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1

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

2

Muscles of the Upper Extremity  

MedlinePLUS

... Home » Cancer Registration & Surveillance Modules » Anatomy & Physiology » Muscular System » Muscle Groups » Upper Extremity Cancer Registration & Surveillance Modules Anatomy & Physiology Intro to the Human Body Body Functions & Life Process Anatomical Terminology Review Quiz ...

3

Innovations in prosthetic interfaces for the upper extremity.  

PubMed

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

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

2013-12-01

4

Obesity-induced Upper Extremity Lymphedema  

PubMed Central

Summary: Obesity increases the risk of upper extremity lymphedema following treatment for breast cancer and can cause lower extremity lymphatic dysfunction in extremely obese individuals. We report the first patient with obesity-induced upper extremity lymphedema. A 62-year-old man with a previous body mass index (BMI) of 105.6, presented with a BMI 60.3 following weight loss. He complained of lymphedema of all 4 extremities, which was confirmed by lymphoscintigraphy. Because the upper limbs are more resistant to lymphedema than the lower extremities, a higher BMI threshold may be necessary to cause upper extremity lymphatic dysfunction. PMID:25289254

Maclellan, Reid A.

2013-01-01

5

Aeromonas hydrophila upper extremity infection.  

PubMed

A severe soft tissue infection of the upper extremity caused by Aeromonas hydrophila followed a water skiing injury in which a tow rope caused degloving of a portion of the skin and severe contusion to underlying muscle. Infection was established within 36 hours of the injury, accompanied by fever, leukocytosis, and a foul odor. Rapid clinical improvement occurred following radical debridement of all nonviable tissue and antibiotic therapy. In cases involving water contamination, Aeromonas hydrophila infection should be suspected with the onset of a rapidly developing infection with a febrile response. Rapid surgical intervention and treatment with an aminoglycoside or a third-generation cephalosporin antibiotic is the treatment of choice. PMID:2754206

Sanger, J R; Yousif, N J; Matloub, H S

1989-07-01

6

Advances in upper extremity prosthetics.  

PubMed

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

Zlotolow, Dan A; Kozin, Scott H

2012-11-01

7

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

8

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

9

Prosthesis use in persons with lower- and upper-limb amputation  

PubMed Central

This study identified clinical (e.g., etiology) and demographic factors related to prosthesis use in persons with upper- and lower-limb amputation (ULA and LLA, respectively) and the effect of phantom limb pain (PLP) and residual limb pain (RLP) on prosthesis use. A total of 752 respondents with LLA and 107 respondents with ULA completed surveys. Factors related to greater use (hours per day) for persons with LLA included younger age, full- or part-time employment, marriage, a distal amputation, an amputation of traumatic etiology, and an absence of PLP. Less use was associated with reports that prosthesis use worsened RLP, and greater prosthesis use was associated with reports that prosthesis use did not affect PLP. Having a proximal amputation and reporting lower average PLP were related to greater use in hours per day for persons with an ULA, while having a distal amputation and being married were associated with greater use in days per month. Finally, participants with LLA were significantly more likely to wear a prosthesis than those with ULA. These results underscore the importance of examining factors related to prosthesis use and the differential effect that these variables may have when the etiology and location of amputation are considered. PMID:19165686

Raichle, Katherine A.; Hanley, Marisol A.; Molton, Ivan; Kadel, Nancy J.; Campbell, Kellye; Phelps, Emily; Ehde, Dawn; Smith, Douglas G.

2009-01-01

10

Parameters for modeling the upper extremity  

Microsoft Academic Search

The purpose of this paper was to provide parameters for the development of a musculoskeletal model of the upper extremity. Five upper extremity specimens were obtained from four fresh cadavers. Anthropometric measures were obtained for each cadaver. Segment inertial parameters were estimated for each specimen from anthropometric measures of the cadaver from which the specimen was obtained. The three-dimensional kinematics

H. E. J. Veeger; Bing Yu; Kai-Nan An; R. H. Rozendal

1997-01-01

11

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

12

Estimation of stature from upper extremity.  

PubMed

With the increasing frequency of mass disasters, identification of an isolated upper extremity and determination of the stature of the person it belonged to have created problems for investigation of the identity of some victims. Despite a need for such a study, there is a lack of systematic studies to identify fragmented and dismembered human remains. The purpose of this study was to analyze anthropometric relationships between dimensions of the upper extremity and body height. Analyses were based on a sample of middle class male (n = 202) and female (n = 108) Turks residing in Istanbul, Turkey. Five variables were entered into the analyses. For male subjects, forearm length was selected as the first factor, followed by hand length and finally upper arm length. For female subjects, upper arm length was selected first, followed by forearm length and finally hand length. There were also individually calculated formulae for some of these measurements that provided smaller R2 values. The study suggested that estimation of a living height could be made possible by using various dimensions of the upper extremity. One must consider differences between populations to apply such functions to other populations. PMID:16673740

Ozaslan, Abdi; Koç, Sermet; Ozaslan, Inci; Tu?cu, Harun

2006-04-01

13

Factitious disorders of the upper extremity.  

PubMed

Factitious disorders of the upper extremity can manifest in many different forms; therefore, it is critical to recognize warning signs in the history and examination indicating that the patient may be creating the symptoms and physical manifestations of the presenting illness. These disorders present in such predictable patterns as lymphedema, Secretan syndrome, ulcerations and wound manipulation, clenched fist, subcutaneous emphysema, pachydermodactyly, nail deformities, and self-mutilation. Management recommendations include assigning therapeutic responsibility to one person and the involvement of a multidisciplinary team. Thorough documentation is essential for the protection of both the patient and the treating physician. Treatment of patients with factitious disorders of the upper extremity requires patience and insight to avoid being manipulated into performing unnecessary surgical procedures. PMID:22302445

Birman, Michael V; Lee, Donald H

2012-02-01

14

Competitive water polo. Upper extremity injuries.  

PubMed

Water polo is a contact sport combining the skills of swimming, swim conditioning, throwing and, occasionally, the elements of wrestling and boxing. As such, the athletes frequently sustain upper extremity injuries involving the shoulder, the elbow, or the hand and fingers; moreover, injuries may result from either overuse or acute trauma. Successful treatment of these injuries requires an understanding of the peculiarities of the game and the likely mechanisms of injury, and the experience to properly recognize when they occur. PMID:10230566

Colville, J M; Markman, B S

1999-04-01

15

Parameters for modeling the upper extremity.  

PubMed

The purpose of this paper was to provide parameters for the development of a musculoskeletal model of the upper extremity. Five upper extremity specimens were obtained from four fresh cadavers. Anthropometric measures were obtained for each cadaver. Segment inertial parameters were estimated for each specimen from anthropometric measures of the cadaver from which the specimen was obtained. The three-dimensional kinematics of the humerus, ulna, and radius in different movements of the glenohumeral, humeroulnar and ulnoradial joints were measured for each specimen using of the 3Space tracking system (Isotrack, Polhemus). The instantaneous rotation center of the glenohumeral joint and the instantaneous rotation axes of elbow flexion and forearm pronation were determined for each specimen from the kinematic data. The specimens were dissected and the muscle origins and insertions and bony structures needed in upper extremity modeling were digitized using the 3Space system. The shapes of muscle origins and insertions were estimated. Muscle length, volume and pennation angle were measured for the estimation of physiological cross-sectional areas of each muscle. The results, which are given for one specimen, showed that the rotation center of the glenohumeral joint was very close to the geometric center of the joint with a mean distance of 4 mm. The mean angle between the flexion-extension and pro-supination axes of the elbow joint was 94 degrees. The minimum distance between these two axes was about 4 mm. PMID:9165401

Veeger, H E; Yu, B; An, K N; Rozendal, R H

1997-06-01

16

The Pediatric Outcomes Data Collection Instrument (PODCI) and functional assessment of patients with unilateral upper extremity deficiencies.  

PubMed

The Pediatric Outcomes Data Collection Instrument (PODCI) questionnaire was used to quantify functional abilities of a group of unilateral upper extremity deficiency (U-UED) patients and compare them with "normal" control children. Sixty-four consecutive patients with U-UED were assessed. Parents and adolescent (ages 11-21) patients responded. Underlying diagnosis, amputation level, and type of prosthesis were recorded. Scores were compared for congenital versus traumatic etiologies for patients with various amputation levels, and for patients using prostheses versus those not using prostheses. In both parent and patient responses, PODCI scores were significantly lower than "normal" for upper extremity function and sports. Scores were similar for congenital and acquired amputees. Responses from adolescent patients showed progressively decreasing scores for upper extremity, transfers, sports, and global function with progressively proximal amputation levels. Patients using prostheses with different terminal devices did not significantly differ. Parent responses for prosthesis wearers showed lower comfort/pain scores (ie, increased pain) than non-prosthesis wearers, but no significant differences in function, including upper extremity function. PMID:15832164

Lerman, Joel A; Sullivan, Elroy; Barnes, Douglas A; Haynes, Richard J

2005-01-01

17

Upper extremity injuries in Homer's Iliad.  

PubMed

Homer's Iliad remains a fascinating source of medical history. This epic poem, compiled around 800 BCE, describes several weeks of the last year of the 10-year siege of Troy (Ilion) by the Achaeans. Homer composed the epic by combining and formalizing oral poems, legends, customs, and experiences that originated in the later Mycenaean age (1600-1100 bce). The story centers on the rage of the great warrior Achilles. The Iliad remains the oldest record of Greek medicine and a unique source of surgical history. This study examines the upper extremity injuries described in the Iliad and compares them to those other sites of injury. PMID:23932117

Hutchison, Richard L; Hirthler, Maureen A

2013-09-01

18

Arterial injury in uncomplicated upper extremity dislocations.  

PubMed

The purpose of this study is to analyze causes and consequences of arterial injury complicating simple dislocations of the upper extremity. This is a multicenter, 5-year, retrospective analysis of vascular injury in patients sustaining shoulder or elbow dislocations without associated fractures. Foci of the study were mechanisms of injury, preoperative imaging, incidence of closed reductions, types of arterial injury, methods of surgical repair, and ultimate outcome. Arterial injury in this patient cohort occurred in 0.74% of patients. Axillary artery injury occurred in 0. 97% and brachial in 0.47%. Both elbow and shoulder dislocations may cause severe arterial damage and strenuously test surgical expertise to achieve successful repair. PMID:10742423

Sparks, S R; DeLaRosa, J; Bergan, J J; Hoyt, D B; Owens, E L

2000-03-01

19

Managing Upper extremity Fx's Sweden 10-Managing Pediatric  

E-print Network

Managing Upper extremity Fx's Sweden 10- 05 1 Managing Pediatric Fractures Andrew Pennock, M extremity Fx's Sweden 10- 05 2 Children Are Not Miniature Adults! · Open Growth Plates · Remodeling is Changing "Citius, Altius, Fortius" - Faster, Higher, Stronger #12;Managing Upper extremity Fx's Sweden 10

Squire, Larry R.

20

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

Liquid-Fueled Actuation for an Anthropomorphic Upper Extremity Prosthesis Kevin B. Fite, Member, in addition to a 17 degree-of-freedom underactuated hand effected by five actuators. The anthropomorphic. INTRODUCTION MONG the many challenges that exist in the development of an anthropomorphic arm

21

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

22

An upper extremity kinematic model for evaluation of hemiparetic stroke  

Microsoft Academic Search

Quantification of rehabilitation progress is necessary for accurately assessing clinical treatments. A three-dimension (3D) upper extremity (UE) kinematic model was developed to obtain joint angles of the trunk, shoulder and elbow using a Vicon motion analysis system. Strict evaluation confirmed the system's accuracy and precision. As an example of application, the model was used to evaluate the upper extremity movement

Brooke Hingtgen; John R. McGuire; Mei Wang; Gerald F. Harris

2006-01-01

23

ORIGINAL ARTICLE Acupuncture for Upper-Extremity Rehabilitation in Chronic  

E-print Network

ORIGINAL ARTICLE Acupuncture for Upper-Extremity Rehabilitation in Chronic Stroke: A Randomized. Acupuncture for upper- extremity rehabilitation in chronic stroke: a randomized sham- controlled study. Arch Phys Med Rehabil 2005;86:2248-55. Objective: To compare the effects of traditional Chinese acupuncture

Schaechter, Judith D.

24

Electrocorticogram encoding of upper extremity movement duration.  

PubMed

Electrocorticogram (ECoG) is a promising long-term signal acquisition platform for brain-computer interface (BCI) systems such as upper extremity prostheses. Several studies have demonstrated decoding of arm and finger trajectories from ECoG high-gamma band (80-160 Hz) signals. In this study, we systematically vary the velocity of three elementary movement types (pincer grasp, elbow and shoulder flexion/extension) to test whether the high-gamma band encodes for the entirety of the movements, or merely the movement onset. To this end, linear regression models were created for the durations and amplitudes of high-gamma power bursts and velocity deflections. One subject with 8×8 high-density ECoG grid (4 mm center-to-center electrode spacing) participated in the experiment. The results of the regression models indicated that the power burst durations varied directly with the movement durations (e.g. R(2)=0.71 and slope=1.0 s/s for elbow). The persistence of power bursts for the duration of the movement suggests that the primary motor cortex (M1) is likely active for the entire duration of a movement, instead of providing a marker for the movement onset. On the other hand, the amplitudes were less co-varied. Furthermore, the electrodes of maximum R(2) conformed to somatotopic arrangement of the brain. Also, electrodes responsible for flexion and extension movements could be resolved on the high-density grid. In summary, these findings suggest that M1 may be directly responsible for activating the individual muscle motor units, and future BCI may be able to utilize them for better control of prostheses. PMID:25570190

Wang, Po T; King, Christine E; McCrimmon, Colin M; Shaw, Susan J; Millett, David E; Liu, Charles Y; Chui, Luis A; Nenadic, Zoran; Do, An H

2014-08-01

25

Rings and things on upper extremity radiographs of emergency patients  

Microsoft Academic Search

  \\u000a Rings, intravenous lines, and other objects on the injured upper extremities of trauma patients are frequently overlooked\\u000a by radiology and emergency department (ED) personnel. This can impair proper radiologic evaluation of the injured extremity\\u000a as well as negatively affect the quality of the patient's treatment. A 1-week sample of radiographs of injured upper extremities\\u000a from the ED of University

Matthew L. Steinway; Mihra S. Taljanovic; Tim B. Hunter; Elizabeth A. Krupinski; William A. Grana

2003-01-01

26

Upper extremity kinetics during Lofstrand crutch-assisted gait  

Microsoft Academic Search

A three-dimensional (3D) biomechanical model was developed to determine upper extremity kinematics and kinetics of persons walking with forearm crutches. Six-component load cells and strain gauges were installed in the crutches to determine crutch forces. A six-camera VICON motion system was used to acquire coordinate data from 24 reflective markers attached to the upper extremities and crutches. Joint axes for

Philip S. Requejo; David P. Wahl; Ernest L. Bontrager; Craig J. Newsam; JoAnne K. Gronley; Sara J. Mulroy; Jacquelin Perry

2005-01-01

27

Evaluation and treatment of upper extremity nerve entrapment syndromes.  

PubMed

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

Floranda, Eric E; Jacobs, Bret C

2013-12-01

28

Congenital Differences of the Upper Extremity: Classification and Treatment Principles  

PubMed Central

For hand surgeons, the treatment of children with congenital differences of the upper extremity is challenging because of the diverse spectrum of conditions encountered, but the task is also rewarding because it provides surgeons with the opportunity to impact a child's growth and development. An ideal classification of congenital differences of the upper extremity would reflect the full spectrum of morphologic abnormalities and encompass etiology, a guide to treatment, and provide prognoses. In this report, I review current classification systems and discuss their contradictions and limitations. In addition, I present a modified classification system and provide treatment principles. As our understanding of the etiology of congenital differences of the upper extremity increases and as experience of treating difficult cases accumulates, even an ideal classification system and optimal treatment strategies will undoubtedly continue to evolve. PMID:21909463

2011-01-01

29

Use of diagnostic modalities for assessing upper extremity vascular pathology.  

PubMed

Vascular pathology of the upper extremity requires consideration of constitutional, anatomic, and functional factors. The medical history and physical examination are essential. The Allen test can be performed alongside a handheld Doppler for arterial mapping. Useful studies include digital-brachial index measurements, digital plethysmography, laser Doppler, and color ultrasounds. Three-phase bone scintigraphy still plays a role in the evaluation of vascularity after of frostbite injury. Angiogram remains the gold standard radiographic instrument to evaluate vascular pathology of the upper extremity, but computed tomography and magnetic resonance scans have an increasing role in diagnosis of vascular pathology. PMID:25455352

Grasu, Beatrice L; Jones, Christopher M; Murphy, Michael S

2015-02-01

30

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

31

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

32

Associations between childhood obesity and upper and lower extremity injuries  

PubMed Central

Objectives To estimate the overall and age-specific associations between obesity and extremity musculoskeletal injuries and pain in children. Methods This cross-sectional study used information from electronic medical records of 913 178 patients aged 2–19 years enrolled in an integrated health plan in the period 2007–2009. Children were classified as underweight, normal weight, overweight, or moderately/extremely obese and, using multivariable logistic regression methods, the associations between weight class and diagnosis of upper or lower extremity fractures, sprains, dislocations and pain were calculated. Results Overweight (OR 1.18, 95% CI 1.15 to 1.20), moderately obese (OR 1.24, 95% CI 1.20 to 1.27) and extremely obese (OR 1.34, 95% CI 1.30 to 1.39) children had statistically significantly higher odds of lower extremity injuries/pain compared to normal weight, adjusted for sex, age, race/ethnicity and insurance status. Age-stratified analyses yielded similar results. No consistent association was observed between body mass index and injuries/pain of the upper extremities. Conclusions Greater body mass index is associated with increased odds of lower extremity injuries and pain issues. Because the benefits of physical activity may still outweigh the risk of injury, attention should be paid to injury prevention strategies for these children at greater risk for lower extremity injuries. PMID:22789612

Adams, Annette L; Kessler, Jeffrey I; Deramerian, Krikor; Smith, Ning; Black, Mary Helen; Porter, Amy H; Jacobsen, Steven J; Koebnick, Corinna

2013-01-01

33

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

34

An arm wrestling robot system for human upper extremity wear  

Microsoft Academic Search

In this study, we develop a prototype of arm wrestling robot system called AssistRobot for human upper extremity wear. Further, we introduce a force display response model based on the impact absorption of human hand, proposed earlier by the authors, into the system. The effectiveness of the system for arm wrestling is demonstrated by sensory evaluation from viewpoints of operability

Takashi Yamada; Tomio Watanabe

2011-01-01

35

Upper Extremity Regional Anesthesia: Essentials of Our Current Understanding, 2008  

Microsoft Academic Search

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

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

2009-01-01

36

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

37

Lipoma causing upper extremity deep vein thrombosis: a case report.  

PubMed

We report a case of lipoma in the right infraclavicular and axillary area compressing subclavian vein there by presenting with upper extremity deep venous thrombosis (UEDVT) and persistent symptoms of venous congestion. Patient was also found to be a heterozygous carrier of prothrombin 20210 gene mutation. Surgical excision of lipomatous tissue performed after 6 months of anticoagulation resulted in a complete resolution of symptoms. PMID:19728038

Palamari, Balavani; Breen, Jerome F; Wysokinski, Waldemar E

2010-07-01

38

Hay baler trauma to the upper extremity: a roller injury.  

PubMed

The mechanism of upper extremity trauma in three patients from a round hay baler is analyzed in relation to previously described experimental models of wringer or roller injury. One patient sustained an avulsive injury with typical tearing of the soft tissues. Thermal insult from roller friction heat and the duration of exposure were significant factors determining the extent of tissue injury in the other two patients. PMID:6655754

Gainor, B J

1983-12-01

39

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

40

[Upper extremity post-thrombotic syndrome and quality of life.  

PubMed

urpose: To assess the occurrence of post thrombotic syndrome and quality of life in patients with upper extremity deep venous thrombosis. Material and methods: Twenty-seven patients with the previous diagnosis of upper extremity venous thrombosis, from January 2006 to March 2010, were recruited for clinical evaluation, ultrasonography studies and an interview utilizing the Modified scale and the SF-36 questionnaire Results: Only II (40.7%) of the patients responded, there women and men, average age of 53.7 years. Ultrasonography revealed a residual thrombus in 18.2% of the cases, with repercussions in the venous flow. A clinical post-thrombotic syndrome was diagnosed in 36.4% of the patients, being light in 27.2% and moderate in 9.2%. Neoplasia and central venous catheter were not associated to the occurrence of the syndrome, but thrombophylia played a significant role in its occurrence. The quality of lyfe questionnaire revealed 90.9% of patients with good functional capacity, but 54.5% of them complained of precarious state of health. Paradoxically, patients with neoplasia displayed a satisfactory health state. Certain emotional aspects related with the provious TVP, affected the quality of life of same patients. Patients with post-thrombotic syndrome have considered as precarious their health status. Conclusion: Deep venous thrombosis of upper extremity may cause a post-thrombotic syndrome of light intensidy. The presence of a central venous catheter or neoplasia were not considered risk factors of its occurrence. Most of the patients displayed a satisfactory functional capacity, but around an half considered as having a precarious health state. Patients classified as having poor quality of life were those having recurrent DVT and post-thrombotic syndrome. PMID:21298124

Maia, Miguel; Ferreira, Joana; Braga, Sandrinha; Vasconcelos, João; Brandão, Pedro; Vaz, Guedes

41

Electrodiagnostic evaluation of ulnar neuropathy and other upper extremity mononeuropathies.  

PubMed

Upper extremity mononeuropathies are some of the common disorders seen in neurophysiology laboratories. Electrophysiologic studies rely on accurate localization based on knowledge of applicable anatomy and features of history and physical examination. Careful electrodiagnostic studies provide an accurate diagnosis, help localize the lesion site, exclude alternate diagnoses, reveal unsuspected diagnoses, determine pathophysiology of lesions, and assess severity, timeframe, and prognosis of lesions. This article discusses the electrodiagnostic approach to ulnar neuropathy, proximal median neuropathy, radial neuropathy, musculocutaneous neuropathy, axillary neuropathy, suprascapular neuropathy, and long thoracic neuropathy. Pertinent aspects of the history and physical examination, nerve conduction studies, and electromyography are presented. PMID:22361371

Dimberg, Elliot L

2012-05-01

42

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

43

A Case with Upper Extremity Deep Vein Thrombosis after in vitro Fertilization  

PubMed Central

Deep vein thrombosis (DVT) is a predisposing condition of pulmonary embolism which can be fatal. Usually, DVT is found in the lower extremities. However, DVT can be occurred in the upper extremities. The usual predisposing conditions of the upper extremity DVT include insertion of central venous catheters and pacemaker wires. Here, we report a case of upper extremity DVT after in vitro fertilization and embryo transfer. The patient was successfully controlled with subcutaneous administration of low molecular weight heparin. PMID:20967157

Seong, Seok-Woo; Shin, Sung Kyun; Jin, Seon-Ah; Park, Yong Kyu; Choi, Si Wan

2010-01-01

44

Control of a pneumatic orthosis for upper extremity stroke rehabilitation.  

PubMed

A key challenge in rehabilitation robotics is the development of a lightweight, large force, high degrees-of-freedom device that can assist in functional rehabilitation of the arm. Pneumatic actuators can potentially help meet this challenge because of their high power-to-weight ratio. They are currently not widely used for rehabilitation robotics because they are difficult to control. This paper describes the control development of a pneumatically actuated, upper extremity orthosis for rehabilitation after stroke. To provide the sensing needed for good pneumatic control, position and velocity of the robot are estimated by a unique implementation of a Kalman filter using MEMS accelerometers. To compensate for the nonlinear behavior of the pneumatic servovalves, force control is achieved using a new method for air flow mapping using experimentally measured data in a least-squares regression. To help patients move with an inherently compliant robot, a high level controller that assists only as needed in reaching exercises is developed. This high level controller differs from traditional trajectory-based, position controllers, allowing free voluntary movements toward a target while resisting movements away from the target. When the target cannot be reached voluntarily, the controller slowly builds up force, pushing the arm toward the target. As each target position is reached, the controller builds an internal model of the subject's capability, learning the forces necessary to complete movements. Preliminary testing performed on a non-disabled subject demonstrated the ability of the orthosis to complete reaching movements with graded assistance and to adapt to the effort level of the subject. Thus, the orthosis is a promising tool for upper extremity rehabilitation after stroke. PMID:17946132

Wolbrecht, Eric T; Leavitt, John; Reinkensmeyer, David J; Bobrow, James E

2006-01-01

45

Automated Assessment of Upper Extremity Movement Impairment due to Stroke  

PubMed Central

Current diagnosis and treatment of movement impairment post-stroke is based on the subjective assessment of select movements by a trained clinical specialist. However, modern low-cost motion capture technology allows for the development of automated quantitative assessment of motor impairment. Such outcome measures are crucial for advancing post-stroke treatment methods. We sought to develop an automated method of measuring the quality of movement in clinically-relevant terms from low-cost motion capture. Unconstrained movements of upper extremity were performed by people with chronic hemiparesis and recorded by standard and low-cost motion capture systems. Quantitative scores derived from motion capture were compared to qualitative clinical scores produced by trained human raters. A strong linear relationship was found between qualitative scores and quantitative scores derived from both standard and low-cost motion capture. Performance of the automated scoring algorithm was matched by averaged qualitative scores of three human raters. We conclude that low-cost motion capture combined with an automated scoring algorithm is a feasible method to assess objectively upper-arm impairment post stroke. The application of this technology may not only reduce the cost of assessment of post-stroke movement impairment, but also promote the acceptance of objective impairment measures into routine medical practice. PMID:25100036

Olesh, Erienne V.; Yakovenko, Sergiy; Gritsenko, Valeriya

2014-01-01

46

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

47

Neuropathic Pain in Patients with Upper-Extremity Nerve Injury  

PubMed Central

ABSTRACT Purpose: The purpose of this review was to present an analysis of the literature of the outcome studies reported in patients following traumatic upper-extremity (UE) nerve injuries (excluding amputation), to assess the presence of an association between neuropathic pain and outcome in patients following traumatic UE nerve injuries, and to provide recommendations for inclusion of more comprehensive outcome measures by clinicians who treat these patients. Summary of Key Points: A Medline and CINAHL literature search retrieved 48 articles. This review identified very few studies of patients with peripheral nerve injury that reported neuropathic pain. When pain was reported, visual analogue or numeric rating scales were most frequently used; standardized questionnaires measuring pain or psychosocial function were rarely administered. Recent evidence shows substantial long-term disability and pain in patients following peripheral nerve injury. Recommendation: To better understand neuropathic pain in patients following peripheral nerve injury, future outcome studies should include valid, reliable measures of physical impairment, pain, disability, health-related quality of life, and psychosocial functioning. PMID:21629596

Katz, Joel

2010-01-01

48

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

49

Workstyle: Development of a Measure of Response to Work in Those With Upper Extremity Pain  

Microsoft Academic Search

Workstyle or the behavioral, cognitive, and physiological response that can occur in some individuals to increases in work demands has been proposed to help explain the link between ergonomic and psychosocial factors in the exacerbation of work-related upper extremity symptoms. Currently, there is no measure of this construct, hindering research on its potential link to work related upper extremity problems

Michael Feuerstein; Rena A. Nicholas; Grant D. Huang; Amy J. Haufler; Glenn Pransky; Michele Robertson

2005-01-01

50

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

51

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

52

Kinesio taping in stroke: improving functional use of the upper extremity in hemiplegia.  

PubMed

The purpose of this article is to present the Kinesio taping method used to improve the upper extremity function in the adult with hemiplegia. The article discusses various therapeutic methods used in the treatment of stroke patients to achieve a functional upper extremity. The only taping technique for various upper extremity conditions that has been described in the literature is the athletic taping technique. In this article, some interpretation is offered on proper assessment of the nonfunctional upper extremity, including the emphasis on postural alignment, trunk control, and scapula alignment. The Kinesio taping method in conjunction with other therapeutic interventions may facilitate or inhibit muscle function, support joint structure, reduce pain, and provide proprioceptive feedback to achieve and maintain preferred body alignment. Restoring trunk and scapula alignment after the stroke is critical in an effective treatment program for the upper extremity in hemiplegia. PMID:16987790

Jaraczewska, Ewa; Long, Carol

2006-01-01

53

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

Microsoft Academic Search

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

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

2000-01-01

54

GENDER DIFFERENCE IN ABILITY USING THE STRETCH-SHORTENING CYCLE IN THE UPPER EXTREMITIES  

Microsoft Academic Search

Miyaguchi, K and Demura, S. Gender difference in ability using the stretch-shortening cycle in the upper extremities. J Strength Cond Res 23(1): 231-236, 2009—A gender difference in ability using the stretch-shortening cycle (SSC ability) in the upper extremities has not been studied in detail. This study aimed to devise an index to evaluate SSC ability during powerful elbow flexion and

KAZUYOSHI MIYAGUCHI; SHINICHI DEMURA

55

The Influence of Altering Push Force Effectiveness on Upper Extremity Demand during Wheelchair Propulsion  

PubMed Central

Manual wheelchair propulsion has been linked to a high incidence of overuse injury and pain in the upper extremity, which may be caused by the high load requirements and low mechanical efficiency of the task. Previous studies have suggested that poor mechanical efficiency may be due to a low effective handrim force (i.e. applied force that is not directed tangential to the handrim). As a result, studies attempting to reduce upper extremity demand have used various measures of force effectiveness (e.g. fraction effective force, FEF) as a guide for modifying propulsion technique, developing rehabilitation programs and configuring wheelchairs. However, the relationship between FEF and upper extremity demand is not well understood. The purpose of this study was to use forward dynamics simulations of wheelchair propulsion to determine the influence of FEF on upper extremity demand by quantifying individual muscle stress, work and handrim force contributions at different values of FEF. Simulations maximizing and minimizing FEF resulted in higher average muscle stresses (23% and 112%) and total muscle work (28% and 71%) compared to a nominal FEF simulation. The maximal FEF simulation also shifted muscle use from muscles crossing the elbow to those at the shoulder (e.g. rotator cuff muscles), placing greater demand on shoulder muscles during propulsion. The optimal FEF value appears to represent a balance between increasing push force effectiveness to increase mechanical efficiency and minimizing upper extremity demand. Thus, care should be taken in using force effectiveness as a metric to reduce upper extremity demand. PMID:20674921

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

2010-01-01

56

Extreme Cranial Ontogeny in the Upper Cretaceous Dinosaur Pachycephalosaurus  

Microsoft Academic Search

BackgroundExtended neoteny and late stage allometric growth increase morphological disparity between growth stages in at least some dinosaurs. Coupled with relatively low dinosaur density in the Upper Cretaceous of North America, ontogenetic transformational representatives are often difficult to distinguish. For example, many hadrosaurids previously reported to represent relatively small lambeosaurine species were demonstrated to be juveniles of the larger taxa.

