Sample records for upper extremity prosthesis

  1. A forearm actuation unit for an upper extremity prosthesis

    Microsoft Academic Search

    Thomas J. Withrow; Xiangrong Shen; Jason E. Mitchell; Michael Goldfarb

    2008-01-01

    This paper presents the design of a 14 degree-of-motion forearm actuation unit for an upper extremity prosthesis. The forearm utilizes pneumatic type actuators which use the reaction products of a monopropellant gas generator as a working fluid. The use of pneumatic type actuators provides a near-human power density, such that the fourteen actuator forearm unit can deliver approximately one half

  2. Liquid-Fueled Actuation for an Anthropomorphic Upper Extremity Prosthesis

    Microsoft Academic Search

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

    2006-01-01

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

  3. Liquid-fueled actuation for an anthropomorphic upper extremity prosthesis.

    PubMed

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

    2006-01-01

    This paper describes the design of a 21 degree-of-freedom, nine degree-of-actuation, gas-actuated arm prosthesis for transhumeral amputees. The arm incorporates a direct-drive elbow and three degree-of-freedom wrist, in addition to a 17 degree-of-freedom underactuated hand effected by five actuators. The anthropomorphic device includes full position and force sensing capability for each actuated degree of freedom and integrates a monopropellant-powered gas generator to provide on-board power for untethered operation. Design considerations addressed in this paper include the sizing of pneumatic actuators based on the requisite output energy at each joint; the development of small low-power servovalves for use with hot/cold gases; the design of compact joints with integrated position sensing; and the packaging of the actuators, on-board power, and skeletal structure within the volumetric envelope of a normal human forearm and elbow. The resulting arm prototype approaches the dexterous manipulation capabilities of its anatomical counterpart while delivering approximately 50% of the force and power output of an average human arm. PMID:17947158

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

    PubMed

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

    2014-01-01

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

  5. Upper Eyelid Ptosis Surgery Using a Preparatory Ocular Prosthesis

    Microsoft Academic Search

    Ilse Mombaerts; Erica Groet

    2009-01-01

    Purpose: When an ocular prosthesis is unable to correct upper eyelid ptosis, surgery is performed with the existing prosthesis, which may be difficult and unsatisfactory. We used an alternative approach, in which the prosthesis was modified as a preparation to surgery. Methods: This retrospective, noncomparative, interventional case series included 26 anophthalmic and 3 microphthalmic patients with unilateral, moderate to severe

  6. Upper extremity deep venous thrombosis.

    PubMed

    Rainey, Charles E; Taysom, Danielle A; Rosenthal, Michael D

    2014-04-01

    The patient was a 34-year-old man currently serving in the military who was referred to a physical therapist by his primary care physician for a chief complaint of worsening right shoulder pain and paresthesias of the first, second, and third digits of his right hand, as well as right upper extremity swelling. Doppler ultrasonography was performed, and the presence of an occlusive thrombus in the right distal subclavian and axillary veins was revealed. PMID:24684195

  7. Prosthesis

    MedlinePLUS

    ... by prosthetic devices. False teeth are known as dental prostheses. An artificial replacement of the jaw bone is called a maxillofacial prosthesis. Penis implants are also known as penile prostheses.

  8. Advances in upper extremity prosthetics.

    PubMed

    Zlotolow, Dan A; Kozin, Scott H

    2012-11-01

    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

  9. Research, design & development project Myoelectric Prosthesis of Upper Limb

    NASA Astrophysics Data System (ADS)

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

    2007-11-01

    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.

  10. 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 and integrates a monopropellant-powered gas generator to provide on-board power for untethered operation. Design

  11. Upper extremity function in spina bifida

    Microsoft Academic Search

    Jette Jansen; Karen Taudorf; Hans Pedersen; Kirsten Jensen; Åse Seitzberg; Torben Smith

    1991-01-01

    Poor upper extremity function is often recorded in meningomyelocele patients. Only 2 of the 25 patients we assessed, 5 to 19 years old, showed normal upper extremity function in the clinical neurological examination and a timed hand function test simulating daily activities. Slow performance with unsystematic variability was typical. Poor hand function correlated strongly with hydrocephalus. A trend towards better

  12. Giant lipomas of the upper extremity

    PubMed Central

    Allen, Brian; Rader, Christine; Babigian, Alan

    2007-01-01

    Lipomas are slow-growing soft tissue tumours that rarely reach a size larger than 2 cm. Lesions larger than 5 cm, so-called giant lipomas, can occur anywhere in the body but are seldom found in the upper extremities. The authors present their experiences with eight patients having giant lipomas of the upper extremity. In addition, a review of the literature, and a discussion of the appropriate evaluation and management are included. PMID:19554145

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

    2014-01-01

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

  15. Lower extremity above-knee prosthesis-associated erectile dysfunction

    Microsoft Academic Search

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

    2003-01-01

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

  16. [Amputation and prosthesis attachment of the lower extremities].

    PubMed

    Matthes, I; Beirau, M; Ekkernkamp, A; Matthes, G

    2015-06-01

    Approximately 61,000 amputations are performed in Germany per year. In most cases the lower limbs are affected. The reasons for amputations are arteriosclerosis, diabetes mellitus, severe infections, tumors and complex trauma to the extremities. A decision must be made concerning whether a salvage procedure or amputation is appropriate, specially after trauma. In cases where the need for amputation is clear, the site of amputation needs to be planned in advance with the aim of creating a stump which allows sufficient prosthetic attachment. Adjuvant pain therapy is mandatory, especially in order to avoid subsequent phantom pain. The type of prosthetic restoration is influenced by the grade of mobility and personal requirements of patients. Moreover, aftercare and adjusted rehabilitation are recommended. PMID:26013390

  17. ORIGINAL ARTICLE Acupuncture for Upper-Extremity Rehabilitation in Chronic

    E-print Network

    Schaechter, Judith D.

    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 acci- dent; Hemiparesis; Muscle spasticity; Range of motion, artic- ular; Rehabilitation. © 2005

  18. Upper extremity injuries in Homer's Iliad.

    PubMed

    Hutchison, Richard L; Hirthler, Maureen A

    2013-09-01

    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

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

    E-print Network

    Nenadic, Zoran

    G-based BCI-controlled upper extremity prosthesis to restore motor function and indepen- dence to paralyzedG)-based brain computer interfaces (BCI) can potentially control upper extremity pros- theses to restore be used as an input feature in future BCIs. I. INTRODUCTION Brain-computer interface (BCI)-controlled

  20. Upper extremity deep vein thrombosis with tourniquet use

    PubMed Central

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

    2014-01-01

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

  1. Venous gangrene of the upper extremity.

    PubMed Central

    Smith, B M; Shield, G W; Riddell, D H; Snell, J D

    1985-01-01

    Gangrene of the hand associated with acute upper extremity venous insufficiency has been seen in four limbs in three patients treated at Vanderbilt University Medical Center. All three patients had life-threatening illnesses associated with diminished tissue perfusion, hypercoagulability, and venous injury. One patient progressed to above-elbow amputation, but venous thrombectomy in one limb and thrombolytic therapy in two others were successful in preventing major tissue loss. All three patients eventually died from their underlying illness. Thirteen previously reported patients with "venous gangrene" of the upper extremity have been analyzed. An underlying life-threatening illness was present in the majority of these patients (7/13, 54%) and, like the Vanderbilt series, amputations were frequent (7/13, 54%) and mortality (5/13, 38%) was high. This unusual form of ischemia appears to be produced by permutations of global circulatory stasis, subclavian or axillary vein occlusion, and peripheral venous thrombosis. Early, aggressive restoration of adequate cardiac output and thrombectomy and/or thrombolytic therapy may provide the best chance for tissue salvage and survival in this group of patients. Images FIG. 1. FIG. 2. FIG. 3. FIG. 4. FIG. 5. FIGS. 6A and B. FIGS. 7A and B. FIG. 8. PMID:3977453

  2. Use of Powered Prosthesis for Children with Upper Limb Deficiency at Hyogo Rehabilitation Center

    PubMed Central

    Shibata, Yaeko; Mizobe, Futoshi

    2015-01-01

    Background There has been no research investigating the use of powered prosthetic for children in Japan. Objective To gain better insight into the state of powered prosthesis usage and identify a ratio of rejection among children. Methods Subjects were 37 unilateral below elbow amputees between the ages of 0 and 16 at the time of their first experienced fitting with a powered prosthesis at our Center. The information was collected from medical records and through face-to-face interviews, and we examined rejection rate and the factors affecting the use of powered prosthesis. Results The rate of discontinuation was 21.6% as 8 of the 37 children stopped using powered prosthesis. All of them were fitted their prosthesis after 2 years of age, and they rejected prosthesis between 5 to 19 years. We found that the level of amputation had no influence on the use of a powered prosthesis. Conclusions Children fitted before 2 years of age tend to accept their powered prosthesis than those fitted after 2 years. Multidisciprinary team approach, adequate rehabilitation, detailed follow-up and involvement of parents are quite important for introducing powered prosthesis for children. PMID:26125974

  3. Interpretation of upper extremity arteriography : vascular anatomy and pathology.

    PubMed

    Wong, Victor W; Katz, Ryan D; Higgins, James P

    2015-02-01

    Understanding the utility and interpretation of upper extremity angiography is critical for the hand surgeon treating vaso-occlusive diseases of the hand. Although invasive and requiring the use of contrast dye, it remains the gold standard for imaging of the vascular system of the upper extremity. Angiography may detect numerous variants of the upper limb arterial system which may contribute to surgical pathology. Extensive vascular collateralization helps to maintain perfusion to the hand and facilitates reconstruction of the upper extremity. It is paramount to remember that angiography is a dynamic study and should represent a "flexible roadmap" for surgical reconstruction. PMID:25455362

  4. Electrocorticogram encoding of upper extremity movement duration.

    PubMed

    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

    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

  5. Exercise-Induced Deep Vein Thrombosis of the Upper Extremity

    Microsoft Academic Search

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

    2006-01-01

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

  6. Upper extremity wheelchair kinematics in children with spinal cord injury.

    PubMed

    Slavens, Brooke A; Graf, Adam; Krzak, Joseph; Vogel, Lawrence; Harris, Gerald F

    2011-01-01

    Current methods for the evaluation of upper extremity dynamics during wheelchair mobility in children are limited. The goal of this study was to characterize upper extremity joint kinematics during wheelchair mobility. A 3-D biomechanical model of the upper extremities is presented for kinematic assessment of manual wheelchair propulsion in children with Spinal Cord Injury (SCI). The bilateral upper extremity model consists of the thorax, upper arms, forearms, and hands. The model was applied to thirteen (13) children with SCI. Joint angles and joint ranges of motion of the shoulders, elbows, and wrists were quantified. Peak joint motions during the stroke cycle were compared between right and left sides for further insight to mobility patterns. This work will provide insight to be used in future kinetic studies of wheelchair mobility. PMID:22256235

  7. Ergonomic considerations in work-related upper extremity disorders.

    PubMed

    Pearce, Brian

    2006-01-01

    Correctly applied, an ergonomics approach can reduce the likelihood of work-induced disorders and can assist in accommodating individuals who have work-related disorders, but it cannot eliminate disorders that have been mistakenly attributed to work by social processes. A contextual model of work-related upper extremity disorders is proposed that explicitly acknowledges that factors extrinsic to work can shape perceptions of upper extremity disorders and influence the process of somatic interpretation and health outcomes. Experiences in the United Kingdom of ergonomic regulations associated with computer use and the media coverage of work-related upper extremity disorders are used to illustrate this model. PMID:16647647

  8. The development of an index for the proximal upper extremity 

    E-print Network

    Walline, Erin Kurusz

    2006-08-16

    Analysis techniques specific to the proximal upper extremity have historically been overlooked in the field of ergonomics. This research effort provides a methodology that will allow the ergonomics practitioner to analyze ...

  9. Upper extremity kinetics during Lofstrand crutch-assisted gait

    Microsoft Academic Search

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

    2005-01-01

    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

  10. Workers' compensation and outcomes of upper extremity surgery.

    PubMed

    Gruson, Konrad I; Huang, Kevin; Wanich, Tony; Depalma, Anthony A

    2013-02-01

    Clinical outcomes following upper extremity surgery among workers' compensation patients have traditionally been found to be worse than those of non-workers' compensation patients. In addition, workers' compensation patients take significantly longer to return to their jobs, and they return to their preinjury levels of employment at a lower overall rate. These unfavorable prognoses may stem from the strenuous physical demands placed on the upper extremity in this group of patients. Further, there is a potential financial benefit within this patient population to report severe functional disability following surgery. Orthopaedic upper extremity surgeons who treat workers' compensation patients should be aware of the potentially prolonged period before return to work after surgical intervention and should counsel this group of patients accordingly. Vocational training should be considered if a patient's clinical progress begins to plateau. PMID:23378370

  11. Predicting Recovery of Voluntary Upper Extremity Movement in Subacute Stroke Patients with Severe Upper Extremity Paresis

    PubMed Central

    Koh, Chia-Lin; Pan, Shin-Liang; Jeng, Jiann-Shing; Chen, Bang-Bin; Wang, Yen-Ho; Hsueh, I-Ping; Hsieh, Ching-Lin

    2015-01-01

    Background and Objective Prediction of voluntary upper extremity (UE) movement recovery is largely unknown in patients with little voluntary UE movement at admission. The present study aimed to investigate (1) the extent and variation of voluntary UE movement recovery, and (2) the best predictive model of the recovery of voluntary UE movement by clinical variables in patients with severe UE paresis. Design Prospective cohort study. Methods 140 (out of 590) stroke patients with severe UE paresis completed all assessments. Voluntary UE movement was assessed using the UE subscale of the Stroke Rehabilitation Assessment of Movement (STREAM-UE). Two outcome measures, STREAM-UE scores at discharge (DCSTREAM-UE) and changes between admission and discharge (?STREAM-UE), were investigated to represent the final states and improvement of the recovery of voluntary UE movement. Stepwise regression analyses were used to investigate 19 clinical variables and to find the best predictive models of the two outcome measures. Results The participants showed wide variation in both DCSTREAM-UE and ?STREAM-UE. 3.6% of the participants almost fully recovered at discharge (DCSTREAM-UE > 15). A large improvement (?STREAM-UE >= 10) occurred in 16.4% of the participants, while 32.9% of the participants did not have any improvement. The four predictors for the DCSTREAM-UE (R2 = 35.0%) were ‘baseline STREAM-UE score’, ‘hemorrhagic stroke’, ‘baseline National Institutes of Health Stroke Scale (NIHSS) score’, and ‘cortical lesion excluding primary motor cortex’. The three predictors for the ?STREAM-UE (R2 = 22.0%) were ‘hemorrhagic stroke’, ‘baseline NIHSS score’, and ‘cortical lesion excluding primary motor cortex’. Conclusions Recovery of voluntary UE movement varied widely in patients with severe UE paresis after stroke. The predictive power of clinical variables was poor. Both results indicate the complex nature of voluntary UE movement recovery in patients with severe UE paresis after stroke. PMID:25973919

  12. Management of severe musculoskeletal injuries of the upper extremity.

    PubMed

    Levin, L S; Goldner, R D; Urbaniak, J R; Nunley, J A; Hardaker, W T

    1990-01-01

    Limb salvage was successful in 25 patients treated for severe grade III upper extremity injuries. In a retrospective review of 20 men and five women, follow-up time averaged 26 months. These high-energy injuries were characterized by massive soft-tissue injury, highly comminuted fractures, and significant neurovascular injury. Farm, industrial, and vehicular accidents accounted for 80% of the cases. Over 50% of the patients had concomitant systemic and/or other significant extremity injuries. Initial treatment consisted of irrigation and debridement and fracture stabilization using external and/or internal fixation. An average of four additional surgical procedures was required to provide soft-tissue coverage and maximum possible functional recovery. Forty-eight percent of the extremities underwent free vascularized or pedicular flaps for coverage or reconstruction. At final follow-up observation, 12% of the extremities rated excellent, 20% rated good, 52% fair, and 16% were poor. Experience gained in managing these severe upper extremity fractures supports the following observations. (a) Grade III open fractures of the upper extremities are frequently associated with significant neural, vascular, and musculotendon injuries. (b) External fixation plays an important role in the stabilization of grossly contaminated fractures. (c) Residual functional disability is common, and most patients do not return to their previous occupation. (d) Staged reconstruction directed toward maximum functional return may take several years. PMID:2266450

  13. Exercise-Induced Deep Vein Thrombosis of the Upper Extremity

    Microsoft Academic Search

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

    2006-01-01

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

  14. EFFECTS OF UPPER EXTREMITY FATIGUE ON BASKETBALL SHOOTING ACCURACY

    Microsoft Academic Search

    Wan-ehin Chen; Shin-Liang Lo; Yun-Kwan Lee; Jen-Sen Wang

    The purpose of this study was to investigate the effect of upper extremity fatigue on basketball shooting accuracy. Twenty-four elite male basketball players from 2 teams the top 3 Taiwan High Schools were chosen as subjects. After a warm-up and proper practice, they were asked to shoot from 3 varied distance positions before and after fatigue protocols. The protocols used

  15. Control of a Pneumatic Orthosis for Upper Extremity Stroke Rehabilitation

    E-print Network

    Bobrow, James E.

    Control of a Pneumatic Orthosis for Upper Extremity Stroke Rehabilitation Eric T. Wolbrecht, John Leavitt, David J. Reinkensmeyer, and James E. Bobrow Abstract-- A key challenge in rehabilitation robotics rehabilitation of the arm. Pneumatic actuators can potentially help meet this challenge because of their high

  16. Upper extremity hemodynamics and sensation with backpack loads.

    PubMed

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

    2014-05-01

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

  17. Driving with upper extremity immobilization: a comprehensive review.

    PubMed

    Sandvall, Brinkley K; Friedrich, Jeffrey B

    2015-05-01

    Driving with upper extremity immobilization can be potentially dangerous. The aim of this article is to review current medical literature, state laws, and guidelines on driving with upper extremity immobilization and appraise the available evidence. A literature search was conducted to identify citations related to driving with upper extremity immobilization and included a law literature search. Each state's Department of Motor Vehicle handbook was reviewed. Fourteen studies were reviewed and 5 provided subjective and/or objective assessments of upper limb immobilization. Of 2 studies that evaluated only below-elbow immobilization, 1 found driving in a wrist splint had no perceptible effect on driving ability, and the other supported safe driving under normal conditions. The studies that evaluated both below- and above-elbow immobilization recommended against driving with left arm above-elbow immobilization. Two of them found a trend toward worse driving performance in both below- and above-elbow splints. The following organizations' policies on driving are (1) The American Medical Association and National Highway Traffic Association have a joint recommendation for older drivers recommending referral to a rehabilitation specialist, (2) the U.S. Public Health Service recommends normal motor function and adequate mobility of both upper extremities and a performance examination when impaired, and (3) the U.S. Department of Transportation recommends a performance evaluation to determine fitness of commercial motor vehicle drivers. There are no state statutes or multijurisdictional surveys on the topic. This review finds that driving is hindered in some splints, there are substantial variations in physician practice patterns, there are no formal guidelines for physicians and patients to consider, and there is a paucity of published literature on this topic in the United States. Both physicians and patients would benefit from evidence-based recommendations or practice guidelines. PMID:24909565

  18. Upper extremity venous aneurysm as a source of pulmonary emboli.

    PubMed

    Wallace, Justin R; Baril, Donald T; Chaer, Rabih A

    2013-02-01

    Spontaneous venous aneurysms of the upper extremities and neck are rare and typically asymptomatic. We present the first reported case of a symptomatic, primary upper extremity venous aneurysm in a patient who initially presented with pulmonary emboli. A 22-year-old patient was admitted with chest pain, dyspnea, and a right axillary mass. Computed tomography revealed diffuse, bilateral pulmonary emboli in addition to a thrombosed axillary vein. Venography confirmed the diagnosis, and also revealed a subclavian vein stenosis at the crossing of the first rib. Pharmacomechanical thrombolysis, catheter-directed thrombolysis, and venoplasty were performed with adequate flow restoration, also revealing the presence of a previously thrombosed proximal brachial/distal axillary venous aneurysm. Hematologic testing showed a positive and persistent lupus anticoagulant. The patient declined surgical reconstruction and opted for long-term anticoagulation. At 24 months, the patient continued to remain symptom-free. PMID:23380560

  19. Soft tissue coverage of the mangled upper extremity.

    PubMed

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

    2015-02-01

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

  20. Lipoma causing upper extremity deep vein thrombosis: A case report

    Microsoft Academic Search

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

    2010-01-01

    We report a case of lipoma in the right infraclavicular and axillary area compressing subclavian vein there by presenting\\u000a with upper extremity deep venous thrombosis (UEDVT) and persistent symptoms of venous congestion. Patient was also found to\\u000a be a heterozygous carrier of prothrombin 20210 gene mutation. Surgical excision of lipomatous tissue performed after 6 months\\u000a of anticoagulation resulted in a complete

  1. Robot-aided neurorehabilitation of the upper extremities

    Microsoft Academic Search

    Robert Riener; Tobias Nef; Gery Colombo

    2005-01-01

    Task-oriented repetitive movements can improve muscle strength and movement co-ordination in patients with impairments due\\u000a to neurological lesions. The application of robotics and automation technology can serve to assist, enhance, evaluate and\\u000a document the rehabilitation of movements. The paper provides an overview of existing devices that can support movement therapy\\u000a of the upper extremities in subjects with neurological pathologies. The

  2. Computer Use Patterns Associated with Upper Extremity Musculoskeletal Symptoms

    Microsoft Academic Search

    Cammie Chaumont Menéndez; Benjamin C. Amick; Jack T. Dennerlein; Ronald B. Harrist; Mark Jenkins; Michelle Robertson; Jeffrey N. Katz

    2008-01-01

    Introduction Over half of surveyed college students are experiencing pain they are attributing to computer use. The study objective was\\u000a to evaluate the effect of computing patterns on upper extremity musculoskeletal symptoms. Methods Symptom experiences and computing\\/break patterns were reported several times daily over three weeks for 30 undergraduate\\u000a students over a semester. Two-level logistic regression models described the daily

  3. [Regional anaesthesia in injuries of the upper extremity].

    PubMed

    Döffert, Jens; Steinfeldt, Thorsten

    2015-04-01

    Regional anaesthesia has significant advantages compared to general anaesthesia with an opiate-based postoperative analgesia in injuries of the upper extremity. Severe pain may be considered a risk factor for the development of chronic postoperative pain syndromes in adults and children. Depending on the anticipated postoperative pain level, a catheter procedure should be used. Fractures of the upper extremity are common and may also be associated with seemingly minor injuries with a high postoperative pain level. Nerve damage can be caused mainly by traumatic fractures, or iatrogenically during surgical procedures. Reduced possible neurological evaluability should not prevent the excellent pain control which regional anesthesia can provide. Since the brachial plexus is predominantly responsible for the sensory innervation of the entire upper extremity, therefore all known block techniques in regional anaesthesia apply. Since the introduction of ultrasound in regional anaesthesia (USGRA), older methods like the supraclavicular approach, which were previously banned due to high complication rates, are now being rediscovered. Both new and old blockade methods are much more effective and safe with ultrasound support because of the rapid visualization of the anatomy and needle. PMID:25919825

  4. Is There Any Association between PEEP and Upper Extremity DVT?

    PubMed Central

    Gupta, Ena; Siddiqi, Furqan; Faisal, Muhammad; Jones, Lisa M.; Louis, Mariam; Cury, James D.; Bajwa, Abubakr A.

    2015-01-01

    Background. We hypothesized that positive end-exploratory pressure (PEEP) may promote venous stasis in the upper extremities and predispose to upper extremity deep vein thrombosis (UEDVT). Methods. We performed a retrospective case control study of medical intensive care unit patients who required mechanical ventilation (MV) for >72 hours and underwent duplex ultrasound of their upper veins for suspected DVT between January 2011 and December 2013. Results. UEDVT was found in 32 (28.5%) of 112 patients. Nineteen (67.8%) had a central venous catheter on the same side. The mean ± SD duration of MV was 13.2 ± 9.5 days. Average PEEP was 7.13 ± 2.97?cm H2O. Average PEEP was ?10?cm H2O in 23 (20.5%) patients. Congestive heart failure (CHF) significantly increased the odds of UEDVT (OR 4.53, 95% CI 1.13–18.11; P = 0.03) whereas longer duration of MV (?13 vs. <13 days) significantly reduced it (OR 0.29, 95% CI 0.11–0.8; P = 0.02). Morbid obesity showed a trend towards significance (OR 3.82, 95% CI 0.95–15.4; P = 0.06). Neither PEEP nor any of the other analyzed predictors was associated with UEDVT. Conclusions. There is no association between PEEP and UEDVT. CHF may predispose to UEDVT whereas the risk of UEDVT declines with longer duration of MV. PMID:25922762

  5. CRPS of the upper or lower extremity: surgical treatment outcomes

    PubMed Central

    2009-01-01

    The hypothesis is explored that CRPS I (the "new" RSD) persists due to undiagnosed injured joint afferents, and/or cutaneous neuromas, and/or nerve compressions, and is, therefore, a misdiagnosed form of CRPS II (the "new" causalgia). An IRB-approved, retrospective chart review on a series of 100 consecutive patients with "RSD" identified 40 upper and 30 lower extremity patients for surgery based upon their history, physical examination, neurosensory testing, and nerve blocks. Based upon decreased pain medication usage and recovery of function, outcome in the upper extremity, at a mean of 27.9 months follow-up (range of 9 to 81 months), gave results that were excellent in 40% (16 of 40 patients), good in 40% (16 of 40 patients) and failure 20% (8 of 40 patients). In the lower extremity, at a mean of 23.0 months follow-up (range of 9 to 69 months) the results were excellent in 47% (14 of 30 patients), good in 33% (10 of 30 patients) and failure 20% (6 of 30 patients). It is concluded that most patients referred with a diagnosis of CRPS I have continuing pain input from injured joint or cutaneous afferents, and/or nerve compressions, and, therefore, similar to a patient with CRPS II, they can be treated successfully with an appropriate peripheral nerve surgical strategy. PMID:19232118

  6. [A case of upper extremity deep vein thrombosis].

    PubMed

    Aguilar Shea, A L; Gallardo Mayo, C

    2013-03-01

    The case is presented of a 41 year-old women with a personal history of smoking and treated with oral contraceptives, who began taking analgesics and muscle relaxants due to a right cervical pain. As her clinical condition did not improve she was seen again. During the physical examination an increase of soft tissue in the right supraclavicular area was observed. The ultrasound revealed thrombosis of the internal jugular, subclavian, brachycephalic, axillar and humeral veins. We believe that upper-extremity deep venous thrombosis is a rare condition that must be considered in patients with oedema of the upper limbs. The key to a prompt diagnosis is to know the risk factors. Ultrasound is the standard approach. PMID:23452538

  7. Isolated Upper Extremity Posttransplant Lymphoproliferative Disorder in a Child

    PubMed Central

    Halula, Sarah E.; Leino, Daniel G.; Patel, Manish N.; Racadio, John M.; Lungren, Matthew P.

    2015-01-01

    Posttransplant lymphoproliferative disorder (PTLD) is a well-described complication of solid organ and bone marrow transplants. The most common presentation is intra-abdominal lymphadenopathy or single or multiple intraparenchymal masses involving the liver, spleen, or kidneys. Here we describe the imaging and pathology findings of an unusual case of PTLD appearing as an intramuscular forearm lesion in a pediatric male. The manifestation of PTLD as an isolated upper extremity mass in a pediatric patient has to our knowledge not been described. PMID:26167324

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

    PubMed

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

    2014-11-01

    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

  9. Upper limb prostheses for amputations above elbow: A review

    Microsoft Academic Search

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

    2009-01-01

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

  10. Extreme Cranial Ontogeny in the Upper Cretaceous Dinosaur Pachycephalosaurus

    PubMed Central

    Horner, John R.; Goodwin, Mark B.

    2009-01-01

    Background Extended 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. Marginocephalians (pachycephalosaurids + ceratopsids) undergo comparable and extreme cranial morphological change during ontogeny. Methodology/Principal Findings Cranial histology, morphology and computer tomography reveal patterns of internal skull development that show the purported diagnostic characters for the pachycephalosaurids Dracorex hogwartsia and Stygimoloch spinifer are ontogenetically derived features. Coronal histological sections of the frontoparietal dome of an adult Pachycephalosaurus wyomingensis reveal a dense structure composed of metaplastic bone with a variety of extremely fibrous and acellular tissue. Coronal histological sections and computer tomography of a skull and frontoparietal dome of Stygimoloch spinifer reveal an open intrafrontal suture indicative of a subadult stage of development. These dinosaurs employed metaplasia to rapidly grow and change the size and shape of their horns, cranial ornaments and frontoparietal domes, resulting in extreme cranial alterations during late stages of growth. We propose that Dracorex hogwartsia, Stygimoloch spinifer and Pachycephalosaurus wyomingensis are the same taxon and represent an ontogenetic series united by shared morphology and increasing skull length. Conclusions/Significance Dracorex hogwartsia (juvenile) and Stygimoloch spinifer (subadult) are reinterpreted as younger growth stages of Pachycephalosaurus wyomingensis (adult). This synonymy reduces the number of pachycephalosaurid taxa from the Upper Cretaceous of North America and demonstrates the importance of cranial ontogeny in evaluating dinosaur diversity and taxonomy. These growth stages reflect a continuum rather than specific developmental steps defined by “known” terminal morphologies. PMID:19859556

  11. Monitoring of Upper Limb Prosthesis Activity in Trans-Radial Amputees

    Microsoft Academic Search

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

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

  12. The Effect of Wrist Guard Use on Upper-Extremity Injuries in Snowboarders

    Microsoft Academic Search

    Brent Hagel; I. Barry Pless; Claude Goulet

    2005-01-01

    The objective of this investigation was to determine the effect of wrist guard use on all upper-extremity injuries in snowboarders. This matched case-control study was conducted at 19 ski areas in Quebec, Canada. Cases were 1,066 injured snowboarders who reported upper-extremity injuries to the ski patrol during the 2001-2002 season. Controls were 970 snowboarders with non-upper-extremity injuries who were matched

  13. Recognizing complex upper extremity activities using body worn sensors.

    PubMed

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

    2015-01-01

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

  14. Effect of upper extremity exercise in people with COPD

    PubMed Central

    Kathiresan, Ganesan; Jeyaraman, Senthil Kumar; Jaganathan, Jayachandran

    2010-01-01

    Background Exercise for people with COPD has focused on leg training, such as walking and cycling. The role and effectiveness of arm training has not been investigated in detail. This review was undertaken to examine the literature for the effectiveness of upper extremity exercise on arm exercise capacity and arm strength in people with COPD. Methods Trials relating to arm endurance and strength training in COPD were located by searching electronic databases and screening the reference lists of pertinent articles. Where possible, effect sizes and 95% CI were determined and meta-analysis used. Results The search strategy yielded 24 articles. Unsupported arm training improved arm endurance capacity (standard mean difference [SMD] =1.25; 95% CI=0.16 to 2.66) and was the optimal mode of arm endurance training. Combined unsupported and supported arm training was also found to have a large positive effect on peak arm exercise capacity (SMD=1.27; 95% CI=0.59 to 1.94). In addition arm strength training produced moderate improvements in arm strength (SMD=0.46; 95% CI=0.10 to 0.81). Conclusion This review suggests that in the short term, arm endurance training improves arm exercise capacity and arm strength training improves arm strength. Further research is required, in people with COPD, to investigate the long-term effects of arm training. PMID:22263051

  15. Postthrombotic syndrome following upper extremity deep vein thrombosis in children.

    PubMed

    Avila, Maria L; Duan, Lucy; Cipolla, Amanda; Kim, Ashley; Kahr, Walter H A; Williams, Suzan; Brandão, Leonardo R

    2014-08-14

    Despite its relatively estimated high occurrence, the characterization of pediatric upper extremity deep vein thrombosis (UE-DVT) and of UE postthrombotic syndrome (PTS) is still lacking. We investigated the occurrence, characteristics, and predictors of UE-PTS in a cohort of children with objectively confirmed UE-DVT. Patients were analyzed in 3 groups according to DVT pathogenesis and neonatal status: primary (G1), secondary neonates (G2neonates), and non-neonates (G2non-neonates). A total of 158 children (23 G1, 25 G2neonates, and 110 G2non-neonates) were included. The most common triggering factors were effort-related (87%) in G1 and central lines in G2neonates (100%) and in G2non-neonates (92%). PTS scores ?1, as per the Modified Villalta Scale, were identified in 87% of primary patients, 16% of G2neonates, and 49% of G2non-neonates. Survival analysis showed that the time to PTS score ?1 significantly differed among group (log-rank test P < .0001). A multivariable logistic regression showed that DVT pathogenesis and imaging-determined degree of thrombus resolution at the end of therapy were independent predictors of a PTS score ?2. In conclusion, pediatric UE-PTS frequency and severity depend on UE-DVT pathogenesis (primary/secondary) and, within the secondary group, on patient's age. Line-related UE-PTS has a more benign course, particularly in neonates. PMID:24957144

  16. Motor learning perspectives on haptic training for the upper extremities.

    PubMed

    Williams, Camille K; Carnahan, Heather

    2014-01-01

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

  17. Epitrochlear node involvement in melanoma of the upper extremity.

    PubMed

    Smith, T J; Sloan, G M; Baker, A R

    1983-02-15

    Between 1955 and 1979, 240 patients with melanoma of the upper extremity were admitted to the National Institutes of Health (NIH). Thirty nine of these patients (16%) had primary lesions of the forearm, hand, or digit. Twenty-two patients underwent axillary dissection during their treatment. Ten patients were subjected to both axillary and epitrochlear lymph node dissection. Nine of these ten patients had lymph node metastases; two in the axillary nodes only, two in the epitrochlear nodes only, and five in both nodal groups. Epitrochlear node involvement occurred in 18% of patients with forearm or hand lesions, and only when the primary melanoma was within 5 cm of the elbow or in the ulnar distribution, the classically described drainage area of the epitrochlear nodes. The prognosis of the patients in this study was related to the depth of their primary lesions and the presence or absence of axillary node involvement. However, since approximately 18% of patients with melanomas of the hand, forearm and elbow area have a high probability of recurrence in the epitrochlear nodes, close attention to this area and early dissection of clinically suspicious nodes can favorably affect locoregional control in this group of melanoma patients. PMID:6821845

  18. Upper extremity activity in adults: Referent values using accelerometry

    PubMed Central

    Bailey, Ryan R.; Lang, Catherine E.

    2013-01-01

    The goal of physical rehabilitation following upper extremity (UE) impairment is functional restoration of the UE for use in daily activities. Because capacity for UE function may not translate into real-world activity, it is important that assessment of real-world UE activity be used in conjunction with clinical measures of capacity. Accelerometry can be used to quantify duration of UE activity outside of the clinic. The purpose of this study was to characterize hours of UE activity and potential modifying factors of UE activity (sedentary activity, cognitive impairment, depressive symptomatology, additive effects of comorbidities, cohabitation status, and age). Seventy-four community dwelling adults wore accelerometers on bilateral wrists for 25 hours and provided information on modifying factors. Mean hours of dominant UE activity was 9.1 ± 1.9 hours and the ratio of activity between the non-dominant and dominant UEs was 0.95 ± 0.06. Decreased hours of dominant UE activity was associated with increased time spent in sedentary activity. No other factors were associated with hours of dominant UE activity. These data can be used to help clinicians establish outcome goals for patients, given pre-impairment level of sedentary activity, and to track progress during rehabilitation of the UEs. PMID:24458962

  19. The stump and the prosthesis.

    PubMed Central

    Day, H. J.

