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1

A Systemic View of an Upper Extremity Prosthesis  

Microsoft Academic Search

When an amputee wears the prosthetic arm, it becomes the amputee's extended body part. This acquired body part should be as easy as to control the original body part. In this paper, an externally powered upper extremity prosthesis is considered as a system. The necessary components to design a better prosthetic arm are viewed and divided into four subsystems: input,

HaeOck Lee; D. J. Roberson

2007-01-01

2

Upper extremity limb loss: functional restoration from prosthesis and targeted reinnervation to transplantation.  

PubMed

For several decades, prosthetic use was the only option to restore function after upper extremity amputation. Recent years have seen advances in the field of prosthetics. Such advances include prosthetic design and function, activity-specific devices, improved aesthetics, and adjunctive surgical procedures to improve both form and function. Targeted reinnervation is one exciting advance that allows for more facile and more intuitive function with prosthetics following proximal amputation. Another remarkable advance that holds great promise in nearly all fields of medicine is the transplantation of composite tissue, such as hand and face transplantation. Hand transplantation holds promise as the ultimate restorative procedure that can provide form, function, and sensation. However, this procedure still comes with a substantial cost in terms of the rehabilitation and toxic immunosuppression and should be limited to carefully selected patients who have failed prosthetic reconstruction. Hand transplantation and prosthetic reconstruction should not be viewed as competing options. Rather, they are two treatment options with different risk/benefit profiles and different indications and, hence vastly different implications. PMID:24397947

Carlsen, Brian T; Prigge, Pat; Peterson, Jennifer

2014-01-01

3

A quantitative test of upper extremity function  

Microsoft Academic Search

IN A number of clinical situations, there is a need for a simple semi-quantitative test of upper extremity function. Measurement of function is of particular importance in evaluating the results of hand surgery and upper extremity prosthesis, in following the development of hand deformities in rheumatoid arthritis and neurological diseases, and in judging the effectiveness of different forms of therapy.

DOUGLAS CARROLL

1965-01-01

4

Upper Extremity Length Equalization  

PubMed Central

Significant upper extremity length inequality is uncommon but can cause major functional problems. The ability to position and use the hand may be impaired by shortness of any of the long bones of the upper extremity. In many respects upper and lower extremity length problems are similar. They most commonly occur after injury to a growing bone and the treatment modalities utilized in the lower extremity may be applied to the upper extremity. These treatment options include epiphysiodesis, shortening osteotomy, angulatory correction osteotomy and lengthening. This report reviews the literature relative to upper extremity length inequality and equalization and presents an algorithm for evaluation and planning appropriate treatment for patients with this condition. This algorithm is illustrated by two clinical cases of posttraumatic shortness of the radius which were effectively treated. ImagesFigure 1Figure 2Figure 3

DeCoster, Thomas A.; Ritterbusch, John; Crawford, Mark

1992-01-01

5

Upper Extremity Prosthetics Research.  

National Technical Information Service (NTIS)

The report is a complete upper extremity instructional manual prepared by the Prosthetics/Orthotics Education Program (POEP) at the University of California, Los Angeles (UCLA) to bring together up-to-date information regarding the state of the art in upp...

J. J. Bray

1972-01-01

6

Upper Extremity Regional Anesthesia  

PubMed Central

Brachial plexus blockade is the cornerstone of the peripheral nerve regional anesthesia practice of most anesthesiologists. As part of the American Society of Regional Anesthesia and Pain Medicine’s commitment to providing intensive evidence-based education related to regional anesthesia and analgesia, this article is a complete update of our 2002 comprehensive review of upper extremity anesthesia. The text of the review focuses on (1) pertinent anatomy, (2) approaches to the brachial plexus and techniques that optimize block quality, (4) local anesthetic and adjuvant pharmacology, (5) complications, (6) perioperative issues, and (6) challenges for future research. PMID:19282714

Neal, Joseph M.; Gerancher, J.C.; Hebl, James R.; Ilfeld, Brian M.; McCartney, Colin J.L.; Franco, Carlo D.; Hogan, Quinn H.

2009-01-01

7

Uncommon upper extremity compression neuropathies.  

PubMed

Hand surgeons routinely treat carpal and cubital tunnel syndromes, which are the most common upper extremity nerve compression syndromes. However, more infrequent nerve compression syndromes of the upper extremity may be encountered. Because they are unusual, the diagnosis of these nerve compression syndromes is often missed or delayed. This article reviews the causes, proposed treatments, and surgical outcomes for syndromes involving compression of the posterior interosseous nerve, the superficial branch of the radial nerve, the ulnar nerve at the wrist, and the median nerve proximal to the wrist. PMID:23895725

Knutsen, Elisa J; Calfee, Ryan P

2013-08-01

8

Innovations in prosthetic interfaces for the upper extremity.  

PubMed

Advancements in modern robotic technology have led to the development of highly sophisticated upper extremity prosthetic limbs. High-fidelity volitional control of these devices is dependent on the critical interface between the patient and the mechanical prosthesis. Recent innovations in prosthetic interfaces have focused on several control strategies. Targeted muscle reinnervation is currently the most immediately applicable prosthetic control strategy and is particularly indicated in proximal upper extremity amputations. Investigation into various brain interfaces has allowed acquisition of neuroelectric signals directly or indirectly from the central nervous system for prosthetic control. Peripheral nerve interfaces permit signal transduction from both motor and sensory nerves with a higher degree of selectivity. This article reviews the current developments in each of these interface systems and discusses the potential of these approaches to facilitate motor control and sensory feedback in upper extremity neuroprosthetic devices. PMID:24281580

Kung, Theodore A; Bueno, Reuben A; Alkhalefah, Ghadah K; Langhals, Nicholas B; Urbanchek, Melanie G; Cederna, Paul S

2013-12-01

9

Obesity-induced Upper Extremity Lymphedema  

PubMed Central

Summary: Obesity increases the risk of upper extremity lymphedema following treatment for breast cancer and can cause lower extremity lymphatic dysfunction in extremely obese individuals. We report the first patient with obesity-induced upper extremity lymphedema. A 62-year-old man with a previous body mass index (BMI) of 105.6, presented with a BMI 60.3 following weight loss. He complained of lymphedema of all 4 extremities, which was confirmed by lymphoscintigraphy. Because the upper limbs are more resistant to lymphedema than the lower extremities, a higher BMI threshold may be necessary to cause upper extremity lymphatic dysfunction.

Maclellan, Reid A.

2013-01-01

10

Advances in upper extremity prosthetics.  

PubMed

Until recently, upper extremity prostheses had changed little since World War II. In 2006, the Defense Advanced Research Projects Agency responded to an increasing number of military amputees with the Revolutionizing Prosthetics program. The program has yielded several breakthroughs both in the engineering of new prosthetic arms and in the control of those arms. Direct brain-wave control of a limb with 22° of freedom may be within reach. In the meantime, advances such as individually powered digits have opened the door to multifunctional full and partial hand prostheses. Restoring sensation to the prosthetic limb remains a major challenge to full integration of the limb into a patient's self-image. PMID:23101609

Zlotolow, Dan A; Kozin, Scott H

2012-11-01

11

Estimating upper extremity tendon slack lengths  

Microsoft Academic Search

Tendon slack lengths are used in a dynamic muscle and limb model to animate the upper extremity based on user supplied activation levels. This paper provides tendon slack length estimates for actuators crossing the elbow and inserting on the radius or ulna. These values were not previously available as a complete see for the upper extremity. Muscle parameters used in

Brian R. von Konsky

1995-01-01

12

Occlusive vascular disorders of the upper extremity.  

PubMed

Arterial occlusive disease of the upper extremity is most often due to posttraumatic occlusion of the ulnar artery. An embolic source of the ischemia should be considered most strongly when sudden ischemia or vasospasm is associated with atrial fibrillation or follows a myocardial infarction. Connective tissue disorders and several arteridities are infrequent causes of upper-extremity occlusive disease and can usually be detected by a thorough peripheral vascular examination and blood studies. Atherosclerosis of the upper extremity is usually localized to the region of the subclavian artery and can present as a subclavian steal syndrome or arm ischemia. Finally, upper-extremity venous occlusive disease occurs in association with the hypercoagulable state, venous endothelial injury, or arises in otherwise healthy patients because of venous impingement in the thoracic outlet. PMID:8444972

Zimmerman, N B

1993-02-01

13

Research, design & development project Myoelectric Prosthesis of Upper Limb  

NASA Astrophysics Data System (ADS)

A Research Design and Development Project was developed of a myoelectric prosthesis for a pediatric patient presenting congenital amputation of the left forearm below the elbow. A multidisciplinary work-team was formed for this goal, in order to solve the several (/various) aspects regarding this project (mechanical, ergonomics, electronics, physical). The prosthesis as an electromechanical device was divided in several blocks, trying to achieve a focused development for each stage, acording to requisites. A mechanical prototype of the prothesis was designed and built along with the circuitry needed for EMG aquisition, control logic and drivers. Having acomplished the previuos stages, the project is now dealing with the definitions of the interface between the prosthesis and the patient, with promising perspectives.

Galiano, L.; Montaner, E.; Flecha, A.

2007-11-01

14

Upper Extremity Problems in Doner Kebab Masters  

PubMed Central

[Purpose] Doner kebab is a food specific to Turkey; it is a cone-shaped meat placed vertically on a high stand. The doner kebab chefs stand against the meat and cut it by using both of their upper extremities. This work style may lead to recurrent trauma and correspondingly the upper extremity problems. The aim of this study was to investigate the upper extremity disorders of doner chefs. [Subjects and Methods] Doner kebab chefs were selected as the study group, and volunteers who were not doner kebab chefs and didn’t exert intense effort with upper extremities their business lives were selected as the control group. A survey form was prepared to obtain data about the participants’ ages, working experience (years), daily work hours, work at a second job, diseases, drug usage, and any musculoskeletal (lasting at least 1 week) complaint in last 6 months. [Results] A total of 164 individuals participated in the study, 82 doner chefs and 82 volunteers. In 20.6% of the study group and 15.6% of the control group, an upper extremity musculoskeletal system disorder was detected. Lateral epicondylitis was more frequently statistically significant in the work group. [Conclusion] Hand pain and lateral epicondylitis are more frequent in doner chefs than in other forms of business. PMID:25276030

Taspinar, Ozgur; Kepekci, Muge; Ozaras, Nihal; Aydin, Teoman; Guler, Mustafa

2014-01-01

15

Upper extremity problems in doner kebab masters.  

PubMed

[Purpose] Doner kebab is a food specific to Turkey; it is a cone-shaped meat placed vertically on a high stand. The doner kebab chefs stand against the meat and cut it by using both of their upper extremities. This work style may lead to recurrent trauma and correspondingly the upper extremity problems. The aim of this study was to investigate the upper extremity disorders of doner chefs. [Subjects and Methods] Doner kebab chefs were selected as the study group, and volunteers who were not doner kebab chefs and didn't exert intense effort with upper extremities their business lives were selected as the control group. A survey form was prepared to obtain data about the participants' ages, working experience (years), daily work hours, work at a second job, diseases, drug usage, and any musculoskeletal (lasting at least 1 week) complaint in last 6 months. [Results] A total of 164 individuals participated in the study, 82 doner chefs and 82 volunteers. In 20.6% of the study group and 15.6% of the control group, an upper extremity musculoskeletal system disorder was detected. Lateral epicondylitis was more frequently statistically significant in the work group. [Conclusion] Hand pain and lateral epicondylitis are more frequent in doner chefs than in other forms of business. PMID:25276030

Taspinar, Ozgur; Kepekci, Muge; Ozaras, Nihal; Aydin, Teoman; Guler, Mustafa

2014-09-01

16

Upper extremity arterial injuries in athletes  

Microsoft Academic Search

Upper extremity arterial injury resulting in hand and digit ischemia can occur in athletes who perform repetitive, high-stress, overhead arm motions. The initial presentation of these injuries often mimics the more common musculoskeletal injuries found in these athletes, and therefore, a high index of suspicion is essential to establish the diagnosis in a timely fashion. There are several described mechanisms

Mark R Jackson

2003-01-01

17

Intraoperative distraction in the upper extremity.  

PubMed

Intraoperative distraction aids in the restoration of length, facilitates reduction, assists in maintaining rotational alignment, and provides a temporary stable platform for definitive fixation of acute fractures, malunions, and nonunions. This technique has been described at length in the lower extremity; however, there is a paucity of literature regarding its use in the upper extremity. Distraction is the application of tension across a fracture site. Proximal and distal fixation may be achieved in several ways, with common instrumentation including the use of an external fixator set. Intraoperative distraction may be invaluable in the treatment of displaced fractures of the upper extremity. The objective of this paper was to detail the technique of intraoperative distraction in the surgical treatment of fractures of the clavicle, humerus, radius, and ulna. PMID:19516131

Boykin, Robert E; Baskies, Michael A; Harrod, Christopher C; Jupiter, Jesse B

2009-06-01

18

Upper extremity considerations for oncologic surgery.  

PubMed

It was estimated that more than 3000 people would be diagnosed with a primary bone or joint malignancy and more than 11,000 people would be diagnosed with a soft tissue sarcoma in 2013. Although primary bone and soft tissue tumors of the upper extremity are infrequent, it is imperative that the clinician be familiar with a systematic approach to the diagnosis and treatment of these conditions to prevent inadvertently compromising patient outcome. With advances in chemotherapy, radiotherapy, tumor imaging, and surgical reconstructive options, limb salvage surgery is estimated to be feasible in 95% of extremity bone or soft tissue sarcomas. PMID:25199424

Wong, Justin C; Abraham, John A

2014-10-01

19

Thoracoscopic removal of dental prosthesis impacted in the upper thoracic esophagus  

PubMed Central

Dental appliances are the most common cause of accidental foreign body esophageal impaction, especially in the elderly population with decreased oral sensory perception. A 47-year-old man with history of oligophrenia and recurrent epileptic seizures was referred to our hospital following dislocation and ingestion of his upper dental prosthesis. Endoscopic removal and clipping of an esophageal tear had been unsuccessfully attempted. A chest CT scan confirmed entrapment of the dental prosthesis in the upper thoracic esophagus, the presence of pneumomediastinum, and the close proximity of one of the metal clasps of the prosthesis to the left subclavian artery. A video-assisted right thoracoscopy in the left lateral decubitus position was performed and the foreign body was successfully removed. The patient was then allowed to wear the retrieved prosthesis after dentistry consultation and repair of the wire clasps by a dental technician. At the 6-month follow-up visit the patient was doing very well without any trouble in swallowing. PMID:24422752

2014-01-01

20

[Nerve compression syndromes of the upper extremity].  

PubMed

The nerve compression syndromes of the upper extremity, the common carpal and cubital tunnel syndromes are described, but also the less common entrapments such as thoracic outlet syndrome,suprascapular-, interosseus-posterior- and anterior entrapments and the Loge-de-Guyon and Wartenberg syndromes are mentioned. Besides history, symptoms and physical examination electrodiagnostic and imaging are necessary for establishing the correct diagnosis. The conservative treatment is less successful than the operative therapy. Surgical procedures and techniques are discussed as well as complications. The prognosis is in most cases good--provided that indication and technique were correct. PMID:20936778

Assmus, H; Martini, A-K

2010-09-01

21

Upper Extremity Composite Tissue Allotransplantation Imaging  

PubMed Central

Objective: Upper extremity (UE) transplantation is the most commonly performed composite tissue allotransplantation worldwide. However, there is a lack of imaging standards for pre- and posttransplant evaluation. This study highlights the protocols and findings of UE allotransplantation toward standardization and implementation for clinical trials. Methods: Multimodality imaging protocols for a unilateral hand transplant candidate and a bilateral mid-forearm level UE transplant recipient include radiography, computed tomography (CT), magnetic resonance (MR) imaging, catheter angiography, and vascular ultrasonography. Pre- and posttransplant findings, including dynamic CT and MR performed for assessment of motor activity of transplanted hands, are assessed, and image quality of vessels and bones on CT and MR evaluated. Results: Preoperative imaging demonstrates extensive skeletal deformity and variation in vascular anatomy and vessel patency. Posttransplant images confirm bony union in anatomical alignment and patency of vascular anastomoses. Mild differences in rate of vascular enhancement and extent of vascular networks are noted between the 2 transplanted limbs. Dynamic CT and MR demonstrate a 15° to 30° range of motion at metacarpophalangeal joints and 90° to 110° at proximal interphalangeal joints of both transplanted hands at 8 months posttransplant. Image quality was slightly better for CT than for MR in the first subject, while MR was slightly better in the second subject. Conclusion: Advanced vascular and musculoskeletal imaging play an important role in surgical planning and can provide novel posttransplantation data to monitor the success of the procedure. Implementation of more standardized protocols should enable a more comprehensive assessment to evaluate the efficacy in clinical trials. PMID:23943677

George, Elizabeth; Mitsouras, Dimitrios; Kumamaru, Kanako K.; Shah, Nehal; Smith, Stacy E.; Schultz, Kurt; Deaver, Pamela M.; Mullen, Katherine M.; Steigner, Michael L.; Gravereaux, Edwin C.; Demehri, Shadpour; Bueno, Ericka M.; Talbot, Simon G.; Pomahac, Bohdan; Rybicki, Frank J.

2013-01-01

22

Managing Upper extremity Fx's Sweden 10-Managing Pediatric  

E-print Network

's Sweden 10- 05 4 Fracture = break Bone set = reduction Greenstick Fracture Buckle Fracture #12;Managing Upper extremity Fx's Sweden 10- 05 5 Compound Fracture Open Fracture (Bone comes through skin) DoubleManaging Upper extremity Fx's Sweden 10- 05 1 Managing Pediatric Fractures Andrew Pennock, M

Squire, Larry R.

23

Multicomponent Intervention for Work-Related Upper Extremity Disorders  

Microsoft Academic Search

Although several multidimensional models have emerged to explain the development, exacerbation and maintenance of work-related upper extremity disorders and disability, there is a paucity of data on the application of these models for the development of worksite-based prevention and management programs. Sign language interpreting is an occupation associated with increased risk for upper extremity symptoms. Ergonomic, work organization, work style,

Michael Feuerstein; Liza Marshall; William S. Shaw; Lolita M. Burrell

2000-01-01

24

Rat Models of Upper Extremity Impairment in Stroke  

Microsoft Academic Search

Stroke remains the leading cause of adult disability, with upper extremity motor impairments being the most promi- nent functional deficit in surviving stroke victims. The de- velopment of animal models of upper extremity dysfunction after stroke has enabled investigators to examine the neural mechanisms underlying rehabilitation-dependent motor re- covery as well as the efficacy of various adjuvant therapies for enhancing

Jeffrey A. Kleim; Jeffery A. Boychuk; DeAnna L. Adkins

25

RUPERT: a Device for Robotic Upper Extremity Repetitive Therapy  

Microsoft Academic Search

We report the development and initial evaluation of a device for robotic assisted upper extremity repetitive therapy (RUPERTtrade). Intense repetitive physical therapies provided by individualized interaction between the patient and a rehabilitation specialist to overcome upper extremity impairment after stroke are beneficial, however, they are expensive and difficult to evaluate quantitatively and objectively. The need is urgent and growing for

Jiping He; E. J. Koeneman; R. S. Schultz; D. E. Herring; J. Wanberg; H. Huang; T. Sugar; R. Herman; J. B. Koeneman

2005-01-01

26

Exercise-Induced Deep Vein Thrombosis of the Upper Extremity  

Microsoft Academic Search

Upper-extremity deep venous thrombosis (UEDVT) is an increasingly important clinical problem in children. These events are classified as primary or secondary, with the latter being the most common and usually associated with the presence of a central venous line. Among primary UEDVT, the so-called Paget-Schroetter syndrome, effort-related or exercise-induced upper-extremity thrombotic event represents an extremely rare finding that has never

Leonardo R. Brandão; Suzan Williams; Walter H. A. Kahr; Clodagh Ryan; Michael Temple; Anthony K.C. Chan

2006-01-01

27

Marquette University Gross Dissection Workshop - Upper & Lower Extremity  

NSDL National Science Digital Library

This website provides information regarding Marquette University's Gross Dissection of the Extremities workshop. The focus of the course is an intensive anatomy and kinesiology review. Even years this course focus on the lower extremity and the odd years the focus is on the upper extremity.

Marquette University (Marquette University)

2012-07-24

28

Case report: upper extremity soft-tissue reconstruction by alloplastic implant: long-term result and follow-up.  

PubMed

Prosthetic implants for reconstruction have found a variety of applications. Soft-tissue defects of the extremities are but one example in which alloplastic reconstruction is useful. As shown in the following case, gratifying cosmetic results can be obtained in posttraumatic upper extremity defects by reconstruction with a silastic implant. Although it is not a novel use for the device, it is one that has not been widely reported. The patient has been followed for 7 years postoperatively and he remains pleased with the cosmetic result. Furthermore, his function has not been compromised by placement of the prosthesis. PMID:9015544

Bonnecarrere, E R; Butler, B

1997-01-01

29

High-resolution magnetic resonance neurography in upper extremity neuropathy.  

PubMed

The most common sites of nerve entrapment are in the upper extremity, commonly diagnosed based on clinical findings and electrophysiologic studies. Cross-sectional imaging modalities, such as ultrasonography and magnetic resonance (MR) imaging, have been used to enhance diagnostic accuracy and provide anatomic mapping of abnormalities. MR neurography offers multiplanar high-resolution imaging of upper extremity nerves as well as adjacent soft tissues, and provides an objective assessment of the neuromuscular anatomy and related abnormalities. This article reviews the normal 3-T MR neurographic appearance of the upper extremity nerves, and abnormal findings related to injury, entrapment, and other pathologic conditions. PMID:24210316

Chalian, Majid; Behzadi, Ashkan Heshmatzadeh; Williams, Eric H; Shores, Jaimie T; Chhabra, Avneesh

2014-02-01

30

Upper Extremity Fungal Invasions Secondary to Large Burns.  

National Technical Information Service (NTIS)

Our experience with 15 cases of fungal invasion of burned upper extremities is presented. The clinical characteristics, the pathology, and the current treatment of this unusual (but potentially lethal) complication are detailed. In our series, 7 of the 15...

R. E. Salisbury, P. Silverstein, M. N. Goodwin

1974-01-01

31

Evaluation and treatment of upper extremity nerve entrapment syndromes.  

PubMed

Nerve entrapment syndromes in the upper extremity are being recognized with increasing frequency. Prompt and correct diagnosis of these injuries is important. This article is a review of the common entrapment nerve injuries seen in the upper extremity. Each of these clinical syndromes is discussed independently, reviewing the anatomy, compression sites, patient presentation (history and examination), the role of additional diagnostic studies, and management. PMID:24209726

Floranda, Eric E; Jacobs, Bret C

2013-12-01

32

Control of a Pneumatic Orthosis for Upper Extremity Stroke Rehabilitation  

E-print Network

Control of a Pneumatic Orthosis for Upper Extremity Stroke Rehabilitation Eric T. Wolbrecht, John rehabilitation of the arm. Pneumatic actuators can potentially help meet this challenge because of their high they are difficult to control. This paper describes the control development of a pneumatically actuated, upper

Bobrow, James E.

33

A method for determination of upper extremity kinematics  

Microsoft Academic Search

Kinematic analysis of the upper extremity has been conducted using a wide variety of techniques, philosophies, and analytic methods. We describe a simple, marker-based three-dimensional video analytic technique that borrows concepts from lower extremity kinematic analysis. A sequential rotation order about orthogonal axes is described, although alternate methods are examined as well. The method has been verified by application to

George Rab; Kyria Petuskey; Anita Bagley

2002-01-01

34

Lymphatic Filariasis Disseminating to the Upper Extremity  

PubMed Central

Lymphatic filariasis is the most common cause of acquired lymphedema worldwide (Szuba and Rockson, 1998). It is endemic to tropical and subtropical regions, and its effects are devastating. With over 100 million infected persons, it ranks second only to leprosy as the leading cause of permanent and long-term disability. Wuchereria bancrofti is the etiologic agent in 90% of cases. There is a dearth of published MRI findings with pathologically proven active infections, making this entity even more of a diagnostic dilemma. Imaging may provide the first clue that one is dealing with a parasite and may facilitate proper treatment and containment of this disease. This is the first report of pathologic correlation with MRI findings in the extremity in active filariasis. The magnetic resonance images demonstrate an enhancing, infiltrative, mass-like appearance with partial encasement of vasculature that has not been previously described in filariasis. Low signal strands in T2-hyperintense dilated lymphatic channels are seen and may depict live adult worms. We hypothesize that the low signal strands correspond to the collagen rich acellular cuticle. This, in combination with the surrounding hyperintense T2 signal, corresponding to a dilated lymphatic channel, may provide more specific MRI findings for active nematodal infection, which can prompt early biopsy, pathological correlation, and diagnosis. PMID:24707427

Maldjian, Catherine; Khanna, Vineet; Tandon, Bevan; Then, Matthew; Yassin, Mohamed; Adam, Richard; Klein, Michael J.

2014-01-01

35

Upper extremity thromboembolism in a patient with subclavian steal syndrome.  

PubMed

Subclavian steal is the physiologic process whereby blood flow through a vertebral artery is reversed at the level of the basilar artery as a means of supplying arterial inflow to the ipsilateral subclavian artery. This occurs in the setting of ipsilateral subclavian artery origin occlusion. We describe a case in which a patient with subclavian steal syndrome developed acute upper extremity ischemia secondary to thromboemboli from a chronically occluded ipsilateral subclavian stent (at the origin of the left subclavian artery). He subsequently underwent staged left upper extremity arterial thromboembolectomy followed by definitive revascularization via carotid-subclavian bypass. In addition, subclavian artery ligation proximal to the ipsilateral vertebral artery was performed. The patient's sensory and motor neurologic hand function returned to baseline with restoration of symmetric upper extremity arterial occlusion pressures and pulse volume recordings. A search of the literature revealed that this was the first case report of acute thromboembolic hand ischemia in the setting of subclavian steal. PMID:23809938

Yamaguchi, Dean J; Matthews, Thomas C

2013-07-01

36

Brachial plexus blocks for upper extremity orthopaedic surgery.  

PubMed

Regional anesthesia of the upper extremity has several clinical applications and is reported to have several advantages over general anesthesia for orthopaedic surgery. These advantages, such as improved postoperative pain, decreased postoperative opioid administration, and reduced recovery time, have led to widespread acceptance of a variety of regional nerve blocks. Interscalene block is the most commonly used block for shoulder surgery. Other brachial plexus nerve blocks used for orthopaedic surgery of the upper extremity are supraclavicular, infraclavicular, and axillary. Several practical and theoretical aspects of regional nerve blocks must be considered to optimize the beneficial effects and minimize the risk of complications. PMID:22207517

Bruce, Benjamin G; Green, Andrew; Blaine, Theodore A; Wesner, Lee V

2012-01-01

37

Hypercoagulable States in Primary Upper-Extremity Deep Vein Thrombosis  

Microsoft Academic Search

Background: There are very few data on the preva- lence of coagulation abnormalities in primary deep vein thrombosis of the upper limbs. Objective: To determine if coagulation abnormalities play a role in effort-related and\\/or idiopathic (non-effort- related) upper-extremity deep vein thrombosis (UEDVT). Methods: Fifty-one consecutive patients (21 men and 30 women) who had effort-related (n = 20) or idiopathic (n

Emmanuel Heron; Olivier Lozinguez; Martine Alhenc-Gelas; Joseph Emmerich; Jean-Noel Fiessinger

2000-01-01

38

Portable Upper Extremity Robotics is as Efficacious as Upper Extremity Rehabilitative Therapy: A Randomized Controlled Pilot Trial  

PubMed Central

Objective To compare the efficacy of a repetitive task specific practice regimen integrating a portable, electromyography-controlled brace called the “Myomo” versus usual care repetitive task specific practice in subjects with chronic, moderate upper extremity impairment. Subjects 16 subjects (7 males; mean age = 57.0 ± 11.02 years; mean time post stroke = 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Interventions Subjects were administered repetitive task specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30-minutes in duration, occurring 3 days/week for 8 weeks. However, one group participated in repetitive task specific practice entirely while wearing the portable robotic while the other performed the same activity regimen manually.. Main Outcome Measures The upper extremity Fugl-Meyer, Canadian Occupational Performance measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. Results After intervention, groups exhibited nearly-identical Fugl-Meyer score increases of ? 2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian occupational performance measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Conclusions Findings suggest that therapist-supervised repetitive task specific practice integrating robotics is as efficacious as manual in subjects with moderate upper extremity impairment. PMID:23147552

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

2013-01-01

39

Injuries to the neck and upper extremities of dancers.  

PubMed

In general, injuries to dancers involving the cervical spine and upper extremities are quite mild and cause only limited disability. When such injuries do not involve specific elements of the musculoskeletal system, their origin may be in the more subtle neurovascular structures of the neck. The importance of a thorough examination is emphasized. PMID:6652697

Nixon, J E

1983-11-01

40

A KINEMATIC AND DYNAMIC MODEL OF THE HUMAN UPPER EXTREMITY  

Microsoft Academic Search

In this paper a kinematic and dynamic model of the human upper extremity is developed for simulating movements and determination of the joints forces. These results can be used for the detection of dangerous movements of a patient having orthopaedic problems or for the design of prosthetic devices.

G. Mansour; S. Mitsi; K.-D. Bouzakis

41

An innovative system to enhance upper-extremity stroke rehabilitation  

Microsoft Academic Search

Stroke rehabilitation is a challenge that is being continuously addressed in the therapeutic world. A unique system is proposed to address upper-extremity stroke rehabilitation. This system incorporates a modified mass-marketed joystick with three distinct subsystems: a) an extended joystick that enables a larger range of motion and arm movements in both the horizontal and vertical fields that can be augmented

Christopher Ellsworth; Jack Winters

2002-01-01

42

Leveraging online virtual worlds for upper extremity Rehabilitation  

Microsoft Academic Search

Virtual environment based systems have been used for rehabilitation of individuals following a stroke. They can be customized to provide specific rehabilitation motor therapy goals, but can be costly to develop and deploy. This paper describes a low cost alternative using commonly available technologies to quickly create interesting virtual environments for upper extremity rehabilitation. The Nintendo Corporation's (Kyoto, Japan) Wiimote,

B. Galego; L. Simone

2007-01-01

43

Exercise-Induced Deep Vein Thrombosis of the Upper Extremity  

Microsoft Academic Search

Paget-Schroetter syndrome or effort-related upper extremity deep vein thrombosis is a rare condition that usually afflicts young healthy individuals, most commonly males. The cause is multifactorial but almost always involves extrinsic compression of the subclavian vein at the thoracic inlet, causing venous stenosis from repetitive trauma. The diagnosis of this condition may be difficult, and its delay may contribute to

Leonardo R. Brandão; Suzan Williams; Walter H. A. Kahr; Clodagh Ryan; Michael Temple; Anthony K.C. Chan

2006-01-01

44

Upper extremity hemodynamics and sensation with backpack loads.  

PubMed

Heavy backpacks are often used in extreme environments, for example by military during combat, therefore completion of tasks quickly and efficiently is of operational relevance. The purpose of this study was to quantify hemodynamic parameters (brachial artery Doppler and microvascular flow by photoplethysmography; tissue oxygenation by near-infrared spectroscopy; arterial oxygen saturation by pulse oximeter) and sensation in upper extremities and hands (Semmes-Weinstein monofilament test and 2-point discrimination test) while wearing a loaded backpack (12 kg) in healthy adults for 10 min. All values were compared to baseline before wearing a backpack. Moderate weight loaded backpack loads significantly decreased upper extremity sensation as well as all macrovascular and microvascular hemodynamic values. Decreased macrovascular and microvascular hemodynamics may produce neurological dysfunction and consequently, probably affect fine motor control of the hands. PMID:24075289

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

2014-05-01

45

Congenital disorders of the hand and upper extremity.  

PubMed

This article summarizes normal formation and growth of the upper limb as a basis for understanding malformation. Shoulder anomalies, including Sprengel's undescended scapula, clavicle pseudarthrosis, cleidocraniodystostosis, and Poland's syndrome, are presented. Classification and examples of limb malformations are discussed as well as neuromuscular disorders, such as obstetric brachial plexopathy, cerebral palsy, and arthrogryposis. The author hopes that this article provides a basic understanding of the evaluation necessary for appropriate counseling and referrals for treatment of the child with hand and upper extremity congenital deformities. PMID:8858076

Van Heest, A E

1996-10-01

46

Robot-aided neurorehabilitation of the upper extremities.  

PubMed

Task-oriented repetitive movements can improve muscle strength and movement co-ordination in patients with impairments due to neurological lesions. The application of robotics and automation technology can serve to assist, enhance, evaluate and document the rehabilitation of movements. The paper provides an overview of existing devices that can support movement therapy of the upper extremities in subjects with neurological pathologies. The devices are critically compared with respect to technical function, clinical applicability, and, if they exist, clinical outcomes. PMID:15742713

Riener, R; Nef, T; Colombo, G

2005-01-01

47

Upper and lower motor neuron lesions in the upper extremity muscles of tetraplegics  

Microsoft Academic Search

Paralysed upper extremity muscles of 24 tetraplegie patients were examined to determine whether their lower motor neuron was intact. Primary emphasis was placed on the forearm finger flexor muscles (Flexor Digitorum Superficialis and Flexor Digitorum Profundus) and finger extensor muscles (Extensor Digitorum Communis and Extensor Indicis). It was found that the vast majority of these muscles in C4, C5 and

P H Peckham; J T Mortimer; E B Marsolais

1976-01-01

48

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

PubMed

Juvenile dermatomyositis (JDM) is a rare but complex and potentially life-threatening autoimmune disease of childhood. Significant proportions of patients have residual weakness, muscle atrophy, joint contractures, and calcinosis. Recently, new clinical findings, such as lipodystrophy accompanied with increased fat deposition in certain areas, have been reported. So far, it is not known whether the redistribution of body fat may be the type of lipedema of lower extremity. We describe a 39-year-old woman who was diagnosed with JDM at the age of 7. Later she developed symmetrical lipodystrophy of upper extremities and symmetrical lipedema of lower extremities (making 2 and 58.3 % of total body fat mass, respectively), with multiple calcified nodules in the subcutaneous tissues. These nodules gradually increased in size despite therapy. Capillaroscopy findings showed scleroderma-like abnormalities. ANA and anti-U1RNP antibodies were positive. Similar cases with simultaneous occurrence of the lipedema of lower extremities, lipodystrophy of upper extremities, and severe calcinosis complicating JDM have not been published so far. We showed that the calcinosis and lipodystrophy were associated with short duration of active disease. Also, we display case that raises the question whether it is possible overlapping autoimmune diseases revealed during follow-up. PMID:24789670

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

2014-11-01

49

Upper extremity physical factors affecting tennis serve velocity.  

PubMed

Forty tournament-level tennis players with expert serve technique volunteered to have their serve evaluated to determine relationships between anthropometric data, extremity strength, and functional serve velocity. All players underwent a complete physical examination, a video taped serve analysis, a radar measurement of serve velocity, and a series of upper extremity strength measurements. Statistical analysis was performed to determine which factors were related to serve velocity. Statistically significant relationships were found between serve velocity and several flexibility measurements including increased dominant wrist flexion (P < 0.05), increased dominant shoulder flexion (P < 0.05), and increased dominant shoulder internal rotation at 0 degrees of abduction (P < 0.05). Several strength measurements were also related to serve velocity including elbow extension torque production (P < 0.01) and the ratios of internal to external rotational torque production for both low- and high-speed measurements (P < 0.01 concentrically and P < 0.05 eccentrically). These findings relate strength and flexibility to serve velocity, suggesting that it may be possible to increase a tennis player's serve velocity through specifically directed muscular strengthening or stretching regimens. However, prospective studies must be undertaken to demonstrate these possibilities. PMID:7856797

Cohen, D B; Mont, M A; Campbell, K R; Vogelstein, B N; Loewy, J W

1994-01-01

50

Motor learning perspectives on haptic training for the upper extremities.  

PubMed

Recent developments in neurorehabilitation have spawned numerous new robotic rehabilitation therapies. However, many of the concepts upon which these therapies are based are not fully understood and it may be necessary to explore some of the motor learning principles that apply to the use of haptics for motor learning in non-clinical scenarios/populations. We conducted a review of studies that utilized a haptic training paradigm teaching healthy participants to perform a motor skill involving the upper extremities. We discuss studies in the context of four important motor learning concepts: performance versus learning, feedback, observational learning, and functional task difficulty. Additionally, we note that the proliferation of research in haptic training has led to an extensive vocabulary of terms, some of which may be misnomers or redundant. We propose a classification of terms describing haptic training in an effort to provide clarity and further contextualize the studies. We believe that making connections to motor learning principles and clarifying meanings will facilitate a fuller understanding of the outcomes of studies in basic science research and allow for more directed applications of these training techniques to clinical populations. PMID:24968385

Williams, Camille K; Carnahan, Heather

2014-01-01

51

Upper limb prostheses for amputations above elbow: A review  

Microsoft Academic Search

In this article, it will be described the state of the art of upper limb prosthesis and several types of them. The prosthesis evolution had allowed people who lost an extremity to win back their normal life and live it with fewer limitations. Designing a myoelectric prosthetic arm that interacts with the amputee requires the integration of countless disciplines. Traditional

C. Toledo; L. Leija; R. Munoz; A. Vera; A. Ramirez

2009-01-01

52

Upper Extremity Axillary Loop Grafts: An Opportunity in Hemodialysis Access  

PubMed Central

Background Dialysis vascular access complications are considered as significant causes of morbidity in chronic hemodialysis patients. Objectives The aim of the present study was a comparison of axillary loop and straight grafts patency and its complications in hemodialysis access. Patients and Methods In this cohort study conducted at Shahid Beheshti Medical University, 77 patients who underwent placement of loop or straight access grafts were included. Demographics, primary and secondary patency rates and complications like thrombosis, infection, bleeding, steal syndrome and other complications were compared in these two groups. The collected data was analyzed by chi-square test, t-test, and logistic regression. Results Primary patency rate in straight and loop groups after 1 month were 88.9% and 92.3% respectively (P = 0.721), and after 24 months were 31% and 55.5% respectively (P = 0.058). Secondary patency rate in straight and loop groups after 3 months were 75.6% and 92.3% respectively (P = 0.189), and after 24 months were 37.9% and 66.7% respectively (P = 0.044). The frequency of complications were the same among two methods of graft replacement and mal incidence of thrombosis, infection, delayed infection, pseudoaneurysm formation and steal syndrome occurrence ultimate graft failure and venous hypertension were not significantly different (P > 0.05). Conclusions Polytetrafluorethylene (PTFE) vascular graft seems to be an appropriate vascular access and is a promising alternative when upper extremity arteriovenous fistulas cannot be constructed. Additionally, there was no significant difference between the two groups for complications and early patency, but late patency was improved in loop group. More study is necessary for a conclusive assessment. PMID:23577334

Khoshnevis, Jalaladin; Sobhiyeh, Mohammad Reza; Lotfolahzadah, Saran; Hoseinzadegan Shirazi, Fatemah; Jalali, Amir Hosein

2012-01-01

53

An electromyographic study of strength and upper extremity muscle activity in simulated meat cutting tasks  

Microsoft Academic Search

Meat cutting has long been associated with a high incidence rate of upper extremity musculoskeletal disorders. This study examined upper extremity muscle activities and force exertion capabilities to identify postures which have potential for causing overexertion injuries. Fifteen subjects exerted force against a handle in postures similar to those observed in the meatpacking industry. Exertion level, direction of exertion, handle

Katharyn A. Grant; Daniel J. Habes

1997-01-01

54

Upper and Lower Extremity Midline Crossing Effects upon Adults with Mild to Moderate Mental Retardation.  

ERIC Educational Resources Information Center

This study examined whether midline crossing inhibition (MCI) was present in 13 adults with mild to moderate mental retardation when crossing the midline of the body with both the upper and lower extremities. Results indicated that participants exhibited MCI with both the upper and lower extremities. (Author/CR)

Woodard, Rebecca J.; Surburg, Paul R.; Lewis, Colleen A.

1998-01-01

55

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

Microsoft Academic Search

Purpose. This review gives an overview of the current state of research regarding the effectiveness of mirror therapy in upper extremity function. Method. A systematic literature search was performed to identify studies concerning mirror therapy in upper extremity. The included journal articles were reviewed according to a structured diagram and the methodological quality was assessed. Results. Fifteen studies were identified

Daniëlle Ezendam; Raoul M. Bongers; Michiel J. A. Jannink

2009-01-01

56

A fuzzy clustering neural network architecture for multifunction upper-limb prosthesis.  

PubMed

Accurate and computationally efficient means of classifying surface myoelectric signals has been the subject of considerable research effort in recent years. The aim of this paper is to classify myoelectric signals using new fuzzy clustering neural network (NN) architectures to control multifunction prostheses. This paper presents a comparative study of the classification accuracy of myoelectric signals using multilayered perceptron NN using back-propagation, conic section function NN, and new fuzzy clustering NNs (FCNNs). The myoelectric signals considered are used in classifying six upper-limb movements: elbow flexion, elbow extension, wrist pronation and wrist supination, grasp, and resting. The results suggest that FCNN can generalize better than other NN algorithms and help the user learn better and faster. This method has the potential of being very efficient in real-time applications. PMID:14619995

Karlik, Bekir; Tokhi, M Osman; Alci, Musa

2003-11-01

57

Giant lipomas of the upper extremity: Case reports and a literature review  

PubMed Central

Giant fibrolipomas involving the upper extremities are rare tumours. These large masses grow slowly and produce symptoms due to their size, location and compression of adjacent structures. Surgical excision usually leads to complete recovery from symptoms. PMID:23997596

Balakrishnan, Chenicheri; Nanavati, Dhiren; Balakrishnan, Anila; Pane, Thomas

2012-01-01

58

Upper Extremity Repetitive Strain Injuries in Connecticut 1996, Extent and Costs.  

National Technical Information Service (NTIS)

A 1996 Connecticut population based, randomized telephone interview survey of self reported, chronic work related musculoskeletal disorders (WRMSD) of the neck and upper extremities was performed to replicate and extend the 1988 National Health Interview ...

C. F. Dillon, T. Morse, N. Warren, M. Cherniack, E. Storey, M. Hodgson, M. Trape

1999-01-01

59

Externally Powered Upper Extremity Prosthetic Systems: Studies of Sensory Motor Control.  

National Technical Information Service (NTIS)

Control problems in the operation of externally powered upper extremity prostheses were investigated in two research programs. The first program involved the evaluation of two sophisticated externally powered prostheses, the AIPR arm and the Belgrade elec...

L. F. Lucaccini, A. Freedy, J. Lyman

1967-01-01

60

Upper Extremity Prosthetics Research, Human Tracking, Sensory Motor Control, and Myoelectric Control.  

National Technical Information Service (NTIS)

Contents: I. Upper Extremity Prosthetics Research: Needs analysis for development of externally-powered prostheses design specification; Analysis of existing externally-powered prostheses and development of advanced design specification; Current status of...

