collision zone. Our results show that both the driving stresses from mantle convection and GPE differences contribute to the deviatoric stress field in

  5. Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

    PubMed Central

    Kyburz, Diego; Ciurea, Adrian; Dubs, Beat; Toniolo, Martin; Bisig, Samuel Pascal; Tamborrini, Giorgio

    2015-01-01

    Objective High resolution ultrasonography is a non-painful and non-invasive imaging technique which is useful for the assessment of shoulder pain causes, as clinical examination often does not allow an exact diagnosis. The aim of this study was to compare the findings of clinical examination and high resolution ultrasonography in patients presenting with painful shoulder. Methods Non-interventional observational study of 100 adult patients suffering from unilateral shoulder pain. Exclusion criteria were shoulder fractures, prior shoulder joint surgery and shoulder injections in the past month. The physicians performing the most common clinical shoulder examinations were blinded to the results of the high resolution ultrasonography and vice versa. Results In order to detect pathology of the m. supraspinatus tendon, the Hawkins and Kennedy impingement test showed the highest sensitivity (0.86) whereas the Jobe supraspinatus test showed the highest specificity (0.55). To identify m. subscapularis tendon pathology the Gerber lift off test showed a sensitivity of 1, whereas the belly press test showed the higher specificity (0.72). The infraspinatus test showed a high sensitivity (0.90) and specificity (0.74). All AC tests (painful arc IIa, AC joint tendernessb, cross body adduction stress testc) showed high specificities (a0.96, b0.99, c0.96). Evaluating the long biceps tendon, the palm up test showed the highest sensitivity (0.47) and the Yergason test the highest specificity (0.88). Conclusion Knowledge of sensitivity and specificity of various clinical tests is important for the interpretation of clinical examination test results. High resolution ultrasonography is needed in most cases to establish a clear diagnosis. PMID:26674725

  6. Frozen shoulder contracture syndrome - Aetiology, diagnosis and management.

    PubMed

    Lewis, Jeremy

    2015-02-01

    Frozen shoulder is a poorly understood condition that typically involves substantial pain, movement restriction, and considerable morbidity. Although function improves overtime, full and pain free range, may not be restored in everyone. Frozen shoulder is also known as adhesive capsulitis, however the evidence for capsular adhesions is refuted and arguably, this term should be abandoned. The aim of this Masterclass is to synthesise evidence to provide a framework for assessment and management for Frozen Shoulder. Although used in the treatment of this condition, manipulation under anaesthetic has been associated with joint damage and may be no more effective than physiotherapy. Capsular release is another surgical procedure that is supported by expert opinion and published case series, but currently high quality research is not available. Recommendations that supervised neglect is preferable to physiotherapy have been based on a quasi-experimental study associated with a high risk of bias. Physiotherapists in the United Kingdom have developed dedicated care pathways that provide; assessment, referral for imaging, education, health screening, ultrasound guided corticosteroid and hydro-distension injections, embedded within physiotherapy rehabilitation. The entire pathway is provided by physiotherapists and evidence exists to support each stage of the pathway. Substantial on-going research is required to better understand; epidemiology, patho-aetiology, assessment, best management, health economics, patient satisfaction and if possible prevention. PMID:25107826

  7. Septic Arthritis of the Pediatric Shoulder: From Infancy to Adolescence

    PubMed Central

    2016-01-01

    Background. Septic arthritis of the glenohumeral joint in the pediatric population (<18 yo) is not commonly described in the literature. There is a corresponding paucity of information regarding its presentation and treatment. Methods. An IRB approved review of patients treated with irrigation and debridement by the Orthopaedic Department was completed. This retrospective study includes four patients, presenting from 2005 to 2015, with septic arthritis of the shoulder. Results. The mean age (Mage) at presentation was 5 years, with a range of 1 month to 15 years. Patients presented on average after 7 days with pain and a mean temperature of 39°C, erythrocyte sedimentation rate of 66 mm/hr, a C-reactive protein level of 11.17 g/dL, and a white blood cell count of 20.2 × 103/mcL. Staphylococcus aureus, Candida albicans, and Pseudomonas aeruginosa were cultured from the wounds. All cases were treated operatively with irrigation and debridement and with antimicrobial therapy. Patients received antibiotics for an average of 6 weeks. Conclusion. Septic arthritis of the shoulder occurs in all pediatric ages. Successful treatment of septic arthritis of the shoulder was accomplished in four cases without division of the biceps sheath, with an average follow-up of 8 months.

  8. Shoulder Manipulation After Distention Arthrography: Does Audible Cracking Affect Improvement in Adhesive Capsulitis? A Preliminary Study

    PubMed Central

    Choi, Jun Kyu; Son, Seok Beom; Park, Bum Jun; Yang, Seung Nam

    2015-01-01

    Objective To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder. Methods A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm-guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention. Results The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05). Conclusion These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion. PMID:26605172

  9. A Parametric Model of Shoulder Articulation for Virtual Assessment of Space Suit Fit

    NASA Technical Reports Server (NTRS)

    Kim, K. Han; Young, Karen S.; Bernal, Yaritza; Boppana, Abhishektha; Vu, Linh Q.; Benson, Elizabeth A.; Jarvis, Sarah; Rajulu, Sudhakar L.