    1980-01-01

    In performing amputations the surgeon must bear in mind the biomechanical and other constraints of the prosthesis likely to be fitted and, so far as possible, should fashion the stump accordingly. The various types of prosthesis and their features are discussed in relation to amputations of the lower and upper limbs at all levels. PMID:7377694

  20. Design and Modeling of an Upper Extremity Exoskeleton S. Moubarak1

    E-print Network

    Boyer, Edmond

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

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

    ClinicalTrials.gov

    2014-12-17

    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

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

    Microsoft Academic Search

    L. Punnett

    1998-01-01

    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

  3. Occup Environ Med. Author manuscript Work, a prognosis factor for upper extremity musculoskeletal disorders?

    E-print Network

    Boyer, Edmond

    musculoskeletal disorders? Descatha Alexis 1 2 * , Roquelaure Yves 3 , Chastang Jean-Fran oisç 2 , Evanoff Bradley Keywords musculoskeletal diseases ; upper extremity ; work ; prognosis factor Upper extremity musculoskeletal (UEMS) disorders are an important problem in industrial countries There is strong evidence for[1

  4. Arthritis Rheum . Author manuscript Risk factors for upper-extremity musculoskeletal disorders in the working

    E-print Network

    Paris-Sud XI, Université de

    Arthritis Rheum . Author manuscript Page /1 13 Risk factors for upper-extremity musculoskeletal risk factors for upper-extremity musculoskeletal disorders (UEMSDs) in the working population. Methods and psychosocial factors were strongly associated with clinically-diagnosed UEMSDs. Author Keywords Musculoskeletal

  5. Soft tissue infections of the upper extremities with special consideration of abscesses in parenteral drug abusers

    Microsoft Academic Search

    H. P. Simmen; P. Giovanoli; H. Battaglia; J. Wüst; V. E. Meyer

    1995-01-01

    Despite surgical advances and new antibiotics, upper extremity infections continue to present a serious problem. Soft tissue infections of the upper extremities were prospectively examined to elucidate incidence, cause, bacterial pathogens involved, and treatment. Special attention was paid to infections associated with parenteral drug abuse. During an 18-month period all patients over 16 years of age presenting for treatment of

  6. Managing upper extremity clonus with intramuscular botulinum toxin-a injections in a patient poststroke.

    PubMed

    Kassam, Adam; Phadke, Chetan P; Ismail, Farooq; Boulias, Chris

    2015-05-01

    Spasticity and clonus are common clinical signs of upper motor neuron lesions poststroke. Intramuscular botulinum toxin-A injections have been shown to reduce spasticity and to improve quality of life. Upper extremity clonus can have a significant impact upon activities of daily living and can pose challenges to comfort, self-care, hygiene, and appearance. Although less common than in the ankle, it is important to understand how upper extremity clonus management may be beneficial to patients presenting with this finding. The majority of previous reports have focused on management of clonus in the lower extremity, but very few have addressed the management of upper extremity clonus. We present a case of poststroke upper extremity clonus with marked improvements following intramuscular botulinum toxin-A injections. PMID:25459654

  7. Influence of Inter-Training Intervals on Intermanual Transfer Effects in Upper-Limb Prosthesis Training: A Randomized Pre-Posttest Study

    PubMed Central

    Romkema, Sietske; Bongers, Raoul M.; van der Sluis, Corry K.

    2015-01-01

    Improvement in prosthetic training using intermanual transfer (the transfer of motor skills from the trained, “unaffected” hand to the untrained, “affected” hand) has been shown in previous studies. The aim of this study is to determine the influence of the inter-training interval on the magnitude of the intermanual transfer effects. This was done using a mechanistic, randomized, single-blinded pretest-posttest design. Sixty-four able-bodied, right-handed participants were randomly assigned to the Short and Long Interval Training Groups and the Short and Long Interval Control Groups. The Short and Long Interval Training Groups used a prosthesis simulator in their training program. The Short and Long Interval Control Groups executed a sham training program, that is, a dummy training program in which the same muscles were trained as with the prosthesis simulator. The Short Interval Training Group and the Short Interval Control Groups trained on consecutive days, while the Long Interval Training Group and Long Interval Control Group trained twice a week. To determine the improvement in skills, a test was administered before, immediately after, and at two points in time after the training. Training was performed with the “unaffected” arm; tests were performed with the “affected” arm. The outcome measurements were: the movement time (the time from the beginning of the movement until completion of the task); the duration of maximum hand opening, (the opening of the prosthetic hand while grasping an object); and the grip-force control (the error from the required grip-force during a tracking task). Intermanual transfer was found in movement times, but not in hand opening or grip-force control. The length of the inter-training interval did not affect the magnitude of intermanual transfer effects. No difference in the intermanual transfer effect in upper-limb prosthesis training was found for training on a daily basis as compared to training twice a week. Trial Registration Nederlands Trial Register NTR3888 PMID:26075396

  8. Nephrotic syndrome complicated with deep venous thrombosis in the upper extremities.

    PubMed

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

    2015-01-01

    Deep venous thrombosis (DVT) in the upper extremities is a rare but important clinical illness, which leads to severe complications such as pulmonary embolism. Unlike DVT in the lower extremities, which is mainly induced by a hypercoagulable state, DVT in the upper extremities is usually caused by mechanical obstruction or anatomical stenosis in the venous system. We herein report a case in which DVT developed in the left upper limb during treatment of nephrotic syndrome. This is the first case report of upper-extremity DVT in association with nephrotic syndrome in the literature. Our patient was a 56-year-old male with nephrotic syndrome due to idiopathic membranous nephropathy who was treated with 40 mg/day of prednisolone. During corticosteroid therapy, he developed a swelling of the left upper limb. Computed tomography revealed thrombi in the left internal jugular vein and the left subclavian vein without anatomical abnormalities in his venous system. Thus, he was diagnosed with DVT of the upper extremities. After the initiation of warfarin treatment and subsequent regression of nephrotic syndrome, the swelling disappeared and the thrombi significantly diminished. DVT should be considered when upper-extremity edema is observed in patients with nephrotic syndrome. PMID:25849667

  9. Prevalence of Upper Extremity Symptoms and Disorders among Dental and Dental Hygiene Students

    Microsoft Academic Search

    Robert A. Werner; Alfred Franzblau; Nancy Gell; Curt Hamann; Pamela A. Rodgers; Timothy J. Caruso; Frank Perry; Courtney Lamb; Shirley Beaver; David Hinkamp; Kathy Eklund; Christine P. Klausner

    2005-01-01

    CONTEXT: Upper extremity musculoskeletal disorders are common among dental professionals. The natural history of these disorders is not well-understood. These disorders are more common in older workers, but the prevalence among younger workers has not been well-studied. OBJECTIVE: The objective of this study was to determine if dental\\/dental hygiene students had a similar prevalence of upper extremity musculoskeletal disorders compared

  10. Measurement of upper extremity torque production and its relationship to throwing speed in the competitive athlete.

    PubMed

    Bartlett, L R; Storey, M D; Simons, B D

    1989-01-01

    This study was conducted to establish whether or not a correlation exists between peak torque production of upper extremity (UE) musculature and throwing speed. Eleven professional baseball players were tested for upper extremity peak torque production using a Cybex II Isokinetic Dynamometer. Throwing speed was measured with a radar gun. Results of statistical analysis performed on the data indicate a correlation between shoulder adductors and throwing speed. PMID:2929844

  11. Recapitulating flesh with silicon and steel: advancements in upper extremity robotic prosthetics.

    PubMed

    Lee, Brian; Attenello, Frank J; Liu, Charles Y; McLoughlin, Michael P; Apuzzo, Michael L J

    2014-01-01

    With the loss of function of an upper extremity because of stroke or spinal cord injury or a physical loss from amputation, an individual's life is forever changed, and activities that were once routine become a magnitude more difficult. Much research and effort have been put into developing advanced robotic prostheses to restore upper extremity function. For patients with upper extremity amputations, previously crude prostheses have evolved to become exceptionally functional. Because the upper extremities can perform a wide variety of activities, several types of upper extremity prostheses are available ranging from passive cosmetic limbs to externally powered robotic limbs. In addition, new developments in brain-machine interface are poised to revolutionize how patients can control these advanced prostheses using their thoughts alone. For patients with spinal cord injury or stroke, functional electrical stimulation promises to provide the most sophisticated prosthetic limbs possible by reanimating paralyzed arms of these patients. Advances in technology and robotics continue to help patients recover vital function. This article examines the latest neurorestorative technologies for patients who have either undergone amputation or lost the use of their upper extremities secondary to stroke or spinal cord injury. PMID:24631910

  12. A pilot study of myoelectrically controlled FES of upper extremity

    Microsoft Academic Search

    Rune Thorsen; Raffaella Spadone; Maurizio Ferrarin

    2001-01-01

    Functional electrical stimulation (FES) of upper limbs can be used for the recovery of some hand functions on patients with CNS lesions. This study deals with the control of FES by means of myoelectrical activity detected from voluntarily activated paretic muscles. The specific aim of this paper is to evaluate the accuracy of myoelectrical control in terms of produced force

  13. J Hand Surg Am . Author manuscript Description of outcomes of upper-extremity musculoskeletal disorders in

    E-print Network

    Boyer, Edmond

    -extremity musculoskeletal disorders in workers highly exposed to repetitive work Alexis Descatha 1 2 * , Yves Roquelaure 3 musculoskeletal (UEMS) symptoms or disorders were described over a three-year period, in a population highly Adult INTRODUCTION Even though upper extremity musculoskeletal (UEMS) disorders are an important problem

  14. Managing Upper extremity Fx's Sweden 10-Managing Pediatric

    E-print Network

    Squire, Larry R.

    the young surgeon whose first case is a child's elbow fracture." M. Rang, 1974 Nursemaid's Elbow extremity Fx's Sweden 10- 05 19 Problems ­ Suspected Pulled Elbow Failure to make correct diagnosis Date of Injury 3wks later Supracondylar Humerus Fractures · 50-60% of elbow fractures · Most frequently 3-10yrs

  15. Proof of Concept of the Ability of the Kinect to Quantify Upper Extremity Function in Dystrophinopathy

    PubMed Central

    Lowes, Linda P; Alfano, Lindsay N; Yetter, Brent A; Worthen-Chaudhari, Lise; Hinchman, William; Savage, Jordan; Samona, Patrick; Flanigan, Kevin M; Mendell, Jerry R

    2013-01-01

    Introduction: Individuals with dystrophinopathy lose upper extremity strength in proximal muscles followed by those more distal. Current upper extremity evaluation tools fail to fully capture changes in upper extremity strength and function across the disease spectrum as they tend to focus solely on distal ability. The Kinect by Microsoft is a gaming interface that can gather positional information about an individual’s upper extremity movement which can be used to determine functional reaching volume, velocity of movement, and rate of fatigue while playing an engaging video game. The purpose of this study was to determine the feasibility of using the Kinect platform to assess upper extremity function in individuals with dystrophinopathy across the spectrum of abilities. Methods: Investigators developed a proof-of-concept device, ACTIVE (Abilities Captured Through Interactive Video Evaluation), to measure functional reaching volume, movement velocity, and rate of fatigue. Five subjects with dystrophinopathy and 5 normal controls were tested using ACTIVE during one testing session. A single subject with dystrophinopathy was simultaneously tested with ACTIVE and a marker-based motion analysis system to establish preliminary validity of measurements. Results: ACTIVE proof-of-concept ranked the upper extremity abilities of subjects with dystrophinopathy by Brooke score, and also differentiated them from performance of normal controls for the functional reaching volume and velocity tests. Preliminary test-retest reliability of the ACTIVE for 2 sequential trials was excellent for functional reaching volume (ICC=0.986, p<0.001) and velocity trials (ICC=0.963, p<0.001). Discussion: The data from our pilot study with ACTIVE proof-of-concept demonstrates that newly available gaming technology has potential to be used to create a low-cost, widely-accessible and functional upper extremity outcome measure for use with children and adults with dystrophinopathy. PMID:23516667

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

    PubMed

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

    2007-10-01

    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

  17. Description of outcomes of upper extremity musculoskeletal disorders in workers highly1 exposed to repetitive work2

    E-print Network

    Paris-Sud XI, Université de

    1 Description of outcomes of upper extremity musculoskeletal disorders in workers highly1 exposed extremity musculoskeletal (UEMS) symptoms or15 disorders were described over a three-year period-3Jun2009 #12;3 INTRODUCTION.34 Even though upper extremity musculoskeletal (UEMS) disorders

  18. Exploring Occupational Therapists’ Perceptions of the Usefulness of Musculoskeletal Sonography in Upper-Extremity Rehabilitation

    PubMed Central

    McLaughlin Gray, Julie; Frank, Gelya; Wolkoff, Monique

    2015-01-01

    OBJECTIVE. To identify the potential utility of musculoskeletal sonographic imaging in upper-extremity rehabilitation. METHOD. Two occupational therapists in an outpatient hand rehabilitation clinic were recruited by convenience, were trained in the use of sonography, and implemented sonographic imaging in their clinical practice. Qualitative data were obtained during and after the implementation period by means of questionnaires and interviews. Data collection, analysis, and interpretation were completed in an iterative process that culminated in a thematic analysis of the therapists’ perceptions. RESULTS. The data indicate four potential areas of utility for musculoskeletal sonography in upper-extremity rehabilitation: (1) mastering anatomy and pathology, (2) augmenting clinical reasoning, (3) supplementing intervention, and (4) building evidence. CONCLUSION. Numerous potential uses were identified that would benefit both therapist and client. Further exploration of complexities and efficacy for increasing patient outcomes is recommended to determine best practices for the use of musculoskeletal sonography in upper-extremity rehabilitation. PMID:26114469

  19. Neurodevelopmental therapy and upper-extremity inhibitive casting for children with cerebral palsy.

    PubMed

    Law, M; Cadman, D; Rosenbaum, P; Walter, S; Russell, D; DeMatteo, C

    1991-05-01

    The purpose of this research was to study the effect of intensive neurodevelopmental therapy (NDT) and upper-extremity inhibitive casting, separately or in combination, on hand function, quality of upper-extremity movement and range of motion of 73 children with spastic cerebral palsy aged 18 months to eight years. There was no significant difference between intensive or regular therapy and casting or no casting for hand function, between intensive and regular NDT, or between intensive NDT plus casting and the other groups for quality of movement and range of motion. Casting led to increased quality of movement and wrist extension after six months. Casting with NDT improved the quality of upper-extremity movement and range of motion. There appear to be no immediate benefits from intensive therapy alone. PMID:2065824

  20. System Characterization of MAHI EXO-II: A Robotic Exoskeleton for Upper Extremity Rehabilitation

    PubMed Central

    French, James A.; Rose, Chad G.; O'Malley, Marcia K.

    2015-01-01

    This paper presents the performance characterization of the MAHI Exo-II, an upper extremity exoskeleton for stroke and spinal cord injury (SCI) rehabilitation, as a means to validate its clinical implementation and to provide depth to the literature on the performance characteristics of upper extremity exoskeletons. Individuals with disabilities arising from stroke and SCI need rehabilitation of the elbow, forearm, and wrist to restore the ability to independently perform activities of daily living (ADL). Robotic rehabilitation has been proposed to address the need for high intensity, long duration therapy and has shown promising results for upper limb proximal joints. However, upper limb distal joints have historically not benefitted from the same focus. The MAHI Exo-II, designed to address this shortcoming, has undergone a static and dynamic performance characterization, which shows that it exhibits the requisite qualities for a rehabilitation robot and is comparable to other state-of-the-art designs. PMID:25984380

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

    PubMed Central

    Punnett, L.

    1998-01-01

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

  2. Nerve Transfers in the Upper Extremity: A Practical User's Guide.

    PubMed

    Rinker, Brian

    2015-06-01

    Nerve injuries above the elbow are associated with a poor prognosis, even with prompt repair and appropriate rehabilitation. The past 2 decades have seen the development of numerous nerve transfer techniques, by which a denervated peripheral target is reinnervated by a healthy donor nerve. Nerve transfers are indicated in proximal brachial plexus injuries where grafting is not possible or in proximal injuries of peripheral nerves with long reinnervation distances. Nerve transfers represent a revolution in peripheral nerve surgery and offer the potential for superior functional recovery in severe nerve injuries. However, the techniques have not been universally adopted due in part to a misconception that nerve transfers can only be understood and performed by superspecialists. Nerve transfer procedures are not technically difficult and require no specialized equipment. Numerous transfers have been described, but there are a handful of transfers for which there is strong clinical evidence. To restore shoulder abduction and external rotation in upper trunk brachial plexus injury, the key transfers are the spinal accessory to suprascapular nerve and the medial triceps branch to axillary nerve. For elbow flexion, the flexor carpi ulnaris branch of ulnar nerve to the biceps and brachialis branches of the musculocutaneous nerve is the key transfer. For ulnar intrinsic function, the distal anterior interosseous nerve to ulnar motor branch transfer has yielded excellent functional results. Nerve transfers form a therapeutic triad with traditional tendon transfers and functional motor unit rehabilitation which, when applied appropriately, can yield excellent functional results in complex nerve injuries. Nerve transfers are a powerful yet underused tool for proximal nerve injuries, which offer hope for traditionally discouraging injuries. PMID:25978554

  3. Specialized connective tissue: bone, the structural framework of the upper extremity

    PubMed Central

    Weatherholt, Alyssa M.; Fuchs, Robyn K.; Warden, Stuart J.

    2011-01-01

    Bone is a connective tissue containing cells, fibers and ground substance. There are many functions in the body in which the bone participates, such as storing minerals, providing internal support, protecting vital organs, enabling movement, and providing attachment sites for muscles and tendons. Bone is unique because its collagen framework absorbs energy, while the mineral encased within the matrix allows bone to resist deformation. This article provides an overview of the structure and function of bone tissue from a macroscopic to microscopic level and discusses the physiological processes contributing to upper extremity bone health. It concludes by discussing common conditions influencing upper extremity bone health. PMID:22047807

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

    PubMed Central

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

    2014-01-01

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

  5. Relative incidence of phlebitis associated with peripheral intravenous catheters in the lower versus upper extremities.

    PubMed

    Benaya, A; Schwartz, Y; Kory, R; Yinnon, A M; Ben-Chetrit, E

    2015-05-01

    Peripheral venous access in elderly, hospitalized patients is often challenging. The usual alternative is insertion of a central venous catheter, with associated risk for complications. The purpose of this investigation was to determine the relative incidence of phlebitis secondary to lower as compared to upper extremity intravenous catheters (IVCs) and associated risk factors. A non-randomized, observational, cohort-controlled study was carried out. Consecutive patients receiving a lower extremity IVC were enrolled and compared with patients receiving an upper extremity IVC. Patients were followed from insertion until removal of the IVC. The major endpoint was phlebitis. The incidence of phlebitis secondary to upper extremity IVCs was 3/50 (6 %) compared to 5/53 (9.4 %) in lower extremity IVCs (?(2) Yates?=?0.08, p?=?0.776). Age, gender, obesity, diabetes mellitus, site (arm versus leg, left versus right), and size of needle were not found to be risk factors for phlebitis according to univariate analysis. None of the patients developed bloodstream infection. In elderly patients with poor venous access, lower extremity IVCs are a reasonable and low-risk alternative to central venous catheters. PMID:25563209

  6. Secondary prevention of work-related upper extremity disorders: recommendations from the annapolis conference

    Microsoft Academic Search

    Michael Feuerstein; Cherise B. Harrington

    2006-01-01

    Introduction: Efforts to improve the secondary prevention of work-related upper extremity (WRUE) symptoms continue to present a challenge. As with many occupational musculoskeletal pain disorders no single, direct cause-effect relationship exists among specific exposures, pathologic processes, and symptoms. The field has yet to create truly effective and efficient interventions for these problems that are based on current epidemiological and clinical

  7. Diagnosis and management of deep vein thrombosis of the upper extremity: a review

    Microsoft Academic Search

    Henk J. Baarslag; Maria M. W. Koopman; Jim A. Reekers; Edwin J. R. van Beek

    2004-01-01

    Deep vein thrombosis of the upper extremity is an increasing clinical problem due to the use of long-term indwelling catheters for chemotherapy or long-term feeding. The clinical diagnosis is difficult to make, and various imaging modalities have been used for this purpose. The use of (interventional) radiological procedures has been advancing in recent years. This review describes the clinical background,

  8. The effects of airbag deployment on severe upper extremity injuries in frontal automobile crashes

    Microsoft Academic Search

    M. Virginia Jernigan; Stefan M. Duma

    2003-01-01

    The purpose of this study was to investigate severe upper extremity injuries resulting from frontal automobile crashes and to determine the effects of frontal airbags. The National Automotive Sampling System database files from 1993 to 2000 were examined in a study that included 25,464 individual cases that occurred in the United States. An analysis of the cases indicated that occupants

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

    Microsoft Academic Search

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

    2001-01-01

    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

  10. A Model of the Upper Extremity for Simulating Musculoskeletal Surgery and Analyzing Neuromuscular Control

    Microsoft Academic Search

    KATHERINE R. S. HOLZBAUR; WENDY M. MURRAY; SCOTT L. DELP

    2005-01-01

    Biomechanical models of the musculoskeletal system are frequently used to study neuromuscular control and simulate surgical procedures. To be broadly applicable, a model must be ac- cessible to users, provide accurate representations of muscles and joints, and capture important interactions between joints. We have developed a model of the upper extremity that includes 15 degrees of freedom representing the shoulder,

  11. Upper extremity lymphangiography as an aid to treatment planning for stage 1A epitrochlear Hodgkin's disease

    Microsoft Academic Search

    Jack E. Meyer; Edward C. Halperin; Rita M. Linggood

    1982-01-01

    A 6-year-old girl with Stage 1A Hodgkin's disease confined to the right epitrochlear area is described. An upper extremity\\u000a lymphangiogram, for planning primary radiation therapy, demonstrated a lymph node adjacent to the medial midhumeral shaft.\\u000a The implication of this finding and the role of the lymphangiogram in treatment planning are discussed.

  12. Screening for Medical Problems in Patients with Upper Extremity Signs and Symptoms

    Microsoft Academic Search

    Catherine C. Goodman

    2010-01-01

    Narrative reviewHand therapists must be able to identify signs and symptoms of systemic disease that can mimic integumentary, neuromuscular, or musculoskeletal dysfunction evaluated and treated within their scope of practice. Pneumonia, complications of pacemakers, liver disease, kidney stones, ectopic pregnancy, and myocardial ischemia are only a few examples of problems and systemic diseases that can cause shoulder or upper extremity

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  14. Effects of mental practice on stroke patients’ upper extremity function and daily activity performance

    PubMed Central

    Park, JuHyung; Lee, Nayun; Cho, Milim; Kim, DeokJu; Yang, Yeongae

    2015-01-01

    [Purpose] The purpose of this study was to evaluate the effects of mental practice on stroke patients’ upper extremity function and activities of daily living (ADL). [Subjects and Methods] In this study, 29 stroke patients were randomly assigned to two groups: an experimental group (n=14) and a control group (n=15). The experimental group performed 10 minutes of mental practice once a day, 5 days a week for 2 weeks in combination with conventional rehabilitation therapy. For the control group, general rehabilitation therapy was provided during the same sessions as the experimental group. The Action Research Arm Test (ARAT) and the Fugl-Myer assessment (FMA) were used to measure upper extremity function, and the Modified Bathel Index (MBI) was used to measure daily activity performance. [Results] After the intervention, the mental practice group showed significant improvements in upper extremity function on the affected side and ADL scores compared to the control group. [Conclusion] The results of this study demonstrate mental practice intervention is effective at improving stroke patients’ upper extremity function and daily activity performance. In follow-up studies, securing a greater number of experimental subjects, and evaluation of the intervention’s therapeutic durability are required. PMID:25995560

  15. Motor Evoked Potentials in Predicting Recovery from Upper Extremity Paralysis after Acute Stroke

    Microsoft Academic Search

    Henk T. Hendricks; Jaco W. Pasman; Jacques van Limbeek; Machiel J. Zwarts

    2003-01-01

    Objective: The use of motor evoked potentials (MEPs) in predicting recovery after stroke still appears to be somehow equivocal. We assessed the prognostic value of MEPs with respect to arm and hand motor recovery in acute stroke patients. Methods: This cohort study included 43 consecutive acute stroke patients with complete paralysis of the upper extremity. MEPs of the abductor digiti

  16. Using a Multi-touch Tabletop for Upper Extremity Motor Rehabilitation

    E-print Network

    Alberta, University of

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

  17. Do workers with self-reported symptoms have an elevated risk of developing upper extremity musculoskeletal disorders three year later?

    E-print Network

    Paris-Sud XI, Université de

    musculoskeletal disorders three year later? Alexis Descatha (1,2), Yves Roquelaure (3), Bradley Evanoff (4), Jean: musculoskeletal diseases, upper extremity, questionnaire, outcomes. Total word count: 1659 words (including-reported symptoms of upper extremity musculoskeletal disorders (UEMSD). Our objective was to study the three

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

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

    PubMed Central

    Panse, Nikhil; Sahasrabudhe, Parag

    2014-01-01

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

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

    PubMed Central

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

    2012-01-01

    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

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

    PubMed

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

    2012-01-01

    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

  2. Upper and Lower Extremity Injuries in Soldiers The massive loss of muscle and tendon tissue (natural fibrous

    E-print Network

    Sibille, Etienne

    Upper and Lower Extremity Injuries in Soldiers The massive loss of muscle and tendon tissue of a traumatic injury can lead to persistent impairment of function to the extremity, potentially leading and reinforcement of the affected extremity for medical/surgical personnel. Deformity and Loss of limb injuries can

  3. Reconstruction of upper-extremity peripheral-nerve injuries with ePTFE conduits.

    PubMed

    Stanec, S; Stanec, Z

    1998-05-01

    This reported investigation was designed to determine the role of a new synthetic conduit-expanded polytetrafluoroethylene (ePTFE) tube--in clinical repair of median and ulnar nerves in the upper extremities. The main goals of this study were: to determine the effectiveness of the ePTFE conduit in clinical nerve reconstruction; to evaluate the potential of this technique in reconstruction of various nerve gaps (1.5 to 6 cm); and to analyze the results of repair with the ePTFE tube regarding different mechanisms of injury. Forty-three patients were evaluated. They had upper-extremity peripheral-nerve injuries (21 injuries to the median nerve, and 22 ulnar nerve injuries) located at the various levels of the upper extremities. All surgical procedures described in the study were secondary reconstructions, and the average delay from injury to repair was 4.2 months. With regard to the nerve-gap lengths, patients were categorized in two groups. Group 1 (gaps from 1.5 to 4 cm) included 28 patients (17 median nerve injuries and 11 ulnar nerve injuries), and Group 2 (gaps from 4.1 to 6 cm) comprised 15 patients (4 median nerve injuries and 11 ulnar nerve injuries). Results showed that 78.6 percent of patients from Group 1 demonstrated functional motor and sensory recovery, while reconstruction of only 13.3 percent of peripheral nerves from Group 2 resulted in useful reinnervation. According to published results, ePTFE conduit is a reliable and successful surgical procedure for nerve repair in reconstruction of nerve gaps up to 4 cm between the ends of median and ulnar nerves in various levels of the upper extremity. Because of its properties, ePTFE conduit has the advantages of promoting better nerve regeneration, compared to other synthetic tubes, especially in reconstruction of proximal nerve injuries, larger nerve gaps, and in cases with unfavorable mechanisms of nerve injury. PMID:9618088

  4. From confounders to suspected risk factors: psychosocial factors and work-related upper extremity disorders

    Microsoft Academic Search

    Michael Feuerstein; William S Shaw; Rena A Nicholas; Grant D Huang

    2004-01-01

    Psychosocial variables have recently been more prominent among epidemiologic risk factors for work-related upper extremity disorders (WRUEDs), but bio-behavioral mechanisms underlying these associations have been elusive. One reason is that the psychosocial domain has included many broad and disparate variables (e.g. mood, coping skills, job control, job satisfaction, job stress, social support), and this lack of specificity in the conceptualization

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

    Microsoft Academic Search

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

    2009-01-01

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

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

    Microsoft Academic Search

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

    2003-01-01

    .   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,

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

    Microsoft Academic Search

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

    2009-01-01

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

  8. Upper extremity skeletal muscle mass: Potential of measurement with single frequency bioimpedance analysis

    Microsoft Academic Search

    Steven B. Heymsfield; Dympna Gallagher; Jill Grammes; Christopher Nuñez; Zimian Wang; Angelo Pietrobelli

    1998-01-01

    This study examined the potential of single frequency (50 kHz) BIA for estimation of upper extremity skeletal muscle (SM) mass. Subjects (n = 50) were weight stable adults varying in age (X ± SD, 51.6 ± 17 yr) and body mass index (27.2 ± 5.9 kg\\/m2). Determinants of arm to arm impedance index (length L; L2\\/Z) were examined using multiple

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

    NASA Astrophysics Data System (ADS)

    Tian, Baoqiang; Fan, Ke

    2013-08-01

    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.

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

    Microsoft Academic Search

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

    1993-01-01

    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

  11. Intrathecal baclofen in tetraplegia of spinal origin: efficacy for upper extremity hypertonia

    Microsoft Academic Search

    AS Burns; JM Meythaler

    2001-01-01

    Study design: Retrospective analysis.Objectives: To evaluate the efficacy of intrathecal baclofen (ITB) for upper extremity spastic hypertonia in tetraplegia of spinal origin.Setting: University of Alabama at Birmingham hospital.Methods: The medical records of 14 individuals with tetraplegia of spinal origin who underwent intrathecal baclofen pump placement were reviewed. The effects of intrathecal baclofen on spasm frequency, deep tendon reflexes, and tone

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

    PubMed Central

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

    2007-01-01

    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

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

    PubMed

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

    2014-10-01

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

  14. The effects of smartphone use on upper extremity muscle activity and pain threshold

    PubMed Central

    Lee, Minkyung; Hong, Yunkyung; Lee, Seunghoon; Won, Jinyoung; Yang, Jinjun; Park, Sookyoung; Chang, Kyu-Tae; Hong, Yonggeun

    2015-01-01

    [Purpose] The purpose of this study was to determine whether muscle activity and pressure-induced pain in the upper extremities are affected by smartphone use, and to compare the effects of phone handling with one hand and with both hands. [Subjects] The study subjects were asymptomatic women 20–22?years of age. [Methods] The subjects sat in a chair with their feet on the floor and the elbow flexed, holding a smartphone positioned on the thigh. Subsequently, the subjects typed the Korean anthem for 3?min, one-handed or with both hands. Each subject repeated the task three times, with a 5-min rest period between tasks to minimize fatigue. Electromyography (EMG) was used to record the muscle activity of the upper trapezius (UT), extensor pollicis longus (EPL), and abductor pollicis (AP) during phone operation. We also used a dolorimeter to measure the pressure-induced pain threshold in the UT. [Results] We observed higher muscle activity in the UT, AP, and EPL in one-handed smartphone use than in its two-handed use. The pressure-induced pain threshold of the UT was lower after use of the smartphone, especially after one-handed use. [Conclusion] Our results show that smartphone operation with one hand caused greater UT pain and induced increased upper extremity muscle activity. PMID:26180311

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

    Microsoft Academic Search

    Darcy Fehlings; Mercer Rang; Janet Glazier; Catherine Steele

    2000-01-01

    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

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

    PubMed Central

    2012-01-01

    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

  17. The epidemiology of upper extremity musculoskeletal symptoms on a college campus

    PubMed Central

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

    2012-01-01

    Objective The study examines temporal variations in upper-extremity musculoskeletal symptoms throughout the day, over a week and throughout the semester. Methods 30 undergraduates were followed in a repeated measures study throughout a semester. Upper extremity musculoskeletal symptoms data were collected on handheld computers randomly throughout the day for seven days over three data collection periods. Multilevel statistical models evaluated associations between time-related predictors and symptoms. Results In adjusted models, pain reported at baseline was associated with increased odds of experiencing both any symptoms (OR = 15.64; 90% CI 7.22–33.88) and moderate or greater symptoms (OR = 16.44; 90% CI 4.57–29.99). Any symptoms were less likely to be reported if responses occurred at 58–76 days (OR = 0.66; 90% CI 0.49–0.86), 77–90 days (OR = 0.29; 90% CI 0.20–0.42) and 91–117 days (OR = 0.54; 90% CI 0.39–0.75) into the semester compared to 35–57 days. Similarly, responding after midnight was associated with greater odds of reporting moderate or greater symptoms (OR = 21.33; 90% CI 6.49–65.97). There was no association observed for day of week and symptoms. Conclusion This pilot work suggests upper extremity musculoskeletal symptoms exhibit temporal variations related to time of day and days into semester. Understanding the natural history of musculoskeletal symptoms and disorders is needed when designing epidemiologic research and/or intervention studies using symptom outcome measures. PMID:20075517

  18. System characterization of RiceWrist-S: a forearm-wrist exoskeleton for upper extremity rehabilitation.

    PubMed

    Pehlivan, Ali Utku; Rose, Chad; O'Malley, Marcia K

    2013-06-01

    Rehabilitation of the distal joints of the upper extremities is crucial to restore the ability to perform activities of daily living to patients with neurological lesions resulting from stroke or spinal cord injury. Robotic rehabilitation has been identified as a promising new solution, however, much of the existing technology in this field is focused on the more proximal joints of the upper arm. A recently presented device, the RiceWrist-S, focuses on the rehabilitation of the forearm and wrist, and has undergone a few important design changes. This paper first addresses the design improvements achieved in the recent design iteration, and then presents the system characterization of the new device. We show that the RiceWrist-S has capabilities beyond other existing devices, and exhibits favorable system characteristics as a rehabilitation device, in particular torque output, range of motion, closed loop position performance, and high spatial resolution. PMID:24187279

  19. Sensory feedback control of upper- and lower-extremity motor prostheses.

    PubMed

    Phillips, C A

    1988-01-01

    The topic is introduced with a conceptual definition of sensory feedback control applied to prosthetic systems. An overview of sensory physiology is then provided. Tactile sensation and audition are specifically discussed. Next, the artificial sensory systems are evaluated. This is done with respect to sensory (input) transducers, signal encoding/decoding, and sensing output transducers. Specific prosthetic systems are then reviewed. First, upper-extremity prostheses are reviewed with respect to artificial arm/hand systems as well as neuroprostheses. Next, lower-extremity prostheses are reviewed, and include both artificial leg and foot systems as well as neuroprostheses. Finally, conclusions are drawn regarding effective state-of-the-art sensory feedback control used with orthotic and prosthetic systems. PMID:3053043

  20. Follow-up study on upper extremity bracing of children with severe athetosis.

    PubMed

    Largent, P; Waylett, J

    1975-07-01

    This paper describes the results of a follow-up evaluation of a bracing program for severely athetoid, mentally retarded children. Bracing to improve upper extremity control was started in 1968 and was described in a 1971 AJOT article. The follow-up study was done in order to provide criteria for selecting patients in future bracing programs, to identify the type of motion problems that could be successfully braced, and to determine the bracing configurations most effecive in aiding arm control. PMID:1180315

  1. Preconditioning electromyographic data for an upper extremity model using neural networks

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

    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.

