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1

An upper extremity prosthesis using SMA actuator  

Microsoft Academic Search

Many kinds of powered upper extremity prostheses with multi-degree-of-freedom have been studied and developed. However, in daily life, there are few upper extremity prostheses which the handicapped can use. In the superior limits of weight and size, the prostheses with multi-degree-of-freedom and multi-functions are requested by the handicapped. To achieve this, the authors tried to develop a prosthesis which imitates

Katsutoshi Kuribayashi; Makoto Takahashi; T. Taniguchi

1992-01-01

2

Liquid-Fueled Actuation for an Anthropomorphic Upper Extremity Prosthesis  

Microsoft Academic Search

This paper describes the design of a 21 degree-of-freedom, nine degree-of-actuation, gas-actuated arm prosthesis for transhumeral amputees. The arm incorporates a direct-drive elbow and three degree-of-freedom wrist, in addition to a 17 degree-of-freedom underactuated hand effected by five actuators. The anthropomorphic device includes full position and force sensing capability for each actuated degree of freedom and integrates a monopropellant-powered gas

Kevin B. Fite; Thomas J. Withrow; Keith W. Wait; Michael Goldfarb

2006-01-01

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

A virtual upper limb prosthesis as a training system  

Microsoft Academic Search

A virtual reality system that improves the functional adjustment between an amputee and an active prosthesis is described. It includes the development of a virtual prosthesis and a myoelectric interface integration. The main purpose of this work is to provide a training system as a previous stage, to subjects who need to use an upper limb myoelectric prosthesis, which will

José Antonio Barraza-Madrigal; Alfredo Ramírez-García; Roberto Muñoz-Guerrero

2010-01-01

5

Sensitivity and Specificity of Upper Extremity Movements Decoded from Electrocorticogram  

E-print Network

, Irvine, CA, USA znenadic@uci.edu necessary for restoring independence in potential BCI arm prosthesis arm prosthesis control capable of restoring independence to those with upper extremity paralysis potentially be used for control of arm prostheses. Restoring independent function to BCI users

Nenadic, Zoran

6

Dynamics simulation on object handling tasks by using a myoelectric upper limb prosthesis with bimanual coordination  

Microsoft Academic Search

We have proposed the upper limb prosthesis control system which helps an amputee perform a two-handed task with the healthy arm and the prosthesis in our previous work. Our first focus was on motion generation of the prosthesis. However, ideal motion of the prosthesis does not guarantee success of a two-hand task because of interaction between the prosthesis and the

E. Inohira; M. Harata

2010-01-01

7

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

8

Upper limb prosthesis for developing countries  

Microsoft Academic Search

Today several kind of high technology prostheses are available; we propose a really cheap under-actuated prosthesis specially designed for developing countries users. Structure and actuation are integrated. The actuation is by tendons, trusted by the shoulder of the patient. These tendons are embedded in an elastomeric matrix providing hand body, compliance where required (finger joints) and grip; the palm is

Enrico Ullmann; Francesco Cepolina; Matteo Zoppi

9

Upper limb prosthesis controlled by myoelectric signal  

Microsoft Academic Search

The authors propose a design of a myoelectric prosthesis with two active and one passive degrees of freedom to fit on a limb with an above elbow amputation. It will be controlled by myoelectric electrodes implanted directly on the muscle surface

Z. Escudero; L. Leija; J. Alvarez; R. Munoz

1999-01-01

10

Modeling upper body kinematics while using a transradial prosthesis  

Microsoft Academic Search

The prostheses used by the majority of persons with upper limb amputations today offer a limited range of motion. Relative to anatomical joints transradial (below the elbow) prosthesis users lose at least two of the three degrees of freedom provided by the wrist and forearm. Some myoeletric prostheses currently allow for forearm pronation and supination (rotation about an axis parallel

Derek J Lura

2008-01-01

11

Upper extremity amputations and prosthetics.  

PubMed

Upper extremity amputations are most frequently indicated by severe traumatic injuries. The location of the injury will determine the level of amputation. Preservation of extremity length is often a goal. The amputation site will have important implications on the functional status of the patient and options for prosthetic reconstruction. Advances in amputation techniques and prosthetic reconstructions promote improved quality of life. In this article, the authors review the principles of upper extremity amputation, including techniques, amputation sites, and prosthetic reconstructions. PMID:25685104

Ovadia, Steven A; Askari, Morad

2015-02-01

12

Liquid-Fueled Actuation for an Anthropomorphic Upper Extremity Kevin B. Fite, Member, IEEE, Thomas J. Withrow, Keith W. Wait, and Michael Goldfarb, Member,  

E-print Network

describes the design of a 21 degree-of- freedom, nine degree-of-actuation, gas-actuated arm prosthesis unlike a human arm, the geometric constraints of a transhumeral prosthesis requires that the elbowLiquid-Fueled Actuation for an Anthropomorphic Upper Extremity Prosthesis Kevin B. Fite, Member

13

Improvement of a neural network-based motion generator with bimanual coordination for upper limb prosthesis  

Microsoft Academic Search

We propose to redesign a neural network used as a motion generator with bimanual coordination for upper limb prosthesis in\\u000a order to improve its learning capability. We assumed that the wearer of the prosthesis was a unilateral amputee. In our previous\\u000a work, we proposed a prosthesis control system using a neural network that learned bimanual coordination in order to implement

Eiichi Inohira; Hirokazu Yokoi

2010-01-01

14

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

ERIC Educational Resources Information Center

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

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

2005-01-01

15

The MANUS-HAND Dextrous Robotics Upper Limb Prosthesis: Mechanical and Manipulation Aspects  

Microsoft Academic Search

Dextrous artificial hand design and manipulation is an active research topic. A very interesting practical application is the field of upper limb prosthetics. This paper presents the mechanical design and manipulation aspects of the MANUS-HAND project to develop a multifunctional upper limb prosthesis. The kinematics of our design makes use of the so-called underactuated principle and leads to an innovative

José Luis Pons Rovira; Eduardo Rocon De Lima; R. Ceres; D. Reynaerts; B. Saro; S. Levin; W. Van Moorleghem

2004-01-01

16

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

17

Prosthesis  

MedlinePLUS

A prosthesis is a device designed to replace a missing part of the body or to make a part of the body work better. Diseased or missing eyes, arms, hands, legs, or joints are commonly replaced by prosthetic devices. False teeth are known as dental prostheses. ...

18

Prescription of the first prosthesis and later use in children with congenital unilateral upper limb deficiency: A systematic review  

Microsoft Academic Search

Background: The prosthetic rejection rates in children with an upper limb transversal reduction deficiency are considerable. It is unclear whether the timing of the first prescription of the prosthesis contributes to the rejection rates. Objective: To reveal whether scientific evidence is available in literature to confirm the hypothesis that the first prosthesis of children with an upper limb deficiency should

M. Meurs; C. G. B. Maathuis; C. Lucas; M. Hadders-Algra; Sluis van der C. K

2006-01-01

19

A CAN-based distributed control system for upper limb myoelectric prosthesis  

Microsoft Academic Search

The paper presents the definition of a prosthetic protocol, specifing an application profile based on CAN bus standard. Aim of this definition is to realize an upper limb prosthesis control oriented bus, which grant an efficient sensors and actuators management, with the possibility both of centralized and distributed control, through the transmission and reception of high level commands and data.

Stefano Banzi; E. Mainardi; A. Davalli

2005-01-01

20

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

21

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

22

Thoracoscopic removal of dental prosthesis impacted in the upper thoracic esophagus.  

PubMed

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

Bonavina, Luigi; Aiolfi, Alberto; Siboni, Stefano; Rausa, Emanuele

2014-01-01

23

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

24

Upper extremity pain after spinal cord injury  

Microsoft Academic Search

Objective: Patients with spinal cord injury (SCI) may complain of upper extremity (UE) pain. The purpose of this study was to determine the frequency and severity of UE pain as well as its association with functional activities. Types of treatments that SCI patients received for UE pain and the benefits of these treatments were also identified. Study design and methods:

M Dalyan; DD Cardenas; B Gerard

1999-01-01

25

Design of a wrist and gripping mechanism for an upper limb prosthesis specifically for the game of golf  

E-print Network

An upper limb prosthesis used for the game of golf was designed. More specifically, the wrist and gripping mechanism was designed. The motivating factor behind his project was to improve a player's ability to make a smooth, ...

Yoder, Michael D

2009-01-01

26

Hierarchical myoelectric control of a human upper limb prosthesis  

Microsoft Academic Search

Myolectric control is nowadays the most used approach for electrically-powered upper limb prostheses. The myoelectric controllers use electromyographic (EMG) signals as inputs. These signals can be collected from the skin surface using surface EMG sensors, or intramuscular, using needle sensors. No matter which method is used, they have to be processed before being used as controller inputs. In this paper,

S. Herle; S. Man; G. Lazea; C. Marcu; P. Raica; R. Robotin

2010-01-01

27

Tire explosion injuries to the upper extremity.  

PubMed

Several articles have been published that bring attention to the destructive potential of tire explosions. Although the severity of tire explosion injuries to the head and neck region is well established, only one previous article has reported injuries to the upper extremity. Fourteen patients with upper extremity tire explosion injuries have been treated by us from 1980 to 1988. Each injury was caused by single-piece wheel assemblies, as opposed to multipiece wheel assemblies, which have traditionally been associated with the injury. Three representative patient reports are discussed. Prevention of this injury can be achieved by increased public awareness, formal industrial safety training, tire servicing with dedicated equipment including restraining devices or barriers, complete evaluation of wheel/tire serviceability before tire mounting, separation of servicing of single and multipiece wheels, and complete tire deflation before servicing. PMID:1466553

Matloub, H S; Prevel, C D; Sanger, J R; Yousif, N J; Devine, C A; Romano, J

1992-12-01

28

Lower extremity above-knee prosthesis-associated erectile dysfunction  

Microsoft Academic Search

Blunt pelvic and perineal trauma has been previously reported to result in site-specific veno-occlusive dysfunction and\\/or site-specific cavernosal artery insufficiency. We herein describe a case of erectile dysfunction in a young previously potent amputee. We postulate that the erectile dysfunction is associated with a newly described form of blunt trauma, that is, site-specific compression from a perineal weight-bearing lower extremity

R Munarriz; H Kulaksizoglu; L Hakim; S Gholami; A Nehra; I Goldstein

2003-01-01

29

ORIGINAL ARTICLE Upper-Extremity Functional Electric StimulationAssisted  

E-print Network

ORIGINAL ARTICLE Upper-Extremity Functional Electric Stimulation­Assisted Exercises, Ellaway P, Prochazka A. Upper-extremity functional electric stimulation assisted exercises in neuroprosthetic applications. Key Words: Electric stimulation therapy; Hemiplegia; Re- habilitation; Stroke

Prochazka, Arthur

30

Upper extremity reachable workspace evaluation with Kinect.  

PubMed

We propose a novel low-cost method for quantitative assessment of upper extremity workspace envelope using Microsoft Kinect camera. In clinical environment there are currently no practical and cost-effective methods available to provide arm-function evaluation in three-dimensional space. In this paper we examine the accuracy of the proposed technique for workspace estimation using Kinect in comparison with a motion capture system. The experimental results show that the developed system is capable of capturing the workspace with sufficient accuracy and robustness. PMID:23400165

Kurillo, Gregorij; Han, Jay J; Obdržálek, St?pán; Yan, Posu; Abresch, Richard T; Nicorici, Alina; Bajcsy, Ruzena

2013-01-01

31

Abstract--This paper presents the preliminary design of a new dexterous upper-limb prosthesis provided with a novel  

E-print Network

Abstract-- This paper presents the preliminary design of a new dexterous upper-limb prosthesis to cover different levels of upper- limb amputations. The hand has 20 DoFs and 11 motors, with a dexterous to enable dexterous manipulation and enhance grasp performance. I. INTRODUCTION ISTORICALLY humans have

Arleo, Angelo

32

Upper extremity deep vein thrombosis with tourniquet use  

PubMed Central

INTRODUCTION Upper extremity deep vein thrombosis is an increasingly important clinical finding with significant morbidity and mortality. The condition may be under-diagnosed in trauma and surgery settings. PRESENTATION OF CASE We present a case of upper extremity thrombosis with venous congestive symptoms secondary to the use of an operative tourniquet. A literature review and discussion of the causes of upper extremity deep vein thrombosis and the pathophysiological disturbances seen with tourniquet use are presented. DISCUSSION Upper extremity deep venous thrombosis is uncommon. In this case the likely cause was operative tourniquet use. CONCLUSION Operative tourniquet may be a risk factor in upper extremity deep vein thrombosis. PMID:25524302

Desai, Karan; Dinh, Trish P.; Chung, Susan; Pierpont, Yvonne N.; Naidu, Deepak K.; Payne, Wyatt G.

2014-01-01

33

Freebal: dedicated gravity compensation for the upper extremities  

Microsoft Academic Search

In most upper-extremity rehabilitation robotics, several components affect the therapy outcome. A common component is gravity compensation which alleviates upper-extremity movements. Gravity compensation by itself could improve motor control further or faster, separate from other effects of robotic therapy. To investigate the rehabilitation value of gravity compensation separately, we created the dedicated gravity compensation system, Freebal. The sling systems with

Amo H. A. Stienen; E. E. G. Hekman; G. B. Prange; M. J. A. Jannink; A. M. M. Aalsma; H. Van der Kooij

2007-01-01

34

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

35

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

36

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

37

Free skin flap coverage of the upper extremity.  

PubMed

Successful soft tissue reconstruction of the upper extremity must provide stable coverage and restore function to the injured hand. To ensure the best possible outcome after traumatic upper extremity injuries, early radical debridement and early flap coverage that restores all missing tissue components is critical to allow early mobilization. Free flaps provide extraordinary versatility in reconstructing defects of soft tissue, muscle, tendon, and bone. PMID:24731610

King, Elizabeth A; Ozer, Kagan

2014-05-01

38

Upper-Extremity Pain Disorders in Breast Cancer  

Microsoft Academic Search

Stubblefield MD, Custodio CM. Upper-extremity pain disorders in breast cancer.Upper-extremity pain is a common and debilitating problem for patients with breast cancer. Although there is considerable literature describing symptoms, little is available on the specific disorders responsible for pain and debility in these patients. Cervical radiculopathy, brachial plexopathy, neuropathy, rotator cuff tendonitis, adhesive capsulitis, epicondylitis, postmastectomy syndrome, swelling, and bone

Michael D. Stubblefield; Christian M. Custodio

2006-01-01

39

Distressing upper extremity phantom limb sensation during intravenous regional anesthesia  

Microsoft Academic Search

Background and Objectives: The objective of this article is to describe a case of distressing upper extremity phantom limb sensation during intravenous regional anesthesia (IVRA). Case Report: A 33-year-old American Society of Anesthesiologists (ASA) status I female with an uncomplicated intrauterine gestation presented for endoscopic carpal tunnel release. Following gravity-assisted exsanguination of the vertically positioned left upper extremity, she underwent

Eric Dominguez

2001-01-01

40

Assessment of upper extremity role functioning in students  

Microsoft Academic Search

Background Upper extremity symptoms associated with use of computers and other upper extremity activities are common in students. Research on these disorders requires psychometrically sound measures of health-related student role function; no such meas- ure is available currently. Methods Based upon input from students and clinicians, we developed a 10-item scale to measure student health-related role function. The measure was

Jeffrey N. Katz; Benjamin C. Amick; Nathaniel Hupert; Marissa C. Cortes; Anne H. Fossel; Michelle Robertson; Christopher M. Coley

2002-01-01

41

Dynamometric assessment of the upper extremity in upholstered furniture workers  

Microsoft Academic Search

For preventing the onset of disorders of the upper extremity, in upholstered furniture workers, it was decided to monitor their handgrip applying a method previously developed to 262 volunteers recruited among upholstered furniture workers. At the test time, only 23 subjects had clinical symptoms referable to upper limb work-related musculoskeletal disorders (clinical symptomatic group), while the remaining 239 subjects made

Livio Quagliarella; Nicola Sasanelli; Sergio Nicoletti; Giovanni Rubino; Rossella Attimonelli

2011-01-01

42

A method for determination of upper extremity kinematics.  

PubMed

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 a mechanical model. In certain positions, gimbal lock may occur, and a different sequence of rotational decomposition may be required. Agreement on standardization of technique would assist in the dissemination of upper extremity scientific data. PMID:11869904

Rab, George; Petuskey, Kyria; Bagley, Anita

2002-04-01

43

Lymphatic filariasis disseminating to the upper extremity.  

PubMed

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

44

What's new in common upper extremity entrapment neuropathies.  

PubMed

Upper extremity entrapment neuropathies are common and disabling, and correct diagnosis is essential for proper management. This article is a review of the recent developments related to diagnosis and treatment of common upper extremity nerve entrapments, including novel treatment strategies for suprascapular, median, ulnar, and radial nerve entrapments. When combined with classic peripheral nerve examination techniques, innovations in imaging modalities have led to more reliable diagnoses. Innovations in surgical techniques, such as endoscopic approaches, have been controversial as to their effects on patient outcome, but recent randomized controlled trials have provided important information regarding common operative techniques, particularly with regard to carpal tunnel surgery and ulnar nerve transpositions. PMID:19010282

Toussaint, Charles P; Zager, Eric L

2008-10-01

45

Vascular injuries in the upper extremity in athletes.  

PubMed

Repetitive, high-stress, or high-impact arm motions can cause upper extremity arterial injuries. The increased functional range of the upper extremity causes increased stresses on the vascular structures. Muscle hypertrophy and fatigue-induced joint translation may incite impingement on critical neurovasculature and can cause vascular damage. A thorough evaluation is essential to establish the diagnosis in a timely fashion as presentation mimics more common musculoskeletal injuries. Conservative treatment includes equipment modification, motion analysis and adjustment, as well as equipment enhancement to limit exposure to blunt trauma or impingement. Surgical options include ligation, primary end-to-end anastomosis for small defects, and grafting. PMID:25455355

de Mooij, Tristan; Duncan, Audra A; Kakar, Sanjeev

2015-02-01

46

Magnetic resonance imaging of acute "wiiitis" of the upper extremity.  

PubMed

We present the first reported case of acute "wiiitis", documented clinically and by imaging, of the upper extremity, caused by prolonged participation in a physically interactive virtual video-game. Unenhanced magnetic resonance imaging (MRI) demonstrated marked T2-weighted signal abnormality within several muscles of the shoulder and upper arm, without evidence of macroscopic partial- or full-thickness tearing of the muscle or of intramuscular hematoma. PMID:18259743

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

2008-05-01

47

Electrocorticogram encoding of upper extremity movement trajectories Po T. Wang1, Christine E. King1, Andrew Schombs1, Jack J. Lin2, Mona Sazgar2, Frank P.K. Hsu3,  

E-print Network

decoding of finger or 2D arm movement trajectories, and these results are modest. This study seeks that ECoG signals can be used to decode movement trajectories of the arm and fingers, thereby indicating that the ECoG-based BCI platform for upper extremity prosthesis control is promising. Prior studies used local

Nenadic, Zoran

48

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

49

Subclavian Vein Compression and Thrombosis Presenting as Upper Extremity Pain  

Microsoft Academic Search

e report a case of upper extremity pain that eluded diagnosis. Only after ultrasonography was repeated with the patient in the sitting position was external compression of the subclavian vein and a subclavian vein thrombosis detected. The patient was diagnosed as having hypertrophied ante- rior scalene muscles that compressed the venous structures when he assumed the upright position. Per- formance

Jihad G. Jiha; Charles E. Laurito; Richard W. Rosenquist

1997-01-01

50

EMG feature evaluation for movement control of upper extremity prostheses  

Microsoft Academic Search

A variety of EMG features have been evaluated for control of myoelectric upper extremity prostheses. Movement class discrimination, robustness, and computational complexity of these features have been investigated for different time window sizes and noise levels. The measurements include novel application of the Davies-Bouldin index, a measure of cluster separability, and the K-nearest neighbor nonparametric classifier. The features evaluated are

Mahyar Zardoshti-Kermani; Bruce C. Wheeler; Kambiz Badie; Reza M. Hashemi

1995-01-01

51

Non familial juvenile distal spinal muscular atrophy of upper extremity  

Microsoft Academic Search

An uncommon variety of non familial, juvenile onset, spinal muscular atrophy with asymmetric distal upper extremity affection is described. One hundred and two patients with a one to 14 year follow up are analysed. Spinal muscular atrophies with a distal distribution are rare. However, in the past three decades, previously unrecognised varieties of neurogenic muscular atrophy have been described in

J B Peiris; K N Seneviratne; H R Wickremasinghe; S B Gunatilake; R Gamage

1989-01-01

52

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 Leavitt, David J. Reinkensmeyer, and James E. Bobrow Abstract-- A key challenge in rehabilitation robotics rehabilitation of the arm. Pneumatic actuators can potentially help meet this challenge because of their high

Bobrow, James E.

53

Long-term outcomes of major upper extremity replantations  

PubMed Central

BACKGROUND: Long-term outcomes of major upper extremity replantations are infrequently reported. It is believed that replantation is indicated for amputations at all levels in children and for all distal amputations in adults. Replantations of arm or proximal forearm amputations in adults are controversial. OBJECTIVE: To evaluate the results of major upper extremity replantations, defined as those that are transmetacarpal, through the wrist, forearm, elbow or arm. METHODS: A review of these types of replantations performed at the authors’ institution from 2002 to 2012 was conducted. Patients’ strength, range of motion and two-point discrimination were assessed. Patients completed the Disabilities of the Arm, Shoulder and Hand (DASH), the Michigan Hand Questionnaire (MHQ), and the Hospital Anxiety and Depression scale (HADS). RESULTS: Seventeen patients underwent major upper extremity replantation surgery. The majority (16 of 17 [94%]) of the included patients were male. Of 17 patients, 13 (76.5%) required reoperations. The mean (± SD) DASH score of seven patients who consented to completing all questionnaires was 75.4±14.2 of 100 (range 59.2 to 91.1). On the MHQ, the mean score for affected hand function was 16% compared with 84% in the unaffected hand. Patients generally demonstrated at least mild levels of anxiety and depression on the HADS. DISCUSSION: The results suggest that major upper extremity injuries and replantations have a significant impact on patients’ long-term hand function, and produce long-term anxiety and depressive symptoms. PMID:25152640

Ng, Wendy KY; Kaur, Manraj Nirmal; Thoma, Achilleas

2014-01-01

54

Development of an adaptive framework for the control of upper limb myoelectric prosthesis  

Microsoft Academic Search

This work presents the development of a sensor for detecting human muscle contraction, which captures myoelectric signals (EMG), in order to control a myoelectric prosthesis of superior limb. The analysis of the signal is carried out through software running in a microcontroller that decides how to open or close the artificial hand. The facilities in changing the acting form by

C. P. Fermo; C. V. De Vincenzo; T. F. Bastos-Filho; V. I. Dynnikov

2000-01-01

55

New options for vascularized bone reconstruction in the upper extremity.  

PubMed

Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction. PMID:25685100

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

2015-02-01

56

Soft tissue coverage of the mangled upper extremity.  

PubMed

Mangled upper extremity injuries usually involve high-impact trauma with crushing and tearing of the limb and its associated soft tissue structures. Such trauma is particularly mutilating because of the nature of the injury and the involvement of structures vital for proper function. Although advancements in flap technique and improvements in bone fixation methods have enabled good functional and clinical outcomes in limb salvage reconstruction, this remains a challenging area. Attempts at limb preservation should be fully exhausted before consideration is given for amputation, which results in significantly decreased function. Here the authors focus on the various modalities of soft tissue coverage available including allogenic substitutes, the adjunctive use of negative pressure wound therapy, and the design and utilization of flaps to address various defect configurations for the goals of wound healing, aesthetics, and functional restoration in the mangled upper extremity. PMID:25685103

Ng, Zhi Yang; Salgado, Christopher J; Moran, Steven L; Chim, Harvey

2015-02-01

57

Hypotheses for ongoing evolution of muscles of the upper extremity.  

PubMed

There are organs and muscles in the human body that may be considered rudimentary in that they have insignificant or undetermined function. Several such muscles are found in the upper extremity. In this review, four muscles that appear to be undergoing evolutionary changes are discussed: flexor digitorum superficialis to the fifth finger, anconeus, palmaris longus, and anconeus epitrochlearis. The present study synthesizes, advances and extends previously described work about these muscles and extends the hypotheses and concludes that: (a) the flexor digitorum superficialis to the fifth finger is currently under adaptive evolution, (b) the anconeus has currently stabilized its evolution and is serving as a transient stability augmenter during a short portion of the human lifespan, and (c) the entire distal upper extremity is currently in the process of undergoing evolutionary change. Understanding of these muscles and their evolutionary context is important for understanding of impact on function, dysfunction, treatment and future research. PMID:24529649

Capdarest-Arest, Nicole; Gonzalez, Jorge P; Türker, Tolga

2014-04-01

58

Patient Satisfaction after Upper Extremity Laser Lipolysis without Suction  

PubMed Central

Background and Objective. There has been a heightened interest in laser-assisted fat reduction procedures. We aimed to determine if lipolysis with the 1,320?nm Nd-YAG short-pulsed laser without subsequent suction results in satisfactory contouring of the upper extremity. Materials and Methods. Unilateral laser lipolysis of the upper arm was performed on 5 patients. Subcutaneous, subdermal, and skin surface temperatures were monitored with flexible thermocouples throughout the procedure to aid in the establishment of a treatment endpoint. Photographs and arm circumference measurements were evaluated before and 3 months after laser lipolysis. Patients were given the choice of undergoing the procedure on the contralateral arm at 3 months. Results. All patients achieved no improvement to minimal improvement in upper arm contour. One of five patients was elected to have lipolysis performed on the contralateral arm. Conclusion. Laser lipolysis may be safely performed with the parameters utilized in this pilot study, although minimal improvement was seen in upper extremity contour. PMID:22567238

Kotlus, Brett S.; Mok, Charles

2011-01-01

59

Decrease in phantom limb pain associated with prosthesis-induced increased use of an amputation stump in humans  

Microsoft Academic Search

The experience of phantom limb pain, non-painful phantom limb sensation and telescoping was ascertained by questionnaire in a group of upper extremity amputees wearing a functionally effective Sauerbruch prosthesis which permits extensive use of the affected limb and in a group of patients wearing a cosmetic prosthesis that did little to increase the utilization of the amputation stump. The Sauerbruch

Thomas Weiss; Wolfgang H. R. Miltner; Torsten Adler; Lutz Brückner; Edward Taub

1999-01-01

60

Modeling the postural disturbances caused by upper extremity movements.  

PubMed

This paper describes the design, validation, and application of a dynamic, three-dimensional (3-D) model of the upper extremity for the purpose of estimating postural disturbances generated by movements of the arms. The model consists of two links representing the upper and lower arms, with the shoulder and elbow modeled as gimbal joints to allow three rotational degrees of freedom. With individualized segment inertial parameters based on anthropometric measurements, the model performs inverse dynamic analysis of recorded arm movements to calculate reaction forces and moments acting on the body at the shoulder in three dimensions. The method was validated by comparing the output of the model to estimates obtained from ground reaction loads during stereotypical and free form unilateral movements at various velocities and with different loads carried by human subjects while seated on biomechanical force platforms. The correlation between predicted and measured reaction forces and moments was very good under all conditions and across all subjects, with average rms errors less than 8% of measured peak-to-peak values. The model was then applied to bimanual activities representative of functional movements that would typically be performed while standing at a counter. The resulting estimates were consistent and adequate for the purpose of evaluating postural disturbances caused by upper extremity movements. PMID:11474966

Triolo, R J; Werner, K N; Kirsch, R F

2001-06-01

61

Satisfaction with upper extremity surgery in individuals with tetraplegia.  

PubMed

Objective To supplement the scant information available regarding the satisfaction of patients with tetraplegia following upper extremity reconstructive surgery for such individuals with spinal cord injury (SCI). Study design Retrospective study with questionnaire follow-up. Setting The Danish Spinal Cord Injury Centers. Material and methods In the initial review period, 119 upper extremity surgeries were performed on patients with tetraplegia (n = 49). Seven died and the remaining 42 were invited to complete a follow-up questionnaire with a five-level scale ranging from strongly agree to strongly disagree regarding satisfaction. Forty patients completed the questionnaire. Results Median time from first surgery was 13 years (2-36). Sixty-five percent of the sample had a C5-C6 SCI, with 64% experiencing complete injury. Initially, 76% of the sample expressed general satisfaction with life, but only 28% of the sample reported that hand appearance improved after surgery. Interestingly, those having surgery from 1991 to 2008 reported significantly greater satisfaction (P < 0.001) and were significantly more satisfied with activities of daily living (ADL) (P < 0.001) than those having surgery between the years 1973 and 1990. In particular, gain of independence was obtained with pinch/specific hand surgery compared to triceps activation. Accordingly, the pinch/specific hand surgery group was significantly more satisfied than the triceps group on the ADL (P = 0.027), and the independence questions (P < 0.001). Conclusion Overall satisfaction with upper extremity surgery is high. It can have a positive impact on life in general, ability to perform ADL, as well as supplying an increased level of independence. PMID:25243666

Gregersen, Hanne; Lybæk, Mille; Lauge Johannesen, Inger; Leicht, Pernille; Nissen, Ulla Vig; Biering-Sørensen, Fin

2015-03-01

62

Early Coverage of Upper Extremity Electrical Injury Wounds  

PubMed Central

Background An appropriate and well-timed surgery has great impact on a patient’s treatment and can prevent further damage to partially injured structures which if untreated will be lost leading to severe disability. In the present study we report our experience with early coverage of electrically injured upper extremity vital structures with encouraging results. Objectives The aim of this study was to evaluate the results of early flap coverage (less than two weeks) after electrical injury in the induced wounds of upper extremity. Materials and Methods The records of electrically injured patients referred during a 10- year period to Firuzgar Medical Center were evaluated. After one or two sessions of debridement, the wounds were covered by distant or pedicled flaps and the results were evaluated according to the number of surgeries, complications and return to work time. Results Thirty patients were registered in this study, mean age at the time of injury was 26.43 (SD = 10.41) years; 40% of patients had right upper extremity injury, 23.3% had left and 36.7% had bilateral injury. 43.4% of patients had no complications, amputation rate was 23.3% and nerve injury was seen in 13.3% of patients. Mean days of return to work was 132.57 (SD = 64.99). In 11 patients distant flaps were used, 9 patients with graft only and 7 patients had a combination of graft and regional flaps.The dominant hand involvement in electrical injury is very high. Conclusions We suggest that the routine treatment protocols of serial debridement until all the wound acquires a bed of granulation tissue should be revised, because the vital structures such as tendons and nerves will have undergone dessication necrosis and a young worker will be crippled for life. Early coverage of partially injured vital structures is gaining acceptance and this paper confirms the above mentioned treatment protocol. PMID:24350119

Nazerani, Shahram; Sohrabi, Mehran; Shirali, Amir; Nazerani, Tina

2012-01-01

63

Surgical management of combat-related upper extremity injuries.  

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

64

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

65

A myoelectric prosthesis controller  

Microsoft Academic Search

Myoelectric prostheses are preferred for their natural way of control and enhanced cosmetic restoration. Developing a software program that proportionally controls an upper limb myoelectric prosthesis is our target. Software processing of the (EMG) signal was performed by extracting the energy, RMS, and zero crossings features from the EMG signal, and then generating the appropriate control signal to the prosthesis

S. M. ElBasiouny; A. M. El-Bialy; M. F. Taher; A. H. Kandil; M. E. Rasmy

2003-01-01

66

Approach to complex upper extremity injury: an algorithm.  

PubMed

Patients with complex upper extremity injuries represent a unique subset of the trauma population. In addition to extensive soft tissue defects affecting the skin, bone, muscles and tendons, or the neurovasculature in various combinations, there is usually concomitant involvement of other body areas and organ systems with the potential for systemic compromise due to the underlying mechanism of injury and resultant sequelae. In turn, this has a direct impact on the definitive reconstructive plan. Accurate assessment and expedient treatment is thus necessary to achieve optimal surgical outcomes with the primary goal of limb salvage and functional restoration. Nonetheless, the characteristics of these injuries places such patients at an increased risk of complications ranging from limb ischemia, recalcitrant infections, failure of bony union, intractable pain, and most devastatingly, limb amputation. In this article, the authors present an algorithmic approach toward complex injuries of the upper extremity with due consideration for the various reconstructive modalities and timing of definitive wound closure for the best possible clinical outcomes. PMID:25685098

Ng, Zhi Yang; Askari, Morad; Chim, Harvey

2015-02-01

67

Adherence to the AAOS upper-extremity clinical practice guidelines.  

PubMed

The American Academy of Orthopaedic Surgeons (AAOS) recently developed several clinical practice guidelines (CPGs) involving upper-extremity conditions. The purpose of this study was to evaluate the adherence to these CPGs by members of the American Society for Surgery of the Hand (ASSH). An e-mail containing a brief study description and access to the survey was sent to ASSH current and candidate members. The survey contained questions involving the existing upper-extremity AAOS CPGs: diagnosis and treatment of carpal tunnel syndrome, treatment of distal radius fractures, and treatment of glenohumeral arthritis. Overall, 469 responses were obtained, for a response rate of 32%. Descriptive statistics were used to evaluate the responses. Members of ASSH do not universally adhere to the AAOS CPGs. For patients with carpal tunnel syndrome, 53% of respondents wait the recommended time to change nonoperative treatment after failure of a given modality, and 32% of respondents always order electrodiagnostic testing when considering surgery. Furthermore, 30% of respondents immobilize the wrist postoperatively. In regard to distal radius fractures, 11% of respondents always prescribe vitamin C after treatment, and 49% respondents never do so. However, ASSH members follow some of the recommendations. These include nighttime splinting (98%) and corticosteroid injections (85%) in the nonoperative treatment of carpal tunnel syndrome. For distal radius fractures, almost 85% of respondents consider the suggested postreduction criteria when determining operative versus cast treatment. Further study is warranted to understand the reasons for and possible solutions to the inconsistent adherence to the AAOS CPGs. PMID:24200445

Matzon, Jonas L; Lutsky, Kevin F; Maloney, Michael; Beredjiklian, Pedro K

2013-11-01

68

Reverse flow flap use in upper extremity burn contractures.  

PubMed

Upper extremity contractures still happen and constitute one of the most trying challenges in burn patients. This series comprised of 4 radial forearm flaps, 14 dorsoulnar artery flaps, and 4 medial arm flaps, all of which were used in a reverse pattern for upper extremity postburn contractures. The reverse flow radial forearm flap (RRFF) was chosen for reconstruction of extensive palmar contractures after burn. The reverse flow dorsoulnar flap (RDUF) was used particularly for reconstruction of the hypothenar aspect of the hand which requires moderate size tissue transfer. The reverse medial arm flap (RMAF) was used for elbow contractures after burn. In the first RMAF, venous congestion occurred and was finaly resolved with minimal flap loss, which was managed with STSG later. In the following 3 cases the flap was supercharged with anastomosis of the brachial vein into the antebrachial vein. Both RRFF and RDUF may provide a smooth and efficient solution. However, RMAF has a significant venous problem, which may result in flap loss, therefore, this flap should not be considered as a first option in the elbow area. PMID:18804917

Uygur, Fatih; Sever, Celalettin; Evinç, Rahmi; Ulkür, Ersin; Duman, Haluk

2008-12-01

69

Amputation and prosthesis.  

