Sample records for upper limb muscle

  1. Muscle Strengths and Musculoskeletal Geometry of the Upper Limb

    Microsoft Academic Search

    A A Amis; D Dowson; V Wright

    1979-01-01

    A survey of past literature has shown that there is a lack of reliable data for use in prediction of joint forces in the upper limb although this is desirable when developing joint replacements. Upper limb geometry has been analysed, leading to muscle moment arm data at the wrist and elbow. The variation of these moment arms during elbow flexion

  2. Activity of upper limb muscles during human walking.

    PubMed

    Kuhtz-Buschbeck, Johann P; Jing, Bo

    2012-04-01

    The EMG activity of upper limb muscles during human gait has rarely been studied previously. It was examined in 20 normal volunteers in four conditions: walking on a treadmill (1) with unrestrained natural arm swing (Normal), (2) while volitionally holding the arms still (Held), (3) with the arms immobilized (Bound), and (4) with the arms swinging in phase with the ipsilateral legs, i.e. opposite-to-normal phasing (Anti-Normal). Normal arm swing involved weak rhythmical lengthening and shortening contractions of arm and shoulder muscles. Phasic muscle activity was needed to keep the unrestricted arms still during walking (Held), indicating a passive component of arm swing. An active component, possibly programmed centrally, existed as well, because some EMG signals persisted when the arms were immobilized during walking (Bound). Anti-Normal gait involved stronger EMG activity than Normal walking and was uneconomical. The present results indicate that normal arm swing has both passive and active components. PMID:21945656

  3. Upper limb muscle strength & endurance in chronic obstructive pulmonary disease

    PubMed Central

    Shah, Swati; Nahar, Pradeep; Vaidya, Savita; Salvi, Sundeep

    2013-01-01

    Background & objectives: There are very few studies that have investigated the muscle strength and endurance of upper limbs (UL) in chronic obstructive pulmonary disease (COPD). We undertook this study to measure and compare the skeletal muscle strength and endurance of UL in COPD patients and age matched healthy controls and to study the association between lung function parameters and UL muscle strength and endurance. Methods: Forty one COPD patients and 45 height and weight matched healthy subjects of the same age group were studied. UL skeletal muscle strength and endurance were measured using the hand grip dynamometer test. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), forced expiratory flow during 25-75% FVC (FEF25-75%) and peak expiratory flow rate (PEFR) were measured. The handgrip muscle strength and endurance between the two groups were compared and correlations between FVC and FEV1 with muscle strength and endurance were analyzed. Results: The mean handgrip strength and mean muscle endurance in COPD patients were significantly lesser than the normal subjects in both males and females (P<0.001). There was significant positive correlation between muscle strength and FVC in males (r2=0.32, P<0.05); and between muscle strength and FEV1 in females (r2=0.20, P<0.05). Interpretation & conclusion: The study showed that the handgrip muscle strength decreases as the FVC and FEV1 decrease in patients with COPD. Identifying those patients who have reduced strength and endurance will allow early interventions targeted at improving the quality of life of the patient. PMID:24434255

  4. Investigation of upper limb muscle activity during repetitive light task using surface electromyography (SEMG)

    Microsoft Academic Search

    Hilma Raimona Zadry; S. Z. M. Dawal; Z. Taha

    2009-01-01

    A study was conducted to investigate the effect of upper limb muscles during repetitive task consisted of three hand-arm directions: 30°, 90°, and 150°. The aims of this study were to investigate muscle activity during repetitive task, to compare muscle activity between genders and to determine the correlation between muscles and time. Biceps brachii, anterior deltoid, and upper trapezius muscles

  5. Upper Limb Effort Does Not Increase Maximal Voluntary Muscle Activation in Individuals with Incomplete Spinal Cord Injury

    PubMed Central

    Huang, Helen J.; Ferris, Daniel P.