John R. Horner; Mark B. Goodwin; Paul Sereno

2009-01-01

57

Upper extremity soft and rigid tissue mass prediction using segment anthropometric measures and DXA  

Microsoft Academic Search

Regression equations for predicting bone mineral content (BMC), fat mass (FM), lean mass (LM), and wobbling mass (WM) of living people from simple anthropometric measures (segment lengths, circumferences, breadths, and skin folds) have been reported in the literature for the lower extremities, but are lacking for the upper extremities. Multiple linear stepwise regression was used to generate such equations for

Katherine L. Arthurs; David M. Andrews

2009-01-01

58

Incidence and prevalence of complaints of the neck and upper extremity in general practice  

PubMed Central

Objective: To study the incidence and prevalence of neck and upper extremity musculoskeletal complaints in Dutch general practice. Methods: Data were obtained from the second Dutch national survey of general practice. In all, 195 general practitioners (GPs) from 104 practices across the Netherlands recorded all contacts with patients during 12 consecutive months. Incidence densities and consultation rates were calculated. Results: The total number of contacts during the registration period of one year was 1 524 470. The most commonly reported complaint was neck symptoms (incidence 23.1 per 1000 person-years), followed by shoulder symptoms (incidence 19.0 per 1000 person-years). Sixty six GP consultations per 1000 person-years were attributable to a new complaint or new episode of complaint of the neck or upper extremity (incidence density). In all, the GPs were consulted 147 times per 1000 registered persons for complaints of the neck or upper extremity. For most complaints the incidence densities and consultation rates were higher for women than for men. Conclusions: Neck and upper extremity symptoms are common in Dutch general practice. The GP is consulted approximately seven times each week for a complaint relating to the neck or upper extremity; of these, three are new complaints or new episodes. Attention should be paid to training GPs to deal with neck and upper limb complaints, and to research on the prognosis and treatment of these common complaints in primary care. PMID:15608309

Bot, S; van der Waal, J M; Terwee, C; van der Windt, D A W M; Schellevis, F; Bouter, L; Dekker, J

2005-01-01

59

Upper and Lower Extremity Motor Performance and Functional Impairment in Alzheimer’s Disease  

PubMed Central

This report examines the relation of upper and lower extremity motor performance to functional impairment among 371 persons with probable AD. Cognitive and motor performance tests were administered at 6-month intervals for up to four years. Motor performance was assessed using three lower extremity tests and two upper extremity tests. Functional impairment was measured at 3-month intervals using caregiver ratings of impairments in activities of daily living, mobility and range of motion. Both lower and upper extremity performance were inversely related to functional impairments on all three scales (all ps < .001), after controlling for age, sex, and level of cognitive impairment. This suggests that motor performance contributes to functional impairments in AD, independent of cognitive impairment. It is important to preserve motor performance in individuals with AD because it influences physical function throughout the course of the disease. PMID:20484749

Hebert, Liesi E.; Bienias, Julia L.; McCann, Judith J.; Scherr, Paul A.; Wilson, Robert S.; Evans, Denis A.

2011-01-01

60

Upper and lower extremity motor performance and functional impairment in Alzheimer's disease.  

PubMed

This report examines the relation of upper and lower extremity motor performance to functional impairment among 371 persons with probable Alzheimer's disease (AD). Cognitive and motor performance tests were administered at 6-month intervals for up to 4 years. Motor performance was assessed using 3 lower extremity tests and 2 upper extremity tests. Functional impairment was measured at 3-month intervals using caregiver ratings of impairments in activities of daily living, mobility, and range of motion. Both lower and upper extremity performance were inversely related to functional impairments on all 3 scales (all Ps < .001), after controlling for age, sex, and level of cognitive impairment. This suggests that motor performance contributes to functional impairments in AD, independent of cognitive impairment. It is important to preserve motor performance in individuals with AD because it influences physical function throughout the course of the disease. PMID:20484749

Hebert, Liesi E; Bienias, Julia L; McCann, Judith J; Scherr, Paul A; Wilson, Robert S; Evans, Denis A

2010-08-01

61

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

62

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

63

Isometric contraction of an upper extremity and its effects on the contralateral lower extremity.  

PubMed

[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

2014-11-01

64

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

65

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

66

Upper-Extremity Stroke Therapy Task Discrimination Using Motion Sensors and Electromyography  

Microsoft Academic Search

Brain injury resulting from stroke often causes upper-extremity motor deficits that limit activities of daily living. Several therapies being developed for motor rehabilitation after stroke focus on increasing time spent using the extremity to promote motor relearning. Providing a novel system for user-worn therapy may increase the amount and rate of functional motor recovery. A user-worn system comprising accelerometers, gyroscopes,

Joseph P. Giuffrida; Alan Lerner; Richard Steiner; Janis Daly

2008-01-01

67

Extreme upper level cyclonic vorticity events in relation to the Southern Hemisphere jet stream  

NASA Astrophysics Data System (ADS)

The mean seasonal variation in the frequency of occurrence of extreme upper level cyclonic vorticity events, and its relation to the jet stream, is examined in the Southern Hemisphere. During the austral summer to fall, extreme cyclonic vorticity occurs most frequently at the upper level jet stream core, while during the austral winter to spring, there is a main peak on the poleward flank of the subtropical jet and a secondary peak on the poleward flank of the eddy-driven jet. Composite analysis shows that the extremes in both seasons are associated with wave breaking and the formation of elongated vorticity tongues. In summer, extreme events occur when waves propagating on the eddy-driven jet break nonlinearly, while in winter, extreme events occur when waves on the eddy-driven jet interact with waves on the subtropical jet. In both seasons, these extreme upper level vorticity events are associated with significant positive precipitation anomalies and a pattern of alternating positive and negative surface temperature anomalies.

Harnik, N.

2014-06-01

68

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

69

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

Microsoft Academic Search

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

Paul J. Vasta; George V. Kondraske

1994-01-01

70

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

71

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

72

Assessment of Risk Factors of Upper Extremity Musculoskeletal Disorders (UEMSDS) by OCRA Method in Repetitive Tasks  

Microsoft Academic Search

The high occurrence of upper extremity musculoskeletal disorders (UEMSDS) in Iranian ironwork industries indicates a need to assess the risk factors of the disorders at such workplaces. In order to prevent such disorders, the Occupational Re- petitive Actions (OCRA) carried out to obtain an integrated assessment of the various risk factors, classify different jobs and suggest ergonomic designing solutions. Four

SA Moussavi Najarkola

73

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

74

Upper extremity replantation at a regional medical center: a six-year review.  

PubMed

Trauma to the upper extremity can be a cause of significant morbidity and disability to otherwise productive people. Traumatic amputation can be particularly devastating, but many of these extremities can be saved by replanatation of the amputated parts. We reviewed the upper extremity replantations performed at the Medical Center of Central Georgia in the 6-year period from September 1987 to August 1993. A total of 48 replantations in 39 patients (33 male, six female) were studied: 36 fingers, seven thumbs, two transmetacarpals, one wrist, one forearm, and one brachium. Average patient age was 32.7 years, with a range of 4 to 69 years. All seven thumbs, two transmetacarpals, and three proximal replants survived. Viability of replanted fingers was 56 per cent; however, sharp injuries fared better than crush injuries (62% vs 50%). The success rate improved with experience of the surgeon (85% after 1990). Leeches were used effectively for venous congestion in nine of 13 cases (70%). Results were comparable with those of large academic medical institutions. Replantation of traumatic amputations can be performed with reasonable success at a regional medical center if a qualified surgeon and appropriate ancillary care are available. Results improve with experience of the surgeon and careful patient selection. Successful replantation significantly reduces the morbidity of upper extremity amputations and will continue to be important in the management of the trauma patient. PMID:7661486

Troum, S; Floyd, W E

1995-09-01

75

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

76

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

PubMed Central

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

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

2011-01-01

77

Use of intermittent pneumatic compression for treatment of upper extremity vascular ulcers.  

PubMed

Ischemic vascular ulcerations of the upper extremities are an uncommon and frequently painful condition most often associated with scleroderma and small vessel inflammatory diseases. Digital amputation has been advocated as primary therapy because of the poor outcome with medical care. Intermittent pneumatic compression (IPC) pump therapy can improve ulcer healing in lower extremity ischemic ulcerations; however, the value of this treatment in upper extremity ischemic ulcerations is not known. This observational pilot study consisted of a consecutive series of 26 patients with 27 upper extremity ischemic vascular ulcers seen at the Mayo Gonda Vascular Center from 1996 to 2003. Inclusion criteria were documented index of ulcer size and follow-up ulcer size and use of the IPC pump as adjunctive wound treatment. Twenty-six of 27 ulcers (96%) healed with the use of the IPC pump. Mean baseline ulcer size was 1.0 cm2 (SD=0.3 cm2) and scleroderma was the underlying disease in 65% (17/26) of cases. Laser Doppler blood flow in the affected digit was 7 flux units (normal greater than 100). The mean ulcer duration before IPC treatment was 31 weeks. The average pump use was 5 hours per day. The mean time to wound healing was 25 weeks. Twenty-five of 26 patients reported an improvement in wound pain with pump use. Intensive IPC pump use is feasible and associated with a high rate of healing in upper extremity ischemic ulcers. A prospective, randomized, sham-controlled study of IPC is needed to determine whether IPC treatment improves wound healing compared to standard medical care. PMID:16079925

Pfizenmaier, David H; Kavros, Steven J; Liedl, David A; Cooper, Leslie T

2005-01-01

78

Correlations between statistical models of robotically collected kinematics and clinical measures of upper extremity function.  

PubMed

One of the obstacles in the development of rehabilitation robotics has been inadequacy in the measurement of treatment effects due to interventions. A measurement tool that will efficiently produce a large reliable sample of measurements collected during a single session that can also produce a rich set of data which reflects a subject's ability to perform meaningful functional activities has not been developed. This paper presents three linear regression models generated from seven kinematic measures collected during the performance of virtually simulated rehabilitation activities that were integrated with haptic robots by 19 persons with upper extremity hemiparesis due to chronic stroke. One of these models demonstrated a statistically significant correlation with the subjects' scores on the Jebsen Test of Hand Function (JTHF), a battery of six standardized upper extremity functional activities. The second and third models demonstrated a statistically significant correlation with the subjects' change scores on the JTHF. PMID:23366834

Rohafza, Maryam; Fluet, Gerard G; Qiu, Qinyin; Adamovich, Sergei

2012-01-01

79

Upper extremity lymphangiography in the radiation therapy of lymphomas and carcinoma of the breast.  

PubMed

Seventeen bilateral upper extremity lymphangiograms were obtained in patients with lymphoma referred for radiation therapy. The projection of the opacified axillary nodes is analyzed when using the mantle technique in various positions. The position of the lymph nodes varies considerably in the supine and prone positions. Placing pads underneath the shoulders in the prone position allows for better protection of the pulmonary parenchyma while still including the opacified lymph nodes. Because these nodes vary in position, it is recommended that if the axillary nodes are clinically involved or if hilar adenopathy is present, upper extremity lymphangiograms should be obtained to ensure inclusion of all the axillary lymph nodes. In treating carcinoma of the intact breast, care should be taken to include the lower axillary nodes in the tangenital breast field and to include 2 cm of lung in the posterior axillary boost. PMID:830340

Weisenburger, T H; Juillard, G J

1977-01-01

80

Cluster Analysis of Symptoms Among Patients with Upper Extremity Musculoskeletal Disorders  

PubMed Central

Introduction Some musculoskeletal disorders of the upper extremity are not readily classified. The study objective was to determine if there were symptom patterns in self-identified repetitive strain injury (RSI) patients. Methods Members (n = 700) of the Dutch RSI Patients Association filled out a detailed symptom questionnaire. Factor analysis followed by cluster analysis grouped correlated symptoms. Results Eight clusters, based largely on symptom severity and quality were formulated. All but one cluster showed diffuse symptoms; the exception was characterized by bilateral symptoms of stiffness and aching pain in the shoulder/neck. Conclusions Case definitions which localize upper extremity musculoskeletal disorders to a specific anatomical area may be incomplete. Future clustering studies should rely on both signs and symptoms. Data could be collected from health care providers prospectively to determine the possible prognostic value of the identified clusters with respect to natural history, chronicity, and return to work. PMID:20414797

Piligian, George; Glutting, Joseph J.; Hanlon, Alexandra; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2010-01-01

81

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

PubMed Central

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

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

2012-01-01

82

Deep vein thrombosis of the upper extremity: intra- and interobserver study of digital subtraction venography  

Microsoft Academic Search

.   Our objective was to assess the inter-observer and intra-observer agreement in the interpretation of digital subtraction\\u000a venography (DSV) in patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Prospectively, 62 consecutive\\u000a DSV studies in 54 patients with clinically suspected DVTUE were included. Hard copies were presented without demographic data\\u000a or original report. All venograms were read twice,

Henk J. Baarslag; Edwin J. van Beek; Jan G. Tijssen; Otto M. van Delden; Ad J. Bakker; Jim A. Reekers

2003-01-01

83

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

84

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

85

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

86

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

87

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

PubMed

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

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

2013-11-01

88

Exploring expectations for upper extremity motor treatment in people after stroke: A secondary analysis  

PubMed Central

Objective Our purpose was to explore expectations for outcomes during a research intervention for people with stroke. Methods Twelve people with chronic stroke participated in this secondary analysis from a pilot trial of a high repetition, task-specific, upper extremity intervention. First, we examined relationships between individual expectancy and session-by-session achievement of high numbers of repetitions. Second, we examined the relationship between expectancy for the intervention as a whole and improvements in upper extremity motor function. Spearman rank correlation coefficients were used to evaluate the relationships. Results Correlations between individual expectancy and session-by-session achievement ranged from 0.0 to 0.84. Expectancy for improvement from the intervention was good (ave. = 7/10), but had a low correlation (0.17) with actual improvement. Conclusions Individual expectancy ratings were inconsistently related to session-by-session achievement. Expectancy for the invention as a whole was not related to improvement in upper extremity motor function. PMID:21834459

Prager, Eliza M.; Birkenmeier, Rebecca L.; Lang PT, Catherine E.

2011-01-01

89

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

90

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

91

Finney flexirod prosthesis.  

PubMed

The experience gained from the implantation of 763 Flexirod Prosthesis is described. Special features of this design include a tapered distal tip which provides for better glans stability, a soft hinge which allows for improved penile concealment, and a trimmable tail which, together with preoperative measurement of the penis, allows the surgeon to determine the correct prothesis size well in advance of surgery. The surgical procedure is not difficult, the complication rate is low, device failure is extremely rare, and most patients are restored to a satisfactory sex life. PMID:6539030

Finney, R P

1984-05-01

92

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

93

Upper-extremity stroke therapy task discrimination using motion sensors and electromyography.  

PubMed

Brain injury resulting from stroke often causes upper-extremity motor deficits that limit activities of daily living. Several therapies being developed for motor rehabilitation after stroke focus on increasing time spent using the extremity to promote motor relearning. Providing a novel system for user-worn therapy may increase the amount and rate of functional motor recovery. A user-worn system comprising accelerometers, gyroscopes, and electromyography amplifiers was used to wirelessly transmit motion and muscle activity from normal and stroke subjects to a computer as they completed five upper-extremity rehabilitation tasks. An algorithm was developed to automatically detect the therapy task a subject performed based on the gyroscope and electromyography data. The system classified which task a subject was attempting to perform with greater than 80% accuracy despite the fact that those with severe impairment produced movements that did not resemble the goal tasks and were visually indistinguishable from different tasks. This developed system could potentially be used for home-therapy compliance monitoring, real-time patient feedback and to control therapy interventions. PMID:18303809

Giuffrida, Joseph P; Lerner, Alan; Steiner, Richard; Daly, Janis

2008-02-01

94

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

PubMed

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 curves and cortical silent periods in the first dorsal interosseus muscle of each hand. Five trials would have provided accurate estimates of the MEP amplitude and silent period duration for the unlesioned side in all patients, but 25% of the datasets from the lesioned side provided poor estimates of MEP amplitude even with 10 trials. Intraclass correlations were >0.70 for all parameters obtained from the lesioned side and for the MEP amplitude, slope of the recruitment curve, silent period, and silent period slope from the unlesioned side. MEP amplitude varied across sessions within subject by 20% on both sides, whereas other parameters showed less variability on the unlesioned side relative to the lesioned side. The Fugl-Meyer upper extremity motor score and the time to complete the 6 fine-motor items from the Wolf Motor Function Test (WMFT) were also found to be highly reliable over this interval. We conclude that the functional and most of the excitability parameters are reliable across time in patients with variable lesions due to stroke. Due to high intrasubject variability, the use of some excitability parameters as indicators of functional neuroplasticity in response to treatment may be limited to interventions with large effect sizes. PMID:17303273

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

2007-05-01

95

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

96

Assessment of the relationship between Quality of Life and Upper Extremity Impairment Due to Occupational Injuries  

PubMed Central

Background: Severe upper extremity injuries can affect the quality of life in patients and cause multi-factorial and long-term costs of disease. The aim of this study was to assess quality of life in patients with upper extremity injuries caused by work-related accidents. Methods: In this study cross-sectional method was used in patients referred to the Occupational medicine Clinic of Rasoul Akram Hospital to determine their impairments. Patient's information including demographic variables, calculation of the impairment rate based on AMA Guide book (in terms of WPI), returning to work, and location of injury, work experience and type of injury. Then the quality of their life was assessed and interpreted using SF36 questionnaire. Results: 203 patients were evaluated. Different aspects of the patients’ life were not associated with age, gender and education of patients based on The SF-36 questionnaire. There was an inverse relationship between the percentage of patients’ impairment and different aspects of life quality; there were also a significance correlation between impairment rate and physical performance of patients (p<0.001, r= -0.26), social performance of patients (p= 0.001, r= -0.24), pain (p= 0.005, r= -0.2), emotional health of patients (p= 0.006, r= -0.29), energy / fatigue in patients (p<0.001, r= -0.29) and the patient's general health (p<0.001, r= -0.27). Conclusion: This study shows that upper extremity impairment due to occupational injuries has an inverse and significant association with various aspects of quality of life. PMID:25250260

Golchin, Mahdie; Attarchi, Mirsaeed; Mirzamohammadi, Elham; Ghaffari, Mostafa; Mohammadi, Saber

2014-01-01

97

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

98

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

99

Takeoff forces transmitted to the upper extremity during water-skiing.  

PubMed

As data were unavailable, this study quantified the forces acting on the upper extremities during water-skiing takeoff in 10 male volunteers (mean age: 28 years). Body weight ranged between 141 and 195 lbs. Low, medium, and full-power takeoffs were used to propel each skier out of the water. Although low-power takeoffs produced significantly less peak force (P < or = .0004), they yielded a trend toward greater time under load (P = .097). As the data suggest that forces assume roughly one and one-half times body weight, individuals with pre-existing shoulder morbidity may risk exacerbation of their condition. PMID:12875566

Keverline, Jeffrey P; Englund, Richard; Cooney, Timothy E

2003-07-01

100

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

101

Psychosocial factors and the rehabilitation of patients with chronic work-related upper extremity disorders  

Microsoft Academic Search

This prospective cohort study investigated the effects of psychosocial factors on long-term employment outcome of a sample\\u000a of chronic work-related upper-extremity pain disorder patients who had completed an interdisciplinary functional restoration\\u000a program. Factors examined included the following: DSM-III-R Axis I and Axis II diagnoses, derived from the Structured Clinical\\u000a Interview for DSM-III-R (SCID); history of childhood abuse experienced as elicited

Kathy Burton; Peter B. Polatin; Robert J. Gatchel

1997-01-01

102

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

PubMed Central

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

Shim, Sunhwa; Kim, Hee; Jung, Jinhwa

2014-01-01

103

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

PubMed Central

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

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

2014-01-01

104

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

105

EVALUATION OF RISK FACTORS ASSOCIATED WITH WORK-RELATED MUSCULOSKELETAL DISORDERS OF UPPER LIMBS EXTREMITY AMONG PRESS WORKERS  

Microsoft Academic Search

Objective: Exposure assessment of individual press workers to risk factors associated with work-related upper extremity muscoluskeletal disorders (UEMSDs). Design: This was a workplace field based, descriptive and analytical study. Place and duration: The study was conducted in presswork shops of an automobile manufacturing industry in Tehran, Iran during 2004-2005. Patients and Methods: Nordic Musculoskeletal Questionnaire (NMQ) and Rapid Upper Limb

Mohammad Pourmahabadian; Kamal Azam

106

"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

107

Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators.  

PubMed

Typing is associated with musculoskeletal complaints (MSCs), caused by multiple risk factors. Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC's, only few of them were found evidence based. This study aimed to test the efficacy of a workplace intervention in reducing MSC's among computer workers. 66 computer workers were assigned randomly to one of three intervention programs: ergonomic intervention including biofeedback, intervention without biofeedback and control group without intervention. The efficacy was tested by advanced assessment including; pain location and severity, posture at work, upper extremity 3D kinematics, muscle activity and psychosocial status. Working hypothesis; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures: pain complaints, upper extremity kinematics, muscle activity and psychosocial status. Significant differences were found between pre and post intervention and between research groups and the control group in pain, posture and motion. The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions. In conclusion; the proposed intervention program was found efficient for reducing pain among computer workers. PMID:22316799

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

2012-01-01

108

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

PubMed

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

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

2013-09-01

109

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

110

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

PubMed Central

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

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

2012-01-01

111

Treatment of giant congenital melanocytic nevus of the left upper extremity with staged expanded flap.  

PubMed

Excision of a congenital giant nevus is advised due to the possibility of it degenerating into a malignant melanoma or for aesthetic concerns. Tissue expansion has emerged as the primary treatment of giant congenital nevi because it enables the body to produce extra skin with excellent texture, better colour match, less severe donor-site deformity and repeated usage of an expanding donor-site. We present a multi-staged expansion/local flap technique to treat a case of a circumferential nevus from the acromioclavicular joint and axillary area throughout the upper extremity excluding the hand. The affected skin was approximately 10% of the total body surface area. The patient underwent eight operations and a total of 11 rounds of tissue expansions (500 cc × 9 rounds, 600 cc × 1 round, 300 cc × 1 round) were completed over a 2-year period prior to the removal of the nevus. A good aesthetic and functional outcome in the left upper extremity was gained. It is recommended that the treatment of giant nevi is best if completed at preschool age after taking several factors into consideration. PMID:21795129

Liu, Yufeng; Huang, Jinlong; Wen, Ke; Liu, Ning; Wang, Jinming

2012-02-01

112

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

PubMed Central

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

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

2013-01-01

113

Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity  

PubMed Central

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

Mirza, Farheen; Brown, Anthony R.

2011-01-01

114

Understanding work-related upper extremity disorders: clinical findings in 485 computer users, musicians, and others.  

PubMed

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 time between the onset of symptoms and our initial visit ranged from 2 weeks to over 17 years. A majority sought care within 30 months with the greatest number of them seeking care before 12 months. Fifty nine percent of subjects were still working when seen despite increasing pain and symptoms such as weakness, numbness, tingling, and stiffness. Following a history, a physical assessment utilizing commonly employed clinical tests were performed including evaluation of joint range of motion, hyperlaxity, muscle tenderness, pain, strength, and imbalance. Neurologic tests included Tinel's sign performed in wrist, elbow, tricipital sulcus, and neck and tests for thoracic out syndrome (TOS). Specific tests such as Finkelstein's test for deQuervain's tenosynovitis, Phalen's test for carpal tunnel syndrome and grip strengths were included in the examination protocol. Significant findings included postural misalignment with protracted shoulders (78%), head forward position (71%), neurogenic TOS (70%), cervical radiculopathy (0.03%), evidence of sympathetic dysfunction (20%), and complex regional pain syndrome (RSD) (0.6%). Hyperlaxity of fingers and elbows was found in over 50%, carpal tunnel syndrome in 8%, radial tunnel syndrome in 7%, cubital tunnel in 64%, shoulder impingement in 13%, medial epicondylitis in 60%, lateral epicondylitis in 33%, and peripheral muscle weakness in 70%. We conclude that despite initial presentation distally, work-related upper-extremity disorders are a diffuse neuromuscular illness with significant proximal upper-body findings that affect distal function. While neurogenic TOS remains a controversial diagnosis, the substantial number of patients with positive clinical findings in this study lends weight to the concept that posture related neurogenic TOS is a key factor in the cascading series of physical events that characterize this illness. A comprehensive upper-body examination produces findings that cannot be obtained through laboratory tests and surveys alone and lays the ground work for generating hypotheses about the etiology of work related upper-extremity disorders that can be tested in controlled investigations. PMID:11706773

Pascarelli, E F; Hsu, Y P

2001-03-01

115

[Variations in the intraoral electromotive force in the electrotherapy of the upper extremities].  

PubMed

We tested the intraoral microwaves under applied electrotherapy in cephalic neuralgia. The tests have been undertaken on 40 patients divided in 4 groups, according to the nature of the metallic components of the prosthetic appliances. There have been withdrawn practical conclusions regarding fixed prosthesis and the use of electrotherapy in the cephalic neuralgia. PMID:9455353

Patra?, E; Vataman, M; Sorin, A; Patra?, A

1995-01-01

116

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

117

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

PubMed

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

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

2014-01-01

118

[Pathomechanogenesis of contractures and deformities of the upper extremities in children with cerebral palsy].  

PubMed

The authors carried out dynamic observation of 180 children aged 3-14 with infantile cerebral paralysis (ICP) who were treated for pronation flexion contractures of the forearm and of the hand, studied up to 45 values connected with the age of the patients, terms of appearance of the symptoms of the disease, subsequently processed the results of their investigations employing methods of analysis of variance, non-linear correlation and regression analysis and constructed analytical models of development of the pathologic process, which allowed to draw the following conclusions. Pathomechanogenesis of disturbances of the upper extremity in ICP includes primary muscular disbalance, successive formation of faulty postures, pathologic locomotor stereotype, vegetotrophic disturbances, contractures of the joint and anatomical changes of the skeleton. These changes are closely correlated with the age of the patients and according to the degree of the disturbances may be regarded as stages of the disease. PMID:2717166

Rutski?, V V; Nen'ko, A M

1989-01-01

119

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

120

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

121

[Experience with the treatment of combined open injuries to the upper extremities with affected main arteries].  

PubMed

The paper deals with the principles of management of combined mechanical injuries to the upper extremities with special reference to amputation of their segments based on the 3-year experience with the treatment of 1488 patients including 405 ones with traumatic amputations. Replantation of large and small segments was undertaken in 24 and 76% of the cases respectively. 43% of the patients underwent one-step traumatic amputation of two and more segments. Skin and soft tissue defects occurred in 111 patients including 27 with extensive lesions. 82.4% of the surgical interventions had the desired outcome. An example of successful replantation is described. The results are compared with the literature data. PMID:21395091

Asamov, P É; Minaev, T R; Akhmedov, R A; Iuldashev, A A; Nizov, O N; Khakimov, A B

2011-01-01

122

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

123

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

PubMed Central

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

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

2004-01-01

124

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

PubMed Central

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

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

2008-01-01

125

Cortical reorganization after macroreplantation at the upper extremity: a magnetoencephalographic study.  

PubMed

With the development of microsurgical techniques, replantation has become a feasible alternative to stump treatment after the amputation of an extremity. It is known that amputation often induces phantom limb pain and cortical reorganization within the corresponding somatosensory areas. However, whether replantation reduces the risk of comparable persisting pain phenomena as well as reorganization of the primary somatosensory cortex is still widely unknown. Therefore, the present study aimed to investigate the potential development of persistent pain and cortical reorganization of the hand and lip areas within the sensory cortex by means of magnetoencephalographic dipole analyses after replantation of a traumatically amputated upper limb proximal to the radiocarpal joint. Cortical reorganization was investigated in 13 patients with limb replantation using air puff stimulation of the phalanges of both thumbs and both corners of the lower lip. Displacement of the centre of gravity of lip and thumb representations and increased cortical activity were found in the limb and face areas of the primary somatosensory cortex contralateral to the replanted arm when compared to the ipsilateral hemisphere. Thus, cortical reorganization in the primary somatosensory cortex also occurs after replantation of the upper extremity. Patients' reports of pain in the replanted body part were negatively correlated with the amount of cortical reorganization, i.e. the more pain the patients reported, the less reorganization of the subjects' hand representation within the primary somatosensory cortex was observed. Longitudinal studies in patients after macroreplantation are necessary to assess whether the observed reorganization in the primary somatosensory cortex is a result of changes within the representation of the replanted arm and/or neighbouring representations and to assess the relationship between the development of persistent pain and reorganization. PMID:24480484

Blume, Kathrin R; Dietrich, Caroline; Huonker, Ralph; Götz, Theresa; Sens, Elisabeth; Friedel, Reinhard; Hofmann, Gunther O; Miltner, Wolfgang H R; Weiss, Thomas

2014-03-01

126

Use of an algorithm for assessment and treatment of the upper extremity post stroke: a case study.  

PubMed

ABSTRACT The objective of this study was to identify movement impairments and plan effective treatments using an evidence-based algorithm. A single subject case study was completed to demonstrate the application of the Neurologic Upper Extremity Recovery Algorithm (NUERA), which integrates the analysis of patient alignment, along with movement of the trunk, ribcage and scapula. The Action Research Arm Test (ARAT) was used for standardized assessment and to assist in analyzing the patient's movement along with the nonstandardized clinicians assessment of movement. Using the NUERA, the patient's upper extremity control improved as demonstrated by a 78% improvement in the ARAT score from a 27 at initial assessment to 48 (57 possible) following 2 months of treatment, along with the achievement of the patient's goals. Use of the NUERA for the assessment and treatment of the upper extremity poststroke has promising utility. PMID:25321406

Ouellette, Debra S; Okamoto, Susie Wong; Rosario, Emily R

2015-01-01

127

A prospective study for upper-extremity cumulative trauma disorders of workers in aircraft manufacturing.  

PubMed

Occupational diseases affect 15 to 20% of all Americans. Cumulative trauma disorders (CTDs) account for 56% of all occupational injuries. The recognition and control of occupational injuries has become a major concern of employees, employers, medicine, and the federal government because of health risk and related costs. Upper-extremity CTDs are identified by the National Institute for Occupational Safety and Health as one of the ten most significant occupational health problems in the United States. It is estimated by the year 2000 that 50 cents on the dollar will be spent on CTDs. Although enlightened aircraft employers have developed primary prevention strategies, primary prevention can never be expected to eliminate 100% of the cases. To evaluate several preventive activities, a CTD risk-assessment program was developed and implemented in cooperation with a major aircraft manufacturer employing over 8000 workers. This program was focused on objectively identifying the relationship of work and other activities to an individual worker experiencing CTDs. Early identification has been linked, when applicable, to intervention algorithms for medical care, job task modification, workplace accommodation, and training. A prospective study group of 212 workers who used rivet guns was placed into a four-way experimental design for ergonomic posture training, exercise training, and rivet-gun type (primary factors). A statistical model was developed for the level of CTD risk and evaluated using the SAS software program (SAS Institute, Inc, Carry, NC). Statistical analysis of the primary factors without regard to associated variables (covariates) demonstrated that only posture training had a beneficial risk reduction for the individual. The impact (beneficial or detrimental) for exercise training and for vibration-dampening rivet guns was probably obscured because of the large variability of the responses regarding the associated variables (covariates). When the covariates were analyzed in conjunction with the four experimental groups, a positive benefit from ergonomic posture training and exercise training was demonstrated for the following groups: the dominant han, time spend in an awkward position, number of standard rivets bucked, number of parts routed, number of parts ground, number of vibration-dampening rivets bucked, and newly hired individuals. A negative effect (increase in individual risk level) for current employees using a vibration-dampening rivet gun was demonstrated. This prospective study helps to identify the possible benefit of education and training for controlling CTDs and demonstrates the usefulness of being able to evaluate materials, methods, machines, and environments as they relate to the individual's risk level for the development of upper-extremity CTDs. PMID:8978519

Melhorn, J M

1996-12-01

128

Evaluation of quantitative measures of upper extremity speed and coordination in healthy persons and in three patient populations.  