  2. Free function muscle transfers for upper extremity reconstruction: a review of indications, techniques, and outcomes.

    PubMed

    Fischer, John P; Elliott, River M; Kozin, Scott H; Levin, L Scott

    2013-12-01

    Free functional muscle transfer (FFMT) replaces destroyed, denervated, or resected skeletal muscle units in the upper extremity with functioning skeletal muscle from other locations in the body. Common indications for FFMT include brachial plexus injuries, ischemic contracture, tumor resection, and extensive direct muscle trauma. Recent studies have focused on improving patient outcomes through refinements in muscle flap harvest and inset, donor nerve selection, and postoperative management. In this review, we assess and summarize the current literature on FFMT, with emphasis on etiopathogenesis, diagnosis, treatment, postoperative management, and clinical outcomes. PMID:24210720

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

    PubMed

    Maitra, Kinsuk K; Junkins, Michael D

    2004-01-01

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

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

    PubMed

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

    2012-01-01

    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

  5. Factors Associated With Upper Extremity Motor Recovery After Repetitive Transcranial Magnetic Stimulation in Stroke Patients

    PubMed Central

    Lee, Jong Hwa; Kim, Sang Beom; Lee, Kyeong Woo; Kim, Min Ah; Lee, Sook Joung

    2015-01-01

    Objective To determine factors associated with motor recovery of the upper extremity after repetitive transcranial magnetic stimulation (rTMS) treatment in stroke patients. Methods Twenty-nine patients with subacute stroke participated in this study. rTMS was applied to the hand motor cortex for 10 minutes at a 110% resting motor threshold and 10 Hz frequency for two weeks. We evaluated the biographical, neurological, clinical, and functional variables, in addition to the motor-evoked potential (MEP) response. The Manual Function Test (MFT) was performed before, immediately after, and two weeks after, the treatment. Patients were divided into a responder and non-responder group according to their respective improvements on the MFT. Data were compared between the two groups. Results Patients with exclusively subcortical stroke, absence of aphasia, the presence of a MEP response, high scores on the Mini-Mental Status Examination, Motricity Index arm score, Functional Independence Measure, and Functional Ambulatory Classification; and a shorter period from stroke onset to rTMS were found to be significantly associated with a response to rTMS. Conclusion The results of this study suggest that rTMS may have a greater effect on upper extremity motor recovery in stroke patients who have a MEP response, suffer an exclusively subcortical stroke, mild paresis, and have good functional status. Applying rTMS early would have additional positive effects in the patients with the identified characteristics. PMID:25932424

  6. Nationwide survey of juvenile muscular atrophy of distal upper extremity (Hirayama disease) in Japan.

    PubMed

    Tashiro, Kunio; Kikuchi, Seiji; Itoyama, Yasuo; Tokumaru, Yukio; Sobue, Gen; Mukai, Eiichiro; Akiguchi, Ichiro; Nakashima, Kenji; Kira, Jun-ichi; Hirayama, Keizo

    2006-03-01

    Juvenile muscular atrophy of the distal upper extremity (JMADUE, Hirayama disease) was first reported in 1959 as 'juvenile muscular atrophy of unilateral upper extremity'. Since then, similar patients in their teens or 20s have been described, under a variety of names, not only in Japan, but also in other Asian countries, as well as Europe and North America. Biomechanical abnormalities associated with JMADUE have recently been reported through various imaging examinations, proposing its disease mechanism. Since JMADUE differs from motor neuron disease, or spinal muscular atrophy, this disease entity should be more widely recognized, and early detection and effective treatments should be considered. We report an epidemiological study in Japan. Two nationwide questionnaire-based surveys, conducted in Japan from 1996 to 1998, identified 333 cases. The numbers of patients per year, distribution of ages at onset, mode of onset, time lapse between onset and quiescence, neurological signs and symptoms, imaging findings, and the effects of conservative treatments were analyzed. The peak age was 15 to 17 years, with a marked male preponderance, usually a slow onset and progression, and quiescence six or fewer years after onset. There was a predominantly unilateral hand and forearm involvement with 'cold paresis'. The imaging findings are described. PMID:16546758

  7. Effects of purposeful action observation on kinematic patterns of upper extremity in individuals with hemiplegia

    PubMed Central

    Kim, Eunjoo; Kim, KyeongMi

    2015-01-01

    [Purpose] This study investigated the effects of purposeful action observation on upper extremity kinematic patterns in individuals with hemiplegia. [Subjects and Methods] Twelve patients were recruited in accordance with the inclusion criteria. The experimental group (n=6) was trained with a purposeful action observation program. The control group (n=6) was trained with only purposeful action without action observation. The programs were performed 30?min/session, 5 times per week for 30 sessions in 6 weeks of training. Upper extremity kinematic patterns were measured by a 3-dimensional motion analysis system before and after training, and the results were analyzed. [Results] The experimental group and the control group showed improvements in average velocity, trajectory ratio, and movement degree, but no statistically significant differences were observed between the groups. The experimental group showed statistically significant improvements in average velocity, trajectory ratio after the intervention. The experimental group also showed an improvement in movement degree, but the post-intervention difference was not significant. [Conclusion] The results of this study show that purposeful action observation training program improved the average velocity and trajectory ratio of stroke patients. Further research should enroll more subjects divided into more specific groups for treatment. PMID:26180326

  8. Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review

    PubMed Central

    2010-01-01

    Background This review examines the evidence for an association between computer work and neck and upper extremity disorders (except carpal tunnel syndrome). Methods A systematic critical review of studies of computer work and musculoskeletal disorders verified by a physical examination was performed. Results A total of 22 studies (26 articles) fulfilled the inclusion criteria. Results show limited evidence for a causal relationship between computer work per se, computer mouse and keyboard time related to a diagnosis of wrist tendonitis, and for an association between computer mouse time and forearm disorders. Limited evidence was also found for a causal relationship between computer work per se and computer mouse time related to tension neck syndrome, but the evidence for keyboard time was insufficient. Insufficient evidence was found for an association between other musculoskeletal diagnoses of the neck and upper extremities, including shoulder tendonitis and epicondylitis, and any aspect of computer work. Conclusions There is limited epidemiological evidence for an association between aspects of computer work and some of the clinical diagnoses studied. None of the evidence was considered as moderate or strong and there is a need for more and better documentation. PMID:20429925

  9. Multidetector CT and three-dimensional CT angiography of upper extremity arterial injury.

    PubMed

    Fritz, Jan; Efron, David T; Fishman, Elliot K

    2015-06-01

    Successful management of upper extremity arterial injury requires fast and accurate diagnosis. The rate of limb preservation depends on the location, severity, and time of ischemia. Indications for diagnostic imaging depend on the mechanism and type of injury, clinical signs, cardiovascular stability, and clinical suspicion. Because of ease of access, speed, and high accuracy for this diagnosis, multidetector computed tomographic (MDCT) angiography is often used as the first line imaging modality. MDCT systems with 64 slice configuration and more afford high temporal and spatial high-resolution, isotropic data acquisition and integration with whole-body trauma MDCT protocols. The use of individual injection timing protocols ensures high diagnostic image quality. Several strategies are available to reduce radiation exposure. Direct MDCT angiography findings of arterial injuries include active extravasation, luminal narrowing, lack of luminal contrast opacification, filling defect, arteriovenous fistula, and pseudoaneurysm. Important descriptors are location and length of defect, degree of luminal narrowing, and presence of distal arterial supply reconstitution. Proximal arterial injuries include the subclavian, axillary, and brachial arteries. Distal arterial injuries include the ulnar and radial arteries, as well as the palmar arterial arches. Concomitant venous injury, musculoskeletal injury, and nerve damage are common. In this exhibit, we outline the role of MDCT angiography in the diagnosis and management of upper extremity arterial injury, discuss strategies for MDCT angiography acquisition and concepts of data visualization, and illustrate various types of injuries. PMID:25504031

  10. Upper extremity snowboarding injuries. Ten-year results from the Colorado snowboard injury survey.

    PubMed

    Idzikowski, J R; Janes, P C; Abbott, P J

    2000-01-01

    A survey of snowboarding injuries was conducted over 10 seasons (1988 to 1998). A questionnaire evaluating 20 variables was used to collect data from 47 medical facilities near Colorado ski resorts. A total of 7430 snowboarding-related injuries were seen. A control group consisted of 3107 noninjured snowboarders. Most of those injured were 30 years of age or younger; 74% of injuries occurred in men and 26% in women; 39% of injured snowboarders were beginners and 61% were intermediate or experts. Men rode at more advanced levels than women. Injured snowboarders were more likely than noninjured snowboarders to be beginners. There were 3645 (49.06% of total) upper extremity injuries; 56.43% were fractures, 26.78% sprains, and 9.66% dislocations. The most common site of injury was the wrist (21.6% of all snowboarding injuries). Wrist fractures (except to the scaphoid) and sprains were more common in beginners, women, and younger age groups. Intermediate and expert men were more likely to sustain hand, elbow, and shoulder injuries, as well as more severe injuries. Falling was the predominant mechanism of upper extremity injuries. Snowboarders who wore protective wrist guards were half as likely to sustain wrist injuries as those who did not wear guards. PMID:11101105

  11. Painful knee prosthesis: surgical approach.

    PubMed

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

    2011-05-01

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

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

    PubMed

    Haddad, Heba; Rotblatt, Michael

    2015-02-01

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

  13. Reliability and Validity of Two Versions of the Upper Extremity Functional Index

    PubMed Central

    Hamilton, Clayon B.; Walton, David M.; Benoit, Melissa; Blake, Tracy A.; Bredy, Heather; Burns, Cameron; Chan, Lianne; Frey, Elizabeth; Gillies, Graham; Gravelle, Teresa; Ho, Rick; Holmes, Robert; Lavallée, Roland L.J.; MacKinnon, Melanie; Merchant, Alishah (Jamal); Sherman, Tammy; Spears, Kelly; Yardley, Darryl

    2014-01-01

    ABSTRACT Purpose: To examine the reliability, validity, and sensitivity to change of the 20-item version and the Rasch-refined 15-item version of the Upper Extremity Functional Index (UEFI-20 and UEFI-15, respectively) and to determine the impact of arm dominance on the positive minimal clinically important difference (pMCID). Methods: Adults with upper-extremity (UE) dysfunction completed the UEFI-20, Upper Extremity Functional Scale (UEFS), Pain Limitation Scale, and Pain Intensity Scale at their initial physiotherapy assessment (Time 1); 24–48 hours later (Time 2); and 3 weeks into treatment or at discharge, whichever came first (Time 3). Demographics, including working status, were obtained at Time 1. Global ratings of change (GRC) were provided by the treating physiotherapist and patient at Time 3. The UEFI-15 was calculated from relevant items in the UEFI-20. The intra-class correlation coefficient (ICC) and minimal detectable change (MDC) quantified test–retest reliability (Time 1–Time 2). Cross-sectional convergent validity was determined by the association (Pearson's r) between Time 1 measures of function and pain. Known-groups validity was evaluated with a one-way ANOVA across three levels of working status. Longitudinal validity was determined by the association (Pearson's r) between function and pain change scores (Time 1–Time 3). Receiver operating characteristic (ROC) curves estimated the pMCID using Time 1–Time 3 change scores and average patient/therapist GRC. Results: Reliability for the UEFI-20 and UEFI-15 was the same (ICC=0.94 for both measures). MDC values were 9.4/80 for the UEFI-20 and 8.8/100 for the UEFI-15. Cross-sectional, known-groups, and longitudinal validity were confirmed for both UEFI measures. pMCID values were 8/80 for the UEFI-20 and 6.7/100 for the UEFI-15; pMCID was higher for people whose non-dominant arm was affected. Conclusions: Both UEFI measures show acceptable reliability and validity. Arm dominance affects pMCID. The UEFI-15 is recommended because it measures only one dimension: UE function. PMID:25125777

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

    PubMed Central

    2013-01-01

    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?

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2014-01-01

    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

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

    PubMed Central

    Warren, Patrick; Burke, Charles

    2011-01-01

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

  18. US-guided injection of the upper and lower extremity joints.

    PubMed

    Collins, James M P; Smithuis, Robin; Rutten, Matthieu J C M

    2012-10-01

    There is a growing interest in the application of ultrasound (US) guidance for diagnostic and therapeutic joint injections. US provides direct visualization of soft tissues and the outer borders of bony structures. With real-time needle guidance the success rate of intra-articular injections improves and iatrogenic damage to anatomic structures can be avoided. An US machine is more readily available, transferrable and more affordable than a fluoroscopy machine or CT scanner and lacks the risk of radiation. These factors make US a valuable alternative to procedures performed either blind or under fluoroscopic or CT guidance. This article focuses on the rationale for injections in the upper and lower extremity joints and describes and illustrates the different US-guided injection techniques. PMID:22130195

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

    PubMed Central

    Levine, Peter; Hill, Valerie

    2015-01-01

    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

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

    PubMed

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

    2015-01-01

    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

  1. Upper extremity deep vein thrombosis (Paget-Schroetter syndrome) after surfing: a case report.

    PubMed

    Keene, David J

    2015-04-01

    This case report summarises the presentation of a 28-year-old female with signs and symptoms characteristic of thoracic outlet syndrome, but who was later found to have an effort-induced Upper Extremity Deep Vein Thrombosis (UEDVT), otherwise known as Paget-Schroetter syndrome. Effort-induced UEDVT is rare, but the similarity between the signs and symptoms of thoracic outlet syndrome and this type of thrombosis can result in patients with this condition presenting to musculoskeletal therapists. The key features of the case are described, followed by an overview of UEDVT and the importance of recognising this condition in musculoskeletal therapy practice. The role of therapists in referring for early medical diagnostics is key to ensuring management of the thrombosis is instigated early, therefore reducing the risk of life threatening consequences such as pulmonary embolism. PMID:25220111

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

    PubMed Central

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

    2004-01-01

    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

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

    PubMed

    Cavuoto, Lora A; Nussbaum, Maury A

    2014-01-01

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

  4. Choosing a Breast Prosthesis

    MedlinePLUS

    ... Prosthesis: A Survivor’s Perspective Print to PDF Choosing a Breast Prosthesis: A Survivor’s Perspective Andrea Zinn June 16, 2015 · Amber ... preferences. Q: Why did you decide to wear a breast form/prosthesis rather than have a reconstruction? ...

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

    PubMed Central

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

    2014-01-01

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

  6. UPPER EXTREMITY FRACTURES IN PEDESTRIAN VERSUS MOTOR VEHICLE ACCIDENTS: AN UNDERAPPRECIATED CONCERN

    PubMed Central

    Landy, David C.; Norton, Robert A.; Barkin, Jodie A.; Henriques, Stephen; Owens, Patrick; Miki, Roberto A.

    2010-01-01

    Background Though pedestrian versus motor vehicle (PVMV) accidents are a common cause of trauma admission and subsequent orthopaedic consult, the prevalence of upper extremity fracture (UEF) in such events and its association with lower extremity injury (LEI) is unknown. We sought to describe UEF in PVMV accident patients at the time of orthopaedic consult. Methods A retrospective chart review was conducted for all pedestrian hit by motor vehicle cases for which an orthopaedic consult was performed at Jackson Memorial Hospital between July 2006 and January 2008. Fractures were recorded by location along with relevant clinical information. Logistic regression was used to calculate odds ratios (O.R.) and 95% confidence intervals (C.I.) for variables associated with UEF. Results 336 cases were identified and reviewed. LEI was the most frequent injury type (67% of cases). UEF was also common, found in 25% of cases (humerus 11%, ulna 7%, radius 6%, hand 4%, and wrist 2%). Tibia or fibula fracture, femur fracture, and spine fracture were negatively associated with UEF in univariate analyses and after controlling for other associated factors. Conclusions In PVMV accident populations, UEF is a frequent injury often seen in the absence of any LEI. These findings emphasize the importance of carefully screening all PVMV accident patients for UEF and may call into question the usefulness of currently discussed injury pattern. PMID:21045980

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

    PubMed Central

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

    2012-01-01

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

  8. Solar Wind Interaction with the Martian Upper Atmosphere at Early Mars/Extreme Solar Conditions

    NASA Astrophysics Data System (ADS)

    Dong, C.; Bougher, S. W.; Ma, Y.; Toth, G.; Lee, Y.; Nagy, A. F.; Tenishev, V.; Pawlowski, D. J.; Combi, M. R.

    2014-12-01

    The investigation of ion escape fluxes from Mars, resulting from the solar wind interaction with its upper atmosphere/ionosphere, is important due to its potential impact on the long-term evolution of Mars atmosphere (e.g., loss of water) over its history. In the present work, we adopt the 3-D Mars cold neutral atmosphere profiles (0 ~ 300 km) from the newly developed and validated Mars Global Ionosphere Thermosphere Model (M-GITM) and the 3-D hot oxygen profiles (100 km ~ 5 RM) from the exosphere Monte Carlo model Adaptive Mesh Particle Simulator (AMPS). We apply these 3-D model output fields into the 3-D BATS-R-US Mars multi-fluid MHD (MF-MHD) model (100 km ~ 20 RM) that can simulate the interplay between Mars upper atmosphere and solar wind by considering the dynamics of individual ion species. The multi-fluid MHD model solves separate continuity, momentum and energy equations for each ion species (H+, O+, O2+, CO2+). The M-GITM model together with the AMPS exosphere model take into account the effects of solar cycle and seasonal variations on both cold and hot neutral atmospheres. This feature allows us to investigate the corresponding effects on the Mars upper atmosphere ion escape by using a one-way coupling approach, i.e., both the M-GITM and AMPS model output fields are used as the input for the multi-fluid MHD model and the M-GITM is used as input into the AMPS exosphere model. In this study, we present M-GITM, AMPS, and MF-MHD calculations (1-way coupled) for 2.5 GYA conditions and/or extreme solar conditions for present day Mars (high solar wind velocities, high solar wind dynamic pressure, and high solar irradiance conditions, etc.). Present day extreme conditions may result in MF-MHD outputs that are similar to 2.5 GYA cases. The crustal field orientations are also considered in this study. By comparing estimates of past ion escape rates with the current ion loss rates to be returned by the MAVEN spacecraft (2013-2016), we can better constrain the total ion loss to space over Mars history, and thus enhance the science returned from the MAVEN mission.

  9. Intra-arterial Autologous Bone Marrow Cell Transplantation in a Patient with Upper-extremity Critical Limb Ischemia

    SciTech Connect

    Madaric, Juraj, E-mail: jurmad@hotmail.com [National Institute of Cardiovascular Diseases (NUSCH) and Slovak Medical University, Department of Cardiology and Angiology (Slovakia)] [National Institute of Cardiovascular Diseases (NUSCH) and Slovak Medical University, Department of Cardiology and Angiology (Slovakia); Klepanec, Andrej [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia)] [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia); Mistrik, Martin [Clinic of Hematology and Transfusiology, Faculty Hospital (Slovakia)] [Clinic of Hematology and Transfusiology, Faculty Hospital (Slovakia); Altaner, Cestmir [Slovak Academy of Science, Institute of Experimental Oncology (Slovakia)] [Slovak Academy of Science, Institute of Experimental Oncology (Slovakia); Vulev, Ivan [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia)] [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia)

    2013-04-15

    Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

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

    PubMed Central

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

    2013-01-01

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

  11. Impact of Timing of Admission and Microvascular Reconstruction on Free Flap Success Rates in Traumatic Upper Extremity Defects.

    PubMed

    Kolbenschlag, Jonas; Klinkenberg, Marek; Hellmich, Susanne; Germann, Günter; Megerle, Kai

    2015-07-01

    Background?Despite a growing body of knowledge, the timing of microsurgical reconstruction for the upper extremity remains a controversial topic. Most of the available literature deals with lower extremity reconstruction and the few reports on microsurgical reconstruction of the upper extremity are mostly concerned with infection rates and rarely consider thrombosis and changes in coagulation parameters. Methods?We performed a retrospective review of all free flaps performed for upper extremity reconstruction at our institution from 2000 to 2010. Only acute, isolated traumatic defects of the upper extremity requiring a free flap for reconstruction were included in this study. A review of medical records was performed to assess, among others, comorbidities, timing of reconstruction, and platelet levels. Results?A total of 41 patients were included in this study, 70% of whom were male. Mean age at the time of surgery was 40.8?±?15.4 years. Patients who were directly referred to our hospital underwent reconstruction significantly faster than those who were transferred secondarily (p?=?0.0001). The number of surgical revisions as well as the flap loss rate was higher in patients undergoing reconstruction more than 1?week after trauma (p?=?0.09 and 0.033, respectively). A significantly higher platelet count was seen in the patients undergoing delayed reconstruction (p?=?0.002). Conclusion?In our study, early microsurgical reconstruction of the upper extremity yielded better results in terms of lower rates of surgical revisions and flap loss. This might be partly because of a trauma-induced thrombocythemia, with a maximum level of platelets in the 2nd week post trauma. We, therefore, advocate a timely coverage of these defects along with an anticoagulatory regimen including some form of platelet inhibition. PMID:25803409

  12. Dynamic injury tolerances for long bones of the female upper extremity.

    PubMed

    Duma, S M; Schreiber, P H; McMaster, J D; Crandall, J R; Bass, C R; Pilkey, W D

    1999-04-01

    This paper presents the dynamic injury tolerances for the female humerus and forearm derived from dynamic 3-point bending tests using 22 female cadaver upper extremities. Twelve female humeri were tested at an average strain rate of 3.7+/-1.3%/s. The strain rates were chosen to be representative of those observed during upper extremity interaction with frontal and side airbags. The average moment to failure when mass scaled for the 5th centile female was 128+/-19 Nm. Using data from the in situ strain gauges during the drop tests and geometric properties obtained from pretest CT scans, an average dynamic elastic modulus for the female humerus was found to be 24.4+/-3.9 GPa. The injury tolerance for the forearm was determined from 10 female forearms tested at an average strain rate of 3.94+/-2.0%/s. Using 3 matched forearm pairs, it was determined that the forearm is 21% stronger in the supinated position (92+/-5 Nm) versus the pronated position (75+/-7 Nm). Two distinct fracture patterns were seen for the pronated and supinated groups. In the supinated position the average difference in fracture time between the radius and ulna was a negligible 0.4+/-0.3 ms. However, the pronated tests yielded an average difference in fracture time of 3.6+/-1.2 ms, with the ulna breaking before the radius in every test. This trend implies that in the pronated position, the ulna and radius are loaded independently, while in the supinated position the ulna and radius are loaded together as a combined structure. To produce a conservative injury criterion, a total of 7 female forearms were tested in the pronated position, which resulted in the forearm injury criterion of 58+/-12 Nm when scaled for the 5th centile female. It is anticipated that these data will provide injury reference values for the female forearm during driver air bag loading, and the female humerus during side air bag loading. PMID:10386782

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

    PubMed Central

    2014-01-01

    Objective The use of hand held devices (HHD) such as mobile phones, game controls, tablets, portable media players and personal digital assistants have increased dramatically in past decade. While sending a text message or using the controls of the HHD the users need to use their thumb and other palm muscles extensively. The objective of this study was to describe the risk factors and clinical features of the musculoskeletal disorders (MSDs) arising due to usage of hand held devices and to evaluate the effectiveness of a sequenced rehabilitation protocol. Methods A retrospective report analysis of 70 subjects, who were diagnosed to have a MSD affecting the upper extremities, was conducted. Medical charts from a tertiary level rehabilitation centre from 2005–2013 were analysed. All the subjects reported pain in their upper extremities following extensive usage of HHD and were examined and diagnosed to have a MSD by an orthopaedic and rehabilitation physician. After the assessment and diagnosis, all the patients underwent rehabilitation using a sequenced protocol. Results All the subjects reported pain in the thumb and forearm with associated burning, numbness and tingling around the thenar aspect of the hand, and stiffness of wrist and hand. 43 subjects had symptoms on the right side; 9 on left and 18 had bilateral symptoms. Correlation was found between hand dominance and MSD. 33 subjects complained of onset of symptoms following extensive text messaging. All the subjects were diagnosed to have tendinosis of Extensor Pollicis Longus and Myofascial Pain Syndrome affecting the 1st interossei, thenar group of muscles and Extensor Digitorum Communis. 23 of the subjects were senior executives, among these 7 were CEO’s of major multinational companies in India. All the subjects recovered completely following the rehabilitation. Conclusions The study concluded that mobile phones and gadgets that promoted the predominant usage of thumb or only one finger while texting or using the controls were associated with a higher prevalence of MSDs. Treatment using a sequenced rehabilitation protocol was found to be effective. PMID:25852936

  14. Upper-Extremity Deep Vein Thrombosis in a Patient on Clozapine Therapy Carrying the Prothrombin G20210A Mutation

    Microsoft Academic Search

    Amparo Vayá; Maria Lopez; Gema Plumé; José Ribes

    2009-01-01

    Clozapine treatment for resistant schizophrenic disorders has been associated to venous thromboembolic events. We report the case of a patient who developed upper-extremity deep vein thrombosis just 2 months after starting on clozapine in whom the thrombophilia work-up revealed the presence of the prothrombin G20210A mutation.

  15. clinical ergonomic job analysis and consultation: Facilitating work reentry in a case with upper extremity cumulative trauma-related disability

    Microsoft Academic Search

    Paul F. Hickey; Michael Feuerstein I

    1993-01-01

    The management of work-related recurrent and chronic upper extremity cumulative trauma disorders (UECTDs) represents a challenge particularly when return to work is a treatment goal. Many of these work-related UECTDs may be the consequence of exposure to such physical stressors as repetition, excessive force, awkward and sustained posture in addition to psychosocial stressors in the workplace. Pain and associated disability

  16. RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY

    Microsoft Academic Search

    M. Pourmahabadian; J. N. Saraji; M. Aghabeighi; H. Saddeghi-Naeeni

    The strain index (SI) is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE) disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is

  17. Effects of psychosocial and individual factors on physiological risk factors for upper extremity musculoskeletal disorders while typing

    Microsoft Academic Search

    Laura E. Hughes; Kari Babski-Reeves; Tonya Smith-Jackson

    2007-01-01

    Psychosocial factors are hypothesized to contribute to work-related musculoskeletal disorder (WMSD) development, although previous research has been largely epidemiological or has focused primarily on the shoulders, back and neck. The objective of this study was to quantify the effects of mental workload and time pressure on perceived workload and physiological responses of the distal upper extremity. A total of 18

  18. The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients

    PubMed Central

    Park, Jin-Young; Chang, Moonyoung; Kim, Kyeong-Mi; Kim, Hee-Jung

    2015-01-01

    The purpose of this study was to examine the effects of mirror therapy on upper-extremity function and activities of daily living in chronic stroke patients. [Subjects and Methods] Fifteen subjects were each assigned to a mirror therapy group and a sham therapy group. The Fugl-Meyer Motor Function Assessment and the Box and Block Test were performed to compare paretic upper-extremity function and hand coordination abilities. The functional independence measurement was conducted to compare abilities to perform activities of daily living. [Results] Paretic upper-extremity function and hand coordination abilities were significantly different between the mirror therapy and sham therapy groups. Intervention in the mirror therapy group was more effective than in the sham therapy group for improving the ability to perform activities of daily living. Self-care showed statistically significant differences between the two groups. [Conclusion] Mirror therapy is effective in improving paretic upper-extremity function and activities of daily living in chronic stroke patients.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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,…

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

    E-print Network

    , canes, walkers and wheelchairs place upper extremity ambulators at increased risk of re-injury due or female patients with shoulder impingement or rotator cuff tear who rely on AWDs for mobility. 2, preoperative and postoperative clinical shoulder measurements and operative findings. Clinical Shoulder

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

    ERIC Educational Resources Information Center

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

    2014-01-01

    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…

  2. The effects of mirror therapy with tasks on upper extremity function and self-care in stroke patients

    PubMed Central

    Park, Youngju; Chang, Moonyoung; Kim, Kyeong-Mi; An, Duk-Hyun

    2015-01-01

    [Purpose] The purpose of this study was to determine the effects of mirror therapy with tasks on upper extremity unction and self-care in stroke patients. [Subjects] Thirty participants were randomly assigned to either an experimental group (n=15) or a control group (n=15). [Methods] Subjects in the experimental group received mirror therapy with tasks, and those in the control group received a sham therapy; both therapies were administered, five times per week for six weeks. The main outcome measures were the Manual Function Test for the paralyzed upper limb and the Functional Independence Measure for self-care performance. [Results] The experimental group had more significant gains in change scores compared with the control group after the intervention. [Conclusion] We consider mirror therapy with tasks to be an effective form of intervention for upper extremity function and self-care in stroke patients.

  3. Ergonomic task reduction prevents bone osteopenia in a rat model of upper extremity overuse

    PubMed Central

    BARBE, Mary F.; JAIN, Nisha X.; MASSICOTTE, Vicky S.; POPOFF, Steven N.; BARR-GILLESPIE, Ann E.

    2015-01-01

    We evaluated the effectiveness of ergonomic workload reduction of switching rats from a high repetition high force (HRHF) lever pulling task to a reduced force and reach rate task for preventing task-induced osteopenic changes in distal forelimb bones. Distal radius and ulna trabecular structure was examined in young adult rats performing one of three handle-pulling tasks for 12 wk: 1) HRHF, 2) low repetition low force (LRLF); or 3) HRHF for 4 wk and than LRLF thereafter (HRHF-to-LRLF). Results were compared to age-matched controls rats. Distal forelimb bones of 12-wk HRHF rats showed increased trabecular resorption and decreased volume, as control rats. HRHF-to-LRLF rats had similar trabecular bone quality as control rats; and decreased bone resorption (decreased trabecular bone volume and serum CTX1), increased bone formation (increased mineral apposition, bone formation rate, and serum osteocalcin), and decreased osteoclasts and inflammatory cytokines, than HRHF rats. Thus, an ergonomic intervention of HRHF-to-LRLF prevented loss of trabecular bone volume occurring with prolonged performance of a repetitive upper extremity task. These findings support the idea of reduced workload as an effective approach to management of work-related musculoskeletal disorders, and begin to define reach rate and load level boundaries for such interventions. PMID:25739896

  4. Psychophysiological measurements in a biocooperative feedback loop for upper extremity rehabilitation.

    PubMed

    Novak, Domen; Mihelj, Matjaž; Ziherl, Jaka; Olenšek, Andrej; Munih, Marko

    2011-08-01

    This paper examines the usefulness of psychophysiological measurements in a biocooperative feedback loop that adjusts the difficulty of an upper extremity rehabilitation task. Psychophysiological measurements (heart rate, skin conductance, respiration, and skin temperature) were used both by themselves and in combination with task performance and biomechanics. Data fusion was performed with discriminant analysis, and a special adaptive version was implemented that can gradually adapt to a subject. Both healthy subjects and hemiparetic patients participated in the study. The accuracy of the biocooperative controller was defined as the percentage of times it matched the subjects' preferences. The highest accuracy rate was obtained for task performance (approximately 82% for both healthy subjects and patients), with psychophysiological measurements yielding relatively low accuracy (approximately 60%). The adaptive approach increased accuracy of psychophysiological measurements to 76.4% for healthy subjects and 68.8% for patients. Combining psychophysiology with task performance yielded an accuracy rate of 84.7% for healthy subjects and 89.4% for patients. Results suggest that psychophysiological measurements are not reliable as a primary data source in motor rehabilitation, but can provide supplementary information. However, it is questionable whether the amount of additional information justifies the increased complexity of the system. PMID:21708507

  5. An upper extremity inverse dynamics model for pediatric Lofstrand crutch-assisted gait.

    PubMed

    Slavens, Brooke A; Bhagchandani, Neha; Wang, Mei; Smith, Peter A; Harris, Gerald F

    2011-07-28

    The objective of this study was to develop an instrumented Lofstrand crutch system, which quantifies three-dimensional (3-D) upper extremity (UE) kinematics and kinetics using an inverse dynamics model. The model describes the dynamics of the shoulders, elbows, wrists, and crutches and is compliant with the International Society of Biomechanics (ISB) recommended standards. A custom designed Lofstrand crutch system with four, six-degree-of-freedom force transducers was implemented with the inverse dynamics model to obtain triaxial UE joint reaction forces and moments. The crutch system was validated statically and dynamically for accuracy of computing joint reaction forces and moments during gait. The root mean square (RMS) error of the system ranged from 0.84 to 5.20%. The system was demonstrated in children with diplegic cerebral palsy (CP), incomplete spinal cord injury (SCI), and type I osteogenesis imperfecta (OI). The greatest joint reaction forces were observed in the posterior direction of the wrist, while shoulder flexion moments were the greatest joint reaction moments. The subject with CP showed the highest forces and the subject with SCI demonstrated the highest moments. Dynamic quantification may help to elucidate UE joint demands in regard to pain and pathology in long-term assistive device users. PMID:21652035

  6. Ergonomic task reduction prevents bone osteopenia in a rat model of upper extremity overuse.

    PubMed

    Barbe, Mary F; Jain, Nisha X; Massicotte, Vicky S; Popoff, Steven N; Barr-Gillespie, Ann E

    2015-06-10

    We evaluated the effectiveness of ergonomic workload reduction of switching rats from a high repetition high force (HRHF) lever pulling task to a reduced force and reach rate task for preventing task-induced osteopenic changes in distal forelimb bones. Distal radius and ulna trabecular structure was examined in young adult rats performing one of three handle-pulling tasks for 12 wk: 1) HRHF, 2) low repetition low force (LRLF); or 3) HRHF for 4 wk and than LRLF thereafter (HRHF-to-LRLF). Results were compared to age-matched controls rats. Distal forelimb bones of 12-wk HRHF rats showed increased trabecular resorption and decreased volume, as control rats. HRHF-to-LRLF rats had similar trabecular bone quality as control rats; and decreased bone resorption (decreased trabecular bone volume and serum CTX1), increased bone formation (increased mineral apposition, bone formation rate, and serum osteocalcin), and decreased osteoclasts and inflammatory cytokines, than HRHF rats. Thus, an ergonomic intervention of HRHF-to-LRLF prevented loss of trabecular bone volume occurring with prolonged performance of a repetitive upper extremity task. These findings support the idea of reduced workload as an effective approach to management of work-related musculoskeletal disorders, and begin to define reach rate and load level boundaries for such interventions. PMID:25739896

  7. Is a modified form of constraint induced movement therapy an effective treatment for increasing upper extremity function in children with hemiplegic cerebral palsy?

    Microsoft Academic Search

    Katie Godt; Kip Christensen

    2006-01-01

    Clinical Scenario: Extensive research has been conducted on the efficacy of constraint induced movement therapy for increasing upper extremity function in the adult post-stroke population. Little is known regarding the efficacy of this treatment in the pediatric population. The purpose of this critically appraised topic is to determine if constraint induced movement therapy is effective in improving upper extremity function

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

    PubMed Central

    Gates, Deanna H.; Dingwell, Jonathan B.

    2009-01-01

    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

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

    PubMed

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

    2014-11-01

    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

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

    PubMed

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

    2013-11-01

    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

  11. Effects of kinesiology taping on the upper-extremity function and activities of daily living in patients with hemiplegia

    PubMed Central

    Kim, Eung-beom; Kim, Young-dong

    2015-01-01

    [Purpose] This study determined the effects of kinesiology taping on the upper-extremity function and activities of daily living of patients with hemiplegia. [Subjects] The experimental group and control group comprised 15 hemiplegia patients each. [Methods] This study was performed from June 4 to December 22, 2012, involving 30 hemiplegia patients. The experimental and controls groups performed task practices for 30 minutes, 3 times per week for 28 weeks with and without taping, respectively. [Results] After treatment, there were significant differences in every outcome measures within each group except for the Brunnstrom recovery stage of the hand. However, there was a significant difference in functional independence movements between the groups. [Conclusion] Task practice has the same effectiveness regardless of the taping of the upper extremities. Nevertheless, taping is helpful for improving both the functions and activities of daily living in patients with hemiplegia. PMID:26157239

  12. Evaluation of Upper Extremity Movement Characteristics during Standardized Pediatric Functional Assessment with a Kinect®-Based Markerless Motion Analysis System

    PubMed Central

    Rammer, Jacob R.; Krzak, Joseph J.; Riedel, Susan A.; Harris, Gerald F.

    2015-01-01

    A recently developed and evaluated upper extremity (UE) markerless motion analysis system based on the Microsoft® Kinect® has potential for improving functional assessment of patients with hemiplegic cerebral palsy. 12 typically-developing adolescents ages 12–17 were evaluated using both the Kinect-based system and the Shriners Hospitals for Children Upper Extremity Evaluation (SHUEE), a validated measure of UE motion. The study established population means of UE kinematic parameters for each activity. Statistical correlation analysis was used to identify key kinematic metrics used to develop automatic scoring algorithms. The Kinect motion analysis platform is technically sound and can be applied to standardized task-based UE evaluation while providing enhanced sensitivity in clinical analysis and automation through scoring algorithms. PMID:25570504

  13. Limb amputation and prosthesis.

    PubMed

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

    2014-03-01

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

  14. Upper Extremity Multifocal Neuropathy in a 10-Year-Old Boy Associated With NS6S Disaccharide Antibodies.

    PubMed

    Edelman, Frederick; Naddaf, Elie; Waclawik, Andrew J

    2015-06-01

    We present a 10-year-old boy with a predominantly motor multifocal neuropathy with demyelinating and axonal changes with sensory involvement, affecting only one upper extremity. Laboratory studies revealed an elevated titer of immunoglobulin M (IgM) antibodies against the NS6S antigen. He responded to treatment with high dose intravenous immunoglobulins. Focal or multifocal immune-mediated neuropathies are not common in children and may be underdiagnosed. PMID:25038124

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

    PubMed Central

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

    2012-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  17. Use-dependent cortical plasticity in thalidomide-induced upper extremity dysplasia: evidence from somaesthesia and neuroimaging

    Microsoft Academic Search

    M. C. Stoeckel; B. Pollok; A. Schnitzler; O. W. Witte; R. J. Seitz

    2004-01-01

    In this study cerebral reorganization was investigated in thalidomide-damaged subjects who use their feet to compensate for their malformed upper extremities. Tactile localization across toes was combined with fMRI to study use-dependent plasticity of the human somatosensory cortex. The manner of compensatory foot use was assessed by a questionnaire. In the behavioural experiment toes were stimulated with above threshold monofilaments

  18. Vascular injuries after minor blunt upper extremity trauma: pitfalls in the recognition and diagnosis of potential "near miss" injuries

    PubMed Central

    Bravman, Jonathan T; Ipaktchi, Kyros; Biffl, Walter L; Stahel, Philip F

    2008-01-01

    Background Low energy trauma to the upper extremity is rarely associated with a significant vascular injury. Due to the low incidence, a high level of suspicion combined with appropriate diagnostic algorithms are mandatory for early recognition and timely management of these potentially detrimental injuries. Methods Review of the pertinent literature, supported by the presentation of two representative "near miss" case examples. Results A major diagnostic pitfall is represented by the insidious presentation of significant upper extremity arterial injuries with intact pulses and normal capillary refill distal to the injury site, due to collateral perfusion. Thus, severe vascular injuries may easily be missed or neglected at the upper extremity, leading to a long-term adverse outcome with the potential need for a surgical amputation. Conclusion The present review article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating or high-velocity trauma mechanism. PMID:19032757

  19. Short interposed pedicle of flow-through anterolateral thigh flap for reliable reconstruction of damaged upper extremity.

    PubMed

    Yokota, Kazunori; Sunagawa, Toru; Suzuki, Osami; Nakanishi, Misa; Ochi, Mitsuo

    2011-02-01

    In microvascular reconstructive surgery, the recipient vessel in free flap transfer is often sacrificed to provide the vascular pedicle anastomosis. As the recipient vessel is likely to be necessary for distal circulation in the damaged upper extremity, preserving its patency is critical. Flow-through anastomosis is one method that preserves the recipient vessel's patency. We present here eight patients who underwent upper-extremity reconstructions with a free flow-through anterolateral thigh flap. The flap's short vascular pedicle was interposed into a division of the radial artery and anastomosed on both sides of the pedicle's T-shaped arterial segment. The flow-through flap has various advantages, not only making it possible to reconstruct both vessels and soft tissues but also preserving recipient vessels and balancing the blood supply or pressure in the flap. In clinical situations that do not require reconstruction of the artery, the short interposed pedicle of the free anterolateral thigh flow-through flap offers a versatile and reliable option for microsurgical reconstruction of defects in the upper extremities. PMID:20976665

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

    PubMed Central

    2014-01-01

    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

  1. Thrombosed hemodialysis access as an unusual source of emboli in the upper extremity of a kidney transplant recipient.