    2016-01-01

    Shoulder injury is one of the most severe risks that have the potential to impair crewmembers' performance and health in long duration space flight. Overall, 64% of crewmembers experience shoulder pain after extra-vehicular training in a space suit, and 14% of symptomatic crewmembers require surgical repair (Williams & Johnson, 2003). Suboptimal suit fit, in particular at the shoulder region, has been identified as one of the predominant risk factors. However, traditional suit fit assessments and laser scans represent only a single person's data, and thus may not be generalized across wide variations of body shapes and poses. The aim of this work is to develop a software tool based on a statistical analysis of a large dataset of crewmember body shapes. This tool can accurately predict the skin deformation and shape variations for any body size and shoulder pose for a target population, from which the geometry can be exported and evaluated against suit models in commercial CAD software. A preliminary software tool was developed by statistically analyzing 150 body shapes matched with body dimension ranges specified in the Human-Systems Integration Requirements of NASA ("baseline model"). Further, the baseline model was incorporated with shoulder joint articulation ("articulation model"), using additional subjects scanned in a variety of shoulder poses across a pre-specified range of motion. Scan data was cleaned and aligned using body landmarks. The skin deformation patterns were dimensionally reduced and the co-variation with shoulder angles was analyzed. A software tool is currently in development and will be presented in the final proceeding. This tool would allow suit engineers to parametrically generate body shapes in strategically targeted anthropometry dimensions and shoulder poses. This would also enable virtual fit assessments, with which the contact volume and clearance between the suit and body surface can be predictively quantified at reduced time and

  10. Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review

    PubMed Central

    Garewal, Devinder; Evans, Mathew; Taylor, David; Hoy, Gregory A.; Barwood, Shane; Connell, David

    2013-01-01

    Background To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability. Methods Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography. Results Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p < 0.01) and 10° (p < 0.001), respectively. Subjective shoulder function was good. Mean (SD) scores on the WOSI, MISS and l'Insalata scales were 78.0 (19.7), 75.8 (11.5) and 89.3 (9.9), respectively. No loss of subscapularis strength was identified (p > 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm2 reconstituted surgically by a bone block of 225.4 (73.8) mm2. Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p < 0.05). Conclusions The Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy.

  11. How to treat a frozen shoulder? A survey among shoulder specialists in the Netherlands and Belgium.

    PubMed

    Kraal, Tim; Visser, Cornelis; Sierevelt, Inger; Beimers, Lijkele

    2016-03-01

    A frozen shoulder is a common cause of a painful and stiff shoulder. A web-based survey was conducted to obtain insight in the current preferences about the diagnosis and treatment of a frozen shoulder. A response rate of 54% was reached among shoulder specialized orthopaedic surgeons from the Netherlands and Belgium. Non-steroidal anti-inflammatory drugs and intra-articular corticosteroid injections are used frequently in the first phase of the condition. Physiotherapy is assumed to be more important in the final phase. The results of the survey indicate a wide variety of treatment strategies in the different phases of a frozen shoulder. Three out of four respondents considered that the management of a frozen shoulder could benefit from a written guideline. The development of a written guideline should lead to an improved level of consensus and a more standardized approach in the treatment of a frozen shoulder among shoulder specialists in the Netherlands and Belgium. PMID:26984658

  12. The Immediate Effect of Humerus Anatomical Neck-shaft Rotation on Glenohumeral Joint Contracture

    PubMed Central

    Ohtsuki, Keisuke

    2014-01-01

    [Purpose] Elderly female patients with glenohumeral joint (GHJ) contracture, forced into prolonged immobility were examined. Range of motion exercises using humerus anatomical neck-shaft rotation were performed, and the immediate effect and adaptation were investigated. [Subjects and Methods] A total of ten individuals with a mean age of 79.4 ± 11.0 years were included in this study. The controlled intervention involved conventional range of motion exercises, and the experimental intervention involved humerus anatomical neck-shaft rotation. Each exercise was performed 30 times. Shoulder joint flexion and abduction and external rotation of the GHJ range of motion were measured with the scapula fixed. Each change in range of motion was compared using ANOVA; less than 5% was considered significant. [Results] After the experimental intervention, significant increases were seen in shoulder joint flexion, abduction, and external rotation ranges of motion. [Conclusion] Therefore, this method was effective as a means of improving the range of motion of the GHJ. PMID:24764621

  13. Magnetic Resonance Imaging of Rotator Cuff Tears in Shoulder Impingement Syndrome

    PubMed Central

    Freygant, Magdalena; Dziurzyńska-Białek, Ewa; Guz, Wiesław; Samojedny, Antoni; Gołofit, Andrzej; Kostkiewicz, Agnieszka; Terpin, Krzysztof

    2014-01-01

    Summary Background Shoulder joint is a common site of musculoskeletal pain caused, among other things, by rotator cuff tears due to narrowing of subacromial space, acute trauma or chronic shoulder overload. Magnetic resonance imaging (MRI) is an excellent modality for imaging of soft tissues of the shoulder joint considering a possibility of multiplanar image acquisition and non-invasive nature of the study. The aim of this study was to evaluate the prevalence of partial and complete rotator cuff tears in magnetic resonance images of patients with shoulder impingement syndrome and to review the literature on the causes and classification of rotator cuff tears. Material/Methods We retrospectively analyzed the results of 137 shoulder MRI examinations performed in 57 women and 72 men in Magnetic Resonance facility of the Department of Radiology and Diagnostic Imaging at the St. Jadwiga the Queen Regional Hospital No. 2 in Rzeszow between June 2010 and February 2013. Examinations were performed using Philips Achieva 1.5T device, including spin echo and gradient echo sequences with T1-, T2- and PD-weighted as well as fat saturation sequences in transverse, frontal and sagittal oblique planes. Patients were referred from hospital wards as well as from outpatient clinics of the subcarpathian province. Results The most frequently reported injuries included partial supraspinatus tendon tear and complete tearing most commonly involved the supraspinatus muscle tendon. The smallest group comprised patients with complete tear of subscapularis muscle tendon. Among 137 patients in the study population, 129 patients suffered from shoulder pain, including 57 patients who reported a history of trauma. There was 44% women and 56% men in a group of patients with shoulder pain. Posttraumatic shoulder pain was predominantly reported by men, while women comprised a larger group of patients with shoulder pain not preceded by injury. Conclusions Rotator cuff injury is a very common

  14. Shoulder 3D range of motion and humerus rotation in two volleyball spike techniques: injury prevention and performance.