PubMed

Amputation of a limb is a drastic therapy in cattle and should be considered as a last resort in the treatment of limb injuries. Even though the surgical technique for amputation is simple, daily limb management, prosthesis manufacture, and adaptation of the animal to the prosthesis are difficult and time consuming. Dedication of the owner to the aftercare required for the rest of the animal's life is extremely important. Amputation of a limb with prosthesis application is a method of saving valuable animals for breeding purposes or animals of sentimental value. The author reviews his experience with partial foreleg amputation and prosthesis application in three heifers. PMID:8705805

St Jean, G

1996-03-01

70

Antimicrobial surface coatings for a permanent percutaneous passage in the concept of osseointegrated extremity prosthesis.  

PubMed

The clinical implementation of percutaneous implants is still limited owing to infections at the side of the stoma. In our concept, this issue is addressed by designing copolymer surface coatings possessing biocompatibility and antimicrobial activity to improve the maintenance of a physiological skin seal at the skin-implant interface. Different copolymers with surface-active phosphonate and antimicrobial cationic groups were designed. Thus, coated titanium samples were cultured with bacterial strains or fibroblasts, respectively. Antimicrobial impact was evaluated by imaging the reduction of bacterial adherence. Biocompatibility was displayed by fibroblast proliferation and morphology. A variety of copolymers of 4-vinylpyridine with vinylbenzylphosphonate or dimethyl(2-methacryloyloxy-ethyl) phosphonate were prepared by free radical polymerization. The optimized polymer coating (copolymer D) showed a reduction of adherent bacteria up to 95%, with only a slight reduction in the adherence of human fibroblasts compared with blank titanium controls. In this study, we demonstrate in vitro that polymer surface coatings can be simultaneously antimicrobial and biocompatible. We consider this to be a promising technology for the realization of a permanent aseptic percutaneous passage as needed for the advancement of osseointegrated limb prosthesis. PMID:23183722

Calliess, Tilman; Sluszniak, Magda; Winkel, Andreas; Pfaffenroth, Cornelia; Dempwolf, Wibke; Heuer, Wieland; Menzel, Henning; Windhagen, Henning; Stiesch, Meike

2012-12-01

71

Upper extremity impedance plethysmography in patients with venous access devices.  

PubMed

Central venous access devices (VADs) are often associated with thrombotic obstruction of the axillary-subclavian venous system. To explore the accuracy of impedance plethysmography (IPG) in identifying this complication we performed IPG on 35 adult cancer patients before their VADs were placed and approximately 6 weeks later. At the time of the second IPG the patients also underwent contrast venography of the axillary-subclavian system. The venograms revealed partial venous obstruction in 12 patients (34%) and complete obstruction in two (5.7%). Although the IPG results from venographically normal and abnormal patients overlapped extensively, mean measurements of venous outflow were significantly lower in the patient population with abnormal venograms (P = 0.052 for Vo; P = 0.0036 for Vo/Vc). In our hands, therefore, upper extremity IPG cannot be used to make clinical decisions about individual patients with VADs, but it can distinguish venographically normal and abnormal populations. PMID:7878628

Horne, M K; Mayo, D J; Alexander, H R; Steinhaus, E P; Chang, R C; Whitman, E; Gralnick, H R

1994-10-01

72

An implantable myoelectric sensor based prosthesis control system.  

PubMed

We present progress on the design and testing of an upper-extremity prosthesis control system based on implantable myoelectric sensors. The implant consists of a single silicon chip packaged with transmit and receive coils. Forward control telemetry to, and reverse EMG data telemetry from multiple implants has been demonstrated. PMID:17946995

DeMichele, Glenn A; Troyk, Philip R; Kerns, Douglas A; Weir, Richard

2006-01-01

73

Development of a prosthesis shoulder mechanism for upper limb amputees: application of an original design methodology to optimize functionality and wearability  

Microsoft Academic Search

The application of a design methodology for the determination of the optimal prosthesis architecture for a given upper limb\\u000a amputee is presented in this paper along with the discussion of its results. In particular, a novel procedure was used to\\u000a provide the main guidelines for the design of an actuated shoulder articulation for externally powered prostheses. The topology\\u000a and the

Marco Troncossi; Corrado Borghi; Marco Chiossi; Angelo Davalli; Vincenzo Parenti-Castelli

2009-01-01

74

Mechanosensitivity in the upper extremity following breast cancer treatment  

PubMed Central

Study Design Descriptive, cross-sectional. Introduction Breast cancer (BC) treatments place the nervous system at risk, which may contribute to upper extremity (UE) mechanosensitivity. Purpose of the Study To evaluate elbow extension range of motion (EE-ROM) during upper limb neurodynamic testing (ULNT) post-BC treatment. Methods ULNT EE-ROM was measured for 145 women post-BC treatment. Women were sub-grouped by presence/absence of pain and lymphedema Results Mean EE-ROM during ULNT1 was ?22.3° (SD: 11.9°) on the unaffected limb and ?25.99° (SD 13.1°) on the affected limb. The women with pain and lymphedema had the greatest limitation in EE-ROM during ULNT1 testing, particularly of their affected limb (?33.8°, SD 12.9). Symptoms were reported more frequently in the affected chest, shoulder, arm, elbow, and hand. The intensity of symptoms was greater at the affected chest (p=0.046), shoulder (p=0.033) and arm (p=0.039). Conclusions Women with lymphedema and pain after BC treatment may present with altered neural mechanosensitivity. PMID:24084387

Smoot, Betty; Boyd, Benjamin S; Byl, Nancy; Dodd, Marylin

2013-01-01

75

Thermograpic study of upper extremities in patients with cerebral palsy  

NASA Astrophysics Data System (ADS)

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

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

2015-03-01

76

Vascularized bone grafts to the upper extremity. Indications and technique.  

PubMed

Massive autogenous bone grafts with an intact vascular pedicle decrease the time to bony union and immobilization required for treatment of segmental bony defects. These techniques have been shown to be effective in treatment of segmental defects of more than 6 cm after trauma or tumor resection in relatively avascular beds. Additionally, in the upper extremity, the free vascularized bone graft is in the developmental phase for employment in the reconstruction of epiphyseal arrest and congenital radial club hand. There are disadvantages to free vascularized bone transfers compared with conventional techniques. For example, a free vascularized fibular transfer requires a team skilled in microvascular technique, a long operative time (6 to 10 hours), and the sacrifice of a major vessel to the lower extremity. If the anastomosis fails, however, the free vascularized fibula will act as a conventional bone graft, thereby minimizing adverse effects. We think that by proper patient selection, appropriate evaluation and preparation of the bony defect, meticulous microvascular anastomosis, and correct fixation and immobilization of the graft a good outcome can be achieved in those patients with large bony defects that defy the use of conventional methods. PMID:1400603

Gerwin, M; Weiland, A J

1992-08-01

77

Identifying the role of proprioception in upper-limb prosthesis control: Studies on targeted motion  

Microsoft Academic Search

Proprioception plays a crucial role in enabling humans to move purposively and interact with their physical surroundings. Current technology in upper-limb prostheses, while beginning to incorporate some haptic feedback, does not provide amputees with proprioceptive information about the state of the limb. Thus, the wearer must visually monitor the limb, which is often inconvenient or even impossible for some tasks.

Amy Blank; Allison M. Okamura; Katherine J. Kuchenbecker

2010-01-01

78

Monitoring of Upper Limb Prosthesis Activity in Trans-Radial Amputees  

Microsoft Academic Search

\\u000a There has been a shift in rehabilitation medicine from conventional evaluation procedures towards more quantitative approaches.\\u000a However, up to now, a quantitative evaluation procedure for upper limb prostheses that is applicable outside of the laboratory\\u000a or clinical environment has not been established. The requirement for such a procedure arises from the findings of a number\\u000a of recent studies suggesting that

Mohammad Sobuh; Laurence Kenney; Phil Tresadern; Martin Twiste; Sibylle Thies

79

Myoelectric signals pattern recognition for intelligent functional operation of upper-limb prosthesis  

Microsoft Academic Search

This paper presents a comparative study of the classification accuracy of myoelectric signals using multilayer perceptron with back-propagation algorithm and radial-basis functions networks. The myoelectric signals considered are used to classify four upper-limb movements which are elbow bending, elbow extension, wrist pronation and wrist supination. The network structure for multilayer perceptron is a fully connected one, while the structures used

N Chaiyaratana; A M S Zalzala; D Datta

1996-01-01

80

Nerve conduction studies of upper extremities in tennis players  

PubMed Central

Objectives: The influence of regular and intense practice of an asymmetric sport such as tennis on nerves in the elbow region was examined. Methods: The study included 21 male elite tennis players with a mean (SD) age of 27.5 (1.7) years and 21 male non-active controls aged 26.4 (1.9) years. Anthropometric measurements (height, weight, limb length, and perimeters of arm and forearm) were determined for each subject, and range of motion assessment and radiographic examination carried out. Standard nerve conduction techniques using constant measured distances were applied to evaluate the median, ulnar, and radial nerves in the dominant and non-dominant limb of each individual. Results: The sensory and motor conduction velocities of the radial nerve and the sensory conduction velocity of the ulnar nerve were significantly delayed in the dominant arms of tennis players compared with their non-dominant arms and normal subjects. There were no statistical differences in the latencies, conduction velocities, or amplitudes of the median motor and sensory nerves between controls and tennis players in either the dominant or non-dominant arms. However, the range of motion of the upper extremity was significantly increased in tennis players when compared with control subjects. Tennis players were taller and heavier than control subjects and their dominant upper limb lengths were longer, and arm and forearm circumferences greater, than those of the control subjects. Conclusions: Many of the asymptomatic tennis players with abnormal nerve conduction tests in the present study may have presymptomatic or asymptomatic neuropathy similar to subclinical entrapment nerve neuropathy. PMID:15388554

Colak, T; Bamac, B; Ozbek, A; Budak, F; Bamac, Y

2004-01-01

81

Recognizing Complex Upper Extremity Activities Using Body Worn Sensors  

PubMed Central

To evaluate arm-hand therapies for neurological patients it is important to be able to assess actual arm-hand performance objectively. Because instruments that measure the actual quality and quantity of specific activities in daily life are lacking, a new measure needs to be developed. The aims of this study are to a) elucidate the techniques used to identify upper extremity activities, b) provide a proof-of-principle of this method using a set of activities tested in a healthy adult and in a stroke patient, and c) provide an example of the method’s applicability in daily life based on readings taken from a healthy adult. Multiple devices, each of which contains a tri-axial accelerometer, a tri-axial gyroscope and a tri-axial magnetometer were attached to the dominant hand, wrist, upper arm and chest of 30 healthy participants and one stroke patient, who all performed the tasks ‘drinking’, ‘eating’ and ‘brushing hair’ in a standardized environment. To establish proof-of-principle, a prolonged daily life recording of 1 participant was used to identify the task ‘drinking’. The activities were identified using multi-array signal feature extraction and pattern recognition algorithms and 2D-convolution. The activities ‘drinking’, ‘eating’ and ‘brushing hair’ were unambiguously recognized in a sequence of recordings of multiple standardized daily activities in a healthy participant and in a stroke patient. It was also possible to identify a specific activity in a daily life recording. The long term aim is to use this method to a) identify arm-hand activities that someone performs during daily life, b) determine the quantity of activity execution, i.e. amount of use, and c) determine the quality of arm-hand skill performance. PMID:25734641

Lemmens, Ryanne J. M.; Janssen-Potten, Yvonne J. M.; Timmermans, Annick A. A.; Smeets, Rob J. E. M.; Seelen, Henk A. M.

2015-01-01

82

Recognizing complex upper extremity activities using body worn sensors.  

PubMed

To evaluate arm-hand therapies for neurological patients it is important to be able to assess actual arm-hand performance objectively. Because instruments that measure the actual quality and quantity of specific activities in daily life are lacking, a new measure needs to be developed. The aims of this study are to a) elucidate the techniques used to identify upper extremity activities, b) provide a proof-of-principle of this method using a set of activities tested in a healthy adult and in a stroke patient, and c) provide an example of the method's applicability in daily life based on readings taken from a healthy adult. Multiple devices, each of which contains a tri-axial accelerometer, a tri-axial gyroscope and a tri-axial magnetometer were attached to the dominant hand, wrist, upper arm and chest of 30 healthy participants and one stroke patient, who all performed the tasks 'drinking', 'eating' and 'brushing hair' in a standardized environment. To establish proof-of-principle, a prolonged daily life recording of 1 participant was used to identify the task 'drinking'. The activities were identified using multi-array signal feature extraction and pattern recognition algorithms and 2D-convolution. The activities 'drinking', 'eating' and 'brushing hair' were unambiguously recognized in a sequence of recordings of multiple standardized daily activities in a healthy participant and in a stroke patient. It was also possible to identify a specific activity in a daily life recording. The long term aim is to use this method to a) identify arm-hand activities that someone performs during daily life, b) determine the quantity of activity execution, i.e. amount of use, and c) determine the quality of arm-hand skill performance. PMID:25734641

Lemmens, Ryanne J M; Janssen-Potten, Yvonne J M; Timmermans, Annick A A; Smeets, Rob J E M; Seelen, Henk A M

2015-01-01

83

Patient selection for an upper extremity neuroprosthesis in tetraplegic individuals.  

PubMed

One hundred and twenty persons with new onset traumatic tetraplegia consecutively admitted to our rehabilitation service were screened for consideration for use of an upper extremity neuroprosthesis. Strict inclusion criteria allowed only for participation of patients with ASIA impairment scale A, B or C injuries at the C5 or C6 level. One hundred and six persons were excluded from participation for the following reasons: five patients died, 27 had central cord syndrome, two had Brown-Sequard syndrome, 12 were injured at too high a level, 42 were injured at too low a level, two were excluded on the basis of motor incompleteness alone, four were excessively denervated, two had limited range of motion, one had overriding medical complications, seven had psychosocial issues making participation impractical, and two elected tendon transfer surgery. In total, 14 patients (representing 11.7% of all tetraplegic individuals and 50% of the C5 or C6 ASIA Impairment Scale A, B or C patients) were found to be candidates for the neuroprosthesis. Given the prevalence of tetraplegia, approximately 12,200 Americans would be candidates for the FES neuroprosthetic hand grasp system under the current research protocols. With both the expansion of current protocols to other diagnostic categories and further research and development, application of this neuroprosthesis to a considerable number of previously excluded subjects will likely be possible. PMID:9300960

Gorman, P H; Wuolle, K S; Peckham, P H; Heydrick, D

1997-09-01

84

Peripheral nerve entrapment and injury in the upper extremity.  

PubMed

Peripheral nerve injury of the upper extremity commonly occurs in patients who participate in recreational (e.g., sports) and occupational activities. Nerve injury should be considered when a patient experiences pain, weakness, or paresthesias in the absence of a known bone, soft tissue, or vascular injury. The onset of symptoms may be acute or insidious. Nerve injury may mimic other common musculoskeletal disorders. For example, aching lateral elbow pain may be a symptom of lateral epicondylitis or radial tunnel syndrome; patients who have shoulder pain and weakness with overhead elevation may have a rotator cuff tear or a suprascapular nerve injury; and pain in the forearm that worsens with repetitive pronation activities may be from carpal tunnel syndrome or pronator syndrome. Specific history features are important, such as the type of activity that aggravates symptoms and the temporal relation of symptoms to activity (e.g., is there pain in the shoulder and neck every time the patient is hammering a nail, or just when hammering nails overhead?). Plain radiography and magnetic resonance imaging are usually not necessary for initial evaluation of a suspected nerve injury. When pain or weakness is refractory to conservative therapy, further evaluation (e.g., magnetic resonance imaging, electrodiagnostic testing) or surgical referral should be considered. Recovery of nerve function is more likely with a mild injury and a shorter duration of compression. Recovery is faster if the repetitive activities that exacerbate the injury can be decreased or ceased. Initial treatment for many nerve injuries is nonsurgical. PMID:20082510

Neal, Sara; Fields, Karl B

2010-01-15

85

The influence of wheelchair propulsion technique on upper extremity muscle demand: A simulation study  

E-print Network

The influence of wheelchair propulsion technique on upper extremity muscle demand: A simulation with wheelchair propulsion. Recent studies have identified cadence, contact angle and peak force as important factors for reduc- ing upper extremity demand during propulsion. However, studies often make comparisons

86

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

Microsoft Academic Search

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

L. Punnett

1998-01-01

87

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

ClinicalTrials.gov

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

2014-12-17

88

Design and Modeling of an Upper Extremity Exoskeleton S. Moubarak1  

E-print Network

Design and Modeling of an Upper Extremity Exoskeleton S. Moubarak1 , M.T. Pham1 , T. Pajdla2 and T presents the design and modeling results of an upper extremity exoskeleton mounted on a wheel chair without the continuous presence of a therapist. The exoskeleton being a wearable robotic device attached

Boyer, Edmond

89

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

Microsoft Academic Search

BACKGROUND: Similar upper extremity symptoms can present with varied physiologic etiologies. However, due to the multifaceted nature of musculoskeletal conditions, a definitive diagnosis using physical examination and advanced testing is not always possible. This report discusses the diagnosis and case management of a patient with two episodes of similar upper extremity symptoms of different etiologies. CASE PRESENTATION: On two separate

Clifford W Daub

2007-01-01

90

Venous haemodynamics of the upper extremity after subclavian vein thrombosis.  

PubMed

Late post-thrombotic complaints after subclavian vein thrombosis are reported with highly varying frequencies (8-80% severe disability). The therapeutic approach depends partly on this frequency. With the aim to evaluate late sequelae a questionnaire was answered by 26 patients with arm-shoulder symptoms leading to arm phlebography, but where the examination did not reveal any thrombi. 65% had remaining symptoms 2-9 years after the examination. 3 had to change profession. 36 patients with phlebographically shown subclavian vein thrombosis answered the same questionnaire. Only 9 (25%) had remaining symptoms and in 4 it was classified as mild, in 4 as moderate and only in 1 patient as severe leading to change of profession. Venous haemodynamics in the upper extremity were also studied in 3 groups of patients; I) healthy volunteers (n = 16 arms), II) patients with arm-shoulder disabilities with negative arm phlebography (n = 7 disabled arms, n = 7 non-disabled arms), III) patients with phlebographically verified subclavian vein thrombi (n = 10 arms with DVT, n = 8 arms without DVT). Strain gauge plethysmography was used measuring venous capacity and maximal venous outflow. Venous pressure measurements were made both with the arms in a resting position and in a military position with and without work-load. Repeat phlebography of arms with symptoms were made. Maximal venous outflow was significantly lower in arms with previous subclavian vein thrombi (p less than 0.05) and venous pressure measurements with the arm in military position was significantly higher in those arms. However, no correlation between these measurements and the degree of arm disability was noted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2238816

Lindblad, B; Bornmyr, S; Kullendorff, B; Bergqvist, D

1990-01-01

91

Upper-extremity stress fractures: distribution and causative activities in 70 patients.  

PubMed

Stress fractures of the upper extremity and thorax are often unrecognized injuries in athletes and nonathletes. The authors reviewed the causative activities and anatomic distribution of rib and upper-extremity stress fractures. Radiographic and clinical information was reviewed for each case to determine anatomic site and causative activity of each stress fracture. Stress fracture, although an uncommon diagnosis outside the lower extremity and lumbar spine, should be included in the differential diagnosis of patients with pain in the ribs and upper extremity. PMID:22955388

Miller, Timothy L; Kaeding, Christopher C

2012-09-01

92

Computer Use Patterns Associated with Upper Extremity Musculoskeletal Symptoms  

PubMed Central

Introduction Over half of surveyed college students are experiencing pain they are attributing to computer use. The study objective was to evaluate the effect of computing patterns on upper extremity musculoskeletal symptoms. Methods Symptom experiences and computing/break patterns were reported several times daily over three weeks for 30 undergraduate students over a semester. Two-level logistic regression models described the daily association between each computing pattern and both any and moderate or greater symptom experienced, for covariates. Results The associations between most computing/break patterns and experiencing any symptoms were positive: total hours of computer use adjOR = 1.1 (90% CI 1.1–1.2), 1–2 breaks versus none adjOR = 1.3 (90% CI 0.9–1.9), 3–6 breaks versus none adjOR = 1.5 (90% CI 1.1–2.2), >15 min break versus none adjOR = 1.6 (90% CI 1.1–2.2), and number of stretch breaks adjOR = 1.3 (90% CI 1.1–1.5). However, breaks for less than 15 min were negatively associated with experiencing any symptoms: adjOR = 0.6 (90% CI 0.5–0.9). The associations between most computing/break patterns and experiencing moderate or greater symptoms were positive: total hours of computer use OR = 1.1 (90% CI 1.1–1.2), 1–2 breaks and 5–6 breaks versus none OR = 1.8 (90% CI 1.1–2.9), 7–8 breaks versus none OR = 2.0 (1.0–4.2), >15 min break versus none 1.8 (1.1–3.1), and number of stretch breaks OR = 1.3 (1.0–1.5). Conclusion Computing/break patterns were consistently associated with experiencing symptoms. Our findings suggest evaluating breaks with computing duration (computing patterns) is more informative than assessing computing duration alone and can be used to better design ergonomic training programs for student populations that incorporate break times. PMID:18204927

Menéndez, Cammie Chaumont; Amick, Benjamin C.; Chang, Che-Hsu (Joe); Dennerlein, Jack T.; Harrist, Ronald B.; Jenkins, Mark; Robertson, Michelle; Katz, Jeffrey N.

2012-01-01

93

Nephrotic Syndrome Complicated with Deep Venous Thrombosis in the Upper Extremities  

PubMed Central

Deep venous thrombosis (DVT) in the upper extremities is a rare but important clinical illness, which leads to severe complications such as pulmonary embolism. Unlike DVT in the lower extremities, which is mainly induced by a hypercoagulable state, DVT in the upper extremities is usually caused by mechanical obstruction or anatomical stenosis in the venous system. We herein report a case in which DVT developed in the left upper limb during treatment of nephrotic syndrome. This is the first case report of upper-extremity DVT in association with nephrotic syndrome in the literature. Our patient was a 56-year-old male with nephrotic syndrome due to idiopathic membranous nephropathy who was treated with 40 mg/day of prednisolone. During corticosteroid therapy, he developed a swelling of the left upper limb. Computed tomography revealed thrombi in the left internal jugular vein and the left subclavian vein without anatomical abnormalities in his venous system. Thus, he was diagnosed with DVT of the upper extremities. After the initiation of warfarin treatment and subsequent regression of nephrotic syndrome, the swelling disappeared and the thrombi significantly diminished. DVT should be considered when upper-extremity edema is observed in patients with nephrotic syndrome.

Onishi, Akira; Inoue, Makoto; Imai, Toshimi; Takeda, Shin-ichi; Kondo, Mariko; Shimada, Kazuyuki; Nagata, Daisuke

2015-01-01

94

[Endoscopically assisted nerve decompression of nerve nerve compression syndromes at the upper extremity].  

PubMed

Besides carpal tunnel and cubital tunnel syndrome, other nerve compression or constriction syndromes exist at the upper extremity. Using the technique of endoscopically assisted decompression such rare nerve compression syndromes of the upper extremity can be treated. The technique of endoscopical decompression is presented in six patients with rare compression or hour-glass-like constriction syndromes at the upper extremity. According to the classification of Roles and Maudsley in 5 of 6 cases excellent results were recorded. All but one patient considered the results excellent. The poorest responder developed a CRPS II and refused postoperative physiotherapy. Endoscopically assisted decompression in rare compression syndrome of the upper extremity is highly appreciated by patients and provides excellent functional results. PMID:24972520

Bignion, Dietmar; Leclère, Franck Marie P; Vögelin, Esther

2014-07-01

95

Regional anesthesia procedures for shoulder and upper arm surgery upper extremity update--2005 to present.  

PubMed

This review of the literature since 2005 assesses developments of RA techniques commonly used for shoulder surgery, and their effectiveness for postoperative analgesia. Advantages of regional techniques include site-specific anesthesia and decreased postoperative opioid use. For shoulder surgeries, the ISB provides effective analgesia with minimal complications, whereas the impacts of IA single-injections remain unclear. When combined with GA, ISB can be used in lower volumes and reducing the complications for shoulder and proximal upper extremity. USG ISB and SCB are both effective and safe for shoulder surgery with a low incidence of complications, especially PONS.53 When compared with intravenous patient-controlled opioid analgesia, a perineural LA infusion using a disposable pump with patient-controlled LA bolus function has led to better pain relief and functional recovery while decreasing the need for rescue analgesics and the number of adverse events after ambulatory orthopedic surgery. The most remarkable advance in RA in the past 5 years is the increased usage of USG. Although there are no large-scale prospective studies to show the safety, efficacy, and success and complication rates for USG blocks, USG RA theoretically could have less risk for neurologic symptoms, except for those induced by LA (less likely perineurally, much more likely intraneurally). The next "quantum leap" lies in reducing LA concentrations and augmenting anesthetic-analgesic effects with perineural additives (including clonidine, buprenorphine, and likely low-dose dexamethasone). Since 2005, perineural catheters have been an analgesic option that offers improved pain relief among other benefits, and are now being used at home. It is clear that patients benefit greatly from a single injection and continuous nerve block for postoperative pain management,but the financial and logistical aspects need to be resolved, not to mention the phrenic hemiparesis coin toss. Whether combined perineural analgesic adjuvants prolong low-concentration LA nerve blocks sufficiently to render brachial plexus catheters as unnecessary would certainly represent another quantum leap. PMID:22227421

Sripada, Ramprasad; Bowens, Clifford

2012-01-01

96

Old and new risk factors for upper extremity deep venous thrombosis  

Microsoft Academic Search

Background: Well known risk factors for upper extremity deep venous thrombosis are the presence of a central venous catheter (CVC) and malignancy, but other potential risk factors, such as surgery, injury and hormone replacement therapy (HRT), have not yet been explored. Methods: We performed a population-based case-control study including 179 consecutive patients, aged 18–70 years with upper extremity deep venous

J. W. Blom; C. J. M. Doggen; S. Osanto; F. R. Rosendaal

2005-01-01

97

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

Microsoft Academic Search

To investigate the role of MR imaging (MRI) in the evaluation of peripheral nerve lesions of the upper extremities and to\\u000a assess its impact on the patient management. Fifty-one patients with clinical evidence of radial, median, and\\/or ulnar nerve\\u000a lesions and unclear or ambiguous clinical findings had MRI of the upper extremity at 1.5 T. MR images and clinical data were

Gustav Andreisek; Doris Burg; Ansgar Studer; Dominik Weishaupt

2008-01-01

98

Reliability of intracortical and corticomotor excitability estimates obtained from the upper extremities in chronic stroke  

Microsoft Academic Search

We estimated the trial-to-trial variability and the test–retest reliability of several intracortical and corticomotor excitability parameters for the upper extremity in chronic stroke patients. Nine patients with hemiparesis of the upper extremity were enrolled 8–17 months after a unilateral stroke. Transcranial magnetic stimulation was used to obtain repeated measures over a two week interval of motor evoked potential (MEP) recruitment

Lisa Koski; Janice Chien-Ho Lin; Allan D. Wu; Carolee J. Winstein

2007-01-01

99

Elimination of upper bracket resonance in extremely high head Francis hydro-generators  

Microsoft Academic Search

Resonance occurred in the upper bracket of extremely high head Francis hydro-generators due to rotational vibrations. The vibration source was determined from field tests and a finite element analysis (FEA) of the structure. The first order natural frequency of the integrated structure including the upper bracket and the stator frame was then altered using the FEA model. The resonance during

Yongyao Luo; Zhengwei Wang; Guodong Chen; Zujian Lin

2009-01-01

100

Preserved grip selection planning in chronic unilateral upper extremity amputees  

Microsoft Academic Search

Upper limb amputees receive no proprioceptive or visual sensory feedback about their absent hand. In this study, we asked\\u000a whether chronic amputees nevertheless retain the ability to accurately plan gripping movements. Fourteen patients and matched\\u000a controls performed two grip selection tasks: overt grip selection (OGS), in which they used their intact hand to grasp an\\u000a object that appeared in different

Benjamin A. PhilipScott; Scott H. Frey

101

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

102

Injuries sustained to the upper extremity due to modern warfare and the evolution of care.  

PubMed

The formation of the American Society for Surgery of the Hand was related to world conflicts and hostilities. Therefore, it is appropriate that upper-extremity surgeons understand injuries resulting from modern-day combat. Because of ongoing warfare, many countries have experienced a large increase in the number of wounded service members and civilians, particularly wounds of the extremities. As a result of increased rate of survival in battlefield trauma in part because of the use of modern body armor, there is increasing complexity of extremity injuries that require complex reconstructions. Decreased mortality and a consequent increase in the incidence of injured extremities underline the need for the development of new treatment options. The purpose of this presentation is to describe upper-extremity injury patterns in modern warfare, the levels of care available, and the treatment at each level of care based on the experience of the United States Military Medical Support System. PMID:17923293

Hofmeister, Eric P; Mazurek, Michael; Ingari, Jack

2007-10-01

103

A Study of Upper Extremity Training for Patients with Stroke Using a Virtual Environment System  

PubMed Central

[Purpose] A virtual environment (VE) system was designed to facilitate the retraining of motor control by feedback of movement trajectory to patients with neurological impairments, such as stroke victims or those with an acquired brain injury. In this study, we quantitatively assessed motion trajectory of the upper extremity during VE in order to further understand the effect of paralyzed upper extremity movement in VE for each patient as well as the functional clinical evaluations. [Subjects and Methods] Six patients with stroke were participated in this study. The VE system consisted of a computer, an electromagnetic motion tracking device, which monitored and displayed patient movement on the computer, and the VE software, which provided the tools for creating training scenes. This system was used to facilitate motor relearning of the upper extremity for six patients with stroke. [Results] The results showed there were improvements in variability and accuracy of the arm movement in motion trajectory. In addition, the scores of clinical evaluations improved, and VE did not hinder motor relearning of the upper extremity, which is necessary for activities of daily living. [Conclusion] This VE system might be effective at facilitating motor relearning of the upper extremity for stroke patients. PMID:24259805

Tanaka, Toshiaki; Kudo, Akira; Sugihara, Syunichi; Izumi, Takashi; Maeda, Yusuke; Kato, Norio; Miyasaka, Tomoya; Holden, Maureen K.

2013-01-01

104

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. PMID:25435682

Lee, Daehee; Park, Jungseo; Lee, Sangyong

2014-01-01

105

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

106

Effects of two workstation positions for below-knee assembly work on upper extremity muscle activity  

PubMed Central

[Purpose] This study was performed to determine which set of below-knee working conditions minimizes upper extremity muscle activity and which of upward- or downward-direction workstations poses the greater risk of upper extremity disorder. [Subjects] The study population consisted of 15 young male workers. [Methods] EMG activities of the right anterior deltoid, biceps brachii, and lower trapezius muscles were measured in two below-knee assembly workstation positions. [Results] The anterior deltoid and biceps brachii muscle activities of Position 1 were significantly higher than those of Position 2. The lower trapezius muscle activity of Position 2 was significantly higher than that of Position 1. [Conclusion] Upward-direction workstations appear to pose a greater risk of upper extremity disorder than downward-direction workstations in below-knee assembly work. PMID:25642024

Shin, Seung-je; Yoo, Won-gyu

2015-01-01

107

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

108

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

109

The Effects of Active Scapular Protraction on the Muscle Activation and Function of the Upper Extremity  

PubMed Central

[Purpose] The purpose of this study was to determine the effects of adjusting the scapula into its ideal position through active scapular protraction on the muscle activation and function of the upper extremity. [Subjects] Twenty female college students aged 19–21 without any physical or functional disability were the subjects of this study. They had no history of injury to their upper extremities or hands. [Methods] After the initial measurements the experimental group was asked to perform active scapular protraction; then, their grip strength and muscle activation were measured again. Every action was maintained for 5 seconds and repeated 3 times. The mean values of the measurements were analyzed. A resting of 1 minute was given between each action. [Results] The results revealed a significant change in the experimental group’s grip strength after active scapular protraction had been performed. The surrounding muscles of the scapula, such as the serratus anterior, upper trapezius, flexor carpi ulnaris, flexor carpi radialis and palmaris longus, showed significant changes in muscle activation after active scapular protraction. The muscles of the upper extremity also showed significant changes after active scapular protraction. [Conclusion] The adjustment of scapula into its ideal position through active scapular protraction increased the activations of the muscles surrounding the shoulder joint and improved the function of the upper extremity. PMID:24764642

Yang, Jeongok; Lee, Joongsook; Lee, Bomjin; Jeon, Sora; Han, Bobae; Han, Dongwook

2014-01-01

110

Subcutaneous abscess formation in the upper extremity caused by toxigenic Corynebacterium ulcerans.  

PubMed

Corynebacterium ulcerans is attracting attention as an emerging zoonosis that causes lymphadenitis, dermatitis and respiratory infections. We report here what appears to be the first case of subcutaneous abscess formation in the upper extremity due to toxigenic C. ulcerans in Japan. Awareness of the fact that C. ulcerans can cause a subcutaneous, elastic-hard, less-mobile mass with heat, redness and pain in the extremities is important for differential diagnosis. PMID:23222862

Urakawa, Takaaki; Seto, Junji; Yamamoto, Akihiko; Nakajima, Tomoko; Goto, Shinichi

2013-03-01

111

The Effect of Upper Extremity Fatigue on Grip Strength and Passing Accuracy in Junior Basketball Players  

PubMed Central

Fatigue is an unavoidable part of a basketball game, which may affect an athlete’s performance. The aim of this study was to investigate the effect of upper extremity fatigue on grip strength and passing accuracy in basketball, and ascertain if the effects of different fatigue protocols on grip strength and passing accuracy are the same. Twenty-four juniors under 18 years old (age: 16.75 ± 0.62 years; body height: 184.5 ± 3.31 cm; body mass: 77.25 ± 3.22 kg) volunteered to participate in the study, and were divided into two groups. After a warm-up, both groups performed the basketball passing test and grip strength was recorded for each group under three different testing conditions: rest, 70% and 90% exercise intensity. The protocol used for the first group was the chest press, and for the second group the wrist curls. Results show that after the upper extremity fatigue protocol all parameters of the study (grip strength and passing accuracy) showed a significant decrease, and there was no significant difference between both groups regarding grip strength and passing accuracy. The study suggested that in order to avoid upper extremity fatigue, basketball trainers and coaches need to include upper extremity conditioning exercises into their training sessions. PMID:24146707

Ahmed, Taghread

112

Paleohydrologic bounds and extreme flood frequency of the Upper Arkansas River, Colorado, USA  

E-print Network

, Flood Hydrology, 86-68250, Denver Federal Ctr., Denver, CO 80225, USA b Bureau of Reclamation, Sedimentation and River Hydraulics, 86-68240, Denver Federal Ctr., Denver, CO 80225, USA c Department of CivilPaleohydrologic bounds and extreme flood frequency of the Upper Arkansas River, Colorado, USA J

Julien, Pierre Y.

113

Nerve compression syndromes of the upper extremity: diagnosis, treatment, and rehabilitation.  