    2009-01-01

    Objective To determine the effect of upper limb effort on maximal lower limb muscle activation in individuals with incomplete spinal cord injury. Methods Fifteen individuals with incomplete spinal cord injury performed recumbent stepping using different combinations of upper and lower limb efforts. Results There was no significant difference in active lower limb electromyography amplitudes regardless of whether the upper limbs were resting or exerting maximal effort. Upper limb effort increased passive lower limb muscle activation and likewise, lower limb effort increased passive upper limb muscle activation. Conclusions Upper limb effort did not increase lower limb muscle activation during active lower limb effort in individuals with incomplete spinal cord injury during recumbent stepping. This suggests that individuals with incomplete spinal cord injury cannot recruit additional lower limb motor units using maximal volitional effort of their upper limbs. Significance Understanding how upper limb effort and movement influences lower limb muscle activation patterns in incomplete spinal cord injury patients has implications for prescribing therapies for lower limb rehabilitation. PMID:19699677

  6. The effect of arm weight support on upper limb muscle synergies during reaching movements

    PubMed Central

    2014-01-01

    Background Compensating for the effect of gravity by providing arm-weight support (WS) is a technique often utilized in the rehabilitation of patients with neurological conditions such as stroke to facilitate the performance of arm movements during therapy. Although it has been shown that, in healthy subjects as well as in stroke survivors, the use of arm WS during the performance of reaching movements leads to a general reduction, as expected, in the level of activation of upper limb muscles, the effects of different levels of WS on the characteristics of the kinematics of motion and of the activity of upper limb muscles have not been thoroughly investigated before. Methods In this study, we systematically assessed the characteristics of the kinematics of motion and of the activity of 14 upper limb muscles in a group of 9 healthy subjects who performed 3-D arm reaching movements while provided with different levels of arm WS. We studied the hand trajectory and the trunk, shoulder, and elbow joint angular displacement trajectories for different levels of arm WS. Besides, we analyzed the amplitude of the surface electromyographic (EMG) data collected from upper limb muscles and investigated patterns of coordination via the analysis of muscle synergies. Results The characteristics of the kinematics of motion varied across WS conditions but did not show distinct trends with the level of arm WS. The level of activation of upper limb muscles generally decreased, as expected, with the increase in arm WS. The same eight muscle synergies were identified in all WS conditions. Their level of activation depended on the provided level of arm WS. Conclusions The analysis of muscle synergies allowed us to identify a modular organization underlying the generation of arm reaching movements that appears to be invariant to the level of arm WS. The results of this study provide a normative dataset for the assessment of the effects of the level of arm WS on muscle synergies in stroke survivors and other patients who could benefit from upper limb rehabilitation with arm WS. PMID:24594139

  7. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds

    Microsoft Academic Search

    Paul W. Hodges; Carolyn A. Richardson

    1999-01-01

    Objective: To compare trunk muscle coordination in people with and without low back pain with varying speeds of limb movement.Study Design: Abdominal and back extensor muscle activity in association with upper limb movement was compared among three speeds of movement and between people with and without low back pain.Participants: Fourteen subjects with a history of recurrent low back pain and

  8. Weight bearing through flexed upper limbs in quadriplegics with paralyzed triceps brachii muscles

    Microsoft Academic Search

    LA Harvey; J Crosbie

    1999-01-01

    Study design: A biomechanical analysis of lifting through flexed and extended elbows in C5 and C6 quadriplegics. Objective: To determine the mechanisms used by C5 and C6 quadriplegics to prevent elbow collapse when bearing weight through flexed upper limbs. Setting: A biomechanics laboratory. Methods: Six motor complete C5 and C6 quadriplegic subjects with paralysis of their triceps brachii muscles were