    PubMed

    Seminati, Elena; Marzari, Alessandra; Vacondio, Oreste; Minetti, Alberto E

    2015-06-01

    Repetitive stresses and movements on the shoulder in the volleyball spike expose this joint to overuse injuries, bringing athletes to a career threatening injury. Assuming that specific spike techniques play an important role in injury risk, we compared the kinematic of the traditional (TT) and the alternative (AT) techniques in 21 elite athletes, evaluating their safety with respect to performance. Glenohumeral joint was set as the centre of an imaginary sphere, intersected by the distal end of the humerus at different angles. Shoulder range of motion and angular velocities were calculated and compared to the joint limits. Ball speed and jump height were also assessed. Results indicated the trajectory of the humerus to be different for the TT, with maximal flexion of the shoulder reduced by 10 degrees, and horizontal abduction 15 degrees higher. No difference was found for external rotation angles, while axial rotation velocities were significantly higher in AT, with a 5% higher ball speed. Results suggest AT as a potential preventive solution to shoulder chronic pathologies, reducing shoulder flexion during spiking. The proposed method allows visualisation of risks associated with different overhead manoeuvres, by depicting humerus angles and velocities with respect to joint limits in the same 3D space. PMID:26151344

  15. Shoulder Symptoms and Function in Geriatric Patients

    PubMed Central

    Burner, Todd; Abbott, Daniel; Huber, Karri; Stout, Monica; Fleming, Raymond; Wessel, Bambi; Massey, Ellen; Rosenthal, Ann; Burns, Edith

    2015-01-01

    Background and Purpose Musculoskeletal problems including shoulder pain are common in the general population and are often cited as reasons for physician visits. Although many risk factors for shoulder pain are postulated, the effects of shoulder pain on functional level and perceived quality of life are poorly characterized in older adults. In this study, we set out to determine the prevalence and impact of shoulder symptoms and dysfunction in an older adult veteran population. Methods A chart review, cross-sectional survey, and examination were performed. A sample of 93 individuals, age >60, were recruited from a primary clinic outpatient waiting room at the Clement J. Zablocki VA Medical Center in Milwaukee, WI. Patients were asked about shoulder symptoms and self-assessed health (SAH), and completed the Stanford Modified Health Assessment Questionnaire (MHAQ). A series of 3 shoulder maneuvers were used to assess shoulder mobility and pain. The presence of diabetes and statin use was documented. A more thorough chart review was performed on individuals who reported shoulder pain and disability. Results Severe shoulder pain was common in the study group, reported by 31% of all participants. Functional limitation measured by the MHAQ and answering “yes” to greater difficulty performing daily tasks was associated with reduced internal rotation, which was present in almost 36% of all participants. Symptoms were often bilateral. No statistically significant risk factors emerged in this small sample, but suggestive trends were apparent. Interestingly, few patients reported discussing these problems with their providers, and shoulder-related problems were documented in only 10% of corresponding problem lists of symptomatic patients. Conclusions With an aging population, the high prevalence of shoulder pain may have considerable impact on public health. It will become increasingly important to define risk factors, delineate etiologies, and devise new management

  16. Shoulder Injury Incidence Rates in NASA Astronauts

    NASA Technical Reports Server (NTRS)

    Laughlin, Mitzi S.; Murray, Jocelyn D.; Foy, Millennia; Wear, Mary L.; Van Baalen, Mary

    2014-01-01

    Evaluation of the astronaut shoulder injury rates began with an operational concern at the Neutral Buoyancy Laboratory (NBL) during Extravehicular Activity (EVA) training. An astronaut suffered a shoulder injury during an NBL training run and commented that it was possibly due to a hardware issue. During the subsequent investigation, questions arose regarding the rate of shoulder injuries in recent years and over the entire history of the astronaut corps.

  17. Patterns of Age-Associated Degeneration Differ in Shoulder Muscles

    PubMed Central

    Raz, Yotam; Henseler, Jan F.; Kolk, Arjen; Riaz, Muhammad; van der Zwaal, Peer; Nagels, Jochem; Nelissen, Rob G. H. H.; Raz, Vered

    2015-01-01

    Shoulder complaints are common in the elderly and hamper daily functioning. These complaints are often caused by tears in the muscle-tendon units of the rotator cuff (RC). The four RC muscles stabilize the shoulder joint. While some RC muscles are frequently torn in shoulder complaints others remain intact. The pathological changes in RC muscles are poorly understood. We investigated changes in RC muscle pathology combining radiological and histological procedures. We measured cross sectional area (CSA) and fatty infiltration from Magnetic Resonance Imaging with Arthrography (MRA) in subjects without (N = 294) and with (N = 109) RC-tears. Normalized muscle CSA of the four RC muscles and the deltoid shoulder muscle were compared and age-associated patterns of muscle atrophy and fatty infiltration were constructed. We identified two distinct age-associated patterns: in the supraspinatus and subscapularis RC muscles CSAs continuously declined throughout adulthood, whereas in the infraspinatus and deltoid reduced CSA was prominent from midlife onwards. In the teres minor, CSA was unchanged with age. Most importantly, age-associated patterns were highly similar between subjects without RC tear and those with RC-tears. This suggests that extensive RC muscle atrophy during aging could contribute to RC pathology. We compared muscle pathology between torn infraspinatus and non-torn teres minor and the deltoid in two patients with a massive RC-tear. In the torn infraspinatus we found pronounced fatty droplets, an increase in extracellular collagen-1, a loss of myosin heavy chain-1 expression in myofibers and an increase in Pax7-positive cells. However, the adjacent intact teres minor and deltoid exhibited healthy muscle features. This suggests that satellite cells and the extracellular matrix may contribute to extensive muscle fibrosis in torn RC. We suggest that torn RC muscles display hallmarks of muscle aging whereas the teres minor could represent an aging