PubMed

Upper extremity tracking tests have been used extensively in clinical studies in patients with neurologic disorders. We evaluated several new measures of upper extremity performance derived from step-response and phase-plane analysis techniques; both techniques are founded in automatic control theory. Using a computer-based tracking test, a visual step function stimulus was applied in 15 healthy subjects and 45 patients from multiple sclerosis, myasthenia gravis, and Parkinson disease populations. The upper extremity response of the subject was analyzed to find the reliability and discriminating power measures that quantify speed, coordination, and steadiness of the upper extremity response during the tracking task. Results show that reliability of the measures, although variable across the populations tested, is generally high (greater than 0.7). The speed and coordination measures derived from phase-plane analysis are more discriminating than the measures of step-response analysis for the populations tested. Some of the measures may be useful for monitoring patient performance, the other measures can be potentially helpful in diagnosis of the disorders. PMID:2302042

Behbehani, K; Kondraske, G V; Tintner, R; Tindall, R A; Imrhan, S N

1990-02-01

129

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

130

Impact of a joint labor-management ergonomics program on upper extremity musculoskeletal symptoms among garment workers  

Microsoft Academic Search

This study evaluated the effect of an ergonomics intervention program on the prevalence and intensity of symptoms of upper extremity work-related musculoskeletal disorders among 36 garment workers performing an operation called spooling. Adjustable chairs were introduced and workers were trained in their use. Symptom surveys were administered prior to and 6 months after introduction of adjustable chairs. Quantitative pre- and

Robin Herbert; Jonathan Dropkin; Nick Warren; Darius Sivin; John Doucette; Laurie Kellogg; Judith Bardin; Dan Kass; Steve Zoloth

2001-01-01

131

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

132

OrthoJacket: an active FES-hybrid orthosis for the paralysed upper extremity.  

PubMed

The loss of the grasp function in cervical spinal cord injured (SCI) patients leads to life-long dependency on caregivers and to a tremendous decrease of the quality of life. This article introduces the novel non-invasive modular hybrid neuro-orthosis OrthoJacket for the restoration of the restricted or completely lost hand and arm functions in high tetraplegic SCI individuals. The primary goal of the wearable orthosis is to improve the paralysed upper extremity function and, thus, to enhance a patient's independence in activities of daily living. The system combines the advantage of orthotics in mechanically stabilising joints together with the possibilities of functional electrical stimulation for activation of paralysed muscles. In patients with limited capacity, for force generation, flexible fluidic actuators are used to support the movement. Thus, the system is not only intended for functional restoration but also for training. Several sensor systems together with an intelligent signal processing allow for automatic adaptation to the anatomical and neurological individualities of SCI patients. The integration of novel user interfaces based on residual muscle activities and detection of movement intentions by real-time data mining methods will enable the user to autonomously control the system in a natural and cooperative way. PMID:21210758

Schill, Oliver; Wiegand, Roland; Schmitz, Bastian; Matthies, Richard; Eck, Ute; Pylatiuk, Christian; Reischl, Markus; Schulz, Stefan; Rupp, Rüdiger

2011-02-01

133

New perspectives on improving upper extremity function after spinal cord injury.  

PubMed

Injury to the cervical spinal cord adversely affects arm and hand function to varying degrees depending on the level and severity of injury. These impairments typically result in reduced independence in the performance of activities of daily living and limit participation in recreational activities. There is evidence to suggest individuals with incomplete spinal cord injury may benefit from intensive rehabilitation interventions aimed at improving hand and arm function. Massed practice (repetitive activity-based training) and somatosensory stimulation (prolonged peripheral nerve electrical stimulation at submotor threshold intensity) are 2 interventions that have been shown to improve strength and function in individuals with stroke, presumably by changing cortical excitability. These techniques, however, had not previously been investigated in individuals with spinal cord injury (SCI). In this article the stroke and SCI literature supporting the use of massed practice and somatosensory stimulation as a potential rehabilitative tool to promote recovery of function in individuals with incomplete cervical spinal cord injury (SCI) is reviewed. Recently published research using these novel techniques in which a combination of massed practice and somatosensory stimulation resulted in increased pinch grip strength and upper extremity function in individuals with incomplete cervical SCI when compared to subjects participating in massed practice alone is presented. PMID:16398948

Beekhuizen, Kristina S

2005-09-01

134

[The facilitation and inhibition of monosynaptic reflexes in the upper extremity of nursing infants].  

PubMed

The upper extremity H-reflex was investigated in healthy children, aged from 3 to 15 months. The electromyographic reflex responses of m. abduct or digiti min. and m. flexor carpi uln. were registered after electric stimulation of n. ulnaris. We constructed the curve of restoration of H-reflex after application of a couple of stimuli with equal duration and intensity, but over increasing intervals. We established changes in the excitation of H-reflex, obtained from m. flexor carpi uln., by increasing of the interval between the conditional and test stimuli. In the interval of 5 ms maximal facilitation was registered, while in the interval of 20 and 30 ms-maximal inhibition. In children aged from 3 to 9 months with persisting H-reflex in m. abductor digit min. we established possibility for its complete inhibition after application of a couple of stimuli with interval of 20 ms. In children aged from 9 to 15 months with vanished H-reflex in m. abductor digiti min. possibility for its obtaining was established after application of a couple of stimuli with interval of 5 ms. Quotation is made of evidences in favour of the hypothesis for the functional character of the disappearance of H-reflex in the small muscles of the arm in the first year of life of the children. PMID:8258317

Gatev, V; Angelova, B; Litvinenko, I

1993-01-01

135

Solitary necrobiotic xanthogranuloma of an upper extremity in association with multiple myeloma.  

PubMed

Necrobiotic xanthogranuloma (NXG) is an uncommon granulomatous disorder of unknown pathogenesis that often presents with yellowish plaques in a periorbital distribution. While a majority of cases are associated with an underlying paraproteinemia of the IgG kappa type, a much smaller number are found to be associated with an underlying multiple myeloma. We present a case of a 78-year-old male with an isolated lesion of NXG on his right upper extremity. Following his diagnosis of NXG, further investigation for underlying systemic disorders with serum immunofixation revealed a monoclonal IgG kappa immunoglobulin with an M-spike of 1.2 g/dL. A PET-CT demonstrated bone destruction in the left proximal fifth rib, left scapula, the anterior lumbar I (L1) vertebrae, the left lumbar III (L3) vertebrae posterior elements and possibly left sacrum. A bone marrow biopsy revealed 18 % plasma cells. With these findings he was diagnosed with stage I multiple myeloma. Though clinically unimpressive and atypical in location for NXG, early biopsy and diagnosis of this solitary lesion led to the discovery of his hematopoietic disorder. PMID:24809886

Bain, E Eugene; Meehan, Shane A; Hale, Elizabeth K

2014-05-01

136

Feasibility of EMG-Based Neural Network Controller for an Upper Extremity Neuroprosthesis  

PubMed Central

The overarching goal of this project is to provide shoulder and elbow function to individuals with C5/C6 Spinal Cord Injury (SCI) using functional electrical stimulation (FES), increasing the functional outcomes currently provided by a hand neuroprosthesis. The specific goal of this study was to design a controller based on an artificial neural network (ANN) that extracts information from the activity of muscles that remain under voluntary control sufficient to predict appropriate stimulation levels for several paralyzed muscles in the upper extremity. The ANN was trained with activation data obtained from simulations using a musculoskeletal model of the arm that was modified to reflect C5 SCI and FES capabilities. Several arm movements were recorded from able-bodied subjects and these kinematics served as the inputs to inverse dynamic simulations that predicted muscle activation patterns corresponding to the movements recorded. A system identification procedure was used to identify an optimal reduced set of voluntary input muscles from the larger set that are typically under voluntary control in C5 SCI. These voluntary activations were used as the inputs to the ANN and muscles that are typically paralyzed in C5 SCI were the outputs to be predicted. The neural network controller was able to predict the needed FES paralyzed muscle activations from “voluntary” activations with less than a 3.6% RMS prediction error. PMID:19211327

Hincapie, Juan Gabriel; Kirsch, Robert F.

2013-01-01

137

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; Lichter, Matthew; Krepkovich, Eileen; Ellington, Allison; White, Marga; Diamond, Paul

2014-09-24

138

Objective quantification of upper extremity motor functions in Unified Parkinson's Disease Rating Scale Test.  

PubMed

Two tri-axial accelerometers were placed on the wrists (one on each hand) of the patients with Parkinson's disease (PD) and a non-PD control group. Subjects were asked to perform three of the upper extremity motor function tasks from the Unified Parkinson's Disease Rating Scale (UPDRS) test. The tasks were: 1) finger tapping, 2) opening and closing of palms, and 3) pronation-supination movements of the forearms. The inertia signals were wirelessly received and stored on a computer for further off-line analysis. Various features such as range, standard deviation, entropy, time to accomplish the task, and maximum frequency present in the signal were extracted and compared. The results showed that among the studied population, "standard deviation", "range", "entropy", "time" and "max frequency" are the best to worst features, respectively, to distinguish between the non-PD and PD subjects. Furthermore, using the mentioned features, it is more probable to distinguish between the non-PD and PD subjects from tasks 2 and 3 as opposed to task 1. PMID:25571201

Xiaoqing Jia; Duroseau, Nathalie; Chan, Vivian; Ciraco, Christina; Rui Wang; Nia, Sarah Mostafa; Ho, Kayla; Govindavari, John P; Delgosha, Farshid; Chan, Thomas; Pergament, Kathleen Mangunay; Krishnamachari, Bhuma; Farajidavar, Aydin

2014-08-01

139

Increase in upper extremity fractures in young male soccer players in the Netherlands, 1998-2009.  

PubMed

Young male soccer players have been identified as a target group for injury prevention, but studies addressing trends and determinants of injuries within this group are scarce. The goal of this study was to analyze age-specific trends in hospital-treated upper extremity fractures (UEF) among boys playing soccer in the Netherlands and to explore associated soccer-related factors. Data were obtained from a national database for the period 1998-2009. Rates were expressed as the annual number of UEF per 1000 soccer players. Poisson's regression was used to explore the association of UEF with the number of artificial turf fields and the number of injuries by physical contact. UEF rates increased significantly by 19.4% in boys 5-10?years, 73.2% in boys 11-14?years, and 38.8% in boys 15-18?years old. The number of injuries by physical contact showed a significant univariate association with UEF in boys 15-18?years old. The number of artificial turf fields showed a significant univariate association with UEF in all age groups, and remained significant for boys aged 15-18?years in a multivariate model. This study showed an increase of UEF rates in boys playing soccer, and an independent association between artificial turf fields and UEF in the oldest boys. PMID:24990273

de Putter, C E; van Beeck, E F; Burdorf, A; Borsboom, G J J M; Toet, H; Hovius, S E R; Selles, R W

2014-07-01

140

User perceptions of gaming interventions for improving upper extremity motor function in persons with chronic stroke.  

PubMed

Finding ways to engage patients with stroke in repetitive intervention protocols long-term is poorly understood, particularly from the patients' perspective. Limited information exists that combines clinical expertise as well as user feedback on improving gaming interaction. The purpose of this study was to utilize input from focus groups of gaming intervention users with chronic stroke to identify characteristics of gaming that influence user/patient engagement in the activity. Two focus groups (n = 10) were conducted with each group participant playing two different gaming systems. Following exposure to the two systems, guided group interview sessions occurred that consisted of open-ended questions encompassing areas of overall gaming system preference, aspects that were liked or disliked, background appearance, music options, feedback provided, as well as recommendations for change. Findings revealed that participants enjoyed playing the gaming systems. Three primary themes emerged differentiating the systems: (1) musical encouragement; (2) focus and attention; and (3) motivation provided by performance feedback. It was concluded that when selecting a gaming system for upper extremity rehabilitation, a clinician should select a system that provides user-relevant music options with a modifiable background appearance for progression from basic to more challenging, providing appropriate feedback in an effort to encompass to a variety of user performance levels. PMID:22924427

Finley, Margaret; Combs, Stephanie

2013-04-01

141

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

142

Upper extremity resurfacing via an expanded latissimus dorsi musculocutaneus flap for large circumferential defects: the “spiral” reconstruction technique  

PubMed Central

We present an expanded latissimus dorsi musculocutaneus (LDMC) flap to treat circumferential upper extremity defects via resurfacing and “spiral reconstruction” in 5 patients during a 17-year period. Five patients with different indications for tissue expansion from burns to congenital hairy nevi were operated. The expansion was done in a longitudinal direction, and a rectangular tissue expander (TE) was inserted under the LD muscle to expand the flap in a longitudinal direction thereby forming a “long” flap rather than a “wide” one. After excising the circumferential lesion, the expanded “elongated” flap was wrapped spirally around the extremity to cover the defect; the donor site was closed as usual. The 5 patients we treated via LDMC flaps in a spiral fashion were free of complications, and all were satisfied with the outcome. All the flaps survived and the spiral reconstruction allowed for a tension-free donor site closure and near complete recipient coverage. This technique is indicated for large circumferential extremity skin defects and deformities. Application of expanded LDMC flaps in a spiral fashion can be used by the reconstructive surgeon to resurface large circumferential upper extremity lesions when indicated. The idea of a long and thinned expansion flap must be in a longitudinal direction and we need this long expanded and thin flap to “spiral” it around the extremity to cover a large defect. The “spiral” flap coverage introduced here for large circumferential extremity defects enables the surgeon to cover the defect with simultaneous donor site closure and good results. PMID:21286355

Nazerani, Shahram; Keramati, Mohammad Reza; Nazerani, Tara

2010-01-01

143

Validation of a new test that assesses functional performance of the upper extremity and neck (FIT-HaNSA) in patients with shoulder pathology  

Microsoft Academic Search

BACKGROUND: There is a lack of standardized tests that assess functional performance for sustained upper extremity activity. This study describes development of a new test for measuring functional performance of the upper extremity and neck and assesses reliability and concurrent validity in patients with shoulder pathology. METHODS: A series of developmental tests were conducted to develop a protocol for assessing

Joy C MacDermid; Myriam Ghobrial; Karine Badra Quirion; Mélanie St-Amour; Tanya Tsui; Dave Humphreys; John McCluskie; Eddy Shewayhat; Vickie Galea

2007-01-01

144

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

145

Muscle fatigue does not lead to increased instability of upper extremity repetitive movements  

PubMed Central

Muscle fatigue alters neuromuscular responses. This may lead to increased sensitivity to perturbations and possibly to subsequent injury risk. We studied the effects of muscle fatigue on movement stability during a repetitive upper extremity task. Twenty healthy young subjects performed a repetitive work task, similar to sawing, synchronized with a metronome before and after performing each of two fatiguing tasks. The first fatigue task (“LIFT”) primarily fatigued the shoulder flexor muscles, while the second fatigue task (“SAW”) fatigued all of the muscles of the arm. Subjects performed each task in random order on two different days at least seven days apart. Instantaneous mean EMG frequencies (IMNF) decreased over both fatiguing tasks indicating that subjects did experience significant muscle fatigue. The slopes of the IMNF over time and the decreases in maximum force measurements demonstrated that the LIFT fatigue task successfully fatigued the shoulder flexors to a greater extent than any other muscle. On average, subjects exhibited more locally stable shoulder movements after the LIFT fatigue task (p = 0.035). They also exhibited more orbitally stable shoulder (p = 0.021) and elbow (p = 0.013) movements after the SAW fatigue task. Subjects also had decreased cocontraction at the wrist post-fatigue for both tasks (p = 0.001) and at the shoulder (p < 0.001) for the LIFT fatigue task. Therefore, increased dynamic stability of these repeated movements cannot be explained by subjects movements did not become more dynamically stable as a result of increased muscle cocontraction. Possible alternative mechanisms are discussed. PMID:19942220

Gates, Deanna H.; Dingwell, Jonathan B.

2009-01-01

146

Upper extremity dynamics during Lofstrand crutch-assisted gait in children with myelomeningocele.  

PubMed

The use of quantitative models for evaluating upper extremity (UE) dynamics in children with myelomeningocele (MM) is limited. A biomechanical model for assessment of UE dynamics during Lofstrand crutch-assisted gait in children with MM is presented. This pediatric model may be a valuable tool for clinicians to characterize crutch-assisted gait, which may advance treatment monitoring, crutch prescription, and rehabilitation planning for children with MM. Nine subjects with L3 or L4 level myelodysplasia (mean+/-S.D. age: 11.1+/-3.8 years) were analyzed during forearm crutch-assisted gait: (1) reciprocal gait and (2) swing-through gait. Three-dimensional (3D) dynamics of the UE were acquired and the Pediatric Outcomes Data Collection Instrument (PODCI) was administered. The goal of this study was to determine if meaningful differences occur between gait patterns in UE kinematics and kinetics, and if correlations exist between dynamics and functional outcomes. Temporal-distance parameters showed significant differences between reciprocal and swing-through gait in stride length, and stance duration. All joint ranges of motion were greater during swing-through gait. Thorax, elbow and crutch ranges of motion were found to be significantly different between gait patterns. Kinetic results demonstrated significant differences between reciprocal and swing-through gait, bilaterally, at all joints for the force variables of mean superior/inferior force, range of force, and maximum inferior force. Functional outcomes were strongly correlated with joint dynamics. Accurate quantitative assessment is essential for preventing injury in long-term crutch users. This study has potential for improving clinical intervention strategies and therapeutic planning of ambulation for children with MM. PMID:19726191

Slavens, Brooke A; Sturm, Peter F; Bajournaite, Ruta; Harris, Gerald F

2009-11-01

147

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

148

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

149

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

150

Congenital and infantile skin lesions affecting the hand and upper extremity, part 1: vascular neoplasms and malformations.  

PubMed

Many dermatologic conditions may be present on a newborn infant's upper extremity that can evoke concern for parents and/or primary caregivers. Although the pediatrician typically remains the first care provider, often these children are referred to specialists to diagnose and treat these lesions. Hand surgeons should be familiar with different infantile skin lesions on an upper extremity. Some lesions are best observed, whereas others require treatment with nonoperative measures, lasers, or surgical interventions. A 2-part series is presented to aid the hand surgeon in becoming familiar with these lesions. This part 1 article focuses on vascular neoplasms and malformations. Particular attention is paid to the multiple types of hemangiomas and hemangioendotheliomas, telangiectasias, angiokeratomas, as well as capillary, venous, and lymphatic malformations. Diagnostic tips and clinical photographs are provided to help differentiate among these lesions. In addition, the recommended treatment for each is discussed. PMID:23707594

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

2013-11-01

151

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

152

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

PubMed Central

Objectives To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. Results In the subgroup of patients who scored high on the pain copying scale “worrying” the hazard ratio of sick leave was 1.32 (95% CI 1.07–1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale “worrying” (adjusted HR = 0.17, 95%-CI 0.04–0.72). Other work-related risk factors were not significantly related to sick leave. Conclusions Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results. PMID:17410376

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

2007-01-01

153

Custom-made ocular prosthesis  

PubMed Central

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

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

2012-01-01

154

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

155

Choosing a Breast Prosthesis  

MedlinePLUS

... Month in October, many mastectomy specialty shops hold sales on these items. You should check with your ... a breast prosthesis is a personal decision. Many women select this option because they want to look ...

156

Towards the development of a wearable feedback system for monitoring the activities of the upper-extremities  

PubMed Central

Background Body motion data registered by wearable sensors can provide objective feedback to patients on the effectiveness of the rehabilitation interventions they undergo. Such a feedback may motivate patients to keep increasing the amount of exercise they perform, thus facilitating their recovery during physical rehabilitation therapy. In this work, we propose a novel wearable and affordable system which can predict different postures of the upper-extremities by classifying force myographic (FMG) signals of the forearm in real-time. Methods An easy to use force sensor resistor (FSR) strap to extract the upper-extremities FMG signals was prototyped. The FSR strap was designed to be placed on the proximal portion of the forearm and capture the activities of the main muscle groups with eight force input channels. The non-kernel based extreme learning machine (ELM) classifier with sigmoid based function was implemented for real-time classification due to its fast learning characteristics. A test protocol was designed to classify in real-time six upper-extremities postures that are needed to successfully complete a drinking task, which is a functional exercise often used in constraint-induced movement therapy. Six healthy volunteers participated in the test. Each participant repeated the drinking task three times. FMG data and classification results were recorded for analysis. Results The obtained results confirmed that the FMG data captured from the FSR strap produced distinct patterns for the selected upper-extremities postures of the drinking task. With the use of the non-kernel based ELM, the postures associated to the drinking task were predicted in real-time with an average overall accuracy of 92.33% and standard deviation of 3.19%. Conclusions This study showed that the proposed wearable FSR strap was able to detect eight FMG signals from the forearm. In addition, the implemented ELM algorithm was able to correctly classify in real-time six postures associated to the drinking task. The obtained results therefore point out that the proposed system has potential for providing instant feedback during functional rehabilitation exercises. PMID:24397984

2014-01-01

157

A case of extreme upper limb surgical revascularization in Buerger's disease.  

PubMed

Thromboangiitis obliterans or Buerger's disease is a rare nonatherosclerotic segmental inflammatory vasculitis that most commonly involves small and medium-sized arteries, veins, and nerves of the extremities, and generally affects young tobacco smokers. A 51-year-old man was found to have critical ischemia of his left hand, with necrosis of 3 fingers. He underwent extremely distal surgical revascularization using a cephalic vein bypass graft. PMID:24887859

Massara, Mafalda; De Caridi, Giovanni; Spinelli, Francesco

2015-01-01

158

Semiconstrained distal radioulnar joint prosthesis.  

PubMed

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

2013-02-01

159

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  

E-print Network

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 ...

Vaisman, Lev

160

Deep vein thrombosis of upper extremities due to reactive thrombocytosis in septic patients  

PubMed Central

Deep venous thrombosis (DVT) is not an uncommon condition in the intensive care unit (ICU), and having high morbidity and mortality. Upper limb DVT also is increasingly being recognized as a clinical entity. The presence of the indwelling catheter in neck veins is a risk for developing venous thrombus, which may be further aggravated by presence of thrombocytosis. In ICU patients with sepsis, reactive thrombocytosis has been found during the recovery phase. Here, we are presenting two cases, having thrombocytosis and central venous catheter who developed upper limb DVT. PMID:25136196

Mishra, Shakti Bedanta; Bhoyer, Jashwini; Gurjar, Mohan; Muzaffar, Nabeel; Verma, Anupam

2014-01-01

161

Closed Kinetic Chain Upper Extremity Stability test (CKCUES test): a reliability study in persons with and without shoulder impingement syndrome  

PubMed Central

Background The Close Kinetic Chain Upper Extremity Stability Test (CKCUES test) is a low cost shoulder functional test that could be considered as a complementary and objective clinical outcome for shoulder performance evaluation. However, its reliability was tested only in recreational athletes’ males and there are no studies comparing scores between sedentary and active samples. The purpose was to examine inter and intrasession reliability of CKCUES Test for samples of sedentary male and female with (SIS), for samples of sedentary healthy male and female, and for male and female samples of healthy upper extremity sport specific recreational athletes. Other purpose was to compare scores within sedentary and within recreational athletes samples of same gender. Methods A sample of 108 subjects with and without SIS was recruited. Subjects were tested twice, seven days apart. Each subject performed four test repetitions, with 45 seconds of rest between them. The last three repetitions were averaged and used to statistical analysis. Intraclass Correlation Coefficient ICC2,1 was used to assess intrasession reliability of number of touches score and ICC2,3 was used to assess intersession reliability of number of touches, normalized score, and power score. Test scores within groups of same gender also were compared. Measurement error was determined by calculating the Standard Error of the Measurement (SEM) and Minimum detectable change (MDC) for all scores. Results The CKCUES Test showed excellent intersession reliability for scores in all samples. Results also showed excellent intrasession reliability of number of touches for all samples. Scores were greater in active compared to sedentary, with exception of power score. All scores were greater in active compared to sedentary and SIS males and females. SEM ranged from 1.45 to 2.76 touches (based on a 95% CI) and MDC ranged from 2.05 to 3.91(based on a 95% CI) in subjects with and without SIS. At least three touches are needed to be considered a real improvement on CKCUES Test scores. Conclusion Results suggest CKCUES Test is a reliable tool to evaluate upper extremity functional performance for sedentary, for upper extremity sport specific recreational, and for sedentary males and females with SIS. PMID:24387196

2014-01-01

162

Mechanical energy and power flow of the upper extremity in manual wheelchair propulsion  

Microsoft Academic Search

Objective. To investigate the characteristics of mechanical energy and power flow of the upper limb during wheelchair propulsion. Design. Mechanical energy and power flow of segments were calculated. Background. Very few studies have taken into account the mechanical energy and power flow of the musculoskeletal system during wheelchair propulsion. Mechanical energy and power flow have proven to be useful tools

Lan-Yuen Guo; Fong-Chin Su; Hong-Wen Wu

2003-01-01

163

Cutaneous nerve transection for the management of intractable upper extremity pain caused by invasive squamous cell carcinoma.  

PubMed

A recurrent clinical dilemma in the management of patients with painful metastatic lesions is achieving a balance between effective analgesic therapies versus intolerable side effects, in particular altered mental status. We present the case of an immunosuppressed patient post-lung transplant who was suffering from intractable pain caused by widely metastatic squamous cell carcinoma. The patient's progressive, excruciating neuropathic pain was localized to the area of the left wrist and forearm. Additionally, the patient complained of moderate pain at sites of tumor involvement on her right arm and scalp. Attempts to adequately manage her left upper extremity pain included a combination of pharmacologic treatments intended to treat neuropathic pain (gabapentin, SNRI, ketamine, opioids) and focused regional analgesia (infraclavicular infusion of local anesthetic). However, the patient developed intolerable side effects including altered mental status and delirium associated with the systemic agents and suboptimal control with the infraclavicular infusion. Given that the most severe pain was well localized, we undertook a diagnostic block of the cutaneous nerves of the left forearm. As this intervention significantly reduced her pain, we subsequently performed neurectomies to the left superficial radial nerve, lateral cutaneous nerve of the forearm and the posterior cutaneous nerve of the forearm. This resulted in immediate and continued relief of her left upper extremity pain without an altered mental status. Residual focal pain from lesions over her right arm and scalp was successfully managed with daily topical applications of lidocaine and capsaicin cream. Successful pain control continued until the patient's death five months later. PMID:21306862

Turnbull, John H; Gebauer, Sara L; Miller, Bruce L; Barbaro, Nicholas M; Blanc, Paul D; Schumacher, Mark A

2011-07-01

164

Impact of a joint labor-management ergonomics program on upper extremity musculoskeletal symptoms among garment workers.  

PubMed

This study evaluated the effect of an ergonomics intervention program on the prevalence and intensity of symptoms of upper extremity work-related musculoskeletal disorders among 36 garment workers performing an operation called spooling. Adjustable chairs were introduced and workers were trained in their use. Symptom surveys were administered prior to and 6 months after introduction of adjustable chairs. Quantitative pre- and post-intervention measurement of joint position was performed utilizing videotapes among a subgroup of nineteen. Eighty nine percent of the cohort reported pain in either the neck or at least one upper extremity anatomic site prior to the adjustable chair intervention. Among subjects reporting pain at baseline, there were significantly decreased pain levels in 10 of 11 anatomic sites after the intervention. Among all subjects, the proportion reporting pain decreased for each anatomic site following the intervention, with statistically significant decreases in 3 sites. However, there were only modest declines in awkward posture among the videotaped subgroup. This study suggests that introduction of an ergonomics program focused on education and introduction of an adjustable chair may diminish musculoskeletal symptomatology in apparel manufacturing workers. PMID:11534790

Herbert, R; Dropkin, J; Warren, N; Sivin, D; Doucette, J; Kellogg, L; Bardin, J; Kass, D; Zoloth, S

2001-10-01

165

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

PubMed Central

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

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

2013-01-01

166

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

167

Sensory reinnervation of free flaps in reconstruction of the breast and the upper and lower extremities?  

PubMed Central

There is long-standing debate about sensate versus non-sensate free microvascular flaps among microsurgeons. The principle of connecting not only the vascular supply, but also sensitive nerves, in free tissue transfer is attractive. However, increased operating time and partial spontaneous innervation led to the common decision to restrict microsurgical tissue transfer to the vascular anastomosis and to leave the nerves “untreated”. Nevertheless, in special cases such as breast reconstruction or extremity reconstruction, the question about sensory nerve coaptation of the flaps remains open. We present our experience with free microvascular tissue transfer for breast and extremity reconstruction and compare the data with previous literature and conclude that most free flap surgeries do not benefit from nerve coaptation.

Sinis, Nektarios; Lamia, Androniki; Gudrun, Helml; Schoeller, Thomas; Werdin, Frank

2012-01-01

168

Method of human-imitating posture generation for mechanical hand prosthesis  

Microsoft Academic Search

To meet the need of matching analysis of human-machine interface in mechanical system and personification design of the posture for mechanical hand prosthesis, a 7-DOF motion model of mechanical hand prosthesis is established on the principle of human anatomy and robot mechanism. With human comfort as optimizing object, an optimizing model of comfort degree of human upper limb posture is

Shaofeng Wang; Jun Hong; Zhigang Liu; Wei Wang; E. Zhang

2009-01-01

169

Habitat use and movements of shovelnose sturgeon in Pool 13 of the upper Mississippi River during extreme low flow conditions  

USGS Publications Warehouse

We monitored habitat use and movement of 27 adult shovelnose sturgeon in Pool 13 of the upper Mississippi River, Iowa-Illinois, by radio-telemetry in April through August 1988. Our objective was to determine the response of this species to unusually low water conditions in the upper Mississippi River in 1988. Most (94%) telemetry contacts were made in 3 habitat types: main channel (50%), main channel border where wing dams were present (29%), and tailwaters of Lock and Dam 12 (15%). Habitat use in spring was affected by the extreme low flows. We often found tagged shovelnose sturgeon in the main channel and tailwaters during the spring period (11 March–20 May) where water velocities were highest. This was in contrast to other studies where shovelnose sturgeon did not occupy those areas during years with normal spring flows. Shovelnose sturgeon were typically found in areas with a sand bottom, mean water depth of 5.8 m, and mean bottom current velocity of 0.23 m sec-1. They occupied areas of swifter current but were not always found in the fastest current in their immediate vicinity. Tagged shovelnose sturgeon tended to remain in the upper, more riverine portion of the pool, and we observed no emigration from the study pool. Linear total range of movement from the tagging site ranged from 1.9 to 54.6 km during the study period.