1965-01-01

61

Recovery of upper-extremity strength in complete and incomplete tetraplegia: A multicenter study  

Microsoft Academic Search

Ditunno JF Jr, Cohen ME, Hauck WW, Jackson AB, Sipski ML. Recovery of upper-extremity strength in complete and incomplete tetraplegia: a multicenter study. Arch Phys Med Rehabil 2000;81:389-93. Objective: To examine upper-extremity motor recovery of subjects with tetraplegia with both complete and incomplete injuries, to predict which patients and at what time they would recover a motor level. Design: Prospective,

John F Ditunno; Michelle E Cohen; Walter W Hauck; Amie B Jackson; Marca L Sipski

2000-01-01

62

Upper Extremity Kinematics during Free Throw Shooting of Thai Wheelchair Basketball Players  

Microsoft Academic Search

\\u000a Wheelchair basketball (WCB) is one of the fastest growing competitive team sports. To score points, free-throw shooting (FTS)\\u000a is the easiest shot since it is an uncontested shot. Although previous studies have been investigated kinematic of FTS, kinematics\\u000a of upper extremity has never been reported in Thai WCB players. Understanding upper extremity kinematics is valuable since\\u000a it can help improve

W. Limroongreungrat; P. Jamkrajang; R. Tongaim

63

Upper Extremity Function and Occupational Performance in Children With Spastic Cerebral Palsy Following Lower Extremity Botulinum Toxin Injections  

Microsoft Academic Search

We studied the effect of botulinum toxin A injections to the lower extremities of spastic cerebral palsy children on upper limb body function and occupational performance. A total of 16 children with spastic cerebral palsy, aged 2 to 8 years, Gross Motor Function Classification System levels I-IV, referred to a child neurology outpatient clinic for botulinum toxin A injections to

Tal Keren-Capelovitch; Tal Jarus; Aviva Fattal-Valevski

2010-01-01

64

Upper Extremity Vascular Injury: A Current In-Theater Wartime Report from Operation Iraqi Freedom  

Microsoft Academic Search

Past wartime experience and recent civilian reports indicate upper extremity (UE) vascular injury occurs less often and with less limb loss than lower extremity (LE) injury. Given advances in critical care, damage control techniques, and military armor technology, the objective of this evaluation was to define contemporary patterns of UE injury and effectiveness of vascular surgical management in UE vascular

W. Darrin Clouse; Todd E. Rasmussen; Jon Perlstein; Michael J. Sutherland; Michael A. Peck; Jonathan L. Eliason; Slobadon Jazerevic; Donald H. Jenkins

2006-01-01

65

Analysis and modeling of upper and lower extremity dynamics in children with cerebral palsy using walkers  

Microsoft Academic Search

Cerebral palsy (CP) is a condition characterized by a motor disorder that is usually diagnosed during the early stages of life. It occurs from brain damage and has symptoms including postural instability and abnormal muscle tone. A large number of CP patients have spastic diplegic cerebral palsy (lower extremities (LEs) affected more severely than the upper extremities (UEs)) and many

Kelly M B Strifling

2006-01-01

66

A Comparison of Upper-Extremity Reaction Forces between the Yurchenko Vault and Floor Exercise  

PubMed Central

The purpose of this study was to examine reaction forces transmitted to the upper extremities of high-level gymnasts during the round-off phase of the Yurchenko vault. A secondary purpose of this study was to compare reaction forces during the Yurchenko vault to reaction forces observed in a tumbling pass during the floor exercise. Ten high-level, female gymnasts volunteered to participate. Conditions of the independent variable were the Yurchenko vault and floor exercise; dependent variables were peak vertical and peak anterior-posterior reaction forces. Each participant performed three trials of both conditions with the trail hand contacting a force platform. Vertical and anterior-posterior reaction forces, normalized to body weight, were greater (p < 0.05) during the round-off phase of the Yurchenko vault (2.38) than during the floor exercise round-off (2.15). Vertical reaction forces during the round-off phase of the Yurchenko vault and floor exercise round-off are similar to reaction forces transmitted to upper extremities during other gymnastic skills and ground reaction forces transmitted to lower extremities while running and walking at various speeds. Results of this study reveal a need for further research considering methods aimed at reducing reaction forces transmitted to the upper extremities during the Yurchenko vault and floor exercise. Key PointsDespite high difficulty and increased risk, a dearth of information exists concerning reaction forces transmitted to upper-extremities of high-level gymnasts performing the Yurchenko vault.Reaction forces experienced by high-level gymnasts performing the Yurchenko vault are relatively high; aforementioned forces are comparable to forces transmitted to lower-extremities during various activities and may be responsible for upper-extremity injury.Reaction forces observed during this study will serve as a baseline in the evaluation of methods purporting to reduce forces transmitted to upper-extremities during the Yurchenko vault. PMID:24431965

Seeley, Matthew K.; Bressel, Eadric

2005-01-01

67

Isometric Contraction of an Upper Extremity and Its Effects on the Contralateral Lower Extremity  

PubMed Central

[Purpose] The aim of this study was to examine effects of the isometric contraction of an upper limb in a supine position on the muscle activity of a healthy adult in the contralateral lower limb. [Subjects] The subjects were 40 healthy adults (35 males and 5 females). [Methods] The muscle activity of the rectus femoris (RF), biceps femoris, anterior tibialis, and medial gastrocnemius (MG) of the contralateral lower limb was measured using electromyography while the subjects flexed, extended, abducted, and adducted the shoulder joint of an upper limb. [Results] The muscle activity of the RF of the contralateral lower limb was significantly high when the subject flexed the shoulder joint of an upper limb, and the muscle activity of the MG of the contralateral lower limb was significantly high when the subject adducted the shoulder joint of an upper limb. [Conclusion] The isometric contraction that results from flexion and adduction of the shoulder joint of an upper limb in a supine position is considered to selectively affect the RF and MG activity of the contralateral lower limb.

Lee, Daehee; Park, Jungseo; Lee, Sangyong

2014-01-01

68

Three-dimensional motion of the upper extremity joints during various activities of daily living.  

PubMed

Highly reliable information on the range of motion (ROM) required to perform activities of daily living (ADL) is important to allow rehabilitation professionals to make appropriate clinical judgments of patients with limited ROM of the upper extremity joints. There are, however, no data available that take full account of corrections for gimbal-lock and soft tissue artifacts, which affect estimation errors for joint angles. We used an electromagnetic three-dimensional tracking system (FASTRAK) to measure the three-dimensional ROM of the upper extremity joints of healthy adults (N=20, age range 18-34) during 16 ADL movement tasks. The ROM required for the performance of each movement was shown in terms of the joint angle at the completion of the task, using a new definition of joint angle and regression analysis to compensate for estimation errors. The results of this study may be useful in setting goals for the treatment of upper extremity joint function. PMID:20727523

Aizawa, Junya; Masuda, Tadashi; Koyama, Takayuki; Nakamaru, Koji; Isozaki, Koji; Okawa, Atsushi; Morita, Sadao

2010-11-16

69

Understanding the importance of natural neuromotor strategy in upper extremity neuroprosthetic control.  

PubMed

A key challenge in upper extremity neuroprosthetics is variable levels of skill and inconsistent functional recovery. We examine the feasibility and benefits of using natural neuromotor strategies through the design and development of a proof-of-concept model for a feed-forward upper extremity neuroprosthetic controller. Developed using Artificial Neural Networks, the model is able to extract and classify neural correlates of movement intention from multiple brain regions that correspond to functional movements. This is unique compared to contemporary controllers that record from limited physiological sources or require learning of new strategies. Functional MRI (fMRI) data from healthy subjects (N = 13) were used to develop the model, and a separate group (N = 4) of subjects were used for validation. Results indicate that the model is able to accurately (81%) predict hand movement strictly from the neural correlates of movement intention. Information from this study is applicable to the development of upper extremity technology aided interventions. PMID:24589839

Nathan, Dominic E; Prost, Robert W; Guastello, Stephen J; Jeutter, Dean C

2014-01-01

70

Theoretical contribution of the upper extremities to reducing trunk extension following a laboratory-induced slip.  

PubMed

Slips are frequently the cause of fall-related injuries. Identifying modifiable biomechanical requirements for successful recovery is a key prerequisite to developing task-specific fall preventive training programs. The purpose of this study was to quantify the biomechanical role of the upper extremities during the initial phase of a slip resulting in trunk motion primarily in the sagittal plane. Two groups of adults were examined: adults over age 65 who fell and adults aged 18-40 who avoided falling after slipping. We hypothesized that rapid shoulder flexion could significantly reduce trunk extension velocity, that adults who slipped would implement this as a fall avoidance strategy, and that younger adults who avoided falling would use this strategy more effectively than older adults who fell. The kinematics of the 12 younger adults and eight older adults were analyzed using a three-segment conservation of momentum model developed to represent the trunk, head, and upper extremities. The model was used to estimate the possible contribution of the upper extremities to reducing trunk extension velocity. The model showed that upper extremity motion can significantly reduce trunk extension velocity. Although the upper extremities significantly reduced the trunk extension velocity of both young and older adults (p<0.027), the reduction found for the young adults, 13.6+/-11.4%, was significantly larger than that of the older adults (5.8+/-3.4%, p=0.045). Given the potential for trunk extension velocity to be reduced by rapid shoulder flexion, fall prevention interventions focused on slip-related falls may benefit from including upper extremity motion as an outcome whether through conventional or innovative strategies. PMID:19356766

Troy, Karen L; Donovan, Stephanie J; Grabiner, Mark D

2009-06-19

71

Ergonomic stressors and upper extremity disorders in vehicle manufacturing: cross sectional exposure-response trends  

PubMed Central

OBJECTIVE: To evaluate the association between upper extremity soft tissue disorders and exposure to preventable ergonomic stressors in vehicle manufacturing operations. METHODS: A cross sectional study was conducted in one vehicle stamping plant and one engine assembly plant. A standardised physical examination of the upper extremities was performed on all subjects. An interviewer administered questionnaire obtained data on demographics, work history, musculoskeletal symptoms, non-occupational covariates, and psycho-physical (relative intensity) ratings of ergonomic stressors. The primary exposure score was computed by summing the responses to the psychophysical exposure items. Multivariate regression analysis was used to model the prevalence of disorders of the shoulders or upper arms, wrists or hands, and all upper extremity regions (each defined both by symptoms and by physical examination plus symptoms) as a function of exposure quartile. RESULTS: A total of 1315 workers (85% of the target population) was examined. The prevalence of symptom disorders was 22% for the wrists or hands and 15% for the shoulders or upper arms; cases defined on the basis of a physical examination were about 80% as frequent. Disorders of the upper extremities, shoulders, and wrists or hands all increased markedly with exposure score, after adjustment for plant, acute injury, sex, body mass index, systemic disease, and seniority. CONCLUSIONS: Musculoskeletal disorders of the upper extremities were strongly associated with exposure to combined ergonomic stressors. The exposure- response trend was very similar for symptom cases and for physical examination cases. It is important to evaluate all dimensions of ergonomic exposure in epidemiological studies, as exposures often occur in combination in actual workplaces.   PMID:9764102

Punnett, L.

1998-01-01

72

Acute central cervical cord injury presenting with only upper extremity involvement  

Microsoft Academic Search

Summary. Twenty-four patients with acute central cervical cord injury with motor and sensory impairment involving only the upper extremities\\u000a are described; none had any abnormality in the lower extremities. They were all treated conservatively with one exception\\u000a in whom an anterior decompression was performed. Seventeen had complete recovery of motor function; the remaining 7 had some\\u000a weakness of the palmar

L. Dai; L. Jia

1998-01-01

73

The incidence of upper extremity injuries in endoscopy nurses working in the United States.  

PubMed

Numerous studies have addressed musculoskeletal disorders in the international working population. The literature indicates that injuries exist at astounding rates with significant economic impact. Attempts have been made by government, private industry, and special interest groups to address the issues related to the occurrence and prevention of musculoskeletal injuries. Because of the limited research on the gastrointestinal (GI) endoscopy nursing sector, this descriptive, correlational study explored the incidence of upper extremity injuries in GI endoscopy nurses and technicians in the United States. A total of 215 subjects were included in the study. Findings show that upper extremity injuries exist among nurses working in GI endoscopy. Twenty-two percent of respondents missed work for upper extremity injuries. The findings also show that the severity of disability is related to the type of work done, type of assistive aids available at work, and whether or not ergonomic or physiotherapy assessments were provided at the place of employment. In reference to rate of injury and the availability of ergonomics and physiotherapy assessments, those who had ergonomic assessments available to them had scores on the Disabilities of the Arm, Shoulder, and Hand (DASH) inventory (indicating upper extremity disability) that were significantly lower (DASH score, 9.96) than those who did not have the assessments available (DASH score, 14.66). The results suggest that there are a significant number of subjects who are disabled to varying degrees and the majority of these are employed in full-time jobs. PMID:24084131

Drysdale, Susan A

2013-01-01

74

Effects of pace and stress on upper extremity kinematic responses in sign language interpreters  

Microsoft Academic Search

Sign language interpreters suffer from high levels of upper extremity disorders and burnout due to the physical and cognitive demands of interpreting. The objective of this research was to quantify the wrist kinematics of interpreting and to assess how speaker pace and psychosocial stress influence wrist kinematics. Professional interpreters interpreted a pre-recorded lecture, while the speaking pace of the lecture

J. Qin; M. Marshall; J. Mozrall; M. Marschark

2008-01-01

75

Development of an upper extremity FES system for individuals with C4 tetraplegia  

Microsoft Academic Search

The application of functional electrical stimulation (FES) to provide upper extremity function for individuals with C4 tetraplegia is under investigation. In this study, a FES system was designed that allowed one individual with complete C4 tetraplegia to coordinate stimulated lateral or palmar prehension with stimulated arm movements using contralateral shoulder position. The system consisted of percutaneous intramuscular electrodes implanted to

B. T. Smith; M. J. Mulcahey; R. R. Betz

1996-01-01

76

Construct Validity of the Quality of Upper Extremity Skills Test for Children with Cerebral Palsy  

ERIC Educational Resources Information Center

Aim: The aim of the study was to investigate the construct validity of the Quality of Upper Extremity Skills Test (QUEST) in children with cerebral palsy (CP). Method: A total of 170 QUEST assessments from a convenience sample of 94 children with CP involved in clinical and research treatment programmes (54 males, 40 females; mean age 6y 10mo, SD…

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

2012-01-01

77

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

Microsoft Academic Search

The purpose of this study was to examine reaction forces transmitted to the upper extremities of high- level gymnasts during the round-off phase of the Yurchenko vault. A secondary purpose of this study was to compare reaction forces during the Yurchenko vault to reaction forces observed in a tumbling pass during the floor exercise. Ten high-level, female gymnasts volunteered to

Matthew Kirk Seeley; Eadric Bressel

78

“What if”: The use of biomechanical models for understanding and treating upper extremity musculoskeletal disorders  

Microsoft Academic Search

To aid understanding of the working of the upper extremity, several musculoskeletal models of the shoulder and arm have been developed. These models comprise the full shoulder girdle, which implies that the thoracohumeral link is formed by a scapular and clavicular segment. These models are based upon limited anatomical parameter sets and work on the assumption of a general control

DirkJan H. E. J. Veeger

2011-01-01

79

Performance prediction of an upper extremity reciprocal task using non-linear causal resource analysis  

Microsoft Academic Search

Nonlinear causal resource analysis (NCRA) is a new method for task analysis and prediction of human performance based on resource economic performance modeling. This method was investigated in an upper extremity coordinated movement task. Prediction accuracy obtained supports the validity of NCRA as an alternative to regression models as a prediction tool

Paul J. Vasta; George V. Kondraske

1994-01-01

80

Upper extremity physical therapy for stroke patients using a general purpose robot  

Microsoft Academic Search

In recent years, the potential of robot-mediated upper extremity therapy has been widely acknowledged in stroke rehabilitation. The primary focus of rehabilitation robotics has been on building exoskeleton robots as well as devising control strategies that leverage robotic forces to adaptively assist and resist the movements of patients' impaired arms during repetitive reach-touch exercises. In our single subject case study,

Hee-Tae Jung; Jennifer Baird; Yu-Kyong Choe; Roderic A. Grupen

2011-01-01

81

Observations of upper-extremity skin temperature and corresponding overall-body thermal sensations and comfort  

Microsoft Academic Search

This paper explores how upper extremity skin temperatures correlate with overall-body thermal sensation. Skin temperature measurements of the finger, hand, and forearm might be useful in monitoring and predicting people's thermal state. Subjective perceptions of overall thermal sensation and comfort were collected by repeated surveys, for subjects in a range of test chamber temperatures. A positive temperature gradient (finger warmer

Danni Wang; Hui Zhang; Edward Arens; Charlie Huizenga

2007-01-01

82

Assessment of Hand Grip Strength of Orthopedically Challenged Persons Affected with Upper Extremity  

Microsoft Academic Search

The present investigation was aimed to assess the extent of variation in grip strength in relation to the sex and type of deformity among the orthopedically challenged persons affected with upper extremity and to compare the grip strength with that of control (normal) persons. For this purpose 213 subjects having the age range 20-60 years were selected at random. Among

Prakash Chandra Dhara; Sujaya De; Amitava Pal; Piyali Sengupta; Sudeshna Roy

2009-01-01

83

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

PubMed

Although musculoskeletal disorders of the low back and upper extremities can affect military readiness, little is known about their extent and risk factors in the U.S. Marine Corps. Using the Defense Medical Epidemiology and Defense Medical Surveillance System databases, back and upper extremity diagnostic categories were among the top four sources of outpatient visits and duty limitation among enlisted Marines. Back disorders were also found to be the fifth most common cause for lost time. Subsequently, high-risk occupations were identified, age-related trends for clinic visit rates were determined, and rate ratios were computed for the top 15 low back and upper extremity diagnoses among enlisted Marines from 1997 through 1998. Occupational categories with the highest rates of musculoskeletal-related outpatient visits included image interpretation, auditing and accounting, disturbsing, surveillance/target acquisition, and aircraft launch equipment. Significantly increasing linear trends in rates across age groups were found for most diagnoses. For 1998, age-specific rate ratios indicated significantly higher rates for most low back and upper extremity disorders for females; lower rank (i.e., E1-E4) was also a risk, but for fewer diagnoses. The findings emphasize the need to identify modifiable (e.g., work-related, individual) risk factors and to develop focused primary and secondary prevention programs for musculoskeletal disorders in the Marine Corps. Subsequently, these efforts can assist in reducing associated effects, maximizing resource utilization, and enhancing operational readiness. PMID:11725313

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

2001-11-01

84

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

PubMed Central

Background: The introduction of perforator flaps by Koshima et al. was met with much animosity in the plastic surgery fraternity. The safety concerns of these flaps following the intentional twist of the perforators have prevented widespread adoption of this technique. Use of perforator based propeller flaps in the lower extremity is gradually on the rise, but their use in upper extremity reconstruction is infrequently reported, especially in the Indian subcontinent. Materials and Methods: We present a retrospective series of 63 free style perforator flaps used for soft tissue reconstruction of the upper extremity from November 2008 to June 2013. Flaps were performed by a single surgeon for various locations and indications over the upper extremity. Patient demographics, surgical indication, defect features, complications and clinical outcome are evaluated and presented as an uncontrolled case series. Results: 63 free style perforator based propeller flaps were used for soft tissue reconstruction of 62 patients for the upper extremity from November 2008 to June 2013. Of the 63 flaps, 31 flaps were performed for trauma, 30 for post burn sequel, and two for post snake bite defects. We encountered flap necrosis in 8 flaps, of which there was complete necrosis in 4 flaps, and partial necrosis in four flaps. Of these 8 flaps, 7 needed a secondary procedure, and one healed secondarily. Although we had a failure rate of 12-13%, most of our failures were in the early part of the series indicative of a learning curve associated with the flap. Conclusion: Free style perforator based propeller flaps are a reliable option for coverage of small to moderate sized defects. Level of Evidence: Therapeutic IV. PMID:24987209

Panse, Nikhil; Sahasrabudhe, Parag

2014-01-01

85

Ultrasound-guided supraclavicular block for the treatment of upper extremity fractures, dislocations, and abscesses in the ED  

Microsoft Academic Search

Emergency department (ED) patients with fractures, dislocations, or abscesses of the upper extremities often require closed reduction or incision and drainage to treat these conditions. Procedural sedation is often necessary when infiltration of local anesthetic provides insufficient analgesia. Anesthesiologists commonly perform supraclavicular brachial plexus nerve blocks to achieve analgesia for upper extremity surgery. We report a series of 5 ED

Michael B. Stone; Daniel D. Price; Ralph Wang

2007-01-01

86

Suprascapular nerve palsy following supraclavicular block for upper extremity surgery: report of 3 cases.  

PubMed

Regional anesthesia has become the preferred method of anesthesia for many upper extremity operations and generally results in decreased hospital stays, postoperative opioid requirement, and postoperative nausea. Complications of regional anesthesia are rarely reported in the literature, possibly because of limited anesthesiologist-patient follow-up. Three cases of suprascapular nerve palsy after ultrasound-guided supraclavicular nerve block for routine outpatient upper extremity surgery are reported. All cases occurred in men who originally presented with shoulder pain, which resolved with time, followed by weakness in the supraspinatus and infraspinatus, which improved over time but did not resolve. One case resulted in ipsilateral phrenic nerve palsy as well. A review of the literature on the subject accompanies the report of these 3 cases. PMID:23123059

Draeger, Reid W; Messer, Terry M

2012-12-01

87

Upper extremity peripheral nerve entrapments among wheelchair athletes: prevalence, location, and risk factors.  

PubMed

Wheelchair athletes commonly experience hand pain and numbness. This investigation studied the prevalence, location, and risk factors of upper extremity peripheral nerve entrapment among wheelchair athletes. Clinical and electrodiagnostic assessments were performed on both upper extremities of 28 wheelchair athletes and 30 able-bodied controls. Included in the assessment were short-segment stimulation techniques of the median nerve across the carpal tunnel and the ulnar nerve across the elbow. By clinical criteria, the prevalence of nerve entrapment among the wheelchair athletes was 23%, whereas it was 64% electrodiagnostically. The most common electrodiagnostic dysfunction was of the median nerve at the carpal tunnel (46%), and the portion of the nerve within the proximal carpal tunnel was most frequently affected. Ulnar neuropathy was the second most common entrapment electrodiagnostically (39%) and occurred at the wrist and forearm segments. Disability duration correlated significantly with electrophysiologic median nerve dysfunction. PMID:8185443

Burnham, R S; Steadward, R D

1994-05-01

88

ASSESSMENT OF UPPER EXTREMITY IMPAIRMENT, FUNCTION, AND ACTIVITY FOLLOWING STROKE: FOUNDATIONS FOR CLINICAL DECISION MAKING  

PubMed Central

The purpose of this review is to provide a comprehensive approach for assessing the upper extremity (UE) after stroke. First, common upper extremity impairments and how to assess them are briefly discussed. While multiple UE impairments are typically present after stroke, the severity of one impairment, paresis, is the primary determinant of UE functional loss. Second, UE function is operationally defined and a number of clinical measures are discussed. It is important to consider how impairment and loss of function affect UE activity outside of the clinical environment. Thus, this review also identifies accelerometry as an objective method for assessing UE activity in daily life. Finally, the role that each of these levels of assessment should play in clinical decision making is discussed in order to optimize the provision of stroke rehabilitation services. PMID:22975740

Lang, Catherine E.; Bland, Marghuretta D.; Bailey, Ryan R.; Schaefer, Sydney Y.; Birkenmeier, Rebecca L.

2012-01-01

89

[Laterality of upper extremity movements in infancy: observations at 4 and 9 months of age].  

PubMed

This study investigated the process involved in the lateralization of movements during infancy by observing upper extremity movements in a laboratory setting. Reaching for flying rings, balls, mini toy cars, and small round cookies were observed and recorded by videotape at 4 and 9 months of age. The subjects were 202 infants who participated in Japan Children's Study, a cohort study on the development of sociability. Infants reached for objects significantly more frequently at 9 months (98%) than at 4 months (40%) (p<0.001). Though the lateral preference in reaching for balls at 4 months was ambiguous, reaching for toy cars was performed more frequently with the right hand at 9 months (50%) than with the left one (19%) (p<0.01). Lateralization of the upper extremity movements is thought to appear by 9 months. PMID:20666135

Shiotani, Yuka; Matsuzawa, Shigeyuki; Ikeda, Hiroko; Sawada, Akiko; Okada, Masako; Kutsuki, Aya; Tomiwa, Kiyotaka

2010-07-01

90

A Rehabilitation Method with Visual and Haptic Guidance for Children with Upper Extremity Disability  

Microsoft Academic Search

\\u000a Activities of daily living present difficulties to children with upper extremity disabilities. Among the activities, handwriting\\u000a is considered essential to the children, and occupational therapy is important for them to adapt to the required motor skills.\\u000a In this paper, a virtual-reality based system is developed for training fine motor skills in the context of writing Chinese\\u000a characters. A haptic device

Kup-Sze Choi; Chum-Ming Chow; King-Hung Lo

2010-01-01

91

A Rare Case Report of Extensive Polyostotic Gorham's Disappearing Bone Disease Involving the Upper Extremity  

PubMed Central

Gorham's disease is a rare disorder involving the proliferation of endothelial channels resulting in resorption and disappearance of bone. An unusual case of polyostotic Gorham's disease affecting the scapula, humerus, radius, and ulna in a 39-year-old woman is described. The patient had extensive disease spreading across both the glenohumeral and humeroulnar joints. This is the first report of Gorham's disease spreading across multiple joints in the upper extremity. PMID:23198213

Ahlmann, Elke R.; Ma, Yanling; Tunru-Dinh, Vonny

2011-01-01

92

The Upper Extremity Loading during Typing Using One, Two and Three Fingers  

Microsoft Academic Search

\\u000a This study aimed to evaluate the effect of the number of fingers used during typing on the biomechanical loading on the upper\\u000a extremity. Six subjects typed in phone numbers using their right hand on a stand-alone numeric keypad in three conditions:\\u000a (1) typing using the index finger; (2) typing using the index and the middle fingers; (3) typing using the

Jin Qin; Matthieu Trudeau; Jack T. Dennerlein

93

Congenital and infantile benign skin lesions affecting the hand and upper extremity, part 2: nonvascular neoplasms.  

PubMed

This article is part 2 of a 2-part series presented to aid the hand surgeon in becoming familiar with dermatological lesions that may be present on the upper extremity during infancy. The discussion focuses on nonvascular neoplasms grouped into the following categories: epithelial, melanocytic, histiocytic, dermal, fibroblastic, and adipocytic neoplasms. Diagnostic tips are offered, including clinical photographs, to help differentiate between these lesions. In addition, the recommended treatment for each is discussed. PMID:24206996

Willard, Katherine J; Cappel, Mark A; Kozin, Scott H; Abzug, Joshua M

2013-11-01

94

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

PubMed Central

Background: The timing and pattern of reperfusion following arterial- venous reversal (AVR) in patients with terminal ischemia of an upper extremity is not well understood. Methods: The current case series describes the timing and pattern of reperfusion observed in patients with terminal upper extremity ischemia who underwent AVR and repeated postoperative indocyanine green (ICG) angiography between 2004 and 2009. For all included patients, the SPY Near-Infrared Perfusion Assessment System permitted visualization of ICG-labeled blood flow for 60-second sampling periods at scheduled postoperative time points; outflow and rate and amplitude of inflow were objectively quantified with SPY-Q Analysis Toolkit image analysis software. Results: The series comprised 6 male patients (mean age, 46 years) who presented with upper extremity ischemia related to hypothenar hammer syndrome (n = 2), embolism with patent foramen ovale (n = 2), atherosclerosis (n = 1), and avulsion amputation of the thumb (n = 1); the patient with the avulsion amputation was diagnosed with thromboangiitis obliterans at the time of replantation. AVR was successful in all 6 patients. In 5 of 6 patients, ICG angiography and SPY-based visualization/quantification showed that venous outflow and arterial inflow gradually normalized (versus unaffected digits) between postoperative days (PODs) 0 and 3 and was maintained at long-term follow-up (?3 months); for the patient who underwent thumb replantation, perfusion normalized between POD 3 and month 5 follow-up. Conclusions: AVR effectively reestablished blood flow in patients with terminal upper extremity ischemia. ICG angiography with SPY technology revealed that, in most cases, kinetic curves, timing, and patterns of perfusion gradually normalized over several PODs.

2014-01-01

95

Evaluation and management of chronic work-related musculoskeletal disorders of the distal upper extremity  

Microsoft Academic Search

This clinical review will describe the epidemiology, clinical presentation, and manage- ment of the following work-related musculoskeletal disorders (WMSDs) of the distal upper extremity: deQuervain's disease, extensor and flexor forearm tendinitis\\/tendinosis, lateral and medial epicondylitis, cubital tunnel syndrome, and hand-arm vibration syndrome (HAVS). These conditions were selected for review either because they were among the most common WMSDs among patients

George Piligian; Robin Herbert; Michael Hearns; Jonathan Dropkin; Paul Landsbergis; Martin Cherniack

2000-01-01

96

Giant cell arteritis presenting as pulseless disease of the upper extremities.  

PubMed

The most frequently recognized clinical features of giant cell arteritis (GCA) derive from the involvement of the cranial arteries. In 10% of patients, however, the aorta and its major branches, are also affected. We report a case of a 53-year-old woman presenting with a fainting episode and diminished pulses in the upper extremities. Histologic examination of the temporal artery revealed features of giant cell arteritis. PMID:8929786

Hatzis, G S; Aroni, K G; Kelekis, D A; Boki, K A

1996-01-01

97

Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors  

PubMed Central

Aim of the study There is little known about any change in postural balance caused by asymmetrical volume increase due to unilateral upper extremity lymphedema in patients who underwent breast surgery. The aim of this study was to determine whether there is a change in postural balance by measuring postural sway velocity (PSV), center of gravity (CoG) displacement and directional control (DCL) in patients with unilateral upper extremity lymphedema in breast cancer survivors. Material and methods Eighteen females 38–60 (M = 53) years old diagnosed with upper extremity lymphedema due to breast cancer surgery, and 18 healthy females with similar ages (M = 52.5) were assessed using the Balance Master system (Neuro Com, Clackamas, USA). Unilateral stance (US) and bilateral stance (BS) tests in eyes open and closed conditions and the limit of stability (LOS) test were applied to quantify postural sway velocity (PSV), CoG displacement, and directional control (DCL). Results The lymphedema group showed a significant increase in PSV in the US test on the ipsilateral leg with eyes open (p = 0.02) and eyes closed (p = 0.005) as well as on the contralateral leg with eyes open (p = 0.004) and eyes closed (p = 0.0001). Average displacement and position of the CoG were 25% of LOS (p = 0.0001) towards the lymphedema side and 60.6 degrees respectively. DCL in the lymphedema group was significantly lower in forward (p = 0.0001), back (p = 0.003), ipsilateral (p = 0.002), and contralateral (p = 0.03) directions. Conclusions These findings suggest that unilateral upper extremity lymphedema may have challenging effects on postural balance.

Karadibak, Didem; Yavuzsen, Tugba; Demirbuken, Ilksan

2014-01-01

98

Interventions for the prevention and management of neck/upper extremity musculoskeletal conditions: a systematic review  

PubMed Central

Considered from medical, social or economic perspectives, the cost of musculoskeletal injuries experienced in the workplace is substantial, and there is a need to identify the most efficacious interventions for their effective prevention, management and rehabilitation. Previous reviews have highlighted the limited number of studies that focus on upper extremity intervention programmes. The aim of this study was to evaluate the findings of primary, secondary and/or tertiary intervention studies for neck/upper extremity conditions undertaken between 1999 and 2004 and to compare these results with those of previous reviews. Relevant studies were retrieved through the use of a systematic approach to literature searching and evaluated using a standardised tool. Evidence was then classified according to a “pattern of evidence” approach. Studies were categorised into subgroups depending on the type of intervention: mechanical exposure interventions; production systems/organisational culture interventions and modifier interventions. 31 intervention studies met the inclusion criteria. The findings provided evidence to support the use of some mechanical and modifier interventions as approaches for preventing and managing neck/upper extremity musculoskeletal conditions and fibromyalgia. Evidence to support the benefits of production systems/organisational culture interventions was found to be lacking. This review identified no single?dimensional or multi?dimensional strategy for intervention that was considered effective across occupational settings. There is limited information to support the establishment of evidence?based guidelines applicable to a number of industrial sectors. PMID:16973739

Boocock, M G; McNair, P J; Larmer, P J; Armstrong, B; Collier, J; Simmonds, M; Garrett, N

2007-01-01

99

Chronic vascular disease of the upper extremity: radiologic and clinical features.  

PubMed

The major chronic vascular diseases of the upper extremity are (1) subclavian artery occlusions, (2) thoracic outlet syndrome, and (3) angiospastic disease of the hand. Central subclavian artery lesions ease of the hand. Central subclavian artery lesions can have either hemodynamic consequences (subclavian steal syndrome) or, by peripheral embolization, can provoke ischemic symptoms of the hand. Costoclavicular narrowing can cause functional or fixed stenosis of the subclavian artery and can also involve the vein or brachial plexus. Symptoms due to pressure on the brachial plexus are most frequent, but embolization to the peripheral vessels may also occur. Angiospastic disease, the most frequent lesion of upper extremity vessels, comprises three types: Raynaud's disease, in which there are intermittent attacks of coldness and discoloration without evidence of occlusion on the angiogram; asphyxia manus et digitorum in which the attacks are also intermittent but there is morphologic evidence of occlusion; and digitus moriens or mortuus, in which there is a painful, permanent discoloration. All investigations of chronic vascular disease of the upper extremity should begin with arch aortography and then proceed to a selective catheterization of the vessels that are presumed to be involved. PMID:6989496

Kobinia, G S; Olbert, F; Russe, O J; Denck, H

1980-01-01

100

Lower and upper extremity loading in nordic walking in comparison with walking and running.  

PubMed

Nordic walking (NW) was compared with walking (W) and running (R) with respect to upper and lower limb injury risks. 24 NW-instructors performed W, NW, and R trials on a runway covered with artificial turf at controlled speeds. Foot pronation and ground reaction forces were measured as well as shock wave transmission to the right wrist. Comparison of NW and W shows similar results for all of the four chosen velocities (5 km/h, 7 km/h, 8 km/h, 8.5 km/h). Except for the 2nd peak of the vertical ground reaction force, NW results in higher loading rates and horizontal forces as well as higher pronation and pronation velocity values as compared with W. Wrist acceleration values up to 7.6 times gravitational acceleration were recorded in NW. Compared with R at the same speeds (8 km/h and 8.5 km/h), NW can be recommended as low impact sport with 36% lower loading rates and 59% lower pronation velocities. However, the high wrist accelerations in NW reveal that the upper extremities are exposed to considerable repetitive shocks, which may cause overuse injuries of the upper extremities. Thus, additional preventive exercises for the upper limb muscles are recommended as well as using shock absorbing walking poles. PMID:21451179

Hagen, Marco; Hennig, Ewald M; Stieldorf, Peter

2011-02-01

101

Factors Affecting Outcomes in Patients Treated Surgically for Upper Extremity Tumors and Tumor-Like Lesions  

PubMed Central

There is little data available regarding outcomes of patients who have undergone surgery for tumors of the upper extremity. Functional data after surgery for upper extremity tumors would aid in guiding patient expectations in the peri-operative period. The purpose of this study was to identify patient, tumor, and surgery-related characteristics associated with patient-reported physical and emo-tional function before and after surgery for tumors of the upper extremity. Pre- and post-operative mental and physical Medical Outcomes Study Short Form 36 (SF-36) scores were collected from 79 patients with benign and malignant neoplasms of the upper extremity. A retrospective chart review was performed to ascertain whether tumor behavior, type, location, patient sex, age, surgical specimen size, or type of surgery were correlated with differing outcomes. Our outcome measure was patient-reported physi-cal and mental score (SF-36) at less than one year, one to two years, and greater than two years post-operatively. We found that patients with tumors proximal to the elbow and patients with right-sided tumors had statistically significantly lower post-operative physical scores at minimum two-year follow-up (p=0.02). Additionally, lower physical scores were associated with age greater than 50 (p=0.03) and tumor resection rather than curettage (p=0.01). The subset of patients with hereditary multiple exostoses had significantly lower post-operative physical scores than other patient sub-populations. There was no difference in physical function after surgery between patients with benign and malig-nant tumors, patients with tumors larger than 5 cm and less than 5 cm in greatest dimension, and patients with bone versus soft tissue tumors. Inter-estingly, we found that there was no difference in mental function scores between any comparisons. Our results suggest that patient age, tumor location, and type of surgery are correlated with patient-reported physical function following sur-gery. These findings could be helpful in counsel-ing patients undergoing surgery for tumors of the upper extremity. PMID:24027471

Otero, Jesse E; Graves, Christopher M; TeKippe, Ashley; Buckwalter, Joseph A; Miller, Benjamin J

2013-01-01

102

Internal models of upper limb prosthesis users when grasping and lifting a fragile object with their prosthetic limb.  

PubMed

Internal models allow unimpaired individuals to appropriately scale grip force when grasping and lifting familiar objects. In prosthesis users, the internal model must adapt to the characteristics of the prosthetic devices and reduced sensory feedback. We studied the internal models of 11 amputees and eight unimpaired controls when grasping and lifting a fragile object. When the object was modified from a rigid to fragile state, both subject groups adapted appropriately by significantly reducing grasp force on the first trial with the fragile object compared to the rigid object (p < 0.020). There was a wide range of performance skill illustrated by amputee subjects when lifting the fragile object in 10 repeated trials. One subject, using a voluntary close device, never broke the object, four subjects broke the fragile device on every attempt and seven others failed on their initial attempts, but improved over the repeated trials. Amputees decreased their grip forces 51 ± 7 % from the first to the last trial (p < 0.001), indicating a practice effect. However, amputees used much higher levels of force than controls throughout the testing (p < 0.015). Amputees with better performance on the Box and Blocks test used lower grip force levels (p = 0.006) and had more successful lifts of the fragile object (p = 0.002). In summary, amputees do employ internal models when picking up objects; however, the accuracy of these models is poor and grip force modulation is significantly impaired. Further studies could examine the alternative sensory modalities and training parameters that best promote internal model formation. PMID:25142151

Lum, Peter S; Black, Iian; Holley, Rahsaan J; Barth, Jessica; Dromerick, Alexander W

2014-12-01

103

Identifying sources of temporal variability in hydrological extremes of the upper Blue Nile basin  

NASA Astrophysics Data System (ADS)

It is known that changes in catchment runoff variability are a function of changes in climate as well as catchment behavior. For proper management of a certain watershed it is important to have a good understanding of the main causes of variability. Specifically, changes in extreme conditions of water resources are imperative as their consequences are far reaching. This paper attempts to identify the cause of hydrological extremes variability in the upper Blue Nile basin of Ethiopia. A method is proposed to utilize conceptual hydrological models to simulate long term (41 years) hydro-meteorological data and analyse the outputs using the Quantile Perturbation Method (QPM) specially designed for investigation of the temporal variability of extreme values in time series over multi-annual to (multi-)decadal time scales. Two conceptual hydrological models were calibrated and evaluated for their performance to simulate extreme high flows and changes in these flows for corresponding changes in rainfall conditions. The temporal variability results show similar patterns for simulated and observed extreme flows. This indicates the major influence of climate variability in extreme flows as demonstrated by the rainfall input in the models. There is no discernible change in the catchment response, e.g. quick runoff coefficient as a function of soil saturation state, between periods of the 1960-1970s, the 1980s and the 1990-2000s, which are attributed to land policy changes. This shows the influence of changes in catchment characteristics is minimal. (Multi-)decadal climate variability is identified as the main cause of temporal variation in hydrological extremes of the Blue Nile basin.

Taye, Meron Teferi; Willems, Patrick

2013-08-01

104

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

PubMed Central

Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A prospective cohort study of distal upper extremity musculoskeletal disorders is underway and has successfully enrolled over 1,000 workers to date. PMID:22672216

2012-01-01

105

Does functional capacity evaluation predict recovery in workers' compensation claimants with upper extremity disorders?  

PubMed Central

Objectives Functional capacity evaluations (FCEs) are commonly used to determine return?to?work readiness and guide decision making following work related injury, yet little is known of their validity. The authors examined performance on the Isernhagen Work Systems' FCE as a predictor of timely and sustained recovery in workers' compensation claimants with upper extremity disorders. A secondary objective was to determine whether FCE is more predictive in claimants with specific injuries (that is, fracture) as compared to less specific, pain mediated disorders (that is, myofascial pain). Methods The authors performed a longitudinal study of 336 claimants with upper extremity disorders undergoing FCE. FCE indicators were maximum performance during handgrip and lift testing, and the number of tasks where performance was rated below required job demands. Outcomes investigated were days receiving time?loss benefits (a surrogate of return to work or work readiness) in the year following FCE, days until claim closure, and future recurrence defined as whether benefits restarted, the claim reopened, or a new upper extremity claim was filed. Cox and logistic regression were used to determine the prognostic effect of FCE crudely and after controlling for potential confounders. Analysis was performed separately on claimants with specific and pain mediated disorders. Results Most subjects (95%) experienced time?loss benefit suspension within one year following FCE. The one year recurrence rate was 39%. Higher lifting performance was associated with faster benefit suspension and claim closure, but explained little variation in these outcomes (r2?=?1.2–11%). No FCE indicators were associated with future recurrence after controlling for confounders. Results were similar between specific injury and less specific groups. Conclusions Better FCE performance was a weak predictor of faster benefit suspension, and was unrelated to sustained recovery. FCE was no more predictive in claimants with specific pathology and injury than in those with more ambiguous, pain mediated conditions. PMID:16551753

Gross, D P; Battie, M C

2006-01-01

106

Gender difference in ability using the stretch-shortening cycle in the upper extremities.  

PubMed

A gender difference in ability using the stretch-shortening cycle (SSC ability) in the upper extremities has not been studied in detail. This study aimed to devise an index to evaluate SSC ability during powerful elbow flexion and to examine its gender differences. Thirty-three men athletes (19.9 +/- 1.0 years) and 21 women athletes (20.6 +/- 1.2 years) with mastered SSC movements participated in this study. They pulled a 20% load of maximal voluntary contraction (MVC) by elbow flexion as quickly as possible with the dominant upper extremity from the following two preliminary conditions: a static relaxed muscle state (SR condition) and using a countermovement (SSC condition). The muscle power was measured accurately by a power measurement device, which adopted the weight loading method. The peak power under both conditions showed significantly higher values in men than in women. In both genders, the peak power showed significantly lower values in the SSC condition than in the SR condition (p < 0.05). The potentiation of using the SSC was not found in the peak power test. However, the initial power showed significantly higher values under the SSC condition (men: 37.2 +/- 6.4 W; women: 17.4 +/- 5.1 W) than in the SR condition (men: 18.3 +/- 4.3 W; women: 11.2 +/- 3.1 W). Hence, assuming a difference between initial muscle power outputs of the SR and SSC conditions as a difference in SSC ability, an SSC index was devised to evaluate the above ability. The SSC index showed significantly higher values in men (50.1 +/- 12.4) than in women (32.1 +/- 23.2). However, the individual difference of SSC ability was very large in women. The ability of women to use SSC in the upper extremities may be inferior to that of men. PMID:19057404

Miyaguchi, Kazuyoshi; Demura, Shinichi

2009-01-01

107

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

PubMed Central

Background Several experimental studies in stroke patients suggest that mirror therapy and various virtual reality programs facilitate motor rehabilitation. However, the underlying mechanisms for these therapeutic effects have not been previously described. Objectives We attempted to delineate the changes in corticospinal excitability when individuals were asked to exercise their upper extremity using a real mirror and virtual mirror. Moreover, we attempted to delineate the role of visual modulation within the virtual environment that affected corticospinal excitability in healthy subjects and stroke patients. Methods A total of 18 healthy subjects and 18 hemiplegic patients were enrolled into the study. Motor evoked potential (MEP)s from transcranial magnetic stimulation were recorded in the flexor carpi radialis of the non-dominant or affected upper extremity using three different conditions: (A) relaxation; (B) real mirror; and (C) virtual mirror. Moreover, we compared the MEPs from the virtual mirror paradigm using continuous visual feedback or intermittent visual feedback. Results The rates of amplitude increment and latency decrement of MEPs in both groups were higher during the virtual mirror task than during the real mirror. In healthy subjects and stroke patients, the virtual mirror task with intermittent visual feedback significantly facilitated corticospinal excitability of MEPs compared with continuous visual feedback. Conclusion Corticospinal excitability was facilitated to a greater extent in the virtual mirror paradigm than in the real mirror and in intermittent visual feedback than in the continuous visual feedback, in both groups. This provides neurophysiological evidence supporting the application of the virtual mirror paradigm using various visual modulation technologies to upper extremity rehabilitation in stroke patients. PMID:23035951

2012-01-01

108

The reliability of side to side measurements of upper extremity activity levels in healthy subjects  

PubMed Central

Background In both clinical and occupational settings, ambulatory sensors are becoming common for assessing all day measurements of arm motion. In order for the motion of a healthy, contralateral side to be used as a control for the involved side, the inherent side to side differences in arm usage must be minimal. The goal of the present study was to determine the reliability of side to side measurements of upper extremity activity levels in healthy subjects. Methods Thirty two subjects with no upper extremity pathologies were studied. Each subject wore a triaxial accelerometer on both arms for three and a half hours. Motion was assessed using parameters previously reported in the literature. Side to side differences were compared with the intraclass correlation coefficient, standard error of the mean, minimal detectable change scores and a projected sample size analysis. Results The variables were ranked based on their percentage of minimal detectable change scores and sample sizes needed for paired t-tests. The order of these rankings was found to be identical and the top ranked parameters were activity counts per hour (MDC% = 9.5, n = 5), jerk time (MDC% = 15.8, n = 8) and percent time above 30 degrees (MDC% = 34.7, n = 9). Conclusions In general, the mean activity levels during daily activities were very similar between dominant and non-dominant arms. Specifically, activity counts per hour, jerk time, and percent time above 30 degrees were found to be the variables most likely to reveal significant difference or changes in both individuals and groups of subjects. The use of ambulatory measurements of upper extremity activity has very broad uses for occupational assessments, musculoskeletal injuries of the shoulder, elbow, wrist and hand as well as neurological pathologies. PMID:20650006

2010-01-01

109

Motor Function of the Upper-Extremity after Transection of the Second Thoracic Nerve Root during Total En Bloc Spondylectomy  

PubMed Central

Background In total en bloc spondylectomy (TES) of upper thoracic spine including the second thoracic (T2) vertebra, T2 nerve roots are usually transected. In this study, we examined the association between transection of the T2 nerve roots and upper-extremity motor function in patients with upper thoracic TES. Methods We assessed 16 patients who underwent upper thoracic TES with bilateral transection of the T2 nerve roots. Patients were divided into three groups: 3 patients without any processing of T1 and upper nerve roots (T2 group), 7 with extensive dissection of T1 nerve roots (T1–2 group), and 6 with extensive dissection of T1 and upper nerve roots (C–T2 group). Postoperative upper-extremity motor function was compared between the groups. Results Postoperative deterioration of upper-extremity motor function was observed in 9 of the 16 patients (56.3%). Three of the 7 patients in the T1–2 group and all 6 patients in the C–T2 group showed deterioration of upper-extremity motor function, but there was no deterioration in the T2 group. In the T1–2 group, 3 patients showed mild deterioration that did not affect their activities of daily living and they achieved complete recovery at the latest follow-up examination. In contrast, severe dysfunction occurred frequently in the C–T2 group, without recovery at the latest follow-up. Conclusions The transection of the T2 nerve roots alone did not result in upper-extremity motor dysfunction; rather, the dysfunction is caused by the extensive dissection of the T1 and upper nerve roots. Therefore, transection of the T2 nerve roots in upper thoracic TES seems to be an acceptable procedure with satisfactory outcomes. PMID:25333299

Yokogawa, Noriaki; Murakami, Hideki; Demura, Satoru; Kato, Satoshi; Yoshioka, Katsuhito; Hayashi, Hiroyuki; Ishii, Takayoshi; Fujii, Moriyuki; Igarashi, Takashi; Tsuchiya, Hiroyuki

2014-01-01

110

Combat-related upper extremity injuries: Surgical management specificities on the theatres of operations.  