  18. Patterns of Age-Associated Degeneration Differ in Shoulder Muscles.

    PubMed

    Raz, Yotam; Henseler, Jan F; Kolk, Arjen; Riaz, Muhammad; van der Zwaal, Peer; Nagels, Jochem; Nelissen, Rob G H H; Raz, Vered

    2015-01-01

    Shoulder complaints are common in the elderly and hamper daily functioning. These complaints are often caused by tears in the muscle-tendon units of the rotator cuff (RC). The four RC muscles stabilize the shoulder joint. While some RC muscles are frequently torn in shoulder complaints others remain intact. The pathological changes in RC muscles are poorly understood. We investigated changes in RC muscle pathology combining radiological and histological procedures. We measured cross sectional area (CSA) and fatty infiltration from Magnetic Resonance Imaging with Arthrography (MRA) in subjects without (N = 294) and with (N = 109) RC-tears. Normalized muscle CSA of the four RC muscles and the deltoid shoulder muscle were compared and age-associated patterns of muscle atrophy and fatty infiltration were constructed. We identified two distinct age-associated patterns: in the supraspinatus and subscapularis RC muscles CSAs continuously declined throughout adulthood, whereas in the infraspinatus and deltoid reduced CSA was prominent from midlife onwards. In the teres minor, CSA was unchanged with age. Most importantly, age-associated patterns were highly similar between subjects without RC tear and those with RC-tears. This suggests that extensive RC muscle atrophy during aging could contribute to RC pathology. We compared muscle pathology between torn infraspinatus and non-torn teres minor and the deltoid in two patients with a massive RC-tear. In the torn infraspinatus we found pronounced fatty droplets, an increase in extracellular collagen-1, a loss of myosin heavy chain-1 expression in myofibers and an increase in Pax7-positive cells. However, the adjacent intact teres minor and deltoid exhibited healthy muscle features. This suggests that satellite cells and the extracellular matrix may contribute to extensive muscle fibrosis in torn RC. We suggest that torn RC muscles display hallmarks of muscle aging whereas the teres minor could represent an aging

  19. Joint swelling

    MedlinePlus

    Swelling of a joint ... Joint swelling may occur along with joint pain . The swelling may cause the joint to appear larger or abnormally shaped. Joint swelling can cause pain or stiffness. After an ...

  20. [Neuralgic amyotrophy is an overlooked diagnosis by sudden onset of shoulder pain].

    PubMed

    Jürgensen, Louise; Fagerberg, Christina; Kibæk, Maria; Brasch-Andersen, Charlotte

    2016-08-22

    Neuralgic amyotrophy (NA) is characterized by sudden onset of severe pain in the shoulder/upper arm and muscle amyotrophy. Up to 60% of patients with NA are misdiagnosed as having shoulder joint pathology or cervical pathology. We report a case of a 13-year-old girl diagnosed with the hereditary form of NA (HNA). Array comparative genomic hybridization showed a maternally inherited duplication of 1.5 Mb including the entire SEPT9-gene. The girl was treated with non-steroidal anti-inflammatory drugs, corticosteroids and physiotherapy. Individuals with HNA should avoid extreme muscle activity and severe cold, as this may trigger attacks. PMID:27549007

  1. Imaging Injuries in Throwing Sports Beyond the Typical Shoulder and Elbow Pathologies.

    PubMed

    Read, Paul J; Morrison, William B

    2016-09-01

    This review article describes injuries that occur in the upper extremities of athletes less commonly than those typically discussed with shoulders and elbows. A survey of osseous, musculotendinous, ligamentous, and neurovascular injuries is presented along with associated imaging findings and standard treatment options. This article does not focus on the classic throwing injuries of the shoulder or elbow; the goal is to survey injuries in throwing sports that involve structures away from the glenohumeral, acromioclavicular, or elbow joints. The goal of this article is to introduce readers to these less common injuries, describe their clinical presentations, and characterize their typical imaging appearances. PMID:27545424

  2. Posttraumatic focal dystonia of the shoulder.

    PubMed

    Vasileiadis, Georgios I; Sakellariou, Vasileios I; Papagelopoulos, Panayiotis J; Zoubos, Aristeides B

    2012-06-01

    Focal posttraumatic shoulder dystonia is a rare and not easily identifiable entity. Its true pathophysiologic nature, predisposing factors, and disease course remain debatable.This article describes a rare case of a 40-year-old man with late symptoms of focal shoulder dystonia after peripheral trauma of his left shoulder girdle. The shoulder was indirectly injured from the impact of a fall off his motorbike 3 years earlier. He was referred to the authors' institution because remarkable reduction of arm abduction, muscle spasms, and circumscribed hypertrophy of the trapezius muscle were noted while his head and neck were in neutral position and had a full range of motion. The left shoulder had a fixed elevated posture compared with the contralateral shoulder. A continuous burning pain was localized over the area of the hypertrophied trapezius muscle, radiating to the ipsilateral side of the head and neck. Dystonic movements of the trapezius, rhomboid, and supraspinatus muscles were observed. The abduction of the shoulder was significantly decreased, and any repetitive effort for arm abduction induced an exaggeration of his movement disorder, leading to a more pronounced shoulder elevation.Plain radiographs and magnetic resonance imaging of the left shoulder revealed a suprascapular tendinitis with no other abnormalities. Repeated needle electromyography of the left trapezius muscle and neurography of the accessory nerve on both sides were normal. Injections of botulinum toxin A were effective in the resolution of muscle hypertrophy and abnormal posture. PMID:22691679