  9. 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

  10. Preliminary results of online classification of upper limb motions from around-shoulder muscle activities.

    PubMed

    Soma, Hirokazu; Horiuchi, Yuse; Gonzalez, Jose; Yu, Wenwei

    2011-01-01

    Recently, detecting upper-limb motion intention for prosthetic control purpose attracted growing research attention. In most of the studies, recordings of forearm muscle activities were used as the signal sources, from which the intention of wrist and hand motions were detected using pattern recognition technology. However, most daily-life upper limb activities need coordination of the shoulder-arm-hand complex. The disadvantage of relying only on the local information to recognize a whole body coordinated motion is that misrecognition could easily happen, so that steady and reliable continuous motions could not be realized. Moreover, using forearm muscle activities would limit the use of the system for higher level amputation patients. Therefore, in this study we aimed to explore the feasibility of using an online classification algorithm to test the intention detection in real time. Experiments were conducted to record around-shoulder muscle activity using EMG and acceleration sensors. Then, a neural network was trained using these data, and finally tested online in a set of tests. Results showed that, from 5 channels of Electromyogram (EMG) and 4 channels of accelerometers, it is possible to discriminate 3 different grips and 5 reaching direction of arm. PMID:22275572

  11. Four-headed biceps brachii, three-headed coracobrachialis muscles associated with arterial and nervous anomalies in the upper limb

    PubMed Central

    Catli, Mehmet Mutlu; Ozsoy, Umut; Kaya, Yasemin; Hizay, Arzu; Yildirim, Fatos Belgin

    2012-01-01

    A four-headed biceps brachii muscle and three-headed coracobrachialis muscle, high-originated radial artery and communication between the median and musculocutaneous nerves have been well documented in the available literature. However co-existence of these variations is rare. In this study we aimed to describe multiple variations in the upper limb and discuss their co-existence from clinical and embryological points of view. PMID:22822469

  12. Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

    PubMed Central

    Chen, Kai-Hua; Hsiao, Kuang-Yu; Lin, Chu-Hsu; Chang, Wen-Ming; Hsu, Hung-Chih; Hsieh, Wei-Chi

    2013-01-01

    Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs) of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40) and Yanglingquan (GB34) points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side) versus sham needling on the contralateral lower limb (control side) in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM) upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P = 0.03) in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P = 0.036). Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle. PMID:23710218

  13. Effect of local leg cooling on upper limb trajectories and muscle function and whole body dynamic balance

    Microsoft Academic Search

    Hugo Piedrahita; Juha Oksa; Hannu Rintamäki; Christer Malm

    2009-01-01

    This study was designed to find out if local leg cooling affects muscle function and trajectories of the upper limb during\\u000a repetitive light work as well as capability to maintain dynamic balance. Nine healthy female subjects performed repetitive\\u000a lifting task with right hand for 60 min while standing in front of a table with six target angles (30°–220°) and with the

  14. The influence of pauses on the fatigue of upper limb muscles during the task of ironing.

    PubMed

    Fernandes, Ângela; Santos, Rubim; Rocha, Nuno; Tavares, João Manuel R S

    2014-03-01

    The aim of this study was to analyze the influence of position and pauses on muscle activity and fatigue during the task of ironing. Ten female participants performed the task of ironing in two different positions (standing and sitting) for 10 min each with a 1-min pause at the end of each task. Muscle activity and fatigue from the upper trapezium, anterior deltoid, and pectoralis major were analyzed using surface electromyography. The results showed that the positions had no significant influence on muscle activity; nevertheless, they had significant influence on muscular fatigue. In addition, the pauses were possibly beneficial in decreasing the muscle fatigue, but the results were not conclusive. PMID:23924185

  15. Comparison of neck and upper-limb muscle activities between able-bodied and paraplegic individuals during wheelchair propulsion on the ground