PubMed

Nerve compression syndromes of the upper extremity, including carpal tunnel syndrome, cubital tunnel syndrome, posterior interosseous syndrome and radial tunnel syndrome, are common in the general population. Diagnosis is made based on patient complaint and history as well as specific exam and study findings. Treatment options include various operative and nonoperative modalities, both of which include aspects of hand therapy and rehabilitation. PMID:23641462

Mansuripur, P Kaveh; Deren, Matthew E; Kamal, Robin

2013-05-01

114

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

Microsoft Academic Search

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

Carin F. Gonsalves; David J. Eschelman; Kevin L. Sullivan; Nancy DuBois; Joseph Bonn

2003-01-01

115

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

Microsoft Academic Search

Significant excursion of the ulnar nerve is required for unimpeded upper extremity motion. This study evaluated the excursion necessary to accommodate common motions of daily living and associated strain on the ulnar nerve. The 2 most common sites of nerve entrapment, the cubital tunnel and the entrance of Guyon's canal, were studied. Five fresh-frozen, thawed transthoracic cadaver specimens (10 arms)

Thomas W. Wright; Frank Glowczewskie; David Cowin; Donna L. Wheeler

2001-01-01

116

An ergonomic evaluation of surgeons’ axial skeletal and upper extremity movements during laparoscopic and open surgery  

Microsoft Academic Search

Background: Many surgeons have complained of fatigue and musculoskeletal pain after laparoscopic surgery. We evaluated differences in surgeons’ axial skeletal and upper extremity movements during laparoscopic and open operations.Methods: Five surgeons were videotaped performing 16 operations (8 laparoscopic and 8 open) to record their neck, trunk, shoulder, elbow, and wrist movements during the first hour of surgery. We also compared

Ninh T Nguyen; Hung S Ho; Warren D Smith; Constantine Philipps; Clare Lewis; Rodel M De Vera; Ramon Berguer

2001-01-01

117

Rehabilitation of the upper extremity following nerve and tendon reconstruction: when and how.  

PubMed

Following upper extremity nerve and tendon reconstruction, rehabilitation is necessary to achieve optimal function and outcome. In this review, the authors present current evidence and literature regarding the strategies and techniques of rehabilitation following peripheral nerve and tendon reconstruction. PMID:25685106

Novak, Christine B; von der Heyde, Rebecca L

2015-02-01

118

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

119

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

ERIC Educational Resources Information Center

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

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

2011-01-01

120

Using a Multi-touch Tabletop for Upper Extremity Motor Rehabilitation  

E-print Network

261 Using a Multi-touch Tabletop for Upper Extremity Motor Rehabilitation Michelle Annett, Fraser,frasera}@cs.ualberta.ca Darrell Goertzen, Jonathan Halton, Quentin Ranson Glenrose Rehabilitation Hospital Edmonton, Alberta into rehabilitation programs to improve their motor functioning and quality of life. Currently, many of the activities

Alberta, University of

121

The effect of upper extremity fatigue on grip strength and passing accuracy in junior basketball players.  

PubMed

Fatigue is an unavoidable part of a basketball game, which may affect an athlete's performance. The aim of this study was to investigate the effect of upper extremity fatigue on grip strength and passing accuracy in basketball, and ascertain if the effects of different fatigue protocols on grip strength and passing accuracy are the same. Twenty-four juniors under 18 years old (age: 16.75 ± 0.62 years; body height: 184.5 ± 3.31 cm; body mass: 77.25 ± 3.22 kg) volunteered to participate in the study, and were divided into two groups. After a warm-up, both groups performed the basketball passing test and grip strength was recorded for each group under three different testing conditions: rest, 70% and 90% exercise intensity. The protocol used for the first group was the chest press, and for the second group the wrist curls. Results show that after the upper extremity fatigue protocol all parameters of the study (grip strength and passing accuracy) showed a significant decrease, and there was no significant difference between both groups regarding grip strength and passing accuracy. The study suggested that in order to avoid upper extremity fatigue, basketball trainers and coaches need to include upper extremity conditioning exercises into their training sessions. PMID:24146707

Ahmed, Taghread

2013-01-01

122

A Piano Training Program to Improve Manual Dexterity and Upper Extremity Function in Chronic Stroke Survivors  

PubMed Central

Objective: Music-supported therapy was shown to induce improvements in motor skills in stroke survivors. Whether all stroke individuals respond similarly to the intervention and whether gains can be maintained over time remain unknown. We estimated the immediate and retention effects of a piano training program on upper extremity function in persons with chronic stroke. Methods: Thirteen stroke participants engaged in a 3-week piano training comprising supervised sessions (9?×?60?min) and home practice. Fine and gross manual dexterity, movement coordination, and functional use of the upper extremity were assessed at baseline, pre-intervention, post-intervention, and at a 3-week follow-up. Results: Significant improvements were observed for all outcomes at post-intervention and follow-up compared to pre-intervention scores. Larger magnitudes of change in manual dexterity and functional use of the upper extremity were associated with higher initial levels of motor recovery. Conclusion: Piano training can result in sustainable improvements in upper extremity function in chronic stroke survivors. Individuals with a higher initial level of motor recovery at baseline appear to benefit the most from this intervention. PMID:25202258

Villeneuve, Myriam; Penhune, Virginia; Lamontagne, Anouk

2014-01-01

123

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

Microsoft Academic Search

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

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

2008-01-01

124

Specific and non-specific upper extremity musculoskeletal disorder syndromes in automobile manufacturing workers  

PubMed Central

Objective A longitudinal cohort of automobile manufacturing workers (n = 1214) was examined for: 1) prevalence and persistence of specific upper extremity musculoskeletal disorders (UEMSDs) such as lateral epicondylitis and de Quervain's disease, and non-specific disorders (NSDs) defined in symptomatic individuals without any specific disorder, and 2) disorder prognoses based on symptom characteristics and other factors. Methods Eight specific disorders were identified through case definitions based on upper extremity physical examinations and symptom surveys administered on three occasions over six years. Results At baseline, 41% of the cohort reported upper extremity symptoms; 18% (n = 214) of these had NSDs. In each survey, tendon-related conditions accounted for over half of the specific morbidity. Twenty-five percent had UEMSDs in multiple anatomical sites, and most with hand/wrist disorders had two or more hand/wrist UEMSDs. Persistence for all specific disorders decreased with length of follow-up. Specific UEMSDs were characterized by greater pain severity and functional impairment, and more lost work days than NSDs. Conclusions Upper extremity symptoms and diagnoses vary over time. NSDs may be the early stages of conditions that will eventually become more specific. NSDs and overlapping specific UEMSDs should be taken into account in UEMSD classification. PMID:19016265

d'Errico, Angelo; Katz, Jeffrey N.; Gore, Rebecca; Punnett, Laura

2009-01-01

125

Musculotendon lengths and moment arms for a three-dimensional upper-extremity model.  

PubMed

Generating muscle-driven forward dynamics simulations of human movement using detailed musculoskeletal models can be computationally expensive. This is due in part to the time required to calculate musculotendon geometry (e.g., musculotendon lengths and moment arms), which is necessary to determine and apply individual musculotendon forces during the simulation. Modeling upper-extremity musculotendon geometry can be especially challenging due to the large number of multi-articular muscles and complex muscle paths. To accurately represent this geometry, wrapping surface algorithms and/or other computationally expensive techniques (e.g., phantom segments) are used. This paper provides a set of computationally efficient polynomial regression equations that estimate musculotendon length and moment arms for thirty-two (32) upper-extremity musculotendon actuators representing the major muscles crossing the shoulder, elbow and wrist joints. Equations were developed using a least squares fitting technique based on geometry values obtained from a validated public-domain upper-extremity musculoskeletal model that used wrapping surface elements (Holzbaur et al., 2005). In general, the regression equations fit well the original model values, with an average root mean square difference for all musculotendon actuators over the represented joint space of 0.39 mm (1.1% of peak value). In addition, the equations reduced the computational time required to simulate a representative upper-extremity movement (i.e., wheelchair propulsion) by more than two orders of magnitude (315 versus 2.3 s). Thus, these equations can assist in generating computationally efficient forward dynamics simulations of a wide range of upper-extremity movements. PMID:22520587

Rankin, Jeffery W; Neptune, Richard R

2012-06-01

126

Prosthesis coupling  

NASA Technical Reports Server (NTRS)

A coupling for use in an apparatus for connecting a prosthesis to the bone of a stump of an amputated limb is described which permits a bio-compatible carbon sleeve forming a part of the prosthesis connector to float so as to prevent disturbing the skin seal around the carbon sleeve. The coupling includes a flexible member interposed between a socket that is inserted within an intermedullary cavity of the bone and the sleeve. A lock pin is carried by the prosthesis and has a stem portion which is adapted to be coaxially disposed and slideably within the tubular female socket for securing the prosthesis to the stump. The skin around the percutaneous carbon sleeve is able to move as a result of the flexing coupling so as to reduce stresses caused by changes in the stump shape and/or movement between the bone and the flesh portion of the stump.

Reswick, J. B.; Mooney, V.; Bright, C. W.; Owens, L. J. (inventors)

1979-01-01

127

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

128

Rotator Cuff Repair in Upper Extremity Ambulators! Andrew Zganjar, 1Steven Grindel MD, 1Dara Mickschl PA-C!  

E-print Network

or female patients with shoulder impingement or rotator cuff tear who rely on AWDs for mobility. 2Rotator Cuff Repair in Upper Extremity Ambulators! ! Andrew Zganjar, 1Steven Grindel MD, 1Dara! ! Introduction · Patients who rely on their upper extremities for mobility are particularly prone to rotator cuff

129

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

ERIC Educational Resources Information Center

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

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

2011-01-01

130

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

131

Classification of surface electromyographic signals for control of upper limb virtual prosthesis using time-domain features  

Microsoft Academic Search

The development of a training system in the field of rehabilitation has always been a challenge for scientists. Surface electromyographical signals are widely used as input signals for upper limb prosthetic devices. The great mental effort of patients fitted with myoelectric prostheses during the training stage, can be reduced by using a simulator of such device. This paper presents an

S. Herle; Paula Raica; G. Lazea; R. Robotin; C. Marcu; L. Tamas

2008-01-01

132

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

133

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

134

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

Microsoft Academic Search

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

Carin F. Gonsalves; David J. Eschelman; Kevin L. Sullivan; Nancy DuBois; Joseph Bonn

2003-01-01

135

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

136

Trans-radial upper extremity amputees are capable of adapting to a novel dynamic environment  

Microsoft Academic Search

This study investigated differences in adaptation to a novel dynamic environment between eight trans-radial upper extremity\\u000a (UE) prosthetic users and eight naive, neurologically intact subjects. Participants held onto the handle of a robotic manipulandum\\u000a and executed reaching movements within a horizontal plane following a pseudo-random sequence of targets. Curl field perturbations\\u000a were imposed by the robot motors, and we compared

Christopher N. Schabowsky; Alexander W. Dromerick; Rahsaan J. Holley; Brian Monroe; Peter S. Lum

2008-01-01

137

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

Microsoft Academic Search

Traditional anticoagulant treatment of deep venous thrombosis (DVT) in the upper extremities (UEDVT) is associated with a\\u000a relatively high incidence of postthrombotic syndrome (PTS). Catheter-directed thrombolysis (CDT) for UEDVT would provide efficient\\u000a thrombolysis with less subsequent PTS than during traditional anticoagulation. Primary efficacy, complications, and long-term\\u000a results after CDT are reported in a retrospective cohort (2002–2007) of patients (n = 30) with

Anders Vik; Pål Andre Holme; Kulbir Singh; Eric Dorenberg; Kåre Christian Nordhus; Satish Kumar; John-Bjarne Hansen

2009-01-01

138

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

Microsoft Academic Search

Traditional anticoagulant treatment of deep venous thrombosis (DVT) in the upper extremities (UEDVT) is associated with a relatively high incidence of postthrombotic syndrome (PTS). Catheter-directed thrombolysis (CDT) for UEDVT would provide efficient thrombolysis with less subsequent PTS than during traditional anticoagulation. Primary efficacy, complications, and long-term results after CDT are reported in a retrospective cohort (2002-2007) of patients (n =

Anders Vik; Pal Andre Holme; Kulbir Singh; Eric Dorenberg; Kare Christian Nordhus; Satish Kumar; John-Bjarne Hansen

2009-01-01

139

Effect of clonidine on upper extremity tourniquet pain in healthy volunteers  

Microsoft Academic Search

Background and Objectives: Tourniquet pain is often a limiting factor during intravenous regional anesthesia (IVRA). The purpose of this study was to evaluate the efficacy of 1 ?g\\/kg of clonidine added to IVRA-lidocaine in decreasing the onset of severe tourniquet pain. Methods: Upper extremity IVRA was performed in 15 volunteers with a double-cuffed tourniquet on 2 separate occasions at least

Shari D. Lurie; Scott S. Reuben; Charles S. Gibson; Patricia A. DeLuca; Holly A. Maciolek

2000-01-01

140

Cognitive-Behavior Therapy in the Management of Upper Extremity Cumulative Trauma Disorder  

Microsoft Academic Search

Cognitive-behavioral techniques have a great deal to offer in the prevention and remediation of upper extremity cumulative trauma disorder (CTD) in the workplace In relation to prevention, cognitive-behavioral methods offer promise as adjuncts to educational programs and ergonomic practices that aim to increase workers' use of safe work postures, movements, and procedures. Cognitive-behavior therapy (CBT) is also an important component

Susan H. Spence

1998-01-01

141

A checklist for evaluating ergonomic risk factors associated with upper extremity cumulative trauma disorders  

Microsoft Academic Search

A two-page checklist for determining the presence of ergonomic risk factors associated with the development of upper extremity cumulative trauma disorders (e.g., repetitiveness, local mechanical contact stresses, forceful manual exertions, awkward postures, and hand tool usage) was developed and evaluated as part of a joint labour-management ergonomics intervention programme. This checklist was used by plant personnel at four work sites

W. M. KEYSERLING; D. S. STETSON; B. A. SILVERSTEIN; M. L. BROUWER

1993-01-01

142

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

143

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

NASA Astrophysics Data System (ADS)

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

Tian, Baoqiang; Fan, Ke

2013-08-01

144

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. PMID:25426368

2014-01-01

145

Free tissue transfer: an advanced strategy for postinfection soft-tissue defects in the upper extremity.  

PubMed

Surgical treatment of severe, necrotizing infections frequently leave compound defects that require complex reconstructive procedures. In the upper extremity, local flap coverage is limited because of the size of the lesions. Regarding the results of early microsurgical coverage of complex postinfectious defects of the lower extremity, the goal of this study was to evaluate the role of free tissue transfer in the treatment of severe infections in the upper extremity. Between 1994 and 1999, 24 patients with major defects as a result of severe necrotizing infections in the upper extremity underwent free tissue transfer. Parameters assessed included the success of infection control, flap survival rate, salvage of the extremity, and an outcome analysis by the Disability of Arm-Shoulder-Hand score and a visual analog scale. Patient age ranged from 17 to 75 years (average age, 50.8 years). Previous treatment of 11 patients in outlying hospitals included 4.2 operative procedures and a delay of admission to the authors' unit of 89 days. The average defect size after debridement was 10.0 x 14.4 cm. Twenty-four free flaps including 16 muscle or musculocutaneous flaps, 4 chimeric flaps from the subscapular system, and 4 osteocutaneous flaps were performed for reconstruction. The overall flap survival was 95.8%. One temporalis fascia flap (TPF) was lost as a result of vascular thrombosis, and three flaps underwent successful revision of the anastomoses. Eight patients required further minor surgical treatment. The Disability of Arm-Shoulder-Hand score yielded an average of 41.5 points, which represents a moderate impairment of activities of daily living. Visual analog scale assessment demonstrated an overall high satisfaction (9.5 points; range, 1-10 points). The data demonstrate that even in severe necrotizing infections resulting in complex acute or chronic defects, limb salvage and infection control can be achieved successfully with radical debridement and early free tissue transfer. PMID:12897517

Koschnick, Martin; Bruener, Simone; Germann, Guenter

2003-08-01

146

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

147

Upper extremity kinematic trends of fly-casting: establishing the effects of line length.  

PubMed

Fly-fishing is a popular form of recreation. Recent evidence has associated overhand fly-casting movements with upper extremity pain. However, little research exists on the motions and coordination common to fly-casting. The aim of this study was to establish upper extremity kinematic trends of fly-casting while casting greater line lengths. It was hypothesized that kinematic casting parameters would increase and time between peak angular velocities would decrease with greater line length. Eighteen males participated in the study. Three-dimensional motion capture was conducted to calculate shoulder, elbow, and wrist kinematics during casting conditions of 6.1, 12.2, 18.3, and 24.4 m of line. Multiple analyses of variance were used to assess the condition effect of line length on the kinematic variables (P = 0.05). Overall, total range of movement increased with increasing length of line cast. Peak angular velocity exhibited a proximal-to-distal trend: peak shoulder internal rotation followed by elbow extension, then wrist ulnar deviation. Time between peak shoulder and elbow angular velocities increased significantly as line length increased. Our findings indicate that specific changes in total range of movement accommodate the demands of casting greater lengths of line. Also, joint velocity coordination patterns of fly-casting appear to follow a proximal-to-distal pattern. These findings represent an initial foundation for connections between kinematics and upper extremity pain reported by fly-fisherman. PMID:18341135

Allen, Joshua R; O'Keefe, Kathryn B; McCue, Timothy J; Borger, Jason J; Hahn, Michael E

2008-01-01

148

Upper Extremity Thrombosis Presenting as Medial Elbow Pain after Shoulder Arthroscopy  

PubMed Central

Deep vein thrombosis of the upper extremity is believed to be an uncommon complication of arthroscopic shoulder surgery. It most commonly presents with significant swelling and pain throughout the upper extremity. However the diagnosis can be easily missed when findings are more subtle and unrelated or the patient asymptomatic. In this study we report on 5 cases of postoperative upper extremity deep vein thrombosis (UEDVT). Each case was performed in the lateral decubitus position with an interscalene block and postoperative sling immobilization. All patients presented with a primary complaint of medial elbow pain and went on to require anticoagulation. Only one patient was found to have a heritable coagulopathy. The true incidence of thromboembolic phenomena after shoulder arthroscopy may be higher than that reported in the current literature. Therefore a high index of suspicion must be maintained when evaluating patients postoperatively to avoid misdiagnosis. Symptoms of medial elbow pain after immobilization in a sling should be considered an indication for duplex ultrasound evaluation. Ultimately, further prospective study is needed to better understand the prevalence, prevention, and management of this entity. PMID:24772360

Manaqibwala, Moiz I.; Ghobrial, Irene E.; Curtis, Alan S.

2014-01-01

149

Upper Extremity Dynamics During Lofstrand Crutch-Assisted Gait in Children With Myelomeningocele  

PubMed Central

Background/Objective: We present a 3-dimensional biomechanical model of the upper extremities to characterize joint dynamics during 2 patterns of Lofstrand crutch-assisted gait in children with myelomeningocele. The upper extremity model incorporates recommendations by the International Society of Biomechanics. Methods: A Vicon motion analysis system (14 cameras) captured the marker patterns. Instrumented crutches measured reaction forces. Five subjects with L3 or L4 level myelodysplasia (aged 9.8 ± 1.6 years) were analyzed during reciprocal and swing-through Lofstrand crutch-assisted gait. Results: The mean walking speed, cadence, and stride length were greatest during swing-through gait. Although the gait patterns had different morphologies, the thorax and elbows remained in flexion, the wrists remained in extension, and the shoulders demonstrated both flexion and extension throughout the gait cycles. Swing-through gait showed larger ranges of motion for all joints than reciprocal gait. Peak crutch forces were highest during swing-through gait. The model was effective in detecting significant differences in upper extremity joint dynamics between reciprocal and swing-through crutch-assisted gait in children with myelomeningocele. Conclusions: Results support continued testing. Future work should include clinical and functional assessment in a correlated study of dynamics and function. Knowledge from the study may be useful in treatment planning and intervention. PMID:17874703

Slavens, Brooke A; Frantz, Jamie; Sturm, Peter F; Harris, Gerald F

2007-01-01

150

Validation of quick DASH outcome measure in breast cancer survivors for upper extremity disability  

PubMed Central

OBJECTIVE To validate the quickDASH as a patient-reported outcome measure for assessing upper extremity disability in breast cancer survivors. DESIGN Large cross-sectional survey SETTING Ambulatory care center at a university hospital PARTICIPANTS Postmenopausal women with stage I to III hormone receptor-positive breast cancer currently taking a third-generation aromatase inhibitor (N = 150) INTERVENTIONS Not applicable MAIN OUTCOME MEASURE QuickDASH, an 11- item self-administered questionnaire assesses global arm function over the past seven days. RESULTS 148 (99%) of 150 surveys were scorable. The factor analysis demonstrated one factor with Eigen value of 6.7, which explains 61% of variance. Score was reliable with Cronbach’s ?=0.93. The test-retest reliability was 0.78 over two weeks. The mean quickDASH score for all patients was 19(SD19). Those with upper extremity arthralgias reported higher quickDASH scores than controls without pain (26 vs. 12, P=0.001). Those with frozen shoulder pain also reported higher quickDASH scores than controls without pain (37 vs. 15, P=0.001). CONCLUSION The quickDASH instrument is a convenient, reliable, and valid patient-reported outcome measure to assess upper extremity disability in breast cancer patients. PMID:24095658

LeBlanc, M; Stineman, M; DeMichele, A; Stricker, C; Mao, JJ

2014-01-01

151

The correlation of cognitive flexibility with pain intensity and magnitude of disability in upper extremity illness.  

PubMed

Cognitive flexibility - the ability to restructure one's knowledge, incorporate new facts, widen perspective, and adapt to the demands of new and unexpected conditions - can help one adapt to illness. The aim of this study was to assess the relationship between cognitive flexibility and hand and upper extremity specific disability in patients presenting to a hand surgeon. Secondarily, we determined predictors of cognitive flexibility and pain. Eighty-nine consecutive outpatients completed the Cognitive flexibility questionnaire (CFS), Short Health Anxiety Inventory-5 (SHAI-5), Pain Self-Efficacy Questionnaire (PSEQ), Disabilities of Arm, Shoulder and Hand, short form (QuickDASH), and Patient Health Questionnaire for Depression-2 (PHQ-2) in a cross-sectional study. CFS did not correlate with disability or pain intensity. Disability correlated with PSEQ (r?=?-0.66, p?Upper extremity specific disability and pain intensity are limited more by self-efficacy than cognitive flexibility. Interventions to improve self-efficacy might help patients with upper extremity illness. PMID:25414552

Hageman, Michiel G J S; Briet, Jan Paul; Oosterhoff, Thijs C H; Bot, Arjan G; Ring, David; Vranceanu, Ana-Maria

2014-12-01

152

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

PubMed Central

Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke. PMID:23533954

Villeneuve, Myriam; Lamontagne, Anouk

2013-01-01

153

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

PubMed

Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke. PMID:23533954

Villeneuve, Myriam; Lamontagne, Anouk

2013-01-01

154

Neuro-orthopedic management of the dysfunctional extremity in upper motor neuron syndromes.  

PubMed

Orthopedic surgery can help restore extremity function to many patients with upper motor neuron syndromes (UMN). Impairments are divided into those that cause problems with the active function of the extremity versus those that impede passive function. Limb deformities commonly result from both dynamic (spastic) and static (contractural) components. Clinical examination supplemented with dynamic electromyographic studies provides the optimal information for planning the most effective surgical procedures. In the upper extremity, selective lengthening of the shoulder adductors and extensors combined with elbow flexor lengthening can improve forward reach. Lengthening of the forearm pronators and finger flexors will improve hand use. In the lower extremity, standing balance is improved with widening the base of support by correcting hip adduction contractures and equinovarus foot deformities. Improvement of knee flexion during swing phase by a rectus femoris to gracilis transfer will enhance the fluidity and efficiency of walking. Correction of hip and knee flexion contractures will allow a upright posture and dramatically decrease the energy requirement of walking. PMID:16046936

Hebela, N; Keenan, M A E

2004-06-01

155

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

PubMed Central

Recurrent deep venous thrombosis, involving bilateral upper extremities, is an extremely rare phenomenon. We are presenting a 43-year-old man who was diagnosed with left upper extremity deep vein thrombosis (UEDVT) and was treated with anticoagulation and surgical decompression in 2004. 9 years later, he presented with right arm swelling and was diagnosed with right UEDVT using US venous Doppler. Venogram showed compression of the subclavian vein by the first rib, diagnosing thoracic outlet syndrome (TOS). He was treated with anticoagulation and local venolysis and later by surgical decompression of the subclavian vein. Bilateral UEDVT, as mentioned above, is an extremely rare condition that is uncommonly caused by TOS. To our knowledge, we are reporting the first case of bilateral UEDVT due to TOS. Diagnosis usually starts with US venous Doppler to detect the thrombosis, followed by the gold standard venogram to locate the area of obstruction and lyse the thrombus if needed. The ultimate treatment for TOS remains surgical decompression of the vascular bundle at the thoracic outlet. PMID:25140182

Sanghavi, Devang; Chalise, Shyam

2014-01-01

156

Quality of Life, Upper Extremity Function and the Effect of Lymphedema Treatment in Breast Cancer Related Lymphedema Patients  

PubMed Central

Objective To evaluate quality of life (QOL), upper extremity function and the effect of lymphedema treatment in patients with breast cancer related lymphedema. Method The basic data comprised medical records (detailing age, sex, dominant side, location of tumor, cancer stage, operation record, cancer treatment and limb circumferences) and questionnaires (lymphedema duration, satisfaction, self-massage). Further to this, we measured upper extremity function and QOL, administered the DASH (Disabilities of Arm Shoulder and Hand outcome measure) and used the EORTC (European Organization for Research and Treatment of Cancer)-QLQ-C30 and the EORTC-QLQ-Br23. Results of these were calculated as main outcome variables. Results The questionnaire responses and arm circumferences of 59 patients with breast cancer related lymphedema were analyzed. In the DASH questionnaire, it was found that the older the lymphedema patient was, the lower their upper extremity function. On the EORTC-QLQ, patients with metastasis had significantly lower scores in physical functioning and role functioning. In terms of upper extremity circumference, there was a significant upper extremity size reduction after lymphedema treatment. Conclusion There were several dissociations between some subscales of quality of life questionnaires and those of upper extremity functions. Upper extremity function was correlated with the age of breast cancer patients and QOL was influenced by M-stage. Lymphedema treatment was found to be effective in reducing edema in patients with breast cancer related lymphedema. PMID:22639749

Park, Ji Eung; Jang, Hye Jin

2012-01-01

157

The risk factors and clinical outcomes of upper extremity deep vein thrombosis.  

PubMed

The prevalence of upper extremity deep vein thrombosis (UEDVT) has shown a dramatic increase with the use of central venous catheters (CVCs) for patient care. The objective of this study was to identify risk factors and clinical outcomes in patients diagnosed with UEDVT at an academic medical center over a 1-year period. Medical records of 373 consecutive patients who underwent upper extremity venous duplex ultrasound (VDU) examination were retrospectively reviewed. A quarter of the patients screened by VDU (94 of 373) had acute UEDVT; 63% presented with arm swelling or arm pain; 48% had cancer; and 93% had indwelling CVCs. Cancer patients with CVCs were more likely to develop UEDVT (48%). Of the 94 UEDVTs, 16% had concurrent lower extremity DVT. The incidence of objectively confirmed pulmonary embolism (PE) was 9% (8 of 94 patients), and the 1-month mortality rate was 6.4%. The majority of patients (80%) with UEDVT received anticoagulation therapy and 20% were not treated. The most common risk factors for UEDVT were indwelling CVCs and a diagnosis of cancer. The incidence rate of PE and mortality rate from UEDVT were not insignificant at 9% and 6%, respectively. There were no institutional screening protocols for patients at risk of UEDVT associated with CVCs. Future research should focus on risk assessment and management protocols for patients at risk of UEDVT. In addition, a comparison of clinical outcomes associated with the type, size, and duration of catheter placement should be conducted in patients at risk of or diagnosed with UEDVT. PMID:22328450

Lee, Jung-Ah; Zierler, Brenda K; Zierler, R Eugene

2012-02-01

158

Upper-Extremity Transplantation Using a Cell-Based Protocol to Minimize Immunosuppression  

PubMed Central

Objective To minimize maintenance immunosuppression in upper-extremity transplantation to favor the risk-benefit balance of this procedure. Background Despite favorable outcomes, broad clinical application of reconstructive transplantation is limited by the risks and side effects of multidrug immunosuppression. We present our experience with upper-extremity transplantation under a novel, donor bone marrow (BM) cell-based treatment protocol (“Pittsburgh protocol”). Methods Between March 2009 and September 2010, 5 patients received a bilateral hand (n = 2), a bilateral hand/forearm (n = 1), or a unilateral (n = 2) hand transplant. Patients were treated with alemtuzumab and methylprednisolone for induction, followed by tacrolimus monotherapy. On day 14, patients received an infusion of donor BM cells isolated from 9 vertebral bodies. Comprehensive follow-up included functional evaluation, imaging, and immunomonitoring. Results All patients are maintained on tacrolimus monotherapy with trough levels ranging between 4 and 12 ng/mL. Skin rejections were infrequent and reversible. Patients demonstrated sustained improvements in motor function and sensory return correlating with time after transplantation and level of amputation. Side effects included transient increase in serum creatinine, hyperglycemia managed with oral hypoglycemics, minor wound infection, and hyperuricemia but no infections. Immunomonitoring revealed transient moderate levels of donor-specific antibodies, adequate immunocompetence, and no peripheral blood chimerism. Imaging demonstrated patent vessels with only mild luminal narrowing/occlusion in 1 case. Protocol skin biopsies showed absent or minimal perivascular cellular infiltrates. Conclusions Our data suggest that this BM cell-based treatment protocol is safe, is well tolerated, and allows upper-extremity transplantation using low-dose tacrolimus monotherapy. PMID:23001085

Schneeberger, Stefan; Gorantla, Vijay S.; Brandacher, Gerald; Zeevi, Adriana; Demetris, Anthony J.; Lunz, John G.; Metes, Diana M.; Donnenberg, Albert D.; Shores, Jaimie T.; Dimartini, Andrea F.; Kiss, Joseph E.; Imbriglia, Joseph E.; Azari, Kodi; Goitz, Robert J.; Manders, Ernest K.; Nguyen, Vu T.; Cooney, Damon S.; Wachtman, Galen S.; Keith, Jonathan D.; Fletcher, Derek R.; Macedo, Camila; Planinsic, Raymond; Losee, Joseph E.; Shapiro, Ron; Starzl, Thomas E.; Andrew Lee, W. P.

2014-01-01

159

Impact of case manager training on worksite accommodations in workers' compensation claimants with upper extremity disorders.  

PubMed

Management of the return-to-work process in claimants with work-related upper extremity disorders often poses challenges to the health care provider, claimant, and employer. Modifying workplace ergonomic risk factors as a component of the workplace accommodation process may improve return-to-work outcomes by reducing recurrent pain and discomfort. The present study is a case-control evaluation of the effects of a 2-day training program for nurse case managers that was designed to facilitate the implementation of workplace accommodations within a workers' compensation health care delivery system. After the training, 101 claimants with compensable upper extremity disorders were randomly assigned to case managers with and without training. Overall, 208 accommodations were recommended and 155 of these were implemented (75%). Claimants of trained nurses received 1.5 times as many recommendations for accommodations as claimants managed by nurses not trained in the process, and 1.4 times as many accommodations were implemented, although no differences were found between the two groups in implementation rates. Trained nurses were more likely to recommend accommodations addressing workstation layout, computer-related improvements, furnishings, accessories, and lifting/carrying aids, whereas the untrained nurses were more likely to suggest light duty and lifting restrictions. This study indicates that the training was associated with a change in the practice behavior of case managers regarding the workplace accommodation process. More research is needed to identify barriers to implementation and develop more effective approaches to facilitate worksite accommodations in disabled workers with carpal tunnel syndrome and other persistent upper extremity disorders. PMID:11911025

Lincoln, Andrew E; Feuerstein, Michael; Shaw, William S; Miller, Virginia I

2002-03-01

160

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

161

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

162

An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy  

Microsoft Academic Search

Objective: In a randomized, controlled, single-blind trial, to test the hypothesis that botulinum-A toxin (BTA) injections into the upper extremity of children with spastic hemiplegia improve upper extremity function. Study design: Thirty children with hemiplegia, aged 2.5 to 10 years, were randomly assigned to receive: (1) a BTA injection into 1 or more of 3 muscle groups (biceps, volar forearm

Darcy Fehlings; Mercer Rang; Janet Glazier; Catherine Steele

2000-01-01

163

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

164

Skin temperature in the dorsal hand of office workers and severity of upper extremity musculoskeletal disorders  

Microsoft Academic Search

Objective  This study aimed to examine the suitability of using mean dorsal (hand) skin temperature (MDT) before and after a short typing\\u000a task as an indicator of upper extremity musculoskeletal disorder (UEMSD) severity. In addition, MDT reproducibility in controls\\u000a was assessed for a pre-typing and three post-typing time periods over three trials.\\u000a \\u000a \\u000a \\u000a Methods  Asymptomatic office workers (n = 10) and office workers with distal

Judith E. Gold; Martin Cherniack; Alexandra Hanlon; Jack T. Dennerlein; Jonathan Dropkin

2009-01-01

165

Principles of nerve repair in complex wounds of the upper extremity.  

PubMed

Peripheral nerve injuries are common in the setting of complex upper extremity trauma. Early identification of nerve injuries and intervention is critical for maximizing return of function. In this review, the principles of nerve injury, patient evaluation, and surgical management are discussed. An evidence-based approach to nerve reconstruction is reviewed, including the benefits and limitations of direct repair and nerve gap reconstruction with the use of autografts, processed nerve allografts, and conduits. Further, the principles and indications of commonly used nerve transfers in proximal nerve injuries are also addressed. PMID:25685102

Moore, Amy M; Wagner, I Janelle; Fox, Ida K

2015-02-01

166

Preconditioning electromyographic data for an upper extremity model using neural networks  

NASA Technical Reports Server (NTRS)

A back propagation neural network has been employed to precondition the electromyographic signal (EMG) that drives a computational model of the human upper extremity. This model is used to determine the complex relationship between EMG and muscle activation, and generates an optimal muscle activation scheme that simulates the actual activation. While the experimental and model predicted results of the ballistic muscle movement are very similar, the activation function between the start and the finish is not. This neural network preconditions the signal in an attempt to more closely model the actual activation function over the entire course of the muscle movement.

Roberson, D. J.; Fernjallah, M.; Barr, R. E.; Gonzalez, R. V.

1994-01-01

167

Upper extremity movement pattern of a common drinking task in well elderly women: A pilot study.  