    PubMed

    Kim, Mi-Hyeong; Hwang, Jeong Kye; Chun, Ho Jong; Moon, In Sung; Kim, Ji Il

    2014-04-01

    Arteriovenous fistula (AVF) is no longer used in kidney transplant recipients. However, there is no consensus regarding whether or not to ligate a well-functioning AVF after successful kidney transplantation, particularly in patients with well and stably functioning kidney transplants. Most AVFs without complications are left in situ and more than one-third of native AVFs close spontaneously. The currently accepted policy toward thrombosed AVFs is retention within the patient's extremity without treatment. These thrombosed AVFs seldom cause serious problems. However, when combined with aneurysmal dilatation of the proximal vein adjacent to the arterial anastomotic area, the AVF could act as the source of distal arterial emboli. This is very similar clinical scenario to that observed in embolization from a peripheral arterial aneurysm. Here we describe a case report of upper extremity ischemia following massage of a thrombosed aneurysmal AVF. The patient was successfully treated with a combination of catheter-directed thromboaspiration, thrombolysis, and surgical repair of the thrombosed AVF. To the best of our knowledge, this is the first report of upper extremity embolism after massage of a thrombosed aneurysmal AVF involving this combined treatment. PMID:24274072

  2. MMG-based multisensor data fusion for prosthesis control

    Microsoft Academic Search

    J. Silva; T. Chau; A. Goldenberg

    2003-01-01

    Advantages in the functionality and comfort of soft silicon sockets or roll-on sleeves over polyester laminate hard sockets for upper-limb prosthesis have been consistently reported. However, attachment and wire breakage issues prevent the use of electromyography (EMG) sensors with soft sockets in electrically powered prosthesis for below-elbow amputees. Mechanomyography (MMG) is the measurement of the mechanical vibrations elicited by contracting

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

    E-print Network

    Cho, Jeongmin

    2009-06-11

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

  4. Effect of mirror therapy with tDCS on functional recovery of the upper extremity of stroke patients.

    PubMed

    Cho, Hyuk-Shin; Cha, Hyun-Gyu

    2015-04-01

    [Purpose] This study aimed to determine the effect of mirror therapy (MT) with transcranial direct current stimulation (tDCS) on the recovery of the upper extremity function of chronic stroke patients. [Subjects] Twenty-seven patients at least 6 months after stroke onset were divided randomly into an experimental group (14 patients) and a control group (13 patients). [Methods] All subjects received tDCS for 20?min followed by a 5?min rest. Then the experimental group received MT while the control group conducted the same exercises as the experimental group using a mirror that did not show the non-paretic upper extremity. The groups performed the same exercises for 20?min. All subjects received this intervention for 45-min three times a week for 6 weeks. [Results] After the intervention, the experimental group showed significant improvements in the box and block test (BBT), grip strength, and the Fugl-Meyer assessment (FMA), and a significant decrease in the Jebsen-Taylor test. The control group showed a significant increase in grip strength after the intervention, and a significant decrease in the Jebsen-Taylor test. Comparison of the result after the intervention revealed that the experimental group showed more significant increases in the BBT and grip strength than the control group. [Conclusion] These results show that MT with tDCS has a positive effect on the functional recovery of the upper extremity of stroke patients, through activating motor regions in the brain, and thus plays an important role in recovery of neuroplasticity. PMID:25995552

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

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

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

    SciTech Connect

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

    2002-12-15

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

  7. Upper and Lower Extremity Muscle Fatigue After a Baseball Pitching Performance

    Microsoft Academic Search

    Michael J. Mullaney; Malachy P. McHugh; Tom M. Donofrio; Stephen J. Nicholas

    2005-01-01

    Background: Previous studies have estimated joint torques and electromyogram activity associated with the pitching motion. Although previous studies have investigated the influence of extended pitching (fatigue) on kinematic and kinetic parameters, no attempts have been made to quantify the fatigue associated with a pitching performance.Purpose: Considering previous investigations on muscle activity during pitching, this study investigated muscle fatigue in upper

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

    Microsoft Academic Search

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

    2003-01-01

    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

  9. Merkel cell carcinoma of the upper extremity: Case report and an update

    Microsoft Academic Search

    Michail Papamichail; Ioannis Nikolaidis; Nicolas Nikolaidis; Chryssoula Glava; Ioannis Lentzas; Konstantinos Marmagkiolis; Kriton Karassavsa; Michail Digalakis

    2008-01-01

    BACKGROUND: Merkel cell carcinoma is a rare but aggressive cutaneous primary small cell carcinoma. It is commonly seen in elderly affecting the head, neck, and extremities. Macroscopically may be difficult to distinguish MCC from other small cells neoplasms especially oat cell carcinoma of the lung. CASE PRESENTATION: It is presented a case report concerning a 72 years old male with

  10. Risk Factors of Work-related Upper Extremity Musculoskeletal Disorders in Male Shipyard Workers: Structural Equation Model Analysis

    PubMed Central

    Park, Byung-Chan; Kim, Eun-A; Kim, Soo Geun

    2010-01-01

    Objectives This study was conducted to develop a model describing the interaction between lifestyle, job, and postural factors and parts of the upper extremities in shipyard workers. Methods A questionnaire survey was given to 2,140 workers at a shipyard in Ulsan City. The questionnaire consisted of questions regarding the subjects' general characteristics, lifestyle, tenure, physical burden, job control, posture and musculoskeletal symptoms. The overall relationship between variables was analyzed by a structural equation model (SEM). Results The positive rate of upper extremity musculoskeletal symptoms increased in employees who worked longer hours, had severe physical burden, and did not have any control over their job. Work with a more frequent unstable posture and for longer hours was also associated with an increased positive rate of musculoskeletal symptoms. Multiple logistic regression analysis showed that unstable posture and physical burden were closely related to the positive rate of musculoskeletal symptoms after controlling for age, smoking, drinking, exercise, tenure, and job control. In SEM analysis, work-related musculoskeletal disease was influenced directly and indirectly by physical and job stress factors, lifestyle, age, and tenure (p < 0.05). The strongest correlations were found between physical factors and work-related musculoskeletal disease. Conclusion The model in this study provides a better approximation of the complexity of the actual relationship between risk factors and work-related musculoskeletal disorders. Among the variables evaluated in this study, physical factors (work posture) had the strongest association with musculoskeletal disorders. PMID:22953172

  11. Motion analysis of the upper extremity in children with unilateral cerebral palsy--an assessment of six daily tasks.

    PubMed

    Klotz, Matthias C M; van Drongelen, Stefan; Rettig, Oliver; Wenger, Patrick; Gantz, Simone; Dreher, Thomas; Wolf, Sebastian I

    2014-11-01

    Restrictions in range of motion of the upper extremity are common in patients with unilateral cerebral palsy (CP). The purpose of this study was to investigate movement deviations of the upper extremity in children with unilateral CP by means of 3D motion capture as well as by the use of easy to use scores and questionnaires (MACS, MRC, MAS, ABILHAND-Kids). 16 children with a spastic, unilateral CP were included and compared to a group of 17 typically developing adolescents (TD). The movement time and range of motion (ROM) of six uni- and bimanual daily tasks were compared and correlated with the scores and questionnaires. Movement times increased significantly with involvement according to MACS in all tasks. The restrictions in ROM were pronounced in the forearm. As a compensatory mechanism the children of the MACS 2 and 3 groups showed increased trunk movement. Furthermore, there was a positive correlation between the MACS and the ABILHAND-Kids Questionnaire. In contrast to previous studies, which reported a correlation between the restrictions in ROM and the MACS, this study showed no consistent correlation between the restrictions in ROM neither with the MACS nor with the ABILHAND-Kids. While the MACS and the ABILHAND-Kids function as a simple rating tool for clinical use, the detailed analysis of different daily tasks using 3-D-motion capture provides more detailed information about the movement deviations and spatiotemporal parameters. PMID:25112796

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2013-01-01

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

  14. Relationships and responsiveness of six upper extremity function tests during the first 6 months of recovery after stroke

    PubMed Central

    Beebe, Justin A.; Lang, Catherine E.

    2010-01-01

    Background Knowing how clinical tests are related to each other, if tests are responsive to change and what constitutes change is critical to evidence-based practice and sound research. Objective To determine 1) relationships between six clinical tests of upper extremity function, and 2) responsiveness for each test during the first 6 months after stroke. Methods Grip strength, Pinch strength, Action Research Arm Test (ARAT), Jebsen Taylor test of hand function, 9-Hole Peg Test (9HPT), and the Stroke Impact Scale-Hand (SIS-Hand) domain were administered to 33 subjects within 1 month, 3 and 6 months after stroke. Spearman’s correlations were used to analyze relationships between tests. Responsiveness was calculated using the single population effect size method. Results All tests were correlated with each other with absolute values ranging from 0.54 to 0.92 at 1 month, 0.57 to 0.97 at 3 months, and 0.41 to 0.97 at 6 months. All tests were at least moderately responsive to change, with effect sizes ranging from 0.50 to 1.02 from 1–3 months, and 0.56 to 0.86 from 1–6 months. Conclusions Our data can assist clinicians and researchers in making decisions to use specific tests for measuring upper extremity function in people with hemiparesis in the first 6 months of recovery. PMID:19556918

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

    PubMed Central

    Jang, Seung-Hee

    2010-01-01

    Over years it has been increasingly concerned with how upper extremity musculoskeletal disorders (UEMSDs) are attributed to psychosocial job stressors. A review study was conducted to examine associations between UEMSDs and psychosocial work factors, and to recommend what to consider for the associations. For studies in which the job demand-control-support (DCS) model or its variables were specifically employed, published papers were selected and reviewed. A number of studies have reported relationships between UEMSDs symptoms and psychosocial exposure variables. For example, the findings are: higher numbness in the upper extremity was significantly attributed to by less decision latitude at work; work demands were significantly associated with neck and shoulder symptoms while control over time was associated with neck symptoms; and the combination of high psychosocial demands and low decision latitude was a significant predictor for shoulder and neck pain in a female working population. Sources of bias, such as interaction or study design, were discussed. UEMSDs were shown to be associated with psychosocial work factors in various studies where the job DCS model was addressed. Nonetheless, this review suggests that further studies should be conducted to much more clarify the association between UEMSDs and psychosocial factors. PMID:22953161

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

    PubMed

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

    2014-01-01

    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

  17. Effort thrombosis of the upper extremity in a young sportsman: Paget–Schroetter syndrome

    Microsoft Academic Search

    Graham Roche-Nagle; Ronan Ryan; Mary Barry; David Brophy; L. G Rocke

    2007-01-01

    Paget-Schroetter syndrome is the spontaneous thrombosis of the axillary\\/subclavian vein. A 16-year-old male presented with acute onset of right upper limb swelling after vigorous weight training. A venogram confirmed the diagnosis of Paget–Schroetter syndrome. He was started on intravenous thrombolytics followed by oral anticoagulation therapy. His symptoms resolved and he was symptom free at six-month follow-up. Thrombolytics and anticoagulation is

  18. Robot-aided rehabilitation of neural function in the upper extremities

    Microsoft Academic Search

    Robert Riener

    Repetitive movements can improve muscle strength and movement coordination in patients with neurological disorders and impairments.\\u000a Robot-aided approaches can serve to enhance the rehabilitation process. They can not only improve the therapeutic outcome\\u000a but also support clinical evaluation and increase the patient motivation. This chapter provides an overview of existing systems\\u000a that can support the movement therapy of the upper

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

    USGS Publications Warehouse

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

    1997-01-01

    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.

  20. Catheter-Directed Thrombolysis with Percutaneous Rheolytic Thrombectomy Versus Thrombolysis Alone in Upper and Lower Extremity Deep Vein Thrombosis

    SciTech Connect

    Kim, Hyun S., E-mail: sikhkim@jhmi.edu; Patra, Ajanta; Paxton, Ben E.; Khan, Jawad [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science (United States); Streiff, Michael B. [Johns Hopkins University School of Medicine, Department of Medicine (United States)

    2006-12-15

    Purpose. To compare the efficacy of catheter-directed thrombolysis (CDT) alone versus CDT with rheolytic percutaneous mechanical thrombectomy (PMT) for upper and lower extremity deep vein thrombosis (DVT). Methods. A retrospective cohort of consecutive patients with acute iliofemoral or brachiosubclavian DVT treated with urokinase CDT was identified, and a chart review was conducted. Demographic characteristics, treatment duration, total lytic dose, clot lysis rates and complications were compared in patients treated with urokinase CDT alone or combined CDT and rheolytic PMT. Results. Forty limbs in 36 patients were treated with urokinase CDT alone. Twenty-seven limbs in 21 patients were treated with urokinase CDT and rheolytic PMT. The mean treatment duration for urokinase CDT alone was 48.0 {+-} 27.1 hr compared with 26.3 {+-} 16.6 hr for urokinase CDT and rheolytic PMT (p = 0.0004). The mean urokinase dose required for CDT alone was 5.6 {+-} 5.3 million units compared with 2.7 {+-} 1.8 million units for urokinase CDT with rheolytic PMT (p = 0.008). Complete clot lysis was achieved in 73% (29/40) of DVT treated with urokinase CDT alone compared with 82% (22/27) treated with urokinase CDT with rheolytic PMT. Conclusion. Percutaneous CDT with rheolytic PMT is as effective as CDT alone for acute proximal extremity DVT but requires significantly shorter treatment duration and lower lytic doses. Randomized studies to confirm the benefits of pharmacomechanical thrombolysis in the treatment of acute proximal extremity DVT are warranted.

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

    PubMed Central

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

    2012-01-01

    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

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

    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. ?0Hc 2 (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 (?0Hc 2 ~ 30 T, with Tc = 18 K)1,2. Its ratio of ?0Hc 2 (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, ?0Hc 2 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.

  3. [Effect of a sanguinarine mouthwash on children with and without upper extremity motor handicap].

    PubMed

    Miller, N A; Laurent, P; Bruant, A; Pierrat, C; Martin, G

    1990-02-01

    A survey was done at the Center of Child Readaptation at Flavigny (Meurthe-et-Moselle) to determine the effect of a mouth rinse containing 0.03% sanguinaria extract, on the plaque accumulation and gingivitis of 30 children 8 to 17 years old. 13 children had a motricity handicap of their superior members and 17 did not. All subjects rinsed their mouths twice with 15 ml of solution each time. The mouth rinses were performed in the morning and in the evening during three weeks. The children were photographed and examined using the P1I and GI indices on days 0, 7, 14, 21 and 35. No statistical significant difference was observed at any moment between children with or without handicapped upper limbs. After 3 weeks of treatment the Plaque Index had decreased 47.3% and Gingival Index 55.6%. PMID:2143534

  4. [Local fibrinolytic therapy of vascular occlusions in the pelvic-leg area and the upper extremity].

    PubMed

    Schild, H; Schuster, C J; Grönniger, J; Schmied, W; Weilemann, L; Lindner, P; Wagner, P; Brunier, A; Thelen, M; Meyer, J

    1987-01-01

    Seventy-three patients with vascular occlusions in the pelvis or lower limbs and three patients with upper limb lesions were treated by local low dose fibrinolysin, with strict control of any possible bleeding tendencies. Adequate recanalisation was obtained in 56 patients (73.6%). In ten patients, the occlusion recurred while the patient was still in hospital. After four to six months, 37 of the 56 (67%) of the vessels were still patent. In 18 patients, peripheral emboli resulted in some deterioration, but in 15 of these cases this could be treated successfully by operation. The methods and indications of local fibrinolysis therapy and the problems associated with it are discussed. PMID:3027788

  5. Modulation of upper extremity motor evoked potentials by cutaneous afferents in humans.

    PubMed

    Kofler, M; Fuhr, P; Leis, A A; Glocker, F X; Kronenberg, M F; Wissel, J; Stetkarova, I

    2001-06-01

    The excitability of motoneurons controlling upper limb muscles in humans may vary with cutaneous nerve stimulation. We investigated the effect of noxious and non-noxious conditioning stimuli applied to right and left digit II and right digit V on motor evoked potentials (MEPs) recorded from right thenar eminence, abductor digiti minimi, biceps and triceps brachii muscles in twelve healthy subjects. Transcranial magnetic stimulation (TMS) was applied at interstimulus intervals (ISI) ranging from 40 to 160 ms following conditioning distal digital stimulation. TMS and transcranial electrical stimulation (TES) were compared at ISI 80 ms. Painful digital stimulation caused differential MEP amplitude modulation with an early maximum inhibition in hand muscles and triceps brachii followed by a maximum facilitation in arm muscles. Stimulation of different digits elicited a similar pattern of MEP modulation, which largely paralleled the behavior of cutaneous silent periods in the same muscles. Contralateral digital stimulation was less effective. MEPs following TMS and TES did not differ in their response to noxious digital stimulation. MEP latencies were shortened by cutaneous stimuli. The observed effects were stimulus intensity dependent. We conclude that activation of A-alpha and A-delta fibers gives rise to complex modulatory effects on upper limb motoneuron pools. A-delta fibers initiate a spinal reflex resulting in MEP amplitude reduction in muscles involved in reaching and grasping, and MEP amplitude facilitation in muscles involved in withdrawal. These findings suggest a protective reflex mediated by A-delta fibers that protects the hand from harm. A-alpha fibers induce MEP latency shortening possibly via a transcortical excitatory loop. PMID:11377265

  6. Neurorehabilitation of Upper Extremities in Humans with Sensory-Motor Impairment

    Microsoft Academic Search

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

    2002-01-01

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

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

    PubMed

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

    2014-01-01

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

  8. Natural history of upper extremity musculoskeletal symptoms and resulting work limitations over 3 years in a newly hired working population

    PubMed Central

    Gardner, Bethany T.; Dale, Ann Marie; Descatha, Alexis; Evanoff, Bradley

    2014-01-01

    Objective To describe the proportions of workers with upper extremity (UE) symptoms and work limitations due to symptoms in a newly hired working population over a 3-year study period and to describe transitions between various outcome states. Methods 827 subjects completed repeat self-reported questionnaires including demographics, medical and work history, symptoms and work status. Outcomes of interest were UE symptoms and work limitations due to symptoms. Results 72% of workers reported symptoms at least once during the study, with 12% reporting persistent symptoms and 27% reporting fluctuating symptoms. 31% reported work limitations at least once, with 3% reporting consistent work limitations and 8% reporting fluctuating limitations. Conclusions UE symptoms and work limitations are common among workers and dynamic in their course. A better understanding of the natural course of symptoms is necessary for targeted interventions. PMID:24854251

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-07-01

    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

  11. Symptomatic upper-extremity deep venous thrombosis after pacemaker placement in a pediatric patient: how to treat?

    PubMed

    Spar, David S; Anderson, Jeffrey B; Palumbo, Joseph S; Kukreja, Kamlesh U; Czosek, Richard J

    2013-06-01

    Symptomatic upper-extremity deep venous thrombosis (UEDVT) after pacemaker placement in adults has been reported, but the occurrence of UEDVT in pediatric patients is poorly defined, and no treatment guidelines exist. This report describes a 14-year old girl with a history of complete atrioventricular block who experienced a symptomatic UEDVT 8 months after placement of a transvenous pacemaker. The girl was treated initially with anticoagulation including subcutaneous enoxaparin and a heparin drip, which did not resolve the venous obstruction. In the interventional laboratory, a venogram demonstrated complete obstruction of the left subclavian vein, which was treated successfully with catheter-directed alteplase, direct thrombus removal by manual suctioning, and balloon angioplasty. Warfarin therapy was continued for an additional 6 months, with follow-up venous ultrasounds demonstrating left subclavian vein patency. Soon after completing warfarin therapy, the girl presented with minimal edema of her left distal extremity and was thought to have post-thrombotic syndrome, which resolved quickly. She continued to receive aspirin therapy, with no recurrence of symptoms. In conclusion, symptomatic UEDVT after pacemaker placement in a pediatric patient can be treated successfully with both anticoagulation and interventional therapies. Further studies are needed to evaluate the incidence of thrombus formation among children with transvenous pacemaker placement together with the development of guidelines based on the safety and effectiveness of differing treatments. PMID:22618585

  12. Efficacy of Constraint-Induced Movement Therapy on Involved Upper-Extremity Use in Children With Hemiplegic Cerebral Palsy Is Not Age-Dependent

    Microsoft Academic Search

    Andrew M. Gordon; Jeanne Charles; Steven L. Wolf

    2010-01-01

    OBJECTIVES.Constraint-induced (CI) movement therapy has been shown recently to be promising for improving upper-limb function in children with cerebral palsy (CP). Because little is known about patient characteristics predicting treatment efficacy, not all children may benefit from this intervention. Here we examine the relationship between efficacy of a child-friendly form of CI therapy and age on involved upper-extremity function. DESIGN.Twenty

  13. Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders

    PubMed Central

    Kwon, Jung Won; Son, Sung Min; Lee, Na Kyung

    2015-01-01

    [Purpose] This study investigated upper-extremity muscle activities in natural, ideal, and corrected head positions. [Subjects and Methods] Forty subjects with a forward head posture and rounded shoulder were recruited and randomly assigned to the natural head position group (n = 13), ideal head position group (n = 14), or corrected head position group (n = 13). Muscle activities were measured using a four-channel surface electromyography system at the sternocleidomastoideus, upper and lower trapezius, and serratus anterior muscles on the right side during an overhead reaching task. [Results] The muscle activities of the upper trapezius and serratus anterior differed significantly among head positions. Post hoc tests revealed significant differences between natural and ideal head positions, and natural and ideal head positions for both the upper trapezius and serratus anterior. [Conclusion] Recovery of normal upper trapezius and serratus anterior muscle functions plays an important role in correcting forward head posture and rounded shoulders. PMID:26180310

  14. 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

    Leistikow, Bruce N.

    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

  15. 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

    Leistikow, Bruce N.

    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

  16. 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

    Leistikow, Bruce N.

    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

  17. The effects of the functional tone management (FTM) arm training program on upper extremity motor control on chronic post-stroke individuals

    Microsoft Academic Search

    J. Farrell; H. Hoffman; J. Snyder; C. Giulian

    2003-01-01

    Background: The purpose of this study is to investigate the effect of functional arm training with a FTM dynamic orthosis on upper extremity movment of chronic post-CVA survivors. The FTM was designed to allow stroke patients to quickly incorporate grasp and release function. Methods: Each subject was fitted for a FTM dynamic orthosis and received 5 days of therapeutic treatment

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

    E-print Network

    New Jersey, University of Medicine and Dentistry of

    To be presented at the Fourth Int. Workshop on Virtual Rehabilitation (IWVR 2005), Catalina Island, CA, September 2005. The Rutgers Arm: An Upper-Extremity Rehabilitation System in Virtual Reality}@caip.rutgers.edu 2 Department of Developmental and Rehabilitative Sciences, University of Medicine and Dentistry

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

    PubMed Central

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

    2013-01-01

    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

  20. Evaluating the effect of four different pointing device designs on upper extremity posture and muscle activity during mousing tasks.

    PubMed

    Lin, Michael Y C; Young, Justin G; Dennerlein, Jack T

    2015-03-01

    The goal of this study was to evaluate the effect of different types of computer pointing devices and placements on posture and muscle activity of the hand and arm. A repeated measures laboratory study with 12 adults (6 females, 6 males) was conducted. Participants completed two mouse-intensive tasks while using a conventional mouse, a trackball, a stand-alone touchpad, and a rollermouse. A motion analysis system and an electromyography system monitored right upper extremity postures and muscle activity, respectively. The rollermouse condition was associated with a more neutral hand posture (lower inter-fingertip spread and greater finger flexion) along with significantly lower forearm extensor muscle activity. The touchpad and rollermouse, which were centrally located, were associated with significantly more neutral shoulder postures, reduced ulnar deviation, and lower forearm extensor muscle activities than other types of pointing devices. Users reported the most difficulty using the trackball and touchpad. Rollermouse was not more difficult to use than any other devices. These results show that computer pointing device design and location elicit significantly different postures and forearm muscle activities during use, especially for the hand posture metrics. PMID:25479996

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2015-01-01

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

  3. Language changes coincide with motor and fMRI changes following upper extremity motor therapy for hemiparesis: a brief report.

    PubMed

    Harnish, Stacy; Meinzer, Marcus; Trinastic, Jonathan; Fitzgerald, David; Page, Stephen

    2014-09-01

    To formally assess changes in language, affected UE movement, and motor functional activation changes via functional magnetic resonance imaging (fMRI) following participation in motor therapy without any accompanying language intervention. Pre-post case series. Five subjects with stroke exhibiting chronic, stable UE hemiparesis. The upper extremity section of the Fugl-Meyer (FM), the Western Aphasia Battery (WAB), and functional magnetic resonance imaging (fMRI), administered during performance of an affected UE motor task. All subjects were administered six weeks of repetitive task specific training (RTP), performed for approximately 2.5 hours per day, split into two sessions. For the first four weeks of the intervention period, RTP was administered every weekday, whereas, for the subsequent two weeks, RTP was administered 3 days/week. Epidural cortical stimulation was co-administered with the RTP via an electrode array and implanted pulse generator. For all sessions, one subject worked with a single therapist. Four weeks before and four weeks after the intervention period, all subjects were administered the FM, WAB, and fMRI. Three of the subjects exhibited clinically significant language changes on the WAB. These individuals exhibited the largest motor changes as measured by the FM. Functional MRI revealed distinct motor activation patterns in these subjects, characterized by more strongly right lateralized focal BOLD activity or a shift in activation toward the right hemisphere. Language changes appear to co-occur with motor changes after UE RTP. Understanding the underlying mechanisms of these findings may lead to more efficient and synergistic rehabilitative therapy delivery. PMID:21989635

  4. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... false Glenoid fossa prosthesis. 872.3950 Section... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device...

  5. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... false Glenoid fossa prosthesis. 872.3950 Section... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device...

  6. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... false Glenoid fossa prosthesis. 872.3950 Section... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device...

  7. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... false Glenoid fossa prosthesis. 872.3950 Section... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device...

  8. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... false Glenoid fossa prosthesis. 872.3950 Section... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device...

  9. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...false Mandibular condyle prosthesis. 872.3960 Section... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that...

  10. Sensitivity of the accelerometer as a measurement tool for upper extremity movement by stroke patients: a comparison with the action research arm test

    PubMed Central

    Lee, Joo-Hyun; Park, Ji Hyuk; Kim, Yeong-Jo

    2015-01-01

    [Purpose] This study investigated the sensitivity of an accelerometer in a comparison with the Action Research Arm Test (ARAT). [Subjects] Fifteen stroke patients participated in this study. [Methods] Subjects wore accelerometers on both wrists and performed the ARAT items. We then compared the data measured by the accelerometer with that of the ARAT. [Results] ARAT scores were higher on the non-affected side than the affected side, while the amount of upper extremity movement was higher on the affected side. The correlation coefficients for the two tools were not significantly different. [Conclusion] Our findings indicate that an accelerometer is a useful and sensitive instrument for clinically measuring the upper extremity activity of patients with stroke. PMID:25995554

  11. Foundation of the ozone\\/NO-ultrasound method in treatment and rehabilitation of patients with milk gland cancer and lymphedema of upper extremity after combined treatment

    Microsoft Academic Search

    Vadim N. Mironenko; V. V. Pedder; V. K. Kosenok; M. V. Naboka; S. V. Dmitrienko; I. V. Surgutskova

    2009-01-01

    The summary form only given. The new high effective ozone\\/NO ultrasonic method in complicated postoperative wound treatment of post-radiation fibroses and lymphedema of upper extremity after combined treatment of milk gland cancer is designed and introduced in clinic practice. Method uses ultrasonic and ozone\\/NO-generating devices which is resolved for clinical application and provides the possibility for treatment the patients with

  12. Use of an extracorporeal membrane oxygenation circuit as a bridge to salvage a major upper-extremity replant in a critically ill patient.

    PubMed

    Greaney, Patrick J; Cordisco, Michael; Rodriguez, Daniel; Newberger, Jordanna; Legatt, Alan D; Garfein, Evan S

    2010-10-01

    Major replantation of the upper extremity is defined as replantation at or above the level of the wrist. Selection of appropriate candidates is complex and requires consideration of many patient- and injury-associated factors including patient age, associated injuries, patient desire, mechanism of injury, ischemia time, wound condition, and presence of multiple-level injury. With respect to age, younger patients, especially children, are deemed to have a distinct advantage over more elderly patients due to improved nerve regeneration, and many advocate making every effort to replant this population. The risks of major upper-extremity replantation are significant and include bleeding, depletion of coagulation factors, secondary infection, and sepsis. As a result, major systemic illness and significant associated injuries are accepted as contraindications to limb salvage in this patient population. Herein we describe the use of an extracorporeal membrane oxygenation (ECMO) circuit as a potential bridge for short-term preservation of the extremity in a young patient with an acute, concomitant systemic illness. In the authors' opinion, use of ECMO perfusion is a viable means of maintaining extremity perfusion over hours or even days and may lead to broadened replant criteria in patients with associated injuries. PMID:20697991

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

    Microsoft Academic Search

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

    1997-01-01

    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

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

    E-print Network

    Paris-Sud XI, Université de

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

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

    PubMed Central

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

    2015-01-01

    Summary: Conjunctival squamous cell carcinoma (SCC) arising from an anophthalmic socket is quite rare, with few reports in the English literature. A 59-year-old man who had used an ocular prosthesis for 40 years had not removed the ocular prosthesis at all during the last 5 years. He had developed a mass on his entire right upper eyelid, and biopsy revealed a moderately differentiated SCC. Orbital exenteration including the upper and lower eyelid skin was performed. The defect was reconstructed with a free forearm flap followed by the placement of a facial epithesis. The pathology revealed an intraepithelial carcinoma on the upper palpebral conjunctiva, which seemed to infiltrate exclusively from that site to the upper eyelid and into the orbit. Other risk factors were not detected; therefore, chronic irritation or microtrauma of the upper conjunctiva from the prosthesis due to persistent prosthesis placement could have been the main trigger for the development of SCC. In cases where the ocular prosthesis is not fitted properly or removed appropriately, clinicians should be aware of this possible long-term consequence. PMID:25878936

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

    PubMed

    Riso, R R

    1999-01-01

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

  17. Pierre Robin syndrome associated with bilateral femoral aplasia, shortening of upper extremities, right kidney agenesis and left kidney malformation

    Microsoft Academic Search

    J. Handži?-?uk; M. Bagatin; V. ?uk

    1997-01-01

    A 5-year-old female infant with a extremely rare combination of Pierre Robin syndrome and multiple malformations of the limbs and kidneys is presented. Orthopaedic, hearing, intellectual and speech disabilities and treatment difficulties are discussed.

  18. Outcome measures for hand function naturally reveal three latent domains in older adults: strength, coordinated upper extremity function, and sensorimotor processing.

    PubMed

    Lawrence, Emily L; Dayanidhi, Sudarshan; Fassola, Isabella; Requejo, Philip; Leclercq, Caroline; Winstein, Carolee J; Valero-Cuevas, Francisco J

    2015-01-01

    Understanding the mapping between individual outcome measures and the latent functional domains of interest is critical to a quantitative evaluation and rehabilitation of hand function. We examined whether and how the associations among six hand-specific outcome measures reveal latent functional domains in elderly individuals. We asked 66 healthy older adult participants (38F, 28M, 66.1 ± 11.6 years, range: 45-88 years) and 33 older adults (65.8 ± 9.7 years, 44-81 years, 51 hands) diagnosed with osteoarthritis (OA) of the carpometacarpal (CMC) joint, to complete six functional assessments: hand strength (Grip, Key and Precision Pinch), Box and Block, Nine Hole Pegboard, and Strength-Dexterity tests. The first three principal components suffice to explain 86% of variance among the six outcome measures in healthy older adults, and 84% of variance in older adults with CMC OA. The composition of these dominant associations revealed three distinct latent functional domains: strength, coordinated upper extremity function, and sensorimotor processing. Furthermore, in participants with thumb CMC OA we found a blurring of the associations between the latent functional domains of strength and coordinated upper extremity function. This motivates future work to understand how the physiological effects of thumb CMC OA lead upper extremity coordination to become strongly associated with strength, while dynamic sensorimotor ability remains an independent functional domain. Thus, when assessing the level of hand function in our growing older adult populations, it is particularly important to acknowledge its multidimensional nature-and explicitly consider how each outcome measure maps to these three latent and fundamental domains of function. Moreover, this ability to distinguish among latent functional domains may facilitate the design of treatment modalities to target the rehabilitation of each of them. PMID:26097455

  19. The responsiveness and correlation between Fugl-Meyer Assessment, Motor Status Scale, and the Action Research Arm Test in chronic stroke with upper-extremity rehabilitation robotic training.

    PubMed

    Wei, Xi-Jun; Tong, Kai-Yu; Hu, Xiao-Ling

    2011-12-01

    Responsiveness of clinical assessments is an important element in the report of clinical effectiveness after rehabilitation. The correlation could reflect the validity of assessments as an indication of clinical performance before and after interventions. This study investigated the correlation and responsiveness of Fugl-Meyer Assessment (FMA), Motor Status Scale (MSS), Action Research Arm Test (ARAT) and the Modified Ashworth Scale (MAS), which are used frequently in effectiveness studies of robotic upper-extremity training in stroke rehabilitation. Twenty-seven chronic stroke patients were recruited for a 20-session upper-extremity rehabilitation robotic training program. This was a rater-blinded randomized controlled trial. All participants were evaluated with FMA, MSS, ARAT, MAS, and Functional Independent Measure before and after robotic training. Spearman's rank correlation coefficient was applied for the analysis of correlation. The standardized response mean (SRM) and Guyatt's responsiveness index (GRI) were used to analyze responsiveness. Spearman's correlation coefficient showed a significantly high correlation (?=0.91-0.96) among FMA, MSS, and ARAT and a fair-to-moderate correlation (?=0.40-0.62) between MAS and the other assessments. FMA, MSS, and MAS on the wrist showed higher responsiveness (SRM=0.85-0.98, GRI=1.59-3.62), whereas ARAT showed relatively less responsiveness (SRM=0.22, GRI=0.81). The results showed that FMA or MSS would be the best choice for evaluating the functional improvement in stroke studies on robotic upper-extremity training with high responsiveness and good correlation with ARAT. MAS could be used separately to evaluate the spasticity changes after intervention in terms of high responsiveness. PMID:22044987

  20. Outcome measures for hand function naturally reveal three latent domains in older adults: strength, coordinated upper extremity function, and sensorimotor processing

    PubMed Central

    Lawrence, Emily L.; Dayanidhi, Sudarshan; Fassola, Isabella; Requejo, Philip; Leclercq, Caroline; Winstein, Carolee J.; Valero-Cuevas, Francisco J.

    2015-01-01

    Understanding the mapping between individual outcome measures and the latent functional domains of interest is critical to a quantitative evaluation and rehabilitation of hand function. We examined whether and how the associations among six hand-specific outcome measures reveal latent functional domains in elderly individuals. We asked 66 healthy older adult participants (38F, 28M, 66.1 ± 11.6 years, range: 45–88 years) and 33 older adults (65.8 ± 9.7 years, 44–81 years, 51 hands) diagnosed with osteoarthritis (OA) of the carpometacarpal (CMC) joint, to complete six functional assessments: hand strength (Grip, Key and Precision Pinch), Box and Block, Nine Hole Pegboard, and Strength-Dexterity tests. The first three principal components suffice to explain 86% of variance among the six outcome measures in healthy older adults, and 84% of variance in older adults with CMC OA. The composition of these dominant associations revealed three distinct latent functional domains: strength, coordinated upper extremity function, and sensorimotor processing. Furthermore, in participants with thumb CMC OA we found a blurring of the associations between the latent functional domains of strength and coordinated upper extremity function. This motivates future work to understand how the physiological effects of thumb CMC OA lead upper extremity coordination to become strongly associated with strength, while dynamic sensorimotor ability remains an independent functional domain. Thus, when assessing the level of hand function in our growing older adult populations, it is particularly important to acknowledge its multidimensional nature—and explicitly consider how each outcome measure maps to these three latent and fundamental domains of function. Moreover, this ability to distinguish among latent functional domains may facilitate the design of treatment modalities to target the rehabilitation of each of them.

  1. 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

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

    2014-01-01

    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

  2. Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms

    PubMed Central

    2012-01-01

    Background The aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users. Methods At baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse. Results The median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively. Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions. Conclusion There was a strong association between high perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between poor perceived comfort and neck pain. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms. PMID:22436251

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

    PubMed Central

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

    2014-01-01

    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

  4. Historical Channel Change on the Upper Gila River, Arizona and New Mexico in Response to Anthropogenic Modifications and Extreme Floods

    NASA Astrophysics Data System (ADS)

    Klawon, J. E.; Levish, D. R.

    2003-12-01

    Over the past century, the majority of alluvial reaches along the upper Gila River in Arizona and New Mexico have been leveed in an attempt to protect adjacent property from flood damage. In addition, the demand for irrigation has prompted the construction of diversion dams in these alluvial reaches to divert water for agriculture. Detailed geomorphic mapping and investigation of historical channel change along the upper Gila River reveals that many channel modifications are catalysts for major channel change and can result in catastrophic property loss rather than safeguarding valuable farmland. Channel widths were measured every kilometer for approximately 160 km from Safford Valley, Arizona through Cliff-Gila Valley, New Mexico for eight decades to develop a quantitative analysis of channel change. An overall pattern of channel narrowing and widening coincides with periods of few large floods and periods of multiple large floods, respectively. Furthermore, reaches along the upper Gila River with greater channel modifications have experienced more variation in channel width than reaches with fewer modifications. Although the average width of the upper Gila River is very similar to the width of the 1935 channel, the lateral position of the channel is very different in many reaches. Many channel changes in recent decades are unprecedented in previous historical aerial photography and reveal that the upper Gila River is currently eroding stream banks that are several hundred years to thousands of years old. These changes are consistently associated with artificial channel constrictions, such as levees, bank protection, and bridges, that have been built and rebuilt following large floods and that have accelerated natural channel narrowing during periods of few large floods. Examples of geomorphic responses due to channel modifications along the upper Gila River include lateral erosion upstream of levees and diversion dams, redirection of flow over diversion dams into opposite banks, breaching of levees during floods and resultant erosion behind levees, channel widening downstream of levees, aggradation in leveed reaches, and lateral migration associated with straightened tributary channels.