    PubMed Central

    Kim, Sang Jin; Park, So Hyun; Lee, Chang-Ryeol

    2015-01-01

    [Purpose] This study compared the muscle activities of the neck and upper-limb muscles between able-bodied individuals and persons with paraplegia during wheelchair propulsion on the ground. [Subjects and Methods] The muscle activities of the neck and upper-limb muscles of 8 normal individuals and 8 individuals with paraplegia were analyzed during wheelchair propulsion. The activities of the latissimus dorsi, pectoralis major, anterior/posterior deltoids, triceps brachii, extensor carpi radialis, and sternocleidomastoid muscles were assessed. [Results] The paraplegic group showed significantly higher sternocleidomastoid activity than the normal group. Latissimus dorsi activity was also higher in the paraplegia group than in the normal group, but the difference was not significant. There were no significant differences in the other muscle activities between groups. [Conclusion] Paraplegic patients tend to use the sternocleidomastoid and latissimus dorsi muscles with greater degrees of activity. Therefore, physiotherapists should not overlook the treatment of these muscles for paraplegic patients who are long-term wheelchair users.

  16. Pilot study on quantitative assessment of muscle imbalance: differences of muscle synergies, equilibrium-point trajectories, and endpoint stiffness in normal and pathological upper-limb movements.

    PubMed

    Oku, Takanori; Uno, Kanna; Nishi, Tomoki; Kageyama, Masayuki; Phatiwuttipat, Pipatthana; Koba, Keitaro; Yamashita, Yuto; Murakami, Kenta; Uemura, Mitsunori; Hirai, Hiroaki; Miyazaki, Fumio; Naritomi, Hiroaki

    2014-01-01

    This paper proposes a novel method for assessment of muscle imbalance based on muscle synergy hypothesis and equilibrium point (EP) hypothesis of motor control. We explain in detail the method for extracting muscle synergies under the concept of agonist-antagonist (AA) muscle pairs and for estimating EP trajectories and endpoint stiffness of human upper limbs in a horizontal plane using an electromyogram. The results of applying this method to the reaching movement of one normal subject and one hemiplegic subject suggest that (1) muscle synergies (the balance among coactivation of AA muscle pairs), particularly the synergies that contributes to the angular directional kinematics of EP and the limb stiffness, are quite different between the normal subject and the hemiplegic subject; (2) the concomitant EP trajectory is also different between the normal and hemiplegic subjects, corresponding to the difference of muscle synergies; and (3) the endpoint (hand) stiffness ellipse of the hemiplegic subject becomes more elongated and orientation of the major axis rotates clockwise more than that of the normal subject. The level of motor impairment would be expected to be assessed from a comparison of these differences of muscle synergies, EP trajectories, and endpoint stiffness among normal and pathological subjects using the method. PMID:25571310

  17. Prediction of upper limb muscle activity from motor cortical discharge during reaching

    NASA Astrophysics Data System (ADS)

    Pohlmeyer, Eric A.; Solla, Sara A.; Perreault, Eric J.; Miller, Lee E.

    2007-12-01

    Movement representation by the motor cortex (M1) has been a theoretical interest for many years, but in the past several years it has become a more practical question, with the advent of the brain-machine interface. An increasing number of groups have demonstrated the ability to predict a variety of kinematic signals on the basis of M1 recordings and to use these predictions to control the movement of a cursor or robotic limb. We, on the other hand, have undertaken the prediction of myoelectric (EMG) signals recorded from various muscles of the arm and hand during button pressing and prehension movements. We have shown that these signals can be predicted with accuracy that is similar to that of kinematic signals, despite their stochastic nature and greater bandwidth. The predictions were made using a subset of 12 or 16 neural signals selected in the order of each signal's unique, output-related information content. The accuracy of the resultant predictions remained stable through a typical experimental session. Accuracy remained above 80% of its initial level for most muscles even across periods as long as two weeks. We are exploring the use of these predictions as control signals for neuromuscular electrical stimulation in quadriplegic patients.