PubMed

Retraining of the upper limb during neurological rehabilitation often involves preparatory therapeutic exercises of concentric and eccentric nature embedded in purposeful activity. However, empirical baseline studies are lacking to justify efficacy of such training. The purpose of this study was to determine the effect of concentric and eccentric exercises on upper extremity movement pattern in healthy elderly persons during a common daily functional task. Nine young women aged between 22 and 23 years and nine elderly women between 70 and 78 years participated in the musculoskeletal study of lifting a cup of water to sip and then lowering the cup back to a table. Two-dimensional forearm movement kinematics and associated electromyography from biceps and triceps were analysed. Forearm motor performance in the elderly participants were slower and needed more corrections compared to the younger participants. The electromyography revealed that lifting and lowering movements were accomplished by concentric and eccentric muscle firing in the biceps. However, in the elderly the muscle responses were varied suggesting a possible decline in object-related visuomotor co-ordination with age. The results indicate that movement patterns and muscular response decline in elderly people during preparatory therapeutic exercises embedded in purposeful activity. The effect of therapeutic exercises on upper limb functional performance needs to be further investigated in patient populations to explore the effectiveness of embedded therapeutic exercises in movement retraining. Small sample number limits the results of the study to be generalized. In addition, future studies should measure movement of more limb and hand segments to gain understanding of the total upper extremity performance during the task. PMID:15181478

Maitra, Kinsuk K; Junkins, Michael D

2004-01-01

168

A Multi-Class Proportional Myocontrol Algorithm for Upper Limb Prosthesis Control: Validation in Real-Life Scenarios on Amputees.  

PubMed

Functional replacement of upper limbs by means of dexterous prosthetic devices remains a technological challenge. While the mechanical design of prosthetic hands have advanced rapidly, the human-machine interfacing and the control strategies needed for the activation of multiple degrees of freedom are not reliable enough for restoring hand function successfully. Machine learning methods capable of inferring the user intent from EMG signals generated by the activation of the remnant muscles are regarded as a promising solution to this problem. However, the lack of robustness of the current methods impedes their routine clinical application. In this study, we propose a novel algorithm for controlling multiple degrees of freedom sequentially, inherently proportionally and with high robustness, allowing a good level of prosthetic hand function. The control algorithm is based on the spatial linear combinations of amplitude-related EMG signal features. The weighting coefficients in this combination are derived from the optimization criterion of the common spatial patterns filters which allow for maximal discriminability between movements. An important component of the study is the validation of the method which was performed on both ablebodied and amputee subjects who used physical prostheses with customized sockets and performed three standardized functional tests mimicking daily-life activities of varying difficulty. Moreover, the new method was compared in the same conditions with one clinical/industrial and one academic state-of-the-art methods. The novel algorithm outperformed significantly the state-of-the-art techniques in both subject groups for tests that required the activation of more than one degree of freedom. Because of the evaluation in real time control on both able-bodied subjects and final users (amputees) wearing physical prostheses, the results obtained allow for the direct extrapolation of the benefits of the proposed method for the end users. In conclusion, the method proposed and validated in real-life use scenarios, allows the practical usability of multifunctional hand prostheses in an intuitive way, with significant advantages with respect to previous systems. PMID:25296406

Amsuess, Sebastian; Gobel, Peter; Graimann, Bernhard; Farina, Dario

2014-10-01

169

Retinal prosthesis  

Microsoft Academic Search

A prosthesis device is designed to replace the functionality of defective photoreceptors in patients suffering from Retinitis Pigmentosa and age-related Macula Degeneration. The circuit designs include a telemetry link used for power transmission and a bidirectional data communication bus. The 28.9mm2 IC dissipates 50mW and is fabricated in 1.2?m technology. Experimental results on human subjects are included.

Wentai Liu; M. S. Hurnayun

2004-01-01

170

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

171

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

172

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

173

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

174

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

175

Claims incidence of work-related disorders of the upper extremities: Washington state, 1987 through 1995.  

PubMed Central

OBJECTIVES: This study examined the claim incidence rate, cost, and industry distribution of work-related upper extremity disorders in Washington. METHODS: Washington State Fund workers' compensation claims from 1987 to 1995 were abstracted and categorized into general and specific disorders of gradual or sudden onset. RESULTS: Accepted claims included 100,449 for hand/wrist disorders (incidence rate: 98.2/10,000 full-time equivalents; carpal tunnel syndrome rate: 27.3), 30,468 for elbow disorders (incidence rate: 29.7; epicondylitis rate: 11.7), and 55,315 for shoulder disorders (incidence rate: 54.0; rotator cuff syndrome rate: 19.9). Average direct workers' compensation claims costs (medical treatment and indemnity) were $15,790 (median: $6774) for rotator cuff syndrome, $12,794 for carpal tunnel syndrome (median: $4190), and $6593 for epicondylitis (median: $534). Construction and food processing were among the industries with the highest rate ratios for all disorders (> 4.0). CONCLUSIONS: Upper extremity disorders represent a large and costly problem in Washington State industry. Industries characterized by manual handling and repetitive work have high rate ratios. The contingent workforce appears to be at high risk. PMID:9842381

Silverstein, B; Welp, E; Nelson, N; Kalat, J

1998-01-01

176

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

177

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

PubMed

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 intermethod 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, andjob 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, Juergen; Evanoff, Bradley Allen

2010-01-01

178

"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

179

Changes in Bone Density and Geometry of the Upper Extremities after Stroke: A Case Report  

PubMed Central

ABSTRACT Purpose: The purpose of this study was to examine changes in bone density and geometry of the forearm region and motor function of the paretic upper extremity in a person with subacute stroke. Client Description: The participant was a 48-year-old man with right hemiparesis. Intervention: Not applicable. Measures and Outcomes: The assessment of upper-extremity (UE) function and bone imaging took place at 3 months and 12 months after stroke. The participant had moderate motor impairment and severe disuse of the paretic UE 3 months after stroke. During the follow-up period, no substantial change in paretic UE function was observed. At the 12 month follow-up, the areal bone mineral density (aBMD) of the ultradistal and mid-regions of the paretic forearm, as measured by dual-energy X-ray absorptiometry, sustained a significant reduction of 7.9% and 5.9%, respectively. The non-paretic side, in contrast, had a significant 4.0% increase in aBMD of the mid-forearm and a 2.8% increase in aBMD of the total forearm. Significant findings from peripheral quantitative computed tomography were a reduction in total volumetric bone mineral density (?12.1%) and bone strength index (?20.6%) in the radius distal epiphysis on the paretic side and an increase in cortical bone mineral content (2.0%) and bone strength index (7.6%) in the radius diaphysis on the non-paretic side. Implications: After a stroke that resulted in moderate to severe UE impairment, a significant decline in bone mineral density was identified in various skeletal sites in the forearm region as the participant entered the subacute and chronic stages of recovery. The results point to the potential importance of early rehabilitative intervention in preventing unfavourable bone changes in the paretic upper limb among individuals with stroke. PMID:23277690

Yang, Feigo Z.H.; Lau, Ricky W.K.; Cheng, Ada Q.; Li, Leonard S.W.; Zhang, Ming

2012-01-01

180

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

181

Upper generalized exponents of two-colored primitive extremal ministrong digraphs  

NASA Astrophysics Data System (ADS)

A two-colored digraph is a digraph each of whose arcs is colored by red or blue. An (h,k)-walk in a two-colored digraph is a walk consisting of h red arcs and k blue arcs. A two-colored digraph is primitive provided that for each pair of vertices u and ? there exists an (h,k)-walk from u to ? and from ? to u. The smallest of such positive integer h+k is called the exponent of D(2). Let D(2) be a primitive two colored digraph and let X be a nonempty subset of V(D(2)). The set exponent of X, denoted exp(X,D), is defined to be the smallest positive integer h+k over all nonnegative integers h and k such that for each vertex ? in D(2) there exists an (h,k)-walk from at least one vertex in X to ?. The kth upper generalized exponent of D, F(k,D(2)) is defined to be F(k,D(2)) = max { exp (X,D(2)):|X| = k} . We discuss upper generalized exponents of two-colored primitive extremal ministrong digraphs on n vertices, that is a two-colored digraph consisting of an (n-1)-cycle and an (n-2)-cycle. We present a lower bound for the kth upper generalized exponent that depends on n and k.

Hussein, Ismail; Prasetyo, Yogo D.; Suwilo, Saib

2014-12-01

182

A case report of sudden-onset upper and lower extremity weakness.  

PubMed

Abstract Thyrotoxic hypokalemic periodic paralysis is characterized by acute attacks of muscle paralysis, hypokalemia, and thyrotoxicosis. It is a medical emergency, as fatal and life-threatening ventricular arrhythmia associated with hypokalemia has been reported. A 24-year-old man presented with severe lower extremity weakness, which progressed to his trunk and arms. He denied any associated symptoms and had no history of a similar episode or predisposing condition. The physical examination was significant for bilateral extremity weakness, more severe in the lower as compared to the upper extremities. The rest of the neurologic exam was normal. A small, smooth, nontender goiter was palpated. Laboratory data was significant for a potassium level of 2.0 mEq/L. Final lab data revealed a thyroid panel consistent with hyperthyroidism. Once the patient's potassium level normalized after repletion, he recovered his strength and was able to walk again. He was diagnosed with thyrotoxic hypokalemic periodic paralysis, a potentially lethal complication of hyperthyroidism. Because it is reversible with treatment of hyperthyroidism, it is imperative that this condition be considered, recognized and managed appropriately. PMID:25556330

Haddad, Heba; Rotblatt, Michael

2015-02-01

183

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

PubMed Central

Background Repetitive task practice is argued to drive neural plasticity following stroke. However, current evidence reveals that hemiparetic weakness impairs the capacity to perform, and practice, movements appropriately. Here we investigated how power training (i.e., high-intensity, dynamic resistance training) affects recovery of upper-extremity motor function post-stroke. We hypothesized that power training, as a component of upper-extremity rehabilitation, would promote greater functional gains than functional task practice without deleterious consequences. Method Nineteen chronic hemiparetic individuals were studied using a crossover design. All participants received both functional task practice (FTP) and HYBRID (combined FTP and power training) in random order. Blinded evaluations performed at baseline, following each intervention block and 6-months post-intervention included: Wolf Motor Function Test (WMFT-FAS, Primary Outcome), upper-extremity Fugl-Meyer Motor Assessment, Ashworth Scale, and Functional Independence Measure. Neuromechanical function was evaluated using isometric and dynamic joint torques and concurrent agonist EMG. Biceps stretch reflex responses were evaluated using passive elbow stretches ranging from 60 to 180º/s and determining: EMG onset position threshold, burst duration, burst intensity and passive torque at each speed. Results Primary outcome: Improvements in WMFT-FAS were significantly greater following HYBRID vs. FTP (p?=?.049), regardless of treatment order. These functional improvements were retained 6-months post-intervention (p?=?.03). Secondary outcomes: A greater proportion of participants achieved minimally important differences (MID) following HYBRID vs. FTP (p?=?.03). MIDs were retained 6-months post-intervention. Ashworth scores were unchanged (p?>?.05). Increased maximal isometric joint torque, agonist EMG and peak power were significantly greater following HYBRID vs. FTP (p < .05) and effects were retained 6-months post-intervention (p’s?

2013-01-01

184

Retinal prosthesis.  

PubMed

Retinal prosthesis has been translated from the laboratory to the clinic over the past two decades. Currently, two devices have regulatory approval for the treatment of retinitis pigmentosa. These devices provide partial sight restoration and patients use this improved vision in their everyday lives. Improved mobility and object detection are some of the more notable findings from the clinical trials. However, significant vision restoration will require both better technology and improved understanding of the interaction between electrical stimulation and the retina. This paper reviews the recent clinical trials and highlights technology breakthroughs that will contribute to next generation of retinal prostheses. PMID:24710817

Weiland, James D; Humayun, Mark S

2014-05-01

185

Prosthesis Material  

NASA Technical Reports Server (NTRS)

FAB/CAM, a subsidiary of the Harshberger Prosthetic and Orthotic Center, Inc., approached Marshall for help in replacing the heavy, fragile plaster they used to produce master molds for prosthetics. Concurrently, Marshall and Martin Marietta were creating a commercial derivative of the foam insulation used to protect the Space Shuttle External Tank from excessive heat. FAB/CAM found the foam blanks to be lighter, cheaper and easier to manufacture than plaster, resulting in lower costs to the consumer. Martin Marietta markets the foam system, MARCORE, for the prosthesis market. The system also has commercial potential in high temperature insulation and structural applications.

1995-01-01

186

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

187

Mental Practice–Triggered Electrical Stimulation in Chronic, Moderate, Upper-Extremity Hemiparesis After Stroke  

PubMed Central

OBJECTIVE. To determine the feasibility and impact of home-based, mental practice–triggered electrical stimulation among stroke survivors exhibiting moderate upper-extremity (UE) impairment. METHOD. Five participants with moderate, stable UE hemiparesis were administered the Fugl-Meyer Assessment, the Box and Block Test, and the Activities of Daily Living, Hand Function, and overall recovery domains of the Stroke Impact Scale (Version 3). They were then administered an 8-wk regimen consisting of 1 hr of mental practice–triggered electrical stimulation every weekday in their home. At the end of every 2 wk, participants attended supervised stimulation to progress therapeutic exercises and stimulation levels and monitor compliance. RESULTS. Six instances of device noncompliance were reported. Participants exhibited reduced UE motor impairment and increased UE dexterity and participation in valued activities. CONCLUSION. The regimen appears feasible and had a substantial impact on UE impairment, dexterity, and participation in valued activities as well as perceptions of recovery. PMID:25553754

Levine, Peter; Hill, Valerie

2015-01-01

188

Endovascular Management of Chronic Upper Extremity Deep Vein Thrombosis and Superior Vena Cava Syndrome  

PubMed Central

Chronic upper extremity deep vein thrombosis (UEDVT) and superior vena cava syndrome (SVCS) are important and underdiagnosed entities that are associated with significant morbidity, and both are becoming increasingly common due to the use of indwelling catheters and implantable central venous access devices. Currently, as many as 25% of patients with an indwelling catheter are diagnosed with chronic UEDVT or venous stenosis. SVCS is most commonly seen in the setting of malignancy, especially lung cancer and lymphoma. Endovascular management of chronic UEDVT and SVCS is accepted as an important first-line treatment given its high overall success rate and low morbidity as compared with medical and surgical treatments. In this article, the indications for treatment, complications, and success rates of the endovascular management of UEDVT and SVCS are reviewed. Relevant findings on presentation and physical exam as well as various imaging modalities and imaging findings are evaluated. Details of preprocedure evaluation, relevant anatomy, and avoidance of potential complications are discussed. PMID:22379274

Warren, Patrick; Burke, Charles

2011-01-01

189

Mental practice-triggered electrical stimulation in chronic, moderate, upper-extremity hemiparesis after stroke.  

PubMed

OBJECTIVE. To determine the feasibility and impact of home-based, mental practice-triggered electrical stimulation among stroke survivors exhibiting moderate upper-extremity (UE) impairment. METHOD. Five participants with moderate, stable UE hemiparesis were administered the Fugl-Meyer Assessment, the Box and Block Test, and the Activities of Daily Living, Hand Function, and overall recovery domains of the Stroke Impact Scale (Version 3). They were then administered an 8-wk regimen consisting of 1 hr of mental practice-triggered electrical stimulation every weekday in their home. At the end of every 2 wk, participants attended supervised stimulation to progress therapeutic exercises and stimulation levels and monitor compliance. RESULTS. Six instances of device noncompliance were reported. Participants exhibited reduced UE motor impairment and increased UE dexterity and participation in valued activities. CONCLUSION. The regimen appears feasible and had a substantial impact on UE impairment, dexterity, and participation in valued activities as well as perceptions of recovery. PMID:25553754

Page, Stephen J; Levine, Peter; Hill, Valerie

2015-01-01

190

Musculoskeletal Disorders of the Upper Extremities Due to Extensive Usage of Hand Held Devices  

PubMed Central

Objective The use of hand held devices (HHD) such as mobile phones, game controls, tablets, portable media players and personal digital assistants have increased dramatically in past decade. While sending a text message or using the controls of the HHD the users need to use their thumb and other palm muscles extensively. The objective of this study was to describe the risk factors and clinical features of the musculoskeletal disorders (MSDs) arising due to usage of hand held devices and to evaluate the effectiveness of a sequenced rehabilitation protocol. Methods A retrospective report analysis of 70 subjects, who were diagnosed to have a MSD affecting the upper extremities, was conducted. Medical charts from a tertiary level rehabilitation centre from 2005–2013 were analysed. All the subjects reported pain in their upper extremities following extensive usage of HHD and were examined and diagnosed to have a MSD by an orthopaedic and rehabilitation physician. After the assessment and diagnosis, all the patients underwent rehabilitation using a sequenced protocol. Results All the subjects reported pain in the thumb and forearm with associated burning, numbness and tingling around the thenar aspect of the hand, and stiffness of wrist and hand. 43 subjects had symptoms on the right side; 9 on left and 18 had bilateral symptoms. Correlation was found between hand dominance and MSD. 33 subjects complained of onset of symptoms following extensive text messaging. All the subjects were diagnosed to have tendinosis of Extensor Pollicis Longus and Myofascial Pain Syndrome affecting the 1st interossei, thenar group of muscles and Extensor Digitorum Communis. 23 of the subjects were senior executives, among these 7 were CEO’s of major multinational companies in India. All the subjects recovered completely following the rehabilitation. Conclusions The study concluded that mobile phones and gadgets that promoted the predominant usage of thumb or only one finger while texting or using the controls were associated with a higher prevalence of MSDs. Treatment using a sequenced rehabilitation protocol was found to be effective.

2014-01-01

191

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

PubMed

Upper extremity (UE) dysfunction may be present in up to ~80% of individuals with multiple sclerosis (MS), although its importance may be under-recognized relative to walking impairment, which is the hallmark symptom of MS. Upper extremity dysfunction affects independence and can impact the ability to use walking aids. Under-recognition of UE dysfunction may result in part from limited availability of performance-based and patient self-report measures that are validated for use in MS and that can be readily incorporated into clinical practice for screening and regularly scheduled assessments. In addition to the 9-Hole Peg Test, which is part of the Multiple Sclerosis Functional Composite, there are several performance-based measures that are generally used in the rehabilitation setting. These measures include the Box and Block Test, the Action Research Arm Test, the Test d'Evaluation de la performance des Membres Supérieurs des Personnes Agées, and the Jebsen-Taylor Test of Hand Function. Several of these measures were developed for use in stroke, although in contrast to stroke, which is characterized by unilateral dysfunction, UE impairment in MS is generally bilateral, and should be assessed as such. Similarly, patient-reported UE measures are available, including Disabilities of the Arm, Shoulder, and Hand (DASH) and its shorter version, QuickDASH, the Manual Ability Measure, and ABILHAND, although none has been psychometrically validated for MS. Recently, item response theory was used to develop a Neuro-QOL (Quality of Life) UE measure and a Patient-Reported Outcomes Measurement Information System UE measure; neither of these have demonstrated sensitivity to change, limiting their use for longitudinal assessment. Consequently, although work is still needed to develop and validate performance-based and patient-reported measures of UE function that are suitable for use in daily MS clinical practice, currently available UE measures can be recommended for incorporation into MS management, albeit with an understanding of their limitations. PMID:25295653

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

2014-09-01

192

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

PubMed

In this study, the main and interactive effects of obesity and age on functional performance were assessed during intermittent exertions involving the upper extremity. The prevalence of obesity has doubled over the past 30 years and this increase is associated with higher health care costs, rates of workplace injury, and lost workdays. Obesity and aging can modify job demands and affect worker capacity in terms of muscular and psychomotor function. However, there is a lack of empirical studies quantifying the work-relevant (or ergonomic) impacts related to task demands, capacities, and their potential imbalance. Eight obese and eight non-obese participants from each of two age groups (18-25 and 50-65 years) completed three endurance tasks involving fixed levels of task demands: hand grip, shoulder flexion, and a simulated assembly task using the upper extremity. Measures of functional performance including endurance, discomfort, motor control, and task performance were recorded for each of the task conditions. Endurance times were ?60% longer for the non-obese group, and older participants had longer endurance times; however there was no evidence of interactive effects of obesity and age. Obesity also impaired functional performance, as indicated by higher rates of strength loss, increases in discomfort, and declines in task performance. These observed impairments may reflect underlying physiological differences among individuals who are obese, but that are independent of age. Obesity-related impairments may have implications for the design of work duration and demand level to prevent fatigue development for workers who are obese. PMID:24484265

Cavuoto, Lora A; Nussbaum, Maury A

2014-01-01

193

Upper extremity kinematic and kinetic adaptations during a fatiguing repetitive task.  

PubMed

Repetitive low-force contractions are common in the workplace and yet can lead to muscle fatigue and work-related musculoskeletal disorders. The current study aimed to investigate potential motion adaptations during a simulated repetitive light assembly work task designed to fatigue the shoulder region, focusing on changes over time and age-related group differences. Ten younger and ten older participants performed four 20-min task sessions separated by short breaks. Mean and variability of joint angles and scapular elevation, joint net moments for the shoulder, elbow, and wrist were calculated from upper extremity kinematics recorded by a motion tracking system. Results showed that joint angle and joint torque decreased across sessions and across multiple joints and segments. Increased kinematic variability over time was observed in the shoulder joint; however, decreased kinematic variability over time was seen in the more distal part of the upper limb. The changes of motion adaptations were sensitive to the task-break schedule. The results suggested that kinematic and kinetic adaptations occurred to reduce the biomechanical loading on the fatigued shoulder region. In addition, the kinematic and kinetic responses at the elbow and wrist joints also changed, possibly to compensate for the increased variability caused by the shoulder joint while still maintaining task requirements. These motion strategies in responses to muscle fatigue were similar between two age groups although the older group showed more effort in adaptation than the younger in terms of magnitude and affected body parts. PMID:24642235

Qin, Jin; Lin, Jia-Hua; Faber, Gert S; Buchholz, Bryan; Xu, Xu

2014-06-01

194

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

195

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

196

Temperature Changes in Deep Muscles of Humans During Upper and Lower Extremity Exercise  

PubMed Central

Objective: To examine the effect of 15 minutes of upper and lower extremity exercise on raising intramuscular temperature in the triceps surae to 39 ° C to 45 ° C (the therapeutic range). Design and Setting: Intramuscular temperature was measured 5 cm deep in the triceps surae using a 23-gauge thermistor needle microprobe connected to a monitor. Each subject was tested under 3 conditions: 15 minutes of rest, 15 minutes of jogging on a treadmill, and 15 minutes of handpedaling an upper-body ergometer. Exercise bouts were performed at 70% of each subject's maximum heart rate. Subjects: Six males, either sedentary or recreational athletes (age = 21.3 ± 2.9 years; ht = 176.8 ± 6.0 cm; wt = 72.7 ± 11.6 kg; resting heart rate = 57.8 ± 6.74 bpm; target heart rate = 156.5 ± 3.0 bpm), volunteered to participate in this experiment. Measurements: Intramuscular temperature was measured at a depth of 5 cm before and after each test condition. Results: Data analyses consisted of analyses of variance with repeated measures and a Tukey post hoc test (P < .05). The results showed a significant temperature increase over baseline after exercise on the treadmill (2.2 ° C ± 0.63 ° C); however, it did not yield temperature increases ? 39 ° C. No significant temperature change occurred after exercise on the upper-body ergometer (-0.45 ° C ± 0.80 ° C). Conclusions: Active exercise increased intramuscular temperature in working muscles but did not affect intramuscular temperature in nonworking muscles. In addition, 15 minutes of jogging on a treadmill at 70% of maximum heart rate was not sufficient to raise intramuscular temperature to 39 ° C to 45 ° C. ImagesFigure 1.Figure 2. PMID:16558512

Wirth, Valerie J.; Van Lunen, Bonnie L.; Mistry, Dilaawar; Saliba, Ethan; McCue, Frank C.

1998-01-01

197

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

198

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

199

Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports.  

PubMed

Understanding when and how much shoulder muscles are active during upper extremity sports is helpful to physicians, therapists, trainers and coaches in providing appropriate treatment, training and rehabilitation protocols to these athletes. This review focuses on shoulder muscle activity (rotator cuff, deltoids, pectoralis major, latissimus dorsi, triceps and biceps brachii, and scapular muscles) during the baseball pitch, the American football throw, the windmill softball pitch, the volleyball serve and spike, the tennis serve and volley, baseball hitting, and the golf swing. Because shoulder electromyography (EMG) data are far more extensive for overhead throwing activities compared with non-throwing upper extremity sports, much of this review focuses on shoulder EMG during the overhead throwing motion. Throughout this review shoulder kinematic and kinetic data (when available) are integrated with shoulder EMG data to help better understand why certain muscles are active during different phases of an activity, what type of muscle action (eccentric or concentric) occurs, and to provide insight into the shoulder injury mechanism. Kinematic, kinetic and EMG data have been reported extensively during overhead throwing, such as baseball pitching and football passing. Because shoulder forces, torques and muscle activity are generally greatest during the arm cocking and arm deceleration phases of overhead throwing, it is believed that most shoulder injuries occur during these phases. During overhead throwing, high rotator cuff muscle activity is generated to help resist the high shoulder distractive forces approximately 80-120% bodyweight during the arm cocking and deceleration phases. During arm cocking, peak rotator cuff activity is 49-99% of a maximum voluntary isometric contraction (MVIC) in baseball pitching and 41-67% MVIC in football throwing. During arm deceleration, peak rotator cuff activity is 37-84% MVIC in baseball pitching and 86-95% MVIC in football throwing. Peak rotator cuff activity is also high is the windmill softball pitch (75-93% MVIC), the volleyball serve and spike (54-71% MVIC), the tennis serve and volley (40-113% MVIC), baseball hitting (28-39% MVIC), and the golf swing (28-68% MVIC). Peak scapular muscle activity is also high during the arm cocking and arm deceleration phases of baseball pitching, with peak serratus anterior activity 69-106% MVIC, peak upper, middle and lower trapezius activity 51-78% MVIC, peak rhomboids activity 41-45% MVIC, and peak levator scapulae activity 33-72% MVIC. Moreover, peak serratus anterior activity was approximately 60% MVIC during the windmill softball pitch, approximately 75% MVIC during the tennis serve and forehand and backhand volley, approximately 30-40% MVIC during baseball hitting, and approximately 70% MVIC during the golf swing. In addition, during the golf swing, peak upper, middle and lower trapezius activity was 42-52% MVIC, peak rhomboids activity was approximately 60% MVIC, and peak levator scapulae activity was approximately 60% MVIC. PMID:19530752

Escamilla, Rafael F; Andrews, James R

2009-01-01

200

Nerve allograft transplantation for functional restoration of the upper extremity: case series  

PubMed Central

Background Major trauma to the spinal cord or upper extremity often results in severe sensory and motor disturbances from injuries to the brachial plexus and its insertion into the spinal cord. Functional restoration with nerve grafting neurotization and tendon transfers is the mainstay of treatment. Results may be incomplete due to a limited supply of autologous material for nerve grafts. The factors deemed most integral for success are early surgical intervention, reconstruction of all levels of injury, and maximization of the number of axonal conduits per nerve repair. Objective To report the second series of nerve allograft transplantation using cadaveric nerve graft and our experience with living-related nerve transplants. Participants Eight patients, seven men and one woman, average age 23 years (range 18–34), with multi-level brachial plexus injuries were selected for transplantation using either cadaveric allografts or living-related donors. Methods Grafts were harvested and preserved in the University of Wisconsin Cold Storage Solution at 5°C for up to 7 days. The immunosuppressive protocol was initiated at the time of surgery and was discontinued at approximately 1 year, or when signs of regeneration were evident. Parameters for assessment included mechanism of injury, interval between injury and treatment, level(s) of deficit, post-operative return of function, pain relief, need for revision surgery, complications, and improvement in quality of life. Results Surgery was performed using living-related donor grafts in six patients, and cadaveric grafts in two patients. Immunosuppression was tolerated for the duration of treatment in all but one patient in whom early termination occurred due to non-compliance. There were no cases of graft rejection as of most recent follow-up. Seven patients showed signs of regeneration, demonstrated by return of sensory and motor function and/or a migrating Tinel's sign. One patient was non-compliant with the post-operative regimen and experienced minimal return of function despite a reduction in pain. Conclusions Despite the small number of subjects, it appears that nerve allograft transplantation may be performed safely, permitting non-prioritized repair of long-segment peripheral nerve defects and maximizing the number of axonal conduits per nerve repair. For patients with long, multi-level brachial plexus injuries or combined upper and lower extremity nerve deficits, the use of nerve allograft allows a more complete repair that may translate into greater functional restoration than autografting alone. PMID:21675363

Elkwood, Andrew I.; Holland, Neil R.; Arbes, Spiros M.; Rose, Michael I.; Kaufman, Matthew R.; Ashinoff, Russell L.; Parikh, Mona A.; Patel, Tushar R.

2011-01-01

201

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

202

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

E-print Network

IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. BME-30, NO. 1, JANUARY 1983 Upper Extremity Limb limb function probabilities. These probabilities are the sufficient statistics for the problem. This technique should be useful in generating control signals for prosthetic devices. I. INTRODUCTION I N

Willsky, Alan S.

203

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

ERIC Educational Resources Information Center

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

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

2012-01-01

204

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

Microsoft Academic Search

BACKGROUND: The purpose of this study was to investigate whether professional drivers of all-terrain vehicles (ATVs) with neck pain have a different array of neuromusculoskeletal disorders in the neck and upper extremities than a referent group with neck pain from the general population. It is hypothesized that exposure to shock-type vibration and unfavorable working postures in ATVs have the capacity

Börje Rehn; Tohr Nilsson; Bengt Järvholm

2004-01-01

205

Treatment of recurrent compressive neuropathy of peripheral nerves in the upper extremity with an autologous vein insulator  

Microsoft Academic Search

The treatment of entrapment neuropathy in the upper extremity with surgical decompression has generally provided good results. Recurrence of symptoms, however, is not uncommon and its management is both challenging and difficult. Nineteen patients with recurrent carpal tunnel and cubital tunnel syndrome were treated with the vein wrapping technique using the autogenous saphenous vein. The average number of surgeries before

Sokratis E Varitimidis; Dimitris G Vardakas; Felix Goebel; Dean G Sotereanos

2001-01-01

206

Upper extremity range of motion and isokinetic strength of the internal and external shoulder rotators in major league baseball players  

Microsoft Academic Search

Forty-one professional baseball players volunteered for upper extremity range of motion measurements and isokinetic testing for internal and external shoulder ro tation. Pitchers demonstrated 9° more external shoul der rotation with the arm abducted, 5° more forearm pronation, and 9° less shoulder extension on the dom inant side compared with the dominant side of position players. Pitchers also demonstrated 9°

Larry P. Brown; Sandra L. Niehues; Andrew Harrah; Patricia Yavorsky; H. Paul Hirshman

1988-01-01

207

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

208

Occupational Therapy Role on the Battlefield: An Overview of Combat and Operational Stress and Upper Extremity Rehabilitation  

Microsoft Academic Search

What happens when the stressors of combat, fatigue, separation, and personal conflict affect a Soldier's ability to perform their wartime mission? What happens when an upper extremity injury or a significant trauma impacts a Soldier's ability to fire their weapon or complete their mission? The Army has specialized units known as Combat Operational Stress Control (COSC) Detachments and Combat Support

Avery Carney; F GONZALESJR; D BASH

2008-01-01

209

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

ERIC Educational Resources Information Center

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

Gordon, Andrew M.

2011-01-01

210

Breast Reconstruction and Prosthesis  

MedlinePLUS

Breast Reconstruction & Prosthesis FACTS FOR LIFE For more information, call Susan G. Komen for the Cure ® at 1-877 GO KOMEN ( ... or visit www.komen.org. Reconstructive surgery or prosthesis? You can have reconstruction at the time of ...

211

Management of disorders of the rotator cuff: proceedings of the ISAKOS upper extremity committee consensus meeting.  

PubMed

The goal of this article is to consolidate the International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee's (UEC's) current knowledge on rotator cuff disease and management, as well as highlight key unresolved issues. The rotator cuff is an anatomically complex structure important for providing glenohumeral function and stability as part of a closed chain system. Current consensus suggests rotator cuff injuries are most accurately diagnosed, at levels similar to diagnosis by magnetic resonance imaging, with a combination of cuff- and impingement-specific clinical tests. Updates in the understanding of acromion morphology, the insertional anatomy of the rotator cuff, and the role of suprascapular nerve release may require changes to current classification systems and surgical strategies. Although initial management focuses on nonoperative protocols, discussion continues on whether surgery for isolated impingement is clinically more beneficial than rehabilitation. However, clear indications have yet to be established for the use of single- versus double-row repair because evidence confirms neither is clinically efficacious than the other. Biceps tenodesis, however, in non-isolated cuff tears has proven more successful in addressing the etiology of shoulder pain and yields improved outcomes over tenotomy. Data reviewing the benefits of tendon transfers, shoulder prostheses, and mechanical scaffolds, as well as new research on the potential benefit of platelet-rich plasma, pluripotential stem cells, and gene therapies, will also be presented. PMID:24041864

Arce, Guillermo; Bak, Klaus; Bain, Gregory; Calvo, Emilio; Ejnisman, Benno; Di Giacomo, Giovanni; Gutierrez, Vicente; Guttmann, Dan; Itoi, Eiji; Ben Kibler, W; Ludvigsen, Tom; Mazzocca, Augustus; de Castro Pochini, Alberto; Savoie, Felix; Sugaya, Hiroyuki; Uribe, John; Vergara, Francisco; Willems, Jaap; Yoo, Yon Sik; McNeil, John W; Provencher, Matthew T

2013-11-01

212

Intravenous regional anesthesia for closed treatment of fractures and dislocations of the upper extremities.  

PubMed

Intravenous regional anesthesia for the treatment of fractures and dislocations of the upper extremity is a very effective, consistent and safe form of analgesia which requires low doses of lidocaine and can be performed in an emergency room using a regular blood pressure cuff. Dosage should be related to body weight and the blood pressure cuff should be maintained at higher than systolic pressure for a minimum of 15 minutes after the lidocaine is injected. Release of the tourniquet should be staged as described. Ninety-one per cent of 77 patients had excellent analgesia following the IVRA. Eight per cent had fair results, but this was still adequate to perform the reduction with only minimal but definite discomfort to the patient. Only one patient failed to respond to the IVRA technique. Other advantages such as muscle relaxation during the anesthetic and rapid full return of sensation after cuff release, permit ease of reducion and early anticipation of cast discomfort or pressure pain from sharp edges of plaster. Unpleasant long term side effects of axillary block anesthesia, such as persistent paresthesia have not been seen. PMID:954282

Schiller, M G

1976-01-01

213

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

214

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

215

Extrinsic and Intrinsic Index Finger Muscle Attachments in an OpenSim Upper-Extremity Model.  