  5. Gait analysis of powered bionic lower prosthesis

    Microsoft Academic Search

    Jian Zhang; Ling Shen; Lixing Shen; Aiping Li

    2010-01-01

    With the demand of active prosthesis continuing to rise, the necessity of developing stable humanoid robots and intelligent leg prosthesis becomes more and more important. This paper presents a closed-loop position servo system of the powered prosthesis, which is designed according to the moving feature of human leg, and consists of the position, velocity and current feedback. Based on bionics

  6. David R. Boyd lecture in trauma care and emergency medical systems: Upper extremity injuries—past, present, and future

    Microsoft Academic Search

    Harold E. Kleinert; Mark A. Pickford

    1997-01-01

    Since its recognition as a subspeciality soon after World War I, hand surgery has evolved into a highly specialized and sophisticated field of medicine. Enormous advances have been made in the diagnosis and treatment of disorders of the upper limb; primary tenorrhaphy and the application of microsurgical techniques for revascularization, replantation, and free tissue transfer are among the most important

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

    E-print Network

    Delp, Scott

    2002-01-01

    Journal 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 and extensor muscles scale with the shorter distance (Ds) between the elbow flexion axis and a muscle's origin

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

    Microsoft Academic Search

    I. Kempf; M. Semlitsch

    1990-01-01

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

  9. Assessing upper extremity capacity as a potential indicator of needs related to household activities for rehabilitation services in people with myotonic dystrophy type 1.

    PubMed

    Raymond, Kateri; Auger, Louis-Pierre; Cormier, Marie-France; Vachon, Christine; St-Onge, Sabrina; Mathieu, Jean; Noreau, Luc; Gagnon, Cynthia

    2015-06-01

    This study aimed to assess upper extremity capacity as a potential indicator of needs related to household activities for rehabilitation services in people with myotonic dystrophy type 1 (DM1). A cross-sectional study was set in an outpatient neuromuscular clinic where 200 adults with a confirmed diagnosis of DM1 (121 women; mean age: 47?y) were selected from the registry of a neuromuscular clinic to participate. Housing-related activities were assessed using the "housing" section of the Assessment of Life Habits Questionnaire (LIFE-H). The upper extremity assessment included grip strength (Jamar dynamometer), lateral pinch strength (pinch gauge), gross dexterity (Box and Block Test) and fine dexterity (Purdue Pegboard Test). Correlations with the LIFE-H item "housing" were stronger for grip and lateral strength (r?=?0.62; 0.61). When difficulties were present in "housing", the cut-off score associated with lateral pinch strength was 4.8?kg (sensitivity: 75.6%; specificity: 79.2%). Grip strength presented cut-off scores that clinically differed by gender. In conclusion, potential indicator of needs related to household activities for rehabilitation services with valid assessment tools were developed for people with DM1 who experience difficulties in housing-related activities. These criteria will assist health professionals in their attempt to refer DM1 patients to rehabilitation services at the appropriate time. PMID:25953319

  10. FES of lower extremities: Comparison of rehabilitation strategies and stimulation equipment in patients with upper \\/ lower motor neuron lesion

    Microsoft Academic Search

    Bijak M; Hofer C; Rakos M; Kern H; Mayr W

    2006-01-01

    http:\\/\\/www.meduniwien.ac.at\\/zbmtp\\/bmt\\/ Abstract Functional Electrical Stimulation (FES) of lower extremities in patients suffering from paraplegia can be used to restore standing up from the wheelchair, standing, walking \\/ stepping and sitting down. Usually only patients with an intact lower motor neuron (spastic paraplegia) can benefit while patients with flaccid paralysis are excluded due to the inexistent or very weak force response

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

    PubMed Central

    2013-01-01

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

  12. A low-cost video game applied for training of upper extremity function in children with cerebral palsy: a pilot study.

    PubMed

    Jannink, Michiel J A; van der Wilden, Gelske J; Navis, Dorine W; Visser, Gerben; Gussinklo, Jeanine; Ijzerman, Maarten

    2008-02-01

    The aim of the present study was to determine the user satisfaction of the EyeToy for the training of the upper limb in children with cerebral palsy (CP). User satisfaction was measured in 12 children with CP, using a postexperience questionnaire, primarily based on a presence questionnaire. In general, children with CP were satisfied with and motivated by the EyeToy training. In addition, a first evaluation study was performed to determine the effect of this training method on the upper limb function. Ten children with CP were randomly assigned to the intervention (mean age 11 years, 9 months; SD 2,3) and the control group (mean age 12 years, 3 months; SD 3,2). After a treatment period of 6 weeks, the intervention group completed a user satisfaction questionnaire. Functional outcome was measured using the Melbourne Assessment scores. Percentage scores of the Melbourne Assessment of 7 of the 10 children were the same or changed only 1% to 2% from baseline to followup. However, in the experimental group, two children improved more, 9% and 13% respectively. In conclusion, it can be said that the EyeToy is a motivational training tool for the training of children with CP and has the potential to improve upper extremity function. PMID:18275309

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

    PubMed Central

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

    2012-01-01

    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

  14. Maximal strength and power characteristics in isometric and dynamic actions of the upper and lower extremities in middle-aged and older men.

    PubMed

    Izquierdo, M; Ibañez, J; Gorostiaga, E; Garrues, M; Zúñiga, A; Antón, A; Larrión, J L; Häkkinen, K

    1999-09-01

    Muscle cross-sectional area of the quadriceps femoris (CSAQF), maximal isometric strength (handgrip test and unilateral knee extension/flexion), the shape of isometric force-time curves, and power-load curves during concentric and stretch-shortening cycle (SSC) actions with loads ranging from 15 to 70% of one repetition maximum half-squat (1RMHS) and bench-press (1RMBP) were examined in 26 middle-aged men in the 40-year-old (M40) (mean age 42, range 35-46) and 21 elderly men in the 65-year-old age group (M65) (mean age 65, range 60-74). Maximal bilateral concentric (1RMHS and 1RMBP), unilateral knee extension (isometric; MIFKE and concentric; 1RMKE) strength and muscle CSA in M65 were lower (P < 0.001) than in M40. The individual values of the CSAQF correlated with the individual values of maximal concentric 1RMHS, 1RMKE and MIFKE in M65, while the corresponding correlations were lower in M40. The maximal MIFKE value per CSA of 4.54 +/- 0.7 N m cm-2 in M40 was greater (P < 0. 05-0.01) than that of 4.02 +/- 0.7 N m cm-2 recorded in M65. The maximal rate of force development of the knee extensors and flexors in M65 was lower (P < 0.01-0.001) and the heights in squat and counter-movement jumps as much as 27-29% lower (P < 0.001) than those recorded in M40. M65 showed lower (P < 0.001) concentric power values for both upper and lower extremity performances than those recorded for M40. Maximal power output was maximized at the 30-45% loads for the upper extremity and at the 60-70% loads for the lower extremity extensors in both age groups. Muscle activation of the antagonists was significantly higher (P < 0.01-0.001) during the isometric and dynamic knee extension actions in M65 than in M40. The present results support a general concept that parallel declines in muscle mass and maximal strength take place with increasing age, although loss of strength may vary in both lower and upper extremity muscles in relation to the type of action and that ageing may also lead to a decrease in voluntary neural drive to the muscles. Explosive strength and power seem to decrease with increasing age even more than maximal isometric strength in both actions but power was maximized at the 30-45% loads for the upper and at the 60-70% loads for the lower extremity action in both age groups. High antagonist muscle activity may limit the full movement efficiency depending on the type of muscle action, testing conditions and the velocity and/or the time duration of the action, especially in the elderly. PMID:10519978

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

    PubMed Central

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

    2007-01-01

    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 upper extremity tasks that required multi-level movement and sustained elevation. Kinematics of movement were investigated to inform subtask structure. Tasks and test composition were refined to fit clinical applicability criteria and pilot tested on 5 patients awaiting surgery for shoulder impingement and age-sex matched controls. Test-retest reliability was assessed on 10 subjects. Then a cohort of patients with mild to moderate (n = 17) shoulder pathology and 19 controls (17 were age-sex matched to patients) were tested to further validate the Functional Impairment Test-Hand, and Neck/Shoulder/Arm (FIT-HaNSA) by comparing it to self-reported function and measured strength. The FIT-HaNSA, DASH and SPADI were tested on a single occasion. Impairments in isometric strength were measured using hand-held dynamometry. Discriminative validity was determined by comparing scores to those of age-sex matched controls (n = 34), using ANOVA. Pearson correlations between outcome measures (n = 41) were examined to establish criterion and convergent validity. Results A test protocol based on three five-minute subtasks, each either comprised of moving objects to waist-height shelves, eye-level shelves, or sustained manipulation of overhead nuts/bolts, was developed. Test scores for the latter 2 subtasks (or total scores) were different between controls as compared to either surgical-list patients with shoulder impingement or a variety of milder shoulder pathologies (p < 0.01). Test 1 correlated the highest with the DASH (r = -0.83), whereas Test 2 correlated highest with the SPADI (r = -0.76). Conclusion Initial data suggest the FIT-HaNSA provides valid assessment of impaired functional performance in patients with shoulder pathology. It discriminates between patients and controls, is related to self-reported function, and yet provides distinct information. Longitudinal testing is warranted. PMID:17509150

  16. Pilot comparative study of unilateral and bilateral robot-assisted training on upper-extremity performance in patients with stroke.

    PubMed

    Yang, Chieh-Ling; Lin, Keh-Chung; Chen, Hsieh-Ching; Wu, Ching-Yi; Chen, Chia-Ling

    2012-01-01

    We compared a unilateral robot-assisted training protocol (URTP) and a bilateral robot-assisted training protocol (BRTP) to study their differential effects. We recruited 21 patients with stroke who received 90-105 min of therapy 5 days/wk for 4 wk. Participants in the URTP and BRTP groups practiced forearm pronation and supination and wrist flexion and extension in a simultaneous manner with the Bi-Manu-Track. The control group received standard rehabilitation. Clinical measures included the Fugl-Meyer Assessment, the Medical Research Council instrument, grip strength, and the Modified Ashworth Scale to assess motor impairment, muscle power, muscle strength, and spasticity, respectively. The pilot study indicated that the URTP and BRTP might have differential benefits for movement improvement. URTP might be a more compelling approach to improving upper-limb motor impairment, muscle power, and strength at the distal joints than BRTP, whereas BRTP could be an optimal approach to improving proximal muscle power. PMID:22394529

  17. Evaluation of Satellite Rainfall Products for Prediction of Extreme High Flows in the Upper Blue Nile Basin

    NASA Astrophysics Data System (ADS)

    Taye, M.; Bitew, M. M.; Gebremichael, M.; Moges, S.; Willems, P.

    2012-12-01

    The upper Blue Nile River Basin is a region characterized by sparse ground based rainfall measurements both at temporal and spatial scale. Satellite rainfall products are becoming an alternative data sources for different hydrological applications. In this study we evaluated the accuracy of two high resolution satellite rainfall estimates (TMPA 3B42 V7 and CMORPH) for the prediction of high flooding events in the Blue Nile River basin and sub-watersheds. The assessment of accuracy of simulated streamflow was conducted at daily time scale for three watershed scales (Gilgel Abay =1,656 km2, Kessie = 65,000 km2 and upper Blue Nile =176,000 km2) using two watershed modeling tools (SWAT and VHM). The hydrological models were calibrated using two approaches: 1) when the satellite estimates were run using model parameters obtained from rain gauge calibrated models and 2) when the satellite rainfall estimates were run using parameter values obtained from model calibrated using the corresponding satellite rainfall data sets. The result shows that the satellite rainfall products are able to capture the general hydrograph of the basins with acceptable skill of simulation when using both lumped and distributed modelling approaches regardless of the varying watershed sizes. An encouraging result is also found for the simulation of flooding events in two of the three watersheds. The study demonstrated the satellite rainfall estimates can be considered suitable for this region for hydrological applications especially when the focus is on predicting total flows which are vital for proper watershed management practices while caution has to be taken when predicting high flooding events indicating that there is room for further improvement.

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

    PubMed Central

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

    2015-01-01

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

  19. Augmenting occupational therapy treatment of upper-extremity spasticity with botulinum toxin A: a case report of progress at discharge and 2 years later.

    PubMed

    Denham, Susan P

    2008-01-01

    This case report summarizes occupational therapy services provided to a participant after botulinum toxin A (BTA) injections and her improvements 2 years later. The injections were performed to neutralize spasticity in the left upper extremity after a stroke. Along with BTA, the participant received occupational therapy for 12 weeks, using neurodevelopmental and biomechanical approaches and an activity-based home program. Spasticity decreased from a 4 to a 1 on the Modified Ashworth Scale (MAS) immediately after the injections. Two years after the injections, the MAS score ranged between 1 and 1+. Initially, the participant demonstrated functional limitations in areas of splint application, dressing, toileting, and bathing. Following BTA injections and occupational therapy, the participant demonstrated increased independence in all deficit areas. For this participant, BTA, combined with functional, activity-based occupational therapy interventions, was associated with neurological change and greater functional use of the spastic limb. PMID:18712010

  20. A myoelectric-controlled virtual hand for the assessment and treatment of phantom limb pain in trans-radial upper extremity amputees: a research protocol.

    PubMed

    Gaggioli, Andrea; Amoresano, Amedeo; Gruppioni, Emanuele; Verni, Gennaro; Riva, Giuseppe

    2010-01-01

    At least 90% of individuals of limb amputees experience phantom limb pain (PLP). Recent clinical research suggests that providing patients with the mirror image representation of the amputated limb may alleviate PLP. However, mirror therapy cannot be used with bilateral amputees, as visual feedback is dependent on the movement of the intact limb. To overcome this limitation, we designed a novel myoelectric-controlled virtual reality (VR) system for the treatment of phantom limb pain in trans-radial upper extremity amputees. The proposed system allows the patient to directly control the virtual limb by recognizing stump muscle patterns recorded with EMG sensors. The hypothesis behind this strategy is that the VR image of the amputated limb induces better limb imagery than the reflected image of their intact limb and, therefore, is more effective in reducing PLP. A research protocol to test this hypothesis is described. PMID:20543301

  1. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function.

    PubMed

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

    2015-01-01

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

  2. Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting.

    PubMed

    Kietrys, David M; Gerg, Michael J; Dropkin, Jonathan; Gold, Judith E

    2015-09-01

    This study aimed to determine the effects of input device type, texting style, and screen size on upper extremity and trapezius muscle activity and cervical posture during a short texting task in college students. Users of a physical keypad produced greater thumb, finger flexor, and wrist extensor muscle activity than when texting with a touch screen device of similar dimensions. Texting on either device produced greater wrist extensor muscle activity when texting with 1 hand/thumb compared with both hands/thumbs. As touch screen size increased, more participants held the device on their lap, and chose to use both thumbs less. There was also a trend for greater finger flexor, wrist extensor, and trapezius muscle activity as touch screen size increased, and for greater cervical flexion, although mean differences for cervical flexion were small. Future research can help inform whether the ergonomic stressors observed during texting are associated with musculoskeletal disorder risk. PMID:25959323

  3. High-Intensity, Unilateral Resistance Training of a Non-Paretic Muscle Group Increases Active Range of Motion in a Severely Paretic Upper Extremity Muscle Group after Stroke

    PubMed Central

    Urbin, M. A.; Harris-Love, Michelle L.; Carter, Alex R.; Lang, Catherine E.

    2015-01-01

    Limited rehabilitation strategies are available for movement restoration when paresis is too severe following stroke. Previous research has shown that high-intensity resistance training of one muscle group enhances strength of the homologous, contralateral muscle group in neurologically intact adults. How this “cross education” phenomenon might be exploited to moderate severe weakness in an upper extremity muscle group after stroke is not well understood. The primary aim of this study was to examine adaptations in force-generating capacity of severely paretic wrist extensors resulting from high intensity, dynamic contractions of the non-paretic wrist extensors. A secondary, exploratory aim was to probe neural adaptations in a subset of participants from each sample using a single-pulse, transcranial magnetic stimulation (TMS) protocol. Separate samples of neurologically intact controls (n = 7) and individuals ?4 months post stroke (n = 6) underwent 16 sessions of training. Following training, one-repetition maximum of the untrained wrist extensors in the control group and active range of motion of the untrained, paretic wrist extensors in the stroke group were significantly increased. No changes in corticospinal excitability, intracortical inhibition, or interhemispheric inhibition were observed in control participants. Both stroke participants who underwent TMS testing, however, exhibited increased voluntary muscle activation following the intervention. In addition, motor-evoked potentials that were unobtainable prior to the intervention were readily elicited afterwards in a stroke participant. Results of this study demonstrate that high-intensity resistance training of a non-paretic upper extremity muscle group can enhance voluntary muscle activation and force-generating capacity of a severely paretic muscle group after stroke. There is also preliminary evidence that corticospinal adaptations may accompany these gains. PMID:26074871

  4. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Total temporomandibular joint prosthesis. 872.3940 Section 872...CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

  5. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Total temporomandibular joint prosthesis. 872.3940 Section 872...CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

  6. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Total temporomandibular joint prosthesis. 872.3940 Section 872...CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

  7. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Total temporomandibular joint prosthesis. 872.3940 Section 872...CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices...Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

  8. 21 CFR 884.3650 - Fallopian tube prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 2012-04-01 false Fallopian tube prosthesis. 884.3650 Section 884...Prosthetic Devices § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a device designed to...

  9. 21 CFR 884.3650 - Fallopian tube prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...2014-04-01 2014-04-01 false Fallopian tube prosthesis. 884.3650 Section 884...Prosthetic Devices § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a device designed to...

  10. 21 CFR 884.3650 - Fallopian tube prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 2013-04-01 false Fallopian tube prosthesis. 884.3650 Section 884...Prosthetic Devices § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a device designed to...

  11. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  12. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  13. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  14. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  15. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  16. 21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 2013-04-01 false Toe joint polymer constrained prosthesis. 888.3720...Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a...

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

    PubMed Central

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

    2011-01-01

    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

  18. Resting state functional connectivity and task-related effective connectivity changes after upper extremity rehabilitation: a pilot study.

    PubMed

    Saleh, Soha; Adamovich, Sergei V; Tunik, Eugene

    2012-01-01

    In this study we investigated the effect of 2 weeks of robot-aided virtual reality therapy for the paretic upper limb in stroke patients on changes in brain activation. Brain activation was acquired during the resting state and during visually-guided hand movement. fMRI analysis focused on characterizing functional connectivity with ipsilesional primary motor cortex (iM1) at rest and during execution of paretic hand movement. Two subjects who sustained a stroke more than 6 months ago participated. Before and after the training period, motor function was evaluated (Wolf Motor Function Test [WMFT], Jebsen Test of Hand Function [JTHF]). After the training period, clinical outcomes (WMFT and JTHF) improved in both subjects. The resting state functional connectivity (rsFC) maps and task-related functional connectivity with iM1 showed different magnitudes of activation, however, the general directionality of the pattern (increases versus decreases) was similar. Specifically, both the rsFC and the task-related functional connectivity between iM1 and contralesional primary motor cortex (cM1) decreased after the therapy for the first subject and increased for the second subject. Our preliminary data suggest that resting state functional connectivity may be a useful measure of brain reorganization, particularly for subjects with limited volitional control of the paretic limb. PMID:23366942

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

    ERIC Educational Resources Information Center

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

    2005-01-01

    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…

  20. 21 CFR 876.3750 - Testicular prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  1. 21 CFR 876.3750 - Testicular prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  2. 21 CFR 876.3750 - Testicular prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  3. 21 CFR 876.3750 - Testicular prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  4. 21 CFR 876.3750 - Testicular prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  5. Three-dimensional printed calcaneal prosthesis following total calcanectomy?

    PubMed Central

    Imanishi, Jungo; Choong, Peter F.M.

    2015-01-01

    Introduction The majority of patients with extremity sarcoma can be surgically treated without amputation. However, limb-salvage surgery for foot sarcomas including the calcaneus remains challenging. Presentation of case A 71-year-old man presented with a 5-year history of right heel persistent pain. Imaging studies revealed an osteolytic, destructive and highly metabolic lesion in the right calcaneus. Computed tomography guided core needle biopsy confirmed the diagnosis of grade 2 chondrosarcoma. A total calcanectomy was performed, and the defect was reconstructed with a patient matched three-dimensional printed titanium calcaneal prosthesis. Intra-operatively, ligaments including the Achilles tendon, and plantar fascia were reattached. The post-operative course was uneventful, and at the 5-month clinical follow-up, the patient was fully weightbearing, with a mobile ankle without pain. Discussion This case is the first to use additive manufacturing to create a prosthetic calcaneus. The complex peri-calcaneal articular surfaces and reattachment of tendinous structures facilitate efforts to stabilize the prosthesis in situ. Conclusion Three-dimensional-printed prosthesis of the calcaneus is a viable alternative to amputation. PMID:25827294

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

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

    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.

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

    PubMed Central

    Stine, Rebecca L.; Gard, Steven A.

    2013-01-01

    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

  8. Extreme erosion response after wildfire in the Upper Ovens, south-east Australia: Assessment of catchment scale connectivity by an intensive field survey

    NASA Astrophysics Data System (ADS)

    Box, Walter; Keestra, Saskia; Nyman, Petter; Langhans, Christoph; Sheridan, Gary

    2015-04-01

    South-eastern Australia is generally regarded as one of the world's most fire-prone environments because of its high temperatures, low rainfall and flammable native Eucalyptus forests. Modifications to the landscape by fire can lead to significant changes to erosion rates and hydrological processes. Debris flows in particular have been recognised as a process which increases in frequency as a result of fire. This study used a debris flow event in the east Upper Ovens occurred on the 28th of February 2013 as a case study for analysing sediment transport processes and connectivity of sediment sources and sinks. Source areas were identified using a 15 cm resolution areal imagery and a logistic regression model was made based on fire severity, aridity index and slope to predict locations of source areas. Deposits were measured by making cross-sections using a combination of a differential GPS and a total station. In total 77 cross-sections were made in a 14.1 km2 sub-catchment and distributed based on channel gradient and width. A more detailed estimation was obtained by making more cross-sections where the volume per area is higher. Particle size distribution between sources and sink areas were obtained by combination of field assessment, photography imagery analyses and sieve and laser diffraction. Sediment was locally eroded, transported and deposited depending on factors such as longitude gradient, stream power and the composition of bed and bank material. The role of headwaters as sediment sinks changed dramatically as a result of the extreme erosion event in the wildfire affected areas. Disconnected headwaters became connected to low order streams due to debris flow processes in the contributing catchment. However this redistribution of sediment from headwaters to the drainage network was confined to upper reaches of the Ovens. Below this upper part of the catchment the event resulted in redistribution of sediment already existing in the channel through a combination of debris flows and hyperconcentrated flows. These results indicate that there is a stepwise outflow of sediment influencing long-term erosion rates and landform development.

  9. Optimization of the visco-elastic parameters describing the heel-region of a prosthesis.

    PubMed

    Johnston, Thomas R; Hubbard, Mont

    2012-10-21

    Although compliance (visco-elasticity) of a prosthesis has the potential to affect clinically relevant aspects of a lower extremity amputee's gait, it is currently unknown what the compliant parameter values should be. Here, a simple dynamical model is used to approximate walking with a compliant prosthesis. An exhaustive search is used to identify the optimal compliant element parameter set in terms of the model's stability as measured by the reciprocal of the gait sensitivity norm (rGSN). We identified a parameter set yielding a 17% larger rGSN than the best commercially available prosthesis; however, this is unlikely to be the global optimum for the physically realizable visco-elastic parameter space. Due to the nonlinear effects of the compliant elements, it is difficult to make generalizations about speed and step length, such difficulties are not present with simpler contact models. However, there is some evidence to support a possible trade-off between efficiency and stability. PMID:22776505

  10. Sex determination using discriminant analysis of upper and lower extremity bones: New approach using the volume and surface area of digital model.

    PubMed

    Lee, U-Young; Kim, In-Beom; Kwak, Dai-Soon

    2015-08-01

    This study used 110 CT images taken from donated Korean cadavers to create 3-D models of the following upper and lower limb bones: the clavicle, scapula, humerus, radius, ulna, hip bone (os coxa), femur, patella (knee cap), tibia, talus, and calcaneus. In addition, the bone volume and surface area were calculated to determine sex differences using discriminant analysis. Significant sex differences were found in all bones with respect to volume and surface area (p<0.01). The order of volume was the same in females and males (femur>hip bone>tibia>humerus>scapula), although the order of surface area was different. The largest surface area in men was the femur and in women was the hip bone (p<0.01). An interesting finding of this study was that the ulna is the bone with the highest accuracy for sex determination (94%). When using the surface area of multiple bones, the maximum accuracy (99.4%) was achieved. The equation was as follows: (discriminant equation of surface area; female<0extremity bones can be used for sex determination. PMID:26117502

  11. Upper extremity and digital replantation

    Microsoft Academic Search

    Marco Maricevich; Brian Carlsen; Samir Mardini; Steven Moran

    Digital replantation has become a well-established technique among reconstructive hand surgeons. Numerous replantation centers\\u000a around the world have published series with impressive survival rates. The ultimate goal of replantation is the restoration\\u000a of normal hand or digital function; thus, replantation success is not solely related to the outcome of the microvascular anastomosis,\\u000a but also to the adequacy of bone, tendon,

  12. Radiography of the Upper Extremity

    MedlinePLUS

    ... American Society of Radiologic Technologists, 15000 Central Ave. SE, Albuquerque, NM 87123-3909, or visit us online ... codos, antebrazos u hombros. Estos tipos de exámenes se realizan para detectar estados tales huesos rotos, daños ...

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

    E-print Network

    Mountziaris, T. J.

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

  14. Constraint-Induced Movement Therapy for Severe Upper-Extremity Impairment after Stroke in an Outpatient Rehabilitation Setting: A Case Report

    PubMed Central

    Shears, Jennifer; Hutchings, Lisa; Osmond, Michelle

    2008-01-01

    Purpose: Laboratory studies confirm that constraint-induced movement therapy (CIMT) improves upper-extremity (UE) function after stroke. Due to strict patient criteria and the intensive resources required, CIMT has been slow to become part of rehabilitation practice. Our purpose was to determine the feasibility and effectiveness of an adapted experimental protocol within an outpatient clinical setting for a patient with moderate to severe UE impairment who did not meet traditional CIMT criteria. Patient Description: AJ, a 16-year-old male, experienced a left middle cerebral artery ischemic stroke due to carotid artery dissection one year before beginning CIMT. He demonstrated some proximal movement but no wrist or finger extension. He had received intensive rehabilitation for 12 months prior to beginning CIMT. Intervention: Two occupational therapists and two physiotherapists collaborated to provide CIMT task training for 6 hours daily for 2 weeks. A knitted mitten extending to the elbow restrained the less-involved UE during 90% of waking hours. Tasks were tailored to AJ's interests, with the goal of integrating his affected UE into his behavioural repertoire. Measures and Outcomes: After 2 weeks of CIMT, AJ improved in all measures (grip and lateral pinch strength, Action Research Arm Test [ARAT], and Box and Block Test) except the Chedoke McMaster Impairment Inventory. Greatest gains were seen at 6 months in the ARAT and Box and Block Test, which coincided with patient and family reports of AJ's using his arm in everyday functional tasks. Implications: Shared workload, emphasis on relevant functional tasks, and complete family participation likely influenced the success of CIMT. Our findings suggest that the strict CIMT criteria used in previous studies may exclude patients who might benefit from the treatment. Controlled trials should be undertaken to examine the effects of CIMT in patients with moderate to severe UE impairment. PMID:20145779

  15. Custom Ocular Prosthesis: A Palliative Approach

    PubMed Central

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

    2012-01-01

    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

  16. Aesthetic finger prosthesis with silicone biomaterial.

    PubMed

    Raghu, K M; Gururaju, C R; Sundaresh, K J; Mallikarjuna, Rachappa

    2013-01-01

    The fabrication of finger prosthesis is as much an art as it is science. The ideally constructed prosthesis must duplicate the missing structures so precisely that patients can appear in public without fear of attracting unwanted attraction. A 65-years-old patient reported with loss of his right index finger up to the second phalanx and wanted to get it replaced. An impression of the amputated finger and donor were made. A wax pattern of the prosthesis was fabricated using the donor impression; a trial was performed and flasked. Medical grade silicone was intrinsically stained to match the skin tone, following which it was packed, processed and finished. This clinical report describes a method of attaining retention by selective scoring of the master cast of partially amputated finger to enhance the vacuum effect at par with the proportional distribution of the positive forces on the tissues exerted by the prosthesis. PMID:23975917

  17. Visuomotor behaviours when using a myoelectric prosthesis

    PubMed Central

    2014-01-01

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

  18. Intraoral angiosarcoma: treatment with a brachytherapy prosthesis.

    PubMed

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

    2015-03-01

    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. This clinical report describes an intraoral angiosarcoma and the fabrication of an intraoral brachytherapy prosthesis to manage this malignancy. PMID:25449613

  19. A Gas-Actuated Anthropomorphic Transhumeral Prosthesis

    Microsoft Academic Search

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

    2007-01-01

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

  20. 21 CFR 888.3025 - Passive tendon prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  1. 21 CFR 888.3025 - Passive tendon prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...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...

  2. Techniques for Evaluating the Fit of Removable and Fixed Prosthesis

    PubMed Central

    Shetty, Mallika S.; Shenoy, K. Kamalakanth

    2011-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  4. Extreme Value Theory, Extreme Temperatures, and demonstration of extRemes

    E-print Network

    Gilleland, Eric

    ) 3. Weibull type) #12;Background on Extreme Value Analysis (EVA) Gumbel type · Light tail on Extreme Value Analysis (EVA) Motivation Central Limit Theorem Extremal Types Theorem Normal (light tail) Reverse Weibull (upper bound) Gumbel (light tails) Frechet (lower bound, heavy upper tail) Sums

  5. Chronic cadmium intoxication caused by a dental prosthesis

    Microsoft Academic Search

    K. Borowiak; T. Dutkiewicz; T. Marcinkowski

    1990-01-01

    We present a case of chronic cadmium intoxication caused by a gold dental prosthesis. The first symptoms of the disease appeared 2 years after insertion and gradually intensified over the next 3 years. Analysis of blood and urine samples, as well as parts of the prosthesis, revealed an excessive concentration of cadmium. The prosthesis was removed and the concentration of

  6. Computational Model of a Skeletal Dental Prosthesis's Mechanic Work

    Microsoft Academic Search

    Wojciech Michalski; Zbigniew Michniowski; M. Kuchta

    2006-01-01

    Computation of the stress pattern (deformations) and displacements of the dental prosthesis required a spatial representation of the systems' work during the chewing process. The aim was to formulate a numerical model that would facilitate optimalisation of the occlusion loads' distribution in prosthesis's shape function. Discretization of the prosthesis thin metal coating that covers the tissues was made with the

  7. Chronic cadmium intoxication caused by a dental prosthesis

    Microsoft Academic Search

    K. Borowiak; T. Dutkiewicz; T. Marcinkowski

    1990-01-01

    Summary We present a case of chronic cadmium intoxication caused by a gold dental prosthesis. The first symptoms of the disease appeared 2 years after insertion and gradually intensified over the next 3 years. Analysis of blood and urine samples, as well as parts of the prosthesis, revealed an excessive concentration of cadmium. The prosthesis was removed and the concentration

  8. Complete denture with pharyngeal bulb prosthesis

    PubMed Central

    Naveen, YG; Jagadeesh, MS; Prajapati, Paranjay; Mallikarjuna, Rachappa

    2013-01-01

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

  9. Complete denture with pharyngeal bulb prosthesis.

    PubMed

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

    2013-01-01

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

  10. Acrylic finger prosthesis: a case report.

    PubMed

    K, Rajeev Kumar Reddy; Bandela, Vinod; M, Bharathi; S V, Giridhar Reddy

    2014-08-01

    Hands basic function is to grasp, hold and manipulate items. Hand gesture is perhaps the most blatant example of non-verbal communication. Finger and partial finger amputations are most frequently encountered forms of partial hand loss. Common causes are traumatic injuries, congenital absence or malformations present great clinical challenges. In addition to immediate loss of grasp strength, finger absence may cause marked psychological trauma. Individuals who desire finger replacement usually have high expectation for the appearance of prosthesis. This clinical report portrays simple method to retain acrylic finger prosthesis. PMID:25302271

  11. Fabrication of a Custom Ocular Prosthesis

    PubMed Central

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

    2014-01-01

    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

  12. Acrylic Finger Prosthesis: A Case Report

    PubMed Central

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

    2014-01-01

    Hands basic function is to grasp, hold and manipulate items. Hand gesture is perhaps the most blatant example of non-verbal communication. Finger and partial finger amputations are most frequently encountered forms of partial hand loss. Common causes are traumatic injuries, congenital absence or malformations present great clinical challenges. In addition to immediate loss of grasp strength, finger absence may cause marked psychological trauma. Individuals who desire finger replacement usually have high expectation for the appearance of prosthesis. This clinical report portrays simple method to retain acrylic finger prosthesis. PMID:25302271

  13. 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.

  14. Biodegradation and biocompatibility of a degradable chitosan vascular prosthesis

    PubMed Central

    Kong, Xiaoying; Xu, Wenhua

    2015-01-01

    An instrument made by ourselves was used to fabricate biodegradable chitosan-heparin artificial vascular prosthesis with small internal diameter (2 mm) and different crosslinking degree from biodegradable chitosan, chitosan derivates and heparin. In vivo and in vitro degradation studies, inflammatory analysis and electron microscope scanning of this artificial vascular prosthesis were performed. It was observed that 50% of the prosthesis decomposed in vivo and was replaced by natural tissues. The degradation process of the chitosan-heparin artificial vascular prosthesis of small diameter could be controlled by changing the crosslinking degree. This kind of artificial vascular prosthesis shows good biocompatibility that can be controllability designed to achieve desirable in vascular replacement application.

  15. Ethical considerations for volunteer recruitment of visual prosthesis trials.

    PubMed

    Xia, Yu; Ren, Qiushi

    2013-09-01

    With the development of visual prostheses research from the engineering phase to clinical trials, volunteer recruitment for the early visual prosthesis trials needs to be carefully considered. In this article, we mainly discuss several issues related to volunteer recruitment that had posed serious challenges to the visual prosthesis trials, such as low rates of participants, high expectations and underlying motivations to participate in the visual prosthesis trials as well as the importance of informed consent. When recruiting volunteers for visual prosthesis implants, it is critical that the visual prosthesis researchers should not only take into account the patient's expectations and motivations, but also make the patients fully aware of the possible benefits and risks involved with their participation, and help patients establish realistic expectations for the early phase of visual prosthesis implantation. Based on these considerations to the challenges, eligible volunteers may be recruited in the preliminary stages of visual prosthesis trials. PMID:22729653

  16. A single unit digital flexor tendon prosthesis.

    PubMed

    King, R N; Dunn, H K; Bolstad, K E

    1975-07-01

    Historically, the surgical repair of serious injuries to the flexor tendons of the hand have met with less than satisfactory clinical results. In an attempt to solve this problem, studies have been made on the design and testing of a Dacron polyester tendon prosthesis for complete replacement of the digital flexor tendon. The prosthesis attaches proximally at the anatomical musculotendon junction via collagen ingrowth into a fabric structure and in similar manner distally via bone ingrowth at the anatomical insertion site. These fabrics are continuous with the tendon body of the prosthesis consisting of an inextensible braided cord which is silicone rubber coated to prevent tissue adherence in the glide zone of the tendon bed. An added benefit of the prosthesis is a simple means of length adjustment which can easily be carried out on the operating table. Studies have been performed in both dogs and chickens which indicate that sufficient tissue ingrowth occurs at both the distal and proximal anastomoses for retention of full load bearing capability in these animals and that postoperative adhesions are negligible, if present at all. Full prostheses have been implanted in dogs for periods of over 1 year and chickens for 2 months. The chicken is the preferred animal model as a tendency for extensive scar tissue generation was shown in the dog. Both in vivo mechanical testing and histological characterization have been made on sacrificed animals which have received the full prostheses. PMID:1176499

  17. Vibrotactile display coding for a balance prosthesis

    Microsoft Academic Search

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

    2003-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  19. 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)

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

    2014-05-01

    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.

  20. 21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  1. 21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  2. Women's satisfaction with partners' penile implant. Inflatable vs noninflatable prosthesis.