  3. Arthroscopic treatment of synovial chondromatosis of the shoulder: A case report

    PubMed Central

    Duymus, Tahir Mutlu; Yucel, Bulent; Mutlu, Serhat; Tuna, Serkan; Mutlu, Harun; Komur, Baran

    2015-01-01

    Introduction Synovial chondromatosis is a mono-articular arthropathy rarely seen in diarthrodial joints. The classic treatment for synovial chondromatosis is open arthrotomy, synovectomy and complete removal of the free fragments. With recent advances in arthroscopic techniques and methods, the indications for arthroscopic treatment have been extended. Presentation of case A 33-year old female presented with complaints of pain in the right shoulder. On the radiological examination, there were seen to be multiple calcified radio-opaque lesions filling all area of the glenohumeral joint. On computed tomography (CT) examination, again multiple radio-opaque free fragments were determined. Arthroscopy was applied to the right shoulder. The free fragments were completely removed. Approximately 33 free fragments, ranging in size from 0.5 to 1.3 cm, were removed. Discussion Cases of synovial chondromatosis in the shoulder have been rarely reported in literature. Generally the disease is self-limiting. Clinically, symptoms are generally not specific. Restrictions in the joint range of movement occur associated with the mechanical effect of the free fragments and in periods of active use, local pain and swelling may be seen in the shoulder. Simple removal of the free fragments, others have stated that removal with synovectomy is necessary to prevent recurrence of the cartilaginous metaplastic focus. Recurrence rates vary from 0 to 31%. Conclusion Arthroscopic surgery can be successfully applied in the treatment of synovial chondromatosis. The advantages of the method include good visualisation during surgery, low morbidity and early healing. PMID:26005571

  4. Reliability and Validity of EN-TreeM Dynamometer for Measurement of Shoulder Rotator Strength in Volleyball Players

    PubMed Central

    Kaleem; Moiz, Jamal Ali; Iqbal, Mohd; Verma, Shalini

    2016-01-01

    Introduction Volleyball involves repeated forceful arm actions that produce a high incidence of shoulder injury. Shoulder rotator strength ratio is an important predictor of the likelihood of shoulder injury, especially, secondary shoulder impingement and instability. Therefore, assessment of muscle strength of external and internal rotators of shoulder is imperative to establish the profiles of shoulder rotator performance, strength ratios, and shoulder mobility of volleyball players. Aim To establish reliability and validity of EN-TreeM dynamometer for the measurement of shoulder rotators strength in volleyball players. Materials and Methods Thirty male volleyball players aged 18-24 years, mean height 1.7m, weight 69.8 Kg and BMI 23.1 participated in the study. They performed 1RM (one repetition maximum) estimation protocols using EN-TreeM dynamometer and free weights for shoulder rotators, to investigate its concurrent validity. A retest using the same protocol was performed 48 hours later to assess test-retest reliability of the EN-TreeM dynamometer. Results The results yielded excellent test-retest reliability (ICC0.96) and internal consistency (Cronbach’s alpha0.98) for both internal and external rotators. The concurrent validity was established using Pearson correlation coefficient (internal rotator r=0.45, p=0.01;External rotator r=0.38, p=0.03). Conclusion The findings establish the reliability and concurrent validity of EN-TreeM dynamometer for the quantification of shoulder rotators strength. Based on these findings in volleyball players, EN-TreeM dynamometer can be used with confidence as an instrument for assessing muscle performance (strength). Additionally, it may also be used for monitoring changes due to rehabilitation interventions in shoulder injuries. PMID:27134986

  5. The effect of shoulder supporting banding and shoulder pulling banding using elastic bands on shoulder pain and scapular position of a scapular dyskinesis patient with shoulder depression and scapular downward rotation

    PubMed Central

    Yoo, Won-gyu

    2016-01-01

    [Purpose] This study developed methods of shoulder supporting banding and shoulder pulling banding using elastic bands for scapular dyskinesis patients with shoulder depression and scapular downward rotation and investigated the effect on shoulder pain and scapular position. [Subject] The subject was a scapular dyskinesis patient with shoulder depression and scapular downward rotation and shoulder pain. [Methods] This study compared the scapular position and upper trapezius pressure pain between before and after applying the shoulder supporting banding and shoulder pulling banding for one month. [Results] The results showed that the acromion depression distance and scapular inferior downward distance decreased and that the pressure pain threshold of the upper trapezius increased after using shoulder supporting banding and shoulder pulling banding for one month. [Conclusion] Therefore, the shoulder banding methods using elastic bands showed positive effect in a scapular dyskinesis patient with shoulder depression and scapular downward rotation. PMID:27064562

  6. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: A randomized controlled trial [ISRCTN75722066