Curtis, Gary L.; Ramsey, John S.; Scarnecchia, Dennis L.

1997-01-01

170

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

171

Upper Extremity-Specific Measures of Disability and Outcomes in Orthopaedic Surgery  

PubMed Central

Outcome measures may consist of simple questions or they may be more complex instruments that evaluate multiple interrelated domains that influence patient function. Outcome measures should be relevant to patients, easy to use, reliable, valid, and responsive to clinical changes. The Disabilities of the Arm, Shoulder and Hand score can be used to measure disability for any region of the upper limb. Joint and disease-specific outcome measures have been developed for the shoulder, the elbow, and the wrist and hand. Many of these measures would benefit from further research into their validity, reliability, and optimal applicability. PMID:22298061

Smith, Matthew V.; Calfee, Ryan P.; Baumgarten, Keith M.; Brophy, Robert H.; Wright, Rick W.

2012-01-01

172

Upper extremities and spinal musculoskeletal disorders and risk factors in students using computers  

PubMed Central

Objective: To examine the effects of computer usage on the musculoskeletal system discomforts (MSD) of Turkish university students, the possible risk factors and study implications (SI). Methods: The study comprised a total of 871 students. Demographic information was recorded and the Student Specific Cornell Musculoskeletal Discomfort Questionnaire (SsCMDQ) was used to evaluate musculoskeletal system discomforts. Results: The neck, lower back and upper back areas were determined to be the most affected areas and percentages for SI were 21.6%, 19.3% and 16.3% respectively. Significant differences were found to be daily computer usage time for the lower back, total usage time for the neck, being female and below the age of 21 years (p<0.05) had an increased risk. Conclusions: The neck, lower back and upper back areas were found to be the most affected areas due to computer usage in university students. Risk factors for MSD were seen to be daily and total computer usage time, female gender and age below 21 years and these were deemed to cause study interference

Calik, Bilge Basakci; Yagci, Nesrin; Gursoy, Suleyman; Zencir, Mehmet

2014-01-01

173

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

174

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

175

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

176

Benign Triton Tumour of Upper Lip- A Rare Neoplasm at an Extremely Uncommon Site  

PubMed Central

Benign Triton tumours are exceedingly rare tumours occurring predominantly in young children. Fewer than 20 cases have been reported in literature. The tumours develop as masses in various large nerve trunks, the most common of them being the brachial and the sciatic. They are very rarely encountered in the head and neck region. Neurological symptoms may manifest due to their strategic locations. Various case studies in literature support their benign nature. Early diagnosis and complete excision avoids deformities and other associated complications. We present one such rare case of benign triton tumour of the head and neck region in a 10 year old female child who presented with a diffuse nodular swelling in the upper lip involving the philtrum and extending upto the left ala of the nose along with a brief review of literature. PMID:25653959

M, Sanjay; K, Anoosha; K. P, Ashok; B.R, Shantha Kumari

2014-01-01

177

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

178

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

179

Reliability and validity of the capabilities of upper extremity test (CUE-T) in subjects with chronic spinal cord injury.  

PubMed

Objective To determine the reliability and validity of the capabilities of upper extremity test (CUE-T), a measure of functional limitations, in patients with chronic tetraplegia. Design Repeated measures. Setting Outpatient rehabilitation center. Participants Fifty subjects (36 male/14 female) with spinal cord injury (SCI) of ?1-year duration participated. Subjects were 17-81 years old (mean 48.1 ± 18.2); neurological levels ranged from C2 through T6, American Spinal Injury Association Impairment Scale grades A-D. Interventions Not applicable. Outcome measures Intraclass correlation coefficients (ICC), weighted kappa and repeatability values for CUE-T; Spearman correlations of CUE-T with upper extremity motor scores (UEMS), and self-care and mobility portions of the Spinal Cord Independence Measure, vIII (SCIM III). Results Score ranges for UEMS were 8-50, CUE-T 7-135, self-care SCIM 0-20, and mobility SCIM 0-40. The ICC values for total, right, and left side scores were excellent (0.97-0.98; 95% confidence interval 0.96-0.99). Item weighted kappa values were ?0.60 for all but five items, four of which were right and left pronation and supination. Repeatability of total score was 10.8 points, right and left sides 6.3 and 6.1 points. Spearman correlations of the total CUE-T with the UEMS and SCIM self-care and mobility scores were 0.83, 0.70, and 0.55 respectively. Conclusions The CUE-T displays excellent test-retest reliability, and good-excellent correlation with impairment and capacity measures in persons with chronic SCI. After revising pronation and supination test procedures, the sensitivity to change should be determined. PMID:25297342

Marino, Ralph J; Kern, Stephen B; Leiby, Benjamin; Schmidt-Read, Mary; Mulcahey, M J

2014-10-01

180

EMG-based control for a C5/C6 spinal cord injury upper extremity neuroprosthesis.  

PubMed

The goal of this project is to enhance the benefits of functional electrical stimulation (FES) for individuals with cervical mid-level spinal cord injury (C5-C6 SCI) by providing upper arm function that complements the hand function provided by current FES systems. As a result of stimulation to selected shoulder and elbow muscles, individuals are able to increase their range of motion, their reaching ability, and improve their overall shoulder stability. An approach that provides a natural way of controlling arm stimulation is proposed. The controller extracts information from recorded EMG activity of muscles under retained voluntary control and processes these signals to generate the appropriate stimulation levels for the stimulated paralyzed muscles. One subject with complete C5 paralysis has been implemented with this advanced neuroprosthesis which includes four implanted EMG electrodes and 24 channels of stimulation. Eight of these channels were used for hand grasp and six were used for trunk stimulation to provide posture control, trunk stability and weight relief. The shoulder and elbow implanted stimulation channels include the suprascapular, thoracodorsal and radial nerves (via nerve-cuff electrodes) and the pectoralis major, rhomboids and pronator quadratus muscles (via muscle-based electrodes). The thoracic portion of the pectoralis major was transferred to the scapula to restore the actions of the denervated serratus anterior muscle, essential for reaching tasks and shoulder stability. The four EMG channels implanted include the trapezius, biceps, deltoids and extensor carpi radialis longus. Currently, the EMG control strategy is being refined and tested with the subject including evaluation of the functional benefits of the intervention. PMID:18002485

Hincapie, Juan Gabriel; Kirsch, Robert F

2007-01-01

181

21 CFR 876.3750 - Testicular prosthesis.  

Code of Federal Regulations, 2011 CFR

... 2011-04-01 false Testicular prosthesis. 876.3750 Section 876.3750 ...Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular prosthesis is an implanted device that...

2011-04-01

182

21 CFR 876.3750 - Testicular prosthesis.  

Code of Federal Regulations, 2010 CFR

... 2010-04-01 false Testicular prosthesis. 876.3750 Section 876.3750 ...Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular prosthesis is an implanted device that...

2010-04-01

183

A tactile control prosthesis  

Microsoft Academic Search

This research involves development and testing of a tactile control prosthesis to aid human operators in control of dynamic vehicles. Specifically, this work includes development and demonstration of a torso mounted tactile drift display that allowed helicopter pilots to hover a Blackhawk helicopter with degraded vision (equivalent to 20\\/200 acuity), a NASA sponsored pilot-in-the-loop simulator study for a hover display

James Franklin Perry

2004-01-01

184

A tactile control prosthesis  

NASA Astrophysics Data System (ADS)

This research involves development and testing of a tactile control prosthesis to aid human operators in control of dynamic vehicles. Specifically, this work includes development and demonstration of a torso mounted tactile drift display that allowed helicopter pilots to hover a Blackhawk helicopter with degraded vision (equivalent to 20/200 acuity), a NASA sponsored pilot-in-the-loop simulator study for a hover display and development and analysis of a tactile control prosthesis to help pilots correctly control an airplane experiencing an engine failure on takeoff. Results of a ten-subject experiment indicate that use of a tactile display in conjunction with a visual display reduces operator delay by 65 msec (SD of 28 msec), (P < 0.001) without a significant increase in error rate. In the pilot-in-the-loop simulation experiment pilots hovered a simulated helicopter better under increased workload conditions with the tactile control prosthesis than without it. The increased workload consisted of an addition drill in which the subject had to agree or disagree with a computer generated sum. Pilots were able to hover more precisely with the tactile display (mean of 5.19, SD of 2.57 feet) than without (mean of 6.39 and SD of 3.31 feet) especially when the secondary task was required (P < 0.001). Although learning effects were exhibited throughout the trials (P < 0.001), the tactile display was of greater benefit in higher workload conditions.

Perry, James Franklin

185

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

186

Upper extremity function and activity in facioscapulohumeral dystrophy and limb-girdle muscular dystrophies: a systematic review.  

PubMed

Abstract Purpose: The aims of this review were (1) to provide insight into the natural course of upper-extremity (UE) impairments and UE activity limitations associated with facioscapulohumeral dystrophy (FSHD) and limb-girdle muscular dystrophies (LGMD), and (2) to provide an overview of outcome measures used to evaluate UE function and activity in patients with FSHD and LGMD. Methods: Scientific literature databases (PubMed, MEDLINE, EMBASE, CINAHL and Cochrane) were searched for relevant publications. Inclusion criteria: (1) studies that included persons with a diagnosis of FSHD or LGMD; and (2) studies that reported the natural course of the UE functions and/or activity with outcome measures at these levels. Results: 247 publications were screened, of which 16 fulfilled the selection criteria. Most studies used manual muscle testing (MMT) to evaluate UE function and the Brooke Scale to evaluate UE mobility activities. The clinical picture of UE impairments and limitations of UE activities in FSHD and LGMD patients was highly variable. In general, FSHD and LGMD patients experience difficulty elevating their upper extremities and the execution of tasks takes considerably longer time. Conclusions: The clinical course of UE impairments and activity limitations associated with FSHD and LGMD is difficult to predict due to its high variability. Although measures like MMT and the Brooke Scale are often used, there is a lack of more specific outcome measures to assess UE function and UE capacity and performance in daily life. Measures such as 3D motion analysis and electromyography (EMG) recordings are recommended to provide additional insight in UE function. Questionnaires like the Abilhand are recommended to assess UE capacity and accelerometry to assess UE performance in daily life. Implications for Rehabilitation There is a need for specific outcome measures on the level of UE activity. Both the level of capacity and performance should be assessed. Possible outcome measures include 3D motion analysis to assess UE function, questionnaires like the Abilhand to assess UE capacity and accelerometry to assess performance of UE activities in daily life. PMID:25098592

Bergsma, Arjen; Cup, Edith H C; Geurts, Alexander C H; de Groot, Imelda J M

2014-08-01

187

A Review of K-wire Related Complications in the Emergency Management of Paediatric Upper Extremity Trauma  

PubMed Central

INTRODUCTION Kirschner wires (K-wires) are immensely versatile in fracture fixation in the paediatric population. Complications associated with the K-wiring procedure vary from minor to a life-threatening. The aim of this study was to analyse the outcome of fracture fixation using K-wires in all types of upper-extremity fractures in children in order to assess the incidence and type of complication critically. PATIENTS AND METHODS Between September 1999 and September 2001, we retrospectively reviewed a consecutive series of 105 fractures in 103 paediatric trauma cases (below 12 years) treated with K-wires in a university teaching hospital. The case notes and radiographs were reviewed by an independent single assessor. All paediatric, acute, upper-extremity, displaced and unstable fractures were included. All elective procedures using K-wires were excluded. RESULTS We observed an overall 32.3% complication rate associated with the K-wiring procedure affecting 34 pins (24 patients). Wound-related complications included over-granulation in 13 cases, pin tract infection in 6 cases and hypersensitive scar in 1 case. Neurapraxia was found in 3 patients and axonotmesis in 1 patient. Wire loosening at the time of removal in 14 cases and retrograde wire migration in 4 cases were observed. There were 2 cases of penetrating tendonitis and 1 case of osteomyelitis. There was a higher complication rate in terms of wire loosening and pin tract infection when the K-wires: (i) were left outside the skin compared with those placed under the skin; (ii) stayed longer in the patients; and (iii) did not traverse both cortices. There were more complications in complex operations performed by senior surgeons (P = 0.056). The duration of K-wire stay, associated co-morbidity and anatomical location were statistically insignificant. CONCLUSIONS Complications are part of operative procedures; an important point to consider is what causes them in order to take preventative measures. We recommend that the risks and complications should be explained to parents during the consenting process to allay their anxiety, irrespective of the fact that most complications are minor and of short duration. PMID:17394709

Sharma, H; Taylor, GR; Clarke, NMP

2007-01-01

188

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.

189

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.

190

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.

191

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

192

Nosology of Juvenile Muscular Atrophy of Distal Upper Extremity: From Monomelic Amyotrophy to Hirayama Disease—Indian Perspective  

PubMed Central

Since its original description by Keizo Hirayama in 1959, “juvenile muscular atrophy of the unilateral upper extremity” has been described under many nomenclatures from the east. Hirayama disease (HD), also interchangeably referred to as monomelic amyotrophy, has been more frequently recognised in the west only in the last two decades. HD presents in adolescence and young adulthood with insidious onset unilateral or bilateral asymmetric atrophy of hand and forearm with sparing of brachioradialis giving the characteristic appearance of oblique amyotrophy. Symmetrically bilateral disease has also been recognized. Believed to be a cervical flexion myelopathy, HD differs from motor neuron diseases because of its nonprogressive course and pathologic findings of chronic microcirculatory changes in the lower cervical cord. Electromyography shows features of acute and/or chronic denervation in C7, C8, and T1 myotomes in clinically affected limb and sometimes also in clinically unaffected contralateral limb. Dynamic forward displacement of dura in flexion causes asymmetric flattening of lower cervical cord. While dynamic contrast magnetic resonance imaging is diagnostic, routine study has high predictive value. There is a need to lump all the nomenclatures under the rubric of HD as prognosis in this condition is benign and prompt diagnosis is important to institute early collar therapy. PMID:24063005

Hassan, Kaukab Maqbool; Sahni, Hirdesh

2013-01-01

193

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

194

A pilot study to measure upper extremity H-reflexes following neuromuscular electrical stimulation therapy after stroke  

PubMed Central

Upper extremity (UE) hemiparesis persists after stroke, limiting hand function. Neuromuscular electrical stimulation (NMES) is an effective intervention to improve UE recovery, although the underlying mechanisms are not fully understood. Our objective was to establish a reliable protocol to measure UE agonist–antagonist forearm monosynaptic reflexes in a pilot study to determine if NMES improves wrist function after stroke. We established the between-day reliability of the H-reflex in the extensor carpi radialis longus (ECRL) and flexor carpi radialis (FCR) musculature for individuals with prior stroke (n = 18). The same-day generation of ECRL/FCR H-reflex recruitment curves was well tolerated, regardless of age or UE spasticity. The between-day reliability of the ECRL H-reflex was enhanced above FCR, similar to healthy subjects [20], with the Hmax the most reliable parameter quantified in both muscles. H-reflex and functional measures following NMES show the potential for NMES-induced increases in ECRL Hmax, but confirmation requires a larger clinical study. Our initial results support the safe, easy, and efficacious use of in-home NMES, and establish a potential method to measure UE monosynaptic reflexes after stroke. PMID:23313593

Stowe, A.M.; Hughes-Zahner, L.; Barnes, V.K.; Herbelin, L.L.; Schindler-Ivens, S.M.; Quaney, B.M.

2013-01-01

195

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

196

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

197

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

198

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

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Interarticular disc prosthesis (interpositional implant). 872... § 872.3970 Interarticular disc prosthesis (interpositional implant). (a) Identification. An interarticular disc prosthesis (interpositional implant) is...

2011-04-01

199

Comparison of the effectiveness of active and passive neuromuscular electrical stimulation of hemiplegic upper extremities: a randomized, controlled trial.  

PubMed

To compare the efficacy of electromyography (EMG)-triggered (active) neuromuscular electrical stimulation (NMES) and passive NMES in enhancing the upper extremity (UE) motor and functional recovery of subacute and chronic stage stroke patients. Thirty-one hemiplegic patients were randomly assigned to active NMES (n=11), passive NMES (n=10), and control (sham stimulation) (n=10) groups. Each treatment regimen was applied five times per week for 45 min for 3 weeks. All of the patients performed the same neurophysiologic exercise program for 45 min five times per week for 3 weeks. Patients were assessed by the UE component of the Fugl-Meyer Motor Assessment (UE-FMA), the self-care component of the Functional Independence Measure (self-care FIM), the Motor Activity Log (MAL), goniometric measurements of active wrist and metacarpophalangeal joint extension, surface EMG potentials, grip strength, and the modified Ashworth scale in a blinded manner. Data were obtained before and at the end of the treatment. Participants were similar in all clinical and demographic features (P>0.05). All groups were comparable with respect to UE-FMA, MAL, self-care FIM, wrist and finger flexor spasticity, active range of motion (ROM), grip strength, and surface EMG potentials before treatment (P>0.05). The active ROM, grip strength, FMA, FIM, surface EMG potentials, and MAL: amount of use were significantly improved in the EMG-triggered NMES group compared with the controls (P<0.05). The active wrist extension ROM and FMA scores were significantly improved in the passive NMES group compared with the controls (P<0.05). There were no statistically significant differences between active and passive NMES groups in any of the parameters evaluated at the end of the treatment (P>0.05). Both active and passive NMES as adjuvant therapy in the neurophysiologic exercise program effectively enhanced the UE motor and functional recovery of stroke survivors. PMID:23579106

Boyaci, Ahmet; Topuz, Oya; Alkan, Hakan; Ozgen, Merih; Sarsan, Ayse; Yildiz, Necmettin; Ardic, Fusun

2013-12-01

200

Epidemiology of work-related upper extremity disorders: understanding prevalence and outcomes to impact provider performances using a practice management reporting tool.  

PubMed

In 2001, the number of repeated trauma cases accounted for 4% of total workplace injuries and 65% of all occupational illnesses, with work-related upper extremity disorders accounting for most cases. Because chronic disability leads to the highest cost, systematic evaluation of this growing occupational condition is needed. This article sheds light on work-related upper extremity disorders by understanding the prevalence and pattern for these diagnoses, their impact on outcomes influenced by age, gender and geography on metrics such as utilization, duration, disability status, and costs. To assess these types of outcomes measurements, a good reporting and management system must be in place to allow for ongoing evaluation and analysis of data and in the construction of intervention programs to improve provider performances and, ultimately, patient outcomes. PMID:16647648

Giang, Geneva M

2006-01-01

201

Musculoskeletal symptoms of the upper extremities and the neck: A cross-sectional study on prevalence and symptom-predicting factors at visual display terminal (VDT) workstations  

PubMed Central

Background The aim of this study was to determine the prevalence and the predictors of musculoskeletal symptoms in the upper extremities and neck at visual display terminal (VDT) workstations. Methods In a cross-sectional study 1,065 employees working at VDT > 1 h/d completed a standardised questionnaire. Workstation conditions were documented in a standardised checklist, and a subgroup of 82 employees underwent a physical examination. Results Using the Nordic Questionnaire, the 12-month prevalence of symptoms of the neck, shoulder region, hand/wrist, or elbow/lower arm was 55%, 38%, 21%, and 15% respectively. The duration of VDT work had a significant impact on the frequency of neck symptoms in employees performing such work > 6 h/d. Conclusion With regard to musculoskeletal symptoms of the upper extremities, preventive measures at VDT workstations should be focused on neck and shoulder symptoms (e.g. ergonomic measures, breaks to avoid sitting over long periods). PMID:18588677

Klussmann, André; Gebhardt, Hansjuergen; Liebers, Falk; Rieger, Monika A

2008-01-01

202

Photovoltaic retinal prosthesis  

NASA Astrophysics Data System (ADS)

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

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

2011-03-01

203

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

204

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

205

21 CFR 878.3550 - Chin 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 § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis is a...

2014-04-01

206

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

207

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

208

21 CFR 878.3590 - Ear 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 § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis is a...

2014-04-01

209

21 CFR 878.3550 - Chin 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 § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis is a...

2010-04-01

210

21 CFR 878.3680 - Nose 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 § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis is a...

2014-04-01

211

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

212

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

213

21 CFR 878.3590 - Ear prosthesis.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

214

21 CFR 878.3590 - Ear 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 § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis is a...

2010-04-01

215

21 CFR 878.3550 - Chin prosthesis.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

216

21 CFR 878.3680 - Nose 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 § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis is a...

2010-04-01

217

21 CFR 878.3680 - Nose prosthesis.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

218

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

219

Instrumented prosthesis for knee implants monitoring  

Microsoft Academic Search

In this work we present an instrumented smart knee prosthesis for in-vivo measurement of forces and kinematics. Studying the constraints, we designed minimal sensory systems to be placed in the polyethylene part of the prosthesis. The magnetic sensors and a permanent magnet are chosen and configured to measure the relative kinematics of the prosthesis. Moreover, the strain gauges were designed

Arash Arami; Matteo Simoncini; Oguz Atasoy; Willyan Hasenkamp; Shafqat Ali; Arnaud Bertsch; Eric Meurville; Steve Tanner; Hooman Dejnabadi; Vincent Leclercq; Philippe Renaud; Catherine Dehollain; Pierre-Andre Farine; Brigitte M. Jolles; Kamiar Aminian; Peter Ryser

2011-01-01

220

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

221

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

222

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

PubMed Central

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

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

2007-01-01

223

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

224

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

E-print Network

joint rotation. Moment arms also play an important role in determining muscle contributions to jointJournal of Biomechanics 35 (2002) 19­26 Scaling of peak moment arms of elbow muscles with upper and anthropometric dimensions are generally not available. We hypothesized that peak moment arms of the elbow flexor

Delp, Scott

225

Pulse oxymetry evaluation of oxygen saturation in the upper extremity with an arteriovenous fistula before and during hemodialysis  

Microsoft Academic Search

We noticed that some patients with arteriovenous (AV) fistula on chronic hemodialysis experience pain in the limb with the fistula a short time after being connected to the dialysis machine. We postulated that the pain is caused by relative ischemia and therefore performed this study to determine whether oxygen saturation (SaO2) of the extremities with AV fistula decreases during hemodialysis.

Guy Lin; Hassan Kais; Zvi Halpern; David Chayen; Joshua Weissgarten; Michael Negri; Mirel Cohn; Jan Averbukh; Ariel Halevy

1997-01-01

226

Partially implantable vibrating ossicular prosthesis  

Microsoft Academic Search

A partially implantable hearing prosthesis for sensorineural hearing loss patients has been developed using a novel electromagnetic actuator. The system is designed to couple acoustic frequency, vibrational energy into the ossicular structure of the middle ear. The complete system includes external signal processing and a transdermal telemetry system. The focus of this paper is to describe the transducer used to

Timothy G. Dietz; Geoffrey R. Ball; Bob H. Katz

1997-01-01

227

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

228

Development and Application of Stereo Camera-Based Upper Extremity Workspace Evaluation in Patients with Neuromuscular Diseases  

PubMed Central

Background The concept of reachable workspace is closely tied to upper limb joint range of motion and functional capability. Currently, no practical and cost-effective methods are available in clinical and research settings to provide arm-function evaluation using an individual’s three-dimensional (3D) reachable workspace. A method to intuitively display and effectively analyze reachable workspace would not only complement traditional upper limb functional assessments, but also provide an innovative approach to quantify and monitor upper limb function. Methodology/Principal Findings A simple stereo camera-based reachable workspace acquisition system combined with customized 3D workspace analysis algorithm was developed and compared against a sub-millimeter motion capture system. The stereo camera-based system was robust, with minimal loss of data points, and with the average hand trajectory error of about 40 mm, which resulted to ?5% error of the total arm distance. As a proof-of-concept, a pilot study was undertaken with healthy individuals (n?=?20) and a select group of patients with various neuromuscular diseases and varying degrees of shoulder girdle weakness (n?=?9). The workspace envelope surface areas generated from the 3D hand trajectory captured by the stereo camera were compared. Normalization of acquired reachable workspace surface areas to the surface area of the unit hemi-sphere allowed comparison between subjects. The healthy group’s relative surface areas were 0.618±0.09 and 0.552±0.092 (right and left), while the surface areas for the individuals with neuromuscular diseases ranged from 0.03 and 0.09 (the most severely affected individual) to 0.62 and 0.50 (very mildly affected individual). Neuromuscular patients with severe arm weakness demonstrated movement largely limited to the ipsilateral lower quadrant of their reachable workspace. Conclusions/Significance The findings indicate that the proposed stereo camera-based reachable workspace analysis system is capable of distinguishing individuals with varying degrees of proximal upper limb functional impairments. PMID:23028947

Abresch, Richard T.; Nicorici, Alina; Yan, Posu; Bajcsy, Ruzena

2012-01-01

229

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

PubMed Central

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

2014-01-01

230

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 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...

2011-04-01

231

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

232

21 CFR 884.3650 - Fallopian tube prosthesis.  

Code of Federal Regulations, 2010 CFR

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

2010-04-01

233

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

234

21 CFR 872.3960 - Mandibular condyle prosthesis.  

Code of Federal Regulations, 2010 CFR

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

2010-04-01

235

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

236

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

237

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 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...

2012-04-01

238

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 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...

2014-04-01

239

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Total temporomandibular joint prosthesis. 872.3940...Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a...

2010-04-01

240

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

241

An uncommon cause of tardy ulnar nerve palsy due to upper extremity prolonged malposition in a comatose child: a case report  

PubMed Central

Abstract: Background: Ulnar nerve neuropathy is one of the most common peripheral nerve dysfunctions. Elbow is the most common area affected by ulnar nerve which is mainly because of fractures or dislocations of this area. Delayed ulnar nerve palsy (Tardy Ulnar Nerve Palsy) in children due to a malpositioning of upper extremity during hospitalization is an uncommon cause of ulnar nerve injury which we have already reported it. Methods: An eight-year-old conscious patient who had weakness, paresthesia and tingling in the right 4th and 5th fingers, as well as right claw hand deformity was evaluated, he had attended once before in 4 months ago due to head trauma in coma state. The child had no clinical and radiological indications of arm or elbow fractures causing nerve compression or entrapment. Elbow malposition had caused ulnar nerve neuropathy during hospitalization. Surgery was attempted, ulnar nerve decompression and anterior transposition done. Results: After three weeks post operatively, active physical therapy was started on the right upper extremity and the hand returned to normal activity after 6 months. Conclusions: In patients with decreased level of consciousness or coma state who need prolonged hospitalization, the limbs must remain in correct position to prevent superficial nerve injuries and neuropathies. Furthermore, careful and scrutinized attention to the traumatic patients and doing on time and targeted imaging, regular follow up of patients, complete and perfect neurological examinations can prevent peripheral nerve injuries or develop on-time treatments which improve the patients' quality of life. Keywords: Ulnar nerve, Elbow malposition, Ulnar nerve decompression

Emamhadi, Mohammad Reza; Mahmoudi, Davood

2012-01-01

242

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

243

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

244

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

PubMed Central

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 three people with a shoulder disarticulation level amputation and three people with a transhumeral level amputation. Performance on timed tests, including the box-and-blocks test and clothespin test, has increased two to six times. Options for new control strategies are discussed. PMID:18303805

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

2015-01-01

245

Golf hand prosthesis performance of transradial amputees.  

PubMed

Background:Typical upper limb prostheses may limit sports participation; therefore, specialized terminal devices are often needed. The purpose of this study was to evaluate the ability of transradial amputees to play golf using a specialized terminal device.Case description and methods:Club head speed, X-factor, and elbow motion of two individuals with transradial amputations using an Eagle Golf terminal device were compared to a non-amputee during a golf swing. Measurements were collected pre/post training with various stances and grips.Findings and outcomes:Both prosthesis users preferred a right-handed stance initially; however, after training, one preferred a left-handed stance. The amputees had slower club head speeds and a lower X-factor compared to the non-amputee golfer, but increased their individual elbow motion on the prosthetic side after training.Conclusion:Amputees enjoyed using the device, and it may provide kinematic benefits indicated by the increase in elbow flexion on the prosthetic side.Clinical relevanceThe transradial amputees were able to swing a golf club with sufficient repetition, form, and velocity to play golf recreationally. Increased elbow flexion on the prosthetic side suggests a potential benefit from using the Eagle Golf terminal device. Participating in recreational sports can increase amputees' health and quality of life. PMID:24570019

Carey, Stephanie L; Wernke, Matthew M; Lura, Derek J; Kahle, Jason T; Dubey, Rajiv V; Highsmith, M Jason

2014-02-25

246

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

NASA Astrophysics Data System (ADS)

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

Burkhart, Timothy A.

247

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

PubMed

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

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

2013-09-01

248

[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

249

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

250

An artificial gastrocnemius for a transtibial prosthesis  

E-print Network

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

Swart, E.

251

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

252

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

253

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

254

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

255

21 CFR 878.3720 - Tracheal prosthesis.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

256

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 tracheal...

2010-04-01

257

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

258

21 CFR 878.3720 - Tracheal 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 § 878.3720 Tracheal prosthesis. (a) Identification. The tracheal...

2014-04-01

259

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

260

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

2010-04-01

261

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

262

Finger prosthesis: a boon to handicapped.  

PubMed

This is a clinical case report of a 52-year-old male patient with four partially missing fingers of the left hand. The article describes the clinical and laboratory procedure of making prosthesis with modern silicone material. A wax pattern was fabricated using the right hand of the patient. A special type of wax was formulated to make the pattern so that it can be easily moulded and carved. Intrinsic and extrinsic staining was also performed to match the adjacent skin colour. The patient was given the finger prosthesis and was asked to use a half glove (sports) to mask the junction between the prosthesis and the normal tissue. It also provides additional retention to the artificial fingers. The patient felt his social acceptance improved after wearing the finger prosthesis. PMID:23988821

Gupta, Ridhima; Kumar, Lakshya; Rao, Jitendra; Singh, Kamleshwar

2013-01-01

263

Intraoral angiosarcoma: Treatment with a brachytherapy prosthesis.  

PubMed

Angiosarcomas are rare, malignant neoplasms of vascular origin that account for less than 1% of all soft tissue tumors. Angiosarcomas of the oral cavity are especially rare, and brachytherapy may be prescribed as a localized treatment to manage these malignancies. Intraoral brachytherapy requires collaboration between the radiation oncologist and a dental professional for the fabrication of the brachytherapy delivery prosthesis. The present clinical report describes an intraoral angiosarcoma and the fabrication of an intraoral brachytherapy prosthesis to manage this malignancy. PMID:25449613

Rosen, Evan B; Ko, Eugene; Wolden, Suzanne; Huryn, Joseph M; Estilo, Cherry L

2014-11-20

264

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

265

The Effect of Driver Age On The Incidence And Severity Of Upper Extremity Injuries Due To Second Generation Front Air Bag Deployment  

PubMed Central

This study used NHTSA NASS/CDS data to examine whether advancing age was associated with a higher incidence and severity of front airbag-related upper extremity injury (UEI). Using a retrospective cohort design we analyzed weighted data from 1998–2007 for. The study population consisted of lap/shoulder belted people over 16 years of age who were driving passenger vehicles with model years 1998–2003 and were involved in a frontal crash where their front airbag deployed. Drivers who were ejected, involved in a vehicle rollover, or accompanied by a passenger sitting directly behind them were omitted. The exposure variable was age and the outcome variables were UEI incidence and severity. Associations were adjusted for gender, seat track position, vehicle type, vehicle weight, intrusion, and delta-v. Logistic regressions were performed using SAS survey procedures to account for the complex survey design. Overall, 42% of drivers sustained an UEI. Advancing age was associated with a higher incidence (p<0. 0001) and severity (p<0. 0001) of UEI. Nineteen percent of drivers sustained an UEI related to the airbag. No significant differences in the incidence or severity of airbag-related UEI were found between young drivers and older driver age groups. The degree of severity due to airbag-related UEI was generally minor. The majority of airbag-related UEI appeared to shift slightly from abrasions to contusions with aging. These results indicate that UEI due to depowered airbag deployment is common but not disproportionately high among older drivers, and injury severity is generally minor across all age groups. PMID:21050604

Marshall, Rafael; Hunting, Katherine; McKay, Mary Pat

2010-01-01

266

[Effect of dental prosthesis on the voice].  