    PubMed

    Beutler, L E; Scott, F B; Karacan, I; Baer, P E; Rogers, R R; Morris, J

    1984-12-01

    We evaluated 49 women whose sexual partners were organically impotent and subsequently received either an inflatable or noninflatable penile prosthesis. The women comprised three groups, based on the type of prostheses their partners had received: inflatable (n = 34), noninflatable (n = 11), and a double implant group (n = 4). The comparisons made were (1) dimensions of sexual satisfaction, (2) emotional stability, (3) satisfaction with the prosthesis, and (4) relationship changes. Two special questionnaires and the Derogatis Sexual Functioning Inventory were utilized in this evaluation. Women in the inflatable prosthesis group were found to be significantly more satisfied with the quality of their sexual relations and with their partner's prosthesis than were the women in the noninflatable prosthesis group. There apparently is a general advantage to women whose partners have received an inflatable prosthesis compared with the noninflatable alternatives. PMID:6506394

  3. Design and Control of a Powered Transfemoral Prosthesis

    PubMed Central

    Sup, Frank; Bohara, Amit; Goldfarb, Michael

    2009-01-01

    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

  4. Control of Dental Prosthesis System With Microcontroller

    Microsoft Academic Search

    Metin Kapidere; Serdar Müldür; ?nan Güler

    2000-01-01

    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

  5. Short term evaluation of interocclusal distance during speech after new removable prosthesis insertion.

    PubMed

    Garcia, Renata Cunha Matheus Rodrigues; Oliveira, Viviane Maia Barreto; Del Bel Cury, Altair Antoninha

    2003-09-01

    The aim of this study was to evaluate the interocclusal distance during the pronunciation of /m/ and /s/ sounds from Portuguese Language, in partially edentulous patients before and after new partial and total prosthesis installation. The subjects were divided into two groups: Experimental group, consisting of 9 patients entirely edentate in the upper maxillary arch and classified as Kennedy Class I in the lower arch; and Control group, consisting of 9 totally dentate patients. The subjects from the first group had their worn out dentures changed and the occlusal vertical dimension (OVD) corrected. A magnetic method of jaw tracking was used to measure the interocclusal distance (mm) during pronunciation of those phonemes. Comparison between groups, by t test, showed significant difference (p<0.05) for /m/ sound in all periods of time: before prosthesis installation - T0 (3.38±1.23), immediately - T1 (2.15±1.06), six hours - T2 (3.41±1.33), twenty-four hours - T3 (2.92±0.92), two days - T4 (4.80±1.93), one week - T5 (3.87±1.43), two weeks - T6 (3.03±0.96), one month - T7 (3.03±0.96), two months - T8 (4.47±1.45) and three months - T9 (4.33±2.56), except for six months - T10 after prosthesis installation. For /s/ sound phoneme the results were different (p<0.05) between the groups in T1 (2.89±1.33), T2 (3.37±1.22), T3 (3.19±1.06), T4 (3.86±1.21), T5 (3.83±1.32), T6 (3.27±1.10), T7 (3.37±0.99) and T10 (3.84±1.38) after oral rehabilitation. The paired-t test, for means comparison between before and after prosthesis insertion, indicated significant differences (p<0.05) for /m/ sound only in T1, and for /s/ sound in T1, T2, T3, T6, T7 and T10. It was concluded that new prosthesis insertion, correcting the OVD, changes the interocclusal distance, and for /m/ sound this distance could be recovered after six months of prosthesis wearing. PMID:21394396

  6. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...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)...

  7. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...AND 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)...

  8. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...AND 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)...

  9. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...AND 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)...

  10. Edentulous maxillary arch fixed implant rehabilitation using a hybrid prosthesis made of micro-ceramic-composite: case report.

    PubMed

    Geckili, Onur; Bilhan, Hakan; Ceylan, Gulsum; Cilingir, Altug

    2013-02-01

    The prosthetic treatment of patients with an edentulous maxilla opposing mandibular natural teeth is one of the most challenging endeavors that face clinicians. Occlusal forces from the opposing natural teeth may cause fractures in the maxillary prosthesis and also result in advanced bone loss of the edentulous maxilla. With the presence of extreme gagging reflex, the treatment may become more complicated. This article describes and illustrates the 2-stage surgical and prosthetic treatment of a patient with an edentulous maxilla opposing natural teeth. In the beginning, the patient was treated with 4 implants and a maxillary implant-supported overdenture. The extreme gagging reflex and the occlusal forces from the mandibular natural teeth obligated the team a second stage surgical and prosthetic treatment, which included increasing the number of implants after bilateral sinus lifting in the posterior maxilla and fabricating a maxillary fixed hybrid prosthesis made of micro-ceramic composite that yielded a satisfactory result. PMID:20932120

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

    PubMed Central

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

    2014-01-01

    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

  12. Large ice-wedge networks and tundra gley horizons in Northern France Upper Pleistocene loess: evidences of extreme cold events and cyclic millennial changes

    NASA Astrophysics Data System (ADS)

    Antoine, Pierre; Moine, Olivier; Guerin, Gilles

    2015-04-01

    Northern France loess-palaeosol sequences from the last interglacial-glacial cycle (Eemian-Weichselian) have been intensely studied during the last 20 years (about 100 individual sequences). Despite thickness variations of the different stratigraphic units, the sequences from the last interglacial-glacial cycle exhibit a particularly constant pedosedimentary pattern, including well-identified pedological and periglacial marker horizons that can be followed north- and eastward in Belgium and Germany. Within this system, new field investigations and luminescence (OSL) datings put in evidence at least four generations of large ice-wedge networks (10-14 m) preserved by loess deposits between ca. 50 and 20 ka. The best- and most systematically preserved network is presently dated at about 31-32 ka according to the OSL ages from its loess infilling. This main ice-wedge cast horizon systematically occurs at the boundary between Middle Pleniglacial brown soil complexes and the base of the Upper Pleniglacial typical loess cover. Consequently, it represents a major stratigraphic marker for correlations in Western Europe. According to recent OSL dating results, the first thick typical loess unit of the Upper Pleniglacial, covering the main ice-wedge cast horizon, has been deposited shortly after GIS-5 interstadial and could be contemporaneous of H3 event in deep-sea cores. In addition, it is shown that all the large ice wedge casts are developed from the surface of a tundra gley horizon (0.3 to 0.5 m in thickness). As it has been previously demonstrated that tundra gley layers were mainly formed during short interstadial events (malacology, sedimentology), a model linking tundra gley horizons, and ice wedges network regarding to DO stadial-interstadial cycles during the last glacial is proposed.

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

    PubMed Central

    2013-01-01

    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

  14. The Effects of Topical Sesame (Sesamum indicum) Oil on Pain Severity and Amount of Received Non-Steroid Anti-Inflammatory Drugs in Patients With Upper or Lower Extremities Trauma

    PubMed Central

    Bigdeli Shamloo, Marzieh Beigom; Nasiri, Morteza; Dabirian, Aazam; Bakhtiyari, Ali; Mojab, Faraz; Alavi Majd, Hamid

    2015-01-01

    Background: Most patients with trauma experience different levels of pain. Due to side effects as well as economic burden of drugs used for pain relief after trauma commonly, it is important to use low-cost methods independently or combined with drugs to alleviate pain. Objectives: Therefore, this study aimed to investigate the effects of topical sesame oil on pain severity and frequency of received NSAIDs of patients with trauma. Patients and Methods: This randomized clinical trial study was conducted on 150 patients with upper or lower extremities trauma in Dezful Ganjavian Hospital, Ahvaz, Iran, in 2014. Data was collected by a researcher-made questionnaire and Visual Analogue Scale (VAS). Patients were divided into two groups of control (n = 75) and intervention (n = 75) randomly. In the intervention group, patients applied topical sesame oil beside the routine cares, while in the control group patients just received routine cares. Severity of pain and frequency of received NSAIDs was assessed in the first, third, seventh and tenth days after the intervention in the both groups. Data was analyzed by SPSS19 software using descriptive and analytic (Chi-square and independent sample t-test) statistical methods. Results: Based on student sample t-test, there was a significant difference between intervention and control groups regarding the pain severity in the first (P = 0.06), third (P = 0.001), seventh (P = 0.001) and tenth (P = 0.001) days after the intervention. Besides, the frequency of received NSAIDs in the intervention group and the control group showed significant difference in four days after the intervention (for four days P = 0.001). Conclusions: Topical application of sesame oil could reduce pain severity and frequency of received NSAIDs in patients with upper or lower extremities trauma. Therefore, it is recommended to use this oil in complementary medicine for pain relief due to low cost, easy usage and lack of adverse effects.

  15. [Myocobacterium tuberculosis endomyocarditis. Apropos of a case in a patient with a mitral valve prosthesis].

    PubMed

    Palcoux, M C; Lamaison, D; Cassagnes, J; Ricoux, M; Lusson, J R; Courtadon, M; Richard, E; Jallut, H

    1982-11-01

    A case of lethal cardiac tuberculosis with myocardial and endocardial involvement is reported in a 46 year old man with a Starr-Edwards mitral valve prosthesis inserted two years previously for severe mitral regurgitation, secondary to ruptured chordae of the posterior mitral leaflet. Apart from tuberculous pericarditis, cardiac involvement is extremely rare; it occurs in "tuberculous septicemia" whose characteristic features--tuberculinic anergy, hematological abnormalities especially pancytopenia,--lead to delay in diagnosis, which is usually fatal. The case presented is an example. PMID:6818922

  16. Invited commentary on comparison of robotics, functional electrical stimulation, and motor learning methods for treatment of persistent upper extremity dysfunction after stroke: a randomized controlled trial.

    PubMed

    Kwakkel, Gert; van Wegen, Erwin E; Meskers, Carel M

    2015-06-01

    In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe and colleagues report findings from their methodologically sound, dose-matched clinical trial in 39 patients beyond 6 months poststroke. In this phase II trial, the effects of 60 treatment sessions, each involving 3.5 hours of intensive practice plus either 1.5 hours of functional electrical stimulation (FES) or a shoulder-arm robotic therapy, were compared with 5 hours of intensive daily practice alone. Although no significant between-group differences were found on the primary outcome measure of Arm Motor Ability Test and the secondary outcome measure of Fugl-Meyer Arm motor score, 10% to 15% within-group therapeutic gains were on the Arm Motor Ability Test and Fugl-Meyer Arm. These gains are clinically meaningful for patients with stroke. However, the underlying mechanisms that drive these improvements remain poorly understood. The approximately $1000 cost reduction per patient calculated for the use of motor learning (ML) methods alone or combined with FES, compared with the combination of ML and shoulder-arm robotics, further emphasizes the need for cost considerations when making clinical decisions about selecting the most appropriate therapy for the upper paretic limb in patients with chronic stroke. PMID:25687763

  17. A computer-aided analysis on dental prosthesis shade matching

    Microsoft Academic Search

    Shuli Wang; Weiting Wang; Fan Wu

    2011-01-01

    Recently dental aesthetics become important requirement when people went to dental clinic. Thus, for the most of dental patient if placed prosthesis, an ideal prosthesis is that the color closes to the adjacent teeth, so the tooth matching become a crucial step before implant. In this paper we proposed a tooth shade matching system by develop a standard procedure, which

  18. The study of compensatory motions while using a transradial prosthesis

    Microsoft Academic Search

    Stephanie Lutton Carey

    2008-01-01

    Improvement of prostheses requires knowledge of how the body adapts. A transradial prosthesis without a dynamic wrist component may cause awkward compensatory motion leading to fatigue, injury or rejection of the prosthesis. This work analyzed the movements of shoulder, elbow and torso during four tasks: drinking from a cup, opening a door, lifting a box and turning a steering wheel.

  19. An Electronic Prosthesis Mimicking the Dynamic Vestibular Function

    Microsoft Academic Search

    Andrei M. Shkela

    This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular

  20. Bone ingrowth in a shoulder prosthesis MSC Thesis, Applied Mathematics

    E-print Network

    Vuik, Kees

    of the joint and to relieve the pain, a prosthesis to replace the glenoid of the shoulder joint is an optionBone ingrowth in a shoulder prosthesis MSC Thesis, Applied Mathematics E.M.van Aken 1107895, rheumatoid arthritis or severe trauma from a shoulder fracture, it is possible that the shoulder joint

  1. Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

    PubMed Central

    Tran, Viet Q.; Lesser, Timothy F.; Kim, Dennis H.; Aboseif, Sherif R.

    2008-01-01

    For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mean follow-up of 18 months (range 12 to 64), all patients had a prosthesis that was functioning properly without evidence of separation, herniation, or erosion of the graft. Sexual activity resumed at a mean time of 9 weeks (range 8 to 10). There were no adverse events related to the graft or its harvest. Use of rectus fascia graft for coverage of a tunical defect during a difficult penile prosthesis placement is surgically feasible, safe, and efficacious. PMID:19009028

  2. Simplified Design Equations for Class-E Neural Prosthesis Transmitters

    PubMed Central

    Troyk, Philip; Hu, Zhe

    2013-01-01

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

  3. Dental Prosthesis' Experimental Measurements of the Mechanical Response for a Numerical Simulation

    Microsoft Academic Search

    Wojciech Michalski; M. Kuchta; K. Fokow

    2006-01-01

    The experimental wing skeletal dental prosthesis, which is a replica of a clinical skeletal prosthesis constructed by the authors, was examined mechanically against the increasing and decreasing static loads ranging from 0.00 -17.67 |N|. The measurements shall facilitate defining prosthesis reactions in terms of deflexion and stress. Therefore, they shall aid in verifying the mathematical model of the prosthesis during

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

    NASA Astrophysics Data System (ADS)

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

    2014-10-01

    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.

  5. Effects of porous coating and collar support on early load transfer for a cementless hip prosthesis.

    PubMed

    Keaveny, T M; Bartel, D L

    1993-10-01

    We used a new postprocessing method with the results from a three-dimensional finite element analysis to describe the general load transfer patterns for a cementless hip arthroplasty in the early postoperative situation, and to determine the effects of porous coating [full, partial (2/3), and none] and calcar-collar support (ideal initial contact with separation allowed upon loading, no collar) on this early load transfer. No-tension interfaces were modeled over the entire bone-prosthesis interface, with an upper bound on the Coulomb-friction over coated surfaces, and zero friction over smooth surfaces to accentuate the frictional effects of the coating. The results indicate that the anteroposterior, mediolateral, and axial forces acting on each cross section of the bone were substantially different from the corresponding homeostatic (no prosthesis) forces for the fully coated device with collar support. The frontal bending moments acting on the bone were substantially less than the homeostatic values all along the prosthesis, while the sagittal bending and torsional loads were relatively similar to the homeostatic values. By far, the largest change in these loading patterns occurred with the loss of collar support, where axial loads acting on the bone were so low that over half the bone was in net tension because appreciable transfer of the compressive head force did not occur until well below the lesser trochanter. Both axial and torsional loads were transferred more distally for devices with more coating, and torsional loading of the bone was also sensitive to the degree of collar support. The frontal bending moments acting over most of the bone were insensitive to the coating or collar support. The strain energy density in the endosteal bone was most sensitive to these design variables in the proximal region, and the largest values occurred without a collar and without coating. These findings indicate that all load components acting on the proximal bone in the early postoperative situation (no bone-ingrowth or fibrous tissue at the interface) are altered by the frictional coefficient of the bone-prosthesis interface (i.e. the presence of porous coating or some other surface treatment) and the degree of collar support, while only the axial and torsional loads are altered in the distal bone. From a prosthesis design perspective this implies that surface treatments and collar support can be used to control the axial forces and the torsional moments acting all along the bone. By contrast, the distal frontal bending moment, which dominates stresses in the diaphysis, cannot be altered by these design variables. PMID:8253825

  6. Photovoltaic Retinal Prosthesis with High Pixel Density

    PubMed Central

    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

    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

  7. [Substitution of an injured finger joint by silicone rubber prosthesis].

    PubMed

    Antal, R; Jenó, M

    1976-01-01

    Between 1973 and the first semester of 1975, on the injured and destroyed digital articulation 27 patients have been operated on by means silicon rubber prosthesis of Swanson type. The prosthesis plasty and the field of its use are shortly resumed, pointing out the importance of its adaptation on the injured articulation. The operative technique is described, as well as the results obtained and the aspects of the evaluation are discussed. The results obtained with the silicon rubber prosthesis are very promising. In the case of failure arthrodesis may be performed at any time. PMID:10486

  8. A Walking Controller for a Powered Ankle Prosthesis

    PubMed Central

    Shultz, Amanda H.; Mitchell, Jason E.; Truex, Don; Lawson, Brian E.; Ledoux, Elissa; Goldfarb, Michael

    2015-01-01

    This paper describes a walking controller implemented on a powered ankle prosthesis prototype and assessed by a below-knee amputee subject on a treadmill at three speeds. The walking controller is a finite state machine which emulates a series of passive impedance functions at the joint in order to reproduce the behavior of a healthy joint. The assessments performed demonstrate the ability of the powered prosthesis prototype and walking controller to reproduce essential biomechanical aspects (i.e. joint angle, torque, and power profiles) of the healthy joint, especially relative to a passive prosthesis. PMID:25571414

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

    PubMed Central

    2012-01-01

    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

  10. Role of loads and prosthesis material properties on the mechanics of the proximal femur after total hip arthroplasty.

    PubMed

    Cheal, E J; Spector, M; Hayes, W C

    1992-05-01

    The objective of this study was to establish the role of loads and prosthesis material properties on the mechanics of the proximal femur after total hip arthroplasty. We developed a three-dimensional finite element model of an intact human femur and the same femur with a conventional collared straight-stem femoral component. Using published data, we defined two sets of loading conditions: one that represented three phases of gait, and one that represented four different extreme loads. The four extreme loads were based on the peak joint contact forces that occur during stair ascent and isometric contraction of various muscle groups. The model was analyzed with three different material properties for the prosthesis, including cobalt-chromium alloy, titanium alloy, and a carbon fiber-reinforced polymer (CFRP) laminate. We assumed that the implant was stable, with rigid bonding, collar contact, and no cement. To address femoral component loosening, we examined the shear stresses at the implant-bone interface; to address adaptive bone remodeling, we examined the principal stresses in the supporting cortical bone relative to those in the intact femur. Our analyses of the various loading conditions demonstrated large out-of-plane bending movements and torsional moments, especially for the load representing stair ascent. Based on stepwise multiple regressions, the maximum shear stresses at the implant-bone interface in the distal region were dependent on the total applied axial force and torsion; the maximum shear stresses in the proximal region were dependent on the axial component of the joint contact force alone. Reduction in the prosthesis stiffness, by substitution of the CFRP material properties, resulted in lower interface shear stresses at the distal end of the stem and higher interface shear stresses at the more proximal sections, consistent with the findings of others. We fit equations, based on composite beam theory, to the maximum implant-bone interface shear stresses and the cortical bone principal stresses as a function of the axial modulus of the prosthesis. These equations can be used to estimate the maximum stresses at the interface and in the cortical bone that would be predicted by similar models, for the same prosthesis constructed of alternative materials, relative to the stresses in the intact femur. The nonlinear nature of these relationships was such that the cortical bone stresses changed more rapidly, as a function of the prosthesis modulus, for lower values of elastic modulus, especially in the more proximal sections. PMID:1569504

  11. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...3940 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a)...

  12. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...3960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification....

  13. Redesigning a prosthesis for a golfer with transhumeral amputation

    E-print Network

    Tsai, Helen

    2009-01-01

    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 ...

  14. Successful coating of an allergenic acrylate-based dental prosthesis

    Microsoft Academic Search

    Lasse Kanerva; Kyllikki Tarvainen; Riitta Jolanki; Tuula Estlander

    1995-01-01

    Background: Most dental prostheses are currently made of acrylate compounds. Therefore, patients sensitized to acrylate compounds may have difficulties in finding prostheses.Objective: A patient with allergic prosthesisinduced stomatitis who was able to use the prosthesis after her allergenic acrylate-based dental prosthesis had been coated with a UV light—cured acrylate lacquer is reported.Methods: The patient was patch tested with the standard

  15. Do removable dental prosthesis have an impact on tooth loss?

    Microsoft Academic Search

    Gerald McKenna

    2011-01-01

    DesignA multi-centre randomised controlled study in 14 dental schools. This report is an interim analysis at 3 years.InterventionPatients were allocated to either the Removable dental prosthesis group (RPD)-109 patients or the no prosthesis group (SDA) -106 patients. Patients had to be older than 35 years with no molars in the study jaw. Follow-up visits were scheduled at 4 to 8

  16. Rehabilitation of a spark erosion prosthesis: a clinical report.

    PubMed

    Berger, Julie C; Driscoll, Carl F

    2006-01-01

    When complex prostheses are fabricated, it is expected that at some point maintenance will be necessary. This clinical report documents a 10-year-old maxillary spark erosion prosthesis that had been repaired many times, was discolored, and exhibited significant signs of wear. The metal superstructure was intact; therefore, only the acrylic resin base and teeth needed to be replaced. To reduce both cost and time without the prosthesis for the patient, the rehabilitation was completed within 24 hours. PMID:16650012

  17. Post Reconstruction Breast Pyoderma Gangrenosum: Early Recognition and Prosthesis Salvage

    PubMed Central

    Cicuto, Bryan; Cheriyan, Thomas; Rudnicki, Pamela

    2015-01-01

    Summary: We report 3 cases of breast pyoderma gangrenosum in patients undergoing total mastectomy with immediate reconstruction. All three received systemic corticosteroid treatment, resulting in resolution of symptoms. As experience grew, early diagnosis in the third patient helped prosthesis salvage and timely return to the original course of reconstruction. This represents the first report of prosthesis salvage from post breast reconstruction pyoderma gangrenosum, and it demonstrates that implant removal is not always necessary during management of this rare condition. PMID:26180735

  18. Benign subcutaneous emphysema of the upper extremity.

    PubMed

    Fowler, John R; Rerko, Michael A; Grand, Aaron G

    2013-11-01

    Benign subcutaneous emphysema is a rare clinical entity, documented by only a small collection of case reports. The presence of crepitus on physical examination and subcutaneous gas on radiographs is concerning for necrotizing fasciitis. Necrotizing fasciitis is a dangerous and deadly infection accounting for 500 to 1000 cases annually in the United States, with mortality rates of up to 76%. Delay in surgical treatment is related to increased morbidity and mortality; therefore, a high clinical suspicion should be maintained in patients with subcutaneous emphysema and/or crepitus. It is critical to recognize that no laboratory result or radiologic finding should delay surgical intervention if a high clinical suspicion for necrotizing fasciitis exists. However, not all subcutaneous emphysema represents a life-threatening infection. This article presents a case of benign subcutaneous emphysema treated with close observation and prophylactic antibiotics. Patients with necrotizing fasciitis typically appear ill and have the triad of swelling, erythema, and disproportionate pain. Patients who are not systemically ill and have minimal pain, no significant inflammatory changes at the site of crepitus, and stable hemodynamic parameters can be treated conservatively, with the caveat that close clinical monitoring is essential to avoid the unnecessary morbidity and mortality that can result from delaying intervention in the case of necrotizing fasciitis. PMID:24200454

  19. Management of abnormal uterine bleeding in women with mechanical heart valve prosthesis and anticoagulant therapy.

    PubMed

    Saha, Pradip Kumar; Rakshit, Bibek Mohan; Jana, Narayan; Dutta, Sanjib; Roy, Subesha Basu; Sengupta, Gautam

    2011-12-01

    In a prospective observational case series, we assessed the effects and management and outcome of oral anticoagulant associated abnormal uterine bleeding in women with mechanical heart valve prosthesis. Six women with mechanical heart valve prosthesis, who were admitted with persistent severe vaginal bleeding between 2003 and 2010, were evaluated. For each woman, detailed history, treatment received, if there was any complication and their final outcome and satisfaction were recorded. All the 6 women were parous, with their ages ranging from 27 to 50 years. They were receiving oral anticoagulant therapy for mechanical heart valve prosthesis. Of the 6 women, 4 had uterine fibroids, and the other 2 had dysfunctional uterine bleeding.Three patients with uterine fibroids underwent abdominal hysterectomy, and one underwent balloon thermal ablation of endometrium. While 1 patient with dysfunctional uterine bleeding underwent hysterectomy, the other patient desirous for further children, required levonorgestrel intra-uterine system. Two women requiring hysterectomy, developed postoperative complications, one a massive intraperitoneal haemorrhage and another a rectus sheath haematoma. At follow-up, 5 women were satisfied, and 1 woman had died suddenly at home 1 year after hysterectomy. Because of the twin problem of heart disease and anticoagulant therapy, treatment of abnormal vaginal bleeding in these women is extremely challenging. Although medical treatment yields only temporary relief, endometrial ablative procedures or levonorgestrel intra-uterine system provides more durable solution. As anticoagulant associated peri-operative haemorrhage can be potentially fatal, hysterectomy should be reserved for women with major pelvic pathologies. Proper counselling and integrated management involving gynaecologist, cardiologist, haematologist and anaesthesiologist is essential to tackle this problem. PMID:23469574

  20. The influence of weight and starting height on lifting mechanics in lower extremity amputees.

    PubMed

    Lieber, Susan J; Boston, J Robert; Rudy, Thomas E; Munin, Michael C

    2002-06-01

    This study compares the lifting mechanics of lower extremity amputees to controls and describes the influence of weight lifted and starting height on lifting style. Subjects included three individuals with transtibial amputation (TTA), two individuals with transfemoral amputation (TFA), and three able-bodied controls (CO). Amputee subjects performed six repetitions of six weights, randomly ordered, from two starting heights. TTA lifted from 30 cm and knee height, TFA from knee and thigh height, and controls from all three heights. Data were obtained from a work simulator, force plate, and a motion analysis system, with starting posture index, lateral sway index, lift duration, synchrony index, and hip moments and elbow moments as dependent measures. The results for each lifting height were analyzed using a mixed model repeated measures MANOVA to test for group and weight differences and post hoc tests were applied when appropriate. Results suggest that healthy lower extremity amputees who have had a number of years to adjust to their prosthesis and develop compensatory strategies can complete a repetitive lifting task at a performance level very similar to able-bodied controls. The most consistent group differences detected were in the timing parameters: synchrony and duration. TTA and TFA tended to lift with less synchronization of hip and knee movements than able-bodied controls and to initiate the lift with their upper bodies. In contrast, able-bodied controls tended to move their upper and lower bodies more synchronously during the lift. TTA had longer lift durations than CO. In terms of stability and moments generated, TTA lifted very similarly to controls. TFA used a different lifting style that involved higher moments and more use of the upper body, particularly for lifts of heavier weights. TFA appeared to be less stable than CO, while TTA did not appear to be less stable than CO. PMID:12236448

  1. Numerical Simulation and Superplastic Forming of Ti-6Al-4V Alloy for a Dental Prosthesis

    NASA Astrophysics Data System (ADS)

    Li, Xiaomei; Soo, Steven

    2011-04-01

    This article investigates superplastic forming (SPF) technique in conjunction with finite element (FE) simulation applied to dental repair. The superplasticity of Ti-6Al-4V alloys has been studied using a uniquely designed five-hole test with the aim of obtaining the modeled grain size and the flow stress parameters. The data from the five-hole test are subsequently put into the FE program for the simulation of a partial upper denture dental prosthesis (PUD4). The FE simulation of the PUD4 is carried out to set up appropriate input parameters for pressing due to the SPF process being fully automatic controlled. A variety of strain rates ranging from 2.4 × 10-5 to 1 × 10-3 s-1 are selected for the characterization of superplastic properties of the alloy. The Superflag FE program is used to generate an appropriate pressure-time profile and provide information on thickness, grain size, and grain growth rate distribution. Both membrane elements and solid elements have been adopted in the simulation and the results from both types of elements are compared. An evaluation of predicted parameters for the SPF of the prosthesis is presented.

  2. Prediction of visual perceptions with artificial neural networks in a visual prosthesis for the blind

    E-print Network

    Rattray, Magnus

    prediction results. 2. The optic nerve based visual prosthesis Since the late eighties cochlear implants have. Introduction The European project OPTIVIP (Optimisation of the Visual Implantable Prosthesis) has recently been

  3. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 false Ankle joint metal/composite semi-constrained cemented prosthesis... § 888.3100 Ankle joint metal/composite semi-constrained cemented prosthesis...Identification. An ankle joint metal/composite semi-constrained cemented...

  4. 21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 2010-04-01 false Wrist joint metal/polymer semi-constrained cemented prosthesis...Prosthetic Devices § 888.3800 Wrist joint metal/polymer semi-constrained cemented prosthesis... (a) Identification. A wrist joint metal/polymer...

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

    E-print Network

    Wyatt, John L.

    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 ...

  6. Zirconia in fixed prosthesis. A literature review

    PubMed Central

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

    2014-01-01

    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

  7. Finite element modeling of retinal prosthesis mechanics

    NASA Astrophysics Data System (ADS)

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

    2009-10-01

    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.

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

    PubMed Central

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

    2013-01-01

    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

  9. Determining the effectiveness of a vibrotactile balance prosthesis.

    PubMed

    Peterka, Robert J; Wall, Conrad; Kentala, Erna

    2006-01-01

    We present a quantitative method for characterizing the effectiveness of a balance prosthesis based on tactile vibrators. The balance prosthesis used an array of 12 tactile vibrators (tactors) placed on the anterior and posterior surfaces of the torso to provide body orientation feedback related to the angular position and velocity of anterior-posterior body sway. Body sway was evoked in subjects with normal sensory function and in vestibular loss subjects by rotating the support surface upon which a test subject stood with eyes closed. Tests were performed both with (tactor trials) and without (control trials) the prosthesis activated. Several amplitudes of support surface stimulation were presented with each stimulus following a pseudorandom motion profile. For each stimulus amplitude, a transfer function analysis characterized the amplitude (gain) and timing (phase) of body sway evoked by the support surface stimulus over a frequency range of 0.017 to 2.2 Hz. A comparison of transfer function results from the control trials of normal subjects with results from tactor trials of vestibular loss subjects provided a quantitative measure of the effectiveness of the balance prosthesis in substituting for missing vestibular information. Although this method was illustrated using a specific balance prosthesis, the method is general and could be applied to balance prostheses that utilize other technology. PMID:16917168

  10. Design and Control of a Pneumatically Actuated Transtibial Prosthesis

    PubMed Central

    Zheng, Hao; Shen, Xiangrong

    2015-01-01

    This paper presents the design and control of a pneumatically actuated transtibial prosthesis, which utilizes a pneumatic cylinder-type actuator to power the prosthetic ankle joint to support the user's locomotion. The pneumatic actuator has multiple advantages over the traditional electric motor, such as light weight, low cost, and high power-to-weight ratio. The objective of this work is to develop a compact and lightweight transtibial prosthesis, leveraging the multiple advantages provided by this highly competitive actuator. In this paper, the design details of the prosthesis are described, including the determination of performance specifications, the layout of the actuation mechanism, and the calculation of the torque capacity. Through the authors’ design calculation, the prosthesis is able to provide sufficient range of motion and torque capacity to support the locomotion of a 75 kg individual. The controller design is also described, including the underlying biomechanical analysis and the formulation of the finite-state impedance controller. Finally, the human subject testing results are presented, with the data indicating that the prosthesis is able to generate a natural walking gait and sufficient power output for its amputee user. PMID:26146497

  11. Progressive upper limb prosthetics.

    PubMed

    Lake, Chris; Dodson, Robert

    2006-02-01

    The field of upper extremity prosthetics is a constantly changing arena as researchers and prosthetists strive to bridge the gap between prosthetic reality and upper limb physiology. With the further development of implantable neurologic sensing devices and targeted muscle innervation (discussed elsewhere in this issue), the challenge of limited input to control vast outputs promises to become a historical footnote in the future annals of upper limb prosthetics. Soon multidextrous terminal devices, such as that found in the iLimb system(Touch EMAS, Inc., Edinburgh, UK), will be a clinical reality (Fig. 22). Successful prosthetic care depends on good communication and cooperation among the surgeon, the amputee, the rehabilitation team, and the scientists harnessing the power of technology to solve real-life challenges. If the progress to date is any indication, amputees of the future will find their dreams limited only by their imagination. PMID:16517345

  12. Utilization of nickel-titanium shape memory alloy for stapes prosthesis

    Microsoft Academic Search

    Fujihiko Kasano; Tamotsu Morimitsu

    1997-01-01

    A new type of stapes prosthesis made of nickel-titanium shape memory alloy wire was developed and its biocompatibility was examined in 24 ears of 12 cats. The prosthesis was implanted at the long crus of the incus. The incus was examined 27–355 days after operation. In 23 ears, the prosthesis was found macroscopically well implanted at the aimed position. In

  13. Mind-Prosthesis Metaphor for Design of Human-Computer Interfaces That Support Better Attention Management

    E-print Network

    Corran, Ruth

    Mind-Prosthesis Metaphor for Design of Human-Computer Interfaces That Support Better Attention and the desktop metaphor in particular, we propose that the mind-prosthesis metaphor may be better suited in particular, we propose that the mind-prosthesis metaphor may serve as a guide for the design of future

  14. Extremely compliant and highly stretchable patterned graphene

    SciTech Connect

    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

    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.

  15. Preliminary Evaluations of a Self-Contained Anthropomorphic Transfemoral Prosthesis.

    PubMed

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

    2009-01-01

    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

  16. Device life of the Provox Vega voice prosthesis.

    PubMed

    Hancock, Kelli L; Lawson, Nadine R; Ward, Elizabeth C

    2013-03-01

    Device life of the Provox Vega Indwelling voice prosthesis is as yet untested outside Europe. The current study examined device life and reasons for replacement within an Australian clinical setting. Twenty-three participants were monitored for device life and reasons for replacement. Main outcome measure was days to failure of initial device. Average device life and reasons for replacement were secondary measures. Initial device life data revealed 67 % had functioning devices at 3 months, 52 % at 6 months and 29 % at 12 months. Average device life was 207 days (median of 222). The majority of devices (97 %) failed due to leakage through the prosthesis. The Provox Vega Indwelling voice prosthesis had favourable device life in this cohort of patients and in comparison to European data. Reasons for replacement were consistent with international literature. PMID:22941391

  17. Preliminary Evaluations of a Self-Contained Anthropomorphic Transfemoral Prosthesis

    PubMed Central

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

    2009-01-01

    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

  18. Multimodal sensor controlled three Degree of Freedom transradial prosthesis.

    PubMed

    Ohnishi, Kengo; Morio, Toshiyuki; Takagi, Tomoo; Kajitani, Isamu

    2013-06-01

    This paper describes the basic concept of our multimodal sensor control system for 3-Degree-of-Freedom transradial prosthesis. The target of developing the controller is to reduce the mental effort of planning operating multiple joints in the conventional multifunctional myoelectric controller and reduce the compensating motion of conventional myoelectric prosthesis. An accelerometer is installed in the socket and the angles of the gravitational force are computed to drive the pronation/spination joint and the palmar flexion/dorsifelxion joint of the prosthesis. A threshold On/Off control using the posture information is implemented with the triggering of a co-contraction EMG signal. Through experiment with able-body subjects, we confirmed that this controller has a potential of reducing compensating shoulder movements for pick-raise-place tasks, when compared to the task conducted with conventional locked-wrist prostheses. Yet modification is required for stability. PMID:24187284

  19. Spontaneous bilateral rod fracture of malleable penile prosthesis

    PubMed Central

    Bozkurt, Ibrahim Halil; Yonguc, Tarik; Arslan, Burak; Kozacioglu, Zafer; Degirmenci, Tansu; Polat, Salih; Minareci, Suleyman

    2014-01-01

    Mechanical failure with a malleable penile prosthesis is very rare. To the best of our knowledge, this is the first case reporting on a bilateral AMS 650 rod mechanical failure. We present a 50-year-old man with organic erectile dysfunction who experienced bilateral AMS 650 rod fracture after 14 years. The rod fracture of the left side was confirmed via X-ray preoperatively. The surgical exploration revealed a fracture of both rods. After the removal of both rods, we implanted a new malleable device during the same session. At the 6-month follow-up, the patient was satisfied with his prosthesis. PMID:25408816

  20. Prosthesis-preserving aortic root repair after aortic valve replacement.

    PubMed

    Hamamoto, Masaki; Kobayashi, Taira; Kodama, Hiroshi

    2015-07-01

    We describe a new technique of prosthesis-preserving aortic root replacement for patients who have previously undergone aortic valve replacement. With preservation of the mechanical prosthesis, we implant a Gelweave Valsalva graft using double suture lines. The first suture line is made between the sewing cuff of the mechanical valve and the graft, with mattress sutures of 2/0 braided polyester with pledgets. After the first sutures are tied, the second suture line is created between the graft collar and the aortic root remnant with continuous 4/0 polypropylene sutures. PMID:25186426

  1. An evaluation of the wire mesh prosthesis in primary reconstruction of the mandible.

    PubMed

    Terz, J J; Bear, S E; Brown, P W; Watkins, J; Lawrence, W

    1978-06-01

    A stainless steel wire mesh prosthesis was used as a primary mandibular replacement in 102 patients after resection of malignant neoplasms arising in the head and neck. In sixty-seven patients the prosthesis was considered successful. Failure of the host to tolerate the prosthesis was associated with a history of previous irradiation, extensive resections, and loss of distant skin flaps used for coverage of the prosthesis. We conclude that the wire mesh mandibular prosthesis is an excellent means to accomplish prompt functional and cosmetic reconstruction after mandibular loss and does not preclude the use of a more complex modality of reconstruction if the initial implant is removed. PMID:665910

  2. Prosthetic Rehabilitation of a Patient with Ocular Defect using Semi-customized Prosthesis: A Case Report

    PubMed Central

    Putanikar, Nagaraj Y.; Patil, Anandkumar G.; Shetty, Pavithra K.; Nagaral, Suresh; Mithaiwala, Hatimali I.