PubMed

Musculoskeletal models allow estimation of muscle function during complex tasks. We used objective methods to determine possible attachment locations for index finger muscles in an OpenSim upper-extremity model. Data-driven optimization algorithms, Simulated Annealing and Hook-Jeeves, estimated tendon locations crossing the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints by minimizing the difference between model-estimated and experimentally-measured moment arms. Sensitivity analysis revealed that multiple sets of muscle attachments with similar optimized moment arms are possible, requiring additional assumptions or data to select a single set of values. The most smooth muscle paths were assumed to be biologically reasonable. Estimated tendon attachments resulted in variance accounted for (VAF) between calculated moment arms and measured values of 78% for flex/extension and 81% for ab/adduction at the MCP joint. VAF averaged 67% at the PIP joint and 54% at the DIP joint. VAF values at PIP and DIP joints partially reflected the constant moment arms reported for muscles about these joints. However, all moment arm values found through optimization were non-linear and non-constant. Relationships between moment arms and joint angles were best described with quadratic equations for tendons at the PIP and DIP joints. PMID:25281408

Lee, Jong Hwa; Asakawa, Deanna S; Dennerlein, Jack T; Jindrich, Devin L

2015-04-01

216

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

PubMed

A study was conducted to investigate the criterion validity of measures of upper extremity (UE) motor function derived during practice of virtual activities of daily living (ADLs). Fourteen hemiparetic stroke patients employed a Virtual Occupational Therapy Assistant (VOTA), consisting of a high-fidelity virtual world and a Kinect™ sensor, in four sessions of approximately one hour in duration. An unscented Kalman Filter-based human motion tracking algorithm estimated UE joint kinematics in real-time during performance of virtual ADL activities, enabling both animation of the user's avatar and automated generation of metrics related to speed and smoothness of motion. These metrics, aggregated over discrete sub-task elements during performance of virtual ADLs, were compared to scores from an established assessment of UE motor performance, the Wolf Motor Function Test (WMFT). Spearman's rank correlation analysis indicates a moderate correlation between VOTA-derived metrics and the time-based WMFT assessments, supporting the criterion validity of VOTA measures as a means of tracking patient progress during an UE rehabilitation program that includes practice of virtual ADLs. PMID:25265612

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

2015-03-01

217

Somatotopic mapping of natural upper- and lower-extremity movements and speech production with high gamma electrocorticography.  

PubMed

Precise delineation of pathological and eloquent cortices is essential in pre-neurosurgical diagnostics of epilepsy. A limitation of existing experimental procedures, however, is that they critically require active cooperation of the patient, which is not always achievable, particularly in infants and in patients with insufficient cognitive abilities. In the present study, we evaluated the potential of electrocorticographic recordings of high gamma activity during natural, non-experimental behavior of epilepsy patients to localize upper- and lower-extremity motor and language functions, and compared the results with those obtained using electrocortical stimulation. The observed effects were highly significant and functionally specific, and agreed well with the somatotopic organization of the motor cortex, both on the lateral convexity and in the supplementary motor area. Our approach showed a similar specificity and sensitivity for extremity movements as previously obtained from experimental data. We were able to quantify, for the first time, sensitivity and specificity of high gamma underlying non-experimental lower-extremity movements in four patients, and observed values in the same range as for upper extremities (analyzed in six patients). Speech-related responses in the three investigated patients, however, exhibited only a very low sensitivity. The present findings indicate that localization of not only upper- but also lower-extremity movements congruent with electrocortical stimulation mapping is possible based on event-related high gamma responses that can be observed during natural behavior. Thus, non-experimental mapping may be usefully applied as adjunct to established clinical procedures for identification of both upper- and lower-extremity motor functions. PMID:23643922

Ruescher, Johanna; Iljina, Olga; Altenmüller, Dirk-Matthias; Aertsen, Ad; Schulze-Bonhage, Andreas; Ball, Tonio

2013-11-01

218

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

219

The Need for Replantation Surgery after Traumatic Amputations of the Upper Extremity—An Estimate Based upon the Epidemiology of Sweden  

Microsoft Academic Search

Reports in the literature give different views of the frequency of serious amputation injuries of the upper extremity. In Sweden the vast majority of work injuries are registered by the Swedish Labour Market Insurance. All registered serious amputation injuries of the upper extremity in Sweden (8 million inhabitants) during 1979 were investigated in this study. For comparison the frequency of

G. NYLANDER; S. VILKKI

1984-01-01

220

Effectiveness of Commercial Gaming-Based Virtual Reality Movement Therapy on Functional Recovery of Upper Extremity in Subacute Stroke Patients  

PubMed Central

Objective To investigate the effectiveness of commercial gaming-based virtual reality (VR) therapy on the recovery of paretic upper extremity in subacute stroke patients. Methods Twenty patients with the first-onset subacute stroke were enrolled and randomly assigned to the case group (n=10) and the control group (n=10). Primary outcome was measured by the upper limb score through the Fugl-Meyer Assessment (FMA-UL) for the motor function of both upper extremities. Secondary outcomes were assessed for motor function of both upper extremities including manual function test (MFT), box and block test (BBT), grip strength, evaluated for activities of daily living (Korean version of Modified Barthel Index [K-MBI]), and cognitive functions (Korean version of the Mini-Mental State Examination [K-MMSE] and continuous performance test [CPT]). The case group received commercial gaming-based VR therapy using Wii (Nintendo, Tokyo, Japan), and the control group received conventional occupational therapy (OT) for 30 minutes a day during the period of 4 weeks. All patients were evaluated before and after the 4-week intervention. Results There were no significant differences in the baseline between the two groups. After 4 weeks, both groups showed significant improvement in the FMA-UL, MFT, BBT, K-MBI, K-MMSE, and correct detection of auditory CPT. However, grip strength was improved significantly only in the case group. There were no significant intergroup differences before and after the treatment. Conclusion These findings suggested that the commercial gaming-based VR therapy was as effective as conventional OT on the recovery of upper extremity motor and daily living function in subacute stroke patients. PMID:25229027

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

2014-01-01

221

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

222

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

223

Finger Muscle Attachments for an OpenSim Upper-Extremity Model.  

PubMed

We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms). Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic finger muscles. Therefore, it was necessary to scale and translate muscle attachments from one experimental or model environment to another while preserving mechanical function. We used a two-step process. First, we estimated muscle function by calculating moment arms for all intrinsic and extrinsic muscles using the partial velocity method. Second, optimization using Simulated Annealing and Hooke-Jeeves algorithms found muscle-tendon paths that minimized root mean square (RMS) differences between experimental and modeled moment arms. The partial velocity method resulted in variance accounted for (VAF) between measured and calculated moment arms of 75.5% on average (range from 48.5% to 99.5%) for intrinsic and extrinsic index finger muscles where measured data were available. RMS error between experimental and optimized values was within one standard deviation (S.D) of measured moment arm (mean RMS error = 1.5 mm < measured S.D = 2.5 mm). Validation of both steps of the technique allowed for estimation of muscle attachment points for muscles whose moment arms have not been measured. Differences between modeled and experimentally measured muscle attachments, averaged over all finger joints, were less than 4.9 mm (within 7.1% of the average length of the muscle-tendon paths). The resulting non-proprietary musculoskeletal model of the human fingers could be useful for many applications, including better understanding of complex multi-touch and gestural movements. PMID:25853869

Lee, Jong Hwa; Asakawa, Deanna S; Dennerlein, Jack T; Jindrich, Devin L

2015-01-01

224

Finger Muscle Attachments for an OpenSim Upper-Extremity Model  

PubMed Central

We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms). Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic finger muscles. Therefore, it was necessary to scale and translate muscle attachments from one experimental or model environment to another while preserving mechanical function. We used a two-step process. First, we estimated muscle function by calculating moment arms for all intrinsic and extrinsic muscles using the partial velocity method. Second, optimization using Simulated Annealing and Hooke-Jeeves algorithms found muscle-tendon paths that minimized root mean square (RMS) differences between experimental and modeled moment arms. The partial velocity method resulted in variance accounted for (VAF) between measured and calculated moment arms of 75.5% on average (range from 48.5% to 99.5%) for intrinsic and extrinsic index finger muscles where measured data were available. RMS error between experimental and optimized values was within one standard deviation (S.D) of measured moment arm (mean RMS error = 1.5 mm < measured S.D = 2.5 mm). Validation of both steps of the technique allowed for estimation of muscle attachment points for muscles whose moment arms have not been measured. Differences between modeled and experimentally measured muscle attachments, averaged over all finger joints, were less than 4.9 mm (within 7.1% of the average length of the muscle-tendon paths). The resulting non-proprietary musculoskeletal model of the human fingers could be useful for many applications, including better understanding of complex multi-touch and gestural movements. PMID:25853869

Lee, Jong Hwa; Asakawa, Deanna S.; Dennerlein, Jack T.; Jindrich, Devin L.

2015-01-01

225

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

226

Selection of acupoints for managing upper-extremity spasticity in chronic stroke patients  

PubMed Central

Background This study investigated the clinical efficacy of electroacupuncture (EA) in inhibiting upper-extremity spasticity in chronic stroke patients, and also in mapping a unique preliminary acupoint-selection protocol. Methods Fifteen patients were divided into two groups: patients in the control group (n=6) received minimal acupuncture (MA), and those in the experimental group (n=9) received EA. Four acupoints, which include Neiguan (PC6), Shaohai (HT3), Zeqian (Ex-UE, A32), and Shounizhu (EX-UE), were treated near the motor points of the muscles for elbow flexion, forearm pronation, and finger flexion. Both groups were treated for twelve sessions, 20 minutes per session, for 6 weeks (two sessions per week). The outcome measures in this study included angle of muscle reaction (R1), passive range of motion (R2), and dynamic component (R2–R1). Results In the experimental group, the R2–R1 of the elbow joint was significantly decreased at 1 (P=0.0079), 3 (P=0.0013), and 6 weeks (P=0.0149) after treatment compared with pretreatment levels (P<0.05). The between-group difference in the R2–R1 of the elbow joint after the 6-week treatment was statistically significant. Conclusion Combining the 6-week EA and standard rehabilitation treatment reduced the spasticity of the elbow for chronic stroke survivors. However, no significant effect was observed in the spasticity of the wrist joints. The choice of acupoints and the frequency of EA have to be taken into account to achieve a positive treatment effect. The correlation between acupoints and motor points provides a model of acupoint selection to improve spasticity. PMID:24453485

Wang, Bi-Huei; Lin, Chien-Lin; Li, Te-Mao; Lin, Shih-Din; Lin, Jaung-Geng; Chou, Li-Wei

2014-01-01

227

[Macro replantation of upper extremity. Update and review of the long-term functional results].  

PubMed

Confronted with increasing problems of financing in health care, some question the relevance of certain interventions of high technicality. Today, the limiting factor for practitioners is not any longer situated at the technical and technological level (the survival of macro replantations is assured in 85-90%) but moves slowly and surely towards the economic level. It is true that medicine has a price and that if a technique is expensive, it should at least be justified at the human level and superior to other less expensive therapeutic options which are available. In this article, we will first focus on the long-term outcome of patients and also on the functional benefit which brings them replantation compared to patients who underwent a regularization of their stump and possibly a reconstruction enabling them to be correctly fitted with a prosthesis. PMID:23614320

Datco, A; Duysens, C; Massagé, P; Carlier, A

2013-03-01

228

[Recovery of voluntary motion in the upper extremity following hemiplegia in patients with cerebrovascular accident. Prognostic evaluation].  

PubMed

The study aims the registration and anlaysis of the main facts which occur during recovery of the voluntary movements in the upper extremity, in patients with hemiplegia following cerebrovascular accident, and it also intends to evaluate the prognosis. Of particular interest was the comparative recognition of the spontaneous recovery of voluntary motricity in different segments of the upper extremity in 88 patients, not previously selected, with hemiplegia after cerebrovascular accident, admitted to the hospital at the acute stage. Of the 88 hemiplegic patients studied whose further evolution has been fairly followed 56 cases (group 1) experienced clinical improvement, either with partial or total remission of neurological manifestations and complete recovery of all voluntary movements in the different upper extremity joints, while 32 patients (group 2) with persistent neurological symptoms, particularly spasticity, showed a slighter clinical improvement, as well as only partial recovery of upper extremity movements. The clinical quantification of neurological signs applied in this study, has made possible to report the main significant changes developed during the 88 patients recovery. This criteria has allowed to emphasize the degree of the spontaneous remission of symptoms and the determination of the critical level of stabilization "plateau". The analysis of the data supplied by the two groups led to the following conclusions: a) the critical level of remission of symptoms and the spontaneous recovery of voluntary movements ocurred around the 70th day after the installation of hemiplegia; b) the 256 average score acquired 70 days after the onset of the hemiplegia represents the critical level stabilization (plateau); c) although the presence of early initial movements, immediately after the installation of hemiplegia, is a valuable data for the prognosis, the characterization of early movement patterns is of most important meaning; d) patients with hemiplegia after cerebrovascular acident who present the thumb flexion-extension and opposition movements showed a better prognosis than those whose initial movements were represented by the elbow flexion and/or arm flexion-adduction. PMID:1275794

Anghinah, A

1976-06-01

229

A Randomized Controlled Trial Comparing Botulinum Toxin A Dosage in the Upper Extremity of Children with Spasticity  

ERIC Educational Resources Information Center

This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group…

Kawamura, Anne; Campbell, Kent; Lam-Damji, Sophie; Fehlings, Darcy

2007-01-01

230

Associations of metabolic factors and adipokines with pain in incipient upper extremity soft tissue disorders: a cross-sectional study  

PubMed Central

Objectives Earlier studies have suggested associations between metabolic factors and musculoskeletal pain or disorders. We studied the associations of obesity, lipids, other features of the metabolic syndrome and adipokines (adiponectin, leptin, resistin, visfatin) with upper extremity pain in a clinical population with incipient upper extremity soft tissue disorders (UESTDs). Design A cross-sectional study. Setting Primary healthcare (occupational health service) with further examinations at a research institute. Participants Patients (N=163, 86% were women) seeking medical advice in the occupational health service due to incipient upper extremity symptoms with symptom duration of <1?month were referred for consultation to the Finnish Institute of Occupational Health from Spring 2006 to Fall 2008. We included all actively working subjects meeting diagnostic criteria based on physical examination. We excluded subjects meeting predetermined conditions. Outcome measure Pain intensity was assessed with visual analogue scale and dichotomised at the highest tertile (cut-point 60). Results Obesity (adjusted OR for high waist circumference 2.9, 95% CI 1.1 to 7.3), high-density lipoprotein cholesterol (OR 3.9, 95% CI 1.4 to 10.1 for low level) and triglycerides (OR 2.6, 95% CI 1.0 to 6.8 for high level) were associated with pain intensity. Of four adipokines studied, only visfatin was associated with upper extremity pain (adjusted OR 1.4, 95% CI 1.0 to 2.1 for 1SD increase in level). Conclusions Abdominal obesity and lipids may have an impact on pain intensity in UESTDs. They may intensify pain through proinflammatory pain-modifying molecular pathways or by causing soft tissue pathology and dysfunction of their supplying arteries. Of four adipokines studied only one (visfatin) was associated with pain intensity. In the future, further studies are required to better understand the relationship between metabolic factors and UESTDs. PMID:23959751

Rechardt, Martti; Shiri, Rahman; Lindholm, Harri; Karppinen, Jaro; Viikari-Juntura, Eira

2013-01-01

231

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

232

Refining the Sensory and Motor Ratunculus of the Rat Upper Extremity Using fMRI and Direct Nerve Stimulation  

PubMed Central

It is well understood that the different regions of the body have cortical representations in proportion to the degree of innervation. Our current understanding of the rat upper extremity has been enhanced using functional MRI (fMRI), but these studies are often limited to the rat forepaw. The purpose of this study is to describe a new technique that allows us to refine the sensory and motor representations in the cerebral cortex by surgically implanting electrodes on the major nerves of the rat upper extremity and providing direct electrical nerve stimulation while acquiring fMRI images. This technique was used to stimulate the ulnar, median, radial, and musculocutaneous nerves in the rat upper extremity using four different stimulation sequences that varied in frequency (5 Hz vs. 10 Hz) and current (0.5 mA vs. 1.0 mA). A distinct pattern of cortical activation was found for each nerve. The higher stimulation current resulted in a dramatic increase in the level of cortical activation. The higher stimulation frequency resulted in both increases and attenuation of cortical activation in different regions of the brain, depending on which nerve was stimulated. PMID:17969116

Cho, Younghoon R.; Pawela, Christopher P.; Li, Rupeng; Kao, Dennis; Schulte, Marie L.; Runquist, Matthew L.; Yan, Ji-Geng; Matloub, Hani S.; Jaradeh, Safwan S.; Hudetz, Anthony G.; Hyde, James S.

2008-01-01

233

Effects of Below-knee Assembly Work at Different Reach Distances on Upper-extremity Muscle Activity  

PubMed Central

[Purpose] We investigated upper-extremity muscle activity during below-knee assembly work performed by healthy adults at three different reach distances evaluate the physical risk factors associated with neck and shoulder disorders of reach distances. [Subjects] Sixteen young male workers were recruited. [Methods] Activities of the right upper trapezius, anterior deltoid, and biceps brachii muscles were measured during below-knee assembly work at the three different reach distances. [Results] The normalized EMG data of the upper trapezius, anterior deltoid, and biceps brachii muscles generally increased significantly as the reach distance at which the assembly work was performed increased. [Conclusion] Below-knee workers should engage in work that involves shorter (nearer) reach distances. PMID:25202196

Shin, Seung-je; Yoo, Won-gyu

2014-01-01

234

Perforator-based flaps in distal upper and lower extremity defects  

Microsoft Academic Search

The reconstruction of complex distal extremity defects is challenging with both cosmetic and functional considerations. This case series reviews our experience of using perforator-based flaps in 28 patients requiring reconstruction of 30 distal extremity defects. Hand held Doppler localisation of the perforators was carried out preoperatively in all cases. Flaps used were either fasciocutaneous or adipofascial and 90% of the

M. A. Bisson; P. K. Spyriounis; J. G. Miller

2002-01-01

235

Upper-Extremity and Mobility Subdomains From the Patient-Reported Outcomes Measurement Information System (PROMIS) Adult Physical Functioning Item Bank  

PubMed Central

Objective To create upper-extremity and mobility subdomain scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning adult item bank. Design Expert reviews were used to identify upper-extremity and mobility items from the PROMIS item bank. Psychometric analyses were conducted to assess empirical support for scoring upper-extremity and mobility subdomains. Setting Data were collected from the U.S. general population and multiple disease groups via self-administered surveys. Participants The sample (N=21,773) included 21,133 English-speaking adults who participated in the PROMIS wave 1 data collection and 640 Spanish-speaking Latino adults recruited separately. Interventions Not applicable. Main Outcome Measures We used English- and Spanish-language data and existing PROMIS item parameters for the physical functioning item bank to estimate upper-extremity and mobility scores. In addition, we fit graded response models to calibrate the upper-extremity items and mobility items separately, compare separate to combined calibrations, and produce subdomain scores. Results After eliminating items because of local dependency, 16 items remained to assess upper extremity and 17 items to assess mobility. The estimated correlation between upper extremity and mobility was .59 using existing PROMIS physical functioning item parameters (r=.60 using parameters calibrated separately for upper-extremity and mobility items). Conclusions Upper-extremity and mobility subdomains shared about 35% of the variance in common, and produced comparable scores whether calibrated separately or together. The identification of the subset of items tapping these 2 aspects of physical functioning and scored using the existing PROMIS parameters provides the option of scoring these subdomains in addition to the overall physical functioning score. PMID:23751290

Hays, Ron D.; Spritzer, Karen L.; Amtmann, Dagmar; Lai, Jin-Shei; DeWitt, Esi Morgan; Rothrock, Nan; DeWalt, Darren A.; Riley, William T.; Fries, James F.; Krishnan, Eswar

2013-01-01

236

PEComa of the Upper Extremity: A Unique Case and Description of an Initial Response to Neoadjuvant Chemotherapy  

PubMed Central

Purpose. Tumors of the perivascular epithelial cell tumor (PEComa), first described in 1992, represent a rare soft tissue neoplasm of varying malignant potential. Cases of PEComa have been previously described in a few somatic and visceral sites, most notably in the gastrointestinal tract, genitourinary tract, and one extremity case in the thigh. To date, most malignant cases of PEComa have been resistant to chemotherapy, and as such, an appropriate therapy is not known. Case report. Here we describe the first case of PEComa of the upper extremity. Open biopsy revealed a high-grade malignant lesion, and the patient subsequently underwent both neoadjuvant therapy with doxorubicin, ifosfamide and mensa, and radiation therapy prior to wide surgical resection. After six cycles of chemotherapy, the tumor underwent an 80% reduction in size. Subsequent neoadjuvant radiation therapy of 5000?cGy did not further reduce the size of the tumor. Following limb sparing radical resection, pathology showed 20% necrosis within a high-grade malignant lesion. Twenty one months after beginning treatment, the patient shows no sign of local recurrence, but metastatic disease was confirmed after resection of a lung nodule. Conclusion. Given the favorable albeit partial response seen in this patient, the course of therapy outlined here may represent a good starting point for neoadjuvant treatment in a tumor with a historically bleak prognosis. In addition, the diagnosis of PEComa must now be entertained in the differential diagnosis of upper extremity soft tissue sarcoma. PMID:18274609

Osei, D. A.; Alvandi, F.; Brooks, J. S.; Ogilvie, C. M.

2007-01-01

237

The effect of music therapy on mood, perceived exertion, and exercise adherence of patients participating in a rehabilitative upper extremity exercise program  

E-print Network

The purpose of this study was to investigate the effects of music therapy on perceived exertion, mood and exercise adherence of patients participating in a group upper extremity exercise program. Twenty two patients ranging in age from 22 to 86...

Cho, Jeongmin

2009-06-11

238

Surgery on the affected upper extremity of patients with a history of complex regional pain syndrome: The use of intravenous regional anesthesia with clonidine  

Microsoft Academic Search

Study objectivesTo evaluate the efficacy of intravenous regional anesthesia (IVRA) with clonidine in patients with a previous history of complex regional pain syndrome (CRPS) who are undergoing upper extremity hand surgery.

Scott S. Reuben; Erik A. Rosenthal; Robert B. Steinberg; Shameema Faruqi; Prasad A. Kilaru

2004-01-01

239

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

240

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

241

Limb amputation and prosthesis.  

PubMed

Limb amputation is an alternative to euthanasia when catastrophic injury prevents successful restoration of the limb or when cost is an issue. Proximal limb disarticulation for amputation is preferred if a prosthesis is not considered. Distal amputations are needed to accommodate exoskeletal prosthesis. This article reviews the considerations and describes techniques for this surgery. PMID:24534663

Desrochers, André; St-Jean, Guy; Anderson, David E

2014-03-01

242

Choosing a Breast Prosthesis  

MedlinePLUS

... faces and the options available after surgery for breast cancer . What is a breast prosthesis? An external breast prosthesis is an artificial ... sometimes useful to petition for coverage. During Breast Cancer Awareness Month ... to determine what is covered under your plan. On average, prostheses ...

243

On the Dynamics of Extreme Meteorological Droughts during Pakistan Summer Monsoon by Focusing the Anomalous States of Upper Troposphere  

NASA Astrophysics Data System (ADS)

The lack of summer monsoon sometimes brings severe droughts in many parts of the world including South Asian countries like Pakistan. Human life and economy in Pakistan considerably depends on the summer monsoon. So, an essential question arises "how can we contribute better to manage the water resources during drought conditions for the societal needs". To address the concern as a hydrologist, we need to develop a basis of the scientific understanding of the different contrast of the climatology during extremely dry rainfall events over Pakistan region. However, compared to other regional studies i.e. Indian Summer Monsoon (ISM) and South-East Asian Monsoon (SEAM), the basis of the thermodynamical structure and the processes associated with upper tropospheric conditions during the climatological mean Pakistan Summer Monsoon (PSM) and its extreme events have not been addressed deeply yet and need to be investigated, because it is immensely vital for the hydrologist as a first step to develop the basis of scientific understanding. By data analysis, an attempt has been made to accomplish this objective. Firstly, the climatological tropospheric conditions and the associated processes from pre-monsoon phase to the PSM mature phase are investigated. During the PSM mature phase (mid July), the climatological-mean structure of the atmosphere favors convective activity compared to the pre-monsoon phase (late June) with weakening of the subsidence in the upper troposphere and also with increasing of incoming moisture flux in the lower troposphere from Arabian Sea and Bay of Bengal around Pakistan. Specifically, in the upper troposphere, the upper-level subsidence and convergence observed over Pakistan during pre-monsoon phase shifts and reallocates to the northwest of Pakistan during mature phase, which results in weakening of the subsidence just over Pakistan, and then the PSM mature phase initiated. Secondly, comparing the PSM mature phase climatological mean characteristics, the characteristics of the extremely dry PSM events are investigated by focusing their common anomalous tropospheric conditions observed during the period 1979-2008. We found that the extremely dry PSM events were closely related with the anomalous state of upper tropospheric cyclonic circulation northwest of Pakistan and the associated cold temperature anomaly around Pakistan. This anomalous state of upper tropospheric cyclonic circulation is accompanied with the anomalous upper level convergence around Pakistan, which anomalously weakens the climatological mean PSM trough to suppress the PSM activities. We found two possibilities i.e. Matsuno-Gill type atmospheric response from the tropics and/or the Rossby wave train along the Asian Jet to trigger, reinforce, and maintain the upper-tropospheric cyclonic circulation. In summary, the strong convection anomalies resulting in severe drought events over the PSM region are suggested to be induced by both the tropical and extratropical processes. However what (i.e. source) triggers the circulation anomaly from the tropics and/or extratropics is unknown at the moment, which needs further investigations to reach a definite conclusion. Further, if hydrologist gets a prediction signal in advance, the integrated water resources management (IWRM) will be much more effective for the region.

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

2012-12-01

244

Endovascular Management of Acute Upper Extremity Deep Venous Thrombosis and the Use of Superior Vena Cava Filters  

PubMed Central

Upper extremity deep venous thrombosis (UEDVT), though less common than lower extremity DVT, is a significant problem with several possible etiologies. The incidence of UEDVT is on the rise, primarily from the increasing use of central venous access devices. However, there are other causes of UEDVT, including primary venous thrombosis (Paget-Schroetter syndrome) and hypercoagulable states associated with underlying malignancy. The morbidity and mortality associated with UEDVT is largely from pulmonary embolism and the postphlebitic syndrome. Nevertheless, many UEDVTs are asymptomatic or patients may present with nonspecific clinical symptoms; therefore, a high index of suspicion is often necessary to make a correct diagnosis. Currently, there is no standard treatment algorithm for UEDVT. Treatment options may range from systemic anticoagulation to surgical correction depending on the etiology of the thrombus, as well as the patient's associated comorbidities, life expectancy and expected quality of life following treatment. PMID:22379271

Koury, Joseph P.; Burke, Charles T.

2011-01-01

245

The need for updated clinical practice guidelines for preservation of upper extremities in manual wheelchair users: a position paper.  

PubMed

The purposes of this article were to examine the existing 2005 Clinical Practice Guidelines for preservation of the upper extremities in spinal cord injury and explore the literature to determine what might need to be included in an update. This is a consensus position article based on a literature review and the expertise of the authors. The findings support the original recommendations of the Clinical Practice Guidelines and provide evidence that suggests that information regarding equipment and skills training as well as impact to caregivers is needed. PMID:25299526

Sawatzky, Bonita; DiGiovine, Carmen; Berner, Theresa; Roesler, Tina; Katte, Lyndall

2015-04-01

246

Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke  

Microsoft Academic Search

OBJECTIVE: Electrical stimulation can be applied in a variety of ways to the hemiparetic upper extremity following stroke. The aim of this review is to explore the relationship between characteristics of stimulation and the effect of electrical stimulation on the recovery of upper limb motor control following stroke. METHODS: A systematic literature search was performed to identify clinical trials evaluating

Kroon de Joke R; Maarten J. IJzerman; John Chae; Gustaaf J. Lankhorst; Gerrit Zilvold

2005-01-01

247

Sequential muscle activity and its functional role in the upper extremity and trunk during overarm throwing  

Microsoft Academic Search

The proximal-to-distal segmental sequence has been identified in many sports activities, including baseball pitching and ball kicking. However, proximal-to-distal sequential muscle activity has not been identified. The aims of this study were to establish whether sequential muscle activity does occur and, if it does, to determine its functional role. We recorded surface electromyograms (EMGs) for 17 muscles from the upper

Masaya Hirashima; Hiroshi Kadota; Shizuka Sakurai; Katzutoshi Kudo; Tatsuyuki Ohtsuki

2002-01-01

248

Understanding Work-Related Upper Extremity Disorders: Clinical Findings in 485 Computer Users, Musicians, and Others  

Microsoft Academic Search

Four hundred eighty five patients whose chief complaints were work related pain and other symptoms received a comprehensive upper-body clinical evaluation to determine the extent of their illness. The group had a mean age of 38.5 years. Sixty-three percent of patients were females. Seventy percent were computer users, 28% were musicians, and 2% were others engaged in repetitive work. The

Emil F. Pascarelli; Yu-Pin Hsu

2001-01-01

249

Cortical reorganization and phantom phenomena in congenital and traumatic upper-extremity amputees  

Microsoft Academic Search

The relationship between phantom limb phenomena and cortical reorganization was examined in five subjects with congenital\\u000a absence of an upper limb and nine traumatic amputees. Neuromagnetic source imaging revealed minimal reorganization of primary\\u000a somatosensory cortex in the congenital amputees (M=0.69 cm, SD 0.24) and the traumatic amputees without phantom limb pain (M=0.27 cm, SD 0.25); the amputees with phantom limb

Herta Flor; Thomas Elbert; Werner Mühlnickel; Christo Pantev; Christian Wienbruch; Edward Taub

1998-01-01

250

Age and gender effects on the proximal propagation of an impulsive force along the adult human upper extremity  

PubMed Central

We tested the null hypotheses that neither age, gender nor muscle pre-cocontraction state affect the latencies of changes in upper extremity kinematics or elbow muscle activity following an impulsive force to the hand. Thirty eight healthy young and older adult volunteers lay prone on an apparatus with shoulders flexed 75 degrees and arms slightly flexed. The non-dominant hand was subjected to three trials of impulsive loading with arm muscles precontracted to 25, 50 or 75% of maximum pre-cocontraction levels. Limb kinematic data and upper extremity electromyographic (EMG) activity were acquired. The results showed that pre-cocontraction muscle level (p < 0.001) and gender (p < 0.05 for wrist and shoulder) affected joint displacement onset times and age affected EMG onset times (p < 0.05). The peak applied force (F1) occurred a mean (± SD) 27 (± 2) msec after impact. The latencies for the wrist, elbow and shoulder displacements were 21 ± 3 msec, 29 ± 5 msec and 34 ± 7 msec, respectively. Because the latencies for elbow flexion and lateral triceps EMG were 23 ± 5 msec and 84 ± 8 msec, respectively, muscle pre-activation rather than stretch reflexes prevent arm buckling under impulsive end loads. PMID:23979475

Lee, Yunju; Ashton-Miller, James A.

2013-01-01

251

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

PubMed Central

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

252

The upper extremity of the professional tennis player: muscle volumes, fiber-type distribution and muscle strength.  

PubMed

The effects of professional tennis participation on dominant and non-dominant upper extremity muscle volumes, and on fiber types of triceps brachii (lateral head) and vastus lateralis muscles were assessed in 15 professional tennis players. Magnetic resonance imaging (MRI, n=8) examination and dual-energy x-ray absorptiometry (DXA, n=7) were used to assess muscle volumes and lean body mass. Muscle fiber-type distribution assessed by biopsy sampling was similar in both triceps brachii (2/3 were type 2 and 1/3 type 1 fibers). The VL was composed of 1/3 of type 2 and 2/3 of type 1 fibers. The dominant had 12-15% higher lean mass (DXA/MRI) than the non-dominant (P<0.05). Type 1, 2a and 2x muscle fibers of the dominant were hypertrophied compared with the non-dominant by 20%, 22% and 34% (all P<0.01), respectively. The deltoid, triceps brachii, arm flexors and forearm superficial flexor muscles of the dominant were hypertrophied (MRI) compared with the non-dominant by 11-15%. These muscles represented a similar fraction of the whole muscle volume in both upper extremities. Dominant muscle volume was correlated with 1RM on the one-arm cable triceps pushdown exercise (r=0.84, P<0.05). Peak power during vertical jump correlated with VL muscle fibers's cross-sectional area (r=0.82-0.95, P<0.05). PMID:19602193

Sanchís-Moysi, J; Idoate, F; Olmedillas, H; Guadalupe-Grau, A; Alayón, S; Carreras, A; Dorado, C; Calbet, J A L

2010-06-01

253

Age-related site-specific muscle wasting of upper and lower extremities and trunk in Japanese men and women.  

PubMed

The purpose of this study was to examine the age-related site-specific muscle loss of the upper and lower extremities and trunk in men and women. Japanese nonobese adults aged 20-79 (n?=?1559, 52 % women) had muscle thickness (MTH) measured by ultrasound at nine sites on the anterior and posterior aspects of the body. An MTH ratio located in the anterior and posterior aspects of the upper arm, upper leg, lower leg, and trunk was calculated. Site-specific muscle loss was defined as a ratio of MTH?>?2 standard deviations below the mean for young adults in each segment. Age was inversely correlated (p?upper-leg MTH ratio in men (r?=?-0.463) and women (r?=?-0.541). Age was correlated positively to upper-arm MTH ratio and inversely to trunk MTH ratio in men (r?=?0.191 and r?=?-0.238, both p?upper-leg muscle loss showed an age-related increasing pattern in men (6 % for ages 30-39, 21 % for ages 50-59, and 38 % for ages 70-79) and women (15 % for ages 30-39, 32 % for ages 50-59, and 50 % for ages 70-79). For other segments, however, the prevalence rate of site-specific muscle loss was relatively low throughout the age groups in men and women, although higher rates were observed in the older group. These results suggest that the anterior/posterior MTH ratio of the upper leg may be useful in providing an earlier diagnosis for site-specific muscle loss. PMID:24243442

Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S; Fukunaga, Tetsuo

2014-04-01

254

The impact of breast cancer-related lymphedema on the ability to perform upper extremity activities of daily living.  

PubMed

We sought to assess the association of breast cancer-related lymphedema (BCRL) with the ability to perform upper extremity activities of daily living (ADL) in our patient population. 324 breast cancer patients who had received treatment for unilateral breast cancer at our institution between 2005 and 2014 were prospectively screened for lymphedema. Bilateral arm measurements were performed pre-operatively and during post-operative follow-up using a Perometer. Patients completed an extensive quality of life (QOL) questionnaire at the time of each study assessment. Lymphedema was defined as a relative volume change (RVC) of ?10% from the patient's pre-operative baseline measurement. Linear regression models were used to evaluate the relationship between post-operative arm function score (as a continuous variable) and RVC, demographic, clinical, and QOL factors. By multivariate analysis, greater fear of lymphedema (p < 0.0001), more pain (p < 0.0001), body mass index >25 (p = 0.0015), mastectomy (p = 0.0001), and having an axillary node dissection (p = 0.0045) were all associated with lower functional scores. Higher emotional well-being score (p < 0.0001) and adjuvant chemotherapy (p = 0.0005) were associated with higher post-operative functional score. Neither low-level volume changes (5-10 % RVC) nor BCRL (RVC ?10 %) were associated with ability to perform upper extremity ADL as measured by self-report (p = 0.99, p = 0.79). This prospective study demonstrates that low-level changes in arm volume (RVC 5-10 %) as well as clinically significant BCRL (RVC ?10 %) did not impact the self-reported ability to use the affected extremity for ADL. These findings may help to inform clinicians and patients on the importance of prospective screening for lymphedema and QOL which enables early detection and intervention. PMID:25749734

O'Toole, Jean A; Ferguson, Chantal M; Swaroop, Meyha N; Horick, Nora; Skolny, Melissa N; Brunelle, Cheryl L; Miller, Cynthia L; Jammallo, Lauren S; Specht, Michelle C; Taghian, Alphonse G

2015-04-01

255

Effect of gender and stroke rate on joint power characteristics of the upper extremity during simulated rowing.  