PubMed

This review presents the current surgical management of combat-related upper extremity injuries during the acute phase. The strategy consists of saving the life, saving the limb and retaining function. Surgical tactics are based on damage control orthopaedics techniques of haemorrhage control, wound debridement, and temporary bone stabilization prior to evacuation out of the combat zone. Features of the definitive management of local casualties in battlefield medical facilities are also discussed. In this situation, reconstructive procedures have to take into account the limited resources and operational constraints. PMID:24798097

Mathieu, L; Bertani, A; Gaillard, C; Chaudier, P; Ollat, D; Bauer, B; Rigal, S

2014-06-01

111

The effect of typing frequency and speed on the incidence of upper extremity cumulative trauma disorder.  

PubMed

Typing in the work setting, with its emphasis on speed, force and repetitive movements and its tendency to be performed under less than optimum conditions has been one of the major causes of upper extremity cumulative trauma disorder (CTD). This disorder, also known as overuse syndrome, is a chronic condition believed to result from habitual overuse of the digits, hands or arms. The objective of this study was to examine the relationship between typing habits, specifically the influence of typing frequency, speed and style, on the incidence of injury. One hundred Israeli female typists aged between 20 and 60 years with no prior history of orthopedic or neurological disease participated in the study. Data collection took place at the work setting and consisted of a clinical evaluation of the upper extremities and trunk, a typing test, and a questionnaire which included questions concerning demographic information, occupational history, and upper extremity usage in the home and at work. Subjects were asked whether they had suffered from pain or other symptoms in the upper extremity (shoulder, arm, forearm, elbow or hand) on more than three occasions in the last year or on one occasion lasting more than a week. Subjects who answered no to this question were designated as 'non-sufferers'. Those who answered yes to the question were designated 'sufferers'. The 100 women who participated in the study represented a wide range of ages and educational levels. The variables describing on-the-job performance showed a wide range of values. Similar variability was found in the anthropometric variables. On the basis of the subjective criterion, 40 of the women belonged to the group labeled 'sufferers'. The remaining 60 subjects belonged to the group of 'non-sufferers'. The Odd's ratio test (OR), a common statistical procedure for risk factor estimation, was used to determine threshold levels associated with the development of CTD. Age, hours worked per week, typing speed, and years worked as a typist were variables in which at least one cut-off value generated a significant OR. The delineation of factors associated with typists who are classified as 'sufferers' establishes a portrait of the typical worker at risk for the development of CTD and provides insight into ways in which employers, clinicians and workers themselves could reduce the risk of CTD. PMID:24441493

Schreuer, N; Lifshitz, Y; Weiss, P L

1996-01-01

112

Does prophylactic anticoagulation prevent PICC-related upper extremity venous thrombosis? A case-control study.  

PubMed

The evidence regarding the value of prophylactic anticoagulation to prevent peripherally inserted central catheter-related upper extremity venous thrombosis (PRUEVT) is inconsistent. The authors reviewed 3 years of data, identifying all cases of PRUEVT at a facility in Texas, and individually matched each for risk factors with 2 controls. Not being on any form of anticoagulant or antiplatelet agent was associated with a modestly increased risk of PRUEVT (odds ratio 1.93, P = .036, 95% confidence interval, 1.025-3.602). Each approach to thrombosis prevention showed a trend toward a protective effect, but none reached statistical significance individually. PMID:25191821

Wilson, James D; Alred, Steven C

2014-01-01

113

Affected upper-extremity movement ability is retained 3 months after modified constraint-induced therapy.  

PubMed

The practicality and patient compliance of constraint-induced movement therapy limit its application in many clinical environments. For more than a decade, the principal investigator's laboratory has shown efficacy of an outpatient, modified constraint-induced therapy (mCIT). The current study examined whether participants administered mCIT retained motor changes 3 mo after intervention. The upper-extremity section of the Fugl-Meyer Impairment Scale (FM) and the Action Research Arm Test (ARA) were administered directly after mCIT intervention. Thirteen patients poststroke were tracked prospectively from directly after intervention concluded to 3 mo after intervention, at which time the FM and ARA were readministered. Three months after intervention, 25 of the 26 scores on the FM and ARA increased between the time after intervention and 3 months after intervention, reflecting continued increases in affected extremity movement ability. It is believed that the continued motor changes were caused by the comparatively larger number of extremity-use opportunities during the 10-wk mCIT intervention period. These opportunities encourage habitual extremity use even after the intervention period has concluded, leading to the changes observed. PMID:22026327

Page, Stephen J; Murray, Colleen; Hermann, Valerie

2011-01-01

114

Oral creatine supplementation enhances upper extremity work capacity in persons with cervical-level spinal cord injury  

Microsoft Academic Search

Jacobs PL, Mahoney ET, Cohn KA, Sheradsky LF, Green BA. Oral creatine supplementation enhances upper extremity work capacity in persons with cervical-level spinal cord injury. Arch Phys Med Rehabil 2002;83:19-23. Objective: To examine the effects of short-term creatine monohydrate supplementation on the upper extremity work capacity of persons with cervical-level spinal cord injury (SCI). Design: Randomized, double-blind, placebo-controlled, crossover design

Patrick L. Jacobs; Edward T. Mahoney; Kelly A. Cohn; Laurey F. Sheradsky; Barth A. Green

2002-01-01

115

Upper Extremity Performance and Self-Care Skill Changes in Children with Spastic Cerebral Palsy following Selective Posterior Rhizotomy  

Microsoft Academic Search

Changes in upper extremity and self-care performance following selective posterior rhizotomy (SPR) are reported frequently, but rarely quantified. In this study, 36 children with spastic cerebral palsy were assessed preoperatively and 1 year following SPR using the Quality of Upper Extremity Skills Test (QUEST). Twenty-six children were assessed at similar intervals using the Functional Independence Measure for Children (WeeFIM) as

Patricia Loewen; Paul Steinbok; Liisa Holsti; Margot MacKay

1998-01-01

116

The effect of the action observation physical training on the upper extremity function in children with cerebral palsy  

PubMed Central

The purpose this study was to investigate the effect of action observation physical training (AOPT) on the functioning of the upper extremities in children with cerebral palsy (CP), using an evaluation framework based on that of the International Classification of Functioning, Disability and Health (ICF). The subjects were divided into an AOPT group and a physical training (PT) group. AOPT group practiced repeatedly the actions they observed on video clips, in which normal child performed an action with their upper extremities. PT group performed the same actions as the AOPT group did after observing landscape photographs. The subjects participated in twelve 30-min sessions, 3 days a week, for 4 weeks. Evaluation of upper extremity function using the following: the power of grasp and Modified Ashworth Scale for body functions and structures, a Box and Block test, an ABILHAND-Kids questionnaire, and the WeeFIM scale for activity and participation. Measurements were performed before and after the training, and 2 weeks after the end of training. The results of this study showed that, in comparison with the PT group, the functioning of the upper extremities in the AOPT group was significantly improved in body functions and activity and participation according to the ICF framework. This study demonstrates that AOPT has a positive influence on the functioning of the upper extremities in children with CP. It is suggested that this alternative approach for functioning of the upper extremities could be an effective method for rehabilitation in children with CP. PMID:25061598

Kim, Jin-young; Kim, Jong-man; Ko, Eun-young

2014-01-01

117

Comparison of Upper Extremity Motor Recovery of Stroke Patients with Actual Physical Activity in Their Daily Lives Measured with Accelerometers  

PubMed Central

[Purpose] This study compared the upper extremity recovery of stroke patients with the amount of their upper extremity use in real life as measured by accelerometers. [Subjects] Forty inpatients who had had a stroke were recruited. [Methods] The subjects were divided into two groups by the Fugl-Meyer Assessment of Motor Function (FMA) score, a moderately recovered group and a well recovered group. The amount of upper extremity physical activity and its ratio in daily time periods were analyzed for the affected and unaffected sides. [Results] The well recovered group showed significantly higher affected arm use and use ratio than the moderately recovered group in all time periods. [Conclusion] The upper extremity recovery level of the affected side is similar to the physical activity level according to the amount of upper extremity physical activity in actual life measured with an accelerometer. Overuse of the normal side regardless of the recovery level of upper extremity proves the International Classification of Functioning (ICF) concept of differentiating between capacity and performance, and rehabilitation treatments should focus on improving performance. PMID:25140084

Shim, Sunhwa; Kim, Hee; Jung, Jinhwa

2014-01-01

118

The effect of the action observation physical training on the upper extremity function in children with cerebral palsy.  

PubMed

The purpose this study was to investigate the effect of action observation physical training (AOPT) on the functioning of the upper extremities in children with cerebral palsy (CP), using an evaluation framework based on that of the International Classification of Functioning, Disability and Health (ICF). The subjects were divided into an AOPT group and a physical training (PT) group. AOPT group practiced repeatedly the actions they observed on video clips, in which normal child performed an action with their upper extremities. PT group performed the same actions as the AOPT group did after observing landscape photographs. The subjects participated in twelve 30-min sessions, 3 days a week, for 4 weeks. Evaluation of upper extremity function using the following: the power of grasp and Modified Ashworth Scale for body functions and structures, a Box and Block test, an ABILHAND-Kids questionnaire, and the WeeFIM scale for activity and participation. Measurements were performed before and after the training, and 2 weeks after the end of training. The results of this study showed that, in comparison with the PT group, the functioning of the upper extremities in the AOPT group was significantly improved in body functions and activity and participation according to the ICF framework. This study demonstrates that AOPT has a positive influence on the functioning of the upper extremities in children with CP. It is suggested that this alternative approach for functioning of the upper extremities could be an effective method for rehabilitation in children with CP. PMID:25061598

Kim, Jin-Young; Kim, Jong-Man; Ko, Eun-Young

2014-06-01

119

Occupational Upper Extremity Symptoms in Sign Language Interpreters: Prevalence and Correlates of Pain, Function, and Work Disability  

Microsoft Academic Search

The interactive role of work demands, occupational stressors, and ergonomic risk factors in work-related upper extremity (UE) disorders remains unclear. Professional sign language interpreting, which involves exposure of the upper limbs to a combination of potential ergonomic and psychosocial stressors represents a unique occupational group to investigate the multivariate nature of UE disorders. The present study reports data on the

Michael Feuerstein; Ann Marie Carosella; Lolita M. Burrell; Liza Marshall; James Decaro

1997-01-01

120

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

NASA Astrophysics Data System (ADS)

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

Li, Zhanling; Li, Zhanjie; Li, Chengcheng

2014-05-01

121

4.5 YEAR FOLLOW-UP AFTER SURGICAL CORRECTION OF UPPER EXTREMITY DEFORMITIES IN SPASTIC CEREBRAL PALSY  

Microsoft Academic Search

Reconstructive surgery was carried out on 27 upper extremities in 24 children with deformities due to spastic cerebral palsy. Functional evaluation of the affected extremities was made preoperatively, at 6 months and at a mean of 4.5 years postoperatively using a score added to the assessment system described by the Committee on Spastic Hand Evaluation. According to the score, dysfunction

G NYLANDER; C CARLSTRÖM; L ADOLFSSON

1999-01-01

122

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

PubMed

Mixing implants with differing metallic compositions has been avoided for fear of galvanic corrosion and subsequent failure of the implants and of bone healing. The purpose of this study was to evaluate upper-extremity fractures treated with open reduction and internal fixation with metallic implants that differed in metallic composition placed on the same bone. The authors studied the effects of using both stainless steel and titanium implants on fracture healing, implant failure, and other complications associated with this method of fixation. Their hypothesis was that combining these metals on the same bone would not cause clinically significant nonunions or undo clinical effects from galvanic corrosion. A retrospective review was performed of 17 patients with upper-extremity fractures fixed with metal implants of differing metallic compositions. The primary endpoint was fracture union. Eight clavicles, 2 proximal humeri, 3 distal humeri, 3 olecranons, and 1 glenoid fracture with an average follow-up 10 months were reviewed. All fractures healed. One patient experienced screw backout, which did not affect healing. This study implies that mixing implants with differing metallic compositions on the same bone for the treatment of fractures does not adversely affect bone healing. No evidence existed of corrosion or an increase in complications with this method of treatment. Contrary to prior belief, small modular hand stainless steel plates can be used to assist in reduction of smaller fracture fragments in combination with anatomic titanium plates to obtain anatomic reduction of the fracture without adversely affecting healing. PMID:24025010

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

2013-09-01

123

Ultrasound-guided regional anesthesia for procedures of the upper extremity.  

PubMed

Anesthesia options for upper extremity surgery include general and regional anesthesia. Brachial plexus blockade has several advantages including decreased hemodynamic instability, avoidance of airway instrumentation, and intra-, as well as post-operative analgesia. Prior to the availability of ultrasound the risks of complications and failure of regional anesthesia made general anesthesia a more desirable option for anesthesiologists inexperienced in the practice of regional anesthesia. Ultrasonography has revolutionized the practice of regional anesthesia. By visualizing needle entry throughout the procedure, the relationship between the anatomical structures and the needle can reduce the incidence of complications. In addition, direct visualization of the spread of local anesthesia around the nerves provides instant feedback regarding the likely success of the block. This review article outlines how ultrasound has improved the safety and success of brachial plexus blocks. The advantages that ultrasound guidance provides are only as good as the experience of the anesthesiologist performing the block. For example, in experienced hands, with real time needle visualization, a supraclavicular brachial plexus block has changed from an approach with the highest risk of pneumothorax to a block with minimal risks making it the ideal choice for most upper extremity surgeries. PMID:21716734

Mirza, Farheen; Brown, Anthony R

2011-01-01

124

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

PubMed

To aid understanding of the working of the upper extremity, several musculoskeletal models of the shoulder and arm have been developed. These models comprise the full shoulder girdle, which implies that the thoracohumeral link is formed by a scapular and clavicular segment. These models are based upon limited anatomical parameter sets and work on the assumption of a general control principle. Upper Extremity models have proven to be useful for different categories of applications, such as quantification of the load on musculoskeletal structures, or the evaluation of changes in the musculoskeletal structure on function and mechanical integrity ("what if" questions). Although these models are increasingly used, validation has long been a difficult issue. With the development of instrumented endoprostheses, a new method for model validation has come within reach. Up till now results have indicated that to obtain 'true' force values, models should be scaled, and should allow for cocontraction. Musculoskeletal models will be finding their way in education and in clinical decision making. On the longer run individualized models might become important for application to individual patients, although scaling will for some time remain a difficult issue. PMID:20951628

Veeger, Dirkjan H E J

2011-02-01

125

Management of Intolerance to Casting the Upper Extremities in Claustrophobic Patients  

PubMed Central

Introduction. Some patients showed unusual responses to the immobilization without any objective findings with casts in upper extremities. We hypothesized their that intolerance with excessive anxiety to casts is due to claustrophobia triggered by cast immobilization. The aim of this study is to analyze the relevance of cast immobilization to the feeling of claustrophobia and discover how to handle them. Methods. There were nine patients who showed the caustrophobic symptoms with their casts. They were assesed whether they were aware of their claustrophobis themselves. Further we investigated the alternative immobilization to casts. Results. Seven out of nine cases that were aware of their claustrophobic tendencies either were given removable splints initially or had the casts converted to removable splints when they exhibited symptoms. The two patients who were unaware of their latent claustrophobic tendencies were identified when they showed similar claustrophobic symptoms to the previous patients soon after short arm cast application. We replaced the casts with removable splints. This resolved the issue in all cases. Conclusions. We should be aware of the claustrophobia if patients showed unusual responses to the immobilization without any objective findings with casts in upper extremities, where removal splint is practical alternative to cast to continue the treatment successfully. PMID:25379544

Nagura, Issei; Kanatani, Takako; Sumi, Masatoshi; Inui, Atsuyuki; Mifune, Yutaka; Kokubu, Takeshi; Kurosaka, Masahiro

2014-01-01

126

Assessing agreement of self-reported and observed physical exposures of the upper extremity  

PubMed Central

Assessment of workplace physical exposures by self-reported questionnaires has logistical advantages in population studies but is subject to exposure misclassification. This study measured agreement between eight self-reported and observer-rated physical exposures to the hands and wrists, and evaluated predictors of inter-method agreement. Workers (n=341) from three occupational categories (clerical/technical, construction, and service) completed self-administered questionnaires and worksite assessments. Analyses compared self-reported and observed ratings using a weighted kappa coefficient. Personal and psychosocial factors, presence of upper extremity symptoms and job type were evaluated as predictors of agreement. Weighted kappa values were substantial for lifting (0.67) and holding vibrating tools (0.61), moderate for forceful grip (0.58) and fair to poor for all other exposures. Upper extremity symptoms did not predict greater disagreement between self-reported and observed exposures. Occupational category was the only significant predictor of inter-method agreement. Self-reported exposures may provide a useful estimate of some work exposures for population studies. PMID:20166314

Dale, Ann Marie; Strickland, Jaime; Gardner, Bethany; Symanzik, Jurgen; Evanoff, Bradley

2012-01-01

127

Upper Extremity Freezing and Dyscoordination in Parkinson's Disease: Effects of Amplitude and Cadence Manipulations  

PubMed Central

Purpose. Motor freezing, the inability to produce effective movement, is associated with decreasing amplitude, hastening of movement, and poor coordination. We investigated how manipulations of movement amplitude and cadence affect upper extremity (UE) coordination as measured by the phase coordination index (PCI)—only previously measured in gait—and freezing of the upper extremity (FO-UE) in people with Parkinson's disease (PD) who experience freezing of gait (PD?+?FOG), do not experience FOG (PD-FOG), and healthy controls. Methods. Twenty-seven participants with PD and 18 healthy older adults made alternating bimanual movements between targets under four conditions: Baseline; Fast; Small; SmallFast. Kinematic data were recorded and analyzed for PCI and FO-UE events. PCI and FO-UE were compared across groups and conditions. Correlations between UE PCI, gait PCI, FO-UE, and Freezing of Gait Questionnaire (FOG-Q) were determined. Results. PD?+?FOG had poorer coordination than healthy old during SmallFast. UE coordination correlated with number of FO-UE episodes in two conditions and FOG-Q score in one. No differences existed between PD?/+FOG in coordination or number of FO-UE episodes. Conclusions. Dyscoordination and FO-UE can be elicited by manipulating cadence and amplitude of an alternating bimanual task. It remains unclear whether FO-UE and FOG share common mechanisms. PMID:24027652

Williams, April J.; Peterson, Daniel S.; Ionno, Michele; Pickett, Kristen A.; Earhart, Gammon M.

2013-01-01

128

Upper extremity strength and range of motion and their relationship to function in breast cancer survivors.  

PubMed

The impact upper extremity impairments (UE) have on UE function in breast cancer survivors (BCS) is unclear. The purpose of this study was to evaluate the associations between upper extremity active range of motion (AROM), passive range of motion (PROM), and strength with self-reported function in BCS. BCS (n = 24) completed the Disabilities of Arm, Shoulder and Hand (DASH) and the Pennsylvania Shoulder Score (PSS). AROM and PROM of shoulder flexion, extension, external rotation (ER) at 0° and 90° of abduction, and internal rotation (IR) at 90° of abduction were measured using a digital inclinometer. Strength was measured using a hand-held dynamometer for scapular abduction and upward rotation, scapular depression and adduction, flexion, IR, ER, scaption, and horizontal adduction. All constructs of AROM, PROM, and strength were correlated with the DASH and PSS. DASH was moderately to highly correlated with 2 of 5 AROM, 2 of 5 PROM, and 6 of 7 shoulder strength measures. PSS was moderately to highly correlated with 2 of 5 AROM, 2 of 5 PROM, and 4 of 7 shoulder strength measures. Regression analysis showed that AROM explained 40% of the DASH scores and strength explained 20% of scores on the PSS. This study characterizes the impact that shoulder motion, flexibility, and strength losses have on shoulder function in BCS. Deficits in AROM and shoulder strength explained the greatest proportion of shoulder disability. Future clinical trials should consider incorporating AROM and strengthening techniques to improve shoulder use after breast cancer treatments. PMID:23343035

Harrington, Shana; Padua, Darin; Battaglini, Claudio; Michener, Lori A

2013-10-01

129

Effect of Wrist Joint Restriction on Forearm and Shoulder Movement during Upper Extremity Functional Activities  

PubMed Central

[Purpose] This study measured %isolation and investigated whether it shows a difference between the presence and absence of wrist joint restriction, as well as changes in muscle activity patterns. [Methods] Twenty subjects performed upper extremity functional movement in the Manual Function Test (MFT) with and without wrist restriction, and the muscle activities of the trapezius, middle deltoid, biceps brachii, triceps brachii, extensor carpi radialis, and flexor carpi radialis were recorded. When there were differences in muscle activation, %isolation was implemented and the changes in the muscle activity patterns were noted. [Results] In the grasping and pinching tasks, there was a significant increase in %isolation of the upper trapezius and a significant decrease in %isolation of the extensor carpi radialis. Carrying a cube task, %isolation of the upper trapezius and middle deltoid significantly increased, whereas %isolation of the triceps brachii and extensor carpi radialis significantly decreased. In the pegboard task, the %isolation values of the extensor carpi radialis and flexor carpi radialis significantly decreased. [Conclusion] The data of this study should be useful for therapists, who can employ the information as material for the education and treatment of patients with wrist joint restriction. Therapists may thus look for ways to improve the quality of mobility by predicting the complement mobility depending on the activity performed and then determine whether to facilitate or restrict mobility. PMID:24396200

Jung, Hye-Young; Chang, Moonyoung; Kim, Kyeong-Mi; Yoo, Wongyu; Jeon, Byoung-Jin; Hwang, Gi-Chul

2013-01-01

130

Upper extremity impairments in women with or without lymphedema following breast cancer treatment  

PubMed Central

Introduction Breast-cancer-related lymphedema affects ?25% of breast cancer (BC) survivors and may impact use of the upper limb during activity. The purpose of this study is to compare upper extremity (UE) impairment and activity between women with and without lymphedema after BC treatment. Methods 144 women post BC treatment completed demographic, symptom, and Disability of Arm-Shoulder-Hand (DASH) questionnaires. Objective measures included Purdue pegboard, finger-tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume. Results Women with lymphedema had more lymph nodes removed (p?upper arm (p?

Wong, Josephine; Cooper, Bruce; Wanek, Linda; Topp, Kimberly; Byl, Nancy; Dodd, Marylin

2010-01-01

131

Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States  

PubMed Central

Background Musculoskeletal disorders of the upper extremity are common reasons for patients to seek care and undergo ambulatory surgery. The objective of our study was to assess the overall and age-adjusted utilization rates of rotator cuff repair, shoulder arthroscopy performed for indications other than rotator cuff repair, carpal tunnel release, and wrist arthroscopy performed for indications other than carpal tunnel release in the United States. We also compared demographics, indications, and operating room time for these procedures. Methods We used the 2006 National Survey of Ambulatory Surgery to estimate the number of procedures of interest performed in the United States in 2006. We combined these data with population size estimates from the 2006 U.S. Census Bureau to calculate rates per 10,000 persons. Results An estimated 272,148 (95% confidence intervals (CI)?=?218,994, 325,302) rotator cuff repairs, 257,541 (95% CI?=?185,268, 329,814) shoulder arthroscopies excluding those for cuff repairs, 576,924 (95% CI?=?459,239, 694,609) carpal tunnel releases, and 25,250 (95% CI?=?17,304, 33,196) wrist arthroscopies excluding those for carpal tunnel release were performed. Overall, carpal tunnel release had the highest utilization rate (37.3 per 10,000 persons in persons of age 45–64 years; 38.7 per 10,000 persons in 65–74 year olds, and; 44.2 per 10,000 persons in the age-group 75 years and older). Among those undergoing rotator cuff repairs, those in the age-group 65–74 had the highest utilization (28.3 per 10,000 persons). The most common indications for non-cuff repair related shoulder arthroscopy were impingement syndrome, periarthritis, bursitis, and instability/SLAP tears. Non-carpal tunnel release related wrist arthroscopy was most commonly performed for ligament sprains and diagnostic arthroscopies for pain and articular cartilage disorders. Conclusions Our data shows substantial age and demographic differences in the utilization of these commonly performed upper extremity ambulatory procedures. While over one million upper extremity procedures of interest were performed, evidence-based clinical indications for these procedures remain poorly defined. PMID:24397703

2014-01-01

132

Multidisciplinary rehabilitation of chronic work-related upper extremity disorders. Long-term effects.  

PubMed

The prevalence of work-related upper extremity disorders has significantly increased in the past decade. Persistent pain, loss of function, and associated work disability in patients with work-related upper extremity disorders appears to be affected by multiple factors including physical capabilities in relation to work demands, ergonomic risk factors on the job, and psychological factors related to worker traits, psychological readiness to return to work, and ability to manage symptoms. The complex nature of these disorders suggests the utility of a multidisciplinary program targeted at these factors. The present study is an investigation of the long-term vocational outcome of a multicomponent rehabilitation program that includes physical conditioning, work conditioning, work-related pain and stress management, ergonomic consultation, and vocational counseling/placement. Two groups equivalent on measures of duration of work disability, pain severity, fear of reinjury, psychological distress, perceived work environment, age, and education level were exposed to either the comprehensive work rehabilitation intervention (n = 19) or usual care (n = 15). Return-to-work status was determined at an average of 17 months posttreatment (range, 3 to 35 months) for the treatment group and an average of 18 months postevaluation (range, 5 to 30 months) for the usual care group. Findings indicated that 74% of the treatment group returned to work or were involved in state-supported vocational training in contrast to 40% of the control group (P < .05). For those who returned to work, 91% of the treatment group were working full-time in contrast to 50% of the control group (P < .05). Although the treatment group demonstrated a higher return-to-work rate than controls, the work reentry rate was not as high as similar approaches with work-related low back pain (80% to 88% return-to-work rate). These findings suggest the need to modify treatment components to facilitate an increased return-to-work rate. Areas that may prove useful include a greater emphasis ergonomic modifications at the workplace to reduce the risks of repetitiveness, force, awkward posture, and insufficient work/rest cycles, as well as efforts to modify work style directly in order to reduce the impact of ergonomic stressors on the ability to perform essential job tasks. In combination with traditional work hardening efforts directed at improving strength and flexibility of the upper extremities and work-related pain and stress management training, these ergonomic and work-style modification efforts may contribute to increases in the percentage of work disabled cases who successfully return to competitive work. PMID:8487118

Feuerstein, M; Callan-Harris, S; Hickey, P; Dyer, D; Armbruster, W; Carosella, A M

1993-04-01

133

Enhanced TheraJoy technology for use in upper-extremity stroke rehabilitation.  

PubMed

Due to rising costs of health care and decreasing length of conventional therapy, it has become imperative to develop affordable, motivating devices that can be used in the home for upper-extremity stroke rehabilitation. In the TheraJoy project, a commercial joystick has been modified to enlarge the range of arm movement used during therapeutic movement tasks, and to support the application of light passive and actuated forces. The enhanced version presented here allows for motion in both the horizontal and vertical planes, uses a dynamic linkage model to map joystick-hand position and force data, uses motivating gaming technology, and can be used in both therapy and in home settings. This study compares performance and benefits of motion in the horizontal to vertical plane, evaluates user performance during assessment and therapy tasks, and documents user opinions of potential uses of this technology for stroke rehabilitation. PMID:17271419

Johnson, Laura; Winters, Jack

2004-01-01

134

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

PubMed

Spastic hemiplegia and cerebral palsy often lead to typical deformities of the upper extremity. Muscle- and joint-contractures may be painful and aesthetically unappealing and may interfere with function and hygiene. Within the first weeks after the cerebral incidence the vital threat is dominating and the exact amount of neurologic impairment is not assessable. During this period, conservative treatment should counteract the development of contractures. After spontaneous neurologic recovery, surgical options should be taken into account. When choosing surgical procedures, factors as volitional motor control, sensibility and cognition must be taken into account besides the morphologic changes. This is best achieved in a multidisciplinary setting of neurologists, rehabilitation specialists, physiotherapists and surgeons. PMID:25228575

Haefeli, Mathias; Calcagni, Maurizio

2014-09-17

135

Feasibility of High-Repetition, Task-Specific Training for Individuals With Upper-Extremity Paresis  

PubMed Central

OBJECTIVE. We investigated the feasibility of delivering an individualized, progressive, high-repetition upper-extremity (UE) task-specific training protocol for people with stroke in the inpatient rehabilitation setting. METHOD. Fifteen patients with UE paresis participated in this study. Task-specific UE training was scheduled for 60 min/day, 4 days/wk, during occupational therapy for the duration of a participant’s inpatient stay. During each session, participants were challenged to complete ?300 repetitions of various tasks. RESULTS. Participants averaged 289 repetitions/session, spending 47 of 60 min in active training. Participants improved on impairment and activity level outcome measures. CONCLUSION. People with stroke in an inpatient setting can achieve hundreds of repetitions of task-specific training in 1-hr sessions. As expected, all participants improved on functional outcome measures. Future studies are needed to determine whether this high-repetition training program results in better outcomes than current UE interventions. PMID:25005508

Waddell, Kimberly J.; Birkenmeier, Rebecca L.; Moore, Jennifer L.; Hornby, T. George

2014-01-01

136

Feasibility of high-repetition, task-specific training for individuals with upper-extremity paresis.  

PubMed

OBJECTIVE. We investigated the feasibility of delivering an individualized, progressive, high-repetition upper-extremity (UE) task-specific training protocol for people with stroke in the inpatient rehabilitation setting. METHOD. Fifteen patients with UE paresis participated in this study. Task-specific UE training was scheduled for 60 min/day, 4 days/wk, during occupational therapy for the duration of a participant's inpatient stay. During each session, participants were challenged to complete ?300 repetitions of various tasks. RESULTS. Participants averaged 289 repetitions/session, spending 47 of 60 min in active training. Participants improved on impairment and activity level outcome measures. CONCLUSION. People with stroke in an inpatient setting can achieve hundreds of repetitions of task-specific training in 1-hr sessions. As expected, all participants improved on functional outcome measures. Future studies are needed to determine whether this high-repetition training program results in better outcomes than current UE interventions. PMID:25005508

Waddell, Kimberly J; Birkenmeier, Rebecca L; Moore, Jennifer L; Hornby, T George; Lang, Catherine E

2014-01-01

137

Tunnel syndromes of the upper extremities in workers using hand-operated vibrating tools.  

PubMed

Neurological and electrophysiological (EMG, ENG) examinations of the upper extremities were carried out in 167 patients exposed to hand-arm vibrations. All patients had typical symptoms (Raynaud's phenomenon and/or numbness, muscle weakness). The results showed that the circumscribed lesions of the tunnel nerves are far more common (92.8%) than diffuse peripheral neuropathies (22.7%). The most common alteration (71.4% below the border-line values) was the lesion of the brachial plexus in the thoracic outlet. In 16.2% of the patients compression of the subclavian artery was also demonstrated by means of a Doppler flowmeter. Cubital tunnel syndrome was observed in 42.5% of the patients. The results suggest that hand-arm vibration can play a part in the development of the thoracic outlet and cubital tunnel syndromes. On the other hand the thoracic outlet syndrome can contribute to the development of vibration-induced Raynaud's phenomenon. PMID:7731406

Kákosy, T

1994-01-01

138

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

PubMed

Cervical spinal cord injury and acquired brain injury commonly imply a reduction in the upper extremity function which complicates, or even constrains, the performance of basic activities of daily living. Neurological rehabilitation in specialised hospitals is a common treatment for patients with neurological disorders. This study presents a practical methodology for the objective and quantitative evaluation of the upper extremity motion during an activity of daily living of those subjects. A new biomechanical model (with 10 rigid segments and 20 degrees of freedom) was defined to carry out kinematic, dynamic and energetic analyses of the upper extremity motion during a reaching task through data acquired by an optoelectronic system. In contrast to previous upper extremity models, the present model includes the analysis of the grasp motion, which is considered as crucial by clinicians. In addition to the model, we describe a processing and analysis methodology designed to present relevant summaries of biomechanical information to rehabilitation specialists. As an application case, the method was tested on a total of four subjects: three healthy subjects and one pathological subject suffering from cervical spinal cord injury. The dedicated kinematic, dynamic and energetic analyses for this particular case are presented. The resulting set of biomechanical measurements provides valuable information for clinicians to achieve a thorough understanding of the upper extremity motion, and allows comparing the motion of healthy and pathological cases. PMID:23181596

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

2014-08-01

139

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems  

PubMed Central

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs:motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model-calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems. PMID:18420213

Blana, Dimitra; Hincapie, Juan G.; Chadwick, Edward K.; Kirsch, Robert F.

2008-01-01

140

Ergonomic stressors and upper extremity musculoskeletal disorders in automobile manufacturing: a one year follow up study  

PubMed Central

Aims: To estimate the one year cumulative incidence and persistence of upper extremity (UE) soft tissue disorders, in a fixed cohort of automotive manufacturing workers, and to quantify their associations with ergonomic exposures. Methods: At baseline and at follow up, cases of UE musculoskeletal disorders were determined by interviewer administered questionnaire and standardised physical examination of the upper extremities. The interview obtained new data on psychosocial strain and updated the medical and work histories. An index of exposure to ergonomic stressors, obtained at baseline interview, was the primary independent variable. Cumulative incidence and persistence of UE disorders (defined both by symptoms and by physical examination plus symptoms) were analysed in relation to baseline ergonomic exposures, adjusting for other covariates. The incidence of new disorders was modelled using multivariate proportional hazards regression among workers who were not cases in the first year and the prevalence on both occasions was modelled by repeated measures analysis. Results: A total of 820 workers (69% of eligible cohort members) was examined. Follow up varied slightly by department group but not by baseline exposure level or other characteristics. Among the non-cases at baseline, the cumulative incidence of UE disorders was 14% by symptoms and 12% by symptoms plus examination findings. These rates increased with index of physical exposures primarily among subjects who had the same jobs at follow up as at baseline. Increased exposure during follow up increased risk of incidence. The persistence of UE disorders from baseline to follow up examination was nearly 60% and somewhat associated with baseline exposure score. Conclusions: These longitudinal results confirm the previous cross sectional associations of UE musculoskeletal disorders with exposure to combined ergonomic stressors. The exposure-response relation was similar for incident cases defined by symptoms alone and those confirmed by physical examination. PMID:15258272

Punnett, L; Gold, J; Katz, J; Gore, R; Wegman, D

2004-01-01

141

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

PubMed Central

Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopaedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood. PMID:24309622

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

2014-01-01

142

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

PubMed

Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood. PMID:24309622

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

2014-01-01

143

Arterial Pressure Gradient of Upper Extremity Arteriovenous Access Steal Syndrome: Treatment Implications  

PubMed Central

Purpose Treatment options after arteriovenous fistula(AVF) associated steal include: ligation, banding, and distal revascularization-interval ligation(DRIL). The purpose of this study was to evaluate arterial pressure gradients in upper extremity steal syndrome. Methods Pre-operative arteriography and sequential intra-arterial pressure readings were performed on consecutive AVF patients with hand ischemia. Analysis of variance(ANOVA) with repeated measures analyzed inter-subject comparisons, and post-hoc analysis identified anatomic locations with highest inflow pressures. Results Nine patients presented with ischemic hand symptoms after AVF. Pullback arterial pressure measurements revealed gradual increases in systolic and mean pressures as the catheter position was moved proximally from the AVF anastomosis. Post-hoc analysis after ANOVA revealed higher axillary artery systolic pressure compared to proximal brachial artery(153vs116.8,p=0.007). Conclusion AVF-related steal syndrome decreases arterial inflow pressure of the affected extremity more proximally than previously thought. When performing a DRIL procedure, consideration should be given to placing the anastomosis as proximally as possible. PMID:20675320

Reifsnyder, Thomas; Arnaoutakis, George J

2011-01-01

144

Upper extremity deep vein thrombosis presenting to a chiropractic clinic: a description of 2 cases  

PubMed Central

Objective The purpose of this case series is to describe the presentation of 2 patients who presented to a chiropractic teaching clinic with Paget-Schroetter syndrome (PSS) and to discuss the potential role for conservative therapy in the management of symptoms. Clinical Features Two patients presented with a vascular and muscular findings suggesting activity-related upper extremity deep vein thrombosis. One patient presented with recent onset of symptoms (pain in the neck with a “pinched nerve sensation” in the left upper trapezius); and the other presented with chronic, low-grade neck pain of 1 year's duration. Intervention and Outcome The initial treatment approach for the patient with acute symptoms included soft tissue therapy. During the second appointment, he was immediately referred for medical evaluation and management because of worsening symptoms. He was diagnosed with thrombus in the left brachial vein, started immediately on a thrombolytic agent, and referred to a thrombosis clinic. Treatment for the second patient with chronic symptoms included soft tissue therapy, spinal manipulative therapy, and active care. Two months after 3 treatments, she reported improved symptoms. She remains under supportive care and has reported continued relief of her symptoms. Conclusion Although a rare condition, PSS has the potential to result in significant morbidity and potentially fatal complications; thus, it is critical that practitioners recognize the signs and symptoms to facilitate appropriate and timely referrals. Clinicians should be aware of the presentation and proposed pathogenesis of PSS, and consider this diagnosis in patients with unilateral upper limb and/or neck pain. PMID:23843762

Stainsby, Brynne E.; Muir, Bradley J.; Miners, Andrew L.

2012-01-01

145

Validity, Reliability, and Sensitivity of a 3D Vision Sensor-based Upper Extremity Reachable Workspace Evaluation in Neuromuscular Diseases  

PubMed Central

Introduction: One of the major challenges in the neuromuscular field has been lack of upper extremity outcome measures that can be useful for clinical therapeutic efficacy studies. Using vision-based sensor system and customized software, 3-dimensional (3D) upper extremity motion analysis can reconstruct a reachable workspace as a valid, reliable and sensitive outcome measure in various neuromuscular conditions where proximal upper extremity range of motion and function is impaired. Methods: Using a stereo-camera sensor system, 3D reachable workspace envelope surface area normalized to an individual’s arm length (relative surface area: RSA) to allow comparison between subjects was determined for 20 healthy controls and 9 individuals with varying degrees of upper extremity dysfunction due to neuromuscular conditions. All study subjects were classified based on Brooke upper extremity function scale. Right and left upper extremity reachable workspaces were determined based on three repeated measures. The RSAs for each frontal hemi-sphere quadrant and total reachable workspaces were determined with and without loading condition (500 gram wrist weight). Data were analyzed for assessment of the developed system and validity, reliability, and sensitivity to change of the reachable workspace outcome. Results: The mean total RSAs of the reachable workspace for the healthy controls and individuals with NMD were significantly different (0.586 ± 0.085 and 0.299 ± 0.198 respectively; p<0.001). All quadrant RSAs were reduced for individuals with NMDs compared to the healthy controls and these reductions correlated with reduced upper limb function as measured by Brooke grade. The upper quadrants of reachable workspace (above the shoulder level) demonstrated greatest reductions in RSA among subjects with progressive severity in upper extremity impairment. Evaluation of the developed outcomes system with the Bland-Altman method demonstrated narrow 95% limits of agreement (LOA) around zero indicating high reliability. In addition, the intraclass correlation coefficient (ICC) was 0.97. Comparison of the reachable workspace with and without loading condition (wrist weight) showed significantly greater RSA reduction in the NMD group than the control group (p<0.012), with most of the workspace reduction occurring in the ipsilateral upper quadrant relative to the tested arm (p<0.001). Reduction in reachable workspace due to wrist weight was most notable in those subjects with NMD with marginal strength reserve and moderate degree of impairment (Brooke = 2) rather than individuals with mild upper extremity impairment (Brooke = 1) or individuals who were more severely impaired (Brooke =3). Discussion: The developed reachable workspace evaluation method using scalable 3D vision technology appears promising as an outcome measure system for clinical studies. A rationally-designed combination of upper extremity outcome measures including a region-specific global upper extremity outcome measure, such as the reachable workspace, complemented by targeted disease- or function-specific endpoints, may be optimal for future clinical efficacy trials. PMID:24459607

Han, Jay J.; Kurillo, Gregorij; Abresch, R. Ted; Nicorici, Alina; Bajcsy, Ruzena

2013-01-01

146

Prosthesis Material  

NASA Technical Reports Server (NTRS)

In this photograph, Amputee Amie Bradly uses a NASA-developed prosthesis to paint her fingernails. Derived from foam insulation technology used to protect the Space Shuttle External Tank from excessive heat, FAB/CAD, a subsidiary of the Harshberger Prosthetic and Orthotic Center, utilized the technology to replace the heavy, fragile plaster they used to produce master molds for prosthetics. The new material was lighter, cheaper and easier to manufacture than plaster, resulting in lower costs to the customer.

2004-01-01

147

Prosthesis Material  

NASA Technical Reports Server (NTRS)

In this photograph, James Carden uses a NASA-developed prosthesis to moved planks around his home. Derived from foam insulation technology used to protect the Space Shuttle External Tank from excessive heat, FAB/CAD, a subsidiary of the Harshberger Prosthetic and Orthotic Center, utilized the technology to replace the heavy, fragile plaster they used to produce master molds for prosthetics. The new material was lighter, cheaper and easier to manufacture than plaster, resulting in lower costs to the customer.

1995-01-01

148

Prosthesis Material  

NASA Technical Reports Server (NTRS)

In this photograph, Sandra Rossi user her NASA-developed prosthesis for the first time. Derived from foam insulation technology used to protect the Space Shuttle External Tank from excessive heat, FAB/CAD, a subsidiary of the Harshberger Prosthetic and Orthotic Center, utilized the technology to replace the heavy, fragile plaster they used to produce master molds for prosthetics. The new material was lighter, cheaper and easier to manufacture than plaster, resulting in lower costs to the customer.