    PubMed Central

    Bron, Carel; Wensing, Michel; Franssen, Jo LM; Oostendorp, Rob AB

    2007-01-01

    Background Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior over others. Systematic reviews provide some evidence that certain physical therapy interventions (i.e. supervised exercises and mobilisation) are effective in particular shoulder disorders (i.e. rotator cuff disorders, mixed shoulder disorders and adhesive capsulitis), but there is an ongoing need for high quality trials of physical therapy interventions. Usually, physical therapy consists of active exercises intended to strengthen the shoulder muscles as stabilizers of the glenohumeral joint or perform mobilisations to improve restricted mobility of the glenohumeral or adjacent joints (shoulder girdle). It is generally accepted that a-traumatic shoulder problems are the result of impingement of the subacromial structures, such as the bursa or rotator cuff tendons. Myofascial trigger points (MTrPs) in shoulder muscles may also lead to a complex of symptoms that are often seen in patients diagnosed with subacromial impingement or rotator cuff tendinopathy. Little is known about the treatment of MTrPs in patients with shoulder disorders. The primary aim of this study is to investigate whether physical therapy modalities to inactivate MTrPs can reduce symptoms and improve shoulder function in daily activities in a population of chronic a-traumatic shoulder patients when compared to a wait-and-see strategy. In addition we investigate the recurrence rate during a one-year-follow-up period. Methods/Design This paper presents the design for a randomized controlled trial to be conducted between September 2007 – September 2008, evaluating the effectiveness of a physical therapy treatment for non-traumatic shoulder complaints. One hundred subjects are included in this study. All subjects have unilateral shoulder

  7. Shoulder arthropathy in primary hyperparathyroidism

    SciTech Connect

    Nussbaum, A.J.; Doppman, J.L.

    1982-12-01

    An erosive arthropathy of the hands and wrists has been recognized in patients with primary and secondary hyperparathyroidism. Recently, intra-articular erosions of the humeral head were described in six patients who had been on chronic long-term hemodialysis with secondary hyperparathyroidism. We would like to present the finding of shoulder erosions in four patients with primary hyperparathyroidism and one patient with renal osteodystrophy and suggest that the humeral erosion can occur in both an intra-articular and peri-articular location.

  8. Sharp-Hook Acupuncture (Feng Gou Zhen) for Patients with Periarthritis of Shoulder: A Randomized Controlled Trial

    PubMed Central

    Ji, Laixi; Wang, Haijun; Cao, Yuxia; Yan, Ping; Jin, Xiaofei; Nie, Peirui; Wang, Chaojian; Li, Rangqian; Zhang, Chunlong; Yang, Mingxiao; Yang, Jie

    2015-01-01

    The Feng Gou Zhen (sharp-hook acupuncture) as a traditional form of ancient acupuncture is said to be particularly effective for managing periarthritis of shoulder. We conducted this randomized controlled trial to evaluate the effectiveness of Feng Gou Zhen as an add-on compared to conventional analgesics for patients with PAS. 132 patients were randomly assigned in a 1 : 1 ratio to either a acupuncture group receiving sharp-hook acupuncture plus acupoint injection with conventional analgesics or a control group. Patients from both groups were evaluated at week 0 (baseline), week 1, and week 4. The primary outcome measure was the change from baseline shoulder pain, measured by Visual Analogue Scale at 7 days after treatment. Secondary outcome measures include the (i) function of shoulder joint and (ii) McGill pain questionnaire. The results showed that patients in acupuncture group had better pain relief and function recovery compared with control group (P < 0.05) at 1 week after treatment. Moreover, there were statistical differences between two groups in VAS and shoulder joint function and McGill pain questionnaire at 4 weeks after treatment (P < 0.05). Therefore, the sharp-hook acupuncture helps to relieve the pain and restore the shoulder function for patients with periarthritis of shoulder. PMID:26640496

  9. Associations between in-vivo glenohumeral joint motion and morphology.

    PubMed

    Peltz, Cathryn D; Divine, George; Drake, Anne; Ramo, Nicole L; Zauel, Roger; Moutzouros, Vasilios; Bey, Michael J

    2015-09-18

    Joint morphology has a significant influence on joint motion and may contribute to the development of rotator cuff pathology, but the relationships between glenohumeral joint (GHJ) morphology and in-vivo GHJ motion are not well understood. The objectives of this study were to assess measures of joint morphology and their relationship with in-vivo joint motion in two populations: shoulders with intact rotator cuffs (n=48) and shoulders with rotator cuff pathology (n=36, including 5 symptomatic tears, 9 asymptomatic tears and 22 repaired tears). GHJ morphology was measured from CT-based three-dimensional models of the humerus and scapula. In-vivo GHJ motion was measured during shoulder abduction using biplane x-ray imaging. Associations between GHJ morphology and motion were assessed with univariate and best subsets regression. The only morphological difference identified between the populations was the critical shoulder angle (intact: 34.5 ± 4.7°, pathologic: 36.9 ± 5.0°, p=0.03), which is consistent with previous research. In intact shoulders, the superior/inferior (S/I) position of the humerus on the glenoid during shoulder abduction was significantly associated with the glenoid's S/I radius of curvature (p<0.01), conformity index (p<0.01), and stability angle (p<0.01). Furthermore, the S/I position of the humerus on the glenoid was negatively associated with the critical shoulder angle (p=0.04), which contradicts previous research. No significant associations between GHJ morphology and GHJ motion were detected in shoulders with rotator cuff tears. It is unknown if rotator cuff pathology compromises the relationships between GHJ morphology and motion, or if the absence of this relationship is a pre-existing condition that increases the likelihood of pathology. PMID:26189094

  10. Adaptive functional specialisation of architectural design and fibre type characteristics in agonist shoulder flexor muscles of the llama, Lama glama.