    2015-01-01

    Severe physical and psychological distress occurs due to disfigurement caused by loss of eye. Ocular prosthesis is the only mode of rehabilitation for the missing eye. There are different materials and techniques used for the fabrication of the same. Resin proved to be the better among the available materials. Either using the stock eye or using customized ocular prosthesis has their own advantages and disadvantages. Through our clinical report, we have fabricated a semi-customized ocular prosthesis with stock iris and customized sclera. This prosthesis had the advantages of both stock and custom ocular prosthesis providing functionally and esthetically satisfactory result. PMID:25954078

  3. Intralbugineous testicular prosthesis, a new technique. Summary of 30 implants.

    PubMed

    Aguilera, R G; López, J P; Aldosa, R R; Rius-Espina, G

    1990-01-01

    A study of 16 patients who underwent intralbugineous testicular implants during the practice of orchiectomy is presented. In 14 cases of prostatic carcinoma, after bilateral subcapsular orchiectomy intralbugineous prostheses were implanted and in 2 other cases of testicular torsion unilateral prosthesis was implanted. With this new, easily executed technique the size, mobility and testicular sensibility are maintained. PMID:2228499

  4. An integrated methodology for the functional design of dental prosthesis

    Microsoft Academic Search

    R. Meneghello; G. Savio; R. Raffaeli; A. Cerardi; M. Turchetto; L. Planchenstainer

    2012-01-01

    In this work it is proposed an integrated methodology for the functional design and simulation of removable complete dentures. This methodology develops in four phases: virtual and physical prototyping, contact forces and areas analysis and functional optimization of teeth and arches geometry. A virtual environment for the modeling of the prosthesis (NM-Tooth) was developed: it includes a database of 3D

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

    Microsoft Academic Search

    R. Giacomo; R. Dini; G. Franceschini; C. Maiorana

    2010-01-01

    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,

  6. [Medial unicompartmental knee prosthesis for patients with unicompartmental gonarthrosis

    Microsoft Academic Search

    N. P. Kort; R. Deutman; J. J. van Raay; J. R. van Horn

    2004-01-01

    The function and survival time of unicompartmental knee prostheses for patients with severe gonarthrosis have been improved the past few years by developments in their design, the instrumentarium and the surgical technique. A medial unicompartmental knee prosthesis may be indicated in patients with arthrosis of the medial tibiofemoral compartment. The prerequisites are an intact anterior cruciate ligament, an intact lateral

  7. Role of cytokines in gonarthrosis and knee prosthesis aseptic loosening

    Microsoft Academic Search

    Maria Paola Loria; Porzia Dambra; Biagio Moretti; Vittorio Patella; Laura Capuzzimati; Elsa Cavallo; Eustachio Nettis; Vito Pesce; Adriana Dell’Osso; Carmelo Simone; Alfredo Tursi

    2004-01-01

    Cytokines, which have been demonstrated in synovial fluids during various joint diseases, play an important role in mediating synovial inflammation and in regulating the immune response of many inflammatory processes. We studied synovial fluid, serum, and synovial fragments obtained from 33 patients—10 affected by serious gonarthrosis re-quiring a prosthetic implant, 8 with knee prosthesis aseptic loosening, and (as controls) 15

  8. FPGA-Based Video Processing for a Vision Prosthesis

    E-print Network

    Diessel, Oliver

    FPGA-Based Video Processing for a Vision Prosthesis Benjamin Kwek1 , Freddie Sunarso1 , Melissa implanted within the retina of an impaired eye. This FPGA prototype ensures the processing is fast, accurate is transferred to the retina. Fig. 3 illustrates two such phases. Both FPGA- and processor-based image processing

  9. Two approaches to the optic nerve visual prosthesis

    Microsoft Academic Search

    Delbeke J; Obeid I; Duret F; Veraart C

    Two volunteers have been implanted with an optic nerve visual prosthesis. In the first case, the spiral cuff electrode was wound around the intracranial segment of the patient's optic nerve. While the system is further improved, functional results are very encouraging In an endeavour to develop a less invasive procedure, the electrode was placed on the intraorbital optic nerve in

  10. Infection after total knee prosthesis - The surgeon's point of view

    Microsoft Academic Search

    J.-Y. Jenny; J. Gaudias; G. Jenny

    1998-01-01

    Summary Infection of a knee prosthesis leads to specific problems in relation to the function of the knee joint and its superficial location in comparison with the better known infection after total hip replacement. Every joint replacement is a foreign body which promotes a reaction of the host organism. The important and dangerous period for infection is the initial period

  11. Electronic implementation of a speech processing system for auditory prosthesis

    Microsoft Academic Search

    Bouafif Lamia; Ouni Kais; ELLOUZE Noureddine

    2010-01-01

    In this paper we present the conception and the implementation of a speech processing interface for auditory prosthesis. This module is based on a numerical speech processing algorithm which modelizes the infected ear and generates the stimulus signals for the cilia cells. This interface uses a gammachirp filter bank (G.F.B) constituted of 16 band pass filters based on IIR filters.

  12. [Laparoscopic treatment of abdominal wall hernias: prosthesis material comparison].

    PubMed

    Biondi, A; Tropea, A; Monaco, N; Musmeci, G; Basile, G; Basile, F

    2011-12-01

    Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude from normal boundaries. Hernias are repaired by implanting a sterile surgical mesh to strengthen the weakened abdominal wall. Aim of this study is to compare the results obtained by bard Composix® L/P mesh or Dualmesh Plus Gore® implanting. The mesh has various beneficial characteristics. It is a reinforcing material for the abdominal wall, even when in the direct contact with the intestinal tract does not cause adhsion problems. The use of biocompatible materials is necessary in laparoscopic hernia repair. e-PTFE prosthesis and Dual Mesh® were the first to be used for laparoscopic treatment of the abdominal wall defects. These prosthesis are the result of many improvements, actually they are 1-mm thick and the two surfaces have different characteristics. Compound meshes are composed by e-PTFE and polypropylene with different percentage of the two materials and methods of interactions. The incidence of early complications were poor in relation to both types of implants, only seroma cases e-PTFE treated showed a prevalence of complication, in agreement with literature. About relapses in our experience we found that e-PTFE cases were predominantly. Dual Mesh® has better adaptability than Bard Composix®, which allows easier placement of the prosthesis as well as a better adaptation to the wall surface. The Bard Composix®, thanks to rigidity due to the polypropylene component has better handling than the Dual Mesh®, as it promotes a rapid and easy deployment of the prosthesis inside the abdominal cavity, favoring its positioning. The use of both prosthesis depends also on the experience specific to each operator, moreover, a rigorous surgical technique remains fundamental for the application of the mesh used. PMID:22233661

  13. Key Parameters Evaluation for Hip Prosthesis with Finite Element Analysis

    NASA Astrophysics Data System (ADS)

    Guo, Hongqiang; Li, Dichen; Lian, Qin; Li, Xiang; Jin, Zhongmin

    2007-09-01

    Stem length and cross section are two key parameters that influence the stability and longevity of metallic hip prosthesis in the total hip arthroplasty (THA). In order to assess their influence to the stress and fatigue behavior of hip prosthesis, a series model of hip prosthesis with round-shaped or drum-shaped cross section, and with different stem lengths were created. These models were analyzed under both static and dynamic loading conditions with finite element analysis, and dynamic loading represents normal walking was used in the dynamic analysis. The stress on the metallic stem, cement, and adjacent bone were got, micromotion on the cement-metal interface were got too. Safety factors for fatigue life of the hip prothesis were calculated based on data obtained from dynamic analysis. Static analysis shows that drum-shaped cross section can decrease the displacement of the stem, that stress on drum-shaped stem focus on the corner of the femoral neck and the distal part of hip prosthesis, whereas the stress on the round-shaped stem distributes evenly over most part of the stem, and maximum stress on stem prosthesis fluctuates with stem length bottoming out at stem length range from 80 mm to 110 mm, that drum-shaped stems with drum height 8 mm generate more stress at the distal part of stem than drum-shaped stems with drum height 10 mm and round stems do. Dynamic and fatigue analysis shows that drum-shaped stem with drum height 10 mm and stem length 90 mm has the greatest safety factor therefore long fatigue life.

  14. Extreme Tourism

    E-print Network

    Hacker, Randi

    2013-03-13

    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 ...

  15. A novel five degree of freedom user command controller in people with spinal cord injury and non-injured for full upper extremity neuroprostheses, wearable powered orthoses and prosthetics.

    PubMed

    Scott, Timothy R D; Vare, Veronica A

    2013-03-01

    An independent lifestyle requires the ability to place the hand in the complete workspace in concert with hand grasp and release. A novel user command controller monitoring head position for purpose of controlling hand location and orientation is proposed and demonstrated. The controller detected five degrees of freedom which were applied to upper limb movements including forearm and hand placement in three-dimensional space. The controller was evaluated by having subjects complete tracking tasks manipulating a simulated on-screen upper limb representation. Thirteen of the eighteen subjects assessed using the controller had sustained a spinal cord injury at or above the sixth cervical vertebra. Two of the injured subjects with decreased cervical spine mobility were unable to operate the controller. The remaining subjects performed the tracking tasks effectively after minimal training. This simple five-degree of freedom controller has been proposed for the use by those disabled by upper limb amputation, paralysis, weakness or hypertonicity. PMID:23238829

  16. Mineralogy under extreme conditions

    SciTech Connect

    Shu, Jinfu (CIW)

    2012-02-07

    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.

  17. False-positive indium-111 labeled leukocyte scintigram in a patient with a painful hip prosthesis

    SciTech Connect

    Feldman, N.; Makler, P.T. Jr.; Alavi, A.

    1986-01-01

    A Tronzo hip prosthesis is designed to elicit an inflammatory reaction in order to promote prosthesis stability. A three-phased bone scan and Ga-67 imaging in conjunction with physical examination and laboratory findings failed to demonstrate evidence for osteomyelitis in a patient with a painful hip prosthesis, in whom images obtained with In-111-labeled leukocytes were positive. This observation demonstrated that the interpretation of the latter technique in demonstrating inflammation can cause a false impression of an infectious process.

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

    NASA Astrophysics Data System (ADS)

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

    2012-10-01

    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.

  19. Research and development of a versatile portable speech prosthesis

    NASA Technical Reports Server (NTRS)

    1981-01-01

    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.

  20. Midterm clinical results of the Autocentric II patellofemoral prosthesis.

    PubMed

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

    2009-12-01

    We studied the outcome of patellofemoral arthroplasties using the Autocentric prosthesis implanted in our clinic between 1994 and 2004. New insight on indications and contraindications motivated us to find risk factors in the failure of this prosthesis. Twenty-four patients had surgery for patellofemoral arthritis not responding to exhaustive nonoperative measures. The mean age at the time of patellofemoral arthroplasty (PFA) was 63.4 (SD 11.3, range 38-81) years with a mean follow-up of 4.8 (SD 2.9, range 2-11) years. Additional interventions were necessary in 21 knees during follow-up in our population, and seven knees required total knee arthroplasty (TKA) mainly due to progressive tibiofemoral osteoarthritis and maltracking of the patella. The patient outcomes and quality of life scores showed disappointing results, even after revision to TKA. This retrospective analysis underlines the importance of strict indications for patellofemoral arthroplasty and, in particular, of contraindications. PMID:19224212

  1. de Sitter extremal surfaces

    E-print Network

    K. Narayan

    2015-05-25

    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 also find 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. The area has structural resemblance with entanglement entropy in a dual $CFT$. 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 surfaces that go from one asymptotic universe to the other through the Cauchy horizons.

  2. Implant-retained cantilever fixed prosthesis: Where and when

    Microsoft Academic Search

    Curtis M. Becker; David A. Kaiser

    2000-01-01

    Statement of Problem. Many clinical situations are suitably treated with cantilevered implant-supported cemented fixed restorations. Purpose. This article details the indications for the restorative dentist to use a cantilever fixed prosthesis after insertion of ITI dental implants. Conclusion. The use of implants to support cantilevered fixed partial dentures has been successful in selected clinical situations. (J Prosthet Dent 2000;84:432-5.)

  3. Penile Enhancement Procedures with Simultaneous Penile Prosthesis Placement

    PubMed Central

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

    2012-01-01

    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

  4. Simulation-Based Stress Analysis for a 3D Modeled Humerus-Prosthesis Assembly

    NASA Astrophysics Data System (ADS)

    Herle, S.; Marcu, C.; Benea, H.; Miclea, L.; Robotin, R.

    The development of mechanical models of the humerus-prosthesis assembly represent a solution for analyzing the behavior of prosthesis devices under different conditions; some of these behaviors are impossible to reproduce in vivo due to the irreversible phenomenon that can occur. This paper presents a versatile model of the humerus-prosthesis assembly. The model is used for stress analysis and displacement distributions under different configurations that correspond to possible in vivo implementations later on. A 3D scanner was used to obtain the virtual model of the humerus bone. The endoprosthesis was designed using 3D modeling software and the humerus-prosthesis assembly was analyzed using Finite Element Analysis software.

  5. [Total hip replacement with isoelastic prosthesis in animals (author's transl)].

    PubMed

    Muhr, O; Stockhusen, H; Müller, O

    1976-10-01

    Uncemented fixation and low-fraction materials are the basis of this experiment. Plastics with an elasticity similar to the bone ("isoelasticity") show very propitious material qualities. The direct cementless incorporation of test bodies must be checked. In 63 sheep isoelastic total hip joints were implanted. After 2 till 51 weeks the animals were sacrificed and 44 specimen of hips and organs were explored macroscopically, radiologically, spherimetrically and histologically. The result was: 1. Plastic hip prosthesis are incorporated in the bone, but the boundary layer is built by a collagenous fiber tissue. 2. Loosening brings resoption of the bone and expansion of the structural changed soft tissue. 3. The transformation of the femoral cortex to osteoporosis is considered possibly as the consequence of an insufficient biological transfer of the weight. 4. Fractures of the femoral prosthesis-stem could not be observed. 5. The radiology allows at the pelvis prosthesis a concret statement concerning stability, on the femoral part a probable one. 6. The abrasion is minimal, the tissue reaction to abrasion products is unessential. 7. Small abrasion particles are carried of by the lymph tract and stored in the first regional gland. A more distant spreading is not demonstrable. PMID:985179

  6. Friction in femoral prosthesis and photoelastic model cone taper joints.

    PubMed

    Fessler, H; Fricker, D C

    1989-01-01

    Static axial push-on and lift-off, and push-on and twist-off experiments were designed and performed to measure the effective, room-temperature coefficient of friction mu for different design femoral prosthesis cone taper joints comprising a universal head on a stem spigot. Alumina and metal heads were tested on metal spigots using either distilled water, Ringer's solution, blood or no lubricant. Complementary push-on and lift-off friction tests of Araldite model joints for subsequent frozen-stress, photoelastic stress analysis were performed at 130 degrees C. It was found that lubricant caused little decrease in the values of the coefficient of friction in prosthesis tapers. The values measured were typically mu = 0.2 for an alumina head on a Co-Cr-Mo or Ti-6Al-4V spigot, mu = 0.15 for a Co-Cr-Mo head on a Co-Cr-Mo or Ti-6Al-4V spigot and mu = 0.13 for a stainless steel head on a stainless steel spigot. For Araldite photoelastic models of an alumina head on a Vitallium spigot, as-cast taper surfaces lubricated with silicone grease gave consistent friction of typically mu = 0.14. The axial displacement of model heads on their spigots were compared with predicted values and previously measured values for prosthesis heads. PMID:2712949

  7. Restoration of function after brain damage using a neural prosthesis

    PubMed Central

    Guggenmos, David J.; Azin, Meysam; Barbay, Scott; Mahnken, Jonathan D.; Dunham, Caleb; Mohseni, Pedram; Nudo, Randolph J.

    2013-01-01

    Neural interface systems are becoming increasingly more feasible for brain repair strategies. This paper tests the hypothesis that recovery after brain injury can be facilitated by a neural prosthesis serving as a communication link between distant locations in the cerebral cortex. The primary motor area in the cerebral cortex was injured in a rat model of focal brain injury, disrupting communication between motor and somatosensory areas and resulting in impaired reaching and grasping abilities. After implantation of microelectrodes in cerebral cortex, a neural prosthesis discriminated action potentials (spikes) in premotor cortex that triggered electrical stimulation in somatosensory cortex continuously over subsequent weeks. Within 1 wk, while receiving spike-triggered stimulation, rats showed substantially improved reaching and grasping functions that were indistinguishable from prelesion levels by 2 wk. Post hoc analysis of the spikes evoked by the stimulation provides compelling evidence that the neural prosthesis enhanced functional connectivity between the two target areas. This proof-of-concept study demonstrates that neural interface systems can be used effectively to bridge damaged neural pathways functionally and promote recovery after brain injury. PMID:24324155

  8. A cortical neural prosthesis for restoring and enhancing memory

    PubMed Central

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

    2011-01-01

    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. PMID:21677369

  9. Impact of removable partial denture prosthesis on chewing efficiency

    PubMed Central

    BESSADET, Marion; NICOLAS, Emmanuel; SOCHAT, Marine; HENNEQUIN, Martine; VEYRUNE, Jean-Luc

    2013-01-01

    Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described. Objectives The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters. Material and Methods Nineteen removable partial denture prosthesis (RPDP) wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I). All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Number of chewing cycles (CC), chewing time (CT) and chewing frequency (CF=CC/CT) were video recorded. Results With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP), F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01). With or without RPD, the boluses' granulometry values were above the masticatory normative index (MNI) determined as 4,000 µm. Conclusion RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function. Clinical relevance This study encourages the clinical improvement of oral rehabilitation procedure. PMID:24212983

  10. Extreme Science

    NSDL National Science Digital Library

    Brought to the Web by ExtremeScience.com, this is a "gee whiz" site for all enthusiasts of scientific drama (be it Mother Earth or the Creature World). From the highest elevation to the deepest cave, from the deadliest creature to the oldest living thing, this site provides color images and interesting facts (some useful scientific ones too) on a slew of natural extremes. Additional recommended sites are provided in a hyperlinked list at the end of each section, for those eager to learn more.

  11. Extreme superstarclusters

    E-print Network

    Paul P. van der Werf; Leonie Snijders

    2006-01-19

    The presence of superstarclusters is a characteristic feature of starburst galaxies. We examine the properties of star forming regions and young star clusters in various environments, ranging from common to extreme. We then discuss new high spatial resolution mid-infrared imaging and spectroscopy of extreme superstarclusters in the obscured region of the Antennae (NGC4038-4039). We find that the PAH emission in this region is not dominated by the superstarclusters but is mostly diffuse. Emission line ratios found in our high spatial resolution data differ significantly from those in larger apertures, strongly affecting the derived results.

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

    PubMed

    Judy, Jack W

    2012-03-01

    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

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

    Microsoft Academic Search

    Jack W. Judy

    2012-01-01

    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

  14. Extreme Ice

    NSDL National Science Digital Library

    Margy Kuntz

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

  15. Extreme Users WHY engage with extreme users

    E-print Network

    Prinz, Friedrich B.

    Extreme Users METHOD WHY engage with extreme users HOW to engage extreme users Designers engage inspiration from their work-arounds and frameworks. When you speak with and observe extreme users, their needs extreme users are often also needs of a wider population. Determine who's extreme Determining who

  16. 21 CFR 888.3560 - Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis...Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis...knee joint patellofemorotibial polymer/metal/polymer semi-constrained...

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

    PubMed

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

    2012-04-01

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

  18. [Restoring the tracheal lumen in the scar closure of its upper part by lysing of the cartilaginous frame].

    PubMed

    Bystrenin, V A; Bystrenin, A V

    1998-01-01

    Reestablishment of the tracheal lumen in its scarring is described. External approach is used to dissect scars in the trachea. The laryngotracheal prosthesis (water-filled cylindric latex balloon fixed to the tracheotomy tube) is placed in the lumen until epithelized (at least for 4 months). The plates 10 mm in size are cut off the rib auto-cartilage, formed as a ring and fixed on the teflon coils which are inserted in the tissues of the anterior abdominal wall for a month. Thus, the plates acquire a stable semi-ring form. Without removal of the laryngotracheal prosthesis, the semi-rings are implanted into the tissues around the upper tracheal part. The laryngotracheal prosthesis is removed 1 month after this. The trachea was reconstructed in 3 patients by this procedure. All of them resumed normal natural breathing. PMID:10081394

  19. Kinematics and laxity of the Souter-Strathclyde total elbow prosthesis

    Microsoft Academic Search

    Alberto G. Schneeberger; Graham J. W. King; Seok-Whan Song; Shawn W. O'Driscoll; Bernard F. Morrey; Kai-Non An

    2000-01-01

    The motion pattern and laxity of 8 cadaveric elbows were recorded with a 3-dimensional electromagnetic tracking device before and after the Souter-Strathclyde total elbow prosthesis was implanted. The Souter-Strathclyde prosthesis replicates the valgus-varus motion pattern of the intact elbow but causes a significant internal rotation of the ulnar shaft of 8.9° ± 4.1° (P

  20. Psychosocial follow-up of penile prosthesis implant patients and partners

    Microsoft Academic Search

    Leonore Tiefer; Beth Pedersen; Arnold Melman

    1988-01-01

    One to four years after penile prosthesis surgery, detailed medical and psychosocial interviews were conducted separately with 52 patients and 22 of their partners. Patients tended to be negative or disappointed about postoperative pain, penis size, postoperative sexual frequency, and prosthesis malfunctions. Positive comments emphasized the psychological benefits of renewed masculine self-esteem, repair of humiliation, and reduction of marital guilt.

  1. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 false Hip joint metal/polymer semi-constrained cemented prosthesis...Devices § 888.3350 Hip joint metal/polymer semi-constrained cemented prosthesis...Identification. A hip joint metal/polymer semi-constrained cemented...

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

    Microsoft Academic Search

    Jill Hahl; Minoru Taya; Makoto Saito

    2000-01-01

    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

  3. Bionic anklefoot prosthesis normalizes walking gait for persons with leg amputation

    E-print Network

    Herr, Hugh

    Bionic ankle­foot prosthesis normalizes walking gait for persons with leg amputation Hugh M. Herr1 comparable to a biological limb. People with a leg amputation using such commercially available passive and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed

  4. Fretting Corrosion Damage of Total Hip Prosthesis: Friction Coefficient and Damage Rate Constant Approach

    E-print Network

    Boyer, Edmond

    1 Fretting Corrosion Damage of Total Hip Prosthesis: Friction Coefficient and Damage Rate Constant Building, University Park 16802 PA USA 4 Chair Professor Center for Research Excellence in Corrosion hip prosthesis. Fretting corrosion tests were conducted with stainless steel and poly (methyl

  5. Studies on the feasibility of a subretinal visual prosthesis: data from Yucatan micropig and rabbit

    Microsoft Academic Search

    Hartmut N. Schwahn; Florian Gekeler; Konrad Kohler; Karin Kobuch; Helmut G. Sachs; Frank Schulmeyer; Wolfgang Jakob; Veit-Peter Gabel; Eberhart Zrenner

    2001-01-01

    Background: To estimate the feasibility of the subretinal concept of a visual prosthesis, animal models and prototypes, each representing a certain aspect of the final prosthesis, were utilised to test for requirements for such a medical device: (1) the ability to elicit - by electrical stimulation - event-related central activity in the central visual system, and (2) the long-term biocompatibility

  6. "Wrap technique": a new operative procedure using a self-adhesive prosthesis for laparoscopic ventral rectopexy.

    PubMed

    Gravié, J-F; Maigné, C

    2015-06-01

    The aim of the present study was to describe and assess a new method of fixation using a self-adhesive prosthesis (Adhesix™) in laparoscopic ventral rectopexy (LVR). The technical principles are based on a very low dissection and the adhesive properties of the prosthesis which can be applied to the rectum without stitches or staples. The prosthesis is made from polypropylene coated with a synthetic hydrogel. The binding of the prosthesis to rectum and vagina takes place in a wet environment after a few minutes and enables the shaping of the mesh on the surface of the rectum (wrap effect). Between March 2010 and March 2013, 41 patients were operated on using LVR with a self-adhesive prosthesis. The effectiveness of prosthesis fixation was evaluated in a subset of 27 patients suffering from complete rectal prolapse. With a median follow-up of 30 months, there were no major complications and no recurrence. In this initial experience, LVR with a self-adhesive prosthesis does not increase the risk of recurrence. No undesirable effects were associated with the prosthesis. PMID:25847195

  7. Bone ingrowth in a shoulder prosthesis E.M.van Aken

    E-print Network

    Vuik, Kees

    and to relief the pain, a prosthesis to replace the glenoid of the shoulder joint is an option. The shoulderBone ingrowth in a shoulder prosthesis E.M.van Aken 1107895 emvanaken@hotmail.com Delft, 2006 arthritis or severe trauma from a shoulder fracture, it is possible that the shoulder joint dysfunctions

  8. Suspensory apparatus prosthesis in the horse. Part 1: In vitro mechanical properties.

    PubMed

    Major, M D; Grant, B D; White, K K; Ratzlaff, M H; Gallina, A M; Crawley, G R

    1992-01-01

    Mechanical properties of equine suspensory apparatus preparations and three braided synthetic prostheses were evaluated in vitro. Force versus displacement plots and failure modes were recorded from single load-to-failure testing in 18 cadaver limbs before and after replacement of each suspensory apparatus with a prosthesis. Mean load at failure, energy to failure, and stiffness values of polytetrafluoroethylene (PTFE) prostheses were lower than those of the suspensory apparatus and aramid prosthesis. The PTFE prosthesis failed by elongation or rupture of the prosthesis. Mechanical properties of the aramid prosthesis with collar augmentation were not significantly different from the suspensory apparatus. The main site of failure in both aramid prostheses was at the screw fixation to bone. PMID:1626381

  9. Using 'stall detection' as an auxiliary mechanism for sensing obstacles and hand grasping in arm prosthesis.

    PubMed

    Moreno, D; Ramirez-Garcia, A; Leija, L; Munoz, R; Vera, A; Toledo, C

    2010-01-01

    This paper proposes a novel method for sensing obstacles and hand grasping activities in electromechanical arm prosthesis. The described method is based on indirectly sensing 'Stall' condition in prosthesis actuators through hall-effect sensors already embedded on its dc motors, thus not requiring external sensors. To test the proposed methodology, an electromechanical arm prosthesis of 3 degrees of freedom (DOF), plus 'open-close' of hand, which is being developed at CINVESTAV Mexico, was used. At the end of this paper, experimental measurements performed on the tested prosthesis, using and non using 'Stall Detection', are shown. We demonstrated that methodology can be used successfully for "sensing obstacles", but it cannot be used alone for "hand grasping". In any case, this technique demonstrated to be a good method to simplify and strengthen control of prosthesis. PMID:21095655

  10. Two-piece denture-obturator prosthesis for a patient with severe trismus: a new approach.

    PubMed

    Mishra, Niraj; Chand, Pooran; Singh, Raghuwar Dayal

    2010-12-01

    Prosthetic intervention with maxillary obturator prosthesis is necessary to restore the contours of resected palate and to recreate the functional separation of the oral cavity and sinus and nasal cavity. Trismus occurs most frequently in maxillectomy patient following surgical procedure. Absence of graft placement and healing by secondary intention always results in healing contracture and trismus. Trismus could also be a result of post radiation sclerosis and scarring of muscles. Two-piece denture-obturator prosthesis is an alternative management to conventional acrylic resin obturator prosthesis for the patient with severe trismus as patient could not insert a large prosthesis in the mouth. The use of flexible or resilient material affords the opportunity to engage in undercut areas, needed to help in the retention of the prosthesis, without causing trauma to the soft, often sensitive, and easily irritable tissues. PMID:22131672

  11. An “Uncrimped” SMart Stapes Prosthesis: A Cause of Late Hearing Deterioration in Otosclerosis

    PubMed Central

    Randhawa, Premjit S.; Hamilton, Nicholas; Narula, Antony A.

    2012-01-01

    Statement of Problem. Stapedotomy is the treatment of choice for otosclerosis. Numerous techniques and prosthesis are available to perform this procedure. Success rates of surgery vary from 17% to 80%, and revision surgery carries an increased risk of complications as well as poorer hearing outcomes. Method of Study. Case report. Results. We report the first case of uncrimping of a SMart stapes prosthesis with no lateral displacement as a cause of late failure despite successful crimping and improvement in audiological outcomes after initial surgery. Conclusion. The SMart stapes prosthesis is widely used and has been shown to be safe and provide good hearing outcomes. Displacement of a stapes prosthesis is the commonest cause of failure. Our case shows that deterioration of hearing thresholds can occur from uncrimping of the prosthesis with no displacement. It is important to improve our understanding of stapedotomy failure as revision procedures are associated with poorer outcomes. PMID:22431926

  12. Tubing Erosion of an Inflatable Penile Prosthesis Long after Implantation

    PubMed Central

    Morales, Alvaro

    2014-01-01

    Introduction Erosion through skin of connecting tubing of an inflatable penile prosthesis (IPP) has not been previously reported. Aim The aim of this study was to present a case of tubing erosion, review the pertinent literature, and discuss the possible causes and management options, including preservation of the device and its components. Methods A 42-year-old male failing to respond to medical treatment for erectile dysfunction underwent insertion of an AMS 700 IPP in 1986. Six years later, a revision was necessary because of a leak in the right cylinder and 4 years after, the pump was replaced. Fourteen years after the original implant, he presented with a portion of the tube connecting the pump to the right cylinder eroding through the skin. There was no infection. The skin area involved was resected and the original pump and tubing were buried in a new scrotal pocket after thorough irrigation. Results The IPP remained in place, allowing vaginal penetration and without infection for another 11 years. Three years later, it was de-functionalized, converted into a fixed volume device. It eventually was replaced 25 years after originally implanted with a semirigid prosthesis because it did not provide sufficient rigidity and because of concerns about the presence of “screws” detected during pelvic imaging. Conclusions Mechanical failures in the early IPP models, as illustrated in this case, were expected. However, the long survival of the device is remarkable. Erosion of the connecting tubing through the skin is unique and, under exceptional circumstances, may be managed conservatively without replacing components of the IPP. Clinicians unfamiliar with procedures involving inflatable devices need to be aware of “foreign bodies” visible in radiological examinations in men who have had revisions of an IPP. Morales A. Tubing erosion of an inflatable penile prosthesis long after implantation. Sex Med 2014;2:103–106. PMID:25356305

  13. Patellofemoral arthroplasty with a custom-fit femoral prosthesis.

    PubMed

    Butler, James E; Shannon, Robert

    2009-02-01

    We reviewed the outcomes of a series of patellar arthroplasty operations with custom-fit femoral prostheses to examine the effectiveness of this procedure in relieving pain and restoring function in the knee. Twenty-two patellofemoral arthroplasty operations were performed in 21 patients (mean age, 48.6 years) at 2 institutions between 1994 and 2002. All patients had advanced patellofemoral arthritis and had undergone an average of 2.5 previous patellofemoral operations. The prosthesis, consisting of a custom-fit chrome cobalt trochlear component and an all-polyethylene patellar button, was implanted in a procedure designed to minimize bone resection. Patients later underwent three-view radiography of the knee to confirm that the prosthesis was positioned correctly. One patient required revision of an undersized patellar button 18 months postoperatively, and 2 other patients had postoperative arthrofibrosis necessitating arthroscopic debridement. No patient required revision of the trochlear component, and no loosening or migration of any component has been found since the first procedure was performed. However, the polyethylene patellar button has worn in 3 patients, and the patella broke in 1 patient. An average of 60 months postoperatively, patients used the Western Ontario and McMaster Universities Osteoarthritis Index to rate their preoperative and present joint pain, stiffness, and function. Patients' mean overall ratings (potential range, 24-96) were significantly lower for their present symptoms (28.4) than for their preoperative symptoms (63.4). Mean scores on each subscale also decreased: from 13.0 to 5.5 for pain, from 5.4 to 2.4 for stiffness, and from 45.0 to 20.6 for function. We conclude that, in carefully selected patients, patellofemoral arthroplasty with a custom-fit prosthesis is a viable surgical treatment for isolated patellofemoral arthritis. PMID:19301809

  14. Cochlear implantation: a biomechanical prosthesis for hearing loss

    PubMed Central

    Yawn, Robert; Hunter, Jacob B.; Sweeney, Alex D.

    2015-01-01

    Cochlear implants are a medical prosthesis used to treat sensorineural deafness, and one of the greatest advances in modern medicine. The following article is an overview of cochlear implant technology. The history of cochlear implantation and the development of modern implant technology will be discussed, as well as current surgical techniques. Research regarding expansion of candidacy, hearing preservation cochlear implantation, and implantation for unilateral deafness are described. Lastly, innovative technology is discussed, including the hybrid cochlear implant and the totally implantable cochlear implant. PMID:26097718

  15. A dual mode FPGA design for the hippocampal prosthesis.

    PubMed

    Li, Will X Y; Chan, Rosa H M; Song, Dong; Berger, Theodore W; Cheung, Ray C C

    2012-01-01

    One important step towards the cognitive neural prosthesis design is to achieve real-time prediction of neuronal firing pattern. An FPGA-based hardware computational platform is designed to guarantee this hard real-time signal processing requirement. The proposed platform can work in dual modes: generalized Laguerre-Volterra model parameters estimation and output prediction, and can switch between these two important system functions. Compared with the traditional software-based platform implemented in C, the hardware platform achieves better efficiency in doing the biocomputations by up to thousandfold speedup in this process. PMID:23366947

  16. Prosthesis?patient mismatch: definition, clinical impact, and prevention

    PubMed Central

    Pibarot, P; Dumesnil, J G

    2006-01-01

    Prosthesis?patient mismatch (PPM) is present when the effective orifice area of the inserted prosthetic valve is too small in relation to body size. Its main haemodynamic consequence is to generate higher than expected gradients through normally functioning prosthetic valves. This review updates the present knowledge about the impact of PPM on clinical outcomes. PPM is common (20–70% of aortic valve replacements) and has been shown to be associated with worse haemodynamic function, less regression of left ventricular hypertrophy, more cardiac events, and lower survival. Moreover, as opposed to most other risk factors, PPM can largely be prevented by using a prospective strategy at the time of operation. PMID:16251232

  17. Sensitivity analysis of a novel five-degrees-of-freedom user command controller in people with spinal cord injury and non-injured for full upper extremity neuroprosthesis, wearable powered orthoses and prosthetics.

    PubMed

    Scott, Timothy R D; Vare, Veronica A

    2015-06-01

    Sensitivity analysis for a user command controller monitoring head position for artificial control of the proximal upper limb was performed. The controller was evaluated by having subjects complete target matching tasks manipulating a simulated on-screen hand representation to investigate the effects of target location and target speed on performance. Sixteen subjects took part in the study, 11 of whom had sustained cervical spinal cord injuries. The subjects were able to control the on-screen hand with overall low sensitivity of performance with the controller to target position in its five-degrees-of-freedom. The optimal speed was found to be a compromise between low speed and high accuracy but longer completion time and fast speed for short completion time with lower accuracy. The results demonstrated the robustness of the controller across a population of non-injured subjects and those with tetraplegia. PMID:25742876

  18. NOTE: How accurate is a CT-based dose calculation on a pencil beam TPS for a patient with a metallic prosthesis?

    Microsoft Academic Search

    Ralph Roberts

    2001-01-01

    The accuracy of a CT-based dose calculation on a treatment planning system (TPS) for a radiotherapy patient with a metallic prosthesis has not previously been reported. In this study, the accuracy of the CT-based inhomogeneity correction on a pencil beam TPS (Helax TMS) was determined in a phantom containing a metallic prosthesis. A steel prosthesis phantom and a titanium prosthesis

  19. Extreme Microlensing

    E-print Network

    Andrew Gould

    1996-03-27

    Extreme microlensing events, defined as events with maximum magnification $A_\\max\\gsim 200$ are a potentially powerful probe of the mass spectrum and spatial distribution of objects along lines of sight toward the Galactic bulge. About 75 yr${}^{-1}$ such events are expected for main-sequence sources with $I_0<19$. For many of these it is possible to measure both a ``proper motion'' and a ``parallax'' which together would yield individual mass, distance, and transverse-speed determinations of the lensing object. The proper motion is determined from finite-source effects when the lens transits, or nearly transits the source. The parallax is determined by observing the difference in the light curve as seen from two Earth observatories separated by about 1 Earth radius, $R_\\oplus$. The size of the parallax effect is $\\sim A_\\max R_\\oplus/\\tilde r_e$ where $\\tilde r_e$ is the projected Einstein radius. This can be of order 1\\%. Detection of candidate events requires a pixel-lensing search of the entire bulge once per day, preferably by at least two observatories on different continents. Follow-up observation must be carried using optical/infrared photometry, with short (e.g.\\ 1 minute) exposures on small ($\\gsim 1$ m) telescopes. Extreme microlensing observations toward the Large Magellanic Cloud do not appear feasible at the present time.