1995-01-01

149

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

PubMed

Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms. PMID:25035115

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

2014-11-01

150

Risk factors for upper-extremity musculoskeletal disorders in the working population  

PubMed Central

SUMMARY Objective The study aimed to assess the relative importance of personal and occupational risk factors for upper-extremity musculoskeletal disorders (UEMSDs) in the working population. Methods A total of 3,710 workers (58% of men) participating in a surveillance program of MSDs in a French region in 2002–2005 were included. UEMSDs were diagnosed by 83 trained occupational physicians performing a standardized physical examination. Personal factors and work exposure were assessed by a self-administered questionnaire. Statistical associations between MSDs, personal and occupational factors were analyzed using logistic regression modeling. Results A total of 472 workers suffered from at least one UEMSD. The risk of UEMSDs increased with age for both genders (P<0.001) (O.R. up to 4.9 in men and 5.0 and in women) and in cases of prior history of UEMSDs (OR 3.1 and 5.0, P<0.001). In men, UEMSDs were associated with obesity (OR 2.2, P=0.014), high level of physical demand (OR 2.0, P<0.001), high repetitiveness of the task (OR 1.5, P=0.027), postures with the arms at or above shoulder level (OR 1.7, P=0.009) or with full elbow flexion (OR 1.6, P=0.006), and high psychological demand (O.R. 1.5, P=0.005). In women, UEMSDs were associated with diabetes mellitus (O.R. 4.9, P=0.001), postures with extreme wrist bending (OR 2.0, P<0.001), use of vibrating hand tools (O.R. 2.2, P=0.025) and low level of decision authority (OR 1.4, P=0.042). Conclusion The study showed that personal and work-related physical and psychosocial factors were strongly associated with clinically-diagnosed UEMSDs. PMID:19790112

Roquelaure, Yves; Ha, Catherine; Rouillon, Clarisse; Fouquet, Natacha; Leclerc, Annette; Descatha, Alexis; Touranchet, Annie; Goldberg, Marcel; Imbernon, Ellen

2009-01-01

151

Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury  

Microsoft Academic Search

Purpose: To evaluate the lower motor neuron (LMN) integrity of upper extremity muscles of persons with high tetraplegia (C1-C4) in order to determine muscles available for stimulation. Methods: Fourteen subjects (23 arms) were evaluated for LMN integrity. Muscles that elicited a functional response (grade 3 or better) to surface electrical stimulation were considered to have intact LMN and good candidates

M-J Mulcahey; BT Smith; RR Betz

1999-01-01

152

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

ERIC Educational Resources Information Center

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

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

2014-01-01

153

Outpatient regional anesthesia for upper extremity surgery update (2005 to present) distal to shoulder.  

PubMed

Multiple different approaches to the brachial plexus are available for the regional anesthesiologist to provide successful anesthesia and analgesia for ambulatory surgery of the upper extremity. Although supraclavicular and infraclavicular blocks are faster to perform than axillary blocks, the operator needs to keep in mind that blocks performed around the clavicle carry the risk for specific side effects and complications, no matter whether ultrasound or nerve stimulation is the chosen modality for neurolocation. Owing to the ambulatory nature of the planned surgical intervention, even significant side effects may not become clinically symptomatic until the patient is discharged from the facility. For example, due to pneumothorax risks, axillary or mid-humeral blocks remain the most logical approaches for ambulatory surgical procedures at and below the elbow, while reserving infra-clavicularor supraclavicular approaches for surgery from the proximal humerus to above the elbow. Smaller interventions such as carpal tunnel release or trigger finger release can be performed under elbow, wrist, or digital blocks. The regional anesthesiologist should strive to develop a tailored plan for each individual case to provide the most effective and safest nerve block technique for their patients. PMID:22227422

Maga, Joni M; Cooper, Lebron; Gebhard, Ralf E

2012-01-01

154

Incorporating haptic effects into three-dimensional virtual environments to train the hemiparetic upper extremity  

PubMed Central

Current neuroscience has identified several constructs to increase the effectiveness of upper extremity rehabilitation. One is the use of progressive, skill acquisition-oriented training. Another approach emphasizes the use of bilateral activities. Building on these principles, this paper describes the design and feasibility testing of a robotic / virtual environment system designed to train the arm of persons who have had strokes. The system provides a variety of assistance modes, scalable workspaces and hand-robot interfaces allowing persons with strokes to train multiple joints in three dimensions. The simulations utilize assistance algorithms that adjust task difficulty both online and offline in relation to subject performance. Several distinctive haptic effects have been incorporated into the simulations. An adaptive master-slave relationship between the unimpaired and impaired arm encourages active movement of the subject's hemiparetic arm during a bimanual task. Adaptive anti-gravity support and damping stabilize the arm during virtual reaching and placement tasks. An adaptive virtual spring provides assistance to complete the movement if the subject is unable to complete the task in time. Finally, haptically rendered virtual objects help to shape the movement trajectory during a virtual placement task. A proof of concept study demonstrated this system to be safe, feasible and worthy of further study. PMID:19666345

Adamovich, Sergei; Fluet, Gerard G.; Merians, Alma S.; Mathai, Abraham; Qiu, Qinyin

2010-01-01

155

Upper extremity rehabilitation of children with cerebral palsy using accelerometer feedback on a multitouch display.  

PubMed

Cerebral palsy is a non-progressive neurological disorder caused by disturbances to the developing brain. Physical and occupational therapy, if started at a young age, can help minimizing complications such as joint contractures, and can improve limb range of motion and coordination. While current forms of therapy for children with cerebral palsy are effective in minimizing symptoms, many children find them boring or repetitive. We have designed a system for use in upper-extremity rehabilitation sessions, making use of a multitouch display. The system allows children to be engaged in interactive gaming scenarios, while intensively performing desired exercises. It supports games which require completion of specific stretching or coordination exercises using one or both hands, as well as games which use physical, or "tangible" input mechanisms. To encourage correct posture during therapeutic exercises, we use a wireless kinematic sensor, worn on the patient's trunk, as a feedback channel for the games. The system went through several phases of design, incorporating input from observations of therapy and clinical sessions, as well as feedback from medical professionals. This paper describes the hardware platform, presents the design objectives derived from our iterative design phases and meetings with clinical personnel, discusses our current game designs and identifies areas of future work. PMID:21096413

Dunne, Alan; Do-Lenh, Son; O' Laighin, Gearoid; Shen, Chia; Bonato, Paolo

2010-01-01

156

The effects of rear-wheel camber on the kinematics of upper extremity during wheelchair propulsion  

PubMed Central

Background The rear-wheel camber, defined as the inclination of the rear wheels, is usually used in wheelchair sports, but it is becoming increasingly employed in daily propulsion. Although the rear-wheel camber can increase stability, it alters physiological performance during propulsion. The purpose of the study is to investigate the effects of rear-wheel cambers on temporal-spatial parameters, joint angles, and propulsion patterns. Methods Twelve inexperienced subjects (22.3±1.6 yr) participated in the study. None had musculoskeletal disorders in their upper extremities. An eight-camera motion capture system was used to collect the three-dimensional trajectory data of markers attached to the wheelchair-user system during propulsion. All participants propelled the same wheelchair, which had an instrumented wheel with cambers of 0°, 9°, and 15°, respectively, at an average velocity of 1 m/s. Results The results show that the rear-wheel camber significantly affects the average acceleration, maximum end angle, trunk movement, elbow joint movement, wrist joint movement, and propulsion pattern. The effects are especially significant between 0° and 15°. For a 15° camber, the average acceleration and joint peak angles significantly increased (p < 0.01). A single loop pattern (SLOP) was adopted by most of the subjects. Conclusions The rear-wheel camber affects propulsion patterns and joint range of motion. When choosing a wheelchair with camber adjustment, the increase of joint movements and the base of support should be taken into consideration. PMID:23173938

2012-01-01

157

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement  

SciTech Connect

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices.Patients with longer catheter dwell time were more likely to develop central vein abnormalities. In order to preserve vascular access for dialysis fistulae and grafts and adhere to Dialysis Outcomes Quality Initiative guidelines, alternative venous access sites should be considered for patients with chronic renal insufficiency and end-stage renal disease.

Gonsalves, Carin F., E-mail: Carin.Gonsalves@mail.tju.edu; Eschelman, David J.; Sullivan, Kevin L.; DuBois, Nancy; Bonn, Joseph [Jefferson MedicalCollege/Thomas Jefferson University Hospital, Suite 4200 GibbonBuilding, 111 South 11th Street, Philadelphia, PA 19107, Department of Radiology (United States)

2003-04-15

158

An Accelerometry-Based Methodology for Assessment of Real-World Bilateral Upper Extremity Activity  

PubMed Central

Background The use of both upper extremities (UE) is necessary for the completion of many everyday tasks. Few clinical assessments measure the abilities of the UEs to work together; rather, they assess unilateral function and compare it between affected and unaffected UEs. Furthermore, clinical assessments are unable to measure function that occurs in the real-world, outside the clinic. This study examines the validity of an innovative approach to assess real-world bilateral UE activity using accelerometry. Methods Seventy-four neurologically intact adults completed ten tasks (donning/doffing shoes, grooming, stacking boxes, cutting playdough, folding towels, writing, unilateral sorting, bilateral sorting, unilateral typing, and bilateral typing) while wearing accelerometers on both wrists. Two variables, the Bilateral Magnitude and Magnitude Ratio, were derived from accelerometry data to distinguish between high- and low-intensity tasks, and between bilateral and unilateral tasks. Estimated energy expenditure and time spent in simultaneous UE activity for each task were also calculated. Results The Bilateral Magnitude distinguished between high- and low-intensity tasks, and the Magnitude Ratio distinguished between unilateral and bilateral UE tasks. The Bilateral Magnitude was strongly correlated with estimated energy expenditure (??=?0.74, p<0.02), and the Magnitude Ratio was strongly correlated with time spent in simultaneous UE activity (??=?0.93, p<0.01) across tasks. Conclusions These results demonstrate face validity and construct validity of this methodology to quantify bilateral UE activity during the performance of everyday tasks performed in a laboratory setting, and can now be used to assess bilateral UE activity in real-world environments. PMID:25068258

Bailey, Ryan R.; Klaesner, Joseph W.; Lang, Catherine E.

2014-01-01

159

Humeral Retrotorsion in Collegiate Baseball Pitchers With Throwing-Related Upper Extremity Injury History  

PubMed Central

Background: Collegiate baseball pitchers, as well as position players, exhibit increased humeral retrotorsion compared with individuals with no history of overhead sport participation. Whether the humeral retrotorsion plays a role in the development of throwing-related injuries that are prevalent in collegiate baseball pitchers is unknown. Hypotheses: Humeral retrotorsion will be significantly different in collegiate pitchers with throwing-related shoulder or elbow injury history compared with pitchers with no injury history. Humeral retrotorsion can also discriminate participants with and without shoulder or elbow injury. Study Design: Cross-sectional study. Methods: Comparisons of ultrasonographically-obtained humeral retrotorsion were made between 40 collegiate pitchers with and without history of throwing-related shoulder or elbow injury. The ability of humeral retrotorsion to discriminate injury history was determined from the receiver operating characteristic area under the curve. Results: Participants with an elbow injury history demonstrated a greater humeral retrotorsion limb difference (mean difference = 7.2°, P = 0.027) than participants with no history of upper extremity injury. Participants with shoulder injury history showed no differences in humeral torsion compared with participants with no history of injury. Humeral retrotorsion limb difference exhibited a fair ability (receiver operating characteristic area under the curve = 0.74) to discriminate elbow injury history. Conclusions: Collegiate pitchers with a history of elbow injury exhibited a greater limb difference in humeral retrotorsion compared with pitchers with no history of injury. No differences in humeral retrotorsion variables were present in participants with and without shoulder injury history. Clinical Relevance: Baseball players with a history of elbow injury demonstrated increased humeral retrotorsion, suggesting that the amount of retrotorsion and the development of elbow injury may be associated. PMID:23016031

Myers, Joseph B.; Oyama, Sakiko; Rucinski, Terri Jo; Creighton, R. Alexander

2011-01-01

160

Hormonal and Neuromuscular Responses to Mechanical Vibration Applied to Upper Extremity Muscles  

PubMed Central

Objective To investigate the acute residual hormonal and neuromuscular responses exhibited following a single session of mechanical vibration applied to the upper extremities among different acceleration loads. Methods Thirty male students were randomly assigned to a high vibration group (HVG), a low vibration group (LVG), or a control group (CG). A randomized double-blind, controlled-parallel study design was employed. The measurements and interventions were performed at the Laboratory of Biomechanics of the University of L'Aquila. The HVG and LVG participants were exposed to a series of 20 trials ×10 s of synchronous whole-body vibration (WBV) with a 10-s pause between each trial and a 4-min pause after the first 10 trials. The CG participants assumed an isometric push-up position without WBV. The outcome measures were growth hormone (GH), testosterone, maximal voluntary isometric contraction during bench-press, maximal voluntary isometric contraction during handgrip, and electromyography root-mean-square (EMGrms) muscle activity (pectoralis major [PM], triceps brachii [TB], anterior deltoid [DE], and flexor carpi radialis [FCR]). Results The GH increased significantly over time only in the HVG (P?=?0.003). Additionally, the testosterone levels changed significantly over time in the LVG (P?=?0.011) and the HVG (P?=?0.001). MVC during bench press decreased significantly in the LVG (P?=?0.001) and the HVG (P?=?0.002). In the HVG, the EMGrms decreased significantly in the TB (P?=?0.006) muscle. In the LVG, the EMGrms decreased significantly in the DE (P?=?0.009) and FCR (P?=?0.006) muscles. Conclusion Synchronous WBV acutely increased GH and testosterone serum concentrations and decreased the MVC and their respective maximal EMGrms activities, which indicated a possible central fatigue effect. Interestingly, only the GH response was dependent on the acceleration with respect to the subjects' responsiveness. PMID:25368995

Di Giminiani, Riccardo; Fabiani, Leila; Baldini, Giuliano; Cardelli, Giovanni; Giovannelli, Aldo; Tihanyi, Jozsef

2014-01-01

161

Upper extremity bioimpedance before and after treadmill testing in women post breast cancer treatment.  

PubMed

Research on the effect of cardiorespiratory (CR) exercise on upper extremity (UE) limb volume is limited in women with breast cancer-related lymphedema (BCRL). The aim of this study was to compare changes in UE volume immediately following a symptom-limited CR treadmill test in women with and without BCRL. As part of a cross-sectional study, 133 women post unilateral BC treatment completed symptom-limited treadmill testing. Bioimpedance spectroscopy (BIS) was used to measure UE resistance before and immediately following treadmill testing. Resistance ratios >1 (unaffected side/affected side) indicate greater volume in the affected limb. T-tests and repeated measures ANOVA were performed to evaluate differences between and within groups. Mean age was 56.2 years (SD 9.4); BMI was 26.13 kg m(-2) (SD 5.04). For women with previously diagnosed BCRL (n = 63), the resistance ratio was 1.116 (SD 0.160) pre-treadmill and 1.108 (SD 0.155) post-treadmill. For women without BCRL (n = 70), the resistance ratio was 0.990 (SD 0.041) pre-treadmill and 1.001 (SD 0.044) post-treadmill. Resistance ratios for women with BCRL were higher than those for women without BCRL at both time points (main effect of group: p < 0.001). No main effects were found for time (p = 0.695). A statistically significant effect was found for the time-by-group interaction (p = 0.002). 78 % of the women with BCRL wore a compression garment during testing. Following testing, the women with BCRL demonstrated a non-statistically significant decrease in the resistance ratio, suggesting an immediate decrease in interlimb volume difference. The women without BCRL demonstrated an increase in the resistance ratio. PMID:25338320

Smoot, Betty; Zerzan, Sarah; Krasnoff, Joanne; Wong, Josephine; Cho, Maria; Dodd, Marylin

2014-11-01

162

Upper extremity stress fractures and spondylolysis in an adolescent baseball pitcher with an associated endocrine abnormality: a case report.  

PubMed

Lower extremity stress fractures are relatively common among competitive athletes. Stress fractures of the upper extremity, however, are rare and most have been reported in the literature as case reports. We present a case of an adolescent baseball pitcher who had both proximal humeral and ulnar shaft stress fractures, as well as spondylolysis of the lumbar spine. This particular patient also had an underlying endocrine abnormality of secondary hyperparathyroidism with a deficiency in vitamin D. A bone mineral density panel demonstrated a high T score (+2.79 SD above the mean) and the patient's biologic bone age was noted to be 2 years ahead of his chronologic age. The patient was treated with a course of vitamin D and calcium supplementation. After treatment, both the vitamin D and parathyroid hormone returned to normal levels. The upper extremity stress fractures and spondylolysis were managed conservatively and he was able to return to full activity and baseball. For patients who present with multiple stress fractures not associated with consistent high levels of repeated stress, a bone mineral density panel should be considered. If vitamin D deficiency is present, a course of oral supplementation may be considered in the management. An endocrinology consult should also be considered in patients who present with multiple stress fractures. Conservative management of upper extremity stress fractures and spondylolysis was successful in returning this patient back to his previous activity level. PMID:20502233

Li, Xinning; Heffernan, Michael J; Mortimer, Errol S

2010-06-01

163

The impact of work configuration, target angle and hand force direction on upper extremity muscle activity during sub-maximal overhead work  

Microsoft Academic Search

Overhead work has established links to upper extremity discomfort and disorders. As many jobs incorporate working overhead, this study aimed to identify working conditions requiring relatively lower muscular shoulder load. Eleven upper extremity muscles were monitored with electromyography during laboratory simulations of overhead work tasks. Tasks were defined with three criteria: work configuration (fixed, stature-specific); target angle (?15°, 0°, 15°,

Jaclyn N. Chopp; Steven L. Fischer; Clark R. Dickerson

2010-01-01

164

Painful knee prosthesis: surgical approach.  

PubMed

There are many conditions that may be responsible of a painful knee prosthesis. The possible causes are not always easily diagnosed. Common causes of prosthetic failure, such as aseptic loosening, infection, instability, progressive patellar arthropathy and recurrent synovitis are associated with clearly defined radiographic and/or clinical evidence. Prosthetic infection should always be considered first until any other cause has been demonstrated. In the presence of an infected prosthesis we carry out a two-step revision. Aseptic loosening needs implant revision more often with increasing prosthesis stability. Varus-valgus, anteroposterior, global and patello-femoral instability are failures often due to technical errors; superstabilized or constrained implants are needed depending on the instability entity.In presence of patello-femoral pain it is necessary to evaluate the stability of the patellar component and any alterations in its motion. Patellar progressive arthropathy can often cause late-onset knee pain; in this case patella resurfacing is needed. Altered patellar tracking, may need a lateral release but in some cases is related to misalignment of the components and the revision procedure is mandatory. Nevertheless, the diagnosis and treatment of a painful knee prosthesis can be extremely difficult if there is no clear evidence of any of the most common causes of failure. Referred pain, ligament and tendon dysfunction, cutaneous neuromas, synovitis, a patellar clunk have to be diagnosed and treated.A possible aetiological understimated factor is painful knee prosthesis due to metals sensibilization, in particular to nickel. In this event the quantity of nickel in the revision prosthesis must be minimal. PMID:22461812

Villano, Marco; Carulli, Christian; Puccini, Serena; Soderi, Stefano; Innocenti, Massimo

2011-05-01

165

Painful knee prosthesis: surgical approach  

PubMed Central

Summary There are many conditions that may be responsible of a painful knee prosthesis. The possible causes are not always easily diagnosed. Common causes of prosthetic failure, such as aseptic loosening, infection, instability, progressive patellar arthropathy and recurrent synovitis are associated with clearly defined radiographic and/or clinical evidence. Prosthetic infection should always be considered first until any other cause has been demonstrated. In the presence of an infected prosthesis we carry out a two-step revision. Aseptic loosening needs implant revision more often with increasing prosthesis stability. Varus-valgus, anteroposterior, global and patello-femoral instability are failures often due to technical errors; superstabilized or constrained implants are needed depending on the instability entity. In presence of patello-femoral pain it is necessary to evaluate the stability of the patellar component and any alterations in its motion. Patellar progressive arthropathy can often cause late-onset knee pain; in this case patella resurfacing is needed. Altered patellar tracking, may need a lateral release but in some cases is related to misalignment of the components and the revision procedure is mandatory. Nevertheless, the diagnosis and treatment of a painful knee prosthesis can be extremely difficult if there is no clear evidence of any of the most common causes of failure. Referred pain, ligament and tendon dysfunction, cutaneous neuromas, synovitis, a patellar clunk have to be diagnosed and treated. A possible aetiological understimated factor is painful knee prosthesis due to metals sensibilization, in particular to nickel. In this event the quantity of nickel in the revision prosthesis must be minimal. PMID:22461812

Villano, Marco; Carulli, Christian; Puccini, Serena; Soderi, Stefano; Innocenti, Massimo

2011-01-01

166

Surgical management of a high-flow arteriovenous malformation of the upper extremity producing severe hemodynamic impairment  

Microsoft Academic Search

Peripheral arteriovenous (AV) malformations may present with a plethora of clinical symptoms such as paradoxical emboli, severe hypertension, nerve palsies or pain syndromes. Hemodynamically compromising lesions of the limbs are rare and involve high-flow AV fistulae with marked arteriovenous shunting. A female patient with a high-flow arteriovenous malformation of the left upper-extremity is presented. Preoperative assessment by magnetic resonance imaging

E. Polykandriotis; C. Böhner; R. Hess; U. Kneser; H. Seyhan; B. Loos; A. Bach; J. Kopp; R. E. Horch

2004-01-01

167

Upper extremity surgery in younger children under ultrasound-guided supraclavicular brachial plexus block: a case series  

Microsoft Academic Search

Purpose  Supraclavicular brachial plexus block is considered to be one of the most effective anesthetic procedures for upper extremity\\u000a surgeries. Its major drawback is placement of the needle, with inaccurate placement, especially in children, being a risk\\u000a factor for pneumothorax and vascular puncture and failure of the procedure. Ultrasound-guided needle placement may reduce\\u000a the risk of complications and increase the accuracy

Hamid Reza Amiri; Ramin Espandar

2011-01-01

168

Upper extremity surgery in younger children under ultrasound-guided supraclavicular brachial plexus block: a case series  

Microsoft Academic Search

Purpose  Supraclavicular brachial plexus block is considered as one of the most effective anesthetic methods for upper extremity surgeries.\\u000a Its major drawback, especially in children, is the risk of pneumothorax, vascular puncture, and failure of the procedure due\\u000a to inaccurate placement of the needle. Ultrasound-guided needle placement may reduce the risk of complications and increase\\u000a the accuracy of block, particularly in

Hamid Reza Amiri; Ramin Espandar

2010-01-01

169

Short-Term Change of Handgrip Strength After Trigger Point Injection in Women With Muscular Pain in the Upper Extremities  

PubMed Central

Objective To determine overall handgrip strength (HGS), we assessed the short-term change of HGS after trigger point injection (TPI) in women with muscular pain in the upper extremities by comparison with established pain scales. Methods The study enrolled 50 female patients (FMS with MPS group: 29 patients with combined fibromyalgia [FMS] and myofascial pain syndrome [MPS]; MPS group: 21 patients with MPS) who presented with muscular pain in the upper extremities at Konyang University Hospital. In addition, a total of 9 healthy women (control group) were prospectively enrolled in the study. We surveyed the three groups using the following established pain scales: the Fibromyalgia Impact Questionnaire (FIQ), the 36-Item Short Form Health Survey (SF-36), and the Short Form McGill Pain Questionnaire (MPQ). HGS was measured in both hands of study participants using a handgrip dynamometer. We performed TPI (0.5% lidocaine, total 10 mL, injected at the pain site of upper extremities). After 20 minutes, we remeasured the patient's HGS and MPQ score. Results ANOVA analysis was conducted among groups. Based on Tukey multiple comparison test, the majority of FIQ and SF-36 subscales, total FIQ and SF-36 scores, MPQ and HGS were significantly different between FMS with MPS and the other groups. There was no statistically significant difference between MPS and control groups. Higher HGS was positively associated with enhanced physical function, negatively associated with total FIQ and MPQ scores, and positively associated with the total SF-36 score calculated using Spearman correlation. Post-TPI MPQ decreased and HGS increased. In patient groups, a negative correlation was found between MPQ and HGS. Conclusion The HGS test might potentially be a complementary tool in assessing the short-term treatment effects of women with muscular pain in the upper extremities. PMID:24855619

Lee, Soo Jin; Ahn, Dong Heun; Jung, Ji Hun; Kim, Yong Rok

2014-01-01

170

Acute Effects of Static Stretching, Dynamic Exercises, and High Volume Upper Extremity Plyometric Activity on Tennis Serve Performance  

PubMed Central

The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg) performed 4 different warm-up (WU) routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice) (TRAD); traditional WU and static stretching (TRSS); traditional WU and dynamic exercise (TRDE); and traditional WU and high volume upper extremity plyometric activity (TRPLYP). Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p< 0.05). However, no significant change in ball speed performance between TRSS and TRAD. (p> 0.05). ICCs for ball speed showed strong reliability (0.82 to 0.93) for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players. Key points After the traditional warm up in tennis, static stretching has no effect on serve speed. Tennis players should perform dynamic exercises and/or high volume upper extremity plyometric activities to improve their athletic performance. PMID:24150068

Gelen, Ertugrul; Dede, Muhittin; Bingul, Bergun Meric; Bulgan, Cigdem; Aydin, Mensure

2012-01-01

171

Dynamic simulation and experimental validation of an upper extremity powered orthosis  

Microsoft Academic Search

The Wilmington Robotic Exoskeleton (WREX) is a passive upper limb orthosis powered by elastic bands, designed to assist children with weakness in their upper limbs. Patient studies with the WREX have determined that an external power source would enhance performance of the system. Two actuation schemes were considered: (i) motors in series with springs at the joints, called `Torsional' (ii)

Daniel Ragonesi; Tariq Rahman; Whitney Sample; Sunil Agrawal

2010-01-01

172

Choosing a Breast Prosthesis  

MedlinePLUS

... examines the option of using a breast prosthesis after surgery. Although many women who choose a mastectomy (removal ... issues a woman faces and the options available after surgery for breast cancer . What is a breast prosthesis? ...

173

Development of a Robotic Device for the Physical Training of Human Upper Extremity  

E-print Network

This thesis focuses on the development of a robotic device to be used in parallel with observational learning techniques for facilitating the recovery of the upper limb in post-stroke patients. It has been shown in the existing observational...

Ramos, Jorge Adrian

2013-04-22

174

Climatology of extreme rainfall and flooding from orographic thunderstorm systems in the upper Arkansas River basin  

Microsoft Academic Search

Analyses of the spatial and temporal distribution of extreme rainfall in the Arkansas River basin above Pueblo, Colorado, are based on volume scan reflectivity observations from the Pueblo WSR-88D radar during the period 1995–2003. A storm catalog of 66 rainfall events during the 9-year period has been developed. Climatological analyses of extreme rainfall are carried out both from an Eulerian

Julie Rose N. Javier; James A. Smith; John England; Mary Lynn Baeck; Matthias Steiner; Alexandros A. Ntelekos

2007-01-01

175

Painful Knee Prosthesis: Surgical Approach  

PubMed Central

A painful knee prosthesis is, unfortunately, a condition whose possible causes are not always easily diagnosed. As a consequence, it can be difficult to resolve. Common causes of prosthetic failure, such as aseptic loosening, infection, instability, progressive patellar arthropathy and recurrent synovitis are associated with clearly defined radiographic and/or clinical evidence. Blood chemistry tests for indicators of infection and synovial fluid culture are always to be considered of primary importance in the diagnostic work up of a painful prosthesis, given that, in this situation, prosthetic infection should always be considered first, and remain a possibility until some other causes has been demonstrated. In the presence of an infected prosthesis we carry out a two-step revision, first using an articulating antibiotic-impregnated cement spacer with two mono-compartment components to preserve the range of movement; subsequently, after the infection has been resolved, we carry out new prosthetic surgery, generally using prostheses of increasing stability and bone grafts, depending on the residual bone stock. Aseptic loosening of a knee prosthesis is a complication that is easily identified radiographically due to the presence of lines of radiolucency at the bone/prosthesis interface, associated with migration or angulation of the components. In these cases, it is necessary to revise the prosthesis, increasing its stability with diaphyseal shafts. With regard to this problem, we have, recently, also been evaluating the opportuneness and efficacy of pre- and post-operative treatment with bone-forming agents in patients with poor bone quality, in order to reduce the risk of loosening and extend the life of the prosthesis. Varus-valgus, anteroposterior, global patellofemoral instability are failures, often due to technical errors, that can be diagnosed through clinical examination. In the presence of a painful prosthesis associated with frank instability, we perform revision using superstabilised or constrained implants, depending on the particular case. Nevertheless, the diagnosis and treatment of a painful knee prosthesis can be extremely difficult if there is no clear evidence of any of the most common causes of failure. In the presence of prosthetic components having large diaphyseal shafts, a sharp pain can be detected; in these situations, it is sometimes possible to observe, on radiographic examinations, effects of periprosthetic stress shielding. To resolve the problem the component would have to be replaced with one having a shaft with a smaller diameter. A painful prosthesis accompanied by a patellar clunk can be attributed to the formation of a subquadricipital fibrous nodule proximal to the patella which can be responsable of impingement with the anterior margin of the posterior-stabilising femoral component box. Arthroscopic removal of the fibrous nodule will, in this case, resolve the pain. Recurrent synovitis can also be effectively treated arthroscopically. If pain is of patellofemoral origin, it is necessary, in the case of a prosthetic patella, to evaluate the stability of the component and any alterations in its motion. As far as the surgical technique is concerned, in cases in which patellar lateralisation is performed, medialising the button so as to obtain improved tracking, we recommend not using too small a patellar component and performing an oblique osteotomy laterally to the button in order to reduce the risk of pain due to non-lined patella/femoral component interference. In the presence of a natural patella progressive arthropathy can often cause late-onset knee pain at anterior patellar level; in this case, prosthetic patella insertion is needed with, in the event of altered tracking, lateral release. In some cases patellofemoral pain is related to misalignment of the components, which can be evaluated precisely through the superimposition of references in CT images. In this situation it is essential to perform a revision of the prosthesis, seeking to obtain the correct rotations and correct m

Villano, M.; Puccini, S.; Soderi, S.; Innocenti, M.

2010-01-01

176

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

PubMed Central

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

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

2014-01-01

177

The effect of limb crossing and limb congruency on multisensory integration in peripersonal space for the upper and lower extremities.  

PubMed

The present study investigated how multisensory integration in peripersonal space is modulated by limb posture (i.e. whether the limbs are crossed or uncrossed) and limb congruency (i.e. whether the observed body part matches the actual position of one's limb). This was done separately for the upper limbs (Experiment 1) and the lower limbs (Experiment 2). The crossmodal congruency task was used to measure peripersonal space integration for the hands and the feet. It was found that the peripersonal space representation for the hands but not for the feet is dynamically updated based on both limb posture and limb congruency. Together these findings show how dynamic cues from vision, proprioception, and touch are integrated in peripersonal limb space and highlight fundamental differences in the way in which peripersonal space is represented for the upper and lower extremity. PMID:23579198

van Elk, Michiel; Forget, Joachim; Blanke, Olaf

2013-06-01

178

A robotic workstation for stroke rehabilitation of the upper extremity using FES  

Microsoft Academic Search

An experimental test facility is developed for use by stroke patients in order to improve sensory-motor function of their upper limb. Subjects are seated at the workstation and their task is to repeatedly follow reaching trajectories that are projected onto a target above their arm. To do this they use voluntary control with the addition of electrical stimulation mediated by

C. T. Freeman; A.-M. Hughes; J. H. Burridge; P. H. Chappell; P. L. Lewin; E. Rogers

2009-01-01

179

Placement of a Retrievable Guenther Tulip Filter in the Superior Vena Cava for Upper Extremity Deep Venous Thrombosis  

SciTech Connect

A retrievable Guenther Tulip caval filter(William Cook, Europe) was successfully placed and retrieved in the superior vena cava for upper extremity deep venous thrombosis in a 56-year-old woman. Bilateral subclavian and internal jugular venous thromboses thought secondary to placement of multiple central venous catheters were present. There have been reports of the use of permanent Greenfield filters and a single case report of a temporary filter in the superior vena cava. As far as we are aware this is the first reported placement and successful retrieval of a filter in these circumstances.

Nadkarni, Sanjay; Macdonald, Sumaira; Cleveland, Trevor J.; Gaines, Peter A. [Sheffield Vascular Institute, Firth 4, Northern General Hospital, Herries Road, Sheffield S5 7AU (United Kingdom)

2002-12-15

180

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

PubMed

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

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

2014-01-01

181

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

PubMed Central

Background Elastic resistance bands (ERB) combined with proprioceptive neuromuscular facilitation (PNF) are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle strength warrant further investigation. Objectives The assessment of the effects of PNF combined with ERB on respiratory muscle strength. Method Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10) or the control group (CG, n=10). Maximal expiratory pressure (MEP) and inspiratory pressure (MIP) were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. Results PNF combined with ERB showed significant increases in MIP and MEP (p<0.05). In addition, there were significant differences between the TG and CG regarding ?MIP (p=0.01) and ?MEP (p=0.04). Conclusions PNF combined with ERB can have a positive impact on respiratory muscle strength. These results may be useful with respect to cardiopulmonary chronic diseases that are associated with reduced respiratory muscle strength. PMID:24346292

Areas, Guilherme P. T.; Borghi-Silva, Audrey; Lobato, Arianne N.; Silva, Alessandra A.; Freire, Renato C.; Areas, Fernando Z. S.

2013-01-01

182

The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects  

PubMed Central

Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG) offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed eleven pediatric patients treated with FVFG reconstructions of the upper extremity after tumor resection. Eight male and three female patients were identified, including four who underwent epiphyseal transfer. All eleven patients retained a functional salvaged limb. Nonunion and graft fracture were the most common complications relating to graft site (27%). Peroneal nerve palsy occurred in 4/11 patients, all of whom received epiphyseal transfer. Patients receiving epiphyseal transplant had a mean annual growth of 1.7?cm/year. Mean graft hypertrophy index increased by more than 10% in all cases. Although a high complication rate may be anticipated, the free vascularized fibula may be used to reconstruct large skeletal defects in the pediatric upper extremity after oncologic resection. Transferring the vascularized physis is a viable option when longitudinal growth is desired. PMID:24222724

Zelenski, Nicki; Brigman, Brian E.; Levin, L. Scott; Erdmann, Detlev; Eward, William C.

2013-01-01

183

Implementation of specific strength training among industrial laboratory technicians: long-term effects on back, neck and upper extremity pain  

PubMed Central

Background Previous studies have shown positive effects of physical exercise at the workplace on musculoskeletal disorders. However, long-term adherence remains a challenge. The present study evaluates long-term adherence and effects of a workplace strength training intervention on back, neck and upper extremity pain among laboratory technicians. Methods Cluster-randomized controlled trial involving 537 industrial laboratory technicians. Subjects were randomized at the cluster level to one of two groups: training group 1 (TG1, n?=?282) performing supervised strength training from February to June 2009 (round one) or training group 2 (TG2, n?=?255) performing supervised strength training from August to December 2009 (round two). The outcome measures were changes in self-reported pain intensity (0–9) in the back, neck and upper extremity as well as Disability of the Arm, Shoulder and Hand (DASH, 0–100). Results Regular adherence, defined as at least one training session per week, was achieved by around 85% in both groups in the supervised training periods. In the intention-to-treat analyses there were significant group by time effects for pain in the neck, right shoulder, right hand and lower back and DASH - resulting in significant reductions in pain (mean 0.3 to 0.5) and DASH (mean 3.9) in the scheduled training group compared to the reference group. For TG1 there were no significant changes in pain in round two, i.e. they maintained the pain reduction achieved in round one. Subgroup analyses among those with severe pain (>?=?3 on a scale of 0–9) showed a significant group by time effect for pain in the neck, right shoulder, upper back and lower back. For these subgroups the pain reduction in response to training ranged from 1.1 to 1.8. Conclusions Specific strength training at the workplace can lead to significant long-term reductions in spinal and upper extremity pain and DASH. The pain reductions achieved during the intensive training phase with supervision appears to be maintained a half year later. PMID:24106771

2013-01-01

184

Oklahoma prosthesis: resection of tumor of clavicle and chest wall reconstructed with a custom composite graft.  

PubMed

Tumors involving the clavicle by primary or metastatic growth may require clavicular resection often with rib resection. The resulting cosmetic and functional impairment of clavicular resection may be significant with a sloped appearing shoulder girdle and chronically impaired movement of the upper extremity. We report a 48-year-old woman presenting with a bulky metastatic renal cell mass of her left clavicle extending to the chest wall. We report en-bloc clavilculectomy and chest wall resection with a novel method of reconstruction using a single methyl methacrylate and prolene composite prosthesis in a configuration resembling the state of Oklahoma. PMID:16798248

Vartanian, Shant M; Colaco, Shanthi; Orloff, Lisa E; Theodore, Pierre R

2006-07-01

185

Superconductivity with extremely large upper critical fields in Nb2Pd0.81S5  

NASA Astrophysics Data System (ADS)

Here, we report the discovery of superconductivity in a new transition metal-chalcogenide compound, i.e. Nb2Pd0.81S5, with a transition temperature Tc 6.6 K. Despite its relatively low Tc, it displays remarkably high and anisotropic superconducting upper critical fields, e.g. ?0Hc2 (T -> 0 K) 37 T for fields applied along the crystallographic b-axis. This value is considerably larger than the value reported for the technologically relevant Nb3Sn compound (?0Hc2 ˜ 30 T, with Tc= 18 K)^1,2. Its ratio of ?0Hc2 (T -> 0 K) to Tc, is also larger than those of the new Fe based superconductors, e.g. ?-FeSe (20 T/8.7 K)^3, Ba1-xKxFe2As2 (˜ 70 T/28 K)^4, and even higher than the reported ratio for the Chevrel-phase PbMo6S8(60T/13.3 K)^5 compound. For a field applied perpendicularly to the b-axis, ?0Hc2 shows a linear dependence in temperature which coupled to a temperature-dependent anisotropy of the upper critical fields, suggests that Nb2Pd0.81S5 is a multi-band superconductor. This is confirmed by band structure calculations which reveal nearly cylindrical and quasi-one-dimensional Fermi surface sheets having hole and electron character, respectively.

Run Zhang, Qiu; Li, Gang; Rhodes, Daniel; Kiswandhi, Andhika; Basara, Tiglet; Sung, J.; Siegrist, Theo; Johannes, Michelle; Balicas, Luis

2013-03-01

186

Superconductivity with extremely large upper critical fields in Nb2Pd0.81S5.  

PubMed

Here, we report the discovery of superconductivity in a new transition metal-chalcogenide compound, i.e. Nb2Pd0.81S5, with a transition temperature Tc is approximately equal to 6.6 K. Despite its relatively low Tc, it displays remarkably high and anisotropic superconducting upper critical fields, e.g. ?0Hc2 (T ? 0 K) > 37 T for fields applied along the crystallographic b-axis. For a field applied perpendicularly to the b-axis, ?0Hc2 shows a linear dependence in temperature which coupled to a temperature-dependent anisotropy of the upper critical fields, suggests that Nb2Pd0.81S5 is a multi-band superconductor. This is consistent with band structure calculations which reveal nearly cylindrical and quasi-one-dimensional Fermi surface sheets having hole and electron character, respectively. The static spin susceptibility as calculated through the random phase approximation, reveals strong peaks suggesting proximity to a magnetic state and therefore the possibility of unconventional superconductivity. PMID:23486091

Zhang, Q; Li, G; Rhodes, D; Kiswandhi, A; Besara, T; Zeng, B; Sun, J; Siegrist, T; Johannes, M D; Balicas, L

2013-01-01

187

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

PubMed

The aim of this review was to identify and summarise publications, which have reported clinical applications of upper limb accelerometry for stroke within free-living environments and make recommendations for future studies. Data was searched from MEDLINE®, Scopus, IEEExplore and Compendex databases. The final search was 31st October 2013. Any study was included which reported clinical assessments in parallel with accelerometry in a free-living hospital or home setting. Study quality is reflected by participant numbers, methodological approach, technical details of the equipment used, blinding of clinical measures, whether safety and compliance data was collected. First author screened articles for inclusion and inclusion of full text articles and data extraction was confirmed by the third author. Out of 1375 initial abstracts, 8 articles were included. All participants were stroke patients. Accelerometers were worn for either 24 hours or 3 days. Data were collected as summed acceleration counts over a specified time or as the duration of active/inactive periods. Activity in both arms was reported by all studies and the ratio of impaired to unimpaired arm activity was calculated in six studies. The correlation between clinical assessments and accelerometry was tested in five studies and significant correlations were found. The efficacy of a rehabilitation intervention was assessed using accelerometry by three studies: in two studies both accelerometry and clinical test scores detected a post-treatment difference but in one study accelerometry data did not change despite clinical test scores showing motor and functional improvements. Further research is needed to understand the additional value of accelerometry as a measure of upper limb use and function in a clinical context. A simple and easily interpretable accelerometry approach is required. PMID:25297823

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

2014-01-01

188

IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. BME-30, NO. 1, JANUARY 1983 Upper Extremity Limb Function Discrimination  

E-print Network

is developed for discriminating a set of lower arm and wrist functions using surface EMG signals. Data wete control signals for a multifunction lower arm prosthesis from a set of surface electromyogram (EMG Function Discrimination Using EMG Signal Analysis PETER C. DOERSCHUK, STUDENT MEMBER, IEEE, DONALD E

Willsky, Alan S.

189

Bilateral ultrasound-guided supraclavicular block in a patient with severe electrocution injuries of the upper extremities.  

PubMed

The performance of bilateral supraclavicular brachial plexus nerve blocks is controversial. We present the challenging case of a 29-year-old male who suffered bilateral high-voltage electrocution injuries to the upper extremities, resulting in severe tissue damage, sensory and motor deficits, and wounds in both axillae. This injury necessitated bilateral below-elbow amputations. His postoperative course was complicated by pain refractory to intravenous narcotics. The decision was made to attempt bilateral supraclavicular brachial plexus blocks. Our concerns with this approach included the risks of pneumothorax and respiratory failure due to phrenic nerve block. Initial attempts at brachial plexus blockade using nerve stimulation were unsuccessful; therefore, ultrasound guidance was employed. With vigilant monitoring in an intensive care unit setting, we were able to safely perform bilateral continuous supraclavicular brachial plexus nerve blocks with an excellent analgesic response and no noted complications. PMID:25075596

Gelpi, Brian; Telang, Pavan R; Samuelson, Christian G; Hamilton, Craig S; Billiodeaux, Seth

2014-01-01

190

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

PubMed

Optimal treatment for the unstable acromioclavicular (AC) joint remains a highly debated topic in the field of orthopaedic medicine. In particular, no consensus exists regarding treatment of grade III injuries, which are classified according to the Rockwood classification by disruption of both the coracoclavicular and AC ligaments. The ISAKOS Upper Extremity Committee has provided a more specific classification of shoulder pathologies to enhance the knowledge on and clinical approach to these injuries. We suggest the addition of grade IIIA and grade IIIB injuries to a modified Rockwood classification. Grade IIIA injuries would be defined by a stable AC joint without overriding of the clavicle on the cross-body adduction view and without significant scapular dysfunction. The unstable grade IIIB injury would be further defined by therapy-resistant scapular dysfunction and an overriding clavicle on the cross-body adduction view. PMID:24485119

Beitzel, Knut; Mazzocca, Augustus D; Bak, Klaus; Itoi, Eiji; Kibler, William B; Mirzayan, Raffy; Imhoff, Andreas B; Calvo, Emilio; Arce, Guillermo; Shea, Kevin

2014-02-01

191

Acute bouts of assisted cycling improves cognitive and upper extremity movement functions in adolescents with Down syndrome.  

PubMed

The aim of this study was to examine the effectiveness of 2 modes of exercise on cognitive and upper extremity movement functioning in adolescents with Down syndrome (DS). Nine participants randomly completed 3 interventions over 3 consecutive weeks. The interventions were: (a) voluntary cycling (VC), in which participants cycled at their self-selected pedaling rate; (b) assisted cycling (AC), in which the participants' voluntary pedaling rates were augmented with a motor to ensure the maintenance of 80 rpm; and (c) no cycling (NC), in which the participants sat and listened to music. Manual dexterity improved after AC, but not after VC or NC. Measures of cognitive function, including reaction time and cognitive planning, also improved after AC, but not after the other interventions. Future research will try to uncover the mechanisms involved in the behavioral improvements found after an acute bout of assisted cycling in adolescents with DS. PMID:24725111

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

2014-04-01

192

Prediction of extreme flood in August 2002 along the Upper-Danube in Hungary  

NASA Astrophysics Data System (ADS)

Specific for summer conditions weather situation caused the flood. A cyclone reached the region of Alps, humid air and great instability of stratification produced high precipitation throughout the region in two vawes. The flood has reached historical maxima on the reach between Bratislava Budapest. This is the first flood of this magnitude, which has passed this section of the Danube without breaching the dikes, flood embankments. The peak flow rate attenuated along this section from 10 000 m3s-1 to 8600 m3s-1. Specifics of flood routing conditions are discussed. Barrages and training has changed flood routing patterns along the Austrian and joined Slovak Hungarian sections of the Danube. Increased velocity of wave propagation decreases the impact of superposition of consequent flood waves, but attenuation of flood waves is also less expressed. The most significant impact on the present flood was, that this was the first flood of this magnitude, which has passed this section of the Danube without breaching the flood embankments. Earlier extreme floods including the 1954 and 1965 floods resulted failure of the dikes and spill over of 1.5- 2 million m3 of water to the protected floodplain. This time the flood was contained within the floodberm.