    PubMed

    Graziotti, Guillermo H; Chamizo, Verónica E; Ríos, Clara; Acevedo, Luz M; Rodríguez-Menéndez, J M; Victorica, C; Rivero, José-Luis L

    2012-08-01

    Like other camelids, llamas (Lama glama) have the natural ability to pace (moving ipsilateral limbs in near synchronicity). But unlike the Old World camelids (bactrian and dromedary camels), they are well adapted for pacing at slower or moderate speeds in high-altitude habitats, having been described as good climbers and used as pack animals for centuries. In order to gain insight into skeletal muscle design and to ascertain its relationship with the llama's characteristic locomotor behaviour, this study examined the correspondence between architecture and fibre types in two agonist muscles involved in shoulder flexion (M. teres major - TM and M. deltoideus, pars scapularis - DS and pars acromialis - DA). Architectural properties were found to be correlated with fibre-type characteristics both in DS (long fibres, low pinnation angle, fast-glycolytic fibre phenotype with abundant IIB fibres, small fibre size, reduced number of capillaries per fibre and low oxidative capacity) and in DA (short fibres, high pinnation angle, slow-oxidative fibre phenotype with numerous type I fibres, very sparse IIB fibres, and larger fibre size, abundant capillaries and high oxidative capacity). This correlation suggests a clear division of labour within the M. deltoideus of the llama, DS being involved in rapid flexion of the shoulder joint during the swing phase of the gait, and DA in joint stabilisation during the stance phase. However, the architectural design of the TM muscle (longer fibres and lower fibre pinnation angle) was not strictly matched with its fibre-type characteristics (very similar to those of the postural DA muscle). This unusual design suggests a dual function of the TM muscle both in active flexion of the shoulder and in passive support of the limb during the stance phase, pulling the forelimb to the trunk. This functional specialisation seems to be well suited to a quadruped species that needs to increase ipsilateral stability of the limb during the support

  11. Adaptive functional specialisation of architectural design and fibre type characteristics in agonist shoulder flexor muscles of the llama, Lama glama

    PubMed Central

    Graziotti, Guillermo H; Chamizo, Verónica E; Ríos, Clara; Acevedo, Luz M; Rodríguez-Menéndez, J M; Victorica, C; Rivero, José-Luis L

    2012-01-01

    Like other camelids, llamas (Lama glama) have the natural ability to pace (moving ipsilateral limbs in near synchronicity). But unlike the Old World camelids (bactrian and dromedary camels), they are well adapted for pacing at slower or moderate speeds in high-altitude habitats, having been described as good climbers and used as pack animals for centuries. In order to gain insight into skeletal muscle design and to ascertain its relationship with the llama’s characteristic locomotor behaviour, this study examined the correspondence between architecture and fibre types in two agonist muscles involved in shoulder flexion (M. teres major – TM and M. deltoideus, pars scapularis – DS and pars acromialis – DA). Architectural properties were found to be correlated with fibre-type characteristics both in DS (long fibres, low pinnation angle, fast-glycolytic fibre phenotype with abundant IIB fibres, small fibre size, reduced number of capillaries per fibre and low oxidative capacity) and in DA (short fibres, high pinnation angle, slow-oxidative fibre phenotype with numerous type I fibres, very sparse IIB fibres, and larger fibre size, abundant capillaries and high oxidative capacity). This correlation suggests a clear division of labour within the M. deltoideus of the llama, DS being involved in rapid flexion of the shoulder joint during the swing phase of the gait, and DA in joint stabilisation during the stance phase. However, the architectural design of the TM muscle (longer fibres and lower fibre pinnation angle) was not strictly matched with its fibre-type characteristics (very similar to those of the postural DA muscle). This unusual design suggests a dual function of the TM muscle both in active flexion of the shoulder and in passive support of the limb during the stance phase, pulling the forelimb to the trunk. This functional specialisation seems to be well suited to a quadruped species that needs to increase ipsilateral stability of the limb during the

  12. Feasibility of Using Low-Cost Motion Capture for Automated Screening of Shoulder Motion Limitation after Breast Cancer Surgery

    PubMed Central

    Gritsenko, Valeriya; Dailey, Eric; Kyle, Nicholas; Taylor, Matt; Whittacre, Sean; Swisher, Anne K.

    2015-01-01

    Objective To determine if a low-cost, automated motion analysis system using Microsoft Kinect could accurately measure shoulder motion and detect motion impairments in women following breast cancer surgery. Design Descriptive study of motion measured via 2 methods. Setting Academic cancer center oncology clinic. Participants 20 women (mean age = 60 yrs) were assessed for active and passive shoulder motions during a routine post-operative clinic visit (mean = 18 days after surgery) following mastectomy (n = 4) or lumpectomy (n = 16) for breast cancer. Interventions Participants performed 3 repetitions of active and passive shoulder motions on the side of the breast surgery. Arm motion was recorded using motion capture by Kinect for Windows sensor and on video. Goniometric values were determined from video recordings, while motion capture data were transformed to joint angles using 2 methods (body angle and projection angle). Main Outcome Measure Correlation of motion capture with goniometry and detection of motion limitation. Results Active shoulder motion measured with low-cost motion capture agreed well with goniometry (r = 0.70–0.80), while passive shoulder motion measurements did not correlate well. Using motion capture, it was possible to reliably identify participants whose range of shoulder motion was reduced by 40% or more. Conclusions Low-cost, automated motion analysis may be acceptable to screen for moderate to severe motion impairments in active shoulder motion. Automatic detection of motion limitation may allow quick screening to be performed in an oncologist's office and trigger timely referrals for rehabilitation. PMID:26076031

  13. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    PubMed Central

    Lacy, Kyle; Cooke, Chris; Cooke, Pat; Schupbach, Justin; Vaidya, Rahul

    2015-01-01

    Traumatic dislocations of the shoulder commonly present to emergency departments (EDs). Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7–11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. PMID:25671019