  18. Study on the description method of upper limb's muscle force levels during simulated in-orbit operations

    NASA Astrophysics Data System (ADS)

    Zhao, Yan; Li, DongXu; Liu, ZhiZhen; Liu, Liang

    2013-03-01

    The dexterous upper limb serves as the most important tool for astronauts to implement in-orbit experiments and operations. This study developed a simulated weightlessness experiment and invented new measuring equipment to quantitatively evaluate the muscle ability of the upper limb. Isometric maximum voluntary contractions (MVCs) and surface electromyography (sEMG) signals of right-handed pushing at the three positions were measured for eleven subjects. In order to enhance the comprehensiveness and accuracy of muscle force assessment, the study focused on signal processing techniques. We applied a combination method, which consists of time-, frequency-, and bi-frequency-domain analyses. Time- and frequency-domain analyses estimated the root mean square (RMS) and median frequency (MDF) of sEMG signals, respectively. Higher order spectra (HOS) of bi-frequency domain evaluated the maximum bispectrum amplitude ( B max), Gaussianity level (Sg) and linearity level (S l ) of sEMG signals. Results showed that B max, S l , and RMS values all increased as force increased. MDF and Sg values both declined as force increased. The research demonstrated that the combination method is superior to the conventional time- and frequency-domain analyses. The method not only described sEMG signal amplitude and power spectrum, but also deeper characterized phase coupling information and non-Gaussianity and non-linearity levels of sEMG, compared to two conventional analyses. The finding from the study can aid ergonomist to estimate astronaut muscle performance, so as to optimize in-orbit operation efficacy and minimize musculoskeletal injuries.

  19. Development of Activity-Related Muscle Fatigue during Robot-Mediated Upper Limb Rehabilitation Training in Persons with Multiple Sclerosis: A Pilot Trial.

    PubMed

    Octavia, Johanna Renny; Feys, Peter; Coninx, Karin

    2015-01-01

    Robot-assisted rehabilitation facilitates high-intensity training of the impaired upper limb in neurological rehabilitation. It has been clinically observed that persons with Multiple Sclerosis (MS) have difficulties in sustaining the training intensity during a session due to the development of activity-related muscle fatigue. An experimental observational pilot study was conducted to examine whether or not the muscle fatigue develops in MS patients during one session of robot-assisted training within a virtual learning environment. Six MS patients with upper limb impairment (motricity index ranging from 50 to 91/100) and six healthy persons completed five training bouts of three minutes each performing lifting tasks, while EMG signals of anterior deltoid and lower trapezius muscles were measured and their subjective perceptions on muscle fatigue were registered. Decreased performance and higher subjective fatigue perception were present in the MS group. Increased mean EMG amplitudes and subjective perception levels on muscle fatigue were observed in both groups. Muscle fatigue development during 15' training has been demonstrated in the arm of MS patients, which influences the sustainability of training intensity in MS patients. To optimize the training performance, adaptivity based on the detection of MS patient's muscle fatigue could be provided by means of training program adjustment. PMID:26090229

  20. Development of Activity-Related Muscle Fatigue during Robot-Mediated Upper Limb Rehabilitation Training in Persons with Multiple Sclerosis: A Pilot Trial

    PubMed Central

    2015-01-01

    Robot-assisted rehabilitation facilitates high-intensity training of the impaired upper limb in neurological rehabilitation. It has been clinically observed that persons with Multiple Sclerosis (MS) have difficulties in sustaining the training intensity during a session due to the development of activity-related muscle fatigue. An experimental observational pilot study was conducted to examine whether or not the muscle fatigue develops in MS patients during one session of robot-assisted training within a virtual learning environment. Six MS patients with upper limb impairment (motricity index ranging from 50 to 91/100) and six healthy persons completed five training bouts of three minutes each performing lifting tasks, while EMG signals of anterior deltoid and lower trapezius muscles were measured and their subjective perceptions on muscle fatigue were registered. Decreased performance and higher subjective fatigue perception were present in the MS group. Increased mean EMG amplitudes and subjective perception levels on muscle fatigue were observed in both groups. Muscle fatigue development during 15? training has been demonstrated in the arm of MS patients, which influences the sustainability of training intensity in MS patients. To optimize the training performance, adaptivity based on the detection of MS patient's muscle fatigue could be provided by means of training program adjustment.