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

    Microsoft Academic Search

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

    2001-01-01

    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

  1. Simultaneous penile prosthesis and male sling/artificial urinary sphincter

    PubMed Central

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

    2013-01-01

    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

  2. Computer design synthesis of a below knee-Syme prosthesis.

    PubMed

    Elangovan, P T; Ghista, D N; Alwar, R S

    1979-03-01

    A detailed design synthesis analysis of the BK Syme prosthesis is provided, to determine the socket's cutout orientation size and shape, cutout fillet shape, socket wall thickness distribution and the reinforced fiber distribution in the socket wall, for a minimally stressed structurally safe lightweight prosthesis. For analysis purpose, the most adverse socket loading is obtained at the push-off stage of gait; this loading is idealised as an axial in-plane loading on the bottom edge of the circular cylindrical socket shell whose top edge is considered fixed. Finite element stress analysis of the socket shell (with uniform and graded wall thickness) are performed for various orientations of the cutout and for various types of corner fillets. A lateral cutout with a streamline fillet is recommended. The wall material (i.e., thickness) distribution is determined so as to minimise the stresses, while ensuring that the wall material's stress limits are not exceeded. For such a maximally-stressed lightweight socket shell, the panels in the neighbourhood of the cutout are checked to ensure that they do not buckle under their acquired stresses. A fiber-reinforced laminated composite socket shell is also analysed, to recommend optimum variables in orientations and densities of reinforcing fibers. PMID:761459

  3. The Relationship between Stapes Prosthesis Length and Rate of Stapedectomy Success

    PubMed Central

    Marchica, Cinzia L; Saliba, Issam

    2015-01-01

    OBJECTIVES To identify whether measurement of the prosthesis length is mandatory in patients requiring otosclerosis surgeries and to assess their postoperative audiometric outcomes. In addition, evaluation of prosthesis length used in revision compared to primary stapedectomy was carried out. STUDY DESIGN Case series with chart review. METHODS Chart review of 393 patients undergoing primary (321) versus revision stapedectomy (72) was performed in a tertiary referral center. The indication for surgery was the presence or persistence/recurrence of an air-bone gap (ABG) greater than 20 dB. Air and bone conduction thresholds (ACT and BCT, respectively), ABG as well as pure tone averages (PTAs) were determined for all patients, and the results were compared preoperatively and postoperatively. RESULTS Prosthesis length used ranged from 3.0 to 6.0 mm without differences between primary and revision groups. Of the revision surgeries, 62.5% were stapedectomies versus stapedotomies (P < 0.001). Patients showed significant decrease in speech discrimination score, with increased air and bone conduction thresholds as well as mean ABG and PTA before the revision surgeries as a first procedure failure. Prosthesis length changes occurred in 73.5% of the cases, with an average absolute change of 0.55 mm. Prosthesis length did not affect postoperative audiometric results between primary and revision groups, in all surgeries combined. When grouping stapes surgery into accurately versus inaccurately measured incus-footplate distance, significant differences were observed in prosthesis length employed (P < 0.01). Hearing outcomes were also better in the group in which an accurately measured prosthesis was chosen, as opposed to “standard-length” prosthesis. CONCLUSIONS This study corroborates postoperative success rates of revision surgeries, which show smaller improvements in hearing compared to a primary intervention. Accurate intra-operative measurement of prosthesis length was correlated with better audiometric results postoperatively. PMID:26124693

  4. Extreme Space Weather on Exoplanets

    NASA Astrophysics Data System (ADS)

    Cohen, O.; Drake, J. J.; Kashyap, V. L.; Glocer, A.; Garraffo, C.; Gombosi, T. I.

    2013-12-01

    The current search for exoplanets is focused on detecting Earth-like rocky planets in the habitable zone around faint, M-dwarf stars, where the definition of the habitable zone is the bounded distances from the star at which liquid water can exist on the planetary surface. However, other factors may play a role in the habitability of the planet. In particular, planets that orbit their host star in a close-in orbit, reside in an extreme space environment, where both the stellar wind and transient Coronal Mass Ejections (CMEs) can erode the planetary atmosphere. We present a detailed, three-dimensional modeling study of the space plasma physics of close-in exoplanets. The study includes the effect of the extreme space conditions on the planetary atmosphere, magnetospheric and upper atmosphere dynamics, extreme space weather on close-in planets, and star-planet magnetic interaction.

  5. Subway mandibular buccal defect blocked with two part prosthesis unified by Earth magnets.

    PubMed

    Punjani, Shikha; Arora, Aman; Upadhyaya, Viram

    2013-03-01

    This clinical report describes the fabrication of a two-piece obturator used to close the mandibular buccal defect. Two-piece obturator prosthesis was fabricated with clear heat cure acrylic resin to be used during the healing period following the marsupialization of odontogenic keratocyst which had lead to the loss of portions of the mandibular buccal region. The prosthesis fabricated in two parts was joined by the rare earth magnets. Retention was increased by lining the prosthesis with tissue conditioner material engaging the undercut. PMID:24431709

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

    PubMed Central

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

    2008-01-01

    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.

  7. 3D optical measurement of relative displacement for the tuberosities in the shoulder prosthesis

    NASA Astrophysics Data System (ADS)

    Yao, XueFeng; Meng, LiBo; Yu, LiuPing; Zhu, YiMing; Jiang, ChunYan

    2011-04-01

    In this paper, a binocular 3-D computer vision measurement system is used to measure the relative displacement for the greater and lesser tuberosities in the shoulder prosthesis. The basic principles of binocular optical measurement are introduced in detail, and the loading apparatus is designed for external rotation and anteflexion of the shoulder prosthesis. Both the motion of external rotation and anteflexion of the shoulder are measured, and the corresponding displacement values for the greater and lesser tuberosities are extracted. These results will play an important role in evaluating the stability of humeral tuberosity in the shoulder prosthesis.

  8. Results of Heart Valve Replacement with the SORIN Prosthesis

    PubMed Central

    Colombo, Tiziano; Donatelli, Francesco; Quaini, Eugenio; Vitali, Ettore; Pellegrini, Alessandro

    1987-01-01

    From March 1977 to December 1981, 872 patients at our institution underwent valve replacement with a pyrolytic carbon tilting disc prosthesis manufactured in Italy by SORIN-Biomedica. To verify the performance characteristics of this prosthesis, we analyzed the intermediate-term results obtained over a cumulative total of 3,041 patient-years (pt-yr) of follow-up. Three hundred sixty-nine patients underwent mitral valve replacement (MVR), 309 had aortic valve replacement (AVR), and 194 had both mitral and aortic (double) valve replacement (DVR). Expressed in actuarial terms (% [± standard error of the mean] free of adverse events at 5 years) and in linearized terms (% pt-yr), respectively, valve-related complications occurred at the following rates: Thromboembolism, 89.9 ± 1.9% and 2.1 ± 0.4% pt-yr (MVR); 92.1 ± 1.9% and 1.7 ± 0.4% (AVR); 90.5 ± 5.0% and 2.2 ± 0.6% (DVR). Anticoagulant-related hemorrhage, 95.2 ± 1.5% and 1.4 ± 0.3% (MVR); 95.9 ± 1.5% and 1.3 ± 0.3% (AVR); 96.0 ± 2.0% and 0.9 ± 0.4% (DVR). Prosthetic valve endocarditis, 99.0 ± 0.6% and 0.2 ± 0.1% (MVR); 97.4 ± 1.0% and 0.6 ± 0.2% (AVR); 94.5 ± 1.7% and 1.4 ± 0.4% (DVR). Reoperation, 92.6 ± 1.5% and 1.7 ± 0.3% (MVR); 89.4 ± 1.9% and 2.4 ± 0.4% (AVR); 82.3 ± 2.9% and 4.8 ± 0.8% (DVR). The total valve-related morbidity and mortality was 79.6 ± 2.6% and 4.9 ± 0.6% (MVR); 79.7 ± 2.6% and 5.1 ± 0.6% (AVR); 70.5 ± 4.0% and 7.7 ± 1.1% (DVR). The 5-year actuarial survival rate without hospital mortality was 86.8 ± 2.0% (MVR), 91.0 ± 1.7% (AVR), and 78.8 ± 3.7% (DVR). The intermediate-term survival and complication rates showed the performance of the SORIN prosthesis to be quite satisfactory. (Texas Heart Institute Journal 1987; 14:77-87) PMID:15227334

  9. Estimating exceedance probabilities of extreme floods

    SciTech Connect

    Fontaine, T.A. [Oak Ridge National Lab., TN (United States); Potter, K.W. [Univ. of Wisconsin, Madison, WI (United States). Dept. of Civil and Environmental Engineering

    1994-09-01

    Estimates of the exceedance probabilities of extreme floods are needed for risk analysis of dams and nuclear facilities. A new approach using a joint probability distribution of extreme rainfalls and antecedent soil moisture conditions, along with a rainfall runoff model, provides estimates of probabilities for floods approaching the probable maximum flood. This approach is illustrated for a 570 km{sup 2} catchment in the upper midwestern U.S.

  10. Symptom burden and infection occurrence among individuals with extremity lymphedema.

    PubMed

    Ridner, S H; Deng, J; Fu, M R; Radina, E; Thiadens, S R J; Weiss, J; Dietrich, M S; Cormier, J N; Tuppo, C M; Armer, J M

    2012-09-01

    Currently, there is a lack of data related to differences in symptoms and infection across different types and anatomical sites of lymphedema. The objective of this study was to examine differences in symptoms and infection status among individuals with lymphedema of the upper or lower extremities. The National Lymphedema Network initiated an online survey of self-report lymphedema data from March 2006 through January 2010. Descriptive statistics, Mann-Whitney tests, and Chi-square tests were used to analyze data. 723 individuals with upper extremity lymphedema and 1114 individuals with lower extremity lymphedema completed the survey. Individuals with extremity lymphedema experienced high symptom burden and infectious complications. Compared with individuals with upper extremity lymphedema, individuals with lower extremity lymphedema experienced more frequent and more severe symptoms (p<.001), infection episodes (p<.001), and infection-related hospitalizations (p<.001). No statistically significant differences of symptom burden and infection status were identified between individuals with lower extremity primary and secondary lymphedema. Individuals with extremity lymphedema experience substantial symptom burden and infectious complications; however, those with lower extremity lymphedema have more severe symptoms and more infections than those with upper extremity lymphedema. PMID:23342931

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

    NASA Astrophysics Data System (ADS)

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

    2010-06-01

    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.

  12. Medium term follow up of the Biodynamic neck sparing prosthesis.

    PubMed

    Molfetta, Luigi; Capozzi, Michele; Caldo, Davide

    2011-01-01

    Hip resurfacing (HR) and neck sparing prostheses (NSP) have been advocated for the treatment of arthritis in younger patients. Some complications following HR have been documented in the recent literature, but NSP are not yet supported by clinical follow-up studies of sufficient duration. We present an assessment of the neck sparing "Biodynamic" prosthesis. 153 patients were evaluated in a longitudinal cohort prospective study, with survival analysis, clinical score and radiographic assessment of stability and osteointegration at 41.8 months average follow up. Survival and clinical outcome were similar to most traditional prostheses in the literature. On radiographic analysis we recorded good neck preservation and osteointegration. Only two stem failures were recorded. Poor clinical outcome was related to misalignment of prostheses implanted during the 'learning curve'. The NSP system described may be a good alternative to HR for younger patients. The system is characterized by good survival and clinical and radiographic outcome combined with bone stock preservation. PMID:21279964

  13. [Limb prosthesis of the 19th and 20th century].

    PubMed

    Knoche, W

    2009-02-01

    Wouldn't the thought of a separate stump-cushioning, as mentioned by Heine, Eichler and others, make sense even today, regarding difficult and badly blood-supplied amputation-stumps? Shouldn't the thought of Hermann and Habermann, to do a knee-saving interference, be updated, especially for the weak and helpless patients? It is safe to say that one has to challenge the question, which objective methods of inspection are under consideration, to check and control the correct fit and construction for every individual patient. It is a credit to the executive of the orthopaedic-supply-center Hamburg-Altona, zur Verth, who challenged that question almost one hundred years ago. Not only zur Verth rated the value of amputation-levels in his amputation-scheme, but Arnsberger invented 1927 a device to objectify the composition of a prosthesis. PMID:19259935

  14. Implantable optrode design for optogenetic visual cortical prosthesis

    NASA Astrophysics Data System (ADS)

    Dong, Na; Sun, Xiaohan; Degenaar, Patrick

    2012-02-01

    The rise of optogenetic neural stimulation has opened new opportunities for neuroprosthesis such as visual cortical prosthesis, which necessitates an efficient delivery of light into the cortex. New forms of photosensitizing channelrhodopsin are reducing the required light intensities for stimulation, but implantable systems need to be highly efficient. Such efficiency calls for low loss in the transmission path, high coupling efficiency between the optic delivery system and optical emitter, as well as emitting efficiency from the light emitting diode. In this paper, we perform simulation results based on ray optics and illuminating theory as to the best strategy to attachment of optrode structures to Gallium Nitride-?LED arrays so as to maximize the efficiency of light delivery to the target neural tissue.Our results show that it is feasible to connect optrode elements and GaN-?LEDarrays for cortical stimulation and describe the optimisation requirements.

  15. Some Examples Of Image Warping For Low Vision Prosthesis

    NASA Astrophysics Data System (ADS)

    Juday, Richard D.; Loshin, David S.

    1988-08-01

    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.

  16. A vestibular prosthesis with highly-isolated parallel multichannel stimulation.

    PubMed

    Jiang, Dai; Cirmirakis, Dominik; Demosthenous, Andreas

    2015-02-01

    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

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

    E-print Network

    Lau, Jacky H. (Jacky Homing)

    2011-01-01

    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 ...

  18. Digital capture, design, and manufacturing of a facial prosthesis: Clinical report on a pediatric patient.

    PubMed

    Grant, Gerald T; Aita-Holmes, Cynthia; Liacouras, Peter; Garnes, Johnathan; Wilson, William O

    2015-07-01

    A digitally captured, designed, and fabricated facial prosthesis is presented as an alternative to customary maxillofacial prosthodontics fabrication techniques, where a facial moulage and patient cooperation may be difficult. PMID:25882970

  19. [Fatigue property analysis of prosthesis of hip joint with two different materials].

    PubMed

    Tang, Gang; Wang, Jiange; Luo, Hongxia

    2015-02-01

    Total hip replacement (THR) is replacing the prosthesis stem similar to human bone that takes advantage of the material with both good mechanical properties and biocompatibility to the damaged articular surface. Thus it can not only alleviate or even eliminate the pain but also effectively maintain the joint stability and freedom and restore its normal performance. Finite element analysis was used in this study to establish a 3D model of artificial hip stem, and explore its fatigue properties of different materials to ensure the safety and reliability. The calculating obtained two results of different metal hip prosthesis, including lifetime and deformation. The minimum service life of titanium prosthesis reaches 568 million times, which satisfies ISO standards, while the stainless steel does not suit to be a prosthesis material. PMID:25997269

  20. Effect of silicone gel breast prosthesis on electron and photon dose distributions

    SciTech Connect

    Krishnan, L.; St. George, F.J.; Mansfield, C.M.; Krishnan, E.C.

    1983-01-01

    The effect of a silicone gel breast prosthesis on the absorbed dose distribution of 9--20 MeV electron beams and 1.25--15 MV photon beams was studied. Compared to water measurements, at depths smaller than the practical range of the electron beams, the central axis depth dose values below the prothesis were lower for all energies by as much as 3.5%. However, at depths near the practical range, the central axis depth dose values for the prosthesis were greater than that of water by as much as 33%. Since this occurs near the end of the electron range, the resultant difference may not be clinically significant. Results of the effect of breast prosthesis on photon depth dose distributions reveal that no clinically significant perturbation is produced by the breast prosthesis using Co-60, 6- and 15-MV radiations.

  1. A procedure for design of a posterior resin-bonded prosthesis.

    PubMed

    Bohnenkamp, D M

    1996-06-01

    A procedure is described that uses red and brown crayon-type pencils and graphite pencil lead with a surveyor to draw a color-coded design on a study cast before fabrication of a posterior resin-bonded prosthesis. During diagnosis and treatment planning, abutments on the study cast are analyzed for undercuts and the height of contour on each abutment tooth is marked with a graphite pencil lead. Metal retainers for the prosthesis are indicated with brown lines drawn on the abutments. Enamel surfaces requiring alteration to allow insertion of the prosthesis and provide resistance to displacement are marked in red on the study cast. The surveyed color-coded study cast can be used as a reference guide by both the clinician and the laboratory technician during fabrication of the posterior resin-bonded prosthesis. PMID:8725847

  2. Self-Contained Powered Knee and Ankle Prosthesis: Initial Evaluation on a Transfemoral Amputee

    PubMed Central

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

    2009-01-01

    This paper presents an overview of the design and control of a fully self-contained prosthesis, which is intended to improve 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. The prosthesis was tested on an unilateral amputee subject for over-ground walking. Prosthesis sensor data (joint angles and torques) acquired during level ground walking experiments at a self-selected cadence demonstrates the ability of the device to provide a functional gait similar to normal gait biomechanics. Battery measurements during level ground walking experiments show that the self-contained device provides over 4,500 strides (9.0 km of walking at a speed of 5.1 km/h) between battery charges. PMID:20228944

  3. Simultaneous Inflatable Penile Prosthesis (IPP) and Male Sling Placement: Aiding in a Faster Return to Patient ...

    MedlinePLUS Videos and Cool Tools

    Simultaneous Inflatable Penile Prosthesis (IPP) and Male Sling Placement: Aiding in a Faster Return to Patient Quality-of-Life You must have Javascript enabled in your web browser. View Program Transcript ...

  4. 21 CFR 888.3170 - Elbow joint radial (hemi-elbow) polymer prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Drugs 8 2013-04-01 2013-04-01 false Elbow joint radial (hemi-elbow) polymer prosthesis. 888.3170 Section 888...ORTHOPEDIC DEVICES Prosthetic Devices § 888.3170 Elbow joint radial (hemi-elbow) polymer...

  5. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 8 2010-04-01 2010-04-01 false Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. 888.3180...ORTHOPEDIC DEVICES Prosthetic Devices § 888.3180 Elbow joint humeral (hemi-elbow) metallic...

  6. 21 CFR 888.3170 - Elbow joint radial (hemi-elbow) polymer prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Drugs 8 2014-04-01 2014-04-01 false Elbow joint radial (hemi-elbow) polymer prosthesis. 888.3170 Section 888...ORTHOPEDIC DEVICES Prosthetic Devices § 888.3170 Elbow joint radial (hemi-elbow) polymer...

  7. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 8 2011-04-01 2011-04-01 false Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. 888.3180...ORTHOPEDIC DEVICES Prosthetic Devices § 888.3180 Elbow joint humeral (hemi-elbow) metallic...

  8. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 8 2014-04-01 2014-04-01 false Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. 888.3180...ORTHOPEDIC DEVICES Prosthetic Devices § 888.3180 Elbow joint humeral (hemi-elbow) metallic...

  9. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 2011-04-01 false Hip joint metal/polymer semi-constrained...Prosthetic Devices § 888.3350 Hip joint metal/polymer semi-constrained...prosthesis. (a) Identification. A hip joint metal/polymer...

  10. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 2011-04-01 false Hip joint metal/composite semi-constrained...Prosthetic Devices § 888.3340 Hip joint metal/composite semi-constrained...prosthesis. (a) Identification. A hip joint metal/composite...

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

    E-print Network

    Chew, Andrea W. (Andrea Wae-Ping)

    2006-01-01

    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 ...

  12. Retrograde nailing of femoral fracture below a hip prosthesis: a case report.

    PubMed

    Verburg, A D

    1998-03-01

    In a frail elderly patient a pathological fracture of the femur at the lower end of a loose femoral stem was treated by the retrograde insertion of an intramedullary nail over the tip of the prosthesis. PMID:9546461

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

    E-print Network

    Markowitz, Jared (Jared John)

    2013-01-01

    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 ...

  14. The boston retinal prosthesis: A 15-channel hermetic wireless neural stimulator

    Microsoft Academic Search

    Shawn K. Kelly; Douglas B. Shire; Patrick Doyle; Marcus D. Gingerich; William A. Drohan; Joseph F. Rizzo; L. S. Theogarajan; Jinghua Chen; Stuart F. Cogan; John L. Wyatt

    2009-01-01

    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 drives a microfabricated thin-film polyimide stimulating electrode array with sputtered iridium oxide electrodes. This array is implanted in the subretinal space using a specially-designed ab externo surgical technique that uses the retina

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

    PubMed

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

    2013-07-01

    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

  16. Design of visual prosthesis image processing system based on SoC

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

    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.

  17. Impact of Valve Prosthesis-Patient Mismatch on Short-Term Mortality After Aortic Valve Replacement

    Microsoft Academic Search

    Claudia Blais; Jean G. Dumesnil; Richard Baillot; Serge Simard; Daniel Doyle; Philippe Pibarot

    2003-01-01

    Background—The prosthesis used for aortic valve replacement (AVR) can be too small in relation to body size, thus causing valve prosthesis-patient mismatch (PPM) and abnormally high transvalvular pressure gradients. This study examined if there is a relation between PPM and short-term mortality after operation. Methods and Results—The indexed valve effective orifice area (EOA) was estimated for each type and size

  18. Technical note: appearances on ultrasound of impalpable injection port in a double chamber breast prosthesis.

    PubMed

    Skene, A I; Collins, C D; Barr, L; Cosgrove, D O

    1993-11-01

    Breast reconstruction utilizing tissue expansion is being increasingly practised by both plastic and general surgeons. Our current experience for both immediate and delayed reconstruction is with the double chamber Becker prosthesis. The prosthesis with the resulting breast mound has on occasions rendered the injection port difficult to localize by palpation. We have found ultrasound useful in identifying impalpable ports and in facilitating needle insertion into the injection dome. PMID:8281383

  19. Advanced engineering tools for design and fabrication of a custom nasal prosthesis

    NASA Astrophysics Data System (ADS)

    Oliveira, Inês; Leal, Nuno; Silva, Pedro; da Costa Ferreira, A.; Neto, Rui J.; Lino, F. Jorge; Reis, Ana

    2012-09-01

    Unexpected external defects resulting from neoplasms, burns, congenital malformations, trauma or other diseases, particularly when involving partial or total loss of an external organ, can be emotionally devastating. These defects can be restored with prosthesis, obtained by different techniques, materials and methods. The increase of patient numbers and cost constraints lead to the need of exploring new techniques that can increase efficiency. The main goal of this project was to develop a full engineering-based manufacturing process to obtain soft-tissue prosthesis that could provide faster and less expensive options in the manufacturing of customized prosthesis, and at the same time being able to reproduce the highest degree of details, with the maximum comfort for the patient. Design/methodology/approach - This case report describes treatment using silicone prosthesis with an anatomic retention for an 80-years-old woman with a rhinectomy. The proposed methodology integrates non-contact structured light scanning, CT and reverse engineering with CAD/CAM and additive manufacturing technology. Findings - The proposed protocol showed encouraging results since reveals being a better solution for fabricating custom-made facial prostheses for asymmetrical organs than conventional approaches. The process allows the attainment of prosthesis with the minimum contact and discomfort for the patient, disclosing excellent results in terms of aesthetic, prosthesis retention and in terms of time and resources consumed.

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

    PubMed

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

    2014-10-01

    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

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

    PubMed Central

    Herr, Hugh M.; Grabowski, Alena M.

    2012-01-01

    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

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

    E-print Network

    anthropomorphic upper extremity prostheses Manuscript received January 31, 2007; revised xxx. This paper://ieeexplore.ieee.org, provided by the author. This material includes one video (IEEETRO arm video.wmv) demonstrating the Vanderbilt University 21 DOF (9 actuator) arm. The arm is commanded by a master exoskeleton. The video (can

  3. Extreme Optimization Announcements

    E-print Network

    Chen, Yiling

    Extreme Optimization Announcements Assignment 3 due tomorrow @ 5pm. No late days on Extreme, we will hold extra office hours during regular section times. #12;Extreme Optimization Extreme University Fall 2014 #12;Extreme Optimization The radiotherapy problem Saving Lives: Radiotherapy Radiation

  4. The European Extreme Right and Religious Extremism

    Microsoft Academic Search

    Jean-Yves Camus

    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,

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

    PubMed

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

    2014-01-01

    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

  6. Statistical Analysis of EXTREMES in GEOPHYSICS

    E-print Network

    Gilleland, Eric

    -point at µ - ). · Weibull (upper end-point at µ - ). #12;Statistical AnalysisStatistical Analysis of EXTREMES in GEOPHYSICS Zwiers FW and Kharin VV. 1998. Changes;Statistical Analysis of Averages Central Limit Theorem: X1, . . . , Xn random sample from any distribution. X1

  7. Trapping of neutrinos in extremely compact stars

    E-print Network

    Zdenek Stuchlik; Martin Urbanec; Gabriel Torok; Stanislav Hledik; Jan Hladik

    2007-01-11

    Trapping of neutrinos in extremely compact stars containing trapped null geodesics is studied. We calculated the ratio of produced to trapped neutrinos in the simplest model of uniform density stars. This gives the upper limit on trapping coefficients in real objects.

  8. Statistical Inference Using Extreme Order Statistics

    Microsoft Academic Search

    James Pickands III

    1975-01-01

    A method is presented for making statistical inferences about the upper tail of a distribution function. It is useful for estimating the probabilities of future extremely large observations. The method is applicable if the underlying distribution function satisfies a condition which holds for all common continuous distribution functions.

  9. The 2014 Silba Precipitation Extreme

    NASA Astrophysics Data System (ADS)

    Rasol, Dubravka; Ólafsson, Haraldur

    2015-04-01

    On 30 July 2014 a 24 h precipitation record of 218 mm was set at the island of Silba in the N-Adriatic Sea. The precipitation was of convective nature and significantly less precipitation was recorded only small distances away, at the coast of mainland Croatia. The event is reproduced numerically and discussed in terms of dynamics and predictability. On a large scale, the precipitation extreme was associated with a slow-moving upper tropospheric low that formed over the N-Atlantic several days earlier. At lower levels, there were humid mediterranean airmasses. On a smaller scale, there are indications that the extreme convection may have been triggered by an orographic disturbance.

  10. Is prosthesis retention effective for chronic infections in hip arthroplasties? A systematic literature review.

    PubMed

    Maillet, M; Pavese, P; Bruley, D; Seigneurin, A; François, P

    2015-08-01

    The success rate of prosthesis removal as the standard approach to manage chronic infection in hip arthroplasties (HA) is 80-90 %. The effectiveness of prosthesis retention, with or without surgical debridement, to treat patients with chronic HA infection (symptom duration of more than 4 weeks) has not been well established, whereas this strategy is sometimes used in clinical practice. This study aimed to explore the cumulative incidence of failure of chronic HA infections treated with prosthesis retention, with or without debridement. A systematic literature review was conducted in accordance with the methods described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies concerning patients with chronically infected HA treated with prosthesis retention were included. The primary outcome was the cumulative risk of failure. We searched the MEDLINE, Embase, and Cochrane databases up to April 2014. The database searches provided a total of 1,213 studies for potential inclusion in the review. Six relevant studies were finally identified, corresponding to 29 patients included. Their treatments consisted of prosthesis retention with debridement. This strategy failed for 14 out of these 29 patients after a 1-year follow-up. The failure rate of the prosthesis retention approach associated to debridement for chronic infection in HA is 48.3 % in this review. Debridement and prosthesis retention in association with prolonged antimicrobial treatment may be an advantageous alternative to arthroplasty exchange for frail patients. The difficulty in finding relevant studies illustrates the challenges of interpreting the existing literature for the management of chronic prosthetic joint infection (PJI). PMID:25926304

  11. High Resolution Implantable Microsystem and Probe Design for Retinal Prosthesis

    PubMed Central

    Talukder, Mohammad Ismail; Siy, Pepe; Auner, Gregory W

    2008-01-01

    By a retinal prosthesis, the researchers have been able to stimulate a limited number of neurons (around 100) by biphasic current stimulus to reproduce an image spatially by multiplexing technique. For functional restoration of sight (visual acuity 20/80), we are to stimulate at least 2500 neurons/mm2. We are far behind that target. The time required by biphasic current stimulus, the sequential stimulation by multiplexing technique, and the conventional probes used for stimulation limits our ability to stimulate large number of neurons and maintains the persistence of vision. To address this problem, we have designed high resolution donut probes and used them in designing neural implant chip (NIC) applying parallel multiplexing technique, which helped us stimulate large number of neurons. This paper presents the design of a donut probe and an implantable CMOS-based 5x5 array NIC to demonstrate that idea. This 5x5 array NIC is scalable to any larger array. It uses external clock, which makes it suitable for any data rate. The programmable biphasic width controller (BWC) used in this design is capable of generating various kinds of stimulus for stimulation. NIC doesn’t need address to route the pixels, which reduces the data transmission overhead. 0.5 µm CMOS technology is used to fabricate NIC with donut probes. Test results verify our technique of increasing the resolution. PMID:19516913

  12. Platelet-rich plasma and the upper extremity.

    PubMed

    Mishra, Allan; Randelli, Pietro; Barr, Cameron; Talamonti, Tazio; Ragone, Vincenza; Cabitza, Paolo

    2012-11-01

    Platelet-rich plasma (PRP) is a fraction of whole blood containing powerful growth factors and cytokines. Preclinical studies suggest PRP may be useful for tendon repair or regeneration. Clinical investigations have focused on the treatment of chronic lateral epicondylar tendinopathy and rotator cuff pathology. Multiple controlled studies support the use of PRP for chronic tennis elbow. Rotator cuff studies, however, have produced conflicting results based on PRP formulation, surgical technique, and size of tendon tear. This article explores the scientific rational for using PRP, its various formulations, and the emerging clinical data. Future potential applications are also explored. PMID:23101598

  13. [Management of catheter-related upper extremity deep vein thrombosis].

    PubMed

    Linnemann, B; Lindhoff-Last, E

    2013-12-01

    Central venous catheters (CVCs) are important tools in the care of patients with acute or chronic diseases, but catheter-related thrombosis and thrombotic occlusions are frequent complications, especially if CVCs are implanted for long-term use. In this review we focus on the management of these complications. Risk factors for catheter-related thrombosis include dislocation of the catheter tip, the presence of malignant disease and hypercoagulability. Catheter-related thrombosis is associated with catheter infection, pulmonary embolism and post-thrombotic syndrome. Catheter-related thromboses which most frequently involve the subclavian vein are usually diagnosed by duplex ultrasound examination and treated with anticoagulation therapy for a minimum of three months or longer if the catheter is left in place. Prevention of catheter-related thrombotic complications includes proper positioning of the CVC with the catheter tip lying in the proximal superior vena cava and regular flushing of the catheter with saline solution or unfractionated heparin. The use of anticoagulants for primary prevention is currently not recommended. PMID:23575524

  14. Towards Understanding the Workspace of The Upper Extremities

    E-print Network

    Abdel-Malek, Karim

    of a wrist undergoing rehabilitation. Keywords: Limb workspace, ergonomics, ranges of motion, shoulder, wrist impairment, the changes in limitations with injury or disease, and the improvements with therapy have always

  15. Evaluation of upper extremity motor function tests in tetraplegics

    Microsoft Academic Search

    JH van Tuijl; YJM Janssen-Potten; HAM Seelen

    2002-01-01

    Objective: To provide an overview of arm–hand function tests useful in tetraplegic subjects. Considerations for selection of an appropriate test are also provided.Data sources: A Medline literature search was conducted covering the period from 1967 to March 2001. Relevant references cited in the selected papers were also considered, regardless of the year of publication.Study selection: This review was restricted to

  16. Upper extremity physeal injury in young baseball pitchers.

    PubMed

    Saltzman, Bryan M; Chalmers, Peter N; Mascarenhas, Randy; Cole, Brian J; Romeo, Anthony A

    2014-09-01

    Adolescent baseball players, especially pitchers, are at increased risk for shoulder and elbow injuries as their level of competition increases. The intersection of the adolescent growth spurt with the high levels of elbow valgus and shoulder rotational torques placed upon the arm during overhand pitching predisposes the shoulder and elbow to physeal injuries. Little League shoulder and Little League elbow syndromes most commonly represent pathology at the physeal regions of the proximal and distal humerus and proximal ulna sustained from repetitive loads caused by overhead throwing. There is a growing understanding that these injuries occur on a wide spectrum from delayed physeal closure and physeal widening to acute transphyseal fracture. Although operative intervention is infrequently required, patient and parent counseling can be complex. Health care professionals who care for adolescent baseball players also can play an important role in prevention. Appropriate counseling requires a comprehensive understanding of the clinical, radiographic, and biomechanical aspects of these injuries. This review summarizes these major concepts, focusing on the best available evidence from recent biomechanical and clinical studies on shoulder and elbow injuries in adolescent baseball pitchers. PMID:25295772

  17. Fluid-structure interaction in a free end textile vascular prosthesis

    NASA Astrophysics Data System (ADS)

    Ben Abdessalem, S.; Durand, B.; Akesbi, S.; Chakfe, N.; Kretz, J. G.

    2005-09-01

    Textile cardiovascular prostheses are tubular structures made of polyester filaments. They present particular mechanical properties linked to wavy form of their walls allowing them to stretch under pressure. Pulsatile blood flow was studied in a moving walls vascular prosthesis. First, an image processing device was used to measure prosthesis displacement under air pressure in an free end impregnated textile prosthesis. Then, fluid-structure interaction is simulated with a numerical computation code allowing to couple prosthesis walls motion with blood flow. Navier-Stokes equations governing fluid flow are numerically solved with N3S code based on finite elements method. The numerical process is based on the Arbitrary Lagrangian Eulerian (ALE) formulation allowing moving domains. The obtained results showed a particular distribution of blood flow velocities and shear stress near the graft walls. The flow velocity distribution near a prosthetic surface is strongly influenced by the crimping morphology and deformation. A local flow analysis is imperative to understanding pathologies implying hemodynamic factors and to optimize the prosthesis design.

  18. Long-Term Effectiveness of Total Hip Replacement with the Collum Femoris Preserving Prosthesis.

    PubMed

    You, Rui-Jin; Zheng, Wen-Zhong; Chen, Kun; Lv, Hong-Sheng; Huang, Dian-Feng; Xiao, Yi-Zeng; Yang, De-Yu; Su, Zhai-Quan

    2014-12-01

    The objective of this study was to follow-up long term (5-12 years) patients with total hip arthroplasty with the collum femoris preserving prosthesis to evaluate clinical outcome and potential complications. Forty-six of 152 patients who underwent this procedure between September 2000 and September 2012 were followed up. The average follow-up time was 7.6 years, and assessed were radiographs, Harris score, limb length, hip function, and complications. Six patients had perioperative complications including five cases of femoral shaft fracture and one case of dislocation 1 week after the operation. No infections of the surgical site, no deep venous thrombosis or pulmonary embolism were observed. The last recorded Harris hip score improved from a preoperative average of 41.2 (range 17-60) to an average of 82.3 (74-96), with the score >80 in 38 patients, 70-80 in six patients, and <70 in two patients. Radiolucent lines were found on radiographs in two patients with acetabular prosthesis and one patient with femoral prosthesis. The remainder of patients had satisfactory positions of acetabular and femoral stem prostheses with no loosening or subsidence, and a good condition of femoral neck. Total hip arthroplasty with the collum femoris preserving prosthesis is a good option for younger patients who need prosthesis revision. This arthroplasty achieves satisfactory long-term effectiveness. PMID:25480429

  19. Role of toll-like receptor 4 in the inflammation reaction surrounding silicone prosthesis.

    PubMed

    Auquit-Auckbur, Isabelle; Caillot, Frédérique; Arnoult, Christophe; Menard, Jean-François; Drouot, Laurent; Courville, Philippe; Tron, François; Musette, Philippe

    2011-05-01

    The inflammation which occurs around the silicone prosthesis is a complex process that can provoke the failure of the device and compromise the health of the implanted patient. Toll-like receptors (TLRs), which are transmembrane proteins, are now known to act in the innate immune response and in endogenous inflammation. The aim of our study was to assess the role of TLR4 in the foreign body reaction to a silicone shell prosthesis. Disks of shell silicone prosthesis were implanted in the subcutaneous tissue of C57BL6-TLR4-/- and C57BL6-WT mice. At day 14, inflammatory cell infiltrate and vessel sections around the prosthesis were less numerous in TLR4-/- than in WT mice. A histomorphometric analysis showed that the capsule around the implant was 1.96-fold less thick in depleted TLR4 than in wild-type mice. In addition, vascular endothelial growth factor and transforming growth factor 1 were underexpressed in the surrounding tissue of the prosthesis in TLR4-/- mice. Our study suggests, from this foreign body response model against silicone in mice, that TLR4 plays a key role in the reaction process around silicone implants. PMID:21272673

  20. Quantum Adversary (Upper) Bound

    E-print Network

    Kimmel, Shelby

    2011-01-01

    We propose a method for upper bounding the general adversary bound for certain boolean functions. Due to the the tightness of query complexity and the general adversary bound \\cite{Lee2010}, this gives an upper bound on the quantum query complexity of those functions. We give an example where this upper bound is smaller than the query complexity of any known quantum algorithm.