PubMed

It is well known that alterations to the oral cavity caused by dental prostheses may affect speech articulation, although influences on the voice are not assumed. In addition to the vocal fundamental frequency, vibrations of the vocal chords generate overtones. Through the shape of the larynx and the upper airway, resonances and antiresonances are formed, and in this way overtones are amplified to a variable extent. Nozzle changes caused by a dental prosthesis in the oral cavity may possibly influence overtones but influences on the vocal fundamental frequency seem unlikely. The influence of dental prostheses on the voice is demonstrated in a patient who owned two different dental prostheses. The fundamental frequency rose by up to five semitones during speech and his vocal range increased by up to four semitones when a thin denture was used instead of a normal denture. When the position of the mandible was checked by intraoral needle point placement, a more rostral position of the mandible was recorded with the thin denture than with the normal denture. Sagittal magnetic resonance tomography imaging also showed that the larynx was in a more cranial position. This change was presumed to be due to an upward movement of the larynx induced by the tongue, which itself was found to be in a more cranial position with the thin denture. In this situation, increased tension of the laryngeal muscles were believed to induce a rise in fundamental frequency, shifting the voice range toward higher frequencies. These findings show that dental prostheses can cause vocal changes in individual cases. The etiology of this occurrence is still not clear. Its consequences, however, should be known to the dentist, ENT surgeon and phoniatrist if patients notice changes in their voice after having altered or replaced their dentures. PMID:10412658

Seifert, E; Runte, C; Selders, D; Lamprecht-Dinnesen, A; Bollmann, F

1999-05-01

267

21 CFR 888.3025 - Passive tendon prosthesis.  

Code of Federal Regulations, 2014 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...

2014-04-01

268

21 CFR 888.3025 - Passive tendon prosthesis.  

Code of Federal Regulations, 2012 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...

2012-04-01

269

21 CFR 872.3950 - Glenoid fossa prosthesis.  

Code of Federal Regulations, 2010 CFR

...prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the temporomandibular joint to augment a glenoid fossa or to provide an articulation surface for the head of a mandibular condyle....

2010-04-01

270

Bar retained dento-alveolar prosthesis: a case report.  

PubMed

A technique for restoring missing anterior teeth with associated extensive alveolar bone loss has been presented. This technique combines fixed and removable restorations where in removable prosthesis that restores the alveolar defect gets attached to the fixed prosthesis through precision attachment. The fixed prosthesis contributes to esthetics, function and also elevates patient's self image. The removable prosthesis provides the much needed soft tissue support and also facilitates oral hygiene maintenance. PMID:25489167

Kannan, Kamala; Isaac, Lijo; Bhaskaran, S; Raj, Nirmal; Sivakumar, Keerthana; Chandrasekaran, Dileepan

2014-12-01

271

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

272

Investigation of hip joint prosthesis damage.  

PubMed

Following total hip arthroplasty the durability of a prosthetic implant depends on many factors but is generally limited by two types of damage: wearing of frictional surfaces of the acetabular and femoral component as well as the loosening and migration of the "rosthesis-cement-bone" system. Since it is possible to establish a cause-and-effect relationship between these two damage types, the aim of this research is to investigate the phenomena related to the contact surface and their influence on the prosthesis-bone relationship in general for various sizes and conditions of loading of the hip joint. The experimental study was conducted using a Timken testing device modified in such a way that simulation of relative movements of the joint elements was achieved using a mechanism that produces conditions similar to those in the human hip joint. The analysis of obtained measurements showed that actual radii of friction of the hip prosthesis did not correspond to the theoretical ones and that only a small portion of the total friction surface is realized. Variations of the radius of friction for the examined prosthesis type were very large, which changes the hypotheses on the ability of the prosthetic head and the "prosthesis-cement-bone" system to bear a certain amount of load. The construction and design of prosthetic implant components has a significant influence on both the amount of wear at the site of contact and the loosening of prosthesis. PMID:11787549

Bajs, I D; Sari?, V; Opali?, M

2001-06-01

273

Adaptability of stock TMJ prosthesis to joints that were previously treated with custom joint prosthesis.  

PubMed

The purpose of this study was to determine if a temporomandibular joint (TMJ) replaced by a custom joint prosthesis could have been replaced by a stock joint prosthesis. Stereolithic models of patients treated with TMJ Concepts® patient fitted joint prosthesis (e.g., custom) were obtained. Biomet Microfixation® TMJ prostheses (e.g. stock) were adapted to these models. Intra-operative insertion of prosthesis, fit and size of stock joints were simulated and evaluated. Adaptability and stability of condyle and fossa as well as their articulation were recorded. 20 models consisting of 34 joints were examined by two oral and maxillofacial surgeons who were blinded to the patient's diagnosis. Overall, 77% of the stock TMJ system fit the stereolithic models. 3mm or less of bone modification was necessary to achieve an acceptable fit. In the majority of the cases examined, a stock TMJ prosthesis had good anatomical adaptation to stereolithic models of patients previously treated with custom TMJ prosthesis, so a stock TMJ prosthesis could have been an acceptable option for these patients. Further prospective clinical studies to compare both systems are necessary. PMID:22169167

Abramowicz, S; Barbick, M; Rose, S P; Dolwick, M F

2012-04-01

274

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

275

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

276

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.

2014-08-22

277

Is Swanson prosthesis better than Sutter prosthesis for metacarpophalangeal joint arthroplasty? A meta-analysis.  

PubMed

Abstract The aim of this meta-analysis is to compare the outcomes of the Swanson and Sutter prostheses (previously the Avanta prosthesis) used for metacarpophalangeal joint arthroplasty, and provide a powerful and rational conclusion regarding the use of prosthesis in MCP joint surgery. The literature search was based on PubMed, Cochrane Library, MEDLINE, EMBASE, and the Chinese National Knowledge Infrastructure. Data were evaluated using a generic evaluation tool designed by the Cochrane Bone, Joint, and Muscle Trauma Group and analysed using RevMan, version 5.0. Six randomised controlled trials were contained in this review, and five of them involving 143 patients were included in the meta-analysis. The results suggested that using the Sutter prosthesis could significantly decrease the rates of recurrence of drift when compared with the Swanson prosthesis for metacarpophalangeal joint arthroplasty (OR = 2.05, 95% Confidence interval (CI) = 1.31-3.20, p = 0.002). No significant difference in the outcomes of prosthesis fracture was found in two groups (OR = 1.07, 95% CI = 0.41-2.79, p = 0.88). Due to the limited data, the outcomes of range of motion, correction of ulnar deviation, pain, grip strength, and radiographic osteolytic changes could not be included in the meta-analyses. Theoretically, recurrence of drift was more common with Swanson prosthesis when compared with the Sutter prosthesis. No significant difference in the outcomes of prosthesis fracture was observed in two groups. More high-quality studies are required in long-term follow-up. PMID:25166510

Zhang, Huahui; Xue, Dan; Yu, Jianxin

2015-02-01

278

New concepts — biomechanical studies of a newly designed femoral prosthesis (cervicotrochanter prosthesis)  

Microsoft Academic Search

Objective. A newly designed stemless (cervico-trochanter) prosthesis was developed for the purpose of reducing the incidence of the stress-shielding effect caused by the traditional stem-type prosthesis.Design. Both mechanical test and three-dimensional finite element analysis were performed for comparing the differences of strain and stress distributions between the intact, C-T and PCA prosthetic femora.Background. The stress-shielding effect and polyethylene (PE) wear

Chun-Hsiung Shih; Weng-Pin Chen; Ching-Lung Tai; Rong-Fu Kuo; Chi-Chuan Wu; Chih-Hwa Chen

1997-01-01

279

Femoral artery occlusion secondary to a spontaneously "migrated" hip prosthesis: case report.  

PubMed

A 77-year-old male patient was admitted to the hospital with a worsening acute ischemia of the left lower extremity. The patient, who had a coxarthrosis and was being followed by the orthopedic clinic, had undergone a total hip prosthesis, with a revision performed at the sixth month of its placement. The physical examination revealed the absence of the femoral, popliteal and distal pulses of the left lower extremity. The left hip movements were painful and limited in external rotation posture. Doppler ultrasonography showed an acute occlusion of the left common femoral artery due to the dislocated hip prosthesis, and right-to-left femorofemoral expanded polytetrafluoroethylene graft bypass was carried out. After successful surgery and an uneventful postoperative period with palpable femoral and popliteal pulses, the patient was put on low molecular weight heparin and referred to orthopedics once the ischemia had subsided with the intervention. Case reports regarding occlusions due to migration of total hip prosthesis are rare in the literature. The emphasis of this case report is to describe one such case. PMID:20517776

Tihan, Deniz Necdet; Ali?, Halil; Aksoy, Murat; Gülo?lu, Recep; Kurto?lu, Mehmet; Dikici, Fatih

2010-03-01

280

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

281

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

282

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

283

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

284

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.  

Code of Federal Regulations, 2011 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...

2011-04-01

285

Design and Control of a Powered Transfemoral Prosthesis  

PubMed Central

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

Sup, Frank; Bohara, Amit; Goldfarb, Michael

2009-01-01

286

Tracheobronchial Foreign Body Aspiration: Dental Prosthesis  

PubMed Central

It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep. PMID:25165606

Köse, Ataman; Kostak, Dilek; Aramagan, Erol; Durak, Asl?han; Seçkin, Nur Sezin; Dönmez, Serdar Süha; Melek, Hüseyin

2014-01-01

287

Vestibular prosthesis tested in rhesus monkeys.  

PubMed

We are studying the effectiveness of a semicircular canal prosthesis to improve postural control, perception of spatial orientation, and the VOR in rhesus monkeys with bilateral vestibular hypofunction. Balance is examined by measuring spontaneous sway of the body during quiet stance and postural responses evoked by head turns and rotation of the support surface; perception is measured with a task derived from the subjective visual vertical (SVV) test during static and dynamic rotation in the roll plane; and the angular VOR is measured during rotation about the roll, pitch, and yaw axes. After the normal responses are characterized, bilateral vestibular loss is induced with intratympanic gentamicin, and then multisite stimulating electrodes are chronically implanted into the ampullae of all three canals in one ear. The postural, perceptual, and VOR responses are then characterized in the ablated state, and then bilateral, chronic electrical stimulation is applied to the ampullary nerves using a prosthesis that senses angular head velocity in three-dimensions and uses this information to modulate the rate of current pulses provided by the implanted electrodes. We are currently characterizing two normal monkeys with these paradigms, and vestibular ablation and electrode implantation are planned for the near future. In one prior rhesus monkey tested with this approach, we found that a one-dimensional (posterior canal) prosthesis improved balance during head turns, perceived head orientation during roll tilts, and the VOR in the plane of the instrumented canal. We therefore predict that the more complete information provided by a three-dimensional prosthesis that modulates activity in bilaterally-paired canals will exceed the benefits provided by the one-dimensional, unilateral approach used in our preliminary studies. PMID:22254795

Lewis, Richard F; Haburcakova, Csilla; Gong, Wangsong; Lee, Daniel; Wall, Conrad; Thompson, Lara; Merfeld, Daniel M

2011-01-01

288

Control of dental prosthesis system with microcontroller.  

PubMed

In this study, a microcontroller-based electronic circuit was designed and implemented for dental prosthesis curing system. Heater, compressor and valve were controlled by 8-bit PIC16C64 microcontroller which is programmed using MPASM package. The temperature and time were controlled automatically by preset values which were inputted from keyboard while the pressure was kept constant. Calibration was controlled and the working range was tested. The test results showed that the system provided a good performance. PMID:10895425

Kapidere, M; Müldür, S; Güler, I

2000-04-01

289

21 CFR 890.3500 - External assembled lower limb prosthesis.  

Code of Federal Regulations, 2013 CFR

...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3500 External assembled lower limb prosthesis. (a)...

2013-04-01

290

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

291

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

PubMed Central

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

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

2014-01-01

292

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

PubMed Central

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

2013-01-01

293

Influence of the weight actions of the hand prosthesis on the performance of pattern recognition based myoelectric control: preliminary study.  

PubMed

In transradial amputees, the muscles in the residual forearm naturally employed by the unimpaired for flexing/extending the hand fingers, are the most appropriate targets, for multi-fingered prostheses control. However, once the prosthetic socket is manufactured and fitted on the residual forearm, the recorded EMG might not be originated only by the intention of performing finger movements, but also by the muscular activity needed to sustain the prosthesis itself. In this work, we preliminary show--on healthy subjects wearing a prosthetic socket emulator--that (i) variations in the weight of the prosthesis, and (ii) upper arm movements significantly influence the robustness of a traditional classifier based on k-nn algorithm. We show in simulated conditions that traditional pattern recognition systems do not allow the separation of the effects of the weight of the prosthesis because a surface recorded EMG pattern caused by the simple lifting or moving of the prosthesis is misclassified into a hand control movement. This suggests that a robust classifier should add to myoelectric signals, inertial transducers like multi-axes position, acceleration sensors or sensors able to monitor the interaction forces between the socket and the end-effector. PMID:22254633

Cipriani, Christian; Sassu, Rossella; Controzzi, Marco; Carrozza, Maria Chiara

2011-01-01

294

Magnet-retained facial prosthesis combined with maxillary obturator.  

PubMed

Prosthetic rehabilitation of the midfacial defects has always perplexed prosthodontists. These defects lead to functional and esthetic deficiencies. The purpose of this clinical case report was the presentation of the prosthetic rehabilitation of an extraoral-intraoral defect using two-piece prosthesis magnetically connected. This prosthesis has dramatically improved the patient's speech, mastication, swallowing, and esthetic. PMID:23738151

Hatami, Mahnaz; Badrian, Hamid; Samanipoor, Siamak; Goiato, Marcelo Coelho

2013-01-01

295

Treating obstructive sleep apnea: can an intraoral prosthesis help?  

PubMed

The author studied the effectiveness of an intraoral airway maintenance prosthesis in treating obstructive sleep apnea syndrome. He found that the prosthesis, which can be constructed and modified easily by a dentist, significantly reduced the number of apneas per night and the syndrome's severity in his subjects. PMID:7722106

Osseiran, H S

1995-04-01

296

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

NASA Astrophysics Data System (ADS)

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

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

2014-05-01

297

The effect of arm support combined with rehabilitation games on upper-extremity function in subacute stroke: a randomized controlled trial.  

PubMed

Background. Use of rehabilitation technology, such as (electro)mechanical devices or robotics, could partly relieve the increasing strain on stroke rehabilitation caused by an increasing prevalence of stroke. Arm support (AS) training showed improvement of unsupported arm function in chronic stroke. Objective. To examine the effect of weight-supported arm training combined with computerized exercises on arm function and capacity, compared with dose-matched conventional reach training in subacute stroke patients. Methods. In a single-blind, multicenter, randomized controlled trial, 70 subacute stroke patients received 6 weeks of training with either an AS device combined with computerized exercises or dose-matched conventional training (CON). Arm function was evaluated pretraining and posttraining by Fugl-Meyer assessment (FM), maximal reach distance, Stroke Upper Limb Capacity Scale (SULCS), and arm pain via Visual Analogue Scale, in addition to perceived motivation by Intrinsic Motivation Inventory posttraining. Results. FM and SULCS scores and reach distance improved significantly within both groups. These improvements and experienced pain did not differ between groups. The AS group reported higher interest/enjoyment during training than the CON group. Conclusions. AS training with computerized exercises is as effective as conventional therapy dedicated to the arm to improve arm function and activity in subacute stroke rehabilitation, when applied at the same dose. PMID:24878589

Prange, Gerdienke B; Kottink, Anke I R; Buurke, Jaap H; Eckhardt, Martine M E M; van Keulen-Rouweler, Bianca J; Ribbers, Gerard M; Rietman, Johan S

2015-02-01

298

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

PubMed

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

Lee, Sangyong; Lee, Daehee; Park, Jungseo

2014-10-01

299

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

PubMed Central

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

Lee, Sangyong; Lee, Daehee; Park, Jungseo

2014-01-01

300

Rigid intraluminal prosthesis for replacement of thoracic and abdominal aorta.  

PubMed

During the past seven years, 80 patients have undergone aortic substitution using a rigid intraluminal prosthesis. There were 9 early deaths. The procedures involved 32 dissecting aneurysms (18 ascending and 14 descending), 16 atherosclerotic aneurysms of the ascending aorta and 13 atherosclerotic aneurysms of the descending aorta, 3 thoracoabdominal aneurysms, 2 arch aneurysms, and 14 abdominal aortic aneurysms. There was one early dislodgment of the rings necessitating reoperation, but no other early complications related to the procedure. In the follow-up period (mean, 25 months) there were 6 late deaths. One occurred 6 months after operation in a patient with empyema. There were no late complications of thrombosis, erosion, pseudoaneurysm formation, or hemorrhage. The follow-up data are extremely encouraging. We now are using this device whenever possible in all substitutions of the aorta, although in approximately 40% of patients, it is necessary to remove one of the spools and suture either the proximal or distal end of the graft owing to the close proximity of the aneurysm to the coronary ostia or the origin of the subclavian artery. Important techniques of insertion and postoperative angiograms are presented. PMID:3966837

Spagna, P M; Lemole, G M; Strong, M D; Karmilowicz, N P

1985-01-01

301

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

NASA Astrophysics Data System (ADS)

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

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

2014-10-01

302

[Chronic endocarditis on valve prosthesis. 6 cases].  

PubMed

Six cases of chronic endocarditis (more than 1 year duration) have been extracted from a series of 72 cases of endocarditis (delayed in 49) associated with intracardiac prosthesis observed over a 15-year period. In these 6 cases endocarditis developed 6 months to 2 years after valve replacement. The prosthetic material included 3 Starr-Edward's valves, 2 Hancock's valves and 1 intracardiac patch. The micro-organism isolated were Streptococcus in 3 cases, Serratia and Corynebacterium in 1 case each. The 18-month to 5-year course of the disease was marked by 2 to 5 relapses separated by long periods of apyrexia. The most significant complications were dysimmune syndrome (5 cases), embolic accidents (2 cases) and prosthesis disinsertion (4 cases). Five patients benefited from antibiotic therapy; 4 were operated upon with recurrent disinsertion in 2 cases. Two patients died, one of repeated disinsertion, the other of myocardial dysfunction. Bacteriostatic antibiotics were administered continuously to 3 patients whose endocarditis persisted or relapsed, with satisfactory results in two cases followed-up for more than 2 years. PMID:6229757

Witchitz, S; Fraisse, F; Bouvet, E; Rabourdin, L F; Regnier, B; Vachon, F

1984-02-01

303

Photovoltaic retinal prosthesis with high pixel density  

NASA Astrophysics Data System (ADS)

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

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

2012-06-01

304

Performance of a new vascular xeno prosthesis.  

PubMed

To date no prosthetic vascular prosthesis performs as well as the autologous saphenous vein in diameters of 6 mm and less. The purpose of this study was to compare the in vitro and in vivo performance of a new glutaraldehyde stabilized, narrow diameter (4 mm), vascular prosthesis fashioned from bovine ureters (Flonova) with the saphenous vein and polytetrafluoroethylene (PTFE) prostheses. The methods used for the comparative in vitro analysis of the bovine ureter and saphenous vein were modifications of tests recommended by the American National Standards for Vascular Prostheses. Blood compatibility was evaluated by measuring platelet consumption in an artificial circulation, and heparin uptake was quantified using tritiated heparin. The results indicate that the bovine ureter grafts have an adequate degree of mural integrity and hemocompatible properties comparable to saphenous vein. The in vivo patency in a canine bilateral femoral interposition model was 62.5% (10/16) for the bovine ureters and 43.75% (7/16) for PTFE. Bovine ureter grafts appear to have an excellent potential for use in narrow diameter peripheral and coronary arterial bypass procedures and warrant further investigation. PMID:2597448

Burns, P; Edwards, G A; Roberts, G R; Ketharanathan, V; Hatami-Monazah, H

1989-01-01

305

Photovoltaic Retinal Prosthesis with High Pixel Density  

PubMed Central

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

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

2012-01-01

306

The TC double socket above-knee prosthesis.  

PubMed

The conventional total contact suction AK prosthesis presents several disadvantages, such as difficulty in wearing the socket in a sitting position, difficulty in obtaining a favourable disposition of the stump soft tissues in the socket and difficulty in avoiding stump perspiration problems. In an attempt to solve these disadvantages, a new AK prosthesis with a thermoplastic double socket was developed at the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Handicapped. The double socket is composed of an external socket attached to the lower parts and a detachable internal socket, and appears to solve all the disadvantages of the conventional prosthesis. This prosthesis is called the TC prosthesis, and abbreviation for the Tokyo Metropolitan Rehabilitation Center. The first model of this prosthesis, (TC-1) has a metal valve. A new rubber sheet valve was developed to solve several disadvantages of the metal valve in the TC-2 prosthesis. Since November 1978 the TC-1 has been fitted to 295 AK amputees, including 9 bilateral AK amputees, and since March 1980, 145 AK amputees have received the TC-2, including 6 bilateral amputees. Satisfactory results have been obtained with both prostheses. PMID:7329773

Koike, K; Ishikura, Y; Kakurai, S; Imamura, T

1981-12-01

307

Acute thrombosis of mechanical bi-leaflet aortic valve prosthesis  

PubMed Central

Thrombosis of mechanical aortic valve prosthesis is a rare but life-threatening complication. In most reported cases, inadequate anticoagulation or cessation of anticoagulation is the cause of prosthesis thrombosis. The case of a 70-year-old male patient hospitalized for severe dyspnoea is presented. Although the patient was under continuous anticoagulation, thrombosis of the 16 years previously implanted mechanical 31-sized aortic valve prosthesis was diagnosed. Emergency surgery was performed and postoperative course was uneventful. Patients with large size prostheses should have closer anticoagulation monitoring, even after many years of event-free postimplant course. PMID:22923942

Tirilomis, Theodor

2012-01-01

308

Italian Biological Prosthesis Work-Group (IBPWG): proposal for a decisional model in using biological prosthesis  

PubMed Central

Introduction Indications for repair of abdominal hernia are well established and widely diffused. Controversies still exist about the indication in using the different prosthetic materials and principally about the biological ones. Material and methods In February 2012, the Italian Biological Prosthesis Work-Group (IBPWG), counting a background of 264 biologic implants, met in Bergamo (Italy) for 1-day meeting with the aim to elaborate a decisional model on biological prosthesis use in abdominal surgery. Results A diagram to simplify the decisional process in using biologics has been elaborated. Conclusion The present score represents a first attempt to combine scientific knowledge and clinical expertise in order to offer precise indications about the kind of biological mesh to use. PMID:23122187

2012-01-01

309

Development of a micromachined epiretinal vision prosthesis  

NASA Astrophysics Data System (ADS)

Microsystems engineering offers the tools to develop highly sophisticated miniaturized implants to interface with the nervous system. One challenging application field is the development of neural prostheses to restore vision in persons that have become blind by photoreceptor degeneration due to retinitis pigmentosa. The fundamental work that has been done in one approach is presented here. An epiretinal vision prosthesis has been developed that allows hybrid integration of electronics on one part of a thin and flexible substrate. Polyimide as a substrate material is proven to be non-cytotoxic. Non-hermetic encapsulation with parylene C was stable for at least 3 months in vivo. Chronic animal experiments proved spatially selective cortical activation after epiretinal stimulation with a 25-channel implant. Research results have been transferred successfully to companies that currently work on the medical device approval of these retinal vision prostheses in Europe and in the USA.

Stieglitz, Thomas

2009-12-01

310

Galvanic gold plating for fixed dental prosthesis.  

PubMed

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

Ozcelik, Tuncer Burak; Yilmaz, Burak

2013-07-01

311

Redesigning a prosthesis for a golfer with transhumeral amputation  

E-print Network

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

Tsai, Helen

2009-01-01

312

21 CFR 878.3750 - External prosthesis adhesive.  

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 § 878.3750 External prosthesis adhesive. (a) Identification. An external...

2012-04-01

313

21 CFR 878.3530 - Silicone inflatable breast 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 § 878.3530 Silicone inflatable breast prosthesis. (a) Identification. A...

2010-04-01

314

21 CFR 878.3800 - External aesthetic restoration 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 § 878.3800 External aesthetic restoration prosthesis. (a) Identification....

2014-04-01

315

21 CFR 878.3750 - External prosthesis adhesive.  

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 § 878.3750 External prosthesis adhesive. (a) Identification. An external...

2013-04-01

316

21 CFR 878.3750 - External prosthesis adhesive.  

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 § 878.3750 External prosthesis adhesive. (a) Identification. An external...

2010-04-01

317

21 CFR 878.3750 - External prosthesis adhesive.  

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 § 878.3750 External prosthesis adhesive. (a) Identification. An external...

2011-04-01

318

21 CFR 878.3530 - Silicone inflatable breast prosthesis.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

319

21 CFR 878.3530 - Silicone inflatable breast 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 § 878.3530 Silicone inflatable breast prosthesis. (a) Identification. A...

2014-04-01

320

21 CFR 878.3530 - Silicone inflatable breast prosthesis.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

321

21 CFR 878.3750 - External prosthesis adhesive.  

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 § 878.3750 External prosthesis adhesive. (a) Identification. An external...

2014-04-01

322

21 CFR 878.3800 - External aesthetic restoration prosthesis.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

323

21 CFR 878.3800 - External aesthetic restoration prosthesis.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

324

21 CFR 878.3800 - External aesthetic restoration prosthesis.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

325

21 CFR 878.3800 - External aesthetic restoration 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 § 878.3800 External aesthetic restoration prosthesis. (a) Identification....

2010-04-01

326

21 CFR 878.3530 - Silicone inflatable breast prosthesis.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

327

21 CFR 888.3025 - Passive tendon prosthesis.  

Code of Federal Regulations, 2011 CFR

... (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 reconstruction of a flexor tendon of...

2011-04-01

328

Electra Trapezio Metacarpal Prosthesis: Results of the First 100 Cases  

Microsoft Academic Search

The Elektra trapeziometacarpal prosthesis is a cementless, unconstrained prosthesis made by Fixano with titanium and chrome–cobalt steel. This paper examines the results of the first 100 prostheses used by the author for one indication only, viz. painful trapeziometacarpal osteoarthritis. The average follow-up period was 54 (range 36–78) months. Studies of pain, mobility and grip and pinch strength were carried out,

P.-J. REGNARD

2006-01-01

329

Craniofacial implant-retained auricular prosthesis: a case report.  

PubMed

Implants provide patients with a safe and reliable method for anchoring auricular prostheses that enable restoration of their normal appearance and offer improved quality of life. In this case report, an auricular prosthesis was fabricated for a patient who had lost his right external ear in a traffic accident. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to the implant were used. PMID:21905887

Dilber, Erhan; Koc, Ozlem; Ozturk, Atiye Nilgun; Karamese, Mehtap

2013-08-01

330

Cadaveric and three-dimensional computed tomography study of the morphology of the scapula with reference to reversed shoulder prosthesis  

PubMed Central

Purpose The purpose of this study is to analyze the morphology of the scapula with reference to the glenoid component implantation in reversed shoulder prosthesis, in order to improve primary fixation of the component. Methods Seventy-three 3-dimensional computed tomography of the scapula and 108 scapular dry specimens were analyzed to determine the anterior and posterior length of the glenoid neck, the angle between the glenoid surface and the upper posterior column of the scapula and the angle between the major craneo-caudal glenoid axis and the base of the coracoid process and the upper posterior column. Results The anterior and posterior length of glenoid neck was classified into two groups named "short-neck" and "long-neck" with significant differences between them. The angle between the glenoid surface and the upper posterior column of the scapula was also classified into two different types: type I (mean 50°–52°) and type II (mean 62,50°–64°), with significant differences between them (p < 0,001). The angle between the major craneo-caudal glenoid axis and the base of the coracoid process averaged 18,25° while the angle with the upper posterior column of the scapula averaged 8°. Conclusion Scapular morphological variability advices for individual adjustments of glenoid component implantation in reversed total shoulder prosthesis. Three-dimensional computed tomography of the scapula constitutes an important tool when planning reversed prostheses implantation. PMID:18847487

Torrens, Carlos; Corrales, Monica; Gonzalez, Gemma; Solano, Alberto; Cáceres, Enrique

2008-01-01

331

Ischemic Gangrene of the Glans following Penile Prosthesis Implantation.  

PubMed

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

García Gómez, Borja; Romero Otero, Javier; Díez Sicilia, Laura; Jiménez Alcaide, Estibaliz; García-Cruz, Eduardo; Rodríguez Antolín, Alfredo

2013-01-01

332

Ischemic Gangrene of the Glans following Penile Prosthesis Implantation  

PubMed Central

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

García Gómez, Borja; Romero Otero, Javier; Díez Sicilia, Laura; Jiménez Alcaide, Estibaliz; García-Cruz, Eduardo; Rodríguez Antolín, Alfredo

2013-01-01

333

Using clinical and robotic assessment tools to examine the feasibility of pairing tDCS with upper extremity physical therapy in patients with stroke and TBI: a consideration-of-concept pilot study  

PubMed Central

BACKGROUND Transcranial direct current stimulation (tDCS) may provide a safe, non-invasive technique for modulating neural excitability during neurorehabilitation. OBJECTIVE 1) Assess feasibility and potential effectiveness of tDCS as an adjunct to standard upper extremity (UE) physical therapy (PT) for motor impairments resulting from neurological insult. 2) Determine sustainability of improvements over a six month period. METHODS Five participants with chronic neurologic insult (stroke or traumatic brain injury > 6 months prior) completed 24 sessions (40 minutes, three times/week) of UE-PT combined with bihemispheric tDCS delivered at 1.5mA over the motor cortex during the first 15 minutes of each PT session. Outcomes were assessed using clinical (UE Fugl-Meyer, Purdue Pegboard, Box and Block, Stroke Impact Scale) and robotic (unimanual and bimanual motor control) measures. Change in scores and associated effects sizes from Pre-test to Post-test and a six month Follow-up were calculated for each participant and group as a whole. RESULTS Scores on UE Fugl-Meyer, Box and Block, Purdue Pegboard, Stroke Impact Scale, and robotic measures improved from Pre- to Post-test. Improvements on UE Fugl-Meyer, Box and Block, and robotic measures were largely sustained at six months. CONCLUSIONS Combining bihemispheric tDCS with UE-PT in individuals with neurological insult warrants further investigation. PMID:25323084

Middleton, Addie; Fritz, Stacy L.; Liuzzo, Derek M.; Newman-Norlund, Roger; Herter, Troy M.