  1. Corticomotor excitability of arm muscles modulates according to static position and orientation of the upper limb

    E-print Network

    Perreault, Eric J.

    of Auckland, Auckland, New Zealand a r t i c l e i n f o Article history: Accepted 13 February 2014 Available rehabilitation aimed at retraining individual muscle recruitment and/or overall coordination patterns. Published by Elsevier Ltd. on behalf of International Federation of Clinical Neurophysiology. 1. Introduction Re

  2. Musculoskeletal upper limb modeling with muscle activation for flexible body simulation

    Microsoft Academic Search

    SeongYong Kim; Dong-Min Kim; Soo-Won Chae

    2009-01-01

    The use of digital human models has been increasing rapidly in various fields from medical to engineering applications. Most\\u000a of the works on human models involving muscle activation have been concentrated on rigid body simulation so far, because the\\u000a dynamics of human body motion has been primary concern regardless of the effects on human musculoskeletal body. Recently the\\u000a need for

  3. A 3 DOF Exoskeleton for Upper Limb Motion Assist: Consideration of the Effect of Bi-articular Muscles

    Microsoft Academic Search

    Kazuo Kiguchi; Toshio Fukuda

    2004-01-01

    We have been developing exoskeleton systems to assist the motion of physically weak persons such as elderly, disabled, and injured persons. The proposed exoskeletons are controlled basically based on the electromyogram (EMG) signals. Even though the EMG signals contain very important information, however, it is not very easy to predict the user's upper-limb motion (elbow and shoulder motion) based on

  4. Neural coupling between upper and lower limbs during recumbent stepping.

    PubMed

    Huang, Helen J; Ferris, Daniel P

    2004-10-01

    During gait rehabilitation, therapists or robotic devices often supply physical assistance to a patient's lower limbs to aid stepping. The expensive equipment and intensive manual labor required for these therapies limit their availability to patients. One alternative solution is to design devices where patients could use their upper limbs to provide physical assistance to their lower limbs (i.e., self-assistance). To explore potential neural effects of coupling upper and lower limbs, we investigated neuromuscular recruitment during self-driven and externally driven lower limb motion. Healthy subjects exercised on a recumbent stepper using different combinations of upper and lower limb exertions. The recumbent stepper mechanically coupled the upper and lower limbs, allowing users to drive the stepping motion with upper and/or lower limbs. We instructed subjects to step with 1) active upper and lower limbs at an easy resistance level (active arms and legs); 2) active upper limbs and relaxed lower limbs at easy, medium, and hard resistance levels (self-driven); and 3) relaxed upper and lower limbs while another person drove the stepping motion (externally driven). We recorded surface electromyography (EMG) from six lower limb muscles. Self-driven EMG amplitudes were always higher than externally driven EMG amplitudes (P < 0.05). As resistance and upper limb exertion increased, self-driven EMG amplitudes also increased. EMG bursts during self-driven and active arms and legs stepping occurred at similar times. These results indicate that active upper limb movement increases neuromuscular activation of the lower limbs during cyclic stepping motions. Neurologically impaired humans that actively engage their upper limbs during gait rehabilitation may increase neuromuscular activation and enhance activity-dependent plasticity. PMID:15180979

  5. [Pathomimia in upper limb].

    PubMed

    Maalla, Riadh; Bensalma, Hichem; Hamdi, Lamia; Assel, Salem; Bahri, Hichem; Hamdi, Abdelaziz

    2005-03-01

    Pathomimia, or factitious disorders, are characterized by producing symptoms voluntarily with the intention of playing the role of the patient. Inspite of being considerd as a psychatric disorder, pathomimuia is often encountered in the daily professional life of doctors without being recognized or diagnosed. There are various clinical aspects of pathomimia. The items that decide the orientation of the diagnosis are essentially the uncommon and odd expression of the reported symptoms, A capricious evolution as well as the multiplicity of the past medical cases. We report a group of five patients who were followed and treated between the years 2000 and 2003. This group was composed of three men and two women with an average age of 30 years. In three cases, we found the notion of skin injury. In one case, we noted a median nerve lesion in the elbow and once in the right upper member. The evolution was performed towards recidives of the initial symptomatology with more or less long periods of improvements. PMID:15929447