Sütheö, L.; Bálint, G.; Szlávik, L.

2003-04-01

193

Clonidine as an adjuvant for ultrasound guided supraclavicular brachial plexus block for upper extremity surgeries under tourniquet: A clinical study  

PubMed Central

Background and Aims: Clonidine has been used as an adjuvant to local anesthetic to extend the duration of block. The present study was aimed to compare the onset and duration of sensory and motor blockade of 0.75% ropivacaine alone or in combination with clonidine during ultrasound guided supraclavicular brachial plexus block for upper extremity surgeries under tourniquet. Materials and Methods: Sixty four adult American Society of Anesthesiologist grade 1 and 2 patients, scheduled for upper extremity surgeries were randomized to receive either 19.8 mL of 0.75% ropivacaine with 0.2 mL of normal saline (Group R) or 0.2 mL (30 ?g) of clonidine (Group RC) in supraclavicular block. Onset and duration of sensory and motor blockade was compared. The hemodynamic variability, sedation, respiratory adequacy and any other adverse effects were also recorded. Result: Ultrasound helped to visualize the nerves, needle and spread of local anesthetic at the brachial plexus block site. There was no statistically significant difference in the onset of sensory and motor blockade between the groups. Surgical anesthesia was achieved at the mean time of 20 min in all patients. Prolonged post-operative analgesia (mean duration 956 min) was observed in RC group as compared with R group (736 min). No complication of technique or adverse effect of ropivacaine and clonidine was reported. Conclusion: Clonidine as an adjuvant to ropivacaine for ultrasound guided supraclavicular brachial plexus enhanced duration of post-operative analgesia. There was no incidence of vessel puncture or pneumothorax.

Gupta, Kumkum; Tiwari, Vaibhav; Gupta, Prashant K; Pandey, Mahesh Narayan; Singhal, Apoorva B; Shubham, Garg

2014-01-01

194

Amputation and prosthesis implantation shape body and peripersonal space representations  

PubMed Central

Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearing or not wearing their prosthesis. When patients performed the tasks on the amputated limb, without the prosthesis, the perception of arm length shrank, with a concurrent shift of PPS boundaries towards the stump. Conversely, wearing the prosthesis increased the perceived length of the stump and extended the PPS boundaries so as to include the prosthetic hand, such that the prosthesis partially replaced the missing limb. PMID:24088746

Canzoneri, Elisa; Marzolla, Marilena; Amoresano, Amedeo; Verni, Gennaro; Serino, Andrea

2013-01-01

195

Amputation and prosthesis implantation shape body and peripersonal space representations.  

PubMed

Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearing or not wearing their prosthesis. When patients performed the tasks on the amputated limb, without the prosthesis, the perception of arm length shrank, with a concurrent shift of PPS boundaries towards the stump. Conversely, wearing the prosthesis increased the perceived length of the stump and extended the PPS boundaries so as to include the prosthetic hand, such that the prosthesis partially replaced the missing limb. PMID:24088746

Canzoneri, Elisa; Marzolla, Marilena; Amoresano, Amedeo; Verni, Gennaro; Serino, Andrea

2013-01-01

196

[Radical tumour resection in the upper extremity and heterotopic replantation of the hand. Analyses of functional results in two patients].  

PubMed

We describe here two cases treated 17 years apart from each other. The patients were young males with malignant soft tissue tumours of the forearm and elbow joint. Radical tumour resection involved removal of the elbow joint. Neither of the patients consented to upper arm amputation, but agreed to undergo heterotopic replantation of the amputated distal third of the forearm together with the hand to the stump of the upper arm. The tendons of the forearm were attached to the three muscles of the upper arm, and the distal nerves were coapted with the nerve trunks of the upper arm. However, the reconstructive procedures carried out in these two patients were anatomically different. In the first patient, for technical reasons, only the deep flexor tendons were sutured. Furthermore, development of a postoperative haematoma necessitated revision surgery with split-thickness skin graft to cover the defect of the forearm. Long-term immobilisation together with a conservative approach to mobility had resulted in less than optimal results so that it appeared meaningful to re-operate the patient even 17 years after the primary operation to help him gain improved sensibility as well as motor function. These goals were achieved to a surprising extent by scar release, Z-plasty, removal of split-thickness skin graft, neurolysis, arthrodesis of the IP joint of the thumb, and tendon transposition together with intensive early postoperative sensibility and mobility training. In the second patient, longitudinal division of the muscles of the upper arm into different compartments and interweaving of the long tendons of the forearm into these muscles as well as early intensive mobility training and reintegration of the replanted hand in the body scheme resulted in the rapid gain of extremely good functional results so that the patient is now able to employs his heterotopically replanted hand quite effectively in his activities of daily living as a farmer. We believe that the differences in the surgical techniques employed and intensive postoperative training may explain the varying functional outcomes of these two patients. What is surprising is that it was possible to achieve marked functional improvement even after an interval of 17 years. PMID:18773390

Piza-Katzer, H; Baur, E-M; Estermann, D

2008-10-01

197

The deeply burned upper extremity: functional graft distribution concept with selective use of a synthetic dermal substitute (Integra) and split-thickness skin grafts  

Microsoft Academic Search

A 15-year-old boy sustained a severe inhalation injury and second\\/third degree burns following a flame burn involving the face, neck, upper thoracic regions, and upper extremities measuring 25% of his total body surface area. The right arm had a full-thickness burn, the left arm deep partial-thickness burns. Tangential excision and split-thickness skin grafting (STSG) were performed. Because of the full-thickness

C. Cedidi; R. Hierner; L. Wilkens; A. Berger

2002-01-01

198

Custom-made ocular prosthesis  

PubMed Central

An ocular defect may affect a patient psychologically. An ocular prosthesis is given to uplift the patient psychologically and improve the confidence. Ocular prosthesis can be custom made or a stock shell. To improve the comfort and matching of the prosthesis with that of the adjacent natural eye an custom made ocular prosthesis is preferred. Different techniques are available to fabricate a custom ocular prosthesis, here we have used paper iris disk technique. PMID:23066246

Gunaseelaraj, Rajkumar; Karthikeyan, Suma; Kumar, Mohan N.; Balamurugan, T.; Jagadeeshwaran, A. R.

2012-01-01

199

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

PubMed Central

Background The motivation of patients during robot-assisted rehabilitation after neurological disorders that lead to impairments of motor functions is of great importance. Due to the increasing number of patients, increasing medical costs and limited therapeutic resources, clinicians in the future may want patients to practice their movements at home or with reduced supervision during their stay in the clinic. Since people only engage in an activity and are motivated to practice if the outcome matches the effort at which they perform, an augmented feedback application for rehabilitation should take the cognitive and physical deficits of patients into account and incorporate a mechanism that is capable of balancing i.e. adjusting the difficulty of an exercise in an augmented feedback application to the patient's capabilities. Methods We propose a computational mechanism based on Fitts' Law that balances i.e. adjusts the difficulty of an exercise for upper-extremity rehabilitation. The proposed mechanism was implemented into an augmented feedback application consisting of three difficulty conditions (easy, balanced, hard). The task of the exercise was to reach random targets on the screen from a starting point within a specified time window. The available time was decreased with increasing condition difficulty. Ten subacute stroke patients were recruited to validate the mechanism through a study. Cognitive and motor functions of patients were assessed using the upper extremity section of the Fugl-Meyer Assessment, the modified Ashworth scale as well as the Addenbrookes cognitive examination-revised. Handedness of patients was obtained using the Edinburgh handedness inventory. Patients' performance during the execution of the exercises was measured twice, once for the paretic and once for the non-paretic arm. Results were compared using a two-way ANOVA. Post hoc analysis was performed using a Tukey HSD with a significance level of p < 0.05. Results Results show that the mechanism was capable of balancing the difficulty of an exercise to the capabilities of the patients. Medians for both arms show a gradual decrease and significant difference of the number of successful trials with increasing condition difficulty (F2;60 = 44.623; p < 0.01; ?2 = 0.623) but no significant difference between paretic and non-paretic arm (F1;60 = 3.768; p = 0.057; ?2 = 0.065). Post hoc analysis revealed that, for both arms, the hard condition significantly differed from the easy condition (p < 0.01). In the non-paretic arm there was an additional significant difference between the balanced and the hard condition (p < 0.01). Reducing the time to reach the target, i.e., increasing the difficulty level, additionally revealed significant differences between conditions for movement speeds (F2;59 = 6.013; p < 0.01; ?2 = 0.185), without significant differences for hand-closing time (F2;59 = 2.620; p = 0.082; ?2 = 0.09), reaction time (F2;59 = 0.978; p = 0.383; ?2 = 0.036) and hand-path ratio (F2;59 = 0.054; p = 0.947; ?2 = 0.002). The evaluation of a questionnaire further supported the assumption that perceived performance declined with increased effort and increased exercise difficulty leads to frustration. Conclusions Our results support that Fitts' Law indeed constitutes a powerful mechanism for task difficulty adaptation and can be incorporated into exercises for upper-extremity rehabilitation. PMID:22304989

2012-01-01

200

Effectiveness of an Upper Extremity Exercise Device Integrated With Computer Gaming for Aerobic Training in Adolescents With Spinal Cord Dysfunction  

PubMed Central

Background/Objective: To determine whether a new upper extremity exercise device integrated with a video game (GameCycle) requires sufficient metabolic demand and effort to induce an aerobic training effect and to explore the feasibility of using this system as an exercise modality in an exercise intervention. Design: Pre-post intervention. Setting: University-based research facility. Subject Population: A referred sample of 8 adolescent subjects with spina bifida (4 girls, 15.5 ± 0.6 years; 4 boys, 17.5 ± 0.9 years) was recruited to participate in the project. All subjects had some level of mobility impairment that did not allow them to participate in mainstream sports available to their nondisabled peers. Five subjects used a wheelchair full time, one used a wheelchair occasionally, but walked with forearm crutches, and 2 were fully ambulatory, but had impaired gait. Main Outcome Measures: Peak oxygen uptake, maximum work output, aerobic endurance, peak heart rate, rating of perceived exertion, and user satisfaction. Results: Six of the 8 subjects were able to reach a Vo2 of at least 50% of their Vo2 reserve while using the GameCycle. Seven of the 8 subjects reached a heart rate of at least 50% of their heart rate reserve. One subject did not reach either 50% of Vo2 reserve or 50% of heart rate reserve. Seven of the 8 subjects increased their maximum work capability after training with the GameCycle at least 3 times per week for 16 weeks. Conclusions: The data suggest that the GameCycle seems to be adequate as an exercise device to improve oxygen uptake and maximum work capability in adolescents with lower extremity disability caused by spinal cord dysfunction. The subjects in this study reported that the video game component was enjoyable and provided a motivation to exercise. PMID:17044386

Widman, Lana M; McDonald, Craig M; Abresch, R. Ted

2006-01-01

201

Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine  

E-print Network

Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine Trauma and Post______________________________: This letter is to welcome you to the University of California, Davis Department of Orthopaedic Surgery

Leistikow, Bruce N.

202

Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine  

E-print Network

Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine Trauma and Post Department of Orthopaedic Surgery 4860 Y Street, 1700 Sacramento, CA 95817 P: 916.734.2700 F: 916

Leistikow, Bruce N.

203

Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine  

E-print Network

Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine Trauma and Post OF CALIFORNIA, DAVIS Department of Orthopaedic Surgery 4860 Y Street, Suite 3800 Sacramento, CA 95817 P: 916

Leistikow, Bruce N.

204

To be presented at the Fourth Int. Workshop on Virtual Rehabilitation (IWVR 2005), Catalina Island, CA, September 2005. The Rutgers Arm: An Upper-Extremity Rehabilitation System in  

E-print Network

these needs by providing therapy through virtual games/exercises designed to motivate the patients and engageTo be presented at the Fourth Int. Workshop on Virtual Rehabilitation (IWVR 2005), Catalina Island, CA, September 2005. The Rutgers Arm: An Upper-Extremity Rehabilitation System in Virtual Reality

New Jersey, University of Medicine and Dentistry of

205

Motion capture of the upper extremity during activities of daily living in patients with spastic hemiplegic cerebral palsy.  

PubMed

Investigations using motion capture to analyze limitations in range of motion (ROM) of the upper extremity in adults with cerebral palsy (CP) are scarce. To evaluate the influence of those limitations on activities of daily living (ADL) and to determine potential mechanisms of compensation, we investigated 15 adults with hemiplegic CP using motion capture while they performed 10 defined ADLs. Data from the nonaffected body side and those from an age-matched able-bodied group were also collected and compared with our subjects. We measured motion of the elbow, shoulder, and trunk and found significant differences in ROM at these sites. The most pronounced reduction in ROM was observed distally in supination and pronation of the elbow. Here, the affected body side of the adults showed a reduction in supination of 45° compared to the able-bodied group. Furthermore we found a correlation between the Manual Ability Classification System (MACS) and the limitations in ROM. In summary, adults with spastic, hemiplegic CP show limitations in ROM accentuated distally during ADLs. The MACS gives conclusive information about those limitations. PMID:23218727

Klotz, M C M; Kost, L; Braatz, F; Ewerbeck, V; Heitzmann, D; Gantz, S; Dreher, T; Wolf, S I

2013-05-01

206

Pediatric Upper Extremity Injuries  

Microsoft Academic Search

The pediatric musculoskeletal system differs greatly from that of an adult. Although these differences diminish with age, they present unique injury patterns and challenges in the diagnosis and treatment of pediatric orthopedic problems. Pediatric bone is highly cellular and porous, and it contains a large amount of collagen and cartilage compared with adult bone. The larger amount of collagen leads

Sarah Carson; Dale P. Woolridge; Jim Colletti; Kevin Kilgore

2006-01-01

207

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

PubMed

An 8.25-year-old boy was incidentally found to have systemic hypertension of the upper extremities. Blood pressures of the upper extremities were 142-150/86-98 mmHg, and those of the lower extremities 110-116/60-66 mmHg. Doppler echocardiography showed in-stent restenosis of the aortic coarctation. Traditional high-pressure balloon angioplasty failed to dilate this inveterate in-stent restenosis. Instead, a cutting balloon angioplasty was performed. The lumen was dilated from 4.80 mm to 7.89 mm. The pressure gradient dropped from 32 mmHg to 9 mmHg. Blood pressures of the upper extremities were 112-116/76-78 mmHg, and those of the lower extremities 100-104/70-72 mmHg. This paper highlights that a cutting balloon angioplasty can serve as a juste milieu to relieve in-stent restenosis of the aortic coarctation when traditional high-pressure balloon angioplasty is debatable. PMID:24579444

Lee, Meng-Luen

2013-12-01

208

Cyproterone acetate- and ethinyloestradiol-containing oral contraceptive as a risk factor for upper extremity deep venous thrombosis-a case report.  

PubMed

Deep venous thrombosis of the upper extremity (UEDVT) is a rare variety of deep venous thrombosis. Compared to lower-extremity deep venous thrombosis, less is known about the risk factors for primary UEDVT. We report on a 27-year-old woman with UEDVT extending from the jugular and subclavian veins to the elbow. The thrombosis was possibly provoked by a shoulder trauma, in combination with heterozygosity for the prothrombin G20210A mutation and a protein S-deficiency, which may have been induced by the use of a cyproterone acetate- and ethinyloestradiol (CPA/EE)-containing oral contraceptive. PMID:19340712

Kapur, Rick; Stramrood, Claire A I; Schutgens, Roger E G; van Asbeck, B Sweder

2009-04-01

209

Movement patterns of the upper extremity and trunk before and after corrective surgery of impaired forearm rotation in patients with cerebral palsy  

Microsoft Academic Search

The effect of surgical correction of impaired forearm rotation on associated body movement patterns was studied prospectively by comparison of preoperative and postoperative three-dimensional video analysis of the upper extremity and trunk in eight male and two female patients with hemiplegic cerebral palsy (CP; mean age 16y 2mo [SD 4y 11mo]; range 11-27y). A customized parameter, 'extrinsic forearm rotation', was

M. Kreulen; M. J. C. Smeulders; H. E. J. Veeger; J. J. Hage

2006-01-01

210

Reoperative Selective Sentinel Lymphadenectomy Combined With Lymphoscintigraphy Is Technically Feasible for Cutaneous Tumors of the Upper Extremity After Radical Dissection of Regional Lymph Node Basins for Breast Cancer  

PubMed Central

Objective: The rising incidence of melanoma and the high prevalence of breast cancer have generated a new scientific problem—how do the regional lymph node basins function after radical lymphadenectomy and are lymphatic drainage patterns altered after radical lymphadenectomy? Furthermore, after radical lymphadenectomy, selective sentinel lymphadenectomy is still a technically feasible and valid staging tool in the upper extremity? Thus, our study asks if selective sentinel lymph node dissection is technically feasible after radical lymph node dissection of the regional draining basin of the upper extremity (axilla). Methods: Retrospective review of a prospectively maintained database of patients was reviewed to identify patients who had lymphoscintigraphy and sentinel lymph node biopsy of the upper extremity after a radical axillary node dissection procedure. Imaging and pathology results were analyzed. Results: Seven patients fulfilling the inclusion criteria were identified. The patients all had either melanoma or invasive squamous cell carcinoma, and sentinel lymph nodes were identified in 6 out of 7 patients. One patient had metastases to 2 sentinel lymph nodes. Alternative drainage pathways were identified in 29% of patients, and 14% of patients had no identifiable drainage basin on lymphoscintigraphy. Conclusions: Sentinel lymph node dissection is technically feasible after previous axillary dissection. Lymphoscintigraphy is an important perioperative tool as lymphatic drainage may be altered or not observed as evidenced in 43% of the studied patients. However, when lymphatic drainage is detected by lymphoscintigraphy, pathologically significant sentinel lymph nodes are surgically identifiable.

Bellevue, Oliver C.; Leong, Stanley P.L.

2014-01-01

211

ON DEVELOPMENT OF TOTALLY IMPLANTABLE VESTIBULAR PROSTHESIS  

E-print Network

ON DEVELOPMENT OF TOTALLY IMPLANTABLE VESTIBULAR PROSTHESIS Andrei M. Shkel 1 Department vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations

Tang, William C

212

An attempt to dendroclimatic reconstruction of winter temperature based on multispecies tree-ring widths and extreme years chronologies (example of Upper Silesia, Southern Poland)  

NASA Astrophysics Data System (ADS)

This study aims at investigating pre-instrumental tree-ring based winter thermal conditions from Upper Silesia, southern Poland. The Scots pine, pedunculate oak and sessile oak ring widths and the extreme index were used to reconstruct winter mean temperature back to A.D. 1770. The climate response analysis showed that the pine is the most sensitive to February (0.36) and March (0.41) temperature, the oaks were found to be sensitive to the previous December (0.27) and January (0.23) temperature. It was found out that the combination of temperature sensitive species and an additional extreme index in regression can improve the reconstruction, with an emphasis on more reliable reconstruction of extreme values. The elimination of variance reduction and precise reconstruction of actual values of temperature is possible by scaling. The obtained calibration/verification results suggest that, through the application of the long-term composite chronologies a detailed study of the climate variability in Upper Silesia in past centuries can be provided.

Opa?a, Magdalena; Mendecki, Maciej J.

2014-01-01

213

The infected knee prosthesis  

Microsoft Academic Search

Deep infections are among the most severe complications in total knee arthroplasty; infection rates described in recent articles\\u000a range between 1 and 2%. The most important infection risk prevention measures are skin preparation, antibiotic prophylaxis,\\u000a and screening and management for methicillin-resistant Staphylococcus aureus (MRSA). Debridement and prosthesis preservation\\u000a is indicated for acute postoperative infections or for acute hematogenous disseminations over

E. C. Rodriguez-Merchan

214

Treatment of upper extremity spasticity in stroke patients by focal neuronal or neuromuscular blockade: a systematic review of the literature  

Microsoft Academic Search

Studies published from January 1966 until October 2000 on the clinical effects of focal neuronal and neuromuscular blockade in post stroke upper limb spasticity were identiéed. Twelve studies were included and evaluated on 13 methodo- logical criteria. Ten studies on Botulinum toxin type A (BTX-A) treatment were found (of which 4 were randomised controlled trials (RCTs) and 6 were uncontrolled

A. A. van Kuijk; A. C. H. Geurts; B. J. W. Bevaart; J. van Limbeek

2002-01-01

215

Archaeomagnetic study of five mounds from Upper Mesopotamia between 2500 and 700 BCE: Further evidence for an extremely strong geomagnetic  

E-print Network

Archaeomagnetic study of five mounds from Upper Mesopotamia between 2500 and 700 BCE: Further a , A.J. Biggin b , M. Frangipane c , T. Matney d , T. O¨ kse e , A. Engin f a Paleomagnetic Laboratory, the Netherlands b Geomagnetism Laboratory, Oliver Lodge Laboratories, Department of Earth and Ocean Sciences

Utrecht, Universiteit

216

Aerobic Fitness and Upper Extremity Strength in Patients Aged 11 to 21 Years With Spinal Cord Dysfunction as Compared to Ideal Weight and Overweight Controls  

PubMed Central

Objective: To determine whether the aerobic fitness, upper extremity strength, and body composition in groups of adolescents with mobility impairment due to thoracic and upper lumbar spinal cord injury (SCI) or spina bifida (SB) are significantly different from those in groups of adolescents without mobility impairment who are of normal weight (CTRL) or overweight (OW). Subjects: One hundred fifteen total subjects were evaluated including 59 female (19 SB, 9 SCI, 17 OW, and 14 CTRL) and 56 male (18 SB, 10 SCI, 8 OW, and 20 CTRL) participants aged 11 to 21 years. Methods: Aerobic fitness was assessed using a ramp protocol with a magnetically braked arm ergometer. Heart rate and oxygen uptake (VO2) were recorded. Peak isokinetic upper arm and shoulder strength values were determined with a dynamometer. Body composition was estimated using dual energy x-ray absorptiometry (DEXA). Male and female subjects were categorized as overweight if their percent body fat by DEXA exceeded 25% and 30%, respectively. Results were analyzed with an ANOVA using the Bonferroni correction. Significance was accepted at P < 0.05. Results: The percent body fat of both the male and female SB and SCI subjects was significantly higher than CTRL but was not different than OW. In general, the shoulder extension and flexion strength in both the SB and SCI males and females was significantly lower than that of the CTRL and OW. The SCI and SB subjects had significantly reduced aerobic capacity (VO2/kg) compared to the CTRL subjects but were not different than the OW subjects. During the maximal exercise test, the SB and SCI subjects reached exhaustion at significantly lower workloads than the CTRL and OW subjects. Conclusions: Patients age 11 to 21 years with SB and SCI had reduced aerobic capacity that was associated with being overweight and having reduced upper extremity strength. These data suggest that interventions to increase strength and fitness and to manage weight should be recommended in this population. PMID:17874693

Widman, Lana M; Abresch, Richard Ted; Styne, Dennis M; McDonald, Craig M

2007-01-01

217

A 100-year extreme snow-avalanche record based on tree-ring research in upper Bødalen, inner Nordfjord, western Norway  

NASA Astrophysics Data System (ADS)

This paper analyses with the help of tree-ring studies the recurrence of extreme snow avalanches in a path situated in the upper Bødalen valley and originating from an outlet glacier of the Jostedalsbreen ice cap. By analysing tree-ring patterns of 91 trees, four extreme snow-avalanche events, extending over the entire valley floor and up to a distance of 800 m from the foot of the slope, are clearly highlighted during the 20th century and at the beginning of the 21st century. Return periods of 15 to 20 years for the most extreme events are extracted from the analyses, and recurrence intervals of 10 to 15 years for avalanches presenting distinct deposition lobes uphill of the distal torrent. Results obtained by tree-ring analyses are successfully compared with available documents at different spatial and temporal scales. Rock-face snow-avalanche occurrences in the area, of small to medium size, are associated with heavy wintry precipitation combined with strong winds. However this normal situation is not valid for extreme snow avalanches crossing the path investigated in the paper, which result from the outlet glacier located in the starting zone; this glacier commands spatial and inter-annual variations of snow accumulation in the departure zone.

Decaulne, Armelle; Eggertsson, Ólafur; Laute, Katja; Beylich, Achim A.

2014-08-01

218

Prolonged mechanical and physiological changes in the upper extremity following short-term simulated power hand tool use  

Microsoft Academic Search

This study investigated in-vivo changes in upper limb dynamic mechanical properties and magnetic resonance imaging (MRI) parameters following short-term power hand tool operation. Previous studies have found reduction in mechanical properties following short-term power tool usage at long build-up times. This study advances that work by having participants operate a simulated pistol grip power hand tool and evaluating changes in

Amrish O. Chourasia; Mary E. Sesto; Walter F. Block; Robert G. Radwin

2009-01-01

219

The Effect of Self-directed Exercise Using a Task Board on Pain and Function in the Upper Extremities of Stroke Patients  

PubMed Central

[Purpose] We evaluated the effect of self-directed exercise using a task board on function and pain in the upper extremities of stroke patients [Subjects and Methods] We used the one group pre-post test design. Seven stroke patients who were selected based on the inclusion criteria participated in the program once a week for 10 weeks. The self-directed exercise comprised 5 stages that were divided according to the level of difficulty. The exercise was performed for 60 minutes using a special task board that we designed. The FMA (Fugl-Meyer Motor Assessment), VAS (Visual Analogue Scale), and speed of stacking were assessed to evaluate the amount of use of the affected arm at before and after intervention. [Results] The scores of the VAS and FMA, but not that of the speed of stacking cups, were improved. There was no significant correlation between the changes in VAS, FMA, and the speed of stacking cups. [Conclusion] The findings suggest that self-directed exercise with the task board could improve the levels of function and pain in the upper extremities. We suggest that self-directed exercise can be utilized as a clinical rehabilitation program and improve therapeutic effects. PMID:24259894

Lee, Han Suk; Kim, Jin Ung

2013-01-01

220

Photostimulator for optogenetic retinal prosthesis  

Microsoft Academic Search

The discovery that neurons can be photostimulated via genetic incorporation of artificial opsins offers potential for many new forms of neural prosthesis. In this work, we demonstrate a photostimulator which has both the irradiance requirement and the spatial resolution for retinal prosthesis. We characterise its electrical and optical properties and show its ability to accurately stimulate individual action potentials.

N. Grossman; K. Nikolic; V. Poher; B. McGovern; E. Drankasis; M. Neil; C. Toumazou; P. Degenaar

2009-01-01

221

[Ulnar head prosthesis].  

PubMed

The ulnar head prosthesis has been the subject of a prospective multicenter-study since 1995. Until 2000, it has been used in 57 patients by the study group. In 35 patients, the indication was painful instability of the distal end of the ulna following previous resection arthroplasties, and in 22 patients it was painful arthritis of the distal radioulnar joint (DRUJ). The mean follow-up was 38 months. Pronation increased from a preoperative mean of 63 degrees to a postoperative value of 78 degrees, while supination increased from 43 degrees to 76 degrees. Grip strength improved from a preoperative mean of 51% to a postoperative mean of 77% of the opposite limb. Pain, measured on the verbal pain scale (1-4), was reduced remarkably from a preoperative mean level of 3.6 to a postoperative mean of 1.7. Patient' satisfaction was evaluated using the visual analog scale (0-10) and improved from a preoperative mean of 2.1 to a postoperative mean of 7.9. With one exception of loosening, we consistently found bony integration of the shaft of the prosthesis. Stability of the DRUJ was achieved in all but three patients. This method has given reliable and excellent results as a salvage procedure for failed resection arthroplasties of the DRUJ with painful instability of the distal end of the ulna. We consider the method an alternative treatment option for the arthritically destroyed DRUJ. Sufficient soft tissue to stabilise the prosthesis is needed to successfully reconstruct the DRUJ. PMID:14508648

V Schoonhoven, J; Herbert, T J; Fernandez, D L; Prommersberger, K-J; Krimmer, H

2003-09-01

222

Sublingual drug dispensing prosthesis.  

PubMed

Sublingual mode of drug administration is one of the fastest and predictable methods of drug delivery to the patient. Some patients, due to the pathological or psychological reasons, experience considerable difficulty in retaining the sub-lingual tablets. Therefore, often they either swallow or chew the sublingual tablets, thus reducing the efficacy of the medicines. Sublingual drug dispensing prosthesis is a special type of appliance that helps such patients to house the sublingual tablets in special slots in an intra-oral appliance, and thus enhances proposed drug delivery and improves the patient's health. PMID:23059595

Ganapthy, Dhanraj; Ariga, Padma; Selvaraj, Anand

2012-01-01

223

21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Interarticular disc prosthesis (interpositional implant). 872... § 872.3970 Interarticular disc prosthesis (interpositional implant). (a) Identification. An interarticular disc prosthesis (interpositional implant) is...

2010-04-01

224

Disability and health after replantation or revascularisation in the upper extremity in a population in southern Sweden - a retrospective long time follow up  

PubMed Central

Background Replantation in the upper extremity is a well-established microsurgical procedure. Many have reported patients’ satisfaction and functional measurements. The aim was to investigate the long time consequences as activity limitations in hand/arm, the general health and cold sensitivity after a replantation or revascularization in the upper extremity and to examine if sense of coherence (SOC) can be an indicator for rehabilitation focus. Methods Between 1994–2008, 326 patients needed replantation/revascularization in the upper extremity. 297 patients were followed up. Information was collected from the medical notes and by questionnaires [Quick-DASH (disability hand/arm), EuroQ-5D (general health), CISS (cold sensitivity) and SOC (sense of coherence)]. Severity of injury was classified with the modified Hand Injury Severity Score (MHISS). Results The patients [272 (84%) men and 54 (16%) women; median age 39 years (1–81 years)], where most injuries affected fingers (63%) and thumb (25%), commonly affecting the proximal phalanx (43%). The injuries were commonly related to saws (22%), machines (20%) and wood splints (20%). A direct anastomosis (30%) or vein grafts (70%) were used. The overall survival was 90%. 59% were classified as Major. Equal parts of the injuries took part during work and leisure, DASH scores at follow up were worse (p?=?0.005) in the former. Twenty percent changed work and 10% retired early. Patients with early retirement were significantly older, had a more severe injury, worse disability, quality of life and functional outcome. Median DASH score was low [11.4 (0–88.6)] and correlated with severity of injury. Abnormal cold sensitivity (CISS?>?50) was seen in 51/209 (24%) and they had a worse disability, quality of life, functional outcome and lower SOC. Patients with a low SOC had on the whole a worse outcome compared to patients with a high SOC and with significant differences in age, EQ-5D, Quick-DASH and CISS. Conclusions A high MHISS, abnormal cold intolerance and a low SOC seems to be factors influencing the patients’ outcome and might be relevant in the rehabilitation of the patients. Also, those who had to retire early had a worse disability, quality of life and functional outcome. PMID:24612503

2014-01-01

225

Optimal case definitions of upper extremity disorder for use in the clinical treatment and referral of patients  

PubMed Central

Objective Experts disagree about the optimal classification of upper limb disorders (ULDs). To explore whether differential response to treatments offers a basis for choosing between case definitions, we analysed previously published research. Methods We screened 183 randomised controlled trials (RCTs) of treatments for ULDs, identified from the bibliographies of 10 Cochrane reviews, four other systematic reviews, and a search in Medline, Embase, and Google Scholar to June 2010. From these, we selected RCTs which allowed estimates of benefit (expressed as relative risks (RRs)) for >1 case definition to be compared when other variables (treatment, comparison group, follow-up time, outcome measure) were effectively held constant. Comparisons of RRs for paired case definitions were summarised by their ratios, with the RR for the simpler and broader definition as the denominator. Result Two RCT reports allowed within-trial comparison of RRs and thirteen others allowed between-trial comparisons. Together these provided 17 ratios of RRs (five for shoulder treatments, 12 for elbow treatments, none for wrist/hand treatments). The median ratio of RRs was 1.0 (range 0.3 to 1.7; interquartile range 0.6 to 1.3). Conclusion Although the evidence base is limited, our findings suggest that for musculoskeletal disorders of the shoulder and elbow, clinicians in primary care will often do best to apply simpler and broader case definitions. Researchers should routinely publish secondary analyses for subgroups of patients by different diagnostic features at trial entry, to expand the evidence base on optimal case definitions for patient management. PMID:22213545

Palmer, Keith T; Harris, E Clare; Linaker, Cathy; Ntani, Georgia; Cooper, Cyrus; Coggon, David

2012-01-01

226

Interfacing a haptic robotic system with complex virtual environments to treat impaired upper extremity motor function in children with cerebral palsy  

PubMed Central

Objective To investigate the ability of the New Jersey Institute of Technology Robot Assisted Virtual Rehabilitation (NJIT-RAVR) system training to elicit changes in upper extremity (UE) function in children with hemiplegia secondary to cerebral palsy. Methods Nine children (mean age 9 years, three males) participated in three pilots. Subjects trained 1 hour, 3 days a week for 3 weeks. Two groups performed this protocol as their only intervention. The third group also performed 5–6 hours of constraint-induced movement therapy. Results All subjects participated in a short programme of nine, 60-minute training sessions without adverse effects. As a group, subjects demonstrated statistically significant improvements in Melbourne Assessment of Unilateral Upper Limb Function Test, a composite of three timed UE tasks and several measurements of reaching kinematics. Several subjects demonstrated clinically significant improvements in active shoulder abduction and flexion as well as forearm supination. Conclusion Three small pilots of NJIT-RAVR training demonstrated measurable benefit with no complications, warranting further examination. PMID:20828330

FLUET, GERARD G.; QIU, QINYIN; KELLY, DONNA; PARIKH, HETA D.; RAMIREZ, DIEGO; SALEH, SOHA; ADAMOVICH, SERGEI V.

2011-01-01

227

Photovoltaic retinal prosthesis  

NASA Astrophysics Data System (ADS)

Electronic retinal prostheses seek to restore sight to patients suffering from retinal degenerative disorders. Implanted electrode arrays apply patterned electrical stimulation to surviving retinal neurons, producing visual sensations. All current designs employ inductively coupled coils to transmit power and/or data to the implant. We present here the design and initial testing of a photovoltaic retinal prosthesis fabricated with a pixel density of up to 177 pixels/mm2. Photodiodes within each pixel of the subretinal array directly convert light to stimulation current, avoiding the use of bulky coil implants, decoding electronics, and wiring, and thereby reducing surgical complexity. A goggles-mounted camera captures the visual scene and transmits the data stream to a pocket processor. The resulting images are projected into the eyes by video goggles using pulsed, near infrared (~900 nm) light. Prostheses with three pixel densities (15, 55, and 177 pix/mm2) are being fabricated, and tests indicate a charge injection limit of 1.62 mC/cm2 at 25Hz. In vitro tests of the photovoltaic retinal stimulation using a 512-element microelectrode array have recorded stimulated spikes from the ganglion cells, with latencies in the 1-100ms range, and with peak irradiance stimulation thresholds varying from 0.1 to 1 mW/mm2. With 1ms pulses at 25Hz the average irradiance is more than 100 times below the IR retinal safety limit. Elicited retinal response disappeared upon the addition of synaptic blockers, indicating that the inner retina is stimulated rather than the ganglion cells directly, and raising hopes that the prosthesis will preserve some of the retina's natural signal processing.

Loudin, James; Mathieson, Keith; Kamins, Ted; Wang, Lele; Galambos, Ludwig; Huie, Philip; Sher, Alexander; Harris, James; Palanker, Daniel

2011-03-01

228

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis...

2013-04-01

229

21 CFR 878.3680 - Nose prosthesis.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis...

2014-04-01

230

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis...

2012-04-01

231

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis...

2012-04-01

232

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis...

2011-04-01

233

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis...

2011-04-01

234

21 CFR 878.3590 - Ear prosthesis.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis...

2014-04-01

235

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis...

2011-04-01

236

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis...

2013-04-01

237

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis...

2013-04-01

238

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis...

2012-04-01

239

21 CFR 878.3550 - Chin prosthesis.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis...

2014-04-01

240

Transtibial prosthesis suspension failure during skydiving freefall: a case report.  

PubMed

This report describes the unusual case of an everyday-use prosthesis suspension system failure during the freefall phase of a skydiving jump. The case individual was a 53-year-old male with a left transtibial amputation secondary to trauma. He used his everyday prosthesis, a transtibial endoskeleton with push-button, plunger-releasing, pin-locking silicon liner suction suspension and a neoprene knee suspension sleeve, for a standard recreational tandem skydive. Within seconds of exiting the plane, the suspension systems failed, resulting in the complete prosthesis floating away. Several factors may have led to suspension system failure, including an inadequate seal and material design of the knee suspension sleeve and liner, lack of auxiliary suspension mechanisms, and lack of a safety cover overlying the push-button release mechanism. This is the first report, to our knowledge, to discuss prosthetic issues specifically related to skydiving. While amputees are to be encouraged to participate in this extreme sport, special modifications to everyday components may be necessary to reduce the possibility of prosthesis failure during freefall, parachute deployment, and landing. PMID:19719060

Gordon, Assaf T; Land, Rebekah M

2009-01-01

241

Biomechanics of the Upper Extremity in Response to Dynamic Impact Loading Indicative of a Forward Fall: An Experimental and Numerical Investigation  

NASA Astrophysics Data System (ADS)

The distal radius is one of the most common fracture sites in humans, often resulting from a forward fall with more than 60 % of all fractures to the wrist requiring some form of surgical intervention. Although there is a general consensus regarding the risk factors for distal radius fractures resulting from forward falling, prevention of these injuries requires a more thorough understanding of the injury mechanisms. Therefore the overall purpose of this dissertation was to assess the response of the upper extremity to impact loading to improve the understanding of distal radius fracture mechanisms and the effectiveness of joint kinematic strategies for reducing the impact effects. Three main studies were conducted that utilized in vivo, in vitro and numerical techniques. In vitro impact testing of the distal radius revealed that fracture will occur at a mean (SD) resultant impact force and velocity of 2142.1(1228.7) N and 3.4 (0.7) m/s, respectively. Based on the failure data, multi-variate injury criteria models were produced, highlighting the dynamic and multidirectional nature of distal radius fractures The in vitro investigation was also used to develop and validate a finite element model of the distal radius. Dynamic impacts were simulated in LS-DYNARTM and the resulting z-axis force validation metrics (0.23--0.54) suggest that this is a valid model. A comparison of the experimental fracture patterns to those predicted numerically (i.e. von-Mises stress criteria) shows the finite element model is capable of accurately predicting bone failure. Finally, an in vivo fall simulation apparatus was designed and built that was found to reliably (Intraclass Correlation Coefficients > 0.6) apply multi-directional motion and upper extremity impacts indicative of forward falls. This study revealed that, to some extent, individuals are capable of selected an impact strategy that minimizes the significant injury variables that were outlined in the in vitro investigation, with very little instruction. The body of work presented here has the potential to be used to develop distal radius fracture prevention methods in an attempt to improve the health and well being of those individuals currently at the highest risk of sustaining these injuries.

Burkhart, Timothy A.

242

The effects of walking speed and prosthetic ankle adapters on upper extremity dynamics and stability-related parameters in bilateral transtibial amputee gait.  

PubMed

Bilateral transtibial amputee (BTA) gait has been investigated less and is not as well understood compared to that of their unilateral counterparts. Relative to able-bodied individuals, BTAs walk with reduced self-selected speeds, increased step width, hip-hiking, and greater metabolic cost. The clinically observed upper body motions of these individuals have not been quantified, but appear substantially different from able-bodied ambulators and may impact upright balance. Therefore, the objective of this study was to characterize the upper extremity kinematics of BTAs during steady-state walking. We measured medial-lateral ground reaction forces, step width and extrapolated center-of-mass (XCoM) trajectory, and observed effects of walking speed and increased prosthetic ankle range-of-motion (ROM) on these parameters. Significantly, BTAs display greater lateral trunk flexion ROM and shoulder abduction than able-bodied individuals when walking at similar speeds, and the inclusion of prosthetic adaptors for increasing passive ankle ROM slightly reduced step width. Overall, exaggerated lateral trunk flexion ROM was invariant with step width. Results suggest that lateral trunk motion is useful for shifting the body center-of-mass laterally onto the leading stance limb while simultaneously unloading the trailing limb. However, exaggerated lateral trunk flexion may introduce an unstable scenario if the XCoM is displaced beyond the lateral base-of-support. Further studies would be useful to identify if either prostheses that assist limb advancement and/or gait training may be effective in reducing this lateral sway while still maintaining efficient ambulation. PMID:23680427

Major, Matthew J; Stine, Rebecca L; Gard, Steven A

2013-09-01

243

The effects of walking speed and prosthetic ankle adapters on upper extremity dynamics and stability-related parameters in bilateral transtibial amputee gait  

PubMed Central

Bilateral transtibial amputee (BTA) gait has been investigated less and is not as well understood compared to that of their unilateral counterparts. Relative to able-bodied individuals, BTAs walk with reduced self-selected speeds, increased step width, hip-hiking, and greater metabolic cost. The clinically observed upper body motions of these individuals have not been quantified, but appear substantially different from able-bodied ambulators and may impact upright balance. Therefore, the objective of this study was to characterize the upper extremity kinematics of BTAs during steady-state walking. We measured medial-lateral ground reaction forces, step width and extrapolated center-of-mass (XCoM) trajectory, and observed effects of walking speed and increased prosthetic ankle range-of-motion (ROM) on these parameters. Significantly, BTAs display greater lateral trunk flexion ROM and shoulder abduction than able-bodied individuals when walking at similar speeds, and the inclusion of prosthetic adaptors for increasing passive ankle ROM slightly reduced step width. Overall, exaggerated lateral trunk flexion ROM was invariant with step width. Results suggest that lateral trunk motion is useful for shifting the body center-of-mass laterally onto the leading stance limb while simultaneously unloading the trailing limb. However, exaggerated lateral trunk flexion may introduce an unstable scenario if the XCoM is displaced beyond the lateral base-of-support. Further studies would be useful to identify if either prostheses that assist limb advancement and/or gait training may be effective in reducing this lateral sway while still maintaining efficient ambulation. PMID:23680427

Stine, Rebecca L.; Gard, Steven A.

2013-01-01

244

Massive wear of a steel ball head by ceramic fragments in the polyethylene acetabular cup after revision of a total hip prosthesis with fractured ceramic ball  

Microsoft Academic Search

The purpose of this case study of severe metallosis is to draw the attention of orthopedic surgeons to extremely serious results of this kind in the event of the fracture of the ceramic ball in a total hip prosthesis. Eleven months after implantation of a KJF hip prosthesis with an aluminum oxide ceramic ball in combination with a polyethylene acetabular

I. Kempf; M. Semlitsch

1990-01-01

245

Photovoltaic retinal prosthesis with high pixel density  

E-print Network

Photovoltaic retinal prosthesis with high pixel density Keith Mathieson1,4 , James Loudin1 to stimulating electrodes via intraocular cables. We present a photovoltaic subretinal prosthesis, in which pixel, demonstrating the possibility of a fully integrated photovoltaic retinal prosthesis with high

Palanker, Daniel

246

Effects of a workplace physical exercise intervention on the intensity of headache and neck and shoulder symptoms and upper extremity muscular strength of office workers: A cluster randomized controlled cross-over trial  

Microsoft Academic Search

The purpose of the study was to examine the effects of a workplace physical exercise intervention on the perceived intensity of headache and the intensity of symptoms in the neck and shoulders, as well as on the extension and flexion strength of the upper extremities. The study was a cluster randomized controlled trial. The cross-over design consisted of physical exercise

Tuulikki Sjögren; Kari J. Nissinen; Salme K. Järvenpää; Markku T. Ojanen; Heikki Vanharanta; Esko A. Mälkiä

2005-01-01

247

A "Wii" bit of fun: the effects of adding Nintendo Wii(®) Bowling to a standard exercise regimen for residents of long-term care with upper extremity dysfunction.  

PubMed

The aims of this randomized, single-blind crossover trial were to investigate the effect of adding a simulated bowling video game via the Nintendo Wii(®) gaming system to the standard exercise regimen of cognitively intact residents of long-term care (LTC) with upper extremity dysfunction and to identify individual characteristics that might predict improvement. Residents (n=34) were recruited through two LTC facilities in southwestern Ontario and were randomized into a standard exercise (SG) or standard exercise plus Wii bowling (Wii) arm. After 4 weeks of intervention, the groups were crossed over to the opposite arm. Outcomes included measures of pain intensity and bothersomeness, physical activity enjoyment, and a six-item measure of functional capacity designed specifically for residents of LTC. Results suggest that subjects improved on all outcomes from pre- to postintervention but that only enjoyment of activity showed a significant difference between the SG and Wii groups. Effect sizes (Cohen's d) ranged from small (0.30 for bothersomeness) to large (1.77 for functional capacity). Responders, defined as those subjects who reported any degree of improvement following the Wii intervention, were less likely to complain of stiffness or shoulder symptoms and were more likely to complain of hand symptoms than non-responders. Limitations in interpretation and recommendations for future research are presented. PMID:20698793

Hsu, Jason K; Thibodeau, Richard; Wong, Stephanie J; Zukiwsky, Daniel; Cecile, Sara; Walton, David M

2011-04-01

248

Bioelectrically Controlled Upper Extremity Prostheses.  