2014-01-01

334

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

PubMed

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

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

2014-07-01

335

Upper extremity injuries associated with strength training.  

PubMed

Most injuries sustained during strength training are mild strains that resolve with appropriate rest. More severe injuries include traumatic shoulder dislocations, tendon ruptures of the pectoralis major, biceps, and triceps; stress fractures of the distal clavicle, humerus, radius, and ulna; traumatic fractures of the distal radius and ulna in adolescent weightlifters; and compressive and stretch neuropathies. These more severe injuries are usually the result of improperly performing a strength training exercise. Educating athletes regarding proper strength-training techniques serves to reverse established injury patterns and to prevent these injuries in the first place. Recognizing the association of anabolic steroid use to several of the injury patterns further reinforces the need for medical specialists to counsel athletes against their use. With the increasing use of supplements such as creatine, the incidence and nature of strength-training injuries may change further. Greater emphasis on the competitive performance of younger athletes undoubtedly will generate enthusiasm for strength training at earlier ages in both sexes. The importance of proper supervision of these young athletes by knowledgeable persons will increase. As the popularity of strength training grows, there will be ample opportunity to continue to catalog the injury patterns associated with this activity. PMID:11494836

Haupt, H A

2001-07-01

336

Nerve Injuries of the Upper Extremity  

MedlinePLUS

... Safety Snowblower Safety Pumpkin Carving Safety Gardening Safety Turkey Carving Safety Removing a Ring News and Updates ... Safety Snowblower Safety Pumpkin Carving Safety Gardening Safety Turkey Carving Safety Removing a Ring News and Updates ...

337

Vascular Disorders of the Upper Extremity  

MedlinePLUS

... Safety Snowblower Safety Pumpkin Carving Safety Gardening Safety Turkey Carving Safety Removing a Ring News and Updates ... Safety Snowblower Safety Pumpkin Carving Safety Gardening Safety Turkey Carving Safety Removing a Ring News and Updates ...

338

Benign cartilaginous lesions of the upper extremity.  

PubMed

Common and rare benign cartilaginous neoplasms and diseases of multiple cartilaginous lesions are discussed. Particular attention is paid to patient demographics, physical and radiographic findings, pathology, and treatment. PMID:7635877

Floyd, W E; Troum, S

1995-05-01

339

An Harmonic Smile Resulted from the Use of Ceramic Prosthesis with Zirconia Structure: A Case Report  

PubMed Central

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

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

2014-01-01

340

Proportional EMG control of ankle plantar flexion in a powered transtibial prosthesis.  

PubMed

The human calf muscle generates 80% of the mechanical work to walk throughout stance-phase, powered plantar flexion. Powered plantar flexion is not only important for walking energetics, but also to minimize the impact on the leading leg at heel-strike. For unilateral transtibial amputees, it has recently been shown that knee load on the leading, intact limb decreases as powered plantar flexion in the trailing prosthetic ankle increases. Not surprisingly, excessive loads on the leading, intact knee are believed to be causative of knee osteoarthritis, a leading secondary impairment in lower-extremity amputees. In this study, we hypothesize that a transtibial amputee can learn how to control a powered ankle-foot prosthesis using a volitional electromyographic (EMG) control to directly modulate ankle powered plantar flexion. We here present preliminary data, and find that an amputee participant is able to modulate toe-off angle, net ankle work and peak power across a broad range of walking speeds by volitionally modulating calf EMG activity. The modulation of these key gait parameters is shown to be comparable to the dynamical response of the same powered prosthesis controlled intrinsically (No EMG), suggesting that transtibial amputees can achieve an adequate level of powered plantar flexion controllability using direct volitional EMG control. PMID:24187210

Wang, Jing; Kannape, Oliver A; Herr, Hugh M

2013-06-01

341

The Boston retinal prosthesis a 15-channel hermetic wireless neural stimulator  

E-print Network

A miniaturized, hermetically-encased, wirelessly-operated retinal prosthesis has been developed for pre-clinical studies in Yucatan minipig animal models. The prosthesis attaches conformally to the outside of the eye and ...

Wyatt, John L.

342

Zirconia in fixed prosthesis. A literature review  

PubMed Central

Statement of problem: Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. Objective: To carry out a literature review of the behavior of zirconium oxide dental restorations. Material and Methods: This literature review searched the Pubmed, Scopus, Medline and Cochrane Library databases using key search words “zirconium oxide,” “zirconia,” “non-metal restorations,” “ceramic oxides,” “veneering ceramic,” “zirconia-based fixed dental prostheses”. Both in vivo and in vitro studies into zirconia-based prosthodontic restoration behavior were included. Results: Clinical studies have revealed a high rate of fracture for porcelain-veneered zirconia-based restorations that varies between 6% and 15% over a 3- to 5-year period, while for ceramo-metallic restorations the fracture rate ranges between 4 and 10% over ten years. These results provoke uncertainty as to the long-term prognosis for this material in the oral medium. The cause of veneering porcelain fractures is unknown but hypothetically they could be associated with bond failure between the veneer material and the zirconia sub-structure. Key words:Veneering ceramic, zirconia-based ceramic restoration, crown, zirconia, tooth-supported fixed prosthesis. PMID:24596638

Román-Rodríguez, Juan L.; Ferreiroa, Alberto; Solá-Ruíz, María F.; Fons-Font, Antonio

2014-01-01

343

Finite element modeling of retinal prosthesis mechanics  

NASA Astrophysics Data System (ADS)

Epiretinal prostheses used to treat degenerative retina diseases apply stimulus via an electrode array fixed to the ganglion cell side of the retina. Mechanical pressure applied by these arrays to the retina, both during initial insertion and throughout chronic use, could cause sufficient retinal damage to reduce the device's effectiveness. In order to understand and minimize potential mechanical damage, we have used finite element analysis to model mechanical interactions between an electrode array and the retina in both acute and chronic loading configurations. Modeling indicates that an acute tacking force distributes stress primarily underneath the tack site and heel edge of the array, while more moderate chronic stresses are distributed more evenly underneath the array. Retinal damage in a canine model chronically implanted with a similar array occurred in correlating locations, and model predictions correlate well with benchtop eyewall compression tests. This model provides retinal prosthesis researchers with a tool to optimize the mechanical electrode array design, but the techniques used here represent a unique effort to combine a modifiable device and soft biological tissues in the same model and those techniques could be extended to other devices that come into mechanical contact with soft neural tissues.

Basinger, B. C.; Rowley, A. P.; Chen, K.; Humayun, M. S.; Weiland, J. D.

2009-10-01

344

Metabolic Prosthesis for Oxygenation of Ischemic Tissue  

SciTech Connect

This communication discloses new ideas and preliminary results on the development of a "metabolic prosthesis" for local oxygenation of ischemic tissue under physiological neutral conditions. We report for the first time the selective electrolysis of physiological saline by repetitively pulsed charge-limited electrolysis for the production of oxygen and suppression of free chlorine. For example, using 800 A amplitude current pulses and <200 sec pulse durations, we demonstrated prompt oxygen production and delayed chlorine production at the surface of a shiny 0.85 mm diameter spherical platinum electrode. The data, interpreted in terms of the ionic structure of the electric double layer, suggest a strategy for in situ production of metabolic oxygen via a new class of "smart" prosthetic implants for dealing with ischemic disease such as diabetic retinopathy. We also present data indicating that drift of the local pH of the oxygenated environment can be held constant using a feedback-controlled three electrode electrolysis system that chooses anode and cathode pair based on pH data provided by local microsensors. The work is discussed in the context of diabetic retinopathy since surgical techniques for multielectrode prosthetic implants aimed at retinal degenerative diseases have been developed.

Greenbaum, Elias [ORNL

2009-01-01

345

Extreme Rainfall Rates: An Extreme Retrieval Challenge  

NASA Astrophysics Data System (ADS)

One of the greatest challenges in remote sensing, from space, or from surface-based measurements, is making accurate estimates of extremely heavy rainfall rates. These extreme rainfall rates, quite understandably, often are responsible for natural disasters that include flooding and landslides. The particular focus of this talk is to demonstrate that extreme rainfall rates can come from two distinctly different types of storms, and to show that the TRMM Precipitation Radar retrievals may have large errors in these storms. One type of extreme storm occurs more frequently in the United States than in Japan, and is characterized by very high radar reflectivity throughout the depth of the troposphere. The second type of extreme storm is characterized by a "low echo centroid", with relatively weak radar echoes in the upper troposphere, and may be more amenable to accurate rain rate retrievals. The first type of storm presents more difficulties for retrievals because of the much greater total path attenuation. Some examples of both types of storms are shown in both the United States and Japan.

Zipser, E. J.; Liu, C.; Hamada, A.; Takayabu, Y. N.

2013-12-01

346

Maxillary cement retained implant supported monolithic zirconia prosthesis in a full mouth rehabilitation: a clinical report  

PubMed Central

This clinical report presents the reconstruction of a maxillary arch with a cement retained implant supported fixed prosthesis using a monolithic zirconia generated by CAD/CAM system on eight osseointegrated implants. The prosthesis was copy milled from an interim prosthesis minimizing occlusal adjustments on the definitive prosthesis at the time of delivery. Monolithic zirconia provides high esthetics and reduces the number of metal alloys used in the oral cavity. PMID:23755349

Liu, Perng-Ru; Aponte-Wesson, Ruth; O'Neal, Sandra J

2013-01-01

347

Closed-eye orbital prosthesis: A clinical report.  

PubMed

One of the most challenging prostheses to fabricate is an acceptable orbital prosthesis. Successful reconstruction of the complex missing tissues, the globe, muscle, skin, and bony elements requires time and high levels of practical skill. A good match to the contralateral nondefect side will help mask the underlying defect and give the patient confidence to return to normal, routine life. The contralateral eye opening will commonly dictate the eye opening of such a prosthesis, but because of the expressive nature of the eye and its high levels of mobility, this can be difficult to achieve. This clinical report presents a patient who had an extended orbital exenteration and right maxillectomy to remove a maxillary squamous cell carcinoma. An alternative approach to constructing an orbital prosthesis was undertaken with the eye closed. Compared to the normal method of fabrication, this process was less complex and quicker, made the prosthesis less "staring," camouflaged the defect, and reduced the detection of the prosthesis because of movements in the remaining eye. The patient engaged in his routine daily life, which reinforced his self-esteem, confidence, and reintegration into the community. PMID:25449612

Hatamleh, Muhanad M; Watson, Jason; Srinivasan, Dilip

2014-11-20

348

Bone vibration measurement using ultrasound: Application to detection of hip prosthesis loosening  

Microsoft Academic Search

Hip prosthesis loosening can be determined in vivo using a vibration-based technique called vibrometry. In this technique, a low frequency (<1000Hz) sinusoidal vibration is applied to the femoral condyles and the resulting vibration is measured at the greater trochanter. If the prosthesis is securely fixed, the output vibration signal matches that of the input vibration, whereas if the prosthesis is

A. Rowlands; F. A. Duck; J. L. Cunningham

2008-01-01

349

Full mouth rehabilitation of a patient with extracoronal attachments and telescopic prosthesis - a case report.  

PubMed

The management of tooth wear is complex and challenging as it involves multidisciplinary approach. Proper diagnosis and elaborative treatment protocol is necessary to obtain successful and predictable outcome. The objective of full mouth rehabilitation includes identification of the cause, prevention and preservation of the remaining tooth structure. This case report presents the management of the remaining teeth by endodontic and periodontic intervention which was followed by porcelain fused to metal fixed prosthesis, telescopic denture for the upper missing teeth and extra-coronal attachments for the lower missing teeth. Segmental arch technique was utilized for the rehabilitation where anterior teeth were restored first followed by the posterior teeth. Patient had a satisfactory functional and aesthetic results. PMID:25478459

Gounder, Revathy; Rao, P Laxman; Kumar, G Ajay; M, Githanjali; Chandrasekhar, N

2014-10-01

350

Preliminary Evaluations of a Self-Contained Anthropomorphic Transfemoral Prosthesis  

PubMed Central

This paper presents a self-contained powered knee and ankle prosthesis, intended to enhance the mobility of transfemoral amputees. A finite-state based impedance control approach, previously developed by the authors, is used for the control of the prosthesis during walking and standing. Experiments on an amputee subject for level treadmill and overground walking are described. Knee and ankle joint angle, torque, and power data taken during walking experiments at various speeds demonstrate the ability of the prosthesis to provide a functional gait that is representative of normal gait biomechanics. Measurements from the battery during level overground walking indicate that the self-contained device can provide more than 4500 strides, or 9 km, of walking at a speed of 5.1 km/h between battery charges. PMID:20054424

Sup, Frank; Varol, Huseyin Atakan; Mitchell, Jason; Withrow, Thomas J.; Goldfarb, Michael

2009-01-01

351

Nasal prosthesis for a patient with xeroderma pigmentosum  

PubMed Central

Acquired facial defects caused by extirpation of neoplasms, congenital malformations or traumatic injury results in a huge functional, cosmetic and psychological handicap in those patients. These defects can be restored by facial prosthesis using different materials and retention methods to achieve a lifelike appearance and function. This clinical report describes a treatment schedule using silicone nasal prosthesis, which is mechanically retained for a patient who has undergone a partial rhinectomy due to basal cell carcinoma of the nose. The prosthesis was made to restore the esthetic appearance of patient with a mechanically retained design using a spectacle glass frame without any prosthetic adhesives so that the patient is more comfortable and confident to resume daily activities. PMID:23956602

Kumar, Suresh; Rajtilak, G.; Rajasekar, V.; Kumar, Muthu

2013-01-01

352

System training and assessment in simultaneous proportional myoelectric prosthesis control  

PubMed Central

Background Pattern recognition control of prosthetic hands take inputs from one or more myoelectric sensors and controls one or more degrees of freedom. However, most systems created allow only sequential control of one motion class at a time. Additionally, only recently have researchers demonstrated proportional myoelectric control in such systems, an option that is believed to make fine control easier for the user. Recent developments suggest improved reliability if the user follows a so-called prosthesis guided training (PGT) scheme. Methods In this study, a system for simultaneous proportional myoelectric control has been developed for a hand prosthesis with two motor functions (hand open/close, and wrist pro-/supination). The prosthesis has been used with a prosthesis socket equivalent designed for normally-limbed subjects. An extended version of PGT was developed for use with proportional control. The control system’s performance was tested for two subjects in the Clothespin Relocation Task and the Southampton Hand Assessment Procedure (SHAP). Simultaneous proportional control was compared with three other control strategies implemented on the same prosthesis: mutex proportional control (the same system but with simultaneous control disabled), mutex on-off control, and a more traditional, sequential proportional control system with co-contractions for state switching. Results The practical tests indicate that the simultaneous proportional control strategy and the two mutex-based pattern recognition strategies performed equally well, and superiorly to the more traditional sequential strategy according to the chosen outcome measures. Conclusions This is the first simultaneous proportional myoelectric control system demonstrated on a prosthesis affixed to the forearm of a subject. The study illustrates that PGT is a promising system training method for proportional control. Due to the limited number of subjects in this study, no definite conclusions can be drawn. PMID:24775602

2014-01-01

353

Extremely compliant and highly stretchable patterned graphene  

SciTech Connect

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

Zhu, Shuze; Huang, Yinjun; Li, Teng, E-mail: LiT@umd.edu [Department of Mechanical Engineering and Maryland NanoCenter, University of Maryland, College Park, Maryland 20742 (United States)

2014-04-28

354

[Ankle joint prosthesis for bone defects].  

PubMed

Large defects of the talus, i.e. due to tumors, large areas of osteolysis in total ankle replacement (TAR) and posttraumatic talus body necrosis are difficult to manage. The gold standard in these circumstances is still tibiocalcaneal arthrodesis with all the negative aspects of a completely rigid hindfoot. We started 10 years ago to replace the talus by a custom-made, all cobalt-chrome implant (laser sintering). The first patient with a giant cell tumor did very well but the following patients showed all subsidence of the metal talus into the tibia due to missing bony edges. Therefore, we constructed a custom-made talus (mirrored from the healthy side) and combined it with a well functioning total ankle prosthesis (Hintegra). So far we have implanted this custom-made implant into 3 patients: the first had a chondrosarcoma of the talus (1 year follow-up), the second had massive osteolysis/necrosis of unknown origin (6 months follow-up) and the third massive osteolysis following a correct TAR (2 months follow-up). The results are very encouraging as all of the patients are practically pain free and have a good range of movement (ROM): D-P flexion 15°-0-20° but less motion in the lower ankle joint: ROM P-S 5°-0-5°. No subsidence was detected in the tibia or the calcaneus. The custom-made talus combined with the Hintegra total ankle replacement will probably be an interesting alternative to a tibiocalcaneal arthrodesis in selected cases with massive defects of the talus. PMID:21989687

Lampert, C

2011-11-01

355

Photovoltaic retinal prosthesis: implant fabrication and performance  

NASA Astrophysics Data System (ADS)

The objective of this work is to develop and test a photovoltaic retinal prosthesis for restoring sight to patients blinded by degenerative retinal diseases. A silicon photodiode array for subretinal stimulation has been fabricated by a silicon-integrated-circuit/MEMS process. Each pixel in the two-dimensional array contains three series-connected photodiodes, which photovoltaically convert pulsed near-infrared light into bi-phasic current to stimulate nearby retinal neurons without wired power connections. The device thickness is chosen to be 30 µm to absorb a significant portion of light while still being thin enough for subretinal implantation. Active and return electrodes confine current near each pixel and are sputter coated with iridium oxide to enhance charge injection levels and provide a stable neural interface. Pixels are separated by 5 µm wide trenches to electrically isolate them and to allow nutrient diffusion through the device. Three sizes of pixels (280, 140 and 70 µm) with active electrodes of 80, 40 and 20 µm diameter were fabricated. The turn-on voltages of the one-diode, two-series-connected diode and three-series-connected diode structures are approximately 0.6, 1.2 and 1.8 V, respectively. The measured photo-responsivity per diode at 880 nm wavelength is ˜0.36 A W-1, at zero voltage bias and scales with the exposed silicon area. For all three pixel sizes, the reverse-bias dark current is sufficiently low (<100 pA) for our application. Pixels of all three sizes reliably elicit retinal responses at safe near-infrared light irradiances, with good acceptance of the photodiode array in the subretinal space. The fabricated device delivers efficient retinal stimulation at safe near-infrared light irradiances without any wired power connections, which greatly simplifies the implantation procedure. Presence of the return electrodes in each pixel helps to localize the current, and thereby improves resolution.

Wang, Lele; Mathieson, K.; Kamins, T. I.; Loudin, J. D.; Galambos, L.; Goetz, G.; Sher, A.; Mandel, Y.; Huie, P.; Lavinsky, D.; Harris, J. S.; Palanker, D. V.

2012-08-01

356

In vivo performance of photovoltaic subretinal prosthesis  

NASA Astrophysics Data System (ADS)

We have developed a photovoltaic retinal prosthesis, in which camera-captured images are projected onto the retina using pulsed near-IR light. Each pixel in the subretinal implant directly converts pulsed light into local electric current to stimulate the nearby inner retinal neurons. 30 ?m-thick implants with pixel sizes of 280, 140 and 70 ?m were successfully implanted in the subretinal space of wild type (WT, Long-Evans) and degenerate (Royal College of Surgeons, RCS) rats. Optical Coherence Tomography and fluorescein angiography demonstrated normal retinal thickness and healthy vasculature above the implants upon 6 months follow-up. Stimulation with NIR pulses over the implant elicited robust visual evoked potentials (VEP) at safe irradiance levels. Thresholds increased with decreasing pulse duration and pixel size: with 10 ms pulses it went from 0.5 mW/mm2 on 280 ?m pixels to 1.1 mW/mm2 on 140 ?m pixels, to 2.1 mW/mm2 on 70 ?m pixels. Latency of the implant-evoked VEP was at least 30 ms shorter than in response evoked by the visible light, due to lack of phototransduction. Like with the visible light stimulation in normal sighted animals, amplitude of the implant-induced VEP increased logarithmically with peak irradiance and pulse duration. It decreased with increasing frequency similar to the visible light response in the range of 2 - 10 Hz, but decreased slower than the visible light response at 20 - 40 Hz. Modular design of the photovoltaic arrays allows scalability to a large number of pixels, and combined with the ease of implantation, offers a promising approach to restoration of sight in patients blinded by retinal degenerative diseases.

Mandel, Yossi; Goetz, George; Lavinsky, Daniel; Huie, Phil; Mathieson, Keith; Wang, Lele; Kamins, Theodore; Manivanh, Richard; Harris, James; Palanker, Daniel

2013-02-01

357

Photovoltaic retinal prosthesis: implant fabrication and performance  

PubMed Central

Objective To develop and test a photovoltaic retinal prosthesis for restoring sight to patients blinded by degenerative retinal diseases. Approach A silicon photodiode array for subretinal stimulation has been fabricated by a silicon-integrated-circuit/MEMS process. Each pixel in the two-dimensional array contains three series-connected photodiodes, which photovoltaically convert pulsed near-infrared light into bi-phasic current to stimulate nearby retinal neurons without wired power connections. The device thickness is chosen to be 30 ?m to absorb a significant portion of light while still being thin enough for subretinal implantation. Active and return electrodes confine current near each pixel and are sputter coated with iridium oxide to enhance charge injection levels and provide a stable neural interface. Pixels are separated by 5 ?m-wide trenches to electrically isolate them and to allow nutrient diffusion through the device. Three sizes of pixels (280?m, 140 ?m, and 70 ?m) with active electrodes of 80 ?m, 40 ?m and 20 ?m in diameter were fabricated. Main results The turn-on voltages of one-, two- and three-series-connected photodiode structures are approximately 0.6V, 1.2V and 1.8V, respectively. The measured photo-responsivity per diode at 880 nm wavelength is ~0.36 A/W, at zero voltage bias and scales with the exposed silicon area. For all three pixel sizes, the reverse-bias dark current is sufficiently low (<100 pA) for our application. Pixels of all three sizes reliably elicit retinal responses at safe near-infrared light irradiances, with good acceptance of the photodiode array in the subretinal space. Significance The fabricated device delivers efficient retinal stimulation at safe near-infrared light irradiances without any wired power connections, which greatly simplifies the implantation procedure. Presence of the return electrodes in each pixel helps to localize the current, and thereby improves resolution. PMID:22791690

Wang, Lele; Mathieson, K; Kamins, T I; Loudin, J D; Galambos, L; Goetz, G; Sher, A; Mandel, Y; Huie, P; Lavinsky, D; Harris, J S; Palanker, D V

2012-01-01

358

A Simplified Technique for Fabrication of Orbital Prosthesis  

PubMed Central

Eye is a vital organ not only for vision, but also an important component of facial expression, and over-all personality of a person. Loss of eye, apart from leading to impaired vision has a crippling effect on the psychology of the patient. Prosthodontic rehabilitation of such cases includes fabrication of prosthesis by acrylic resin, silicone and implants. However, not all patients are willing to use implants for maxillofacial rehabilitation. Therefore, a custom made orbital prosthesis serves as an affordable and satisfactory alternative. PMID:25121068

Thakral, G.K.; Mohapatra, Abhilash; Seth, Jyotsna; Vashisht, Pallavi

2014-01-01

359

Comparison of a new mobile-bearing total knee prosthesis with a fixed-bearing prosthesis: a matched pair analysis  

Microsoft Academic Search

Background  New prosthesis designs should provide either superior function or durability. Before long time follow up studies are started\\u000a it should at least prove its effectiveness in clinical outcomes. Therefore we have studied the early clinical results of a\\u000a new mobile bearing total knee prosthesis (e.motion; Aesculap®) in comparison with our established fixed-bearing device (PFC; DePuy®) in a matched-pair analysis.\\u000a \\u000a \\u000a \\u000a Patients

Florian Geiger; Hans Mau; Marlis Krüger; Marc Thomsen

2008-01-01

360

Graded levels of foot control for below elbow prosthesis  

Microsoft Academic Search

Summary form only given. Multifunctional below elbow prosthesis have not been accepted by the user due to limitations in graded control actuating mechanisms. Previously pneumatic and electric switches have been tried which offered a fixed number of control levels. A number of graded levels of control have been achieved by EMG control but its use is restricted because of the

M. S. Ghiyasvand

2003-01-01

361

Verge of Collapse: The Pros/thesis of Art Research  

ERIC Educational Resources Information Center

This article explores "prosthesis" as a metaphor of embodiment in art-based research to challenge the utopian myth of wholeness and normality in art and the human body. Bearing in mind the correspondences between amputated bodies and the cultural dislocations of art, I propose "prosthetic epistemology" and "prosthetic ontology" as embodied knowing…

Garoian, Charles R.

2008-01-01

362

[Arterial revascularization of liver graft with PTFE vascular prosthesis].  

PubMed

When the hepatic artery is not available in liver transplantation because of its bad quality or low flow, arterial grafts from the donor have to be used to obtain arterial blood flow from the aorta. The case of use of a vascular PTFE prosthesis when no vascular grafts were available is presented, with good outcome 6 months after transplantation. PMID:8534542

Calleja Kempin, J; Martin Cavanna, J; Jiménez Almonacid, P; Pérez-Ferreiroa, J; Clemente Ricote, G; Bañares Cañizares, R

1995-11-01

363

A Probabilistic Decoding Approach to a Neural Prosthesis for Speech  

Microsoft Academic Search

Neural prosthetic systems for motor control and communication have produced striking results in recent studies with non-human primates and human volunteers. We describe a new approach in our ongoing work toward developing an intracortical neural prosthesis for speech restoration with a 26 year old human volunteer with tetraplegia (including loss of vocal and facial muscle control). We propose to use

Brett Matthews; Jonathan Kim; Jonathan S. Brumberg; Mark Clements

2010-01-01

364

SAFETY AND EFFECTIVENESS OF A NEW SALINE FILLED TESTICULAR PROSTHESIS  

Microsoft Academic Search

PurposeTesticular prostheses have been used for 50 years to replace missing or removed testes. In 1995 the manufacture of the silicone gel filled testis prosthesis in the United States was discontinued because of concern about the safety profiles of other implants. We assessed the safety and effectiveness of a new, saline filled implant for testicular replacement.

PAUL J. TUREK; VIRAJ A. MASTER

2004-01-01

365

Powered Ankle-Foot Prosthesis for the Improvement of Amputee Samuel K. Au, Hugh Herr, Jeff Weber, and Ernesto C. Martinez-Villalpando  

E-print Network

Powered Ankle-Foot Prosthesis for the Improvement of Amputee Ambulation Samuel K. Au, Hugh Herr, control scheme, and clinical evaluation of a novel, motorized ankle-foot prosthesis, called MIT Powered Ankle-Foot Prosthesis. Unlike a conventional passive-elastic ankle-foot prosthesis, this prosthesis can

Herr, Hugh

366

Extreme Tourism  

E-print Network

Broadcast Transcript: The stereotype of the Japanese tourist with his camera has been taken to an extreme by one Toshifumi Fujimoto. Mr. Fujimoto likes to don camo clothing and sneak up to the front lines of international ...

Hacker, Randi

2013-03-13

367

Extreme Heat  

MedlinePLUS

... its limits. In extreme heat and high humidity, evaporation is slowed and the body must work extra ... the body by increasing the perspiration rate of evaporation. Eat well-balanced, light, and regular meals. Avoid ...

368

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

ERIC Educational Resources Information Center

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

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

2011-01-01

369

The method of manufacture of nylon dental partially removable prosthesis using additive technologies  

NASA Astrophysics Data System (ADS)

The article is devoted to the topic of creating new methods of dental prosthesis. The aim of this work is to investigate the possibility of using additive technology to create nylon prosthesis. As a result of experimental studies, was made a sample of nylon partially removable prosthesis using 3D printing has allowed to simplify, accelerate and reduce the coat of manufacturing high-precision nylon dentures.

Kashapov, R. N.; Korobkina, A. I.; Platonov, E. V.; Saleeva, G. T.

2014-12-01

370

Magnetic resonance imaging compatibility test of a cranial prosthesis with titanium screws  

NASA Astrophysics Data System (ADS)

The follow-up of patients with skull prosthesis is necessary to provide adequate medical care. Skull prostheses for cranioplasty have been developed at the Faculty of Odontology of Universidad Nacional Autonoma de Mexico. We built a skull prosthesis phantom and tested for compatibility with standard magnetic resonance imaging procedures. Results showed full compatibility but susceptibility artefacts occurred due to titanium used to fix the prosthesis to the skull.

Jimenez, R.; Benavides, A.; Flores, D.; Hidalgo, S. S.; Solis, S. E.; Uribe, E.; Rodriguez, A. O.

2012-10-01

371

Research and development of a versatile portable speech prosthesis  

NASA Technical Reports Server (NTRS)

The Versatile Portable Speech Prosthesis (VPSP), a synthetic speech output communication aid for non-speaking people is described. It was intended initially for severely physically limited people with cerebral palsy who are in electric wheelchairs. Hence, it was designed to be placed on a wheelchair and powered from a wheelchair battery. It can easily be separated from the wheelchair. The VPSP is versatile because it is designed to accept any means of single switch, multiple switch, or keyboard control which physically limited people have the ability to use. It is portable because it is mounted on and can go with the electric wheelchair. It is a speech prosthesis, obviously, because it speaks with a synthetic voice for people unable to speak with their own voices. Both hardware and software are described.

1981-01-01

372

A Blue Tooth – Auricular Prosthesis: A Case Report  

PubMed Central

The absence of an ear is a considerable aesthetic problem which affects the patient’s psychology and social behaviour. We are describing a case of 25-year-old male reporting to the Department of Prosthodontics, with a chief complaint of deficient left auricular tissue. This can be corrected surgically, prosthetically or through a combination of these approaches; but the choice of treatment depends on patient. The patient chose prosthetic rehabilitation over surgical procedures & retention becomes a critical issue in this approach. Out of many types of retentive methods, we selectively incorporated new materials and used the latest technology to ensure the highest quality prosthesis. Creative approach for each patient with a focus on their individual needs was considered as it gives more satisfaction to the patient. This article describes a new, simple and cost effective technique by embedding Bluetooth-headset device into the silicone elastomer of a mechanically-retained auricular prosthesis. PMID:25302281

H. Naveen, Bandlar; R. Kashinath, Korapathi; B. Shankargouda, Swapnil

2014-01-01

373

The AGC total knee prosthesis at average 11 years  

Microsoft Academic Search

A retrospective study of a series of 126 consecutive primary cemented total knee replacements using the AGC prosthesis is reported. Sixty-two knees were available for long-term review with an average clinical follow-up of 11.4 years (range, 8.4-13.6 years). The survivorship was 95%, defining the endpoint as revision of all components for any reason except sepsis. The average knee flexion was

Roger H Emerson; Linda L Higgins; William C Head

2000-01-01

374

Improved results for dissecting aneurysms. Intraluminal sutureless prosthesis.  