PubMed

Males typically have greater upper body strength than do females, which is likely to impact on the rowing techniques adopted by each sex. The aim of this study was to quantify energy contributions and compare the joint power production of upper extremity joints between the sexes. Seven males and eight females performed 60 s trials at five different stroke rates. External forces were measured at the handle and stretcher, while kinematics were recorded by motion analysis. Joint moments were derived by inverse dynamic calculations, followed by the calculation of joint powers and gross mechanical energy expenditure. Male rowers expended more total external energy per stroke and made a larger percentage contribution of angular shoulder energy to their total external energy expenditure. As stroke rate increased, the contribution from elbow and angular shoulder energy contributions decreased for both males and females. Female rowers decreased their angular shoulder contribution at a slower rate than did males as stroke rate increased. The overall percentage of work done on the stretcher was higher for male rowers, and this difference further increased at higher stroke rates. The results of this study suggest that specific upper body conditioning may be particularly important for female rowers. PMID:22296106

Attenborough, Alison S; Smith, Richard M; Sinclair, Peter J

2012-01-01

256

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

PubMed Central

Objectives. To study whether the reinforced feedback in virtual environment (RFVE) is more effective than traditional rehabilitation (TR) for the treatment of upper limb motor function after stroke, regardless of stroke etiology (i.e., ischemic, hemorrhagic). Design. Randomized controlled trial. Participants. Forty-four patients affected by stroke. Intervention. The patients were randomized into two groups: RFVE (N = 23) and TR (N = 21), and stratified according to stroke etiology. The RFVE treatment consisted of multidirectional exercises providing augmented feedback provided by virtual reality, while in the TR treatment the same exercises were provided without augmented feedbacks. Outcome Measures. Fugl-Meyer upper extremity scale (F-M UE), Functional Independence Measure scale (FIM), and kinematics parameters (speed, time, and peak). Results. The F-M UE (P = 0.030), FIM (P = 0.021), time (P = 0.008), and peak (P = 0.018), were significantly higher in the RFVE group after treatment, but not speed (P = 0.140). The patients affected by hemorrhagic stroke significantly improved FIM (P = 0.031), time (P = 0.011), and peak (P = 0.020) after treatment, whereas the patients affected by ischemic stroke improved significantly only speed (P = 0.005) when treated by RFVE. Conclusion. These results indicated that some poststroke patients may benefit from RFVE program for the recovery of upper limb motor function. This trial is registered with NCT01955291. PMID:24745024

Kiper, Pawe?; Luque-Moreno, Carlos; Tonin, Paolo

2014-01-01

257

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

PubMed Central

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. 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

258

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

259

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

260

Axillary nerve palsy consequent to a guided manual stretch of the upper extremities: a case report.  

PubMed

Reflexive breathing therapy and complementary manual therapy aim to improve breathing by mobilizing the chest, reducing the muscle tone of the breath supporting muscles, and improving secretion and chest wall compliance. We describe an uncommon case of axillary nerve (AN) palsy in association with a treatment session of reflexive breathing therapy combined with manual therapy. After a therapist's guided intensive movement of crossed arms in front of the body, upward, as high as possible, a sudden ache in the left shoulder that radiated to the lateral upper arm occurred along with loss of elevation and abduction of the shoulder. An electrophysiological examination demonstrated a diminished and delayed compound muscle action potential that indicated AN injury. Following conservative treatment, the nerve dysfunction resolved completely. Stretching of the nerve may have resulted in tearing some nerve fibers and is discussed as a possible pathophysiological mechanism. PMID:24976752

Heckmann, Josef G

2014-05-01

261

Neurorehabilitation of Upper Extremities in Humans with Sensory-Motor Impairment  

Microsoft Academic Search

ABSTRACT Today,most,clinical,investigators,agree,that,the common,denominator,for successful,therapy,in sub- jects after central,nervous,system,(CNS) lesions is to induce concentrated, repetitive practice of the more affected,limb,as,soon,as possible,after the,onset,of impairment.,This paper,reviews,representative,meth- ods,of neurorehabilitation such,as constraining,the,less affected,arm,and,using,a,robot,to facilitate move- ment of the affected arm, and focuses on functional electrotherapy,promoting,the,movement,recovery. The functional,electrical,therapy,(FET) encompasses three,elements:,1) control,of,movements,that,are compromised because of the impairment, 2) en- hanced exercise of paralyzed extremities, and 3) augmented,activity,of

Dejan B. Popovic; Mirjana B. Popovic; Thomas Sinkjaer

2002-01-01

262

Semiconstrained Distal Radioulnar Joint Prosthesis  

PubMed Central

Distal radioulnar joint (DRUJ) problems can occur as a result of joint instability, abutment, or incongruity. The DRUJ is a weight-bearing joint; the ulnar head is frequently excised either totally or partially, and in some cases it is fused, because of degenerative, rheumatoid, or posttraumatic arthritis. Articles about these procedures report the ability to pronate and supinate, but they rarely discuss grip strength, and even less do they address lifting capacity. We report the long term results of the first 35 patients who underwent total DRUJ arthroplasty with the Aptis DRUJ prosthesis after 5 years follow-up. Surgical indications were all causes of dysfunctional DRUJ (degenerative, posttraumatic, autoimmune, congenital). We recorded data for patient demographics, range of motion (ROM), strength, and lifting capacity of the operated and of the nonoperated extremity. Pain and functional assessments were also recorded. The Aptis DRUJ prosthesis, a bipolar self-stabilizing DRUJ endoprosthesis that restores forearm function, consists of a semiconstained and modular implant designed to replace the function of the ulnar head, the sigmoid notch of the radius, and the triangular fibrocartilage ligaments. The surgical technique is presented in detail. The majority of the patients regained adequate ROM and improved their strength and lifting capacity to the operated side. Pain and activities of daily living were improved. Twelve patients experienced complications, most commonly being extensor carpi ulnaris (ECU) tendinitis, ectopic bone formation, bone resorption with stem loosening, low-grade infection, and need for ball replacement. The Aptis total DRUJ replacement prosthesis is an alternative to salvage procedures that enables a full range of motion as well as the ability to grip and lift weights encountered in daily living activities. PMID:24436788

Savvidou, Christiana; Murphy, Erin; Mailhot, Emilie; Jacob, Shushan; Scheker, Luis R.

2013-01-01

263

Effects of Bilateral Passive Range of Motion Exercise on the Function of Upper Extremities and Activities of Daily Living in Patients with Acute Stroke  

PubMed Central

[Purpose] To evaluate the effects of early passive range of motion exercise on the function of upper extremities and activities of daily living in patients with acute stroke. [Methods] A total of 37 patients with acute stroke in intensive care units, were assigned to the experimental group (n=19) and control group (n=18). The experimental group performed passive range of motion exercise twice a day, for 4 weeks, immediately after a pretest; the patients in the control group performed the range of motion exercise in the same manner for 2 weeks beginning 2 weeks after the pretest. The functions of upper extremities (edema, range of motion), manual function, and activities of daily living of both groups were measured before and at four weeks after the intervention. [Results] The experimental group showed a significant decrease in the edema of upper extremities compared with the control group. It also showed a significant increase in the range of motion, function of upper extremities, and the activities of daily living compared to the control group. [Conclusion] Passive range of motion exercise in the early stage can improve the function of upper extremities and activities of daily living in patients with acute stroke. PMID:24567696

Kim, Hyun Ju; Lee, Yaelim; Sohng, Kyeong-Yae

2014-01-01

264

In-flight estimation of gyro noise on the Upper Atmosphere Research Satellite (UARS) and Extreme Ultraviolet Explorer (EUVE) missions  

NASA Technical Reports Server (NTRS)

This paper characterizes the low-frequency noise response of the Teledyne dry rotor inertial reference unit (DRIRU) gyroscopes on the Upper Atmosphere Research Satellite (UARS) and the Extreme Ultraviolet Explorer (EUVE). The accuracy of spacecraft attitude estimation algorithms that use gyro data for propagating the spacecraft attitude is sensitive to gyro noise. EUVE gyro data were processed to validate a single-axis gyro noise model, which is used onboard various spacecraft. The paper addresses the potential impact of temperature effects on the gyro noise model and the overall impact on attitude determination accuracy. The power spectral density (PSD) of the gyro noise is estimated from UARS in-flight data by Fast Fourier Transform (FFT). The role of actuator dynamics on the PSD function is also discussed.

Lee, M.; Crouse, P.; Harman, R.; Leid, Terry; Davis, W.; Underwood, S.

1994-01-01

265

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

266

Motor impairments related to brain injury timing in early hemiparesis Part II: abnormal upper extremity joint torque synergies  

PubMed Central

Background Extensive neuromotor development occurs early in human life, and the timing of brain injury may affect the resulting motor impairment. In part I of this paper series it was demonstrated that the distribution of weakness in the upper extremity depended on the timing of brain injury in individuals with childhood-onset hemiparesis. Objective The goal of this study was to characterize how timing of brain injury impacts joint torque synergies, or losses of independent joint control. Method Twenty-four individuals with hemiparesis were divided into three groups based on the timing of their injury: before birth (PRE-natal, n=8), around the time of birth (PERI-natal, n=8) and after 6 months of age (POST-natal, n=8). Individuals with hemiparesis, as well as 8 typically developing peers participated in maximal isometric shoulder, elbow, wrist, and finger torque generation tasks while their efforts were recorded by a multiple degree-of-freedom load cell. Motor output in 4 joints of the upper extremity were concurrently measured during 8 primary torque generation tasks to quantify joint torque synergies. Results There were a number of significant coupling patterns identified in individuals with hemiparesis that differed from the typically developing group. POST-natal differences were most noted in the coupling of shoulder abductors with elbow, wrist, and finger flexors, while the PRE-natal group demonstrated significant distal joint coupling with elbow flexion. Conclusion The torque synergies measured provide indirect evidence for the use of bulbospinal pathways in the POST-natal group, while those with earlier injury may utilize relatively preserved ipsilateral corticospinal motor pathways. PMID:23911972

Sukal-Moulton, Theresa; Krosschell, Kristin J.; Gaebler-Spira, Deborah J.; Dewald, Julius P.A.

2014-01-01

267

Post-thrombotic syndrome, functional disability and quality of life after upper extremity deep venous thrombosis in adults.  

PubMed

The post-thrombotic syndrome (PTS) after upper extremity deep venous thrombosis (UEDVT) has not been well characterized. The objective of our study was to describe and quantify residual symptoms, functional disability and quality of life associated with PTS after UEDVT in adults. Twenty-four patients with objectively diagnosed UEDVT (bilateral in 1 patient) at least 6 months previously were recruited from two Canadian thrombosis clinics. Data were collected on demographic characteristics, DVT risk factors and affected venous segments. The Villalta PTS scale, modified for the upper extremity, was used to diagnose PTS. Patients completed questionnaires on degree of functional disability (DASH questionnaire), and generic (SF-36) and disease-specific (VEINES-QOL) quality of life. Results were compared in patients with and without PTS. Patients were assessed a median of 13 months after the diagnosis of UEDVT. Daily ipsilateral arm or hand swelling was reported by 52% of patients and daily ipsilateral arm pain by 20% of study patients, compared with 0% and 0%, respectively, in the contralateral arm. PTS was present in 11/25 (44%) limbs (11/24 patients). One patient had severe PTS. Patients with PTS, compared with those without PTS, had significantly more functional disability (mean DASH score 20.9 vs. 3.7, p=0.009) and poorer quality of life (mean VEINES-QOL score 45.6 vs. 53.6; p=0.001; mean SF-36 Physical Component Score (PCS) 40.8 vs. 50.2; p=0.12). PTS scores were higher and quality of life was poorer when PTS involved the dominant arm. In conclusion, PTS occurs frequently after UEDVT and is associated with significant functional disability and reduced quality of life. Patients with dominant arm PTS appear to fare worse than those with non-dominant arm PTS. Larger, prospective studies to identify prognostic factors that lead to PTS after UEDVT are warranted. PMID:15735801

Kahn, Susan R; Elman, Elyssa A; Bornais, Chantal; Blostein, Mark; Wells, Phillip S

2005-03-01

268

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. PMID:25425780

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

2014-01-01

269

Relationship between gluteal muscle activation and upper extremity kinematics and kinetics in softball position players.  

PubMed

As the biomechanical literature concerning softball pitching is evolving, there are no data to support the mechanics of softball position players. Pitching literature supports the whole kinetic chain approach including the lower extremity in proper throwing mechanics. The purpose of this project was to examine the gluteal muscle group activation patterns and their relationship with shoulder and elbow kinematics and kinetics during the overhead throwing motion of softball position players. Eighteen Division I National Collegiate Athletic Association softball players (19.2 ± 1.0 years; 68.9 ± 8.7 kg; 168.6 ± 6.6 cm) who were listed on the active playing roster volunteered. Electromyographic, kinematic, and kinetic data were collected while players caught a simulated hit or pitched ball and perform their position throw. Pearson correlation revealed a significant negative correlation between non-throwing gluteus maximus during the phase of maximum external rotation to maximum internal rotation (MIR) and elbow moments at ball release (r = -0.52). While at ball release, trunk flexion and rotation both had a positive relationship with shoulder moments at MIR (r = 0.69, r = 0.82, respectively) suggesting that the kinematic actions of the pelvis and trunk are strongly related to the actions of the shoulder during throwing. PMID:23519517

Oliver, Gretchen D

2014-03-01

270

New scoring system predicting the occurrence of deep infection in open upper and lower extremity fractures: efficacy in retrospective re-scoring  

Microsoft Academic Search

Background  It is important to predict the occurrence of deep infection in open fractures when treating such fractures. We tried to develop\\u000a a new scoring system for predicting the occurrence of deep infection in open upper and lower extremity fractures on the basis\\u000a of the Hannover Fracture Scale’98 (HFS-98).\\u000a \\u000a \\u000a \\u000a Methods  A total of 394 open upper and lower extremity fractures (351 patients)

Kazuhiko Yokoyama; Moritoshi Itoman; Koushin Nakamura; Masataka Uchino; Hiroshi Nitta; Yoshiaki Kojima

2009-01-01

271

[Designing special prosthesis "spacer"].  

PubMed

Malignant diseases of the medial part of the femur, humerus and tibia, treated with surgical removal of the affected part of the bone and prosthesis fitting special "Spacer". This type of prosthesis is made in the form of the proximal and distal components that connect by screws. The design of endoprosthesis provides without possible rotation linear relationship and allows the transfer of load from the proximal to the distal bone, but the screws that provide connection are not exposed to stress. For pro-per sizing and implementation of a special prosthesis is necessary to determine the geometric parameters of bone mass and disease and then develop a computer model of the prosthesis. Designing a special prosthesis "spacer" is a complex procedure based on the processing of diagnostic images (X-ray, CT or MRI) with the use of specialized software digitized picture elements pixels translate into voxels. In this way a geometric model contains a form of external (KORTEX), and the internal geometry of the bone (medullary canal). On the basis of such a developed computer models is possible accurately determine the part of the bone that is necessary to remove, and the size of medullary canal space that is built into proximal or distal component of special endoprosthesis "Spacer". PMID:24298748

Gruji?, Jovan; Tabakovi?, Slobodan; Zeljkovi?, Milan; Zivkovi?, Aleksandar; Vucini?, Zoran; Djordjevi?, Aca; Mandi?, Nikica; Luji?, Nenad; Sekuli?, Jovan

2013-01-01

272

Changes in Health Status Among Aging Survivors of Pediatric Upper and Lower Extremity Sarcoma: A Report from the Childhood Cancer Survivor Study (CCSS)  

PubMed Central

Objective To evaluate health status and participation restrictions in childhood extremity sarcoma survivors. Design Members of the CCSS cohort with extremity sarcomas, who completed 1995, 2003 or 2007 questionnaires, were included. Setting Cohort Study of extremity sarcomas survivors. Participants Childhood cancer survivors diagnosed and treated between 1970–1986. Interventions Not applicable. Main Outcome Measure Prevalence rates for poor health status in six domains and five sub-optimal social participation categories were compared by tumor location and treatment exposure with generalized estimating equations adjusted for demographic/personal factors and time/age. Results Among 1094 survivors, median age at diagnosis 13 years (range 0–20), current age 33 years (range 10–53), 49% were male, 87.5% Caucasian, and 75% had lower extremity tumors. In adjusted models, when compared to upper extremity survivors, lower extremity survivors had increased risk of activity limitations but lower risk of not completing college. Compared to those who did not have surgery, those with limb-sparing (LS) and upper extremity amputations (UEA) were 1.6 times more likely to report functional impairment; while those with an above the knee amputation (AKA) were 1.9 times more likely to report functional impairment. Survivors treated with LS were 1.5 times more likely to report activity limitations. Survivors undergoing LS were more likely to report inactivity, incomes < $20,000, unemployment and no college degree. Those with UEA more likely reported inactivity, unmarried status and no college degree. Lastly, those with AKA more likely reported no college degree. Treatment with abdominal irradiation was associated with increased risk of poor mental health, functional impairment and activity limitation. Conclusion Treatment for lower extremity sarcomas is associated with a 50% increased risk for activity limitations; upper extremity survivors are at 10% higher risk for not completing college. Type of local control influences health status and participation restrictions. Both these outcomes decline with age. PMID:23380347

Marina, Neyssa; Hudson, Melissa M.; Jones, Kendra E.; Mulrooney, Daniel A.; Avedian, Raffi; Donaldson, Sarah S.; Popat, Rita; West, Dee W.; Fisher, Paul; Leisenring, Wendy; Stovall, Marilyn; Robison, Leslie L.; Ness, Kirsten K.

2014-01-01

273

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

PubMed

Electrical spinal neuromodulation in the form of spinal cord stimulation is currently used for treating chronic painful conditions such as complex regional pain syndrome, diabetic neuropathy, postherpetic neuralgia, peripheral ischemia, low back pain, and other conditions refractory to more conservative treatments. To date, there are very few published reports documenting the use of spinal cord stimulation in the treatment of head/neck and upper limb pain. This paper reports a case series of 5 consecutive patients outlining the use of spinal cord stimulation to treat upper extremity pain. All subjects had previously undergone cervical fusion surgery to treat chronic neck and upper limb pain. Patients were referred following failure of the surgery to manage their painful conditions. Spinal cord stimulators were placed in the cervical epidural space through a thoracic needle placement. Stimulation parameters were adjusted to capture as much of the painful area(s) as possible. In total, 4 out of 5 patients moved to implantation. In all cases, patients reported significant (70-90%) reductions in pain, including axial neck pain and upper extremity pain. Interestingly, 2 patients with associated headache and lower extremity pain obtained relief after paresthesia-steering reportedly covered those areas. Moreover, 2 patients reported that cervical spinal cord stimulation significantly improved axial low back pain. Patients continue to report excellent pain relief up to 9 months following implantation. This case series documents the successful treatment of neck and upper extremity pain following unsuccessful cervical spine fusion surgery. Given this initial success, prospective, controlled studies are warranted to more adequately assess the long term utility and cost effectiveness of electrical neuromodulation treatment of chronic neck and upper extremity pain. PMID:17387353

Vallejo, Ricardo; Kramer, Jeffery; Benyamin, Ramsin

2007-03-01

274

The intra- and interrater reliability of the action research arm test: A practical test of upper extremity function in patients with stroke  

Microsoft Academic Search

van der Lee JH, de Groot V, Beckerman H, Wagenaar RC, Lankhorst GJ, Bouter LM. The intra- and interrater reliability of the Action Research Arm test: a practical test of upper extremity function in patients with stroke. Arch Phys Med Rehabil 2001;82:14-9. Objectives: To determine the intra- and interrater reliability of the Action Research Arm (ARA) test, to assess its

Johanna H. van der Lee; Vincent de Groot; Heleen Beckerman; Robert C. Wagenaar; Gustaaf J. Lankhorst; Lex M. Bouter

2001-01-01

275

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

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 Virtual Reality}@caip.rutgers.edu 2 Department of Developmental and Rehabilitative Sciences, University of Medicine and Dentistry

New Jersey, University of Medicine and Dentistry of

276

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.

277

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.

278

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.

279

Congenital and acquired thrombotic risk factors in lymphoma patients bearing upper extremities deep venous thrombosis: a preliminary report  

PubMed Central

Background Congenital thrombotic risk factors, oncological diseases and its therapies have been related to an increased occurrence of upper extremities deep venous thrombosis (UEDVT). Patients and methods We studied seven patients bearing lymphoma (one Hodgkin's and six non-Hodgkin's) who developed UEDVT, one at diagnosis and six during chemotherapy (two of these six cases had implantation of a central venous catheter and four received Growth Colony Stimulating Factors in addition to chemotherapy). Patients were screened for: factor V G1691A (Leiden), prothrombin G20210A, methylene tetrahydrofolate reductase (MTHFR) C677T mutations and antithrombin III, proteins C and S plasma activity. Results All patients were wild-type homozygotes for G20210A. One was heterozygote for factor V G1691A, the other 6 were wild-type homozygotes. Three of the 7 patients were homozygotes and 2 heterozygotes for the MTHFR mutation; the remaining 2 were wild-type homozygotes. Clotting inhibitor levels were normal in all patients. Conclusions UEDVT in patients bearing haematological malignancies can occur irrespective of congenital thrombophilic alterations. However, in a subgroup of patients UEDVT could also depend on congenital thrombophilic alterations. A screening for inherited thrombophilia can identify high risk patients that could be specifically treated to prevent thrombotic complications. PMID:15035664

Di Micco, Pierpaolo; Niglio, Alferio; De Renzo, Amalia; Lucania, Anna; Di Fiore, Rosanna; Scudiero, Olga; Castaldo, Giuseppe

2004-01-01

280

Predictive factors of response to phase I complete decongestive therapy in upper extremity lymphedema following breast carcinoma in Iran.  

PubMed

Post-mastectomy chronic lymphedema as a complication of breast cancer treatment is primarily managed with Complete Decongestive Therapy (CDT). We examined various factors for correlating with results of Phase I CDT treatment in controlling the upper extremity lymphedema. Study population consisted of patients with lymphedema referred to the Lymphedema Clinic of the Iranian Breast Cancer Research Center for control of arm edema. After obtaining the demographic and clinical data, patients were treated with CDT for 2 - 3 weeks. One hundred and thirty seven patients (mean age +/- SD; 53.5 +/- 10 years) were studied. In 48.7% of patients, the affected arm was the dominant limb. Fifty percent of patients experienced lymphedema during the first year after surgery, and mean duration of lymphedema was 35 +/- 43 months. Mean volume reduction was 43% +/- 14.87% (p = 0.03). There was a significant relationship between the percent of volume reduction and initial lymphedema volume (p=0.003) as well as duration of lymphedema (p=0.002). Our results demonstrate that Phase I CDT treatment is very effective for post mastectomy lymphedema, and particularly if it is provided in earlier stages of disease. In addition, CDT also has an important role in reducing clinical symptoms and improving limb function. In the appropriate setting, Phase I CDT has been an effective method of controlling post mastectomy lymphedema in this Iranian population. PMID:24354108

Haghighat, S; Lotfi-Tokaldany, M; Maboudi, A A Khadem; Karami, M; Bahadori, A; Weiss, J

2013-06-01

281

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

PubMed Central

[Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 items), grasp and pinch (2 items), and manipulation (2 items). The experiment was conducted with the subjects sitting in a chair. The mirror was vertically placed in the sagittal plane on the desk. The paretic hand was placed behind the mirror, and the non-paretic hand was placed in front of the mirror so that it was reflected in the mirror. In this position, the subjects completed activities repetitively according to the mirror therapy program over the course of four weeks. [Results] There were significant increases in the grasp-and-pinch score and manipulation score. [Conclusion] In conclusion, the grasp-and-pinch and manipulation functions were improved through mirror therapy. PMID:25642079

Kim, Hwanhee; Shim, Jemyung

2015-01-01

282

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

PubMed

[Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 items), grasp and pinch (2 items), and manipulation (2 items). The experiment was conducted with the subjects sitting in a chair. The mirror was vertically placed in the sagittal plane on the desk. The paretic hand was placed behind the mirror, and the non-paretic hand was placed in front of the mirror so that it was reflected in the mirror. In this position, the subjects completed activities repetitively according to the mirror therapy program over the course of four weeks. [Results] There were significant increases in the grasp-and-pinch score and manipulation score. [Conclusion] In conclusion, the grasp-and-pinch and manipulation functions were improved through mirror therapy. PMID:25642079

Kim, Hwanhee; Shim, Jemyung

2015-01-01

283

Clinical evaluation of motion and position sense in the upper extremities of the elderly using motion analysis system  

PubMed Central

The purpose of this study was to measure kinesthetic accuracy in healthy older adults by using arm position and motion matching tests. We investigated the effect of task type, joint angle, and matching arm results on kinesthetic accuracy in the upper extremities of 17 healthy right-handed older adults. Blinded subjects were asked to match positions and motions at four reference joint angles: 1) shoulder flexion, 0°–60°; 2) elbow flexion, 90°–135°; 3) wrist extension, 0°–50° in the sagittal plane; and 4) shoulder abduction, 0°–60° in the frontal plane. The absolute difference in angular displacement between the reference and matching arms was calculated to determine kinesthetic accuracy. Results showed that subjects were more accurate at matching motion than position tasks (P=0.03). Shoulder and elbow joints were more sensitive than wrist joints in perceiving passive positions and motions (P<0.05). The effect of the matching arm was found only when matching the joint angles of shoulder abduction and wrist extension (P<0.01). These results are comparable to findings of other studies that used machine-generated kinesthetic stimuli. The manual measurement of kinesthetic accuracy could be effective as a preliminary screening tool for therapists in clinical settings. PMID:25075181

Li, Kuan-yi; Wu, Yi-hui

2014-01-01

284

An upper limit on the ratio between the Extreme Ultraviolet and the bolometric luminosities of stars hosting habitable planets  

E-print Network

A large number of terrestrial planets in the classical habitable zone of stars of different spectral types has already been discovered and many are expected to be discovered in near future. However, owing to the lack of knowledge on the atmospheric properties, the ambient environment of such planets are unknown. It is known that sufficient amount of Extreme Ultraviolet (EUV) radiation from the star can drive hydrodynamic outflow of hydrogen that may drag heavier species from the atmosphere of the planet. If the rate of mass loss is sufficiently high then substantial amount of volatiles would escape causing the planet to become uninhabitable. Considering energy-limited hydrodynamical mass loss with an escape rate that causes oxygen to escape along with hydrogen, I present an upper limit for the ratio between the EUV and the bolometric luminosities of stars which constrains the habitability of planets around them. Application of the limit to planet-hosting stars with known EUV luminosities implies that many M-t...

Sengupta, Sujan

2015-01-01

285

Development of a parent-report computer-adaptive test to assess physical functioning in children with cerebral palsy II: upper-extremity skills.  

PubMed

The specific aims of this study were to (1) examine the psychometric properties (unidimensionality, differential item functioning, scale coverage) of an item bank of upper-extremity skills for children and adolescents with cerebral palsy (CP); (2) evaluate a simulated computer-adaptive test (CAT) using this item bank; (3) examine the concurrent validity of the CAT with the Pediatric Outcomes Data Collection Instrument (PODCI) upper-extremity core scale; and (4) determine the discriminant validity of the simulated CAT with Manual Ability Classification System (MACS) levels and CP type (i.e. diplegia, hemiplegia, or quadriplegia). Parents (n=180) of children and adolescents with CP (spastic diplegia 49%, hemiplegia 22%, or quadriplegia 28%) consisting of 102 males and 78 females with a mean age of 10 years 6 months (SD 4y 1mo, range 2-21y), and MACS levels I through V participated in calibration of an item pool and completed the PODCI. Confirmatory factor analyses supported a unidimensional model using 49 of the 53 upper-extremity items. Simulated CATs of 5, 10, and 15 items demonstrated excellent accuracy (intraclass correlation coefficient [ICCs] >0.93) with the full item bank, had high correlations with the PODCI upper-extremity core scale score (ICC 0.79), and discriminated among MACS levels. The simulated CATs demonstrated excellent overall content coverage over a wide age span and severity of upper-extremity involvement. The future development and refinement of CATs for parent report of physical function in children and adolescents with CP is supported by our work. PMID:19416341

Tucker, Carole A; Montpetit, Kathleen; Bilodeau, Nathalie; Dumas, Helene M; Fragala-Pinkham, Maria A; Watson, Kyle; Gorton, George E; Ni, Pengsheng; Hambleton, Ronald K; Mulcahey, M J; Haley, Stephen M

2009-09-01

286

Implanted Myoneural Interface for Upper Limb Prosthesis  

Microsoft Academic Search

\\u000a The wide use of powered prosthetic hands is hampered by the availability of good human-machine interfaces. Current interfaces\\u000a using electromyography suffer from stringent requirements of electrode placement and limited multi-functionality.\\u000a \\u000a \\u000a An implanted EMG acquisition system with a transcutaneous packet-radio link and power transfer addresses the problems with\\u000a electrode placement. It also makes possible the use of sophisticated classification algorithms to

N. R. Prabhav; S. R. Devasahayam; R. Ojha

287

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

288

Prevalence of work-related musculoskeletal symptoms of the neck and upper extremity among dentists in China  

PubMed Central

Objectives Studies from western countries show that dentists are vulnerable to work-related musculoskeletal disorders (WMSDs) of the neck and upper extremities, but little is known about their epidemiology among members of this rapidly growing profession in China. This study aims to investigate the prevalence of WMSDs and identify potential risk factors associated with their occurrence in the dental profession in China. Setting and participants A cross-sectional survey was carried out in 52 different hospitals in a large metropolitan city in China. A total of 304 questionnaires were distributed to respondents identified via stratified random sampling and 272 dentists (121 females and 151 males) completed the survey. The response rate was 89.5%. Outcomes Visual analogue score was used to record neck and upper limb musculoskeletal symptoms on a body chart. Work-related risk factors, including physical and psychosocial factors, were accounted for in the regression analysis. Results 88% of the dentists reported at least one musculoskeletal disorder and 83.8% suffered from neck pain. In the multivariate analyses, working hours per day were associated with neck pain (OR=1.43; 95% CI 1.03 to 1.98). Inability to select the appropriate size of dental instrument was associated with shoulder (OR=2.07; 95% CI 1.00 to 4.32) and wrist/hand (OR=2.47; 95% CI 1.15 to 5.32) pain. As for psychosocial factors, high job demand was associated with symptoms in the shoulder (OR=1.09; 95% CI 1.00 to 1.18), elbow (OR=1.11; 95% CI 1.03 to 1.19) and wrist/hand (OR=1.09; 95% CI 1.02 to 1.17). Regular physical exercise was associated with decreased neck pain (OR=0.37; 95% CI 0.14 to 1.00). Conclusions The prevalence of WMSDs among Chinese dentists is high. Specifically, long working hours, inability to select the appropriate size of dental instrument and high job demand are the most significant risk factors. PMID:25526795

Feng, Beibei; Liang, Qi; Wang, Yuling; Andersen, Lars L; Szeto, Grace

2014-01-01

289

Elbow reconstruction with a pedicled thoracodorsal artery perforator flap after excision of an upper-extremity giant hairy nevus.  

PubMed

The complexity of managing large soft-tissue defects at the elbow region by conventional techniques arises from the difficulty of providing sufficient tissue with adequate elasticity and durability. Reconstruction options that allow early mobilisation and avoid the risk of functional loss should be considered to achieve defect closure at the elbow region. A 21-year-old man presented with a congenital giant hairy nevus on his left upper extremity. The nevus was excised and the resulting raw surface after the excision was covered with a split-thickness skin graft except for the elbow region. The elbow was covered in one stage with an ipsilateral 24 cm long pedicled thoracodorsal artery perforator (TDAP) flap. The follow-up examination 3 years after total reconstruction demonstrated durable elbow support provided by the TDAP flap. The patient revealed no complaint considering pain or sensitivity even when exposed to mechanical stress. Split-thickness skin grafting of the large superficial defects is almost always possible; however, impairment of the function on joint areas due to gradual contraction and skin graft propensity to ulcers under mechanical stresses can be devastating. The elbow is a weight-bearing area of the body. Elbow defects require durable and thin soft-tissue coverage and the tissue cover must possess excellent elastic properties to re-establish elbow mobility. The TDAP flap is an ideal choice for elbow soft-tissue defects. The longest pedicle length reported for the TDAP flap is 23 cm. In our case, the pedicle length was 24 cm and it was possible to transfer this flap to the elbow on its pedicle. A pedicled TDAP skin flap so as to provide elbow coverage in one stage is a useful choice to retain in one's armamentarium. PMID:22959307

Oksüz, Sinan; Ulkür, Ersin; Tuncer, Serhan; Sever, Celalettin; Karagöz, Hüseyin

2013-04-01

290

Prediction on Affected Upper Extremity Function in Hemiplegic Patients after Thalamic Hemorrhage Using Somatosensory Evoked Magnetic Fields  

PubMed Central

The aim of the present study was to investigate the prognostic value of somatosensory evoked magnetic fields (SEFs) at an acute stage on recovery of an affected upper extremity (UE) function as practicality in hemiplegic patients after thalamic hemorrhage. Nine hemiplegic patients after thalamic hemorrhage were enrolled in this study. Median nerve SEFs, evoked by electrical stimulation at the wrist of the affected UE, were measured using a 204 channel whole-head magnetoencephalography system within 72 hours after the onset of thalamic hemorrhage (acute stage). Assessments on the affected UE, which included the motor palsies of the UE and fingers (Brunnstrom's motor recovery stage: BS), sensory disturbance (the thumb localizing test) and UE function (the UE ability test), were performed at both the acute stage and 3 months after the onset of thalamic hemorrhage (chronic stage). Almost all the patients showing any median nerve SEF components that originated from the somatosensory cortex in the affected hemisphere and occurred between about 20 ms and 100 ms post-stimulus at the acute stage demonstrated good outcomes in the motor palsies (BSV), sensory disturbance (normal) and affected UE function (practical hand) at the chronic stage. In contrast, majority of patients not showing them at all demonstrated poor outcomes in the motor palsies (BSIII or less), sensory disturbance (severely impaired) and affected UE function (disabled hand) at the chronic stage. These results suggest that the findings of the median nerve SEFs at the acute stage would contribute to the early outcome prediction on the affected UE function in hemiplegic patients after thalamic hemorrhage.