  6. EMG Activity in the Abdominal Muscles and the Kinematics of the Lumbar Spine during Unilateral Upper-limb Resistance Exercises under Stable and Unstable Conditions

    PubMed Central

    Kang, Min-Hyeok; Kim, Man-Sig

    2014-01-01

    [Purpose] We investigated the effects of unstable conditions on the electromyographic (EMG) activity of the rectus abdominis (RA) and the transverse abdominis–internal oblique (TrA-IO) muscles, and lumbar kinematics during unilateral upper-limb resistance exercises using elastic tubing bands. [Subjects] Twelve healthy males were recruited. [Methods] The subjects performed isometric left shoulder abduction using an elastic tubing band in a sitting position on a chair, and on a Swiss ball. During this exercise, EMG activities of the RA and TrA-IO were recorded using a wireless EMG system, and a three-dimensional motion analysis system monitored lumbar kinematics. Differences in EMG activities of the RA and TrA-IO, the ratio of TrA-IO to RA activity, and lumbar kinematics were compared between the stable and unstable conditions using the paired t-test. [Results] Under the unstable condition, the EMG activities of both muscles were significantly greater than that under the stable condition; however the ratio of TrA-IO to RA activity did not significantly differ between the conditions. The lumbar angle significantly differed only in the coronal plane. [Conclusions] These findings indicate that trunk posture should be considered when performing exercises under unstable conditions. PMID:25013286

  7. Electromyographic analysis of upper limb muscles during standardized isotonic and isokinetic robotic exercise of spastic elbow in patients with stroke.

    PubMed

    Sin, Minki; Kim, Won-Seok; Park, Daegeun; Min, Yu-Sun; Kim, Woo Jin; Cho, Kyujin; Paik, Nam-Jong

    2014-02-01

    Although it has been reported that strengthening exercise in stroke patients is beneficial for their motor recovery, there is little evidence about which exercise method is the better option. The purpose of this study was to compare isotonic and isokinetic exercise by surface electromyography (EMG) analysis using standardized methods. Nine stroke patients performed three sets of isotonic elbow extensions at 30% of their maximal voluntary isometric torque followed by three sets of maximal isokinetic elbow extensions with standardization of mean angular velocity and the total amount of work for each matched set in two strengthening modes. All exercises were done by using 1-DoF planner robot to regulate exact resistive torque and speed. Surface electromyographic activity of eight muscles in the hemiplegic shoulder and elbow was recorded. Normalized root mean square (RMS) values and co-contraction index (CCI) were used for the analysis. The isokinetic mode was shown to activate the agonists of elbow extension more efficiently than the isotonic mode (normalized RMS for pooled triceps: 96.0±17.0 (2nd), 87.8±14.4 (3rd) in isokinetic, 80.9±11.0 (2nd), 81.6±12.4 (3rd) in isotonic contraction, F[1,8]=11.168; P=0.010) without increasing the co-contraction of muscle pairs, implicating spasticity or synergy. PMID:24290983

  8. The Armeo Spring as training tool to improve upper limb functionality in multiple sclerosis: a pilot study

    Microsoft Academic Search

    Domien Gijbels; Ilse Lamers; Lore Kerkhofs; Geert Alders; Els Knippenberg; Peter Feys

    2011-01-01

    BACKGROUND: Few research in multiple sclerosis (MS) has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle

  9. Tourniquet use in upper limb surgery

    Microsoft Academic Search

    Emeka Oragui; Antony Parsons; Thomas White; Umile Giuseppe Longo; Wasim Sardar Khan