PubMed

Surgical therapy for dissection of the thoracic aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. A method of treatment with an intraluminal prosthesis that requires no end-to-end anastomosis has been developed. We have used this method in 14 patients, of whom eight had acute thoracic aortic dissections and six had chronic dissections. We assembled our own prosthesis in the first five cases but, more recently, we have utilized an intraluminal prosthesis provided by USCI. Eight of the patients had type 1 dissection, of whom five required concomitant aortic valve replacement and three coronary artery bypass grafting; one had a type II dissection and five had type III dissections. The age range was 31 to 71 years with a mean of 58. There were 12 men and 2 women. There were no intraoperative deaths, but one patient died 10 days postoperatively of a perforated ulcer and another died at 6 months of empyema. Follow-up has been from 9 to 51 months with a mean of 22 months. There has been no evidence of compromise of the aortic lumen and no prosthetic problems, such as erosion, migration, or thrombosis. This technique provides a safe and simple way to repair dissecting aneurysms of the thoracic aorta and has provided long-term reliability. We have subsequently used this graft for 11 patients with aneurysm of the aorta with favorable results. We presently recommend this technique for dissecting, atherosclerotic, and Marfanoid aneurysms of the thoracic aorta. PMID:6977074

Lemole, G M; Strong, M D; Spagna, P M; Karmilowicz, N P

1982-02-01

375

Preclotting of knitted Dacron prosthesis. A scanning electron microscope study.  

PubMed

A scanning electron microscope study of preclotting on knitted Dacron prosthesis is reported. Five steps of the interaction are well identified: (1) before any blood contact (virgin Dacron), (2) during the first 3 minutes (fibrin and platelet aggregates), (3) fifth minute of contact (clotting), (4) 15 minutes of contact with heparinized blood (thin fibrin network), and (5) the following minutes (invasion of fibrin, which enmeshes blood cells). PMID:125367

Guidoin, R G; Gosselin, C; Rouleau, C; Haggis, G H; Boulay, J; Awad, J

1975-07-01

376

Penile Enhancement Procedures with Simultaneous Penile Prosthesis Placement  

PubMed Central

Here we present an overview of various techniques performed concomitantly during penile prosthesis surgery to enhance penile length and girth. We report on the technique of ventral phalloplasty and its outcomes along with augmentation corporoplasty, suprapubic lipectomy, suspensory ligament release, and girth enhancement procedures. For the serious implanter, outcomes can be improved by combining the use of techniques for each scar incision. These adjuvant procedures are a key addition in the armamentarium for the serious implant surgeon. PMID:22811703

Hakky, Tariq S.; Suber, Jessica; Henry, Gerard; Smith, David; Bradley, Paul; Martinez, Daniel; Carrion, Rafael E.

2012-01-01

377

A hollow silicone finger prosthesis with modified metal-mesh conformer.  

PubMed

Loss of an organ such as a finger not only imposes a functional impairment, but also leads to unaesthetic appearance and a deep psychological stigma to the patient. Hence replacement of such missing finger with the help of an artificial finger prosthesis has been very successful. The success of the prosthesis depends on the precision in meticulous planning and designing of prosthesis, technique of fabrication and the materials used. This article describes fabrication of a finger prosthesis by a modified technique, by making a metal conformer with a wire mesh. This design offers maximum retention and excellent aesthetics, thereby imparting a lifelike appearance to the hand with missing finger. PMID:25183916

Saxena, Kanupriya; Sharma, Anil; Hussain, Mohd Abid Zahir; Thombare, Ram U; Bhasin, Saranjit Singh

2014-09-01

378

Magnet retained intraoral-extra oral combination prosthesis: a case report  

PubMed Central

Facial prosthesis is generally considered over surgical reconstruction to restore function and appearance in patients with facial defects that resulted from cancer resection. Retention of the prosthesis is challenging due to its size and weight. Retention can be achieved by using medical grade adhesives, resilient attachments, clips and osseointegrated implants. It can also be connected to obturator by magnets. This clinical report highlights the rehabilitation of a lateral midfacial defect with a two piece prosthesis that included an extra oral facial prosthesis and an intraoral obturator with the use of magnets. PMID:23236576

Kumar, Surender; Bera, Amit; Gupta, Tapas; Banerjee, Ardhendu

2012-01-01

379

Reverse shoulder prosthesis: implementation and experience in Croatia.  

PubMed

Reverse shoulder prosthesis has become one of the most often used prosthetic implants in shoulder replacement surgery. It has a wide spectrum of indications, starting from comminuted humeral fractures and posttraumatic arthritis to arthritis caused by the rotator cuff loss. Its application at our hospital began in 2004, at first in few specific cases and with time in ever growing number of patients. Over 8 years, more than 250 reverse shoulder prostheses were implanted at our institution. In addition, our surgeons supervised its application in other hospitals all over Croatia. In the postoperative course, the shoulder was immobilized for 4-6 weeks with a thoracobrachial cast. After removal of the cast, physical therapy was initiated. The length of physical therapy program depended upon many factors. As a rule, immobilization lasted longer in patients that were operated on due to posttraumatic arthritis and those that suffered from deltoid muscle atrophy and shoulder contracture before surgery. Complications included dislocation of the prosthesis shortly after surgery (in the first four weeks) and infection. Infection was a special problem and treatment included even explantation of the prosthesis. PMID:25509240

Ben?i?, Ivan; Matej?i?, Aljoša; Doj?inovi?, Bojan; ?uti, Tomislav

2014-09-01

380

A multiaxial force-sensing implantable tibial prosthesis.  

PubMed

Accurate in vivo measurement of tibiofemoral forces is important in total knee arthroplasty. These forces determine polyethylene stresses and cold-flow, stress distribution in the implant, and stress transfer to the underlying implant bone interface. Theoretic estimates of tibiofemoral forces have varied widely depending on the mathematical models used. The six degrees of freedom of motion, complex articular surface topography, changing joint-contact position, intra- and extra-articular ligaments, number of muscles crossing the knee joint, and the presence of the patellofemoral joint contribute to the difficulty in developing reliable models of the knee. A prototype instrumented total knee replacement tibial prosthesis was designed, manufactured, and tested. This prosthesis accurately measured all six components of tibial forces (R2>0.997). The prosthesis was also instrumented with an internal microtransmitter for wireless data transmission. Remote powering of the sealed implanted electronics was achieved using magnetic coil induction. This device can be used to validate existing models of the knee that estimate these forces or to develop more accurate models. In conjunction with kinematic data, accurate tibiofemoral force data may be used to design more effective knee-testing rigs and wear simulators. Additional uses are intraoperative measurement of forces to determine soft-tissue balancing and to evaluate the effects of rehabilitation, external bracing, and athletic activities, and activities of daily living. PMID:16023656

Kirking, Bryan; Krevolin, Janet; Townsend, Christopher; Colwell, Clifford W; D'Lima, Darryl D

2006-01-01

381

One-stage microvascular mandible reconstruction and alloplastic TMJ prosthesis.  

PubMed

Severely deformed or absent temporomandibular joints (TMJ) benefit from total alloplastic joint replacement and large mandibular defects from revascularized free tissue transfer for reconstruction. However no cases of their combined one-stage placement with outcomes can be found in the literature. We present two cases with different indications and reconstruction. The first patient required mandibular body and ascending ramus reconstruction after previous sarcoma resection. This was with a condyle-bearing reconstruction plate which resulted in significant dysfunction, leaving the patient unable to open her mouth. A one-stage vascularized iliac crest free flap and alloplastic TMJ prosthesis was used to reconstruct the mandible. Subsequently, metal removal, soft tissue augmentation by lipotransfer and dental implant placement were performed. At 63 months follow-up patient was pain-free, with mouth opening, protrusion and lateral excursion back to normal. The second patient required mandibular body, ascending ramus and joint reconstruction, performed by transoral vascularized fibula free flap with temporal vessel anastomosis. The traumatic deep bite and posterior facial height were corrected, additional submandibular scars avoided by transoral placement of the fibula transplant and a miniaturized TMJ prosthesis along with the vascularised free flap with 28 months follow-up. A miniaturized TMJ prosthesis may become placed transorally for reconstruction of the TMJ, together with a vascularized free flap for mandibular reconstruction and promises good long-term stability with normal function above all for protrusion and lateral excursion. PMID:23466124

Landes, Constantin; Korzinskas, Tadas; Dehner, Jan-Friedrich; Santo, Gregor; Ghanaati, Shahram; Sader, Robert

2014-01-01

382

A cortical neural prosthesis for restoring and enhancing memory  

NASA Astrophysics Data System (ADS)

A primary objective in developing a neural prosthesis is to replace neural circuitry in the brain that no longer functions appropriately. Such a goal requires artificial reconstruction of neuron-to-neuron connections in a way that can be recognized by the remaining normal circuitry, and that promotes appropriate interaction. In this study, the application of a specially designed neural prosthesis using a multi-input/multi-output (MIMO) nonlinear model is demonstrated by using trains of electrical stimulation pulses to substitute for MIMO model derived ensemble firing patterns. Ensembles of CA3 and CA1 hippocampal neurons, recorded from rats performing a delayed-nonmatch-to-sample (DNMS) memory task, exhibited successful encoding of trial-specific sample lever information in the form of different spatiotemporal firing patterns. MIMO patterns, identified online and in real-time, were employed within a closed-loop behavioral paradigm. Results showed that the model was able to predict successful performance on the same trial. Also, MIMO model-derived patterns, delivered as electrical stimulation to the same electrodes, improved performance under normal testing conditions and, more importantly, were capable of recovering performance when delivered to animals with ensemble hippocampal activity compromised by pharmacologic blockade of synaptic transmission. These integrated experimental-modeling studies show for the first time that, with sufficient information about the neural coding of memories, a neural prosthesis capable of real-time diagnosis and manipulation of the encoding process can restore and even enhance cognitive, mnemonic processes.

Berger, Theodore W.; Hampson, Robert E.; Song, Dong; Goonawardena, Anushka; Marmarelis, Vasilis Z.; Deadwyler, Sam A.

2011-08-01

383

Mineralogy under extreme conditions  

SciTech Connect

We have performed measurements of minerals based on the synchrotron source for single crystal and powder X-ray diffraction, inelastic scattering, spectroscopy and radiography by using diamond anvil cells. We investigated the properties of iron (Fe), iron-magnesium oxides (Fe, Mg)O, silica(SiO{sub 2}), iron-magnesium silicates (Fe, Mg)SiO{sub 3} under simulated high pressure-high temperature extreme conditions of the Earth's crust, upper mantle, low mantle, core-mantle boundary, outer core, and inner core. The results provide a new window on the investigation of the mineral properties at Earth's conditions.

Shu, Jinfu (CIW)

2012-02-07

384

de Sitter Extremal Surfaces  

E-print Network

We study extremal surfaces in de Sitter space in the Poincare slicing in the upper patch, anchored on spatial subregions at the future boundary ${\\cal I}^+$, restricted to constant boundary Euclidean time slices (focussing on strip subregions). We find real extremal surfaces of minimal area as the boundaries of past lightcone wedges of the subregions in question: these are null surfaces with vanishing area. We find also complex extremal surfaces as complex extrema of the area functional, and the area is not always real-valued. In $dS_4$ the area is real and has some structural resemblance with entanglement entropy in a dual $CFT_3$. There are parallels with analytic continuation from the Ryu-Takayanagi expressions for holographic entanglement entropy in $AdS$. We also discuss extremal surfaces in the $dS$ black brane and the de Sitter "bluewall" studied previously. The $dS_4$ black brane complex surfaces exhibit a real finite cutoff-independent extensive piece. In the bluewall geometry, there are real surface...

Narayan, K

2015-01-01

385

[Operative aspects of prosthesis change in the hip joint after fracture of the prosthesis shaft].  

PubMed

Between 1983 and 1988 revision arthroplasty was performed in 45 patients with broken femoral stems, an average of 11 years after primary total hip replacement. There were 25 men and 20 women, with an average age of 70 years at revision. The primary endoprostheses were all cemented and of the following types: Buchholz A1 (41) Charnley-Müller (2), Weber-Huggler (1), Charnley (1). In 8 cases the femoral stem only was changed, while in 37 both components had to be replaced. The posterior approach with the patient in the lateral position gave excellent exposure of both the acetabulum and the femur. This approach gave ready access to a dorsal window, through which the broken femoral stem could be removed with a punch. To achieve stability of the femur permitting immediate full weight-bearing, the femoral defect was always made good by a revision stem with at least twice the femoral diameter. In order to stabilize large acetabular defects a combination of homologous bone graft and an acetabular support ring was used. The implanted prostheses were of the revision type, cemented and individually selected in each case. It was possible to implant an adequate revision prosthesis in all cases. The following complications were noted during surgery: fracture of the femur (1) defects of the femur (5), and haemorrhages that were difficult to manage (2). It was necessary to reoperate in 2 patients, in 1 because of a stitched-up drain and in 1 because of postoperative haematoma. Postoperatively, 21 patients had cardiopulmonary complications, which were successfully treated in the intensive care unit in all cases but 1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1925610

Stark, A; Elssner-Beyer, T; Wolf, L

1991-07-01

386

Extreme Adventure  

NSDL National Science Digital Library

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

New York Hall of Science

387

Neural interfaces for upper-limb prosthesis control: opportunities to improve long-term reliability.  

PubMed

Building on a long history of innovation in neural-recording interfaces, the Defense Advanced Research Projects Agency (DARPA) has launched a program to address the key challenges related to transitioning advanced neuroprosthesis technology to clinical use for amputated service members. The goal of the Reliable Neural Technology (RE-NET) Program is to develop new technology to extract information from the nervous system at a scale and rate needed to reliably control modern robotic prostheses over the lifetime of the amputee. The RE-NET program currently encompasses three separate efforts: histology for interface stability over time (HIST), reliable peripheral interfaces (RPIs), and reliable central nervous system (CNS) interfaces (RCIs). PMID:22481748

Judy, Jack W

2012-03-01

388

Neural Interfaces for Upper-Limb Prosthesis Control: Opportunities to Improve Long-Term Reliability  

Microsoft Academic Search

Building on a long history of innovation in neural-recording interfaces, the Defense Advanced Research Projects Agency (DARPA) has launched a program to address the key challenges related to transitioning advanced neuroprosthesis technology to clinical use for amputated service members. The goal of the Reliable Neural Technology (RE-NET) Program is to develop new technology to extract information from the nervous system

Jack W. Judy

2012-01-01

389

The Extreme Hosts of Extreme Supernovae  

NASA Astrophysics Data System (ADS)

We present the results from a deeper survey of Luminous Supernova (LSN) hosts with the Galaxy Evolution Explorer (GALEX). We have added new, multiple kilo-second observations to our original observations of seventeen LSN hosts providing better constraints on their physical properties. We place the LSNe hosts on the galaxy NUV-r versus M(r) color magnitude diagram (CMD) with a larger comparison sample ( 26,000) to illustrate the extreme nature of these galaxies. The LSN hosts favor low-density regions of the galaxy CMD falling on the blue edge of the blue cloud toward the low luminosity end. The new observations provide tighter constraints on the star formation rates (SFRs) and stellar masses, M(*), and show that the LSNe result from regions of high specific star formation and yet low total SFR. This regime is of particular interest for exploring the upper end of the stellar IMF and its variation. If our understanding of the progenitors of the LSNe leans toward very massive (> 200 M_sun) progenitors, the potential for a conflict with IMF theory exists because the conditions found in the hosts producing the LSNe should not create such massive stars. If it also required that LSNe can only be produced in primordial or very low metallicity environments, then they will also provide evidence for strong variation in metallicity within a dwarf galaxy, since their masses are consistent with low, but not extreme metallicity.

Neill, James D.

2012-01-01

390

Extreme Sounds  

NSDL National Science Digital Library

This activity (on page 2 of the PDF) is a full inquiry investigation into sound. Groups of learners will use a decibel meter or a simple set of benchmark sounds to record and quantify sound levels of varying loudness at ten locations in their city. The average sound level for each location is calculated and then listed in increasing order on a graph. Relates to linked video, DragonflyTV: Extreme Sounds.

Twin Cities Public Television, Inc.

2005-01-01

391

Informing Ankle-Foot Prosthesis Prescription through Haptic Emulation of Candidate Devices  

E-print Network

Informing Ankle-Foot Prosthesis Prescription through Haptic Emulation of Candidate Devices Joshua M range of devices in a short period of time. We developed a prototype ankle-foot prosthesis emulator Prescription Process The prescription of ankle-foot prostheses has been plagued by uncertainty about which

Collins, Steven H.

392

Optimization of mass-produced trans-tibial prosthesis made of pultruded fiber reinforced plastic  

Microsoft Academic Search

Saito et al. [Mod. Plast. (1997) 175–177] have developed a low-cost transtibial prosthesis made of fiber reinforced plastic (FRP). The basic design of the prosthesis consists of an aluminum pylon, constant crosssection composite foot, and cosmetic cover. Aluminum supports are screwed into the foot section to increase the load bearing capacity. Replacing these supports with a single integrated FRP stiffener

Jill Hahl; Minoru Taya; Makoto Saito

2000-01-01

393

Proportional EMG Control of Ankle Plantar Flexion in a Powered Transtibial Prosthesis  

E-print Network

Proportional EMG Control of Ankle Plantar Flexion in a Powered Transtibial Prosthesis Jing Wang plantar flexion in the trailing prosthetic ankle increases. Not surprisingly, excessive loads to control a powered ankle- foot prosthesis using a volitional electromyographic (EMG) control to directly

Herr, Hugh

394

Powered Ankle-Foot Prosthesis for the Improvement of Amputee Walking Economy  

E-print Network

Powered Ankle-Foot Prosthesis for the Improvement of Amputee Walking Economy by Samuel Kwok-Wai Au LIBRARIES #12;#12;Powered Ankle-Foot Prosthesis for the Improvement of Amputee Walking Economy by Samuel The human ankle provides a significant amount of net positive work during the stance period of walking

Herr, Hugh

395

Development of a shape memory alloy actuator for a robotic eye prosthesis  

Microsoft Academic Search

The quality of life of patients who wear an orbital prosthesis would be vastly improved if their prostheses were also able to execute vertical and horizontal motion. This requires appropriate actuation and control systems to create an intelligent prosthesis. A method of actuation that meets the demanding design criteria is currently not available. The present work considers an activation system

M G Faulkner; J Wolfaardt

2005-01-01

396

The processed silicone gingival prosthesis: a simple solution to a complex problem.  

PubMed

The clinical use of a flexible, removable gingival prosthesis that is constructed by the dental laboratory on a stone cast to reproduce interdental spaces resulting from gingival recession is described. The thin prosthesis replaces lost gingival tissue and is retained by extension into interproximal undercuts. It is readily removable for convenient home care. PMID:1813048

Lacy, A M

1991-10-01

397

Influence on fluid dynamics of coronary artery outlet angle variation in artificial aortic root prosthesis  

Microsoft Academic Search

BACKGROUND: Because of higher life expectancy, the number of elderly patients today with degenerative aortic diseases is on the increase. Often artificial aortic roots are needed to replace the native tissue. This surgical procedure requires re-implantation of the previous separated coronary arteries into the wall of the prosthesis. Regardless of the prosthesis type, changes in the reinsertion technique, e.g., the

Janko F Verhey; Christoph Bara

2008-01-01

398

Bone-prosthesis composite with rotating hinged-knee prosthesis in limb salvage surgery for high-grade sarcoma around the knee.  

PubMed

Bone prosthesis composite (BPC) had been widely-used in reconstruction after wide excision of malignant tumors around the knee. However, implant selection for BPC remains a dilemma. Forty-one patients with high-grade malignant bone tumors around the knee who underwent excision and reconstruction with BPC and rotating hinged knee (RHK) prosthesis were included. The mean follow-up time was 54months (range, 31-78months). The average Musculoskeletal Tumor Society Rating score was 93.4% (range, 73-100%). The mean range of motion was 125°. Complications included 2 local recurrences, 2 nonunions, and 1 peri-prosthetic fracture. The reconstruction with BPC using the RHK prosthesis provided consistently good functional results with a low complication rate. The RHK prosthesis is a promising choice for BPC reconstruction. PMID:25155237

Wang, Chien-Shun; Wu, Po-Kuei; Chen, Cheng-Fong; Chen, Wei-Ming; Liu, Chien-Lin; Chen, Tain-Hsiung

2015-01-01

399

Prosthesis Infections after Orthopedic Joint Replacement: The Possible Role of Bacterial Biofilms  

PubMed Central

Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore, important to understand the comprehensive interaction between the microbiological situation and the host immune responses that lead to prosthesis infections. Evidence indicates that prosthesis infections are actually biofilm-correlated infections that are highly resistant to antibiotic treatment and the host immune responses. The authors reviewed the related literature in the context of their clinical experience, and discussed the possible etiology and mechanism leading to the infections, especially problems related to bacterial biofilm, and prophylaxis and treatment of infection, including both microbiological and surgical measures. Recent progress in research into bacterial biofilm and possible future treatment options of prosthesis-related infections are discussed. PMID:23888204

Song, Zhijun; Borgwardt, Lotte; Høiby, Niels; Wu, Hong; Sørensen, Torben Sandberg; Borgwardt, Arne

2013-01-01

400

Nontraumatic fracture of the femoral condylar prosthesis in a total knee arthroplasty leading to mechanical failure.  

PubMed

This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before. PMID:24587928

Swamy, Girish N; Quah, Conal; Bagouri, Elmunzar; Badhe, Nitin P

2014-01-01

401

Nontraumatic Fracture of the Femoral Condylar Prosthesis in a Total Knee Arthroplasty Leading to Mechanical Failure  

PubMed Central

This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before. PMID:24587928

Swamy, Girish N.; Quah, Conal; Bagouri, Elmunzar; Badhe, Nitin P.

2014-01-01

402

Customised attachments retained cheek plumper prosthesis: a case report.  

PubMed

Emphasis on facial esthetics has become an integral part of dental treatment. Prosthetic rehabilitation of a completely edentulous patient no longer confines to only replacement of missing teeth. Patients are increasingly demanding improvement in esthetics at the end of treatment. Slumped or hollow cheeks can add years to a person's age. This article has described a simple, effective and noninvasive treatment alternative to improve facial appearance in a completely edentulous patient with hollow cheeks by making use of detachable plumper prosthesis using customised attachments. PMID:23997472

Keni, Nandita N; Aras, Meena A; Chitre, Vidya

2012-09-01

403

Sectional prosthesis for total maxillectomy patients: a clinical report.  

PubMed

Total maxillectomy is a relatively uncommon surgical procedure and usually results in a surgical and prosthetic reconstructive challenge. The goals of prosthetic treatment include separation of oral and nasal cavities, which allows for adequate speech and deglutition, along with restoration of esthetics. Treatment of a patient with total maxillectomy due to verrucous carcinoma was presented in this clinical report. Clinical and laboratory procedures of the prosthetic treatment were described. The sectional prosthesis retained by magnets eliminated long-term use of a nasogastric tube, rehabilitated the patient's speech, and restored proper midfacial esthetic contour. PMID:9297638

Wang, R R

1997-09-01

404

Load transfer with the Austin Moore cementless hip prosthesis.  

PubMed

More than 1,300 Austin Moore hemiarthroplasties have been reviewed in the literature, with no reports of fracture of the stem. Many patients with these hip implants had good function. The lack of stem fractures in patients with good functions has not been explained and contrasts with stem fractures that have occurred in patients with cemented prostheses of other designs during the same time. We used three-dimensional finite-element analysis and free-body diagrams to explain the lack of fractures for this device by a description of the probable load-transfer mechanisms between the prosthesis and the bone. Results from our finite-element analysis indicate that, with good calcar-collar support, the stresses in the stem are small because the stem portion of the prosthesis and the bone are uncoupled and, consequently, do not share the resultant bending moment of the head and abductor forces. If the stem is coupled to the bone so that the resultant bending moment is shared, high stresses in the stem are predicted; such stresses are inconsistent with the complete absence of fractures of these prostheses. The results of the finite-element analysis further showed that loss of calcar-collar support with proximal fixation through the fenestrations resulted in high stresses in the stem and stress shielding of the proximal medial cortex. The uncoupled prosthesis also may be modeled with a free-body diagram as a three-force member loaded at the head, stem tip, and in the proximal region. With this model, it can be shown that the reaction force of the stem tip, and thus the peak bending stress in the stem, increases as calcar-collar support is decreased. If there is no calcar-collar support, proximal support must be provided by some combination of integration of bone in the fenestrations and wedging due to the lateral-medial taper of the device. Stresses in the stem are largest when there is no wedging, but high stresses develop in the cancellous bone in the fenestrations. When there is wedging, stresses in the stem can be low, but stresses in the supporting cancellous bone can be high; additional proximal support through the fenestrations substantially reduces these bone stresses. If reduced stresses in the cancellous bone are indicative of a stable device, these mechanisms indicate that fractures of the Austin Moore prosthesis have not occurred in normally loaded hips because load was transferred primarily either through the collar or by wedging, with additional support at the fenestrations. PMID:8483040

Keaveny, T M; Bartel, D L

1993-03-01

405

Potential of an electric prosthesis for dynamic facial reanimation.  

PubMed

Chronic facial paralysis is a devastating condition with severe functional and emotional consequences. The current surgical armamentarium permits the predictable reestablishment of a protective blink as well as good resting symmetry. Yet the ultimate goal of symmetric, spontaneous emotional expression remains elusive despite significant progress in the areas of peripheral nerve grafting and free tissue transfer. This commentary explores the possibility of an implantable electrical prosthesis for facial reanimation. It reviews animal studies supporting this concept as well as recent human data suggesting that such an implant could rescue denervated facial musculature, thus overcoming a major hurdle for existing reanimation techniques. PMID:21636836

Griffin, Garrett R; Kim, Jennifer C

2011-09-01

406

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

PubMed

The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. PMID:22464092

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

2012-04-01

407

An isoelastic prosthesis using a new composite material.  

PubMed

A new particulate composite material has been assessed with regard to the design of an 'isoelastic' or 'modulus matched' hip prosthesis. Three different prototype designs were assessed, each of which consisted of a femoral component made from the composite material, attached to a metal ball via a metal 'spike' insert. The prototypes varied in terms of the detailed shape of the spike, which was modified in the light of photoelastic stress analysis, so as to produce a more acceptable stress distribution to the composite material in the proximal region. Prototypes were made by hand moulding and by transfer moulding; both methods produced defects of various kinds. Simulation tests were conducted using a model of the proximal femur constructed from glass fibre composite, cyclically loaded in a servo-hydraulic testing machine. Though some difficulties were experienced with defective mouldings, especially for the transfer moulding process, a clear improvement was demonstrated for the final (Mark III) design. The fatigue endurance of this prototype was similar to that of conventional metal prostheses tested under similar conditions. Fatigue crack propagation tests were carried out on samples of the composite material to establish its propagation threshold. These results were combined with a finite element stress analysis and fracture mechanics theory to estimate the critical crack length for fatigue in this prosthesis. It was thus possible to specify the maximum safe size of defect that could be tolerated in use. PMID:8280313

Taylor, D; Martin, C; Cornelis, B; Jones, M E

1993-01-01

408

Development of a carbon-carbon hip prosthesis.  