Kondo, Takeo; Nakasato, Nobukazu

2006-01-01

291

Upper extremity acute compartment syndrome during tissue plasminogen activator therapy for pulmonary embolism in a morbidly obese patient  

PubMed Central

Introduction Deep vein thrombosis (DVT) and pulmonary embolism (PE) are more frequently observed in morbidly obese patients. Tissue plasminogen activator (tPA) is a thrombolytic agent which dissolves the thrombus more rapidly than conventional heparin therapy and reduces the mortality and morbidity rates associated with PE. Compartment syndrome is a well-known and documented complication of thrombolytic treatment. In awake, oriented and cooperative patients, the diagnosis of compartment syndrome is made based on clinical findings including swelling, tautness, irrational and continuous pain, altered sensation, and severe pain due to passive stretching. These clinical findings may not be able to be adequately assessed in unconscious patients. Presentation of case In this case report, we present compartment syndrome observed, for which fasciotomy was performed on the upper right extremity of a 46-year old morbidly obese, conscious female patient who was receiving tPA due to a massive pulmonary embolism. Discussion Compartment syndrome had occurred due to the damage caused by the repeated unsuccessful catheterisation attempts to the brachial artery and the accompanying tPA treatment. Thus, the bleeding that occurred in the volar compartment of the forearm and the anterior compartment of the arm led to acute compartment syndrome (ACS). After relaxation was brought about in the volar compartment of the forearm and the anterior compartment of the arm, the circulation in the limb was restored. Conclusion As soon as the diagnosis of compartment syndrome is made, an emergency fasciotomy should be performed. Close follow-up is required to avoid wound healing problems after the fasciotomy. PMID:25618841

Tuna, Serkan; Duymus, Tahir Mutlu; Mutlu, Serhat; Ketenci, Ismail Emre; Ulusoy, Ayhan

2015-01-01

292

Efficacy of recombinant human ?- L -iduronidase (laronidase) on restricted range of motion of upper extremities in mucopolysaccharidosis type I patients  

Microsoft Academic Search

The aims of the study were to assess the effectiveness of enzyme replacement therapy (ERT) with laronidase on the range of\\u000a motion (ROM) of upper extremities and influence on activities of daily living (ADLs) of patients with mucopolysaccharidosis\\u000a type I (MPS I). The ROM of 17 patients with MPS I was followed from the first year of life until the introduction of ERT

Anna Tylki-Szymanska; Jolanta Marucha; Agnieszka Jurecka; Malgorzata Syczewska; Barbara Czartoryska

2010-01-01

293

Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain  

PubMed Central

Aims: To describe the presence of musculoskeletal co-morbidity of the neck and upper extremities among industrial workers with low back pain, and to examine whether it has an impact on healthcare utilisation and sickness absence for low back pain. Methods: A self administered questionnaire was used to collect data from 505 industrial workers (response 86%). Results: The 12 month prevalence of low back pain was 50%. Among subjects with low back pain the 12 month prevalence of musculoskeletal co-morbidity of the neck and upper extremities was 68%. Among workers with low back pain, subjects with high pain intensity or disabling low back pain were more likely to have musculoskeletal co-morbidity. In comparison to the subjects who report back pain only, subjects with co-morbidity showed worse general health and health related quality of life. No impact of upper extremity co-morbidity was found on healthcare utilisation, and sickness absence due to low back pain. Conclusions: This study provides no evidence that musculoskeletal co-morbidity of the neck and upper extremities influences the choice to seek care or take sick leave due to low back pain among industrial manual workers. For occupational health practitioners the finding of a high co-morbidity is important to consider when implementing workplace interventions aimed at the reduction of specific musculoskeletal complaints, since the controls for one musculoskeletal complaint may impact adversely on another musculoskeletal complaint. Researchers who perform low back pain intervention studies using generic health measures, should take into account the impact of musculoskeletal co-morbidity on these measures. PMID:15377765

IJzelenberg, W; Burdorf, A

2004-01-01

294

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

295

Abstract This paper presents a new gravity compensation method for an upper extremity exoskeleton mounted on a wheel  

E-print Network

extremity exoskeleton mounted on a wheel chair. This new device is dedicated to regular the continuous presence of a therapist. The exoskeleton is a wearable robotic device attached extremity exoskeleton covers four basic degrees of freedom of the shoulder and the elbow

Paris-Sud XI, Université de

296

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 of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular

Tang, William C

297

Strategies for providing upper extremity amputees with tactile and hand position feedback--moving closer to the bionic arm.  

PubMed

A continuing challenge for prostheses developers is to replace the sensory function of the hand. This includes tactile sensitivity such as finger contact, grip force, object slippage, surface texture and temperature, as well as proprioceptive sense. One approach is sensory substitution whereby an intact sensory system such as vision, hearing or cutaneous sensation elsewhere on the body is used as an input channel for information related to the prosthesis. A second technique involves using electrical stimulation to deliver sensor derived information directly to the peripheral afferent nerves within the residual limb. Stimulation of the relevant afferent nerves can ultimately come closest to restoring the original sensory perceptions of the hand, and to this end, researchers have already demonstrated some degree of functionality of the transected sensory nerves in studies with amputee subjects. This paper provides an overview of different types of nerve interface components and the advantages and disadvantages of employing each of them in sensory feedback systems. Issues of sensory perception, neurophysiology and anatomy relevant to hand sensation and function are discussed with respect to the selection of the different types of nerve interfaces. The goal of this paper is to outline what can be accomplished for implementing sensation into artificial arms in the near term by applying what is present or presently attainable technology. PMID:10665673

Riso, R R

1999-01-01

298

Use of a pattern recognition technique to control a multifunctional prosthesis  

Microsoft Academic Search

Various kinds of command source can be used to control an above-elbow prosthesis. But none of them can be used to perform\\u000a a specified task easily. The research is devoted to investigation of the potential effectiveness of applying the kinematic\\u000a data of the shoulder joint to control an upper-limb prosthesis. Using these data as input signals, an appropriate signal processing

F. Aghili; M. Haghpanahi

1995-01-01

299

Improved Myoelectric Prosthesis Control Using Targeted Reinnervation Surgery: A Case Series  

Microsoft Academic Search

Targeted reinnervation is a surgical technique developed to increase the number of myoelectric input sites available to control an upper-limb prosthesis. Because signals from the nerves related to specific movements are used to control those missing degrees-of-freedom, the control of a prosthesis using this procedure is more physiologically appropriate compared to conventional control. This procedure has successfully been performed on

Laura A. Miller; Kathy A. Stubblefield; Robert D. Lipschutz; Blair A. Lock; Todd A. Kuiken

2008-01-01

300

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

PubMed Central

Little is known about whether our knowledge of how the central nervous system controls the upper extremities (UE), can generalize, and to what extent to the lower limbs. Our continuous efforts to design the ideal adaptive robotic therapy for the lower limbs of stroke patients and children with cerebral palsy highlighted the importance of analyzing and modeling the kinematics of the lower limbs, in general, and those of the ankle joints, in particular. We recruited 15 young healthy adults that performed in total 1,386 visually evoked, visually guided, and target-directed discrete pointing movements with their ankle in dorsal–plantar and inversion–eversion directions. Using a non-linear, least-squares error-minimization procedure, we estimated the parameters for 19 models, which were initially designed to capture the dynamics of upper limb movements of various complexity. We validated our models based on their ability to reconstruct the experimental data. Our results suggest a remarkable similarity between the top-performing models that described the speed profiles of ankle pointing movements and the ones previously found for the UE both during arm reaching and wrist pointing movements. Among the top performers were the support-bounded lognormal and the beta models that have a neurophysiological basis and have been successfully used in upper extremity studies with normal subjects and patients. Our findings suggest that the same model can be applied to different “human” hardware, perhaps revealing a key invariant in human motor control. These findings have a great potential to enhance our rehabilitation efforts in any population with lower extremity deficits by, for example, assessing the level of motor impairment and improvement as well as informing the design of control algorithms for therapeutic ankle robots. PMID:25505881

Michmizos, Konstantinos P.; Vaisman, Lev; Krebs, Hermano Igo

2014-01-01

301

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

NASA Astrophysics Data System (ADS)

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

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

2012-04-01

302

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

PubMed

Little is known about whether our knowledge of how the central nervous system controls the upper extremities (UE), can generalize, and to what extent to the lower limbs. Our continuous efforts to design the ideal adaptive robotic therapy for the lower limbs of stroke patients and children with cerebral palsy highlighted the importance of analyzing and modeling the kinematics of the lower limbs, in general, and those of the ankle joints, in particular. We recruited 15 young healthy adults that performed in total 1,386 visually evoked, visually guided, and target-directed discrete pointing movements with their ankle in dorsal-plantar and inversion-eversion directions. Using a non-linear, least-squares error-minimization procedure, we estimated the parameters for 19 models, which were initially designed to capture the dynamics of upper limb movements of various complexity. We validated our models based on their ability to reconstruct the experimental data. Our results suggest a remarkable similarity between the top-performing models that described the speed profiles of ankle pointing movements and the ones previously found for the UE both during arm reaching and wrist pointing movements. Among the top performers were the support-bounded lognormal and the beta models that have a neurophysiological basis and have been successfully used in upper extremity studies with normal subjects and patients. Our findings suggest that the same model can be applied to different "human" hardware, perhaps revealing a key invariant in human motor control. These findings have a great potential to enhance our rehabilitation efforts in any population with lower extremity deficits by, for example, assessing the level of motor impairment and improvement as well as informing the design of control algorithms for therapeutic ankle robots. PMID:25505881

Michmizos, Konstantinos P; Vaisman, Lev; Krebs, Hermano Igo

2014-01-01

303

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

PubMed Central

Objective: The main aim of the study was to determine the nature and extent of work-related upper extremity musculoskeletal disorders (MSDs) and physiological stress among the blacksmiths involved in surgical instrument industry. Materials and Methods: In the present investigation, 50 male blacksmiths of each skilled and unskilled groups of the forging section had been selected. For the symptom survey, a questionnaire on discomfort symptoms was performed. Repetitiveness of work and hand grip strength of both the groups were measured. Results: It was revealed that upper limb MSD was a major problem among both group of blacksmith, primarily involving the hand, wrist, fingers, and shoulder. From this study it was found that 66% (33) skilled and 80% (40) unskilled blacksmith workers are feeling discomfort. The most commonly affected regions among the skilled and unskilled blacksmith workers were lower back (skilled 65% and unskilled 80%), neck (skilled 60% and unskilled 80%), and hand (skilled 50% and unskilled). PMID:22412291

Ghosh, Tirthankar; Das, Banibrata; Gangopadhyay, Somnath

2011-01-01

304

Verruciform xanthoma of the upper-extremity in the absence of chronic skin disease or syndrome: a case report and review of the literature.  

PubMed

Verruciform xanthoma is a rare, benign lesion classically presenting on the oral mucosa or genital area. The etiology is not yet completely understood; however, verruciform xanthoma is often associated with (a) conditions of chronic inflammation or trauma, such as lichen sclerosis, recessive dystrophic epidermolysis bullosa, and pemphigus vulgaris, as well as in a setting of (b) chronic lymphedema, (c) chronic graft versus host disease, or (d) congenital epidermal nevi, such as those associated with the Congenital Hemidysplasia with Ichthyosiform nevus and Limb Defects (CHILD) syndrome. We report a case of a solitary verruciform xanthoma on the forearm of an 82-year-old man without history of chronic dystrophic skin disease or syndrome. In addition, a thorough literature review of extra-oral and extra-genital verruciform xanthomas is presented. On the basis of this review, we believe this case is an extremely rare presentation of a solitary verruciform xanthoma on the upper-extremity of an otherwise healthy individual. PMID:23656213

Blankenship, D Winslow; Zech, Loren; Mirzabeigi, Marjan; Venna, Suraj

2013-08-01

305

Development of Retinal Prosthesis Module for Fully Implantable Retinal Prosthesis  

Microsoft Academic Search

\\u000a To restore visual sensation of blind patients, we have proposed a fully implantable retinal prosthesis comprising an three\\u000a dimensionally (3D) stacked retinal chip for transforming optical signal to electrical signal, a flexible cable with stimulus\\u000a electrode array for stimulating retina cells, and coupling coils for power transmission. For realizing the fully implantable\\u000a retinal prosthesis, we developed a key component of

Kangwook Lee; Tetsu Tanaka

306

Self-Reported Musculoskeletal Disorders of the Distal Upper Extremities and the Neck in German Veterinarians: A Cross-Sectional Study  

PubMed Central

Background Veterinary work is a physically demanding profession and entails the risk of injuries and diseases of the musculoskeletal system, particularly in the upper body. The prevalence of musculoskeletal disorders (MSD), the consequences and work-related accidents in German veterinarians were investigated. Work-related and individual factors associated with MSD of upper extremities and the neck were analyzed. Methods In 2011, a self-reporting Standardized Nordic Questionnaire was mailed to registered veterinarians in seven federal medical associations in Germany. A total of 3174 (38.4%) veterinarians responded. Logistic regression analysis was used to determine the association between risk factors and MSD-related impairment of daily activities. Results MSD in the neck (66.6%) and shoulder (60.5%) were more prevalent than in the hand (34.5%) or elbow (24.5%). Normal activities were affected in 28.7% (neck), 29.5% (shoulder), 19.4% (hand) and 14% (elbow) of the respondents. MSD in the upper body occurred significantly more often in large animal practitioners. Accidents that resulted in MSD were most frequently reported in the hand/wrist (14.3%) or in the shoulder (10.8%). The majority of all accidents in the distal upper extremities were caused by animals than by other factors (19% vs. 9.2%). For each area of the body, a specific set of individual and work-related factors contributed significantly to severe MSD: Older age, gender, previous injuries, BMI, practice type, veterinary procedures such as dentistry, rectal procedures and obstetric procedures as well as high demands and personal burnout. Conclusion From the perspective of occupational health and safety, it seems to be necessary to improve accident prevention and to optimize the ergonomics of specific tasks. Our data suggest the need for target group-specific preventive measures that also focus on the psychological factors at work. PMID:24586718

Kozak, Agnessa; Schedlbauer, Grita; Peters, Claudia; Nienhaus, Albert

2014-01-01

307

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

308

Journal of Biomechanics 35 (2002) 1926 Scaling of peak moment arms of elbow muscles with upper extremity  

E-print Network

August 2001 Abstract It is often assumed that moment arms scale with size and can be normalized by bodyJournal of Biomechanics 35 (2002) 19­26 Scaling of peak moment arms of elbow muscles with upper segment lengths or limb circumferences. However, quantitative scaling relationships between moment arms

Delp, Scott

2002-01-01

309

Conjunctival Squamous Cell Carcinoma due to Long-term Placement of Ocular Prosthesis  

PubMed Central

Summary: Conjunctival squamous cell carcinoma (SCC) arising from an anophthalmic socket is quite rare, with few reports in the English literature. A 59-year-old man who had used an ocular prosthesis for 40 years had not removed the ocular prosthesis at all during the last 5 years. He had developed a mass on his entire right upper eyelid, and biopsy revealed a moderately differentiated SCC. Orbital exenteration including the upper and lower eyelid skin was performed. The defect was reconstructed with a free forearm flap followed by the placement of a facial epithesis. The pathology revealed an intraepithelial carcinoma on the upper palpebral conjunctiva, which seemed to infiltrate exclusively from that site to the upper eyelid and into the orbit. Other risk factors were not detected; therefore, chronic irritation or microtrauma of the upper conjunctiva from the prosthesis due to persistent prosthesis placement could have been the main trigger for the development of SCC. In cases where the ocular prosthesis is not fitted properly or removed appropriately, clinicians should be aware of this possible long-term consequence.

Komoto, Masakazu; Matsumura, Takashi; Horiguchi, Masatoshi; Tanaka, Rica; Arakawa, Atsushi; Mizuno, Hiroshi

2015-01-01

310

[Fracture of macroporous hydroxyapatite prosthesis].  

PubMed

Different prosthesis implants are offered to perform a cranioplasty after a decompressive craniectomy when autologous bone graft cannot be used. The authors report the case of a 25-year-old man who benefited a unilateral decompressive craniectomy after a severe head trauma. Seven months later, a cranioplasty using custom macroporous hydroxyapatite prosthesis was performed. The postoperative course was marked by a generalized seizure leading to a traumatic head injury. The CT-scan showed a comminutive fracture of the prosthesis and an extradural hematoma. The patient underwent a removal of the fractured prosthesis and an evacuation of the extradural clot. The postoperative course was uneventful with a Glasgow outcome scale score at 5. A second cranioplasty using a polyether ether ketone (PEEK) implant was performed. Among cranioplasty prosthesis solutions, hydroxyapatite implants seem to have similar property to the bone. However, its weak mechanic resistance is an actual problem in patients susceptible to present generalized seizures with consecutive head impact. Hence, in patients with decompressive craniectomy who are exposed to potential brain injury, we favor the use of more resistant implant as PEEK prosthesis. PMID:22898300

Adetchessi, A T; Pech-Gourg, G; Metellus, P; Fuentes, S

2012-12-01

311

Input-increase and input-decrease types of cortical reorganization after upper extremity amputation in humans  

Microsoft Academic Search

A plastic remodeling of regions in somatosensory cortex has previously been observed to occur in separate experimental paradigms\\u000a in response to loss of somatosensory input and to increase in input. In this study, both types of cortical reorganization\\u000a have been observed to occur concurrently in the same adult human nervous system as a result of a single intervention. Following\\u000a upper

T. Elbert; Annette Sterr; Herta Flor; Brigitte Rockstroh; Stefan Knecht; Christo Pantev; Christian Wienbruch; Edward Taub

1997-01-01

312

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

313

Incidence and risk factors of upper extremity deep vein lesions after permanent transvenous pacemaker implant: a 6-month follow-up prospective study.  

PubMed

The incidence of venous lesions after permanent pacemaker insertion is around 45%. However, this incidence has been based on retrospective studies in a small series; moreover, factors predicting the development of these venous injuries have not been clearly defined. The aim of this study was to identify the risk factors for higher incidence of upper extremity deep vein thrombosis after transvenous permanent pacemaker insertion. The study included 229 patients and the criteria were age above 12 years and first permanent transvenous pacemaker implant. Exclusion criteria were pulmonary embolism, lower or upper extremity deep venous thrombosis, previous use of central venous catheters, coagulation disturbances, and malignancy. Age, race, sex, underlying cardiac disease, functional class to heart failure, LVEF, venous access, number, material and caliber of the leads, and previous use of a transvenous temporary pacemaker were considered. Six months after the pacemaker was implanted, 202 patients were submitted to digital subtraction venography ipsilateral to pacemaker implant. The venographies were normal in 73 (36%) patients and abnormal in 129 (64%) patients. Patients with previous use of transvenous temporary leads (P = 0,0001, OR = 4,260, confidence limits = 2,133-8,465) and LVEF < or = 40% (P = 0,0378, OR = 3,437, confidence limits = 1,064-12,326), had higher incidence of venous lesions. Previous use of a temporary pacemaker and LVEF < or = 0.40 were considered independent risk factors to a higher incidence of venous stenosis or thrombosis 6 months after permanent pacemaker insertion. PMID:12380764

Da Costa, Sergio Sidney do Carmo; Scalabrini Neto, Augusto; Costa, Roberto; Caldas, José Guilherme; Martinelli Filho, Martino

2002-09-01

314

Effects of Age, Gender and Level of Co-contraction on Elbow and Shoulder Rotational Stiffness and Damping in the Impulsively End-Loaded Upper Extremity.  

PubMed

Whether an arm will buckle under an impulsive end-load should partly depend on the elastic and viscous properties of the pretensed arm muscles. In measuring these properties we hypothesized that neither age, gender, nor muscle pre-contraction level would affect the bilinear elbow or shoulder lumped rotational stiffness or damping parameters in the impulsively end-loaded upper extremity of 38 healthy men and women. Subjects were instructed to preactivate triceps to either 25, 50 or 75% of maximum myoelectric activity levels. Then a standardized impulsive end-load was applied via a 6-axis load cell to the wrist of the slightly flexed arm in the prone posture. Arm kinematic responses were acquired at 280 Hz and an inverse dynamics analysis was used to estimate the bilinear rotational stiffnesses and damping parameters at the elbow and shoulder. The results show that pre-contraction level affected normalized joint rotational stiffness and damping coefficients (p < 0.02). Age affected the initial stiffness for the elbow (p < 0.05), and gender affected that of the shoulder in the sagittal plane (p < 0.006). Arm muscle strength was positively related to normalized stiffness at the elbow, but not the shoulder. We conclude that age, gender and pre-contraction level each affect the viscoelastic behavior of the end-loaded upper extremity in healthy adults. PMID:25395216

Lee, Yunju; Ashton-Miller, James A

2014-11-14

315

Oxygen uptake, heart rate, perceived exertion, and integrated electromyogram of the lower and upper extremities during level and Nordic walking on a treadmill  

PubMed Central

The purpose of this study was to characterize responses in oxygen uptake ( V·O2), heart rate (HR), perceived exertion (OMNI scale) and integrated electromyogram (iEMG) readings during incremental Nordic walking (NW) and level walking (LW) on a treadmill. Ten healthy adults (four men, six women), who regularly engaged in physical activity in their daily lives, were enrolled in the study. All subjects were familiar with NW. Each subject began walking at 60?m/min for 3?minutes, with incremental increases of 10?m/min every 2?minutes up to 120?m/min V·O2 , V·E and HR were measured every 30?seconds, and the OMNI scale was used during the final 15?seconds of each exercise. EMG readings were recorded from the triceps brachii, vastus lateralis, biceps femoris, gastrocnemius, and tibialis anterior muscles. V·O2 was significantly higher during NW than during LW, with the exception of the speed of 70?m/min (P?upper extremities was significantly higher during NW than during LW at all speeds (P?extremities during the stance and push-off phases, and decreases that of the lower extremities and increase energy expenditure of the upper body and respiratory system at certain walking speeds. PMID:23406834

2013-01-01

316

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2011 CFR

...DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis is a silicone rubber solid device intended to be implanted to augment or reconstruct the chin. (b) Classification. Class...

2011-04-01

317

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2014 CFR

...DEVICES Prosthetic Devices § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis is a silicone rubber solid device intended to be implanted to augment or reconstruct the nasal dorsum. (b) Classification....

2014-04-01

318

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2014 CFR

...DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis is a silicone rubber solid device intended to be implanted to augment or reconstruct the chin. (b) Classification. Class...

2014-04-01

319

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2013 CFR

...SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis is a silicone rubber solid device intended to be implanted to reconstruct the external ear. (b) Classification. Class...

2013-04-01

320

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2010 CFR

...DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis is a silicone rubber solid device intended to be implanted to augment or reconstruct the chin. (b) Classification. Class...

2010-04-01

321

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2010 CFR

...DEVICES Prosthetic Devices § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis is a silicone rubber solid device intended to be implanted to augment or reconstruct the nasal dorsum. (b) Classification....

2010-04-01

322

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2010 CFR

...SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis is a silicone rubber solid device intended to be implanted to reconstruct the external ear. (b) Classification. Class...

2010-04-01

323

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2014 CFR

...SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis is a silicone rubber solid device intended to be implanted to reconstruct the external ear. (b) Classification. Class...

2014-04-01

324

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2012 CFR

...DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis is a silicone rubber solid device intended to be implanted to augment or reconstruct the chin. (b) Classification. Class...

2012-04-01

325

21 CFR 878.3720 - Tracheal prosthesis.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

326

21 CFR 878.3720 - Tracheal prosthesis.  

Code of Federal Regulations, 2014 CFR

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

2014-04-01

327

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2013 CFR

...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 is a silicone rubber solid...

2013-04-01

328

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2011 CFR

...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 is a silicone rubber solid...

2011-04-01

329

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2010 CFR

...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal prosthesis is a rigid,...

2010-04-01

330

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2011 CFR

...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 is a silicone rubber solid...

2011-04-01

331

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2013 CFR

...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 is a silicone rubber solid...

2013-04-01

332

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2012 CFR

...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 is a silicone rubber solid...

2012-04-01

333

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2012 CFR

...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 is a silicone rubber solid...

2012-04-01

334

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

335

Upper Extremity Proprioception in Healthy Aging and Stroke Populations, and the Effects of Therapist- and Robot-Based Rehabilitation Therapies on Proprioceptive Function  

PubMed Central

The world’s population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review, we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research. PMID:25784872

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

2015-01-01

336

Psychometric Properties and Administration of the Wrist/Hand Subscales of the Fugl-Meyer Assessment in Minimally-Impaired Upper Extremity Hemiparesis in Stroke  

PubMed Central

There is a need for time-efficient, valid measures of distal paretic upper extremity (UE) movement. The purposes of this study were to: (a) determine the psychometric properties of the wrist stability and mobility and hand items of the upper extremity scale of the Fugl-Meyer (w/h UE FM) as a “stand alone” measure of distal UE movement; and (b) provide detailed instructions on w/h UE FM administration and scoring. The UE FM and Action Research Arm Test (ARAT) were administered on 2 separate occasions to each of 29 subjects exhibiting stable, mild, UE hemiparesis (23 males; age (mean (sd)) 60.8 (12.3) years; mean time since stroke onset for subjects in the sample: 36.0 months). Fifty-eight observations were collected on each measure. w/h UE FM internal consistency levels (measured by Cronbach’s alpha) were high (0.90 and 0.88 for first and second testing sessions, respectively). The intraclass correlation coefficients for the UE FM was 0.98, while the intraclass correlation coefficient for the w/h UE FM was 0.97. Concurrent validity measured by Spearman’s correlation was moderately high between the w/h UE FM and ARAT (.72 p < .0001). From these data, it appears that the w/h UE FM is a promising tool to measure distal UE movement in minimally impaired stroke, although more research with a larger sample is needed. A standardized approach to UE test administration is critical to accurate score interpretation across patients and trials. Thus, the article also provides instructions and pictures for w/h UE FM administration and scoring. PMID:22759831

Page, Stephen J.; Levine, Peter; Hade, Erinn

2012-01-01

337

Neuroprosthetics of the upper extremity--clinical application in spinal cord injury and challenges for the future.  

PubMed

The complete restoration of movements lost due to a spinal cord injury (SCI) is the greatest hope of physicians, therapists and certainly of the patients themselves. Particularly, in patients with lesions of the cervical spinal cord every little improvement of missing or weak grasp function will result in a large gain in quality of life. Despite the fact that novel drugs for axonal regeneration in the spinal cord are in the phase of imminent human application, up to now, the only possibility of restoration of basic movements in SCI persons consists in the use of functional electrical stimulation (FES). While FES systems in the lower extremities for standing or walking have not reached widespread clinical acceptance yet, devices are available for demonstrable improvement of the grasp function. This applies to tetraplegic patients with stable, active shoulder function, but missing control of hand and fingers. Particularly, with the use of implantable systems a long-term stable, user-friendly application is possible. Most recent work aims at the development of minimally invasive, subminiature systems for individual functional support. The possibility of direct brain control of FES systems will extend the application of grasp neuroprostheses to patients with injuries of the highest cervical spinal cord. PMID:17691405

Rupp, R; Gerner, H J

2007-01-01

338

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

339

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

340

[Necrotizing soft tissue infection of upper extremity complicated with toxic shock syndrome--clinical presentation and treatment options].  

PubMed

Necrotizing soft tissue infections (NSTI) are uncommon infections associated with considerable morbidity and mortality (20%-40%). They are characterized by rapidly progressive necrosis of soft tissue that primarily involves subcutaneous fat and fascia with variable involvement of the overlying skin and muscle. Extensive soft tissue necrosis is often accompanied by systemic toxicity. Establishing the diagnosis in the early stage of the infection can be difficult, which leads to a delay in surgical treatment and a poor outcome. The principles of treatment are early and aggressive surgical debridement, broad spectrum antimicrobial therapy administered empirically and reassessed pending culture and sensitivity results, and intensive care management. We report a case of NSTI of the arm in a 64-year-old female patient caused by group A Streptococcus and Staphylococcus aureus complicated with toxic shock-like syndrome with emphasis on the pathophysiology of toxic shock-like syndrome and treatment modalities. NSTI developed 10 days after a knife cut wound of the thumb. The patient had no significant comorbidity. Treatment included aggressive surgical debridement with removal of necrotic tissue and extensive fasciotomies 24 h of admission, cardiovascular stabilization and monitoring at intensive care unit, and repeat surgical debridement at 72 h of admission. Early triple drug antimicrobial therapy included high-dose clindamycin, which inhibits protein synthesis and bacterial exotoxin production that is responsible for inflammatory response and toxic shock-like syndrome. In addition, the patient received hyperbaric oxygen therapy (8 treatments in total). The above management led to control of the infective process. Prolonged surgical wound care followed by thin split-skin grafting and placement of secondary sutures on day 36 of admission preserved the extremity with good functional and cosmetic result. PMID:19382634

Oberhofer, Dagmar; Kucisec-Tepes, Nastja; Huljev, Dubravko

2008-12-01

341

Sediment transport and development of banner banks and sandwaves in an extreme tidal system: Upper Bay of Fundy, Canada  

NASA Astrophysics Data System (ADS)

Multibeam sonar mapping and geophysical and geological groundtruth surveys were coupled with tidal current and sediment transport model calculations to investigate the sediment transport and formation processes of the complex seabed features off the Cape Split headland in the upper Bay of Fundy. The Cape Split banner bank, composed of coarse to very coarse sand, is a southwest-northeast oriented, large tear-drop shaped sand body with superimposed sand waves that show wavelengths from 15 to 525 m and heights from 0.5 to 19 m. Isolated and chains of barchan dunes occur on top of a shadow bank to the southeast of the banner bank. The barchan dunes are composed of well-sorted medium sand and are oriented northwest-southeast. Their mean height and width are 1.5 and 55 m, respectively. A gravel bank, with an elongated elliptical shape and west-east orientation, lies in the Minas Passage erosional trough east of the headland to form the counterpart to the sandy Cape Split banner bank. The southern face is featureless but the northern face is covered by gravel megaripples. Tidal model predictions and sediment transport calculations show that the formation of the banner bank and the gravel bank are due to the development of the transient counter-clockwise and clockwise tidal eddies respectively to the west and east of the headland. The formation of barchan dunes is controlled by the nearly unidirectional flow regime in outer Scots Bay. Sand waves on the flanks of the Cape Split banner bank show opposite asymmetry and the barchan dunes are asymmetric to the northeast. The tidal current and sediment transport predictions corroborate bedform asymmetry to show that sand wave migration and net sediment transport is to southwest on the northern flank of the banner bank but to northeast on the southern bank. Long-term migration of the Scots Bay barchan dunes is to the northeast. Spring-condition tidal currents can cause frequent mobilization and high-stage transport over the banner bank and barchan dunes. Strong currents in Minas Passage can cause infrequent low-stage transport over the megarippled northern face but are not high enough to mobilize the coarser gravels on the southern face of the gravel bank.

Li, Michael Z.; Shaw, John; Todd, Brian J.; Kostylev, Vladimir E.; Wu, Yongsheng

2014-07-01

342

Retinal Prosthesis for the Blind  

Microsoft Academic Search

Most of current concepts for a visual prosthesis are based on neuronal electrical stimulation at different locations along the visual pathways within the central nervous system. The different designs of visual prostheses are named according to their locations (i.e., cortical, optic nerve, subretinal, and epiretinal). Visual loss caused by outer retinal degeneration in diseases such as retinitis pigmentosa or age-related

Eyal Margalit; Mauricio Maia; James D Weiland; Robert J Greenberg; Gildo Y Fujii; Gustavo Torres; Duke V Piyathaisere; Thomas M O'Hearn; Wentai Liu; Gianluca Lazzi; Gislin Dagnelie; Dean A Scribner; Eugene de Juan; Mark S Humayun

2002-01-01

343

21 CFR 890.3500 - External assembled lower limb prosthesis.  

Code of Federal Regulations, 2013 CFR

... External assembled lower limb prosthesis. 890.3500...DEVICES Physical Medicine Prosthetic Devices § 890.3500 External assembled lower limb prosthesis. (a) Identification...An external assembled lower limb prosthesis is a device...

2013-04-01

344

21 CFR 890.3500 - External assembled lower limb prosthesis.  

Code of Federal Regulations, 2011 CFR

... External assembled lower limb prosthesis. 890.3500...DEVICES Physical Medicine Prosthetic Devices § 890.3500 External assembled lower limb prosthesis. (a) Identification...An external assembled lower limb prosthesis is a device...

2011-04-01

345

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

Code of Federal Regulations, 2010 CFR

...prosthesis (interpositional implant). 872.3970 Section...DEVICES DENTAL DEVICES Prosthetic Devices § 872.3970 Interarticular...prosthesis (interpositional implant). (a) Identification...prosthesis (interpositional implant) is a device that is...

2010-04-01

346

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

Code of Federal Regulations, 2011 CFR

...prosthesis (interpositional implant). 872.3970 Section...DEVICES DENTAL DEVICES Prosthetic Devices § 872.3970 Interarticular...prosthesis (interpositional implant). (a) Identification...prosthesis (interpositional implant) is a device that is...

2011-04-01

347

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 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...

2014-04-01

348

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

349

21 CFR 872.3960 - Mandibular condyle prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 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...

2011-04-01

350

21 CFR 872.3950 - Glenoid fossa prosthesis.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 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...

2014-04-01

351

21 CFR 872.3950 - Glenoid fossa prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 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...

2011-04-01

352

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 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...

2013-04-01

353

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.  

Code of Federal Regulations, 2013 CFR

...false Toe joint polymer constrained prosthesis. 888.3720 Section 888.3720...3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of...

2013-04-01

354

21 CFR 872.3950 - Glenoid fossa prosthesis.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 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...

2012-04-01

355

21 CFR 872.3960 - Mandibular condyle prosthesis.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 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...

2014-04-01

356

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.  

Code of Federal Regulations, 2011 CFR

... Wrist joint polymer constrained prosthesis. 888.3780 Section 888.3780... Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of...

2011-04-01

357

21 CFR 872.3950 - Glenoid fossa prosthesis.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 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...

2013-04-01

358

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

359

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2013 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...

2013-04-01

360

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 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...

2014-04-01

361

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

362

21 CFR 878.3750 - External prosthesis adhesive.  

Code of Federal Regulations, 2014 CFR

...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

363

21 CFR 878.3750 - External prosthesis adhesive.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 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...

2010-04-01

364

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

365

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

366

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Total temporomandibular joint prosthesis. 872.3940 Section 872...872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

2011-04-01

367

Prosthesis evaluation questionnaire for persons with lower limb amputations: Assessing prosthesis-related quality of life  

Microsoft Academic Search

Objective: To develop a self-report questionnaire for persons with lower limb amputations who use a prosthesis. The resulting scales were intended to be suitable to evaluate the prosthesis and life with the prosthesis. The conceptual framework was health-related quality of life.Design: Multiple steps of scale development, terminating with test-retest of the Prosthesis Evaluation Questionnaire (PEQ) by mail.Source of Sample: Records

Marcia W. Legro; Gayle D. Reiber; Douglas G. Smith; Michael del Aguila; Jerrie Larsen; David Boone

1998-01-01

368

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

369

Experience from the in-flight calibration of the Extreme Ultraviolet Explorer (EUVE) and Upper Atmosphere Research Satellite (UARS) fixed head star trackers (FHSTs)  

NASA Technical Reports Server (NTRS)

Since the original post-launch calibration of the FHSTs (Fixed Head Star Trackers) on EUVE (Extreme Ultraviolet Explorer) and UARS (Upper Atmosphere Research Satellite), the Flight Dynamics task has continued to analyze the FHST performance. The algorithm used for inflight alignment of spacecraft sensors is described and the equations for the errors in the relative alignment for the simple 2 star tracker case are shown. Simulated data and real data are used to compute the covariance of the relative alignment errors. Several methods for correcting the alignment are compared and results analyzed. The specific problems seen on orbit with UARS and EUVE are then discussed. UARS has experienced anomalous tracker performance on an FHST resulting in continuous variation in apparent tracker alignment. On EUVE, the FHST residuals from the attitude determination algorithm showed a dependence on the direction of roll during survey mode. This dependence is traced back to time tagging errors and the original post launch alignment is found to be in error due to the impact of the time tagging errors on the alignment algorithm. The methods used by the FDF (Flight Dynamics Facility) to correct for these problems is described.