National Technical Information Service (NTIS)

Contents: Electronic circuits for multifunctional prostheses with bioelectric control; Modes of controlling multifunctional bioelectrical prostheses; Design requirements for a feedback scheme for sensing grasping force in bioelectrical prostheses; Distrib...

C. H. Dodge

1966-01-01

249

Hip arthroplasty. Part 1: prosthesis terminology and classification.  

PubMed

Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion. PMID:19748000

Pluot, E; Davis, E T; Revell, M; Davies, A M; James, S L J

2009-10-01

250

Upper extremity kinematics and kinetics during the performance of a stationary wheelie in manual wheelchair users with a spinal cord injury.  

PubMed

No comprehensive biomechanical study has documented upper extremity (U/E) kinematics and kinetics during the performance of wheelchair wheelies among manual wheelchair users (MWUs). The aim of this study was to describe movement strategies (kinematics), mechanical loads (kinetics), and power at the nondominant U/E joints during a wheelie among MWUs with spinal cord injury (SCI). During a laboratory assessment, 16 MWUs with SCI completed four wheelie trials on a rigid surface. Each participant's wheelchair was equipped with instrumented wheels to record handrim kinetics, while U/E and wheelchair kinematics were recorded with a 3D motion analysis system. The greatest mean and peak total net joint moments were generated by the shoulder flexors (mean = 7.2 ± 3.5 N·m; peak = 20.7 ± 12.9 N·m) and internal rotators (mean = 3.8 ± 2.2 N·m; peak = 11.4 ± 10.9 N·m) as well as by the elbow flexors (mean = 5.5 ± 2.5 N·m; peak = 14.1 ± 7.6 N·m) during the performance of wheelies. Shoulder flexor and internal rotator efforts predominantly generate the effort needed to lift the front wheels of the wheelchair, whereas the elbow flexor muscles control these shoulder efforts to reach a state of balance. In combination with a task-specific training program that remains essential to properly learn how to control wheelies among MWUs with SCI, rehabilitation professionals should also propose a shoulder flexor, internal rotator, and elbow flexor strengthening program. PMID:24610281

Lalumiere, Mathieu; Gagnon, Dany H; Routhier, François; Bouyer, Laurent; Desroches, Guillaume

2014-08-01

251

Plasticity in the Visual System is Associated with Prosthesis Use in Phantom Limb Pain  

PubMed Central

The experience of strong phantom limb pain (PLP) in arm amputees was previously shown to be associated with structural neural plasticity in parts of the cortex that belong to dorsal and ventral visual streams. It has been speculated that this plasticity results from the extensive use of a functional prosthesis which is associated with increased visual feedback to control the artificial hand. To test this hypothesis, we reanalyzed data of cortical volumes of 21 upper limb amputees and tested the association between the amount of use of the hand prosthesis and cortical volume plasticity. On the behavioral level, we found no relation between PLP and the amount of prosthesis use for the whole patient group. However, by subdividing the patient group into patients with strong PLP and those with low to medium PLP, stronger pain was significantly associated with less prosthesis use whereas the group with low PLP did not show such an association. Most plasticity of cortical volume was identified within the dorsal stream. The more the patients that suffered from strong PLP used their prosthesis, the smaller was the volume of their posterior parietal cortex. Our data indicate a relationship between prosthesis use and cortical plasticity of the visual stream. This plasticity might present a brain adaptation process to new movement and coordination patterns needed to guide an artificial hand. PMID:23805096

Preissler, Sandra; Dietrich, Caroline; Blume, Kathrin R.; Hofmann, Gunther O.; Miltner, Wolfgang H. R.; Weiss, Thomas

2013-01-01

252

Are Work Disability Prevention Interventions Effective for the Management of Neck Pain or Upper Extremity Disorders? A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.  

PubMed

Purpose We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. Methods We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology. Results Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers' recovery from recent work-related neck and upper extremity complaints. Conclusions At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions. PMID:24522460

Varatharajan, Sharanya; Côté, Pierre; Shearer, Heather M; Loisel, Patrick; Wong, Jessica J; Southerst, Danielle; Yu, Hainan; Randhawa, Kristi; Sutton, Deborah; van der Velde, Gabrielle; Mior, Silvano; Carroll, Linda J; Jacobs, Craig; Taylor-Vaisey, Anne

2014-12-01

253

Sizzling Hand Prosthesis. On the Design and Development of a Pneumatically Powered Hand Prosthesis for Children.  

National Technical Information Service (NTIS)

The thesis contains five chapters, which describe the design of an innovative pneumatically powered, hand prosthesis. Chapter 1, Introduction, starts with a definition of the notion prosthesis. After presenting a very brief review of the development of up...

D. H. Plettenburg

2002-01-01

254

Intraocular retinal prosthesis.  

PubMed Central

PURPOSE: An electronic implant that can bypass the damaged photoreceptors and electrically stimulate the remaining retinal neurons to restore useful vision has been proposed. A number of key questions remain to make this approach feasible. The goal of this thesis is to address the following 2 specific null hypotheses: (1) Stimulus parameters make no difference in the electrically elicited retinal responses. (2) Just as we have millions of photoreceptors, so it will take a device that can generate millions of pixels/light points to create useful vision. METHODS: For electrophysiologic experiments, 2 different setups were used. In the first setup, charge-balanced pulses were delivered to the retinal surface via electrodes inserted through an open sky approach in normal or blind retinal degenerate (rd) mice. In the second setup, the rabbit retina was removed under red light conditions from an enucleated eye and then maintained in a chamber while being superfused with oxygenated, heated Ames media. In both setups, stimulating electrodes and recording electrodes were positioned on the retinal surface to evaluate the effect of varying stimulation parameters on the orthodromic retinal responses (i.e., recording electrode placed between stimulating electrodes and optic nerve head). For psychophysical experiments, visual images were divided into pixels of light that could be projected in a pattern on the retina in up to 8 sighted volunteers. Subjects were asked to perform various tasks ranging from reading and face recognition to various activities of daily living. RESULTS: Electrophysiologic experiments: In a normal mouse, a single cycle of a 1-kHz sine wave was significantly more efficient than a 1-kHz square wave (P < .05), but no such difference was noted in either of the 8- or 16-week-old rd mouse groups (8-week-old, P = .426; 16-week-old, P = .078). Charge threshold was significantly higher in 16-week-old rd mouse versus both 8-week-old rd and normal mouse for every stimulus duration (P < .05). In all groups, short duration pulses (40, 80, and 120 microseconds) were more efficient in terms of total charge (the product of pulse amplitude and pulse duration) than longer (500 and 1,000 microseconds) pulses (P < .05). In all groups, applying a pulse train did not lead to more efficient charge usage (P < .05). Psychophysical experiments: In high-contrast tests, facial recognition rates of over 75% were achieved for all subjects with dot sizes of up to 31.5 minutes of arc when using a 25 x 25 grid with 4.5 arc minute gaps, a 30% dropout rate, and 6 gray levels. Even with a 4 x 4 array of pixels, some subjects were able to accurately describe 2 of the objects. Subjects who were able to read the 4-pixel letter height sentences (on the 6 x 10 and 16 x 16 array) seemed to have a good scanning technique. Scanning at the proper velocity tends to bring out more contrast in the lettering. The reading speed for the 72-point font is a bit slower than for the next smaller font. This may be due to the limited number of letters (3) visible in the window with this large font. CONCLUSIONS: Specific parameters needed to stimulate the retina were identified. Delineating the optimum parameters will decrease the current requirements. Psychophysical tests show that with limited pixels and image processing, useful vision is possible. Both these findings should greatly simplify the engineering of an electronic retinal prosthesis. PMID:11797315

Humayun, M S

2001-01-01

255

21 CFR 878.3750 - External prosthesis adhesive.  

...2014-04-01 false External prosthesis adhesive. 878.3750 Section 878.3750... § 878.3750 External prosthesis adhesive. (a) Identification. An external prosthesis adhesive is a silicone-type adhesive...

2014-04-01

256

21 CFR 878.3750 - External prosthesis adhesive.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false External prosthesis adhesive. 878.3750 Section 878.3750... § 878.3750 External prosthesis adhesive. (a) Identification. An external prosthesis adhesive is a silicone-type adhesive...

2011-04-01

257

21 CFR 878.3750 - External prosthesis adhesive.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false External prosthesis adhesive. 878.3750 Section 878.3750... § 878.3750 External prosthesis adhesive. (a) Identification. An external prosthesis adhesive is a silicone-type adhesive...

2013-04-01

258

21 CFR 878.3750 - External prosthesis adhesive.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false External prosthesis adhesive. 878.3750 Section 878.3750... § 878.3750 External prosthesis adhesive. (a) Identification. An external prosthesis adhesive is a silicone-type adhesive...

2012-04-01

259

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.  

Code of Federal Regulations, 2010 CFR

... 2010-04-01 false Toe joint polymer constrained prosthesis. 888.3720...Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a...

2010-04-01

260

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.  

Code of Federal Regulations, 2011 CFR

... 2011-04-01 false Toe joint polymer constrained prosthesis. 888.3720...Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a...

2011-04-01

261

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Wrist joint polymer constrained prosthesis. 888.3780...Devices § 888.3780 Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a...

2010-04-01

262

21 CFR 874.3695 - Mandibular implant facial prosthesis.  

Code of Federal Regulations, 2010 CFR

... false Mandibular implant facial prosthesis. 874.3695 Section 874.3695...3695 Mandibular implant facial prosthesis. (a) Identification. A mandibular implant facial prosthesis is a device that is...

2010-04-01

263

21 CFR 872.3960 - Mandibular condyle prosthesis.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Mandibular condyle prosthesis. 872.3960 Section 872.3960... § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to...

2010-04-01

264

21 CFR 872.3950 - Glenoid fossa prosthesis.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872.3950...Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to...

2010-04-01

265

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2010 CFR

...false Total temporomandibular joint prosthesis. 872.3940 Section 872.3940...3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended...

2010-04-01

266

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Fallopian tube prosthesis. 884.3650 Section 884.3650...Devices § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a device designed to maintain...

2010-04-01

267

Late Hematoma After Aesthetic Breast Augmentation with Textured Silicone Prosthesis: A Case Report  

Microsoft Academic Search

Late hematoma is an extremely rare complication after augmentation mammaplasty with silicone prostheses. The authors present a case of late hematoma after breast augmentation with textured gel-filled silicone prostheses, which appeared after intense physical effort 1 year after the implantation of the prosthesis. The hematoma was drained in three subsequent ultrasound-guided percutaneous needle aspirations, with no need for removal of

Daniela Francescato Veiga; Joel Veiga Filho; Caroline Sormanti Schnaider; Ivanildo Archangelo Jr

2005-01-01

268

The Efficacy of Two Non-Conventional Interventions for Treatment of Upper Extremity Hemiparesis in People who have had a Cerebrovascular Accident: Mental Imagery and Robot-Assisted Therapy  

Microsoft Academic Search

Clinical Question: Does current research support the use of mental imagery or robot-assisted therapy in conjunction with conventional physical therapy for patients post stroke to enhance motor recovery and functional use of the hemiparetic arm? P: Patients who have had a stroke with resultant upper-extremity hemiparesis I: Mental imagery or robot-assisted therapy in addition to conventional therapy C: Conventional physical

Alisa Waibel; Tracy Kelton

2006-01-01

269

Women's Satisfaction with Their Breast Prosthesis: What Determines a Quality Prosthesis?  

ERIC Educational Resources Information Center

The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38 women who received their hospital's usual funding were recruited. Women rated the information provided about breast prostheses very…

Livingston, Patricia M.; White, Victoria M.; Roberts, Susan B.; Pritchard, Emma; Hayman, Jane; Gibbs, Anne; Hill, David J.

2005-01-01

270

21 CFR 876.3750 - Testicular prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular...

2012-04-01

271

21 CFR 876.3750 - Testicular prosthesis.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular...

2013-04-01

272

21 CFR 876.3750 - Testicular prosthesis.  

Code of Federal Regulations, 2010 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular...

2010-04-01

273

21 CFR 876.3750 - Testicular prosthesis.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular...

2014-04-01

274

21 CFR 876.3750 - Testicular prosthesis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular...

2011-04-01

275

21 CFR 878.3720 - Tracheal prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3720 Tracheal prosthesis. (a) Identification. The...

2012-04-01

276

21 CFR 878.3720 - Tracheal prosthesis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3720 Tracheal prosthesis. (a) Identification. The...

2011-04-01

277

21 CFR 878.3720 - Tracheal prosthesis.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3720 Tracheal prosthesis. (a) Identification. The...

2014-04-01

278

21 CFR 878.3720 - Tracheal prosthesis.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3720 Tracheal prosthesis. (a) Identification. The...

2013-04-01

279

21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...joint metal constrained cemented prosthesis. 888.3790 Section 888...joint metal constrained cemented prosthesis. (a) Identification. A wrist joint metal constrained cemented prosthesis is a device intended...

2010-04-01

280

Prosthesis infection: prevention and treatment.  

PubMed

Implantation of a vascular prosthesis increases surgical site infection risk by producing a microenvironment conducive to bacterial attachment and biofilm formation, which sustains bacterial colonization and protects encased organisms from host defenses and antimicrobial therapy. Many maneuvers are used in an attempt to reduce infection in arterial reconstructions, but there are no clear guidelines on the most appropriate or effective. As well, there is no good evidence to guide management. A general principle is that indication for removal of the entire infected graft is mandatory when a suture line is involved in the infectious process, an infected anastomotic aneurism and a suture-line hemorrhage is evident, or when a graft-enteric fistula is diagnosed. Conservative, non-resectional management of graft infection is still a respectable solution for selected patients, as those with significant comorbidities, or those where the implanted aortic graft is in a location that precludes excision without causing a high likelihood of morbidity and/or mortality. Anyway, definitive management depends on the patient's condition and a tailored approach should be always offered. Surgical techniques favor in terms of mortality, patency and reinfection rate the in situ reconstruction. Currently, the choice of the technique used relies on center and operator's experience. This article summarizes the incidence of graft infection, analyze the predisponding factors to graft infection, and review current strategies for prevention and treatment of prosthesis and endograft infection. PMID:25017788

de Donato, G; Setacci, F; Galzerano, G; Ruzzi, U; Borrelli, M P; Mazzitelli, G; Setacci, C

2014-12-01

281

Instruments and techniques for the analysis of wheelchair propulsion and upper extremity involvement in patients with spinal cord injuries: current concept review  

PubMed Central

Summary The correct functionality of the upper limbs is an essential condition for the autonomy of people with disabilities, especially for those in wheelchair. In this review we focused on the biomechanics of wheelchair propulsion and we described the instrumental analysis of techniques for the acquisition of wheelchair propulsion. PMID:24367774

Dellabiancia, Fabio; Porcellini, Giuseppe; Merolla, Giovanni

2013-01-01

282

Inhibitory Response Capacities of Bilateral Lower and Upper Extremities in Children with Developmental Coordination Disorder in Endogenous and Exogenous Orienting Modes  

ERIC Educational Resources Information Center

This study was designed to investigate separately the inhibitory response capacity and the lateralization effect in children with developmental coordination disorder (DCD) in the endogenous and exogenous modes of orienting attention. Children with DCD on the lower extremities (DCD-LEs), along with age-matched controls, completed four tasks that…

Tsai, Chia-Liang; Yu, Yi-Kai; Chen, Yung-Jung; Wu, Sheng-Kuang

2009-01-01

283

Fracture embolization of a Duromedics mitral prosthesis.  

PubMed Central

The Duromedics bileaflet pyrolitic carbon mechanical prosthesis was introduced by Hemex in 1982 and subsequently acquired by Baxter. This communication documents a case of sudden leaflet fracture of a Duromedics mitral valve 48 months after implantation, which was managed successfully by replacement with a St. Jude Medical mechanical prosthesis. The patient presented in acute distress with paroxysmal atrial tachycardia and pulmonary edema. Transesophageal echocardiography was used to diagnose the leaflet fracture. The fracture had occurred transversely, with the fragments embolizing bilaterally to the iliofemoral arteries. These were removed at a subsequent operation. Cases of such fractures of the Duromedics prosthesis have been reported, with cavitation damage being the postulated mechanism. PMID:9205987

Baumgartner, F J; Munro, A I; Jamieson, W R

1997-01-01

284

Computer simulation tool for upper-limb prosthesis design  

Microsoft Academic Search

Prosthetic fittings, especially those for higher level or bilateral arm amputation, take considerable time and effort to achieve. A computer-based Prosthetic Arm Design and Simulation System (PADSS) is under development in an effort to improve the efficiency and cost of this process. Graphical simulations of the client and alternative prostheses would allow the prosthetist to determine the most likely configuration

Pinata Hungspreugs; C. W. Heckathorne; Dudley S. Childress

2000-01-01

285

An artificial gastrocnemius for a transtibial prosthesis  

E-print Network

A transtibial amputee does not have a functional gastrocnemius muscle, which affects the knee as well as the ankle joint. In this investigation, we developed a transtibial prosthesis comprising an artificial gastrocnemius ...

Swart, E.

286

Penile prosthesis implantation in a transsexual neophallus.  

PubMed

Reconstruction surgery for a female to male transsexual usually involves mastectomy, hysterectomy and creating an aesthetically appealing neophallus. We have successfully inserted an inflatable prosthesis using the AMS CX prosthesis in a 45 year old transsexual, who had a large bulky neophallus constructed from the anterior abdominal subcutaneous fat, about 9 years ago. The single cylinder CX prosthesis was well anchored to the symphysis pubis using a dacron windsock tubing, the activation pump was placed in the dependent pouch of the right labium and the reservior in the usual perivesical space. The patient subsequently had debulking procedure using liposuction to create a more aesthetic and functional phallus. To date, the inflatable neophallus prosthesis is functioning well. PMID:11202422

Tan, H M

2000-12-01

287

[Removable prosthesis insertion steps: controls-qualifications].  

PubMed

Support a prosthetic edentulous patient aims to optimize the rudimentary functions of mastication and phonation. Knowing the routine procedures in dentistry is needed. These prostheses can be a source of criticism in terms of the quality of life they provide. Chronologically, several steps must be followed when delivered: Reception at the dental office of the prosthesis, with its technical specifications, Meticulous checks prosthetic surfaces, Introduction in the oral cavity of dentures smoothly, The stability of the prosthesis is tested initially, Second occlusion is checked, The esthetic of the prosthesis previously endorsed in the fittings, is popular again, Phonetic tests are performed to help verify the positioning of the teeth in relation to the lips, Tests for judging the ability to swallow, to incise and biting at the posterior teeth are made by the patient, Check alignment of mounting the entire face, Follow the recommendations for proper use of the prosthesis. The complementarily of these steps determines the integration of the prosthesis, but the patient must be informed early in the treatment of functional and aesthetic limits of its future prosthesis. PMID:24979957

Kouadio, A A; Niagha, G; N'Goran, Koffi; Le Bars, P

2014-03-01

288

The upper transition height over the Kharkiv incoherent scatter radar before, during and after the extreme minimum of the solar activity: Observational results and comparison with the IRI-2012 model  

NASA Astrophysics Data System (ADS)

Variations in the diurnal minimum of upper transition height (height at which total light ions fraction is 50%) over Kharkiv, Ukraine are considered for vernal and autumnal equinoxes from 2006 to 2010. The data were obtained using the incoherent scatter radar of the Institute of ionosphere [1]. It was found that the decrease of daily F10.7 values approximately by 22 % (from 82 for spring 2006 to 67 for autumn 2007) was accompanied by a decrease in the upper transition height approximately by 19% too (from 518 km to 436 km). The linear correlation coefficient between the upper transition height and daily F10.7 was approximately 0.81. It should be noted that according to our knowledge such low values of upper transition height is the minimum ever recorded. In 2008-2009, the upper transition height over Kharkiv was up to 40 km lower than over the equator [2] and even up to 10-15 km lower than over Arecibo [3]. A comparison of the observational results with the IRI-2012 model [4] was made. It was found that the IRI-2012 model overestimates upper transition height up to 100 km in 2006, and 2010. The model also overestimates the upper transition height up to 150 km during the extreme solar minimum (2008-2009). It is clearly seen that for solar minimum under consideration latitudinal dependence of upper transition height according to observational data have decreasing character in contrast to the model dependence. Such behavior can be called latitudinal inversion of upper transition height. Strong dependence of upper transition height on Ap index was found for the conditions under consideration. It is suggested that model values for 2006 and 2010 are overestimated due to a higher geomagnetic activity during the satellite measurements (1974) underlying the model for the low level of solar activity compared with geomagnetic conditions for 2006 and 2010. Perhaps this led to the fact that the model does not show latitudinal inversion, which occurs only at very low geomagnetic activity. However, this hypothesis requires further careful checking. In 2008 and 2009, the decreasing of the upper transition height has been apparently caused by a prolonged general cooling of the thermosphere and ionosphere [5]. [1] I.F. Domnin et. al., Geomag. And Aeronomy, Intern. 53, 113 (2013). [2] R.A. Heelis et. al.,Geophys. Res. Lett. 36, L00C03, doi:10.1029/2009GL038652 (2009). [3] N. Aponte et. al., J. Geophys. Res. 118, 4465, doi:10.1002/jgra.50416 (2013). [4] V. Truhlik et al., Adv. Space. Res., Towards better description of solar activity variation in the IRI topside ion composition model, in review. [5] S.C. Solomon et. al., J. Geophys. Res. 116, doi:10.1029/2011JA016508.

Kotov, Dmytro; Truhlik, Vladimir; Richards, Philipp; Huba, Joseph; Chernogor, Leonid; Bogomaz, Oleksandr; Domnin, Igor

2014-05-01

289

Archaeomagnetic study of five mounds from Upper Mesopotamia between 2500 and 700 BCE: Further evidence for an extremely strong geomagnetic field ca. 3000 years ago  

NASA Astrophysics Data System (ADS)

The distribution of archaeomagnetic data in eastern Europe and the Near and Middle East shows a remarkable gap in Turkey. This study presents the first archaeomagnetic results from five different mounds in southeast Turkey, the northern part of Mesopotamia. The rock magnetic experiments indicate that in the majority of the samples the dominant magnetic carrier is magnetite, which is stable to heating to temperatures of 700 °C. In general, the demagnetization diagrams are single component and all five sets display well-defined characteristic magnetizations and clustered directions. For the period between 2500 and 700 BCE, the declinations are between 350° and 20° while inclinations are in the range of 49-64°. The directional results are compared with the global geomagnetic field models (CALS7k.2, ARCH3k_cst.1 and CALS3k.4) and the data from the archaeomagnetic database GEOMAGIA50v2. The results are coherent with both the data and the models except for two near-contemporaneous sets dating ˜2000 BCE, which are offset to the east by more than 20° with respect to CALS7k.2. Archaeointensity measurements were made using the microwave and conventional thermal Thellier methods applied to five sets of samples (four furnaces and a mud-brick wall). These yielded comparable and intriguing results. While those from the furnaces are slightly higher than the CALS7k.2 model and in agreement with the GEOMAGIA50v2 and the Middle East data, the results from the mud-brick wall suggest a high intensity of 100.8 ?T (17.7×1022 Am2) at ˜1000 BCE. This result is in excellent agreement with recent claims of extremely high intensity measured in other regions of the Middle East for this time period though less consistent with these being associated with extremely short-lived events. Finally, we discuss our new and other recently published archaeointensity results in terms of geomagnetic intensity versus climate.

Ertepinar, P.; Langereis, C. G.; Biggin, A. J.; Frangipane, M.; Matney, T.; Ökse, T.; Engin, A.

2012-12-01

290

Dielectric elastomers as actuators for upper limb prosthetics: challenges and opportunities.  

PubMed

Recent research has indicated that consumers of upper limb prostheses desire lighter-weight, anthropomorphic devices. The potential of dielectric elastomer (DE) actuators to better meet the design priorities of prosthesis users is explored. Current challenges are critically reviewed with respect to (1) durability, (2) precision control, (3) energy consumption, and (4) anthropomorphic implementation. The key points arising from the literature review are illustrated with empirical examples of the strain performance and durability of one of the most popular DEs, VHB 4910. Practical application of DE actuators in powered upper extremity prosthetics is at present impeded by poor durability and susceptibility to air-borne contaminants, unreliable control owing to viscoelasticity, hysteresis, stress relaxation and creep mechanisms, high voltage requirements, and insufficient stress and strain performance within the confines of anthropomorphic size, weight, and function. Our review suggests that the implementation of DE actuators in powered upper extremity prosthetics is not feasible at present but worthy of reevaluation as the materials advance. PMID:17632030

Biddiss, Elaine; Chau, Tom

2008-05-01

291

Virtual reality environment for simulating tasks with a myoelectric prosthesis: an assessment and training tool  

PubMed Central

Intuitively and efficiently controlling multiple degrees of freedom is a major hurdle in the field of upper limb prosthetics. A virtual reality myoelectric transhumeral prosthesis simulator has been developed for cost-effectively testing novel control algorithms and devices. The system acquires EMG commands and residual limb kinematics, simulates the prosthesis dynamics, and displays the combined residual limb and prosthesis movements in a virtual reality environment that includes force-based interactions with virtual objects. A virtual Box and Block Test is demonstrated. Three normally-limbed subjects performed the simulated test using a sequential and a synchronous control method. With the sequential method, subjects moved on average 6.7±1.9 blocks in 120 seconds, similar to the number of blocks transhumeral amputees are able to move with their physical prostheses during clinical evaluation. With the synchronous method, subjects moved 6.7±2.2 blocks. The virtual reality prosthesis simulator is thus a promising tool for developing and evaluating control methods, prototyping novel prostheses, and training amputees. PMID:23476108

Lambrecht, Joris M.; Pulliam, Christopher L.; Kirsch, Robert F.

2013-01-01

292

Techniques for Evaluating the Fit of Removable and Fixed Prosthesis  

PubMed Central

The importance of an accurately fitting fixed prosthesis or a removable prosthesis is essential for the success of the restoration. Ill-fitting prosthesis may cause mechanical failures of the prosthesis, implant systems, or biologic complications of the surrounding tissue. There are several causes related to improper seating of the prosthesis. Some of which can be corrected and the others need to be repeated. Hence the clinician must carefully evaluate the adaptation of the prosthesis using the clinical techniques and combination of the available materials and evaluation methods to optimize the fit of prosthesis. This article reviews the various clinical methods that have been suggested for evaluating the fit of the fixed and removable prosthesis. PMID:21991469

Shetty, Mallika S.; Shenoy, K. Kamalakanth

2011-01-01

293

21 CFR 888.3230 - Finger joint polymer constrained prosthesis.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Finger joint polymer constrained prosthesis... Prosthetic Devices § 888.3230 Finger joint polymer constrained prosthesis. (a) Identification. A finger joint polymer constrained...

2010-04-01

294

21 CFR 888.3230 - Finger joint polymer constrained prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Finger joint polymer constrained prosthesis... Prosthetic Devices § 888.3230 Finger joint polymer constrained prosthesis. (a) Identification. A finger joint polymer constrained...

2011-04-01

295

An archaeomagnetic study of Upper Mesopotamia and Central Anatolia between 2500 and 700 BCE. Further evidence for an extremely strong geomagnetic field ca. 3000 years ago  

NASA Astrophysics Data System (ADS)

The distribution of archaeomagnetic data in eastern Europe and the Near and Middle East shows a remarkable gap in Turkey. This study presents the first archaeomagnetic results from eight different archaeological sites in Central and Southeast Turkey. We sampled furnaces, burnt mud-brick walls, and granite and ignimbrite foundation stones. The rock magnetic experiments indicate that in the majority of the samples the dominant magnetic carrier is magnetite, which is stable to heating to temperatures of 700° C. In general, the demagnetization diagrams are single component and all sets display well-defined characteristic magnetizations and clustered directions. For the period between 2500 and 700 BCE, the declinations are between 350° and 20° while inclinations are in the range of 49-64° . The directional results are compared with the global geomagnetic field models (CALS7k.2, ARCH3k_cst.1 and CALS3k.4) and the data from the archaeomagnetic database GEOMAGIA50v2. The results are coherent with both the data and the models except for two near-contemporaneous sets dating ~2000 BCE, which are offset to the east by more than 20° with respect to CALS7k.2. Archaeointensity measurements were made using the microwave and conventional thermal Thellier methods, as well as the multi-specimen method. These different methods yielded comparable and intriguing results. While intensities from the furnaces are slightly higher than the CALS7k.2 model and in agreement with the GEOMAGIA50v2 and the Middle East data, the results from mud-brick walls suggest a high intensity of 100.8?T (17.7 x 1022 Am2 )at ~1000 BCE. This result is in excellent agreement with recent claims of extremely high intensity measured in other regions of the Middle East for this time period though less consistent with these being associated with extremely short-lived events. Finally, we discuss our new and other recently published archaeointensity results in terms of geomagnetic intensity versus climate.

Ertepinar, Pinar; Langereis, Cor; Biggin, Andrew; de Groot, Lennart

2014-05-01

296

Optogenetic approaches to retinal prosthesis.  

PubMed

The concept of visual restoration via retinal prosthesis arguably started in 1992 with the discovery that some of the retinal cells were still intact in those with the retinitis pigmentosa disease. Two decades later, the first commercially available devices have the capability to allow users to identify basic shapes. Such devices are still very far from returning vision beyond the legal blindness. Thus, there is considerable continued development of electrode materials, and structures and electronic control mechanisms to increase both resolution and contrast. In parallel, the field of optogenetics-the genetic photosensitization of neural tissue holds particular promise for new approaches. Given that the eye is transparent, photosensitizing remaining neural layers of the eye and illuminating from the outside could prove to be less invasive, cheaper, and more effective than present approaches. As we move toward human trials in the coming years, this review explores the core technological and biological challenges related to the gene therapy and the high radiance optical stimulation requirement. PMID:25100257

Barrett, John Martin; Berlinguer-Palmini, Rolando; Degenaar, Patrick

2014-09-01

297

Individually Prefabricated Prosthesis for Maxilla Reconstuction.  

PubMed

The reconstruction of maxillofacial bone defects by the intraoperative modeling of implants may reduce the predictability of the esthetic result, leading to more invasive surgery and increased surgical time. To improve the maxillofacial surgery outcome, modern manufacturing methods such as rapid prototyping (RP) technology and methods based on reverse engineeing (RE) and medical imaging data are applicable to the manufacture of custom-made maxillary prostheses. After acquisition of data, an individual computer-based 3D model of the bony defect is gernerated. These data are tranferrred into RE software to create the prosthesis using a computer-aided design (CAD) model, which is directed into the RP machine for the production of the physical model. The precise fit of the prosthesis is evaulated using the prosthesis and skull model. The prosthesis is then directly used in investment casting such as "Quick Cast" pattern to produce the titanium model. In the clincical reports presented here, reconstructions of two patients with large maxillary bone defects during the operations, and surgery time was reduced. These cases show that the prefabrication of a prosthesis using modern manufacturing technology is an effective method for maxillofacial defect reconstruction. PMID:17971119

Singare, Sekou; Liu, Yaxiong; Li, Dichen; Lu, Bingheng; Wang, Jue; He, Sanhu

2008-02-01

298

Effect of the Shoulder Flexion Angle in the Sagittal Plane on the Muscle Activities of the Upper Extremities when Performing Push-up plus Exercises on an Unstable Surface  

PubMed Central

[Purpose] The purpose of this study was to investigate the effect of the shoulder flexion angle on the muscle activities of the upper extremities when performing the push-up plus exercise (PUPE) on an unstable surface with the forearm in the external rotation position. [Subjects] The subjects were conducted on 15 normal male adults. [Methods] A sling device was used for the unstable surface, and PUPE was performed with the forearm in the external rotation position. The shoulder flexion angles measured in the sagittal plane were 110°, 90°, and 70°. Electromyography was used for a comparitive analysis of the muscle activities of the serratus anterior (SA), the pectoralis major (PM), and the upper trapezius (UT). [Results] In the intra-group comparison, the muscle activity of SA was statistically the highest when the shoulder-flexion angle was 110°. [Conclusion] performing PUPE on an unstable surface, the muscle activity of the SA is activated the most when the shoulder flexion angle is 110° and the forearm is in the external rotation position. PMID:25364120

Lee, Sangyong; Lee, Daehee; Park, Jungseo

2014-01-01

299

Complete denture with pharyngeal bulb prosthesis.  

PubMed

Velopharyngeal dysfunction is the inability of the soft palate to affect complete seal with the posterior or lateral pharyngeal walls. Rehabilitation of these patients with palatal defects is challenging for both surgical and prosthetic fields of dentistry. The development of sophisticated surgical techniques and procedures has greatly enhanced the rehabilitation of congenital or acquired palatal defects. However, some of these patients may present oral or systemic factors contraindicating surgical intervention. In addition, since total elimination of these defects surgically has not yet become a reality, there exists a patient population for whom non-surgical rehabilitation must be approached with the help of prosthesis and such prosthesis must restore the basic functions of mastication, deglutition and speech production. Here a non-surgical approach of rehabilitation of such defect is presented in the form of a case report of pharyngeal bulb prosthesis given for a patient with a soft palate defect. PMID:23605828

Naveen, Y G; Jagadeesh, M S; Prajapati, Paranjay; Mallikarjuna, Rachappa

2013-01-01

300

Upper extremity lymphatic function at rest and during exercise in breast cancer survivors with and without lymphedema compared with healthy controls.  

PubMed

Lymphoscintigraphy was used to measure lymphatic function at rest and during exercise in breast cancer survivors with lymphedema (BCRL, n = 10), breast cancer survivors (BC, n = 10), and controls (Cont, n = 10). After injection of (99m)Tc-antimony colloid to the hands, subjects rested or performed 12 repeated sets of arm cranking for 2.5 min at 0.6 W/kg followed by 2.5 min of rest. One-minute spot views were taken with a gamma-radiation camera immediately postinjection and every 10 min over 60 min to calculate clearance rate. As well, an upper body scan was taken at 65 min postinjection to measure radiopharmaceutical uptake in the axilla (Ax) and forearm (Fore). All groups displayed similar increases in clearance rate with exercise (P = 0.000). Ax significantly increased with exercise in Cont only [Cont: (mean +/- SD) 4.9 +/- 2.6 vs. 7.9 +/- 4.2%, P = 0.000; BCRL: 1.4 +/- 1.2 vs. 1.7 +/- 2.1%, P = 0.531; BC: 3.9 +/- 3.4 vs. 5.2 +/- 3.2%, P = 0.130], whereas Fore, indicating dermal backflow, significantly increased in BCRL only (BCRL: 2.4 +/- 0.87 vs. 4.4 +/- 2.0%, P = 0.004; BC: 1.1 +/- 0.25 vs. 1.1 +/- 0.31%, P = 0.784; Cont: 0.93 +/- 0.26 vs. 1.0 +/- 0.20%, P = 0.296). The results indicate that, in women with BCRL, exercise causes radiopharmaceuticals to clear from the hand at the same rate as BC and Cont, but, instead of reaching the axilla, a greater amount of activity gets trapped in the dermis of the forearm. BC, meanwhile, have similar lymphatic function as Cont; however, there is a highly variable response that may suggest that some BC subjects may be at risk for developing lymphedema. PMID:17585046

Lane, Kirstin N; Dolan, Lianne B; Worsley, Dan; McKenzie, Don C

2007-09-01

301

Groningen prosthesis for voice rehabilitation after laryngectomy.  

PubMed

Singer and Blom's endoscopic technique, using a single valved silicone prosthesis, constituted a dramatic advance in speech rehabilitation following total laryngectomy. Since 1980, we have developed a silicone biflanged prosthesis that overcomes some of the inconveniences of previous prostheses. Insertion via the mouth and the oesophagus, or as a primary procedure during total laryngectomy is easily done with the use of specially developed instruments. The success rate in 36 patients in which the voice button was inserted at the time of total laryngectomy was 86.2%. PMID:6723098

Annyas, A A; Nijdam, H F; Escajadillo, J R; Mahieu, H F; Leever, H

1984-02-01

302

Production of porous coating on a prosthesis  

DOEpatents

Preselected surface areas of a prosthesis are covered by a blend of matching primary metallic particles and expendable particles. The particles are compressed and heated to assure that deformation and metallurgical bonding occurs between them and between the primary particles and the surface boundaries of the prosthesis. Porosity is achieved by removal of the expendable material. The result is a coating including discrete bonded particles separated by a network of interconnected voids presenting a homogeneous porous coating about the substrate. It has strength suitable for bone implant usage without intermediate adhesives, and adequate porosity to promote subsequent bone ingrowth.

Sump, Kenneth R. (Richland, WA)

1987-01-01

303

Acrylic Finger Prosthesis: A Case Report  

PubMed Central

Hands basic function is to grasp, hold and manipulate items. Hand gesture is perhaps the most blatant example of non-verbal communication. Finger and partial finger amputations are most frequently encountered forms of partial hand loss. Common causes are traumatic injuries, congenital absence or malformations present great clinical challenges. In addition to immediate loss of grasp strength, finger absence may cause marked psychological trauma. Individuals who desire finger replacement usually have high expectation for the appearance of prosthesis. This clinical report portrays simple method to retain acrylic finger prosthesis.

Bandela, Vinod; M, Bharathi; S V, Giridhar Reddy

2014-01-01

304

Implant-Retained Auricular Prosthesis: A Case Report  

PubMed Central

Extraoral implant retained prosthesis have been proven to be a predictable treatment option for maxillofacial rehabilitation. This case report describes the clinical and laboratory procedures for fabricating an auricular prosthesis. In this case report, an auricular prosthesis was fabricated for a patient who lost the left and right external ear in an electrical burn. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to implant were used. This prosthesis was acceptable to the patient because of excellent support, retentive abilities and the patient’s appearance. PMID:20046483

Ozturk, A. Nilgun; Usumez, Aslihan; Tosun, Zekeriya

2010-01-01

305

External breast prosthesis use: experiences and views of women with breast cancer, breast care nurses, and prosthesis fitters.  

PubMed

After mastectomy, the provision of an appropriate breast prosthesis can help to improve body image and quality of life and reduce associated emotional distress. Although up to 90% of women use an external breast prosthesis after mastectomy, little is known about their experiences and satisfaction with breast prosthesis use. Focus groups were conducted with women who had been fitted with an external breast prosthesis, breast care nurses, and prosthesis fitters to explore women's experiences of prosthesis use. Qualitative thematic content analysis of focus group transcripts indicated that whereas women's initial reaction to the prosthesis generally was negative, this improved over time. Provision of adequate information and support, characteristics of the fitter and the fitting experience, and relationships with breast care nurses and prosthesis fitters were important to women's acceptance and satisfaction with their prosthesis. The study results highlighted the key role that breast care nurses play and the underestimation of the prosthesis fitter's role. Common themes concerning the impact of prosthesis use included body image, appearance, and feminine identity. These findings have important implications for professionals involved in the delivery of breast prostheses services. PMID:12832950

Roberts, Susan; Livingston, Patricia; White, Victoria; Gibbs, Anne

2003-06-01

306

Metabolic Prosthesis for Oxygenation of Ischemic Tissue  

Microsoft Academic Search

This communication discloses new ideas and preliminary results on the development of a metabolic prosthesis for local oxygenation of ischemic tissue under physiologically neutral conditions. We report for the first time selective electrolysis of physiological saline by repetitively pulsed, charge-limited electrolysis for the production of oxygen and suppression of free chlorine. Using 800-mu A amplitude current pulses and < 200

Elias Greenbaum; Mark S. Humayun; Charlene A. Sanders; D. Close; H. M. O'Neill; B. R. Evans

2009-01-01

307

Fuzzy EMG classification for prosthesis control  

Microsoft Academic Search

Proposes a fuzzy approach to classify single-site electromyograph (EMG) signals for multifunctional prosthesis control. While the classification problem is the focus of this paper, the ultimate goal is to improve myoelectric system control performance, and classification is an essential step in the control. Time segmented features are fed to a fuzzy system for training and classification. In order to obtain

Francis H. Y. Chan; Yong-Sheng Yang; F. K. Lam; Yuan-Ting Zhang; Philip A. Parker

2000-01-01

308

A biomimetic controller for a multifinger prosthesis  

Microsoft Academic Search

A novel controller for a multifinger hand prosthesis was developed and tested to measure its accuracy and performance in transducing volitional signals for individual “phantom” fingers. Pneumatic sensors were fabricated from open-cell polymeric foam, and were interposed between the prosthetic socket and superficial extrinsic tendons associated with individual finger flexion. Test subjects were prompted to move individual fingers or combinations

Rochel L. Abboudi; Carey A. Glass; Nicki A. Newby; James A. Flint; William Craelius

1999-01-01

309

Upper Extremity Applications of Functional Neuromuscular Stimulation  

Microsoft Academic Search

Functional electrical stimulation (FES) has been used for increasing muscle strength, decreasing spasticity, and controlling movement of limbs for many years. Most of this work, however, has been done in a research setting. Over the past decade, FES has moved slowly from the laboratory to the clinical world through feasibility studies in groups of patients with spinal cord injuries and

Carl Billian; Peter H. Gorman

1992-01-01

310

[Diagnostic algorithm for upper extremity peripheral paresis].  

PubMed

The authors have rejected applying of image identification algorithms and searching for given sequence in favor of algorithms sorting, eliminating thereby an influence of subjective factors on diagnostic process. To create the program, the diagnostic signs with probability coefficient 1 (positive indicator) or 0 (negative indicator) were used. To positive signs were attributed indicator muscles and indicator sensitive zones--the cutaneous areas where sensitive disorders appeared in the first turn, in response to a lesion in corresponding segment of peripheral nervous system, and disappeared in the last turn; to negative ones--muscles or cutaneous areas, being never affected by paresis or hyperesthesia in response to the given lesion type. The first part of the algorithm concerns a definition of defect level and the second one--an establishment of final diagnosis. The use of the algorithm developed simplifies diagnostics and raises its efficacy. PMID:14564778

Neretin, V Ia; Iakushin, M A

2003-01-01

311

21 CFR 888.3170 - Elbow joint radial (hemi-elbow) polymer prosthesis.  

Code of Federal Regulations, 2010 CFR

... Elbow joint radial (hemi-elbow) polymer prosthesis. 888.3170 Section 888... Elbow joint radial (hemi-elbow) polymer prosthesis. (a) Identification. An elbow joint radial (hemi-elbow) polymer prosthesis is a device intended to...

2010-04-01

312

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.  

Code of Federal Regulations, 2011 CFR

...false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section...3760 Wrist joint carpal scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one-piece...

2011-04-01

313

21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.  

Code of Federal Regulations, 2011 CFR

...Wrist joint ulnar (hemi-wrist) polymer prosthesis. 888.3810 Section...Wrist joint ulnar (hemi-wrist) polymer prosthesis. (a) Identification...wrist joint ulnar (hemi-wrist) polymer prosthesis is a...

2011-04-01

314

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.  

Code of Federal Regulations, 2010 CFR

...false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section...3770 Wrist joint carpal trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one-piece...

2010-04-01

315

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.  

Code of Federal Regulations, 2010 CFR

... Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888... Toe joint phalangeal (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis is a device made of...

2010-04-01

316

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.  

Code of Federal Regulations, 2011 CFR

...false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section...3770 Wrist joint carpal trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one-piece...

2011-04-01

317

21 CFR 888.3170 - Elbow joint radial (hemi-elbow) polymer prosthesis.  

Code of Federal Regulations, 2011 CFR

... Elbow joint radial (hemi-elbow) polymer prosthesis. 888.3170 Section 888... Elbow joint radial (hemi-elbow) polymer prosthesis. (a) Identification. An elbow joint radial (hemi-elbow) polymer prosthesis is a device intended to...

2011-04-01

318

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.  

Code of Federal Regulations, 2011 CFR

... Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888... Toe joint phalangeal (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis is a device made of...

2011-04-01

319

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.  

Code of Federal Regulations, 2010 CFR

...false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section...3760 Wrist joint carpal scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one-piece...

2010-04-01

320

21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...hemi-knee) metallic resurfacing uncemented prosthesis. 888.3590 Section 888.3590...hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee...hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be...

2010-04-01

321

21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...femoral (hemi-knee) metallic uncemented prosthesis. 888.3570 Section 888.3570...femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee...femoral (hemi-knee) metallic uncemented prosthesis is a device made of alloys,...