PubMed

This article deals with the use of carbon-fiber-reinforced-carbon materials for the manufacture of hip prosthesis stems. It considers the manufacturing process of carbon-carbon (C-C) composites made of carbon fibers infiltrated either with dense pyrolytic carbon or silicon carbide (SiC) through chemical vapor infiltration. The chemicophysical properties of these composites are examined according to their structures. The long-term response (2 years) of cortical bone to various types of carbon-carbon was evaluated mainly for bone contact and ingrowth. Carbon-carbon coated with calcium phosphate was found to speed up the bone formation as compared to pyrolytic carbon or SiC coatings. The low modulus of elasticity of the C-C materials could be responsible for quicker bone contact as compared to a much stiffer material like sintered aluminum oxide. The biomechanical performance of C-C hip stems was assessed through (a) implantations into cadaver femurs, (b) fatigue testing, and (c) finite element analysis. These tests showed: (a) a better stress transfer as compared to a metal prosthesis having the same design, (b) no fatigue damage, (c) a computerized stem stress distribution in accordance with the fractures obtained during static mechanical testing. PMID:3624286

Christel, P; Meunier, A; Leclercq, S; Bouquet, P; Buttazzoni, B

1987-08-01

409

Simultaneous penile prosthesis and male sling/artificial urinary sphincter  

PubMed Central

Erectile dysfunction (ED) and stress urinary incontinence (SUI) from urethral sphincteric deficiency is not an uncommon problem. The commonest etiology is intervention for localized prostate cancer and/or radical cystoprostatectomy for muscle invasive bladder cancer. Despite advances in surgical technology with robotic assisted laparoscopic prostatectomy and nerve sparing techniques, the rates of ED and SUI remain relatively unchanged. They both impact greatly on quality of life domains and have been associated with poor performance outcomes. Both the artificial urinary sphincter and penile prosthesis are gold standard treatments with proven efficacy, satisfaction and durability for end-stage SUI and ED respectively. Simultaneous prosthesis implantation for concurrent conditions has been well described, mostly in small retrospective series. The uptake of combination surgery has been slow due in part to technical demands of the surgery and to an extent, a heightened anxiety over potential complications. This paper aims to discuss the technical aspect of concurrent surgery for both disease entity and the current published outcomes of the various surgical techniques with this approach. PMID:23202702

Lee, Dominic; Romero, Claudio; Alba, Frances; Westney, O Lenaine; Wang, Run

2013-01-01

410

Assessment of Lower Limb Prosthesis through Wearable Sensors and Thermography  

PubMed Central

This study aimed to explore the application of infrared thermography in combination with ambulatory wearable monitoring of temperature and relative humidity, to assess the residual limb-to-liner interface in lower-limb prosthesis users. Five male traumatic transtibial amputees were involved, who reported no problems or discomfort while wearing the prosthesis. A thermal imaging camera was used to measure superficial thermal distribution maps of the stump. A wearable system for recording the temperature and relative humidity in up to four anatomical points was developed, tested in vitro and integrated with the measurement set. The parallel application of an infrared camera and wearable sensors provided complementary information. Four main Regions of Interest were identified on the stump (inferior patella, lateral/medial epicondyles, tibial tuberosity), with good inter-subject repeatability. An average increase of 20% in hot areas (P < 0.05) is shown after walking compared to resting conditions. The sensors inside the cuff did not provoke any discomfort during recordings and provide an inside of the thermal exchanges while walking and recording the temperature increase (a regime value is ?+1.1 ± 0.7 °C) and a more significant one (?+4.1 ± 2.3%) in humidity because of the sweat produced. This study has also begun the development of a reference data set for optimal socket/liner-stump construction. PMID:24618782

Cutti, Andrea Giovanni; Perego, Paolo; Fusca, Marcello C.; Sacchetti, Rinaldo; Andreoni, Giuseppe

2014-01-01

411

Evaluation of ranges of motion of a new constrained acetabular prosthesis for canine total hip replacement  

PubMed Central

Background Total hip replacement (THR) is considered to be the most effective treatment option for advanced osteoarthritis of the hip in large breed dogs. However, a proportion of post-THR patients suffer prosthesis dislocation for various reasons, which may be addressed by a constrained acetabular prosthesis design. The study proposed a new THR with constrained acetabular component that aimed to decrease the incidence of postoperative dislocation while maintaining the necessary range of motion (ROM); and, through computer-simulated implantations, evaluated the ROM of the THR with and without malpositioning of the acetabular component. Methods A new THR with a constrained acetabular component that had an inward eccentric lining and a 60° cut-out on the dorsal side was designed, and its computer-aided design models were implanted into the pelvic and femoral models reconstructed from the computed tomography data of six healthy Labrador Retriever dogs. The allowable and functional ROM of the implanted THR were determined via computer simulations. The contact patterns between the bone or the prosthetic components at extreme positions of the THR were analyzed. Influence of malpositioning of the acetabular component on the ROM was assessed. Results The means (SD) of the functional ranges for flexion, extension, adduction, abduction, internal rotation and external rotation were 51.8° (6.6°), 163.3° (7.3°), 33.5° (5.7°), 74.0° (3.7°), 41.5° (8.3°) and 65.2° (9.9°), respectively. Malpositioning of the acetabular component by 20° in one direction was found to reduce ROM in other directions (reducing lateral opening: flexion: 12°, adduction: 20°, internal/external rotations: < 20°; increasing lateral opening: extension and abduction: < 16°; reducing retroversion: extension: < 20°, abduction: 15°, external rotation: < 20°; increasing retroversion: flexion: < 20°, abduction, adduction and internal rotation: 20°). Conclusions From the computer-aided surgical simulations, the new THR was found to have sufficient functional ranges for flexion, extension, abduction, adduction and external rotation for Labrador Retrievers. Analysis of the malpositioning of the acetabular component suggests that accurate placement of the acetabular component is critical for achieving desirable ROM for daily activities. PMID:24207109

2013-01-01

412

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

PubMed Central

Introduction: Prostheses for upper-limb amputees are currently controlled by either myoelectric or peripheral neural signals. Performance and dexterity of these devices is still limited, particularly when it comes to controlling hand function. Movement-related brain activity might serve as a complementary bio-signal for motor control of hand prosthesis. Methods: We introduced a methodology to implant a cortical interface without direct exposure of the brain surface in an upper-limb amputee. This bi-directional interface enabled us to explore the cortical physiology following long-term transhumeral amputation. In addition, we investigated neurofeedback of electrocorticographic brain activity related to the patient’s motor imagery to open his missing hand, i.e., phantom hand movement, for real-time control of a virtual hand prosthesis. Results: Both event-related brain activity and cortical stimulation revealed mutually overlapping cortical representations of the phantom hand. Phantom hand movements could be robustly classified and the patient required only three training sessions to gain reliable control of the virtual hand prosthesis in an online closed-loop paradigm that discriminated between hand opening and rest. Conclusion: Epidural implants may constitute a powerful and safe alternative communication pathway between the brain and external devices for upper-limb amputees, thereby facilitating the integrated use of different signal sources for more intuitive and specific control of multi-functional devices in clinical use. PMID:24834047

Gharabaghi, Alireza; Naros, Georgios; Walter, Armin; Roth, Alexander; Bogdan, Martin; Rosenstiel, Wolfgang; Mehring, Carsten; Birbaumer, Niels

2014-01-01

413

An anthropometric study of the radial head: Implications in the design of a prosthesis  

Microsoft Academic Search

The dimensions of the native radial head were measured in 28 cadaveric upper extremities and radiographs of the contralateral elbows of 40 patients who had received a radial head replacement. The mean difference between the maximum and minimum radial head diameters was 1.7 ± 0.7 mm (range, 0.12-3.27 mm). This variability suggests that although the native radial head is not

Graham J. W. King; Zane D. S. Zarzour; Stuart D. Patterson; James A. Johnson

2001-01-01

414

Structural Simulation of a Bone-Prosthesis System of the Knee Joint  

PubMed Central

In surgical knee replacement, the damaged knee joint is replaced with artificial prostheses. An accurate clinical evaluation must be carried out before applying knee prosthe-ses to ensure optimal outcome from surgical operations and to reduce the probability of having long-term problems. Useful information can be inferred from estimates of the stress acting onto the bone-prosthesis system of the knee joint. This information can be exploited to tailor the prosthesis to the patient's anatomy. We present a compound system for pre-operative surgical planning based on structural simulation of the bone-prosthesis system, exploiting patient-specific data.

Andrä, Heiko; Battiato, Sebastiano; Bilotta, Giuseppe; Farinella, Giovanni M.; Impoco, Gaetano; Orlik, Julia; Russo, Giovanni; Zemitis, Aivars

2008-01-01

415

The Evolution of Dental Materials for Hybrid Prosthesis  

PubMed Central

Since the immemorial, the replacement of missing teeth has been a medical and cosmetic necessity for human kind. Nowadays, middle-aged population groups have experienced improved oral health, as compared to previous generations, and the percentage of edentulous adults can be expected to further decline. However, with the continued increase in the number of older adult population, it is anticipated that the need for some form of full-mouth restoration might increase from 53.8 million in 1991 to 61 million in 2020 [1]. Denture prosthetics has undergone many development stages since the first dentures were fabricated. The introduction of computer-aided design/computer aided manufacturing (CAD/CAM) has resulted in a more accurate manufacturing of prosthetic frameworks, greater accuracy of dental restorations, and in particular, implant supported prosthesis. PMID:24893781

Gonzalez, Jorge

2014-01-01

416

The evolution of dental materials for hybrid prosthesis.  

PubMed

Since the immemorial, the replacement of missing teeth has been a medical and cosmetic necessity for human kind. Nowadays, middle-aged population groups have experienced improved oral health, as compared to previous generations, and the percentage of edentulous adults can be expected to further decline. However, with the continued increase in the number of older adult population, it is anticipated that the need for some form of full-mouth restoration might increase from 53.8 million in 1991 to 61 million in 2020 [1]. Denture prosthetics has undergone many development stages since the first dentures were fabricated. The introduction of computer-aided design/computer aided manufacturing (CAD/CAM) has resulted in a more accurate manufacturing of prosthetic frameworks, greater accuracy of dental restorations, and in particular, implant supported prosthesis. PMID:24893781

Gonzalez, Jorge

2014-01-01

417

A vestibular prosthesis with highly-isolated parallel multichannel stimulation.  

PubMed

This paper presents an implantable vestibular stimulation system capable of providing high flexibility independent parallel stimulation to the semicircular canals in the inner ear for restoring three-dimensional sensation of head movements. To minimize channel interaction during parallel stimulation, the system is implemented with a power isolation method for crosstalk reduction. Experimental results demonstrate that, with this method, electrodes for different stimulation channels located in close proximity ( mm) can deliver current pulses simultaneously with minimum inter-channel crosstalk. The design features a memory-based scheme that manages stimulation to the three canals in parallel. A vestibular evoked potential (VEP) recording unit is included for closed-loop adaptive stimulation control. The main components of the prototype vestibular prosthesis are three ASICs, all implemented in a 0.6- ?m high-voltage CMOS technology. The measured performance was verified using vestibular electrodes in vitro. PMID:25073175

Jiang, Dai; Cirmirakis, Dominik; Demosthenous, Andreas

2015-02-01

418

Computerized transcutaneous control of a multichannel implantable urinary prosthesis.  

PubMed

In the present paper we describe a personal computer interface of a multichannel implantable urinary prosthesis. This system is composed of two main parts: the first one is internal and consists of an implant using a 4-microns CMOS gate array chip controlling a wide variety of waveforms via eight monopolar channels. The second, an external controller featuring a versatile software, a PCB card plugged in a portable microcomputer, and a radiofrequency-coupled technique. This device is used to transmit the power, the data and the synchronization clock to the implant by a simple binary signal modulating a 20 MHz carrier. We also report the features of implant encapsulation and electrode design and fabrication. In the experimental phase, we studied the effect of early electric stimulation of the bladder during the spinal shock phase in the dog. We present the operative techniques that enabled us to perform chronic electrostimulation of the sacral roots and discuss the results. PMID:1601441

Sawan, M; Duval, F; Hassouna, M M; Li, J S; Elhilali, M M; Lachance, J; Leclair, M; Pourmehdi, S; Mouïne, J

1992-06-01

419

Evaluation of Strength in the ``Toronto'' Osseous-Prosthesis System  

NASA Astrophysics Data System (ADS)

Several surgical techniques like are today available in order to recovery large bone defects of the jaw. Aim of the surgeon is to obtain a good tridimensional volume to place dental implant and to recovery the patient’s aesthetics and function. Several prosthetic solution were considered for prosthetic rehabilitation. However after a bone graft surgery Toronto screwed prosthesis on dental implants, following Branemark intuitions, was considered the better prosthetic rehabilitation solution. According to Wölff, the dental implants osteointegration is related to the strengths directed to mandibular bone. Our investigation’s aim is to underline through FEM analysis the stress over the prosthetic elements and over bone surface in order to help the surgeon choice about the dental implant positioning, and at the same time reducing the bone trauma on the patients.

Giacomo, R.; Cicciã¹, M.; Dini, R.; Franceschini, G.; Maiorana, C.

2010-06-01

420

Some Examples Of Image Warping For Low Vision Prosthesis  

NASA Astrophysics Data System (ADS)

NASA and Texas Instruments have developed an image processor, the Programmable Remapper 1, for certain functions in machine vision. The Remapper performs a highly arbitrary geometric warping of an image at video rate. It might ultimately be shrunk to a size and cost that could allow its use in a low-vision prosthesis. We have developed coordinate warpings for retinitis pigmentosa (tunnel vision) and for maculapathy (loss of central field) that are intended to make best use of the patient's remaining viable retina. The rationales and mathematics are presented for some warpings that we will try in clinical studies using the Remapper's prototype. (Recorded video imagery was shown at the conference for the maculapathy remapping.

Juday, Richard D.; Loshin, David S.

1988-08-01

421

A data-driven neuromuscular model of walking and its application to prosthesis control  

E-print Network

In this thesis we present a data-driven neuromuscular model of human walking and its application to prosthesis control. The model is novel in that it leverages tendon elasticity to more accurately predict the metabolic ...

Markowitz, Jared (Jared John)

2013-01-01

422

Esthetic transformation of a failed implant reconstruction to fixed-supported prosthesis: a case report.  

PubMed

This article describes a clinical situation where an ill-fitting prosthesis supported by malpositioned dental implants was esthetically transformed to fixed definitive restorations. Provisional restorations were used as a blueprint for fabrication of definitive restorations. PMID:22856033

Cascione, Domenico; Nowzari, Hessam; Reshad, Mamaly

2012-06-01

423

A vibrotactile display design for the feedback of external prosthesis sensory information to the amputee wearer  

E-print Network

This thesis documents the development of a vibrotactile display to be incorporated into a powered ankle-foot prosthesis. Although existing devices have addressed the need for tactile and proprioceptive feedback in external ...

Chew, Andrea W. (Andrea Wae-Ping)

2006-01-01

424

Design of test bench apparatus and preliminary weight reduction strategy for an active knee prosthesis  

E-print Network

This thesis presents the design and structural analyses of an experimental test bench for the characterization of an active biomimetic knee prosthesis currently being developed by the Biomechatronics research group at MIT ...

Lau, Jacky H. (Jacky Homing)

2011-01-01

425

Customization of Stock Eye Prosthesis for a Pediatric Patient by a Simplified Technique  

PubMed Central

ABSTRACT The unfortunate loss or absence of an eye may be caused by congenital defect , irreparable trauma, tumor or blind eye. The role of the maxillofacial prosthodontist in fabricating an ocular prosthesis to restore facial symmetry and normal appearance for the anophthalmic patient becomes essential. A custom-made ocular prosthesis is an excellent alternative for the people who lose their eye especially in young age. It has acceptable fit, retention and esthetics but is technically difficult to fabricate. On the other hand the stock eye has compromised fit and poor esthetics. Our case report presents a simple technique of customization of stock eye prosthesis to provide accurate fit and acceptable esthetics. How to cite this article: Jurel SK, Talwar N, Chand P, Singh RD, Gupta DS. Customization of Stock Eye Prosthesis for a Pediatric Patient by a Simplified Technique. Int J Clin Pediatr Dent 2012;5(2):155-158. PMID:25206159

Talwar, Naina; Chand, Pooran; Singh, Raghuwar D; Gupta, Durga Shanker

2012-01-01

426

Rehabilitation of a Partial Nasal Defect with Facial Prosthesis: A Case Report  

PubMed Central

>Malignancies of the midface result in cosmetic deformities that make maxillofacial prosthesis as an integral part of the treatment plan. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potentional compromises in quality of life. Reconstruction of nasal defects is a challenge for the prosthodontist because of esthetic and retention problems associated with the facial prosthesis. This paper reports the rehabilitation of a partial nasal defect caused by basal cell carcinoma treatment using a nasal prosthesis made with silicone elastomers and mechanical and anatomical retentive aids. The patient had no problem with the prosthesis, except for a partial loss of extrinsic coloration in the two-year follow-up. PMID:25587390

Negahdari, Ramin; Pournasrollah, Alireza; Bohlouli, Sepideh; Sighari Deljavan, Alireza

2014-01-01

427

21 CFR 874.3540 - Prosthesis modification instrument for ossicular replacement surgery.  

Code of Federal Regulations, 2012 CFR

...modification instrument for ossicular replacement surgery. 874.3540 Section 874.3540 ...modification instrument for ossicular replacement surgery. (a) Identification. A prosthesis...modification instrument for ossicular replacement surgery is a device intended for use by...

2012-04-01

428

21 CFR 874.3540 - Prosthesis modification instrument for ossicular replacement surgery.  

Code of Federal Regulations, 2011 CFR

...modification instrument for ossicular replacement surgery. 874.3540 Section 874.3540 ...modification instrument for ossicular replacement surgery. (a) Identification. A prosthesis...modification instrument for ossicular replacement surgery is a device intended for use by...

2011-04-01

429

21 CFR 874.3540 - Prosthesis modification instrument for ossicular replacement surgery.  

Code of Federal Regulations, 2010 CFR

...modification instrument for ossicular replacement surgery. 874.3540 Section 874.3540 ...modification instrument for ossicular replacement surgery. (a) Identification. A prosthesis...modification instrument for ossicular replacement surgery is a device intended for use by...

2010-04-01

430

21 CFR 878.3540 - Silicone gel-filled breast 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 § 878.3540 Silicone gel-filled breast prosthesis. (a) Identification...

2014-04-01

431

21 CFR 878.3540 - Silicone gel-filled breast 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 § 878.3540 Silicone gel-filled breast prosthesis. (a) Identification...

2010-04-01

432

21 CFR 874.3540 - Prosthesis modification instrument for ossicular replacement surgery.  

Code of Federal Regulations, 2014 CFR

...modification instrument for ossicular replacement surgery. 874.3540 Section 874.3540 ...modification instrument for ossicular replacement surgery. (a) Identification. A prosthesis...modification instrument for ossicular replacement surgery is a device intended for use by...

2014-04-01

433

21 CFR 878.3540 - Silicone gel-filled breast prosthesis.  

Code of Federal Regulations, 2012 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3540 Silicone gel-filled breast prosthesis. (a) Identification...

2012-04-01

434

21 CFR 878.3540 - Silicone gel-filled breast prosthesis.  

Code of Federal Regulations, 2011 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3540 Silicone gel-filled breast prosthesis. (a) Identification...

2011-04-01

435

21 CFR 878.3540 - Silicone gel-filled breast prosthesis.  

Code of Federal Regulations, 2013 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3540 Silicone gel-filled breast prosthesis. (a) Identification...

2013-04-01

436

21 CFR 874.3540 - Prosthesis modification instrument for ossicular replacement surgery.  

Code of Federal Regulations, 2013 CFR

...modification instrument for ossicular replacement surgery. 874.3540 Section 874.3540 ...modification instrument for ossicular replacement surgery. (a) Identification. A prosthesis...modification instrument for ossicular replacement surgery is a device intended for use by...

2013-04-01

437

TAVI in the case of preexisting mitral prosthesis: tips & tricks and literature review.  

PubMed

Very limited data exist on transcatheter aortic valve implantation (TAVI) in the setting of a preexisting mitral prosthesis regarding the technique, potential complications, and outcomes. Here, we report two cases of transfemoral TAVI with a self-expanding bioprosthesis (CoreValve; Medtronic, Inc) in patients who had previously undergone mitral valve replacement (one with an Omniscience and one with a St. Jude prosthesis). A brief literature review is also presented. PMID:25364003

Vavuranakis, Manolis; Vrachatis, Dimitrios A; Kariori, Maria G; Moldovan, Carmen; Kalogeras, Konstantinos; Lavda, Maria; Aznaouridis, Konstantinos; Stefanadis, Christodoulos

2014-11-01

438

Design of visual prosthesis image processing system based on SoC  

NASA Astrophysics Data System (ADS)

This paper presents a visual prosthesis image processing system based on Leon3 SoC (System on Chip) platform. The system is built through GRLIB system development platform. It integrates the image preprocessing IP core, image encoder IP core and image data modulation IP core we designed. We transplant the system to the FPGA development board and verify the system functions. The results show that the designed system can achieve the functions of visual prosthesis image processing system effectively.

Guo, Fei; Yang, Yuan; Gao, Yong; Wu, Chuan Ke

2014-07-01

439

Neurocognitive deficit following aortic valve replacement with biological\\/mechanical prosthesis  

Microsoft Academic Search

Objective: The aim of this study was to objectively measure neurocognitive deficit following aortic valve replacement with a mechanical or biological prosthesis. Materials and methods: In this prospective, contemporary study we followed 82 consecutive patients undergoing isolated aortic valve replacement with either a mechanical (n=29, mean age=52±7 years) or a biological (n=53, mean age=68±10 years) valve prosthesis. Neurocognitive function was

Daniel Zimpfer; Juliane Kilo; Martin Czerny; Marie-Theres Kasimir; Christian Madl; Edith Bauer; Ernst Wolner; Michael Grimm

2003-01-01

440

Titanium ball joint total ossicular replacement prosthesis--experimental evaluation and midterm clinical results.  

PubMed

During reconstruction of the ossicular chain, there is a need to address the forces and loads caused by the ambient atmospheric pressure variations and the resulting tympanic membrane movements. It is understood that when a rigid middle ear prosthesis is inserted the malleoincudal joint, a keyfactor in controlling pressure variations in the middle ear space is bypassed. In this paper we describe a modified total titanium ossicular replacement prosthesis with an innovative micro ball joint in the headplate which is designed to compensate for tympanic membrane movements caused by atmospheric pressure variations. The characteristics of this modified prosthesis were examined in temporal bone experiments and compared to the standard titanium total ossicular reconstruction prosthesis. Sound-induced stapes footplate movements were investigated by means of a Laser vibrometer and revealed no significant differences between the two prostheses in vitro. Intraoperatively, the insertion of the modified prosthesis required more delicate handling. The angle between the shaft and the headplate was variable and ranged from 60 to 90° as estimated by the surgeon. Twelve consecutive patients were eligible for clinical evaluation. The pure tone average (PTA) air-bone gap after a mean follow up period of 32 months was 18.8 dB. Furthermore, no extrusion, dislocation or other adverse events were observed. We conclude that the modified total ossicular replacement prosthesis with integrated micro ball joint yields similar volume velocities of the stapes footplate in the laboratory experiments compared to the standard rigid prosthesis. The audiological and morphological results are encouraging and show that the mobile prosthesis headplate adjusting to the level of the tympanic membrane is a further step in the development of a physiological middle ear implant. This article is part of a special issue entitled "MEMRO 2012". PMID:23142147

Gostian, A O; Pazen, D; Luers, J C; Huttenbrink, K B; Beutner, D

2013-07-01

441

Strut fracture in the new Bjørk-Shiley mitral valve prosthesis.  

PubMed

The case of a patient with the new type Bjørk-Shiley aortic and mitral valve prosthesis is described. Three months after implant she suffered acute heart failure and died. Post-mortem examination revealed a fractured outlet strut in the mitral valve prosthesis with dislocation of the disc. The fracture was regarded as due to excessive brittleness caused by demonstrated deposition of chromium-tungsten-carbide. PMID:6166068

Brubakk, O; Simonsen, S; Källman, L; Fredriksen, A

1981-04-01

442

Fabrication of a new silicone auricular prosthesis without removing the existing metallic framework.  

PubMed

Silicone prostheses require constant repair and refabrication. Auricular prostheses retained with implants have better retention than adhesive-retained prostheses. However, refabrication is complicated if the patient is unwilling to surrender the metallic framework attached to the implants and revert to the use of adhesives. This article describes a technique by which the metal framework of the existing prosthesis need not be removed, thereby improving the patient's quality of life until the new prosthesis is delivered. PMID:24998323

Goveas, Reiyal; Shrestha, Binit; Srithavaj, M L Theerathavaj; Thaworanunta, Sita

2014-12-01

443

Extended Durability of a Cloth-Covered Star-Edwards Caged Ball Prosthesis in Aortic Position  

PubMed Central

The Starr-Edwards caged ball valve is one of the oldest cardiac valve prosthesis and was widely used all around the world in the past decades. Despite the long-term results that have been reported there are only a few cases reported that exceed 30 years of durability. Here in, we report a 53-year-old patient with a well-functioning 35-year-old aortic Starr-Edwards caged ball prosthesis. PMID:20148067

Ata, Yusuf; Turk, Tamer; Eris, Cüneyt; Yalcin, Mihriban; Ata, Filiz; Ozyazicio?lu, A.

2009-01-01

444

Stresses in the normal and diabetic human penis following implantation of an inflatable prosthesis  

Microsoft Academic Search

The prevalence of impotence in diabetes mellitus ranges as high as 75%. The implantation of an inflatable penile prosthesis\\u000a (IPP) is frequently carried out to restore erectile function. However, clinical studies have demonstrated that severe post-implantation\\u000a penile pain during erection is a common complication in diabetic men. A biomechanical model of the penis\\/prosthesis complex\\u000a is developed, based on cross-sectional anatomy,

A. Gefen; J. Chen; D. Elad

1999-01-01

445

Bionic ankle–foot prosthesis normalizes walking gait for persons with leg amputation  

PubMed Central

Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biological ankle during level-ground walking, specifically providing the net positive work required for a range of walking velocities. We compared metabolic energy costs, preferred velocities and biomechanical patterns of seven people with a unilateral transtibial amputation using the bionic prosthesis and using their own passive-elastic prosthesis to those of seven non-amputees during level-ground walking. Compared with using a passive-elastic prosthesis, using the bionic prosthesis decreased metabolic cost by 8 per cent, increased trailing prosthetic leg mechanical work by 57 per cent and decreased the leading biological leg mechanical work by 10 per cent, on average, across walking velocities of 0.75–1.75 m s?1 and increased preferred walking velocity by 23 per cent. Using the bionic prosthesis resulted in metabolic energy costs, preferred walking velocities and biomechanical patterns that were not significantly different from people without an amputation. PMID:21752817

Herr, Hugh M.; Grabowski, Alena M.

2012-01-01

446

Automatic modeling of pectus excavatum corrective prosthesis using artificial neural networks.  

PubMed

Pectus excavatum is the most common deformity of the thorax. Pre-operative diagnosis usually includes Computed Tomography (CT) to successfully employ a thoracic prosthesis for anterior chest wall remodeling. Aiming at the elimination of radiation exposure, this paper presents a novel methodology for the replacement of CT by a 3D laser scanner (radiation-free) for prosthesis modeling. The complete elimination of CT is based on an accurate determination of ribs position and prosthesis placement region through skin surface points. The developed solution resorts to a normalized and combined outcome of an artificial neural network (ANN) set. Each ANN model was trained with data vectors from 165 male patients and using soft tissue thicknesses (STT) comprising information from the skin and rib cage (automatically determined by image processing algorithms). Tests revealed that ribs position for prosthesis placement and modeling can be estimated with an average error of 5.0 ± 3.6mm. One also showed that the ANN performance can be improved by introducing a manually determined initial STT value in the ANN normalization procedure (average error of 2.82 ± 0.76 mm). Such error range is well below current prosthesis manual modeling (approximately 11 mm), which can provide a valuable and radiation-free procedure for prosthesis personalization. PMID:25070021

Rodrigues, Pedro L; Rodrigues, Nuno F; Pinho, A C M; Fonseca, Jaime C; Correia-Pinto, Jorge; Vilaça, João L

2014-10-01

447

The effect of screw fixation type on a modular hemi-pelvic prosthesis: a 3-D finite element model.  

PubMed

In this article, a 3-D finite element (FE) model of human pelvic with a modular hemi-pelvic prosthesis was constructed to study the effect of screw fixation type on the biomechanics of the prosthesis. The results showed that the elimination of the screw far away from the pelvic arcuate line did not induce the instability and stress increase in the prosthesis. On the contrary, some stress in the sustain and acetabular parts decreased by 26.4% and 11.4%, respectively. In conclusion, the optimization of screw fixation can maintain the prosthesis stability and reduced stress concentration on some prosthesis parts. It was deduced that the optimization of the prosthesis could help surgeon reconstruct the pelvic joint function better and diminish the clinical time and cost. PMID:23244444

Hao, Zhixiu; Wan, Chao; Gao, Xiangfei; Ji, Tao; Wang, Haosen

2013-03-01

448

Use of Screws and Cement in Revision TKA With Primary or Revision Specific Prosthesis With Up to 17Years Followup.  

PubMed

The purpose of this study was to investigate the use for screws and cement, and primary and revision specific prosthesis for revision TKA. Between July 1989 and February 2010, 839 consecutive revision TKAs were performed, with 609 knees meeting inclusion criteria. At 17years followup, Kaplan-Meier survivorship was 0.9859 for revision specific prosthesis with screws and cement, 0.9848 for revision prosthesis with no screws, 0.9118 for primary prosthesis with screws, and 0.9424 for primary prosthesis with no screws. Revision TKAs using screws had greater defects (P<.0001). Use of revision prosthesis along with screws and cement to correct largely defective revision TKAs is highly recommended. PMID:25151092

Berend, Michael E; Ritter, Merrill A; Keating, E Michael; Jackson, Michael D; Davis, Kenneth E; Malinzak, Robert A

2015-01-01

449

The European Extreme Right and Religious Extremism  

Microsoft Academic Search

The ideology of the Extreme Right in Western Europe is rooted in Catholic fundamentalism and Counter-Revolutionary ideas. However, the Extreme Right, like all other political families, has had to adjust to an increasingly secular society. The old link between religion and the Extreme Right has thus been broken and in fact already was when Fascism overtook Europe: Fascism was secular,

Jean-Yves Camus

450

Long-term results of combined tunica albuginea plication and penile prosthesis implantation for severe penile curvature and erectile dysfunction.  

PubMed

Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile "modelling" over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. PMID:24790766

Cormio, Luigi; Massenio, Paolo; Di Fino, Giuseppe; Lucarelli, Giuseppe; Mancini, Vito; Liuzzi, Giuseppe; Carrieri, Giuseppe

2014-01-01

451

Long-Term Results of Combined Tunica Albuginea Plication and Penile Prosthesis Implantation for Severe Penile Curvature and Erectile Dysfunction  

PubMed Central

Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile “modelling” over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. PMID:24790766

Massenio, Paolo; Di Fino, Giuseppe; Mancini, Vito; Carrieri, Giuseppe

2014-01-01

452

IEEE TRANSACTIONS ON ROBOTICS, VOL. 24, NO. 1, FEBRUARY 2008 159 A Gas-Actuated Anthropomorphic Prosthesis  

E-print Network

IEEE TRANSACTIONS ON ROBOTICS, VOL. 24, NO. 1, FEBRUARY 2008 159 A Gas-Actuated Anthropomorphic anthropomorphic upper extremity prostheses Manuscript received January 31, 2007; revised xxx. This paper those currently available. Among the many challenges that exist in the development of an anthropomorphic

453

Extremal equation for optimal completely positive maps  

NASA Astrophysics Data System (ADS)

We derive an extremal equation for an optimal completely positive map, which most closely approximates a given transformation between pure quantum states. Moreover, we also obtain an upper bound on the maximal mean fidelity that can be attained by the optimal approximate transformation. The developed formalism is applied to a universal-NOT gate, quantum cloning machines, quantum entanglers, and a qubit ? shifter.

Fiurášek, Jaromír

2001-12-01

454

Management of an Extremely Displaced Maxillary Canine  

Microsoft Academic Search

Case Report: Aligning a displaced maxillary canine into the den- tal arch is one of the most complicated problems in orthodontics. In cases of extremely high displacement, the tooth is frequently removed surgically. Because of the upper canines' significance to dental esthetics and functional occlusion, such a decision is a very serious one. This case report illustrates the treatment of

Torsten Grande; Annemarie Stolze; Heiko Goldbecher

2005-01-01

455

Design-related fretting wear in modular neck hip prosthesis.  

PubMed

An accelerated cyclic loading corrosion test was used to determine the corrosion behavior of a commercial (GSP) and a prototype titanium hip prosthesis each with a modular neck. Four GSP and four prototype stems were subjected to a 2-Hz cyclic load ranging between 200 and 2,100 N for 1,000,000 cycles. Three stems were tested in an environment of FeCl3 solution, three stems were tested in Ringer's solution, and two stems were tested in air. After cyclic loading, the specimens were carefully examined with optical and scanning electron microscopy (SEM). None of them showed macroscopic or microscopic signs of corrosion, regardless of the environment to which the specimens were subjected. However, macroscopic evidence of mechanical fretting was present at the neck-stem modular junction, primarily concentrated at the medial contact point between stem and neck, especially for the prototype stems. SEM analysis confirmed these observations. The appreciable differences observed between the two designs suggest that the problem can be minimized or eliminated with an accurately designed taper fitting. PMID:9019482

Viceconti, M; Ruggeri, O; Toni, A; Giunti, A

1996-02-01

456

Control aspects of motor neural prosthesis: sensory interface.  

PubMed

A neural prosthesis (NP) has two applications: permanent assistance of function, and temporary assistance that contributes to long-term recovery of function. Here, we address control issues for a therapeutic NP which uses surface electrodes. We suggest that the effective NP for therapy needs to implement rule-based control. Rule-based control relies on the triggering of preprogrammed sequences of electrical stimulation by the sensory signals. The sensory system in the therapeutic NP needs to be simple for installation, allow self-calibration, it must be robust, and sufficiently redundant in order to guarantee safe operation. The sensory signals need to generate control signals; hence, sensory fusion is needed. MEMS technology today provides sensors that fulfill the technical requirements (accelerometers, gyroscopes, force sensing resistors). Therefore, the task was to design a sensory signal processing method from the mentioned solid state sensors that would recognize phases during the gait cycle. This is necessary for the control of multi channel electrical stimulation. The sensory fusion consists of the following two phases: 1) estimation of vertical and horizontal components of the ground reaction force, center of pressure, and joint angles from the solid-state sensors, and 2) fusion of the estimated signals into a sequence of command signals. The first phase was realized by the use of artificial neural networks and adaptive neuro-fuzzy inference systems, while the second by the use of inductive learning described in our earlier work [1]. PMID:18002969

Popovi?, Dejan B; Dosen, Strahinja; Popovi?, Mirjana B; Stefanovi?, Filip; Kojovi?, Jovana

2007-01-01