Lee, Michael

1995-01-01

370

Management of the complications of traditional bone setting for upper extremity fractures: the experiences of a French Forward Surgical Team in Chad.  

PubMed

The practice of traditional bone setting (TBS) in sub-Saharan Africa often leads to severe complications after upper extremity fracture. The purpose of this study was to evaluate the management of these complications by a French Forward Surgical Team deployed in Chad. An observational, prospective study was conducted over a six-month period between 2010 and 2011. During this period 28 patients were included. There were 20 males and 8 females with a mean age of 30.6 years (range 5-65 years). Thirteen patients (47%) had mal-union of their fracture, nine had non-union (32%), three children (10.5%) presented gangrene and three patients (10.5%) suffered from other complications. Fifteen (54%) patients did not undergo a corrective procedure either because it was not indicated or because they declined. Only 13 (46%) patients were operated on. Twelve of these patients were reviewed with a mean follow-up of 2.4 months. All of them were satisfied with conventional treatment. The infection seemed to be under control in every septic patient. Bone union could not be evaluated in most patients because of the short follow-up. Management of TBS complications is always challenging, even in a deployed Western medical treatment facility. Surgical expectations should be low because of the severity of the sequelae and the uncertainty of patient follow-up. Prevention remains the best treatment. PMID:24679676

Mathieu, L; Bertani, A; Chaudier, P; Charpail, C; Rongiéras, F; Chauvin, F

2014-04-01

371

Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: a prospective observational cohort study: part 2.  

PubMed

This is the second part of a 2-part series that reports on the results of a prospective observational cohort study designed to examine risk factors associated with symptomatic upper extremity deep vein thrombosis (UEDVT) in patients with peripherally inserted central catheters (PICCs). Part 1, published in the May/June 2014 issue of the Journal of Infusion Nursing, provided an extensive review and critique of the literature regarding risk factors associated with catheter-related UEDVT and identified 28 suspected risk factors. A study was undertaken to examine each of the risk factors among 203 acute care patients with PICCs, 13 of whom experienced a UEDVT, yielding an incidence of 6.4%. The most common reason for admission was infection (33.5%), and the primary reason for insertion of the PICC was venous access (58.6%). Hypertension (P = .022) and obesity (P = .008), defined as a body mass index ?30, were associated with UEDVT. The clinical symptoms of edema (P < .001) and a 3-cm or more increase in arm circumference (P < .001) in the PICC arm after PICC placement were associated with UEDVT. All other variables were not statistically significant. The results suggest that patients who are obese and hypertensive may be at greater risk for the development of UEDVT and that the physical finding of edema and increased arm circumference in the PICC arm are possibly suggestive of UEDVT. PMID:24983259

Maneval, Rhonda E; Clemence, Bonnie J

2014-01-01

372

Dosimetry of a silicone breast prosthesis  

SciTech Connect

Dose measurements were conducted in a phantom which simulates breast tissue and in another phantom which simulates a breast containing a silicone prosthesis. No detectable difference was found when the irradiations were carried out with tangential beams of /sup 60/Co radiation. The degree of backscatter and absorption of radiation by the prosthesis and phantom were also similar. A slight decrease in dose of approximately 8% was found at the interface between the prosthesis and muscle-equivalent material.

McGinley, P.H.; Powell, W.R.; Bostwick, J.

1980-04-01

373

A Newly Designed Postoperative Ischial Weight-Bearing Proximal Contact Lower-Limb Prosthesis  

Microsoft Academic Search

Postamputation prostheses for the lower extremities help reduce medical complications and improve patients overall function. However, there were drawbacks with these postoperative prostheses that limited their use. A recent development is a newly designed ischial weight-bearing prosthesis used postoperatively. We performed a random review of 12 amputee patients retrospectively to determine whether there were any complications with its use. There

Daniel M. Ryan

1998-01-01

374

In-situ evaluation of lower limb prosthesis fit by spiral-computed tomography  

Microsoft Academic Search

Spiral x-ray computed tomography (SXCT) volumetric imaging was applied to in situ goodness of fit evaluation for lower extremity (LE) prostheses with and without axial loading. SXCT data was obtained (Siemens Somatom PLUS-S) with and without the prosthesis in place. An algorithm was developed to map and measure the residuum bony and soft tissue structure and their relationship to the

Michael W. Vannier; Kirk E. Smith; Paul K. Commean; Gulab H. Bhatia

1995-01-01

375

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

376

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

377

21 CFR 876.3750 - Testicular prosthesis.  

Code of Federal Regulations, 2014 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...

2014-04-01

378

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

379

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

380

21 CFR 878.3720 - Tracheal prosthesis.  

Code of Federal Regulations, 2010 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...

2010-04-01

381

Tracheostomy cannulas and voice prosthesis  

PubMed Central

Cannulas and voice prostheses are mechanical aids for patients who had to undergo tracheotomy or laryngectomy for different reasons. For better understanding of the function of those artificial devices, first the indications and particularities of the previous surgical intervention are described in the context of this review. Despite the established procedure of percutaneous dilatation tracheotomy e.g. in intensive care units, the application of epithelised tracheostomas has its own position, especially when airway obstruction is persistent (e.g. caused by traumata, inflammations, or tumors) and a longer artificial ventilation or special care of the patient are required. In order to keep the airways open after tracheotomy, tracheostomy cannulas of different materials with different functions are available. For each patient the most appropriate type of cannula must be found. Voice prostheses are meanwhile the device of choice for rapid and efficient voice rehabilitation after laryngectomy. Individual sizes and materials allow adaptation of the voice prostheses to the individual anatomical situation of the patients. The combined application of voice prostheses with HME (Head and Moisture Exchanger) allows a good vocal as well as pulmonary rehabilitation. Precondition for efficient voice prosthesis is the observation of certain surgical principles during laryngectomy. The duration of the prosthesis mainly depends on material properties and biofilms, mostly consisting of funguses and bacteries. The quality of voice with valve prosthesis is clearly superior to esophagus prosthesis or electro-laryngeal voice. Whenever possible, tracheostoma valves for free-hand speech should be applied. Physicians taking care of patients with speech prostheses after laryngectomy should know exactly what to do in case the device fails or gets lost. PMID:22073098

Kramp, Burkhard; Dommerich, Steffen

2011-01-01

382

Radiography of the Upper Extremity  

MedlinePLUS

... radiológico, es un profesional médico altamente capacitado con estudios en las áreas de protección contra la radiación, ... para mostrar cómo se ve la zona en estudio cuando levanta peso. Si es difícil darse vuelta ...

383

Muscles of the Upper Extremity  

MedlinePLUS

... Larynx & Trachea Bronchi, Bronchial Tree, & Lungs Review Quiz Digestive System General Structure Regions of the Digestive System Mouth Pharynx & Esophagus Stomach Small & Large Intestine Accessory ...

384

Contact dermatitis from a prosthesis.  

PubMed

Patients wearing a prosthesis face a wide variety of medical problems. Skin complications have long been recognized, but their prevalence is still unknown. The most frequently reported disorders are allergic contact dermatitis (ACD), acroangiodermatitis, epidermoid cysts, epidermal hyperplasia, follicular hyperkeratosis, verrucous hyperplasia, bullous diseases, hyperhidrosis, infections, malignancies, and ulcerations. Contact dermatitis represents one-third of the dermatoses in amputees wearing prostheses. All patients who are suspected of having ACD should be patch tested with standard allergen series as well as materials from the patient's own prosthesis, topical medicaments, moisturizers, and cosmetics. We report a patient with an ACD to mixed dialkyl thiourea present in the rubber parts of his below-the-knee prosthesis. Thiourea derivates are used as accelerators in the manufacture of chloroprene rubber and as fixatives in photography and photocopy paper. Allergy to thiourea is relatively uncommon; different studies have shown a prevalence of 0.7% up to 2.4% in patch-tested patients. Thiourea derivates are often the allergic sources in ACD involving high-grade rubber products made of neoprene such as diving suits, protective goggles, knee braces, and continuous positive airway pressure masks. They are also present in the rubber material of prostheses, as in the case of our patient. PMID:18413115

Munoz, Carla A; Gaspari, Anthony; Goldner, Ronald

2008-01-01

385

Early Clinical Experience with the Mobi-C Disc Prosthesis  

PubMed Central

Purpose We have experienced 23 patients who had underwent cervical disc replacement with Mobi-C disc prosthesis and analyzed their radiological results to evaluate its efficacy. Patients and Methods This study was performed on 23 patients with degenerative cervical disc disease who underwent CDR with Mobi-C disc prosthesis from March 2006 to June 2006. Results The age of the study population ranged from 31 to 62 years with mean of 43 years, and 16 male and 7 female cases. Regarding axial pain, the average preoperative VAS score was 6.47 ± 1.4, while at final follow-up it was 1.4 ± 0.7 (p < 0.001). The preoperatively VAS score for radiculopathy was 6.7 ± 0.7 compared with an average score of 0 ± 0 at the final follow-up (p < 0.001). At postoperative 6th month, Odom's criteria were excellent, good, or fair for all 23 patients (100%). 7 patients (30.4%) were classified as excellent, 15 patients (65.2%) as good, and 1 patients (4.4%) as fair. Prolo economic and functional rating scale was average 8.9 ± 0.7 at postoperative 6th month. ROM in C2-7, ROM of FSU, and ROM in upper adjacent level were well preserved after CDR. Conclusion This report would be the first document about the CDR with Mobi-C disc prosthesis in the treatment of degenerative cervical disc disease. CDR with Mobi-C disc prosthesis provided a favorable clinical and radiological outcome in this study. However, Long-term follow-up studies are required to prove its efficacy and ability to prevent adjacent segment disease. PMID:17594154

Kim, Sang Hyun; Shin, Hyun Chul; Shin, Dong Ah; Kim, Keung Nyun

2007-01-01

386

Size Doesn’t Matter: Cortical Stroke Lesion Volume is Not Associated with Upper Extremity Motor Impairment and Function in Mild, Chronic, Hemiparesis  

PubMed Central

Objective To determine: (a) the relationship between lesion volume and upper extremity (UE) motor impairment using the UE section of the Fugl-Meyer (FM); and (b) the relationship between lesion volume and UE functional outcomes using the Arm Motor Ability Test (AMAT) Functional Ability (FA) and Time scales. Design Secondary, retrospective analysis of randomized controlled trial data Setting Not applicable Participants 139 subjects with chronic stroke (83 males; mean age of all subjects = 56.7 ± 11.2 years; mean time since stroke onset = 59.6 ± 65.6 months; 90 subjects with right hemiparesis) and stable, active, distal UE movement. Intervention Data were collected related to subjects’ lesion volum and UE movement prior to their participation in a multicenter randomized controlled trial. Main Outcome Measures The FM and the AMAT. Results Neither age nor lesion volume was related to FM performance. The p-value for the regression coefficient of lesion volume was 0.045 in the AMAT FA model and 0.016 in the AMAT Time model. Lesion volume accounted for only an additional 1.7% (AMAT FA) to 3.1% (AMAT Time) of the variability in motor function, and was not clinically meaningful. Conclusions Data suggest no relationship between lesion volume and UE impairment, and a small, clinically insignificant relationship between lesion volume and UE motor function. Stroke affects metabolic changes in intact regions, and causes diffuse structural loss in anatomically remote regions from the infarction. These other factors may account for variance in motor outcomes following stroke. PMID:23337427

Page, Stephen J.; Gauthier, Lynne; White, Susan

2013-01-01

387

Determining skill level in myoelectric prosthesis use with multiple outcome measures.  

PubMed

To obtain more insight into how the skill level of an upper-limb myoelectric prosthesis user is composed, the current study aimed to (1) portray prosthetic handling at different levels of description, (2) relate results of the clinical level to kinematic measures, and (3) identify specific parameters in these measures that characterize the skill level of a prosthesis user. Six experienced transradial myoelectric prosthesis users performed a clinical test (Southampton Hand Assessment Procedure [SHAP]) and two grasping tasks. Kinematic measures were end point kinematics, joint angles, grasp force control, and gaze behavior. The results of the clinical and kinematic measures were in broad agreement with each other. Participants who scored higher on the SHAP showed overall better performance on the kinematic measures. They had smaller movement times, had better grip force control, and needed less visual attention on the hand. The results showed that time was a key parameter in prosthesis use and should be one of the main focus aspects of rehabilitation. The insights from this study are useful in rehabilitation practice because they allow therapists to specifically focus on certain parameters that may result in a higher level of skill for the prosthesis user. PMID:23408215

Bouwsema, Hanneke; Kyberd, Peter J; Hill, Wendy; van der Sluis, Corry K; Bongers, Raoul M

2012-01-01

388

"Development of Haptic Feedback Devices for Upper Limb Amputees" Andrew Erwin  

E-print Network

"Development of Haptic Feedback Devices for Upper Limb Amputees" Andrew Erwin Faculty Mentor the prosthesis is in relation to the rest of the body. To make prostheses more natural for amputees, haptic feedback is required. Many attempts have been made to create a prosthesis that incorporates haptic feedback

Mountziaris, T. J.

389

[Medico legal considerations on prosthesis surgery of the erectile dysfunction in a La Peyronie disease case].  

PubMed

Peyronie's disease is characterized by the presence of an inelastic fibrous plaque of the penile tunica albuginea affecting 3-10% of the male population. The fibrous scar causes the curvature of the erect penis, which prevents the penetration. In the stabilization phase the plaque can cause a variable degree of erectile dysfunction (20-54%). In the treatment of the chronic disease, surgery is the gold standard and in case of concomitant erectile dysfunction the placement of a penile prosthesis is indicated. This surgery is loaded with an increase of the variables which can affect the outcome, such as individual clinical features and functionality of the device. The present case concerns a patient suffering from erectile dysfunction associated with Peyronie's disease who underwent surgery for implantation of hydraulic three-component penile prosthesis. After surgery a malfunction of the prosthesis was detected, which required unloading measures under sedation and a surgical revision of the scrotal pump. The latter was followed by the displacement of the prosthesis' cylinder and by a new surgical treatment for the reintegration of the prosthesis and the repair of the left corpus cavernosum. After two months a wrong positioning of the two cylinders inserted into the corpora cavernosa, with the left cranial extreme positioned 2 cm below the contralateral, was detected. In this case the failure of surgical treatment highlights a negligent behavior and the responsibility of the doctors by failing to examine adequately the variables, both clinical and not clinical, that might affect the outcome of the intervention. PMID:23612236

Ricci, S; Massoni, F; Simeone, C; Letizia, P; Alei, G

2013-04-01

390

Biohybrid Visual Prosthesis for Restoring Blindness  

Microsoft Academic Search

A visual prosthesis is an articial organ to re- store vision in blind patients by applying electri- cal stimulation to the visual nervous system. For years, our research group has been studying \\\\bio- hybrid\\

Tohru Yagi

2009-01-01

391

Custom Ocular Prosthesis: A Palliative Approach  

PubMed Central

The goal of palliative care is the achievement of the best quality of life for patients and their families. Eyes are generally the first features of the face to be noticed. Loss of an eye is a traumatic event which has a crippling effect on the psychology of the patient. Several ocular and orbital disorders require surgical intervention that may result in ocular defects. An ocular prosthesis is fabricated to restore the structure, function, and cosmetics of the defects created by such conditions. Although an implant eye prosthesis has a superior outcome, due to economic factors it may not be a feasible option for all patients. Therefore, a custom-made ocular prosthesis is a good alternative. This case report presents a palliative treatment for a patient with an enucleated eye by fabricating a custom ocular prosthesis which improved his psychological, physical, social, functional, emotional and spiritual needs. PMID:22837616

Thakkar, Prachi; Patel, JR; Sethuraman, Rajesh; Nirmal, Narendra

2012-01-01

392

21 CFR 878.3610 - Esophageal 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 § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal...

2011-04-01

393

21 CFR 878.3610 - Esophageal 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 § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal...

2012-04-01

394

21 CFR 878.3610 - Esophageal 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 § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal...

2013-04-01

395

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 tracheal...

2012-04-01

396

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 tracheal...

2013-04-01

397

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2014 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal...

2014-04-01

398

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

399

Automated lower limb prosthesis design  

NASA Astrophysics Data System (ADS)

The design of lower limb prostheses requires definitive geometric data to customize socket shape. Optical surface imaging and spiral x-ray computed tomography were applied to geometric analysis of limb residua in below knee (BK) amputees. Residua (limb remnants after amputation) of BK amputees were digitized and measured. Surface (optical) and volumetric (CT) data of the residuum were used to generate solid models and specify socket shape in (SDRC I-DEAS) CAD software. Volume measurements on the solid models were found to correspond within 2% of surface models and direct determinations made using Archimedean weighing. Anatomic 3D reconstruction of the residuum by optical surface and spiral x-ray computed tomography imaging are feasible modalities for prosthesis design.

Bhatia, Gulab H.; Commean, Paul K.; Smith, Kirk E.; Vannier, Michael W.

1994-09-01

400

Visuomotor behaviours when using a myoelectric prosthesis  

PubMed Central

Background A recent study showed that the gaze patterns of amputee users of myoelectric prostheses differ markedly from those seen in anatomically intact subjects. Gaze behaviour is a promising outcome measures for prosthesis designers, as it appears to reflect the strategies adopted by amputees to compensate for the absence of proprioceptive feedback and uncertainty/delays in the control system, factors believed to be central to the difficulty in using prostheses. The primary aim of our study was to characterise visuomotor behaviours over learning to use a trans-radial myoelectric prosthesis. Secondly, as there are logistical advantages to using anatomically intact subjects in prosthesis evaluation studies, we investigated similarities in visuomotor behaviours between anatomically intact users of a trans-radial prosthesis simulator and experienced trans-radial myoelectric prosthesis users. Methods In part 1 of the study, we investigated visuomotor behaviours during performance of a functional task (reaching, grasping and manipulating a carton) in a group of seven anatomically intact subjects over learning to use a trans-radial myoelectric prosthesis simulator (Dataset 1). Secondly, we compared their patterns of visuomotor behaviour with those of four experienced trans-radial myoelectric prosthesis users (Dataset 2). We recorded task movement time, performance on the SHAP test of hand function and gaze behaviour. Results Dataset 1 showed that while reaching and grasping the object, anatomically intact subjects using the prosthesis simulator devoted around 90% of their visual attention to either the hand or the area of the object to be grasped. This pattern of behaviour did not change with training, and similar patterns were seen in Dataset 2. Anatomically intact subjects exhibited significant increases in task duration at their first attempts to use the prosthesis simulator. At the end of training, the values had decreased and were similar to those seen in Dataset 2. Conclusions The study provides the first functional description of the gaze behaviours seen during use of a myoelectric prosthesis. Gaze behaviours were found to be relatively insensitive to practice. In addition, encouraging similarities were seen between the amputee group and the prosthesis simulator group. PMID:24758375

2014-01-01

401

A Gas-Actuated Anthropomorphic Transhumeral Prosthesis  

Microsoft Academic Search

This paper presents the design of an anthropomorphic 21 degree-of-freedom, 9 degree-of-actuation arm prosthesis for use by transhumeral amputees. The design leverages the power density of pneumatic actuation with the energy density of liquid propellants to obtain a self-powered dexterous prosthesis in which all of the requisite power, actuation, and sensing is packaged within the volumetric envelope of a normal

Kevin B. Fite; Thomas J. Withrow; Keith W. Wait; Michael Goldfarb

2007-01-01

402

Electromyography Signal Based For Intelligent Prosthesis Design  

Microsoft Academic Search

Electromyography (EMG) is widely used throughout the world for different study such as clinical diagnosis and for movement\\u000a analysis. One of the applications of EMG is in the development of myoelectric prosthesis. It is intended by all the biomechanics\\u000a engineer in order to provide better living to the amputees since the current prosthesis are limited. It is principally operated\\u000a based

Zunaidi Ibrahim; R. Nagarajan; M. Rizon; D. Hazry; D. Ruslizam; C. O. Azlin

403

Implementing human-like motion patterns in a trans-humeral prosthesis of three degrees of freedom and parallel actuators  

Microsoft Academic Search

This work purposes an innovative methodology for implementing and executing patterns of natural motion from a healthy human arm in an upper limb prostheses using parallel actuators. Firstly, it was developed a calibration control capable of simultaneously gathering on-line the movement range of all actuators of prosthesis. Then, ten calibration tests were performed in which movement ranges were characterized and

D. Moreno; A. Ramirez-Garcia; L. Leija; R. Munoz; A. Vera

2011-01-01

404

Role of magnetic resonance imaging in entrapment and compressive neuropathy--what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity.  

PubMed

The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging. PMID:16572333

Kim, Sungjun; Choi, Jin-Young; Huh, Yong-Min; Song, Ho-Taek; Lee, Sung-Ah; Kim, Seung Min; Suh, Jin-Suck

2007-02-01

405

Online human training of a myoelectric prosthesis controller via actor-critic reinforcement learning  

Microsoft Academic Search

As a contribution toward the goal of adaptable, intelligent artificial limbs, this work introduces a continuous actor-critic reinforcement learning method for optimizing the control of multi-function myoelectric devices. Using a simulated upper-arm robotic prosthesis, we demonstrate how it is possible to derive successful limb controllers from myoelectric data using only a sparse human-delivered training signal, without requiring detailed knowledge about

Patrick M. Pilarski; Michael R. Dawson; Thomas Degris; Farbod Fahimi; Jason P. Carey; Richard S. Sutton

2011-01-01

406

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

407

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2011 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a...

2011-04-01

408

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.  

Code of Federal Regulations, 2012 CFR

...prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone elastomer or polyester reinforced silicone elastomer intended to be implanted to replace the first metatarsophalangeal (big toe) joint....

2012-04-01

409

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.  

Code of Federal Regulations, 2013 CFR

...polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of polyester-reinforced silicone elastomer intended to be implanted to replace a wrist joint. This generic type of device...

2013-04-01

410

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.  

Code of Federal Regulations, 2014 CFR

...prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone elastomer or polyester reinforced silicone elastomer intended to be implanted to replace the first metatarsophalangeal (big toe) joint....

2014-04-01

411

21 CFR 888.3025 - Passive tendon prosthesis.  

Code of Federal Regulations, 2011 CFR

...Passive tendon prosthesis. (a) Identification. A passive tendon prosthesis is a device intended to be implanted made of silicon elastomer or a polyester reinforced medical grade silicone elastomer intended for use in the surgical...

2011-04-01

412

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 of the joint and to relieve the pain, a prosthesis to replace the glenoid of the shoulder joint is an option

Vuik, Kees

413

21 CFR 888.3025 - Passive tendon prosthesis.  

Code of Federal Regulations, 2010 CFR

...Passive tendon prosthesis. (a) Identification. A passive tendon prosthesis is a device intended to be implanted made of silicon elastomer or a polyester reinforced medical grade silicone elastomer intended for use in the surgical...

2010-04-01

414

21 CFR 872.3960 - Mandibular condyle prosthesis.  

Code of Federal Regulations, 2012 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis...

2012-04-01

415

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2012 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a...

2012-04-01

416

21 CFR 872.3960 - Mandibular condyle prosthesis.  

Code of Federal Regulations, 2010 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis...

2010-04-01

417

21 CFR 878.3750 - External prosthesis adhesive.  

Code of Federal Regulations, 2012 CFR

...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3750 External prosthesis adhesive. (a) Identification. An external prosthesis adhesive...

2012-04-01

418

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2010 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a...

2010-04-01

419

21 CFR 888.3025 - Passive tendon prosthesis.  

Code of Federal Regulations, 2014 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3025 Passive tendon prosthesis. (a) Identification. A passive tendon prosthesis is...

2014-04-01

420

21 CFR 872.3960 - Mandibular condyle prosthesis.  

Code of Federal Regulations, 2013 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis...

2013-04-01

421

21 CFR 888.3025 - Passive tendon prosthesis.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3025 Passive tendon prosthesis. (a) Identification. A passive tendon prosthesis is...

2012-04-01

422

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

423

In-situ evaluation of lower limb prosthesis fit by spiral-computed tomography  

NASA Astrophysics Data System (ADS)

Spiral x-ray computed tomography (SXCT) volumetric imaging was applied to in situ goodness of fit evaluation for lower extremity (LE) prostheses with and without axial loading. SXCT data was obtained (Siemens Somatom PLUS-S) with and without the prosthesis in place. An algorithm was developed to map and measure the residuum bony and soft tissue structure and their relationship to the rigid prosthesis socket. A transform was applied along the main axis of the structure to estimate the local soft tissue thickness relative to bone and map it from a Cartesian coordinate voxel array into cylindrical and spherical (Lambert projection) maps. Interval changes in the soft tissue envelope relative to the underlying skeleton were measured by comparing maps obtained from serial examinations. The test-retest repeatability and validity of SXCT methods was assessed using cadaver parts, phantom test objects, and human volunteers. The soft tissue envelope of lower limb residua were successfully determined, and the precision (repeatability) of SXCT was consistently better than 90%. Soft tissue SXCT mapping of a lower limb residuum is feasible with the prosthesis in situ and provides comprehensive information on the geometry and tissue characteristics for static evaluation of prosthesis fit.

Vannier, Michael W.; Smith, Kirk E.; Commean, Paul K.; Bhatia, Gulab H.

1995-05-01

424

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil  

PubMed Central

Background The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. Methods We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. Results We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. Conclusion The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population. PMID:16219095

Lacerda, Eliana M; Nácul, Luis C; da S Augusto, Lia G; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

2005-01-01

425

Life Estimation of Hip Joint Prosthesis  

NASA Astrophysics Data System (ADS)

Hip joint is one of the largest weight-bearing structures in the human body. In the event of a failure of the natural hip joint, it is replaced with an artificial hip joint, known as hip joint prosthesis. The design of hip joint prosthesis must be such so as to resist fatigue failure of hip joint stem as well as bone cement, and minimize wear caused by sliding present between its head and socket. In the present paper an attempt is made to consider both fatigue and wear effects simultaneously in estimating functional-life of the hip joint prosthesis. The finite element modeling of hip joint prosthesis using HyperMesh™ (version 9) has been reported. The static analysis (load due to the dead weight of the body) and dynamic analysis (load due to walking cycle) have been described. Fatigue life is estimated by using the S-N curve of individual materials. To account for progressive wear of hip joint prosthesis, Archard's wear law, modifications in socket geometry and dynamic analysis have been used in a sequential manner. Using such sequential programming reduction in peak stress has been observed with increase in wear. Finally life is estimated on the basis of socket wear.

Desai, C.; Hirani, H.; Chawla, A.

2014-11-01

426

CASE REPORT Open Access Mycobacterial infection of breast prosthesis a  

E-print Network

CASE REPORT Open Access Mycobacterial infection of breast prosthesis ­ a conservative treatment of infected breast prosthesis by Mycobacterium canariasense. One year after thoroughly follow-up, appropriate antibiotherapy and the change of the infected prosthesis, the patient presented no signs of reinfection

Paris-Sud XI, Université de

427

Ability of CCSM4 to simulate California extreme heat conditions from evaluating simulations of the associated large scale upper air pattern  

NASA Astrophysics Data System (ADS)

This study assesses how well the Community Climate System Model version 4 (CCSM4) simulates the large scale conditions needed for extreme hot surface temperatures in the California Central Valley (CV). Extreme hot summer days in the CV are associated with a large scale meteorological pattern (LSMP) described in Grotjahn and Faure (2008). The strength and sign of that pattern are assessed using a circulation index developed in Grotjahn (2011). The circulation index is strongly linked to daily maximum surface temperature normalized anomalies at stations spanning the CV. (Extreme heat events in the CV also affect a wider area of California and United States west coast). This study makes two primary points. First, the approach used in Grotjahn (2011) can be applied as a novel tool to evaluate how skillfully a model simulates conditions present during CV hot spells by evaluating how well the LSMP is simulated. The circulation index is calculated from historical simulations by CCSM4 and its distribution compared with that of the observed circulation index. Second, values of the CCSM4 based circulation index have smaller standard deviation than observed in reanalysis data. CCSM4 can generate a few comparably large circulation index values (implying high surface temperature anomalies) but not as often as in reanalysis data. Correct simulation of this large scale pattern is a necessary condition for successful simulation of California extreme hot days by a regional climate model. Also, the CCSM4 topography does not have a CV, but a broad topographic slope instead. Various choices of CCSM4 grid points were tested and none satisfactorily represented the CV maximum temperatures. These results should discourage use of CCSM4 surface data directly but encourage use of a regional climate model driven by the CCSM4 to capture hot spells in the CV.

Grotjahn, Richard

2013-09-01

428

The Workings of the Retinal Prosthesis  

NSDL National Science Digital Library

This YouTube video, created by Southwest Center for Microsystems Education (SCME), describes a biomedical application of MEMS technology. This 5:08 minute long video describes "how a microsystems array is used in the retinal prosthesis to stimulate cells in the retina that talk to the brain via the optic nerve." Diagrams of the prosthesis, as well as the retina, and descriptions of how resolution can be increased are included. Viewers can learn more about this topic on the SCME website.

429

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. PMID:25302271

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

2014-01-01

430

Fabrication of a Custom Ocular Prosthesis  

PubMed Central

Defects of the eye may follow removal of a part of or the entire orbit. This results in the patient becoming visually, esthetically and psychologically handicapped. Restoring the defect with a silicone- or acrylic-based prosthesis not only restores esthetics but also gives back the lost confidence to the patient. This is a case report of a patient with a ‘pthisical eye’ and details the steps in fabrication of an ocular prosthesis. Particular attention has been given to the laboratory process in this technique to minimize the residual monomer content in the artificial eye. PMID:25100916

Sethi, Tania; Kheur, Mohit; Haylock, Colin; Harianawala, Husain

2014-01-01

431

Supra-annular aortic valve replacement with a mechanical prosthesis.  

PubMed

Supra-annular placement of the aortic valve prosthesis is primarily used in small aortic annulus to prevent a patient-prosthesis mismatch. The most important surgical steps are: careful removal of the diseased valve including annular decalcification; assessment of the prosthesis seating to guarantee free movement of leaflets and to prevent obstruction of coronary orifices; implantation with interrupted stitches placed infra-annularly, with the prosthesis being seated in a supra-annular position. If necessary, a sub-annular resection of asymmetric septal hypertrophy should be carried out prior to placement of the prosthesis. PMID:24415215

Turina, Marko

2005-01-01

432

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

433

Preoperative Psychosocial Evaluation of Penile Prosthesis Candidates  

Microsoft Academic Search

Penile prosthesis surgery is a recommended treatment option for a subset of patients who present with erectile dysfunction (ED). Although treatment outcome research indicates that patients are generally satisfied with this intervention, it remains an invasive procedure with risk for complications. A review of the literature reveals gen- eral agreement for the importance of a thorough preop- erative evaluation to

Erin Winters Ulloa; Amy K. Silberbogen; Kirstin Brown

2008-01-01

434

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

435

A Micropower Cochlear Prosthesis System Demonstrator  

Microsoft Academic Search

This demonstrator presents an ultra low power mixed-signal implementation of a cochlear prosthesis system. A laptop PC provides an audio stimulus to the cochlear chip. A microcontroller on the demonstrator board monitors the output channels of the chip and returns these to the PC to be displayed as a spectrogram. The audiological settings of the implant chip are controlled via

Julius Georgiou; Timothy G. Constandinou; Chris Toumazou

2007-01-01

436

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

437

DSP based image processing for retinal prosthesis  

Microsoft Academic Search

The real-time image processing in retinal prosthesis consists of the implementation of various image processing algorithms like edge detection, edge enhancement, decimation etc. The algorithmic computations in real-time may have high level of computational complexity and hence the use of digital signal processors (DSPs) for the implementation of such algorithms is proposed here. This application desires that the DSPs be

Neha J. Parikh; James D. Weiland; Mark S. Humayun; Saloni S. Shah; Gaurav S. Mohile

2004-01-01

438

Vibrotactile display coding for a balance prosthesis  

Microsoft Academic Search

Preliminary experiments have demonstrated the potential usefulness of a precursor balance prosthesis that displays the tilt of the subject using tactile vibrators (tactors) which arc in contact with the subject's skin. The device consists of a motion sensing system mounted on the head or body whose signals are converted into estimates of head or body tilt. Tilt is displayed to

Prajoy P. Kadkade; Brian J. Benda; Patricia B. Schmidt; Conrad Wall

2003-01-01

439

Reading Visual Braille with a Retinal Prosthesis  

PubMed Central

Retinal prostheses, which restore partial vision to patients blinded by outer retinal degeneration, are currently in clinical trial. The Argus II retinal prosthesis system was recently awarded CE approval for commercial use in Europe. While retinal prosthesis users have achieved remarkable visual improvement to the point of reading letters and short sentences, the reading process is still fairly cumbersome. This study investigates the possibility of using an epiretinal prosthesis to stimulate visual braille as a sensory substitution for reading written letters and words. The Argus II retinal prosthesis system, used in this study, includes a 10?×?6 electrode array implanted epiretinally, a tiny video camera mounted on a pair of glasses, and a wearable computer that processes the video and determines the stimulation current of each electrode in real time. In the braille reading system, individual letters are created by a subset of dots from a 3 by 2 array of six dots. For the visual braille experiment, a grid of six electrodes was chosen out of the 10?×?6 Argus II array. Groups of these electrodes were then directly stimulated (bypassing the camera) to create visual percepts of individual braille letters. Experiments were performed in a single subject. Single letters were stimulated in an alternative forced choice (AFC) paradigm, and short 2–4-letter words were stimulated (one letter at a time) in an open-choice reading paradigm. The subject correctly identified 89% of single letters, 80% of 2-letter, 60% of 3-letter, and 70% of 4-letter words. This work suggests that text can successfully be stimulated and read as visual braille in retinal prosthesis patients. PMID:23189036

Lauritzen, Thomas Z.; Harris, Jordan; Mohand-Said, Saddek; Sahel, Jose A.; Dorn, Jessy D.; McClure, Kelly; Greenberg, Robert J.

2012-01-01

440

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

Code of Federal Regulations, 2013 CFR

...false Hip joint (hemi-hip) acetabular metal cemented prosthesis. 888.3370 Section...3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device...

2013-04-01

441

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

Code of Federal Regulations, 2014 CFR

...false Hip joint (hemi-hip) acetabular metal cemented prosthesis. 888.3370 Section...3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device...

2014-04-01

442

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.  

Code of Federal Regulations, 2013 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...

2013-04-01

443

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

Code of Federal Regulations, 2013 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...

2013-04-01

444

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

Code of Federal Regulations, 2013 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...

2013-04-01

445

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

Code of Federal Regulations, 2012 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...

2012-04-01

446

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

Code of Federal Regulations, 2011 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...

2011-04-01

447

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

448

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

Code of Federal Regulations, 2014 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...

2014-04-01

449

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

Code of Federal Regulations, 2011 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...

2011-04-01

450

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

Code of Federal Regulations, 2014 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,...

2014-04-01

451

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.  

Code of Federal Regulations, 2013 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...

2013-04-01

452

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.  

Code of Federal Regulations, 2014 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...

2014-04-01

453

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

Code of Federal Regulations, 2012 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...

2012-04-01

454

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

455

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

456

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

457

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

Code of Federal Regulations, 2011 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,...

2011-04-01

458

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.  

Code of Federal Regulations, 2014 CFR

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

2014-04-01

459

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

Code of Federal Regulations, 2012 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,...

2012-04-01

460

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

Code of Federal Regulations, 2013 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,...

2013-04-01