2010-04-01

322

21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...hemi-elbow) metallic uncemented prosthesis. 888.3180 Section 888.3180...hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow...hemi-elbow) metallic uncemented prosthesis is a device intended to be...

2010-04-01

323

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

Code of Federal Regulations, 2010 CFR

...hemi-shoulder) metallic uncemented prosthesis. 888.3690 Section 888.3690...hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder...hemi-shoulder) metallic uncemented prosthesis is a device made of alloys,...

2010-04-01

324

21 CFR 888.3480 - Knee joint femorotibial metallic constrained cemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...femorotibial metallic constrained cemented prosthesis. 888.3480 Section 888.3480...femorotibial metallic constrained cemented prosthesis. (a) Identification. A knee...femorotibial metallic constrained cemented prosthesis is a device intended to be...

2010-04-01

325

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.  

Code of Federal Regulations, 2010 CFR

... Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750... Wrist joint carpal lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece device made of...

2010-04-01

326

21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...hemi-hip) acetabular metal cemented prosthesis. 888.3370 Section 888.3370...hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip...hemi-hip) acetabular metal cemented prosthesis is a device intended to be...

2010-04-01

327

21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.  

Code of Federal Regulations, 2010 CFR

...femoral (hemi-hip) metallic resurfacing prosthesis. 888.3400 Section 888.3400...femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip...femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be...

2010-04-01

328

21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...metal constrained cemented or uncemented prosthesis. 888.3300 Section 888.3300...metal constrained cemented or uncemented prosthesis. (a) Identification. A hip...metal constrained cemented or uncemented prosthesis is a device intended to be...

2010-04-01

329

[Experiences with the Groningen voice prosthesis after laryngectomy].  

PubMed

The tracheoesophageal puncture technique with insertion of a valved prosthesis for speech rehabilitation after total laryngectomy is a reliable and simple procedure for successful vocal rehabilitation. The available voice prosthesis can be separated into indwelling and non-indwelling types. The details of the indwelling long-term prostheses (low-pressure Groningen Prosthesis, Nijdam, prosthesis, Provox prosthesis) are discussed. These prostheses need limited patient care. Replacement of the indwelling prosthesis is a simple out-patient procedure, although it is best performed by an ENT-specialist. The local complication rate is low and generally not significant. Hand-free speech is now possible by placement of a tracheostoma valve. Current experiences are encouraging for continued use. PMID:8071096

Manni, J J; van den Hoogen, F J; Oudes, M

1994-06-01

330

Design and Control of a Powered Transfemoral Prosthesis  

PubMed Central

The paper describes the design and control of a transfemoral prosthesis with powered knee and ankle joints. The initial prototype is a pneumatically actuated powered-tethered device, which is intended to serve as a laboratory test bed for a subsequent self-powered version. The prosthesis design is described, including its kinematic optimization and the design of a three-axis socket load cell that measures the forces and moments of interaction between the socket and prosthesis. A gait controller is proposed based on the use of passive impedance functions that coordinates the motion of the prosthesis with the user during level walking. The control approach is implemented on the prosthesis prototype and experimental results are shown that demonstrate the promise of the active prosthesis and control approach in restoring fully powered level walking to the user. PMID:19898683

Sup, Frank; Bohara, Amit; Goldfarb, Michael

2009-01-01

331

Postoperative death associated with a reverse prosthesis.  

PubMed

The mortality rate after total shoulder arthroplasty, and specifically after reverse total shoulder arthroplasty, has not received much attention in the literature. Although complications of the reverse total shoulder arthroplasty are well known, fatalities secondary to complications related to the unique features of the reverse prosthesis have not, to our knowledge, been previously reported. We report the case of an elderly man who developed shoulder instability after the implantation of a reverse prosthesis followed by disassociation of the glenosphere from the baseplate. After a reoperation to revise and reassemble the components, he developed an infected shoulder and sepsis, and subsequently died from the complications of sepsis. This death represents a perioperative mortality rate of 0.5% in our series of 190 cases. The mortality rate after reverse total shoulder seems to be similar to that after standard total shoulder arthroplasty. PMID:23431552

Garzon-Muvdi, Juan; Stein, Benjamin E; Tantisricharoenkul, Gof; Petersen, Steve A; McFarland, Edward G

2013-02-01

332

Orbital prosthesis: a novel reconstructive approach.  

PubMed

Rehabilitation of facial defects is a daunting task, requiring an individualized design of the technique for each patient. The disfigurement associated with the loss of an eye may result in significant physical and emotional problems. Various treatment modalities are available, one of which is the use of implants. Although implant-supported orbital prosthesis has a superior outcome, it may not be advisable in all the patients due to economic factors. The present article describes a reconstructive approach for a patient with exenterated right eye using silicone orbital prosthesis which improved his psychological, physical, social, functional, emotional and spiritual needs. Multidisciplinary management and team approach are essential in providing accurate and effective rehabilitation. PMID:25284538

Soni, Bhavita Wadhwa; Soni, Nitin; Bansal, Mohit

2014-09-01

333

21 CFR 878.3800 - External aesthetic restoration prosthesis.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3800 External aesthetic restoration prosthesis. (a)...

2013-04-01

334

21 CFR 878.3800 - External aesthetic restoration prosthesis.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3800 External aesthetic restoration prosthesis. (a)...

2014-04-01

335

21 CFR 878.3800 - External aesthetic restoration prosthesis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3800 External aesthetic restoration prosthesis. (a)...

2011-04-01

336

21 CFR 878.3530 - Silicone inflatable breast prosthesis.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3530 Silicone inflatable breast prosthesis. (a)...

2011-04-01

337

21 CFR 878.3530 - Silicone inflatable breast prosthesis.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3530 Silicone inflatable breast prosthesis. (a)...

2013-04-01

338

21 CFR 878.3530 - Silicone inflatable breast prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3530 Silicone inflatable breast prosthesis. (a)...

2012-04-01

339

21 CFR 878.3530 - Silicone inflatable breast prosthesis.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3530 Silicone inflatable breast prosthesis. (a)...

2014-04-01

340

21 CFR 878.3800 - External aesthetic restoration prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3800 External aesthetic restoration prosthesis. (a)...

2012-04-01

341

The Nijdam voice prosthesis: a self-retaining valveless voice prosthesis for vocal rehabilitation after total laryngectomy.  

PubMed

Voice prosthesis-assisted speech rehabilitation after total laryngectomy has proven to be successful in the majority of patients and exceeds the results of traditional oesophageal speech. Nevertheless 10-30% failure rates are still reported. In part this is due to prosthesis-related problems, in particular ingrowth of Candida species in the valve-bearing parts of the devices. A new indwelling, low-resistance and valveless voice prosthesis is described; the Nijdam voice prosthesis. The device has an average device lifetime of 19 weeks which appears to be superior to other indwelling voice prostheses. Replacement indications mainly comprise leakage or increased airflow resistance. Most frequent local complications are granulation tissue and hypertrophic scar tissue formation. These occur in 12% of the patients and can easily be treated. Replacement is a simple outpatient procedure. The prosthesis is interchangeable with other types of indwelling voice prosthesis. PMID:8973732

van den Hoogen, F J; Nijdam, H F; Veenstra, A; Manni, J J

1996-11-01

342

The Penile Prosthesis Option for Erectile Dysfunction  

Microsoft Academic Search

\\u000a Erectile dysfunction (ED) treatment can be divided into three main categories. These are oral agents, intracavernosal and\\u000a intraurethral therapies, and local devices, such as vacuum and penile prosthesis. The first-line treatment for ED is oral\\u000a phosphodiesterase type 5 inhibitors (PDE5Is); second-line treatment options include any combination of intracavernosal agents,\\u000a such as papaverine, phentolamine, PGE1, or transurethral alprostadil. For this reason,

Fikret Erdemir; Andrew Harbin; Wayne J. G. Hellstrom

343

Oscillation and Reaction Board Techniques for Estimating Inertial Properties of a Below-knee Prosthesis  

PubMed Central

The purpose of this study was two-fold: 1) demonstrate a technique that can be used to directly estimate the inertial properties of a below-knee prosthesis, and 2) contrast the effects of the proposed technique and that of using intact limb inertial properties on joint kinetic estimates during walking in unilateral, transtibial amputees. An oscillation and reaction board system was validated and shown to be reliable when measuring inertial properties of known geometrical solids. When direct measurements of inertial properties of the prosthesis were used in inverse dynamics modeling of the lower extremity compared with inertial estimates based on an intact shank and foot, joint kinetics at the hip and knee were significantly lower during the swing phase of walking. Differences in joint kinetics during stance, however, were smaller than those observed during swing. Therefore, researchers focusing on the swing phase of walking should consider the impact of prosthesis inertia property estimates on study outcomes. For stance, either one of the two inertial models investigated in our study would likely lead to similar outcomes with an inverse dynamics assessment. PMID:24837164

Smith, Jeremy D.; Ferris, Abbie E.; Heise, Gary D.; Hinrichs, Richard N.; Martin, Philip E.

2014-01-01

344

[Tracheal replacement with a swine prosthesis].  

PubMed

In 12 experimental operations the authors tested the biocompatibility of a xenologous trachea from a pig which was used to replace a 5 cm defect of the trachea in a dog. After special preparation eliminating the antigenicity of the pig trachea the thus prepared graft was sutured into the thoracic portion of the dog trachea. The experiment could not be evaluated in two instances because the dog died on the operating table. In the remaining ten cases it was found that all anastomoses healed perfectly. The fibrous tissues of the tunica propria of the graft was replaced by granulation tissue. Across the anastomoses newly formed capillaries penetrated into the trachea where they caused chondrolysis. This led to a breakdown of the central portion of the prosthesis and stenosis in the airways with terminal respiratory failure. The mucosa of the graft was at some sites covered by metaplastically altered epithelium. Even a reinforcing vascular prosthesis did not prevent the breakdown of the wall of the xenologous graft. An asset for future work is the finding of a well healed suture between the graft and the trachea and evidence that newly formed blood vessels penetrated into the prosthesis. PMID:7482050

Fanta, J; Pohunková, H; Stol, M; Jirava, D

1995-08-01

345

Effects of a powered ankle-foot prosthesis on kinetic loading of the unaffected leg during level-ground walking  

PubMed Central

Background People with a lower-extremity amputation that use conventional passive-elastic ankle-foot prostheses encounter a series of stress-related challenges during walking such as greater forces on their unaffected leg, and may thus be predisposed to secondary musculoskeletal injuries such as chronic joint disorders. Specifically, people with a unilateral transtibial amputation have an increased susceptibility to knee osteoarthritis, especially in their unaffected leg. Previous studies have hypothesized that the development of this disorder is linked to the abnormally high peak knee external adduction moments encountered during walking. An ankle-foot prosthesis that supplies biomimetic power could potentially mitigate the forces and knee adduction moments applied to the unaffected leg of a person with a transtibial amputation, which could, in turn, reduce the risk of knee osteoarthritis. We hypothesized that compared to using a passive-elastic prosthesis, people with a transtibial amputation using a powered ankle-foot prosthesis would have lower peak resultant ground reaction forces, peak external knee adduction moments, and corresponding loading rates applied to their unaffected leg during walking over a wide range of speeds. Methods We analyzed ground reaction forces and knee joint kinetics of the unaffected leg of seven participants with a unilateral transtibial amputation and seven age-, height- and weight-matched non-amputees during level-ground walking at 0.75, 1.00, 1.25, 1.50, and 1.75 m/s. Subjects with an amputation walked while using their own passive-elastic prosthesis and a powered ankle-foot prosthesis capable of providing net positive mechanical work and powered ankle plantar flexion during late stance. Results Use of the powered prosthesis significantly decreased unaffected leg peak resultant forces by 2-11% at 0.75-1.50 m/s, and first peak knee external adduction moments by 21 and 12% at 1.50 and 1.75 m/s, respectively. Loading rates were not significantly different between prosthetic feet. Conclusions Use of a biomimetic powered ankle-foot prosthesis decreased peak resultant force at slow and moderate speeds and knee external adduction moment at moderate and fast speeds on the unaffected leg of people with a transtibial amputation during level-ground walking. Thus, use of an ankle-foot prosthesis that provides net positive mechanical work could reduce the risk of comorbidities such as knee osteoarthritis. PMID:23758860

2013-01-01

346

Upper limb injuries in sports  

Microsoft Academic Search

Injuries, either to the athletes, amateurs, trainees or professional players, are common in any sporting event. Injuries can be to the limbs or to the trunk; acute, chronic or repetitive, from mild to severely disabling in severity. The most commonly injured regions are knee (28%) followed by the upper limb (23%). The common upper extremity injuries are the shoulder, followed

B B Putty

2010-01-01

347

‘Elephant’ graft to assist implant-retained nasal prosthesis  

Microsoft Academic Search

Large rhinectomy defects can be reconstructed with endosseous craniofacial implants and an alloplastic implant-retained prosthesis. The survival of the implants and prosthesis is aided by the placement of split skin grafts. A simple and effective technique is described to enable accurate placement of a split skin graft in a single piece, by shaping it ‘like an elephant’.

M. Ethunandan; I. P. Downie

2008-01-01

348

INNOVATIVE DESIGN, DEVELOPMENT AND PROTOTYPING OF KNEE PROSTHESIS  

Microsoft Academic Search

This paper deals with innovative solutions in semi-passive electronic controlled above knee prosthesis. The project is developed at Robotics Laboratory, Mechanical Dept. of Politecnico di Milano, with the co-operation of INAIL National Prosthesis Centre. In particular, new issues deal with mechanical, electronic and IT solutions, in order to get larger efficiency, stability, safety and easy production, innovative step control for

Marita CANINA; Federico VICENTINI; Alberto ROVETTA

349

Sequential estimation of intramuscular EMG model parameters for prosthesis control  

E-print Network

processing Prosthesis control is usually performed with surface EMG signals. The analysis of surface EMGSequential estimation of intramuscular EMG model parameters for prosthesis control Jonathan¨ottingen Georg-August University, Von-Siebold-Str. 4, 37075 G¨ottingen, Germany Abstract--EMG signals

Paris-Sud XI, Université de

350

An Electronic Prosthesis Mimicking the Dynamic Vestibular Andrei M. Shkela  

E-print Network

An Electronic Prosthesis Mimicking the Dynamic Vestibular Function Andrei M. Shkela a, USA 92697 ABSTRACT This paper reports our progress toward development of a unilateral vestibular the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate

Tang, William C

351

An Electronic Prosthesis Mimicking the Dynamic Vestibular Function  

E-print Network

An Electronic Prosthesis Mimicking the Dynamic Vestibular Function Jiayin Liu Mechanical function of a unilateral semicircular canal of the vestibular system. The circuitry is an integral part a prosthesis that matches the signal recorded from the vestibular nerve in squirrel monkey experiments reported

Tang, William C

352

Results after revision stapedectomy with malleus grip prosthesis.  

PubMed

Revision stapedectomy with a malleus grip prosthesis is a technically challenging otologic procedure. The prosthesis is usually longer and extends deeper into the vestibule than a conventional stapes prosthesis, creating the potential to affect the vestibular sense organs. The prosthesis also bypasses the ossicular joints, which are thought to play a role in protecting the inner ear from large changes in static pressure within the middle ear. The prosthesis is in close proximity to the tympanic membrane, thus increasing the risk for its extrusion. We reviewed our experience with revision stapedectomy with the Schuknecht Teflon-wire malleus grip prosthesis in 36 ears with a mean follow-up of 23 months. The air-bone gap was closed to within 10 dB in 16 ears (44%) and to within 20 dB in 26 ears (72%). The incidence of postoperative sensorineural hearing loss was 8% (3 ears). There were no dead ears. Extrusion of the prosthesis occurred in 1 case (3%). Nearly 50% of patients reported various degrees of vertigo or disequilibrium during the first 3 weeks after surgery. These vestibular symptoms resolved by 6 weeks in all but 1 case. We did not find evidence of damage to the inner ear due to the length of the prosthesis or due to the potential for direct transmission of changes in static pressures within the middle ear to the labyrinth. Our results are similar to those published in the literature for malleus attachment stapedectomy and conventional revision incus stapedectomy. PMID:16676830

Sarac, Sarp; McKenna, Michael J; Mikulec, Anthony A; Rauch, Steven D; Nadol, Joseph B; Merchant, Saumil N

2006-04-01

353

Polyethylene sponge total ossicular replacement prosthesis. A histopathologic study.  

PubMed

The histopathologic findings of a functioning high-density polyethylene sponge (Plastipore) total ossicular replacement prosthesis in a patient who died of unrelated causes are reported herein. The lack of inflammatory cell infiltration of foreign-body giant cells within, or adjacent to, the prosthesis helps substantiate the safety and efficacy of Plastipore in the reconstruction of the ossicular chain. PMID:7150073

Postma, D; Shea, J J

1982-12-01

354

Three-piece Inflatable Penile Prosthesis: Surgical Techniques and Pitfalls  

PubMed Central

Penile prosthesis surgery plays a vital role in the treatment of erectile dysfunction (ED). As far as outcome is concerned, it is one of the most rewarding procedures for both patients and surgeons. We describe our surgical technique for implantation of the three-piece inflatable penile prosthesis and point out the major surgical pitfalls accompanying this procedure and their specific management. The psychological outcome of penile prosthesis surgery is also discussed. Different surgical approaches are available when performing the procedure. A number of procedure-related problems can be encountered and a thorough knowledge of these is of paramount importance. Penile prosthesis surgery has a favorable psychological outcome. Surgery for implantation of an inflatable penile prosthesis is a rewarding procedure, with a high yield of patient satisfaction. Urologists should have thorough understanding of the surgical pitfalls peculiar to this procedure and their management. PMID:22413049

Al-Enezi, Ahmad; Al-Khadhari, Sulaiman; Al-Shaiji, Tariq F.

2011-01-01

355

Channel selection for simultaneous and proportional myoelectric prosthesis control of multiple degrees-of-freedom  

NASA Astrophysics Data System (ADS)

Objective. Recent studies have shown the possibility of simultaneous and proportional control of electrically powered upper-limb prostheses, but there has been little investigation on optimal channel selection. The objective of this study is to find a robust channel selection method and the channel subsets most suitable for simultaneous and proportional myoelectric prosthesis control of multiple degrees-of-freedom (DoFs). Approach. Ten able-bodied subjects and one person with congenital upper-limb deficiency took part in this study, and performed wrist movements with various combinations of two DoFs (flexion/extension and radial/ulnar deviation). During the experiment, high density electromyographic (EMG) signals and the actual wrist angles were recorded with an 8 × 24 electrode array and a motion tracking system, respectively. The wrist angles were estimated from EMG features with ridge regression using the subsets of channels chosen by three different channel selection methods: (1) least absolute shrinkage and selection operator (LASSO), (2) sequential feature selection (SFS), and (3) uniform selection (UNI). Main results. SFS generally showed higher estimation accuracy than LASSO and UNI, but LASSO always outperformed SFS in terms of robustness, such as noise addition, channel shift and training data reduction. It was also confirmed that about 95% of the original performance obtained using all channels can be retained with only 12 bipolar channels individually selected by LASSO and SFS. Significance. From the analysis results, it can be concluded that LASSO is a promising channel selection method for accurate simultaneous and proportional prosthesis control. We expect that our results will provide a useful guideline to select optimal channel subsets when developing clinical myoelectric prosthesis control systems based on continuous movements with multiple DoFs.

Hwang, Han-Jeong; Hahne, Janne Mathias; Müller, Klaus-Robert

2014-10-01

356

Simplified Design Equations for Class-E Neural Prosthesis Transmitters  

PubMed Central

Extreme miniaturization of implantable electronic devices is recognized as essential for the next generation of neural prostheses, owing to the need for minimizing the damage and disruption of the surrounding neural tissue. Transcutaneous power and data transmission via a magnetic link remains the most effective means of powering and controlling implanted neural prostheses. Reduction in the size of the coil, within the neural prosthesis, demands the generation of a high-intensity radio frequency magnetic field from the extracoporeal transmitter. The Class-E power amplifier circuit topology has been recognized as a highly effective means of producing large radio frequency currents within the transmitter coil. Unfortunately, design of a Class-E circuit is most often fraught by the need to solve a complex set of equations so as to implement both the zero-voltage-switching and zero-voltage-derivative-switching conditions that are required for efficient operation. This paper presents simple explicit design equations for designing the Class-E circuit topology. Numerical design examples are presented to illustrate the design procedure. PMID:23292784

Troyk, Philip; Hu, Zhe

2013-01-01

357

Prototype to product—developing a commercially viable neural prosthesis  

NASA Astrophysics Data System (ADS)

The Cochlear implant or 'Bionic ear' is a device that enables people who do not get sufficient benefit from a hearing aid to communicate with the hearing world. The Cochlear implant is not an amplifier, but a device that electrically stimulates the auditory nerve in a way that crudely mimics normal hearing, thus providing a hearing percept. Many recipients are able to understand running speech without the help of lipreading. Cochlear implants have reached a stage of maturity where there are now 170 000 recipients implanted worldwide. The commercial development of these devices has occurred over the last 30 years. This development has been multidisciplinary, including audiologists, engineers, both mechanical and electrical, histologists, materials scientists, physiologists, surgeons and speech pathologists. This paper will trace the development of the device we have today, from the engineering perspective. The special challenges of designing an active device that will work in the human body for a lifetime will be outlined. These challenges include biocompatibility, extreme reliability, safety, patient fitting and surgical issues. It is emphasized that the successful development of a neural prosthesis requires the partnership of academia and industry.

Seligman, Peter

2009-12-01

358

Bionic anklefoot prosthesis normalizes walking gait for persons with leg amputation  

E-print Network

Bionic ankle­foot prosthesis normalizes walking gait for persons with leg amputation Hugh M. Herr1 and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed the bionic prosthesis and using their own passive- elastic prosthesis to those of seven non-amputees during

Herr, Hugh

359

[Aortoenteric fistula secondary to aortobifemoral prosthesis infection].  

PubMed

We present the case of a 76 year-old man, intervened of an obstruction bilateral iliac by means of placement of a prosthesis aortobifemoral that presented pain in the grave left iliac and fever in needles of 39 degrees C to the five years of the intervention. In the physical exploration it highlighted a painful abdomen in the grave left iliac with signs of peritoneal irritation. In the laboratory tests a leukocytosis was detected with neutrophilia and negative culture. The computed thomography (CT) show the presence of gas bubbles around the prosthesis, as well as a liquid collection with areas necrotics in their interior that affected to the psoas and iliac muscles. In the same exploration the aspirative puncture with drainage of the absces demonstrated in the cultivations carried out in aerobic means the presence of Enterococcus faecalis and Enterobacter cloacae. When presenting a high gastrointestinal hemorrhage abruptly, he was practiced and gastroduodenal endoscope in which a aortoduodenal fistula was evidenced with having bled active. When a bypass extra-anatomic, the sick person will practice it died when presenting a shock abrupt hipovolemic that he didn't respond to the pertinent treatment. We analyze the approaches current diagnoses of infection of the vascular prosthesis and their more serious complication, the aortoenteric fistula (AEF) that either appears in the 0.3-5.9% of the patients who undergo prosthetic reconstruction of the abdominal aorta, for occlusive or aneurismal disease. We highlight the importance of carrying out a precocious diagnosis of the infection of the portion retroperitoneal of the vascular graft that, often, it is manifested with subtle and not specific clinical signs, with the techniques at the moment available as: the CT, fine needle aspiration guided by her, and to diminish the rates of mortality, from the current of 43%, until the most optimistic estimated in 19%. PMID:12108001

Gabriel Botella, F; Labiós Gómez, M; Ibáñez Gadea, L; Fácila Rubio, L; Carbonell Cantí, C

2002-05-01

360

Auricular Prosthesis-A Case Report  

PubMed Central

Loss of facial organs in an individual may be developmental anomalies or acquired. The missing parts of the face ear, eyes and nose are considered as maxillofacial defects which can be rehabilitated by the prosthesis and/or cosmetic surgeries. This art of science has developed into a more reliable and predictable process due to ever increasing development of materials and equipments used in the procedure. This article describes a simple technique to rehabilitate patients with auricular defects which are both aesthetically acceptable and economical for the individual. PMID:24596801

Ravuri, Rajyalakshmi; Bheemalingeshwarrao; Tella, Suchita; Thota, Kiran

2014-01-01

361

[Obturator dislocation--a rare complication of the total hip prosthesis. Case study].  

PubMed

The article presents the case of a 55-year-old patient with an injury of the right leg, which was due to a falling lightly at her buttocks during squatting. Patient was transferred to hospital with complaints of severe pain and limited motion in her right hip. In view of the patient's clinical status and following radiological diagnostic work-up, she was diagnosed with femoral neck fractures, the decision was made to perform a primary total hip arthroplasty (THA) using an lateral approach in the lateral decubitus position. A good clinical and radiological outcome was achieved. Patient after 12 days without complications was released home. After 4 days being home she was transferred to hospital again with complaints of severe pain and limited motion in her operated hip. On admission, her right lower leg was lying in an extremely rotated and abducted position. However, the extremity was neurologically intact with good pedal pulses. Physical examination and an initial anteroposterior radiograph showed obturator dislocation of the hip prosthesis. The decision was made to perform an open reduction. The operative problem in this particular case was removing the head of the prosthesis from the obturator foramen without making any jatrogenic harm. PMID:22420183

Niciejewski, Krzysztof; Banachowski, Witold; Kowalczyk, Adam

2011-01-01

362

Photovoltaic retinal prosthesis with high pixel density  

NASA Astrophysics Data System (ADS)

Retinal degenerative diseases lead to blindness due to loss of the `image capturing' photoreceptors, while neurons in the `image-processing' inner retinal layers are relatively well preserved. Electronic retinal prostheses seek to restore sight by electrically stimulating the surviving neurons. Most implants are powered through inductive coils, requiring complex surgical methods to implant the coil-decoder-cable-array systems that deliver energy to stimulating electrodes via intraocular cables. We present a photovoltaic subretinal prosthesis, in which silicon photodiodes in each pixel receive power and data directly through pulsed near-infrared illumination and electrically stimulate neurons. Stimulation is produced in normal and degenerate rat retinas, with pulse durations of 0.5-4 ms, and threshold peak irradiances of 0.2-10 mW mm-2, two orders of magnitude below the ocular safety limit. Neural responses were elicited by illuminating a single 70 µm bipolar pixel, demonstrating the possibility of a fully integrated photovoltaic retinal prosthesis with high pixel density.

Mathieson, Keith; Loudin, James; Goetz, Georges; Huie, Philip; Wang, Lele; Kamins, Theodore I.; Galambos, Ludwig; Smith, Richard; Harris, James S.; Sher, Alexander; Palanker, Daniel

2012-06-01

363

Photovoltaic Retinal Prosthesis with High Pixel Density  

PubMed Central

Retinal degenerative diseases lead to blindness due to loss of the “image capturing” photoreceptors, while neurons in the “image processing” inner retinal layers are relatively well preserved. Electronic retinal prostheses seek to restore sight by electrically stimulating surviving neurons. Most implants are powered through inductive coils, requiring complex surgical methods to implant the coil-decoder-cable-array systems, which deliver energy to stimulating electrodes via intraocular cables. We present a photovoltaic subretinal prosthesis, in which silicon photodiodes in each pixel receive power and data directly through pulsed near-infrared illumination and electrically stimulate neurons. Stimulation was produced in normal and degenerate rat retinas, with pulse durations from 0.5 to 4 ms, and threshold peak irradiances from 0.2 to 10 mW/mm2, two orders of magnitude below the ocular safety limit. Neural responses were elicited by illuminating a single 70 ?m bipolar pixel, demonstrating the possibility of a fully-integrated photovoltaic retinal prosthesis with high pixel density. PMID:23049619

Mathieson, Keith; Loudin, James; Goetz, Georges; Huie, Philip; Wang, Lele; Kamins, Theodore I.; Galambos, Ludwig; Smith, Richard; Harris, James S.; Sher, Alexander; Palanker, Daniel

2012-01-01

364

Extremely compliant and highly stretchable patterned graphene  

NASA Astrophysics Data System (ADS)

Graphene is intrinsically ultra-stiff in its plane. Its huge mechanical mismatch when interfacing with ultra-compliant biological tissues and elastomers (7-9 orders of magnitude difference in stiffness) poses significant challenge in its application to functional devices such as epidermal electronics and sensing prosthesis. We offer a feasible and promising solution to this significant challenge by suitably patterning graphene into a nanomesh. Through systematic coarse-grained simulations, we show that graphene nanomesh can be made extremely compliant with nearly zero stiffness up to about 20% elongation and then remain highly compliant up to about 50% elongation.

Zhu, Shuze; Huang, Yinjun; Li, Teng

2014-04-01

365

In vivo aerodynamic characteristics of the Nijdam voice prosthesis.  

PubMed

The Nijdam voice prosthesis is an indwelling valveless voice prosthesis for postlaryngectomy voice rehabilitation. The in vitro aerodynamic characteristics are reported to be comparable to that of the low-resistance Groningen voice prosthesis. Owing to the design of the prosthesis the airflow resistance depends on the shaft length of the voice prosthesis in relation to the thickness of the tracheo-oesophageal wall. As tissue characteristics of the patient's oesophageal mucosa could also be of importance, an in vivo study was found necessary. To assess in vivo characteristics the following parameters were recorded in 10 patients: intratracheal pressure, intraoesophageal pressure and airflow during phonation. At an airflow of 0.15 1/sec the transdevice pressure loss varied from 0.5 up to 7 kPa (mean 3.9 kPa). With an artificial increase of the tracheo-oesophageal wall thickness, transdevice pressure losses up to 13 kPa were found. Significant interindividual as well as intraindividual differences were noted. The airflow resistance of the Nijdam voice prosthesis in relation to the thickness of the tracheo-oesophageal wall was compared with the airflow resistance reported for various other voice prostheses. The in vivo aerodynamic characteristics of the Nijdam voice prosthesis found in this study indicate the need to modify the present design in order to improve its airflow resistance and to eliminate the influence of the thickness and tissue characteristics of the tracheo-oesophageal wall. PMID:9442834

Van den Hoogen, F J; Veenstra, A; Verkerke, G J; Schutte, H K; Manni, J J

1997-11-01

366

Aspiration of tracheoesophageal prosthesis in a laryngectomized patient  

PubMed Central

Background The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation We describe a case of tracheoesophageal prosthesis’ (TEP) aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature. PMID:22958961

2012-01-01

367

Testicular prosthesis in a Quarterhorse stallion: a case report.  

PubMed

A testicular prosthesis was surgically removed from the scrotum of a Quarterhorse stallion presented for evaluation of a large, firm, unilateral scrotal mass. The prosthesis was constructed from methyl methacrylate moulded around a roll of fiberglass casting tape. The prosthesis had been surgically implanted in the scrotum approximately 4 yr prior to presentation in order to give the appearance of 2 testicles in the scrotum for showing and breeding purposes. The horse had been used to successfully breed mares prior to presentation and produced 4.046 x 10(9) progressively motile, morphologically normal spermatozoa in an ejaculate collected 4 mo after surgery to remove the prosthesis. Ethical issues raised by this case are discussed. PMID:16727816

Perkins, N R; Frazer, G S; Threlfall, W R

1996-02-01

368

Analysis of the mechanical behavior of the Nijdam voice prosthesis.  

PubMed

The valveless Nijdam prosthesis is a new voice prosthesis for laryngectomized patients using tracheoesophageal speech. An "umbrella-like hat" covers the esophageal side of the tracheoesophageal fistula and is deformed during speech by air pressure. To decrease pressure loss during speech, a good understanding of the mechanical behavior is essential. In the present study, the Finite Element Method (FEM), used in engineering to analyze the mechanical behavior of complex structures, was applied to analyze eight possible improvements of the Nijdam prosthesis. This study found that, during speech, deformation of hat and soft tissue occur. Distinct differences in the hat's deformation of the eight models also were found. It is concluded that complex structures like the Nijdam prosthesis can be analyzed by FEM. An optimal model was found to decrease pressure loss while stresses in the device remain safe. PMID:9396682

Verkerke, G J; de Vries, M P; Schutte, H K; van den Hoogen, F J; Rakhorst, G

1997-12-01

369

Mechanical Specifications for a Closed Leaflet Valve Prosthesis.  

National Technical Information Service (NTIS)

The investigations described were intended to formulate mechanical specifications for the design of an artificial leaflet valve prosthesis. The research is part of a larger project founded upon the opinion that a detailed analysis of the behavior of the n...

E. P. M. Rousseau

1985-01-01

370

Retinal Prosthesis (PAT-APPL-10-918 112).  

National Technical Information Service (NTIS)

The invention is a retinal prosthesis with an improved configuration mounting necessary components within and surrounding the eye. The present invention better allows for the implantation of electronics within the delicate eye structure. The invention fur...

B. V. Mech, J. Little, N. Talbot, R. Greenberg

2004-01-01

371

Redesigning a prosthesis for a golfer with transhumeral amputation  

E-print Network

The objective of this thesis was to determine the motions needed in a prosthesis that would enable a transhumeral amputee professional golfer, Michael Gibson, to play golf with similar dynamics to those of a two-armed ...

Tsai, Helen

2009-01-01

372

A laboratory silicone for preclinical training in ear prosthesis.  

PubMed

This article describes an industrial elastic silicone as a material for the laboratory fabrication of ear prosthesis. It has been tested for toxicity in lab animals by the SGS India Pvt. Ltd and approved as a material to pass the parameter of abnormal toxicity. This material therefore can be safely recommended for laboratory exercise to fabricate facial prosthesis. The high cost of the maxillo facial silicone materials prohibits their use for facial prosthesis in pre-clinical training of post-graduate students in maxillofacial prosthodontics. For this reason, pre-clinical laboratory exercise in facial prosthesis is inadequate. A few institutions use polymethyl methacrylate resins which are rigid and do not have elastic characteristics of silicone, which is used for facial defects. This cost-effective industrial silicone material which mimics the elastic and color characteristics of the conventional silicones can be recommended for preclinical exercises. PMID:23956609

Anand, Vijay; Haribabu; Vimala; Gnanasamband, Vimala

2013-07-01

373

Galvanic gold plating for fixed dental prosthesis.  

PubMed

Metal ceramic partial fixed dental prostheses have been commonly used for the replacement of missing teeth for many years. Because of an increase in the price of gold, base metal alloys have been the choice of alloy for the fabrication of metal ceramic restorations in many dental clinics. Some major disadvantages of base metals are their corrosion and the dark coloration they may cause at the crown margins. This article describes a galvanic gold-plating technique, which is used to minimize corrosion and improve the esthetics of metal ceramic restorations fabricated with Cr-Co base metal alloys. This technique involves the deposition of a 6 ?m to 8 ?m 24 K gold layer directly onto the Cr-Co cast prosthesis framework. The technique improves metal surface properties, making them more biocompatible and usable, however, requires additional equipment and experienced laboratory technicians. Clinical studies should be performed to corroborate the long term success of this technique. PMID:24926220

Ozcelik, Tuncer Burak; Yilmaz, Burak

2013-07-01

374

Midterm outcomes of total cervical total disc replacement with Bryan prosthesis.  

PubMed

Short-term results have indicated that the Bryan cervical total disc replacement (TDR) favorably compares to anterior cervical decompression and fusion, while it is associated with fewer complications and higher levels of satisfaction. The aim of the present work was to assess the safety and efficacy of the device in the treatment for cervical degenerative disc disease, at 6-year follow-up. Fifty-eighty patients have performed their 6-year follow-up visit and have been analyzed clinically and radiologically. Clinical evaluation was based on neck disability index (NDI), visual analog scale (VAS), SF-36, and range of motion (ROM) at index levels. Each measurement was taken preoperatively and at 3 months, 6 months, 1 year, 3 years, and 6 years postoperatively. Complications and re-operations were also investigated. Occurrences of heterotopic ossifications (HO) and of adjacent level degeneration were detected by radiographs at 6-year follow-up. The mean NDI and VAS scores for arm and neck were significantly reduced for all postoperative periods compared with the average preoperative values. Motion was preserved at index levels (mean ROM = 8.6° ± 0.2° at 6 years), and 81.3 % of the segments were mobile at 6 years. HO was evident in 12/64 operated segments and not restricting the movement of the prosthesis in any case at 6-year follow-up. Six of sixty-four upper adjacent levels and 4/64 lower adjacent levels showed a slight degradation. There was 2 case of posterior migration of the prosthesis, which did not cause any clinical symptoms. No case showed evidence of subsidence, wear of the implant. At a 6-year follow-up, the cervical TDR using Bryan prosthesis displayed satisfactory clinical and radiographic outcomes without any significant complication. However, future efforts need to be directed toward the evaluation of a larger number of patients with longer follow-up. PMID:24515394

Zhang, Zhenxiang; Zhu, Wei; Zhu, Lixian; Du, Yaqing

2014-07-01

375

Microfluidic neurotransmiter-based neural interfaces for retinal prosthesis.  

PubMed

Natural inter-neuronal communication is mediated primarily via neurotransmitter-gated ion channels. While most of the methods for neural interfacing have been based upon electrical stimulation, neurotransmitter-based approaches for the spatially and temporally controlled delivery of neurotransmitters are relatively new. Methods of neurotransmitter stimulation retinal prosthesis may provide new ways to control neural excitation. Experimental results for retinal ganglion cell stimulation demonstrate the feasibility of a neurotransmitter-based retinal prosthesis. PMID:19963838

Iezzi, Raymond; Finlayson, Paul; Xu, Yong; Katragadda, Rakesh

2009-01-01

376

Midterm clinical results of the Autocentric II patellofemoral prosthesis  

Microsoft Academic Search

We studied the outcome of patellofemoral arthroplasties using the Autocentric prosthesis implanted in our clinic between 1994\\u000a and 2004. New insight on indications and contraindications motivated us to find risk factors in the failure of this prosthesis.\\u000a Twenty-four patients had surgery for patellofemoral arthritis not responding to exhaustive nonoperative measures. The mean\\u000a age at the time of patellofemoral arthroplasty (PFA)

J. M. F. van Wagenberg; B. Speigner; T. Gosens; J. de Waal Malefijt

2009-01-01

377

[Radiologic signal of dehiscence of Starr-Edwards aortic prosthesis].  

PubMed

A male 54 years-old patient with infective endocarditis through Staphylococcus aureus with prosthesis of Starr-Edwards aortic with clinical and echocardiographic signs compatible with dysfunction classified as severe. The x-ray images presented double silhouette of the prosthesis, thus suggesting its partial dehiscence. This case report points out that the detailed analysis of the X-ray may supply relevant data for the diagnosis of one of this complication thus influencing on management and prognosis. PMID:7980079

Jorge, S do C; Arnoni, A S; Sejópoles, J A; Paulista, P P; Souza, L C; Assef, J E; Piegas, L S; Magalhães, H M; Sousa, J E

1994-03-01

378

Light-controlled pupil size for ocular prosthesis  

NASA Astrophysics Data System (ADS)

Ocular prosthesis requires great skill in craftsmanship and technology to match the appearance of the natural eye for cosmetic reasons. All the effort and cost going into the prosthesis is neutralized by the effect of a fixed pupil size. The possibility of replacing the fixed pupil in the prosthetic eye with a light controlled liquid crystal light valve (LCLV), to match the pupil size of the healthy eye, is discussed.

Leuschner, F. Wilhelm

1992-08-01

379

21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.  

Code of Federal Regulations, 2010 CFR

...an uncemented acetabular component, prosthesis. 888.3330 Section 888.3330...an uncemented acetabular component, prosthesis. (a) Identification. A hip...an uncemented acetabular component, prosthesis is a two-part device...

2010-04-01

380

21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.  

Code of Federal Regulations, 2010 CFR

...with a cemented acetabular component, prosthesis. 888.3320 Section 888.3320...with a cemented acetabular component, prosthesis. (a) Identification. A hip...with a cemented acetabular component, prosthesis is a two-part device...

2010-04-01

381

Esthetic interim acrylic resin prosthesis reinforced with metal casting.  

PubMed

Fabrication of an interim prosthesis is an important procedure in oral rehabilitation because it aids in determining the esthetics, phonetics, and occlusal relationship of the definitive restoration. The typical material (acrylic resin) used in interim prostheses commonly fails due to fractures. During extended oral rehabilitation with fixed partial prostheses, high strength interim prostheses are often required to protect hard and soft tissues, avoid dental mobility, and to allow the clinician and patient a chance to evaluate cosmetics and function before the placement of the definitive prosthesis. Furthermore, a satisfactory interim prosthesis can serve as a template for the construction of the definitive prosthesis. The maintenance of this prosthesis is important during treatment for protection of teeth and occlusal stability. Procedures to reinforce interim prostheses help to improve performance and esthetics in long-term treatment. Due to the low durability of acrylic resin in long-term use, the use of reinforcing materials, such as metal castings or spot-welded stainless steel matrix bands, is indicated in cases of extensive restoration and long-term treatment. This paper describes an easy technique for fabricating a fixed interim prosthesis using acrylic resin and a cast metallic reinforcement. PMID:19519710

Verri, Fellippo Ramos; Pellizzer, Eduardo Piza; Mazaro, José Vitor Quinelli; de Almeida, Erika Oliveira; Antenucci, Rosse Mary Falcón

2009-08-01

382

Mastication improvement after partial implant-supported prosthesis use.  

PubMed

Partially edentulous patients may be rehabilitated by the placement of removable dental prostheses, implant-supported removable dental prostheses, or partial implant fixed dental prostheses. However, it is unclear the impact of each prosthesis type over the masticatory aspects, which represents the objective of this paired clinical trial. Twelve patients sequentially received and used each of these 3 prosthesis types for 2 months, after which maximum bite force was assessed by a strain sensor and food comminution index was determined with the sieving method. Masseter and temporal muscle thicknesses during rest and maximal clenching were also evaluated by ultrasonography. Each maxillary arch received a new complete denture that was used throughout the study. Data were analyzed by analysis of variance for repeated measures, followed by the Tukey test (p < .05). Maximum bite force and food comminution index increased (p < .0001) after implant-supported dental prosthesis and implant fixed dental prosthesis use, with the higher improvement found after the latter's use. Regardless of implant-retained prosthesis type, masseter muscle thickness during maximal clenching also increased (p < .05) after implant insertion. Partial implant-supported prostheses significantly improved masseter muscle thickness and mastication, and the magnitude of this effect was related to prosthesis type. PMID:24158344

Gonçalves, T M S V; Campos, C H; Gonçalves, G M; de Moraes, M; Rodrigues Garcia, R C M

2013-12-01

383

Ischemic Gangrene of the Glans following Penile Prosthesis Implantation  

PubMed Central

The development of ischemic gangrene of the penis following implantation of prosthesis is unusual, and very few cases are available in the literature. As a result, no established treatment protocol is available. We report our experience within a case of gangrene of the glans following implantation of a three-component prosthesis. We present a 53-year-old male, smoker with diabetes and hypercholesterolemia, who underwent surgery for the insertion of a penile prosthesis with 3 components to correct his erectile dysfunction and severe Peyronie's disease. The procedure was carried out without incidents. During the postoperative period, the patient began to complain from penile and perineal pain. He developed avascular necrosis of the glans. The necrosed area was excised. Four weeks later, he developed fever and perineal pain arriving to the emergency room with the prosthesis extruding through the glans. He had emergency surgery to remove the prosthesis plus surgical lavage and was prescribed broad-spectrum antibiotic therapy. Four weeks later, the penis was completely revascularized and reepithelialized. Ischemic gangrene following penile prosthesis implantation takes place in patients with poor peripheral vascularisation. Diabetes mellitus has been the common denominator to all of the reported cases. PMID:23956919

Garcia Gomez, Borja; Romero Otero, Javier; Diez Sicilia, Laura; Jimenez Alcaide, Estibaliz; Garcia-Cruz, Eduardo; Rodriguez Antolin, Alfredo

2013-01-01

384

Dielectric elastomers as actuators for upper limb prosthetics: Challenges and opportunities  

Microsoft Academic Search

Recent research has indicated that consumers of upper limb prostheses desire lighter-weight, anthropomorphic devices. The potential of dielectric elastomer (DE) actuators to better meet the design priorities of prosthesis users is explored. Current challenges are critically reviewed with respect to (1) durability, (2) precision control, (3) energy consumption, and (4) anthropomorphic implementation. The key points arising from the literature review

Elaine Biddiss; Tom Chau

2008-01-01

385

Extreme Adventure  

NSDL National Science Digital Library

Do you have what it takes to win the Ultimate Race? Find out with the Tryscience Extreme Challenge! Compete on seven courses in four sports - mountain biking, kayaking, rock climbing and snowboarding. You must train and apply the science behind the sport to beat the challenge time and earn each course medal.