  14. Test-retest reliability of isometric shoulder muscle strength measurement with a handheld dynamometer and belt

    PubMed Central

    Katoh, Munenori

    2015-01-01

    [Purpose] The aim of this study was to develop a method of measuring isometric shoulder joint muscle strength using a handheld dynamometer with a belt and investigate its test-retest reliability. [Subjects] The subjects comprised 40 healthy adults. [Methods] Six types of isometric shoulder muscle strength were measured twice, and reliability was assessed. [Results] The intraclass correlation coefficient (1, 1) values ranged from 0.976 to 0.902. The result of a Bland-Altman analysis showed differences in the types of errors between measurement items. [Conclusion] The relative reliability of isometric shoulder muscle measurement using a handheld dynamometer with a belt was high. However, analysis of absolute reliability revealed errors that may affect interpretation of values; therefore, it was considered that adapting the greater of two measurement values is appropriate. PMID:26180305

  15. Emerging Indications for Reverse Shoulder Arthroplasty.

    PubMed

    Urch, Ekaterina; Dines, Joshua S; Dines, David M

    2016-01-01

    Historically, reverse shoulder arthroplasty was reserved for older, low-demand patients in whom rotator cuff arthropathy was diagnosed. Other common indications included sequelae of previously treated proximal humerus fractures, failed anatomic total shoulder arthroplasty, tumor resection, and rheumatoid arthritis in the elderly population. Unpredictable implant durability and high complication rates have limited the use of reverse shoulder arthroplasty to a narrow group of patients. Over the past decade, however, research has led to an improved understanding of the biomechanics behind reverse shoulder prostheses, which has improved implant design and surgical techniques. Consequently, orthopaedic surgeons have slowly begun to expand the indications for reverse shoulder arthroplasty to include a wider spectrum of shoulder pathologies. Recent studies have shown promising results for patients who undergo reverse shoulder arthroplasty for the treatment of acute proximal humerus fractures, massive rotator cuff tears without arthropathy, primary osteoarthritis, and chronic anterior dislocation, as well as for younger patients who have rheumatoid arthritis. These data suggest that, with judicious patient selection, reverse shoulder arthroplasty can be an excellent treatment option for a growing patient cohort. PMID:27049188

  16. Current Concepts in Anaesthesia for Shoulder Surgery

    PubMed Central

    Sulaiman, Lutfi; MacFarlane, Robert J; Waseem, Mohammad

    2013-01-01

    There has been an exponential growth in the volume of shoulder surgery in the last 2 decades and a very wide variety of anaesthetic techniques have emerged to provide anaesthesia and post-operative analgesia. In this article we examine current opinion, risks, benefits and practicalities of anaesthetic practice and the provision of post-operative analgesia for shoulder surgery. PMID:24082970

  17. Concept of healing of recurrent shoulder dislocation.

    PubMed

    D'Angelo, Donato

    2014-01-01

    This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others. The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases. Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical-pathological lesions, without considering the so-called essential lesions. The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique. Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles. PMID:26229839

  18. [Prediction, prevention and management of shoulder dystocia].

    PubMed

    Csorba, Roland

    2012-05-20

    Shoulder dystocia is one of the most tragic, fatal and unexpected obstetrical events, which is mostly unpredictable and unpreventable. This clinical picture is defined as a delivery that requires additional obstetric maneuvers to release the shoulders after gentle downward traction has failed. Shoulder dystocia occurs when the fetal shoulder impacts on the maternal symphysis or sacral promontory. The incidence of shoulder dystocia is 0.2-0.6%. High perinatal mortality and morbidity is associated with the condition, even when it is managed appropriately. Obstetricians should be aware of the existing risk factors, but should always be alert to the possibility of shoulder dystocia in all labors. Maternal morbidity is also increased, particularly postpartum hemorrhage, rupture of the uterus, injury of the bladder, urethra and the bowels and fourth-degree perineal tears. Complications of the newborn include asphyxia, perinatal mortality, fracture of the clavicula and the humerus. Brachial plexus injuries are one of the most important fetal complications of shoulder dystocia, complicating 4-16% of such deliveries. The purpose of this article is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia. PMID:22580502

  19. 49 CFR 572.194 - Shoulder.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Shoulder. 572.194 Section 572.194 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES IIsD Side Impact Crash Test Dummy, Small Adult Female § 572.194 Shoulder....

  20. The effect of mechanical strains in soft tissues of the shoulder during load carriage.

    PubMed

    Hadid, Amir; Belzer, Noa; Shabshin, Nogah; Zeilig, Gabi; Gefen, Amit; Epstein, Yoram

    2015-11-26

    Soldiers and recreational backpackers are often required to carry heavy loads during military operations or hiking. Shoulder strain appears to be one of the limiting factors of load carriage due to skin and underlying soft tissue deformations, trapped nerves, or obstruction of blood vessels. The present study was aimed to determine relationships between backpack weights and the state of loads in the shoulder׳s inner tissues, with a special focus on the deformations in the brachial plexus. Open-MRI scans were used for developing and then verifying a three-dimensional, non-linear, large deformation, finite element model of the shoulder. Loads were applied at the strap-shoulder contact surfaces of the model by pulling the strap towards the shoulder until the desired load was reached. Increasing the strap tensile forces up to a load that represents 35kg backpack resulted in gradual increase in strains within the underlying soft tissues: the maximal tensile strain in the brachial plexus for a 25kg backpack was 12%, and while carrying 35kg, the maximal tensile strain increased to 16%. The lateral aspect of the brachial plexus was found to be more vulnerable to deformation-inflicted effects than the medial aspect. This is due to the anatomy of the clavicle that poorly shields the plexus from compressive loads applied during load carriage, while the neural tissue in the medial aspect of the shoulder is better protected by the clavicle. The newly developed model can serve as a tool to estimate soft tissue deformations in the brachial plexus for heavy backpack loads, up to 35kg. This method will allow further development of new strap structures and materials for alleviating the strains applied on the shoulder soft tissues. PMID:26542788