2007-12-12

386

Extreme Ice  

NSDL National Science Digital Library

This activity students through the ways scientists monitor changes in Earth's glaciers, ice caps, and ice sheets. Students investigate about glacier locations, glacial movement, and impacts of climate change on glaciers depending on the depth of research. It is linked to 2009 PBS Nova program entitled Extreme Ice.

Kuntz, Margy; Teachers, Pbs

387

An harmonic smile resulted from the use of ceramic prosthesis with zirconia structure: a case report.  

PubMed

The rehabilitation of patients requiring an esthetic smile demands a multidisciplinary approach. This clinical report describes a treatment plan for recovery aesthetics' smile of anterior teeth using ceramic prosthesis with zirconia structure. Initially, a review of aesthetic parameters, diagnostic waxing, mock-up and provisional restorations was performed. A contextual assessment of aesthetic, proportion and shape of teeth was done to recreate a natural looking for teeth in consonance with the smile line. Subsequently, based on these parameters, fixed prostheses of the upper anterior teeth using ceramic restorations with zirconia infrastructures were performed. The use of ceramic restorations with zirconia structures associated with a careful treatment plan allows the professional to integrate esthetic and function for satisfactory clinical results. How to cite the article: Tavarez RR, Gonçalves LM, Dias AP, Dias AC, Malheiros AS, Silva AC, Bandeca MC. An harmonic smile resulted from the use of ceramic prosthesis with zirconia structure: A case report. J Int Oral Health 2014;6(3):90-2. PMID:25083040

Tavarez, Rudys Rodolfo de Jesus; Goncalves, Leticia Machado; Dias, Ana Paula; Dias, Anna Claudia Pereira; Malheiros, Adriana Santos; Silva, Alice Carvalho; Bandeca, Matheus Coelho

2014-06-01

388

Automated estimation of hip prosthesis migration: a feasibility study  

NASA Astrophysics Data System (ADS)

A common complication associated with hip arthoplasty is prosthesis migration, and for most cemented components a migration greater than 0.85 mm within the first six months after surgery, are an indicator for prosthesis failure. Currently, prosthesis migration is evaluated using X-ray images, which can only reliably estimate migrations larger than 5 mm. We propose an automated method for estimating prosthesis migration more accurately, using CT images and image registration techniques. We report on the results obtained using an experimental set-up, in which a metal prosthesis can be translated and rotated with respect to a cadaver femur, over distances and angles applied using a combination of positioning stages. Images are first preprocessed to reduce artefacts. Bone and prosthesis are extracted using consecutive thresholding and morphological operations. Two registrations are performed, one aligning the bones and the other aligning the prostheses. The migration is estimated as the difference between the found transformations. We use a robust, multi-resolution, stochastic optimization approach, and compare the mean squared intensity differences (MS) to mutual information (MI). 30 high-resolution helical CT scans were acquired for prosthesis translations ranging from 0.05 mm to 4 mm, and rotations ranging from 0.3° to 3° . For the translations, the mean 3D registration error was found to be 0.22 mm for MS, and 0.15 mm for MI. For the rotations, the standard deviation of the estimation error was 0.18° for MS, and 0.08° for MI. The results show that the proposed approach is feasible and that clinically acceptable accuracies can be obtained. Clinical validation studies on patient images will now be undertaken.

Vandemeulebroucke, Jef; Deklerck, Rudi; Temmermans, Frederik; Van Gompel, Gert; Buls, Nico; Scheerlinck, Thierry; de Mey, Johan

2013-09-01

389

Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy  

ERIC Educational Resources Information Center

The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

2011-01-01

390

21 CFR 888.3530 - Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis.  

Code of Federal Regulations, 2011 CFR

...false Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis...3530 Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis... A knee joint femorotibial metal/polymer semi-constrained cemented...

2011-04-01

391

21 CFR 888.3520 - Knee joint femorotibial metal/polymer non-constrained cemented prosthesis.  

Code of Federal Regulations, 2011 CFR

...false Knee joint femorotibial metal/polymer non-constrained cemented prosthesis...3520 Knee joint femorotibial metal/polymer non-constrained cemented prosthesis... A knee joint femorotibial metal/polymer non-constrained cemented...

2011-04-01

392

21 CFR 888.3550 - Knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis.  

Code of Federal Regulations, 2011 CFR

...false Knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis...3550 Knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis...Identification. A knee joint patellofemorotibial polymer/metal/metal constrained...

2011-04-01

393

21 CFR 888.3565 - Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis.  

Code of Federal Regulations, 2011 CFR

...Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis...Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis...knee joint patellofemorotibial metal/polymer porous-coated uncemented...

2011-04-01

394

21 CFR 888.3565 - Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis...Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis...knee joint patellofemorotibial metal/polymer porous-coated uncemented...

2010-04-01

395

21 CFR 888.3530 - Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...false Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis...3530 Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis... A knee joint femorotibial metal/polymer semi-constrained cemented...

2010-04-01

396

The Boston retinal prosthesis a 15-channel hermetic wireless neural stimulator  

E-print Network

A miniaturized, hermetically-encased, wirelessly-operated retinal prosthesis has been developed for pre-clinical studies in Yucatan minipig animal models. The prosthesis attaches conformally to the outside of the eye and ...

Wyatt, John L.

397

Fixation of the reversed shoulder prosthesis.  

PubMed

The last decade has seen an increased interest in reversed shoulder prostheses. Success rates with these designs have been varied, with initial performance marred by failures resulting from improper implant alignment and an emerging engineering understanding. Competitor products to the well-documented Grammont design have yielded increasingly high success rates. Understanding the relationships between implant design, surgical procedure, and clinical outcome is important so that current results can be improved upon. This study considers the performance of 3 different reversed shoulder designs from the perspective of osseointegration, with the results broadly validated through comparison with experimental data. Finite element modeling was used to clarify the relationships between lateral offset of the center of rotation, screw insertion angle, screw length, screw diameter, bone material quality, and the potential for interdigitation of the supporting bone onto the reversed prosthesis. The results indicate that screw length, insertion angle, and diameter, when maximized, allow the least relative motion between the implant and underlying bone. When the bone is stiffer, the relative motion of the implant is lower. In almost all scenarios modeled, the interface micromotion was small enough to suggest that the glenoid was stable enough to encourage bone ingrowth across the majority of the bone-implant interfaces. PMID:18760632

Hopkins, Andrew R; Hansen, Ulrich N; Bull, Anthony M J; Emery, Roger; Amis, Andrew A

2008-01-01

398

Finite element modeling of retinal prosthesis mechanics  

NASA Astrophysics Data System (ADS)

Epiretinal prostheses used to treat degenerative retina diseases apply stimulus via an electrode array fixed to the ganglion cell side of the retina. Mechanical pressure applied by these arrays to the retina, both during initial insertion and throughout chronic use, could cause sufficient retinal damage to reduce the device's effectiveness. In order to understand and minimize potential mechanical damage, we have used finite element analysis to model mechanical interactions between an electrode array and the retina in both acute and chronic loading configurations. Modeling indicates that an acute tacking force distributes stress primarily underneath the tack site and heel edge of the array, while more moderate chronic stresses are distributed more evenly underneath the array. Retinal damage in a canine model chronically implanted with a similar array occurred in correlating locations, and model predictions correlate well with benchtop eyewall compression tests. This model provides retinal prosthesis researchers with a tool to optimize the mechanical electrode array design, but the techniques used here represent a unique effort to combine a modifiable device and soft biological tissues in the same model and those techniques could be extended to other devices that come into mechanical contact with soft neural tissues.

Basinger, B. C.; Rowley, A. P.; Chen, K.; Humayun, M. S.; Weiland, J. D.

2009-10-01

399

[Septic loosing of hip and knee prosthesis].  

PubMed

Loosening of an artificial joint is a common complication in orthopedic surgery. It is estimated that bacteriological implant contamination is responsible for its loosening in 2-5 percent of cases, and in most cases aseptic loosening takes place. Despite low percentage of positive microbiological studies, histopathological examinations and modern laboratory techniques, including PCR (Polymerase Chain Reaction) allow to diagnose the bacterial contamination of the loose implant to ca 70 percent. Those observations point out to the high coincidence of bacterial contamination with implant loosening strongly suggesting its influence on activation of the inflammatory process destabilizing an implant. But the question, why in those cases bacterial contamination does not lead to clinically obvious suppuration, remains unknown. The possibility to activate the immune system by the subcellular elements of the bacterial cells leading to persistent inflammation with granulation tissue formation is likely. Presented paper discusses the process of orthopedic prosthesis loosening, the role of bacterial contamination in it. and the newest techniques for their examination. PMID:16294691

Szczesny, Grzegorz; Babiak, Ireneusz; Kowalewski, Micha?; Górecki, Andrzej

2005-01-01

400

Cervical disc prosthesis replacement and interbody fusion: a comparative study.  

PubMed

The purpose of this paper is to compare the new functional intervertebral cervical disc prosthesis replacement and the classical interbody fusion operation, including the clinical effect and maintenance of the stability and segmental motion of cervical vertebrae. Twenty-four patients with single C5-6 intervertebral disk hernias were specifically selected and divided randomly into two groups: One group underwent artificial cervical disc replacement and the other group received interbody fusion. All patients were followed up and evaluated. The operation time for the single disc replacement was (130 +/- 50) minutes and interbody fusion was (105 +/- 53) minutes. Neurological or vascular complications were not observed during or after operation. There was no prosthesis subsidence or extrusion. The JOA score of the group with prosthesis replacement increased from an average of 8.6 to 15.8. The JOA score of the group with interbody fusion increased from an average of 9 to 16.2. The clinical effect and the ROM of the adjacent space of the two groups showed no statistical difference. The short follow-up time does not support the advantage of the cervical disc prosthesis. The clinical effect and the maintenance of the function of the motion of the intervertebral space are no better than the interbody fusion. At least 5 years of follow-up is needed to assess the long-term functionality of the prosthesis and the influence on adjacent levels. PMID:17180356

Peng-Fei, Sun; Yu-Hua, Jia

2008-02-01

401

Aerodynamic characteristics of the Nijdam voice prosthesis in relation to tracheo-esophageal wall thickness.  

PubMed

Tracheo-esophageal speech using various prostheses is currently the most successful form of voice and speech rehabilitation for laryngectomies. Main inter-device differences are durability and trans-device pressure loss during speech. The valveless indwelling Nijdam voice prosthesis is a new voice prosthesis. A barrier mechanism is created by a combination of the esophageal mucosa and the umbrella-like "hat" of the prosthesis that covers the esophageal side of the tracheo-esophageal fistula. The Nijdam prosthesis can be used clinically for longer periods of time when compared to such other indwelling voice prostheses as the Provox prosthesis and the low-resistance Groningen prosthesis. However, transdevice pressure loss during speech has been unknown. Adjustment of the shft length of the Nijdam voice prosthesis to tracheo-esophageal wall thickness was expected to affect trans-device pressure loss during speech. We report the results of in vitro tests to quantify the effect of tracheo-esophageal wall thickness on trans-device pressure loss. In the present study pressure loss was measured at different air flow rates in relation to tracheo-esophageal wall thickness. Findings demonstrated that when shaft length of the Nijdam prosthesis corresponded exactly to tracheo-esophageal wall thickness, trans-device pressure loss was comparable to that of the Provox prosthesis. If a relatively shorter Nijdam prosthesis was chosen to prevent aspiration from occurring, the pressure loss across the prosthesis increased to that of the low-resistance Groningen prosthesis. PMID:9115703

Veenstra, A; van den Hoogen, F J; Schutte, H K; Nijdam, H F; Manni, J J; Verkerke, G J

1997-01-01

402

Penile Prosthesis Insertion With Corporeal Reconstruction With Synthetic Vascular Graft Material  

Microsoft Academic Search

Difficulty with penile prosthesis insertion may be encountered in patients with severe cavernous scarring or tunica albuginea deficiencies. Eleven patients who underwent penile prosthesis implantation required simultaneous corporeal reconstruction due to prior prosthesis infection and\\/or erosion in 6, priapism in 2 and Peyronie's disease in 1. One patient underwent prior neophallus construction with a tubularized abdominal wall flap for gender

Sender Herschorn; Raul C. Ordorica

1995-01-01

403

Design and Evaluation of a Biomimetic Agonist-Antagonist Active Knee Prosthesis  

E-print Network

Design and Evaluation of a Biomimetic Agonist-Antagonist Active Knee Prosthesis by ARCHIVES Ernesto;Design and Evaluation of a Biomimetic Agonist-Antagonist Active Knee Prosthesis by Ernesto Carlos. This thesis presents the design and evaluation of a novel biomimetic active knee prosthesis capable

Herr, Hugh

404

Study of a Pendulum in Vivo Electromechanical Generator to be Used in a Knee Prosthesis  

E-print Network

Study of a Pendulum in Vivo Electromechanical Generator to be Used in a Knee Prosthesis Sylvie is intended to be used in intelligent knee prosthesis. As the combined human, mechanical, and electrical, human-powered systems, direct drive generator, knee prosthesis. Nomenclature UHMWPE = Ultra

Paris-Sud XI, Université de

405

Preliminary Evaluations of a Self-Contained Anthropomorphic Transfemoral Prosthesis  

PubMed Central

This paper presents a self-contained powered knee and ankle prosthesis, intended to enhance the mobility of transfemoral amputees. A finite-state based impedance control approach, previously developed by the authors, is used for the control of the prosthesis during walking and standing. Experiments on an amputee subject for level treadmill and overground walking are described. Knee and ankle joint angle, torque, and power data taken during walking experiments at various speeds demonstrate the ability of the prosthesis to provide a functional gait that is representative of normal gait biomechanics. Measurements from the battery during level overground walking indicate that the self-contained device can provide more than 4500 strides, or 9 km, of walking at a speed of 5.1 km/h between battery charges. PMID:20054424

Sup, Frank; Varol, Huseyin Atakan; Mitchell, Jason; Withrow, Thomas J.; Goldfarb, Michael

2009-01-01

406

An electronic prosthesis mimicking the dynamic vestibular function  

NASA Astrophysics Data System (ADS)

This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular motion is translated into voltage pulses. The voltage pulses are converted into current pulses and are delivered through specially designed electrodes, conditioned to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular neurons to those in animal models reported in the literature. The proposed design is scalable; the sensing unit, pulse generator, and the current source can be potentially implemented on a single chip using integrated MEMS technology.

Shkel, Andrei M.

2006-03-01

407

Spontaneous bilateral rod fracture of malleable penile prosthesis  

PubMed Central

Mechanical failure with a malleable penile prosthesis is very rare. To the best of our knowledge, this is the first case reporting on a bilateral AMS 650 rod mechanical failure. We present a 50-year-old man with organic erectile dysfunction who experienced bilateral AMS 650 rod fracture after 14 years. The rod fracture of the left side was confirmed via X-ray preoperatively. The surgical exploration revealed a fracture of both rods. After the removal of both rods, we implanted a new malleable device during the same session. At the 6-month follow-up, the patient was satisfied with his prosthesis.

Bozkurt, Ibrahim Halil; Yonguc, Tarik; Arslan, Burak; Kozacioglu, Zafer; Degirmenci, Tansu; Polat, Salih; Minareci, Suleyman

2014-01-01

408

An investigation into vascular prosthesis modified with an electron beam.  

PubMed

The present paper shows the results of an investigation into the effect of implanted electric charge on blood platelet adhesion to woven surfaces of "Dallon" polyester vascular prosthesis. The electrets were formed using the electron beam method. The assessment of the electret effect on blood platelet adhesion was performed on the basis of microscopic studies. It was shown that an implanted negative electric charge remarkably suppresses thrombocyte adhesion to the prosthesis surface. The electret effect was found to play a significant role in the process of preparing nonthrombogenic surfaces. PMID:9513250

Lowkis, B; Szymonowicz, M; Rutkowski, J

1997-01-01

409

Photovoltaic retinal prosthesis: implant fabrication and performance  

NASA Astrophysics Data System (ADS)

The objective of this work is to develop and test a photovoltaic retinal prosthesis for restoring sight to patients blinded by degenerative retinal diseases. A silicon photodiode array for subretinal stimulation has been fabricated by a silicon-integrated-circuit/MEMS process. Each pixel in the two-dimensional array contains three series-connected photodiodes, which photovoltaically convert pulsed near-infrared light into bi-phasic current to stimulate nearby retinal neurons without wired power connections. The device thickness is chosen to be 30 µm to absorb a significant portion of light while still being thin enough for subretinal implantation. Active and return electrodes confine current near each pixel and are sputter coated with iridium oxide to enhance charge injection levels and provide a stable neural interface. Pixels are separated by 5 µm wide trenches to electrically isolate them and to allow nutrient diffusion through the device. Three sizes of pixels (280, 140 and 70 µm) with active electrodes of 80, 40 and 20 µm diameter were fabricated. The turn-on voltages of the one-diode, two-series-connected diode and three-series-connected diode structures are approximately 0.6, 1.2 and 1.8 V, respectively. The measured photo-responsivity per diode at 880 nm wavelength is ˜0.36 A W-1, at zero voltage bias and scales with the exposed silicon area. For all three pixel sizes, the reverse-bias dark current is sufficiently low (<100 pA) for our application. Pixels of all three sizes reliably elicit retinal responses at safe near-infrared light irradiances, with good acceptance of the photodiode array in the subretinal space. The fabricated device delivers efficient retinal stimulation at safe near-infrared light irradiances without any wired power connections, which greatly simplifies the implantation procedure. Presence of the return electrodes in each pixel helps to localize the current, and thereby improves resolution.

Wang, Lele; Mathieson, K.; Kamins, T. I.; Loudin, J. D.; Galambos, L.; Goetz, G.; Sher, A.; Mandel, Y.; Huie, P.; Lavinsky, D.; Harris, J. S.; Palanker, D. V.

2012-08-01

410

Photovoltaic retinal prosthesis: implant fabrication and performance  

PubMed Central

Objective To develop and test a photovoltaic retinal prosthesis for restoring sight to patients blinded by degenerative retinal diseases. Approach A silicon photodiode array for subretinal stimulation has been fabricated by a silicon-integrated-circuit/MEMS process. Each pixel in the two-dimensional array contains three series-connected photodiodes, which photovoltaically convert pulsed near-infrared light into bi-phasic current to stimulate nearby retinal neurons without wired power connections. The device thickness is chosen to be 30 ?m to absorb a significant portion of light while still being thin enough for subretinal implantation. Active and return electrodes confine current near each pixel and are sputter coated with iridium oxide to enhance charge injection levels and provide a stable neural interface. Pixels are separated by 5 ?m-wide trenches to electrically isolate them and to allow nutrient diffusion through the device. Three sizes of pixels (280?m, 140 ?m, and 70 ?m) with active electrodes of 80 ?m, 40 ?m and 20 ?m in diameter were fabricated. Main results The turn-on voltages of one-, two- and three-series-connected photodiode structures are approximately 0.6V, 1.2V and 1.8V, respectively. The measured photo-responsivity per diode at 880 nm wavelength is ~0.36 A/W, at zero voltage bias and scales with the exposed silicon area. For all three pixel sizes, the reverse-bias dark current is sufficiently low (<100 pA) for our application. Pixels of all three sizes reliably elicit retinal responses at safe near-infrared light irradiances, with good acceptance of the photodiode array in the subretinal space. Significance The fabricated device delivers efficient retinal stimulation at safe near-infrared light irradiances without any wired power connections, which greatly simplifies the implantation procedure. Presence of the return electrodes in each pixel helps to localize the current, and thereby improves resolution. PMID:22791690

Wang, Lele; Mathieson, K; Kamins, T I; Loudin, J D; Galambos, L; Goetz, G; Sher, A; Mandel, Y; Huie, P; Lavinsky, D; Harris, J S; Palanker, D V

2012-01-01

411

In vivo performance of photovoltaic subretinal prosthesis  

NASA Astrophysics Data System (ADS)

We have developed a photovoltaic retinal prosthesis, in which camera-captured images are projected onto the retina using pulsed near-IR light. Each pixel in the subretinal implant directly converts pulsed light into local electric current to stimulate the nearby inner retinal neurons. 30 ?m-thick implants with pixel sizes of 280, 140 and 70 ?m were successfully implanted in the subretinal space of wild type (WT, Long-Evans) and degenerate (Royal College of Surgeons, RCS) rats. Optical Coherence Tomography and fluorescein angiography demonstrated normal retinal thickness and healthy vasculature above the implants upon 6 months follow-up. Stimulation with NIR pulses over the implant elicited robust visual evoked potentials (VEP) at safe irradiance levels. Thresholds increased with decreasing pulse duration and pixel size: with 10 ms pulses it went from 0.5 mW/mm2 on 280 ?m pixels to 1.1 mW/mm2 on 140 ?m pixels, to 2.1 mW/mm2 on 70 ?m pixels. Latency of the implant-evoked VEP was at least 30 ms shorter than in response evoked by the visible light, due to lack of phototransduction. Like with the visible light stimulation in normal sighted animals, amplitude of the implant-induced VEP increased logarithmically with peak irradiance and pulse duration. It decreased with increasing frequency similar to the visible light response in the range of 2 - 10 Hz, but decreased slower than the visible light response at 20 - 40 Hz. Modular design of the photovoltaic arrays allows scalability to a large number of pixels, and combined with the ease of implantation, offers a promising approach to restoration of sight in patients blinded by retinal degenerative diseases.

Mandel, Yossi; Goetz, George; Lavinsky, Daniel; Huie, Phil; Mathieson, Keith; Wang, Lele; Kamins, Theodore; Manivanh, Richard; Harris, James; Palanker, Daniel

2013-02-01

412

Lightweight acrylic resin facial prosthesis for maxillofacial defects: a fabrication and retention method.  

PubMed

Extraoral maxillofacial rehabilitation for compromised or lost facial anatomy resulting from the surgical eradication of malignancy, trauma, or congenital anomalies is commonly accomplished with a silicone prosthesis. However, with increasing size and weight, a silicone prosthesis can lose retention. This report presents 2 patient treatments to introduce a fabrication and retention method for a lightweight acrylic resin facial prosthesis. The prosthesis was fabricated by bonding an acrylic resin facial shell to a computer-edited facial image printed with iron-on transfers. The completed prosthesis was attached to the skin with medical-grade double-sided adhesive tape, which maintained a tight marginal seal even when in contact with saliva and water. The strong prosthetic retention of the lightweight prosthesis enabled orofacial and speech rehabilitation, which makes it a promising alternative to the conventional silicone prosthesis, especially for the restoration of extensive maxillofacial defects. PMID:24079569

Nomura, Takayoshi; Sato, Junichi; Matsuura, Masaro; Kawaguchi, Koji; Sekiguchi, Rei; Horie, Akihisa; Seto, Kanichi

2013-10-01

413

Comparison of a new mobile-bearing total knee prosthesis with a fixed-bearing prosthesis: a matched pair analysis  

Microsoft Academic Search

Background  New prosthesis designs should provide either superior function or durability. Before long time follow up studies are started\\u000a it should at least prove its effectiveness in clinical outcomes. Therefore we have studied the early clinical results of a\\u000a new mobile bearing total knee prosthesis (e.motion; Aesculap®) in comparison with our established fixed-bearing device (PFC; DePuy®) in a matched-pair analysis.\\u000a \\u000a \\u000a \\u000a Patients

Florian Geiger; Hans Mau; Marlis Krüger; Marc Thomsen

2008-01-01

414

Studies on control commands for FES in the paralyzed extremities  

Microsoft Academic Search

A description of commands for controlling the paralyzed upper extremities by functional electrical stimulation (FES) is given. Respiration was used for restoration of totally paralyzed upper limbs in C4 quadriplegic patients. The paralyzed hand in C6-7 quadriplegics was volitionally controlled by wrist movements of the patient. EMG control of the paralyzed upper limbs is also described

T. Handa; Y. Handa; M. Ichie; J. Kameyama; H. Takahashi; M. Yajima; T. Itoh; N. Hoshimiya

1989-01-01

415

Total hip replacement with the "Biodirect" cementless prosthesis.  

PubMed

The authors discuss the biomechanical features of the "Biodirect" cementless prosthesis, which has been used for over 6 years in the treatment of displaced femoral neck fractures. The long-term clinical and radiographic results of this study were generally favorable and seemed directly proportional to the accuracy of the implantation technique. PMID:1894518

Agrifoglio, E; Sanguineti, F; Di Stadio, M

1991-03-01

416

Groningen temporomandibular joint prosthesis. Development and first clinical application  

Microsoft Academic Search

Patients with a severely degenerated temporomandibular joint (TMJ) may benefit from an alloplastic TMJ replacement. The aim of the study was to develop a safe and properly functioning TMJ prosthesis. The design was based on imitation of anterior condylar translation by an inferiorly located centre of rotation, unrestricted mandibular movements by a double articulation, correct fit to the skull by

J.-P. van Loon; L. G. M. de Bont; B. Stegenga; F. K. L. Spijkervet; G. J. Verkerke

2002-01-01

417

A neural interface for a cortical vision prosthesis  

Microsoft Academic Search

The development of a cortically based vision prosthesis has been hampered by a lack of basic experiments on phosphene psychophysics. This basic research has been hampered by the lack of a means to safely stimulate large numbers of cortical neurons. Recently, a number of laboratories have developed arrays of silicon microelectrodes that could enable such basic studies on phosphene psychophysics.

Richard A Normann; Edwin M Maynard; Patrick J Rousche; David J Warren

1999-01-01

418

Bone ingrowth in a shoulder prosthesis MSC Thesis, Applied Mathematics  

E-print Network

Bone ingrowth in a shoulder prosthesis MSC Thesis, Applied Mathematics E.M.van Aken 1107895.1 Fracture healing after 2.4 days . . . . . . . . . . . . . . . . . . . 28 6.2 Fracture healing after 4 days . . . . . . . . . . . . . . . . . . . . 29 6.3 Fracture healing after 8 days . . . . . . . . . . . . . . . . . . . . 30 6.4 Fracture healing

Vuik, Kees

419

CASE REPORT Open Access Mycobacterial infection of breast prosthesis a  

E-print Network

by bilateral breast augmentation and presented approximately three years later with clinical evidenceCASE REPORT Open Access Mycobacterial infection of breast prosthesis ­ a conservative treatment Veziris5,6,7 and Dolla Sarkis8 Abstract Background: Bacterial infection is a well-known risk of breast

Paris-Sud XI, Université de

420

Anatomy and physiology of perforator flaps of the upper limb.  

PubMed

Perforator flaps are an excellent reconstructive option for a functional upper limb reconstruction. This article explores the physiology and general principles of perforator flaps and their indications for use in reconstruction of the upper extremity. Workhorse perforator flaps of the upper extremity, such as the radial artery perforator, ulnar artery perforator, lateral arm perforator, posterior interosseous artery, first dorsal metacarpal artery perforator and perforator-based propeller flaps, are discussed in greater detail. PMID:24731605

Appleton, Sarah E; Morris, Steven F

2014-05-01

421

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

PubMed

The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. PMID:22464092

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

2012-04-01

422

On the Acceptance, Functional Gain and Mental Load in ARM Prosthesis and Orthosis Control.  

National Technical Information Service (NTIS)

The problem of acceptance of arm prostheses and orthoses is discussed. Available clinical and field data show that only a very small percentage of prostheses for upper extremities are really worn by patients; one of the reasons may be the large amount of ...

M. Soede, J. S. M. J. Vandieten, H. G. Stassen

1974-01-01

423

The Design and Control of a Low-Power, Upper-Limb Prosthesis  

Microsoft Academic Search

Control moment gyroscopes (CMGs) offer a unique approach to address power consumption issues that currently limit the design of prosthetic limbs. CMGs generate large output torques while requiring less power than conventional actuators. This advance is possible because CMGs conserve angular momentum without increasing the kinetic energy of the system, providing high-agility, low-power movements. We have designed a novel, three

A. M. Jarc; A. B. Kimes; M. E. Pearson; M. A. Peck

2006-01-01

424

Neural Interfaces for Upper-Limb Prosthesis Control: Opportunities to Improve Long-Term Reliability  

Microsoft Academic Search

Building on a long history of innovation in neural-recording interfaces, the Defense Advanced Research Projects Agency (DARPA) has launched a program to address the key challenges related to transitioning advanced neuroprosthesis technology to clinical use for amputated service members. The goal of the Reliable Neural Technology (RE-NET) Program is to develop new technology to extract information from the nervous system

Jack W. Judy

2012-01-01

425

Neural interfaces for upper-limb prosthesis control: opportunities to improve long-term reliability.  

PubMed

Building on a long history of innovation in neural-recording interfaces, the Defense Advanced Research Projects Agency (DARPA) has launched a program to address the key challenges related to transitioning advanced neuroprosthesis technology to clinical use for amputated service members. The goal of the Reliable Neural Technology (RE-NET) Program is to develop new technology to extract information from the nervous system at a scale and rate needed to reliably control modern robotic prostheses over the lifetime of the amputee. The RE-NET program currently encompasses three separate efforts: histology for interface stability over time (HIST), reliable peripheral interfaces (RPIs), and reliable central nervous system (CNS) interfaces (RCIs). PMID:22481748

Judy, Jack W

2012-03-01

426

Magnetic resonance imaging compatibility test of a cranial prosthesis with titanium screws  

NASA Astrophysics Data System (ADS)

The follow-up of patients with skull prosthesis is necessary to provide adequate medical care. Skull prostheses for cranioplasty have been developed at the Faculty of Odontology of Universidad Nacional Autonoma de Mexico. We built a skull prosthesis phantom and tested for compatibility with standard magnetic resonance imaging procedures. Results showed full compatibility but susceptibility artefacts occurred due to titanium used to fix the prosthesis to the skull.

Jimenez, R.; Benavides, A.; Flores, D.; Hidalgo, S. S.; Solis, S. E.; Uribe, E.; Rodriguez, A. O.

2012-10-01

427

Research and development of a versatile portable speech prosthesis  

NASA Technical Reports Server (NTRS)

The Versatile Portable Speech Prosthesis (VPSP), a synthetic speech output communication aid for non-speaking people is described. It was intended initially for severely physically limited people with cerebral palsy who are in electric wheelchairs. Hence, it was designed to be placed on a wheelchair and powered from a wheelchair battery. It can easily be separated from the wheelchair. The VPSP is versatile because it is designed to accept any means of single switch, multiple switch, or keyboard control which physically limited people have the ability to use. It is portable because it is mounted on and can go with the electric wheelchair. It is a speech prosthesis, obviously, because it speaks with a synthetic voice for people unable to speak with their own voices. Both hardware and software are described.

1981-01-01

428

[Protective silicone prosthesis prior to radiotherapy of recurrent colonic cancer].  

PubMed

Radiation therapy for abdominal recurrence of colon cancer is rarely an option due to subsequent bowel injury. Our case is a woman who underwent resection for a large retroperitoneal recurrence of caecal cancer. Tumour deposits encasing the iliac vessels had to be left behind. A silicone breast prosthesis for displacement of the abdominal content was implanted, allowing postoperative irradiation with 50 Gy. The prosthesis was removed once radiotherapy was accomplished; tumour regression was then complete. Complications are described, so are indications for surgical management of local recurrences of colonic origin as well as technical aspects of abdominal implantation of displacing prostheses. At follow-up after eighteen months the patient has no signs of enteropathy, she enjoys a good quality of life, and she is free of disease. Still, her prognosis is considered uncertain. PMID:16477282

Hølmebakk, Toto; Wiig, Johan N; Wanderås, Eva Hoff; Harbitz, Thorstein B

2006-02-01

429

A blue tooth - auricular prosthesis: a case report.  

PubMed

The absence of an ear is a considerable aesthetic problem which affects the patient's psychology and social behaviour. We are describing a case of 25-year-old male reporting to the Department of Prosthodontics, with a chief complaint of deficient left auricular tissue. This can be corrected surgically, prosthetically or through a combination of these approaches; but the choice of treatment depends on patient. The patient chose prosthetic rehabilitation over surgical procedures & retention becomes a critical issue in this approach. Out of many types of retentive methods, we selectively incorporated new materials and used the latest technology to ensure the highest quality prosthesis. Creative approach for each patient with a focus on their individual needs was considered as it gives more satisfaction to the patient. This article describes a new, simple and cost effective technique by embedding Bluetooth-headset device into the silicone elastomer of a mechanically-retained auricular prosthesis. PMID:25302281

H Naveen, Bandlar; R Kashinath, Korapathi; B Shankargouda, Swapnil; Halappa, Mythri

2014-08-01

430

A Blue Tooth - Auricular Prosthesis: A Case Report  

PubMed Central

The absence of an ear is a considerable aesthetic problem which affects the patient’s psychology and social behaviour. We are describing a case of 25-year-old male reporting to the Department of Prosthodontics, with a chief complaint of deficient left auricular tissue. This can be corrected surgically, prosthetically or through a combination of these approaches; but the choice of treatment depends on patient. The patient chose prosthetic rehabilitation over surgical procedures & retention becomes a critical issue in this approach. Out of many types of retentive methods, we selectively incorporated new materials and used the latest technology to ensure the highest quality prosthesis. Creative approach for each patient with a focus on their individual needs was considered as it gives more satisfaction to the patient. This article describes a new, simple and cost effective technique by embedding Bluetooth-headset device into the silicone elastomer of a mechanically-retained auricular prosthesis. PMID:25302281

H. Naveen, Bandlar; R. Kashinath, Korapathi; B. Shankargouda, Swapnil

2014-01-01

431

Magnet retained intraoral-extra oral combination prosthesis: a case report  

PubMed Central

Facial prosthesis is generally considered over surgical reconstruction to restore function and appearance in patients with facial defects that resulted from cancer resection. Retention of the prosthesis is challenging due to its size and weight. Retention can be achieved by using medical grade adhesives, resilient attachments, clips and osseointegrated implants. It can also be connected to obturator by magnets. This clinical report highlights the rehabilitation of a lateral midfacial defect with a two piece prosthesis that included an extra oral facial prosthesis and an intraoral obturator with the use of magnets. PMID:23236576

Kumar, Surender; Bera, Amit; Gupta, Tapas; Banerjee, Ardhendu

2012-01-01

432

Isolated pump erosion of an inflatable penile prosthesis through the scrotum in a diabetic patient.  

PubMed

Isolated pump erosion is a rare complication in patients with inflatable penile prosthesis. We describe a case of a diabetic patient who underwent inflatable penile prosthesis implantation with subsequent isolated pump erosion. Repeated attempts of conservative repair of the erosion failed. Finally, the inflatable penile prosthesis was replaced with a malleable one to avoid new pump erosion. In case of isolated pump erosion, replacement of the inflatable penile prosthesis with a malleable one looks to be a good alternative salvage treatment for the patient. PMID:23695409

Talib, Raidh A; Shamsodini, Ahmad; Salem, Emad A; Canguven, Onder; Al Ansari, Abdulla

2013-03-01

433

Psychosocial follow-up of penile prosthesis implant patients and partners.  

PubMed

One to four years after penile prosthesis surgery, detailed medical and psychosocial interviews were conducted separately with 52 patients and 22 of their partners. Patients tended to be negative or disappointed about postoperative pain, penis size, postoperative sexual frequency, and prosthesis malfunctions. Positive comments emphasized the psychological benefits of renewed masculine self-esteem, repair of humiliation, and reduction of marital guilt. Most patients said they would have the surgery again. Partners corroborated patients' assessments of psychological benefits, but tended to rate the mechanical benefits of the prosthesis somewhat lower. Methodological difficulties in measuring satisfaction with the prosthesis and suggestions for future follow-up research are emphasized in the discussion. PMID:3172252

Tiefer, L; Pedersen, B; Melman, A

1988-01-01

434

The AGC total knee prosthesis at average 11 years  

Microsoft Academic Search

A retrospective study of a series of 126 consecutive primary cemented total knee replacements using the AGC prosthesis is reported. Sixty-two knees were available for long-term review with an average clinical follow-up of 11.4 years (range, 8.4-13.6 years). The survivorship was 95%, defining the endpoint as revision of all components for any reason except sepsis. The average knee flexion was

Roger H Emerson; Linda L Higgins; William C Head

2000-01-01

435

Hip Prosthesis Detection based on Complex Natural Resonances.  

PubMed

Resonance based radar target detection has been applied to Ground Penetrating Radar (GPR) applications for the detection and recognition of landmines. Target detection is achieved by searching for certain target dependent Complex Natural Resonances (CNRs), which could be considered as a feature set for identification. In this paper, detection of a hip prosthesis under human tissues using resonance based target detection technique is investigated. PMID:17282504

Lui, Hoi-Shun; Shuley, Nicholas; Crozier, Stuart

2005-01-01

436

Friction in femoral prosthesis and photoelastic model cone taper joints.  

PubMed

Static axial push-on and lift-off, and push-on and twist-off experiments were designed and performed to measure the effective, room-temperature coefficient of friction mu for different design femoral prosthesis cone taper joints comprising a universal head on a stem spigot. Alumina and metal heads were tested on metal spigots using either distilled water, Ringer's solution, blood or no lubricant. Complementary push-on and lift-off friction tests of Araldite model joints for subsequent frozen-stress, photoelastic stress analysis were performed at 130 degrees C. It was found that lubricant caused little decrease in the values of the coefficient of friction in prosthesis tapers. The values measured were typically mu = 0.2 for an alumina head on a Co-Cr-Mo or Ti-6Al-4V spigot, mu = 0.15 for a Co-Cr-Mo head on a Co-Cr-Mo or Ti-6Al-4V spigot and mu = 0.13 for a stainless steel head on a stainless steel spigot. For Araldite photoelastic models of an alumina head on a Vitallium spigot, as-cast taper surfaces lubricated with silicone grease gave consistent friction of typically mu = 0.14. The axial displacement of model heads on their spigots were compared with predicted values and previously measured values for prosthesis heads. PMID:2712949

Fessler, H; Fricker, D C

1989-01-01

437

Visual prosthesis wireless energy transfer system optimal modeling  

PubMed Central

Background Wireless energy transfer system is an effective way to solve the visual prosthesis energy supply problems, theoretical modeling of the system is the prerequisite to do optimal energy transfer system design. Methods On the basis of the ideal model of the wireless energy transfer system, according to visual prosthesis application condition, the system modeling is optimized. During the optimal modeling, taking planar spiral coils as the coupling devices between energy transmitter and receiver, the effect of the parasitic capacitance of the transfer coil is considered, and especially the concept of biological capacitance is proposed to consider the influence of biological tissue on the energy transfer efficiency, resulting in the optimal modeling’s more accuracy for the actual application. Results The simulation data of the optimal model in this paper is compared with that of the previous ideal model, the results show that under high frequency condition, the parasitic capacitance of inductance and biological capacitance considered in the optimal model could have great impact on the wireless energy transfer system. The further comparison with the experimental data verifies the validity and accuracy of the optimal model proposed in this paper. Conclusions The optimal model proposed in this paper has a higher theoretical guiding significance for the wireless energy transfer system’s further research, and provide a more precise model reference for solving the power supply problem in visual prosthesis clinical application. PMID:24428906

2014-01-01

438

A cortical neural prosthesis for restoring and enhancing memory  

NASA Astrophysics Data System (ADS)

A primary objective in developing a neural prosthesis is to replace neural circuitry in the brain that no longer functions appropriately. Such a goal requires artificial reconstruction of neuron-to-neuron connections in a way that can be recognized by the remaining normal circuitry, and that promotes appropriate interaction. In this study, the application of a specially designed neural prosthesis using a multi-input/multi-output (MIMO) nonlinear model is demonstrated by using trains of electrical stimulation pulses to substitute for MIMO model derived ensemble firing patterns. Ensembles of CA3 and CA1 hippocampal neurons, recorded from rats performing a delayed-nonmatch-to-sample (DNMS) memory task, exhibited successful encoding of trial-specific sample lever information in the form of different spatiotemporal firing patterns. MIMO patterns, identified online and in real-time, were employed within a closed-loop behavioral paradigm. Results showed that the model was able to predict successful performance on the same trial. Also, MIMO model-derived patterns, delivered as electrical stimulation to the same electrodes, improved performance under normal testing conditions and, more importantly, were capable of recovering performance when delivered to animals with ensemble hippocampal activity compromised by pharmacologic blockade of synaptic transmission. These integrated experimental-modeling studies show for the first time that, with sufficient information about the neural coding of memories, a neural prosthesis capable of real-time diagnosis and manipulation of the encoding process can restore and even enhance cognitive, mnemonic processes.

Berger, Theodore W.; Hampson, Robert E.; Song, Dong; Goonawardena, Anushka; Marmarelis, Vasilis Z.; Deadwyler, Sam A.

2011-08-01

439

[Prosthesis of ligament by specially treated collagenous tissue.].  

PubMed

Artificial prostheses of ligaments are associated with many problems. At first they take over the function of the ligament, later however their strength declines. Therefore at present collagen autotransplants are prefered. Prosthesis made from processed seem however promising, after their breakdown they should be replaced by the patient's connective tissue with an orientation of fibres resembling the original ligament. The poor results reported in the literature are probably due to inadequate treatment of these ligaments. The authors mention their own method of treatment of collagen and its use as a prosthesis of ligaments in experiments on dogs. These ligaments were investigated by histological methods after an interval of 3 and 6 months following operation. The reported results are promising. Histological examination revealed incorporation of connective tissue into the artificial collagen and the connective tissue fibres were oriented parallel with the implanted ligament. Further investigation call for long-term implantation, but even the present investigation confirms that treatment of collagen in the described manner is a suitable method. Key words: xenograph, arteficial ligament replacement, tendon prosthesis. PMID:20483075

Trc, T; Pohunková, H; Stol, M; Novotná, J; Adam, M

1992-01-01

440

21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.  

Code of Federal Regulations, 2010 CFR

...femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis...femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis...femorotibial (uni-compartmental) metal/polymer porous-coated uncemented...

2010-04-01

441

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

Code of Federal Regulations, 2010 CFR

...Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. 888...Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. ...shoulder joint metal/metal or metal/polymer constrained cemented...

2010-04-01

442

21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.  

Code of Federal Regulations, 2011 CFR

...femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis...femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis...femorotibial (uni-compartmental) metal/polymer porous-coated uncemented...

2011-04-01

443

Archaeological evidence for dental innovation: an eighteenth century porcelain dental prosthesis belonging to Archbishop Arthur Richard Dillon.  

PubMed

During archaeological investigation by Gifford of St Pancras Old Church burial ground, on the eastern edge of Somers Town, London, in advance of construction of the new London terminus for the Channel Tunnel Rail Link, a full porcelain denture was discovered. The high quality porcelain dentures, manufactured in the late eighteenth century French style, may have been brought with their owner, Archbishop Arthur Richard Dillon, on his journey into exile. There is evidence of prolonged use, not only for cosmetic or vocal functions but also in mastication. The dentures are unique archaeological artefacts and represent a pivotal time in dental history, with the adoption of new materials and methods of manufacture. They reflect a period of significant social and economic change for the upper echelons of French society. This paper outlines the development of porcelain dentures, discusses the prosthesis, their owner, and a possible provenance. PMID:17031354

Powers, N

2006-10-01

444

The indwelling voice prosthesis for speech rehabilitation after total laryngectomy: a safe approach  

Microsoft Academic Search

Primary prosthetic voice restoration by performing tracheoesophageal puncture (TEP) and immediate insertion of a voice prosthesis at the time of total laryngectomy (TLE) is presently the method of choice. This enables the easiest and most comfortable voice rehabilitation with the patient still under general anesthesia when the first prosthesis is inserted. Reconstruction of the pharynx with e.g. free revascularized or

A. J. M. Balm; Brekel van den M. W. M; I. B. Tan; F. J. M. Hilgers

2011-01-01

445

A biomechanical model for the development of myoelectric hand prosthesis control systems  

Microsoft Academic Search

Advanced myoelectric hand prostheses aim to reproduce as much of the human hand's functionality as possible. Development of the control system of such a prosthesis is strongly connected to its mechanical design; the control system requires accurate information on the prosthesis' structure and the surrounding environment, which can make development difficult without a finalized mechanical prototype. This paper presents a

Bart Peerdeman; D. Boerey; L. Kallenbergy; Stefano Stramigioli; Sarthak Misra

2010-01-01

446

21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Ankle joint metal/polymer semi-constrained cemented prosthesis...Devices § 888.3110 Ankle joint metal/polymer semi-constrained cemented prosthesis...Identification. An ankle joint metal/polymer semi-constrained cemented...

2011-04-01

447

21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Elbow joint metal/polymer semi-constrained cemented prosthesis...Devices § 888.3160 Elbow joint metal/polymer semi-constrained cemented prosthesis...Identification. An elbow joint metal/polymer semi-constrained cemented...

2011-04-01

448