    2011-01-01

    Tourniquets are compressive devices that occlude venous and arterial blood flow to limbs and are commonly used in upper limb\\u000a surgery. With the potential risk of complications, there is some debate as to whether tourniquets should continue to be routinely\\u000a used. In this review, we first look at the different designs, principles, and practical considerations associated with the\\u000a use of

  10. Congenital cervical spinal muscular atrophy: a non-familial, non progressive condition of the upper limbs.

    PubMed Central

    Hageman, G; Ramaekers, V T; Hilhorst, B G; Rozeboom, A R

    1993-01-01

    Two patients with congenital cervical spinal muscular atrophy had symmetrical severe muscle weakness and wasting confined to the upper limbs, areflexia and congenital contractures. The shoulders were internally rotated, elbows extended and wrists flexed. There were no sensory or bulbar symptoms, scoliosis, long tract signs or lower limb involvement. This condition should be regarded as a neurogenic type of arthrogryposis, limited to the upper limbs. Images PMID:8482956

  11. Effects of physical and mental task demands on cervical and upper limb muscle activity and physiological responses during computer tasks and recovery periods.

    PubMed

    Wang, Yuling; Szeto, Grace P Y; Chan, Chetwyn C H

    2011-11-01

    The present study examined the effects of physical and mental workload during computer tasks on muscle activity and physiological measures. Activity in cervical postural muscles and distal forearm muscles, heart rate and blood pressure were compared among three tasks and rest periods of 15 min each in an experimental study design. Fourteen healthy pain-free adults participated (7 males, mean age = 23.2 ± 3.0 years) and the tasks were: (1) copy-typing ("typing"), (2) typing at progressively faster speed ("pacing"), (3) mental arithmetic plus fast typing ("subtraction"). Typing task was performed first, followed by the other two tasks in a random order. Median muscle activity (50th percentile) was examined in 5-min intervals during each task and each rest period, and statistically significant differences in the "time" factor (within task) and time × task factors was found in bilateral cervical erector spinae and upper trapezius muscles. In contrast, distal forearm muscle activity did not show any significant differences among three tasks. All muscles showed reduced activity to about the baseline level within first 5 min of the rest periods. Heart rate and blood pressure showed significant differences during tasks compared to baseline, and diastolic pressure was significantly higher in the subtraction than pacing task. The results suggest that cervical postural muscles had higher reactivity than forearm muscles to high mental workload tasks, and cervical muscles were also more reactive to tasks with high physical demand compared to high mental workload. Heart rate and blood pressure seemed to respond similarly to high physical and mental workloads. PMID:21409399

  12. Upper-Limb Powered Exoskeleton Design

    Microsoft Academic Search

    Joel C. Perry; Jacob Rosen; Stephen Burns

    2007-01-01

    An exoskeleton is an external structural mechanism with joints and links corresponding to those of the human body. With applications in rehabilitation medicine and virtual reality simulation, exoskeletons offer benefits for both disabled and healthy populations. A pilot database defining the kinematics and dynamics of the upper limb during daily living activities was one among several factors guiding the development

  13. Upper limb musculoskeletal disorders in healthcare personnel.

    PubMed

    Occhionero, Vincenzo; Korpinen, Leena; Gobba, Fabriziomaria

    2014-08-01

    The literature on upper limb musculoskeletal disorders (UL-MSD) in different groups of healthcare workers was reviewed: 65 relevant studies were collected. In dentists, the neck was the most frequently affected segment, with prevalences up to 73% and exceeding 50% in 7 out of 12 studies. In dental hygienists and in laboratory technicians, the hand/wrist had the highest prevalence in the majority of the studies. In nurses, the most seriously affected anatomic sites were the neck and shoulders. Physiotherapists had the lowest prevalence of UL-MSD. A high prevalence of upper limb disease, mainly carpal tunnel syndrome, was reported in dentists, dental hygienists, anesthesia nurses and endoscopists. The high prevalence of upper limb disorders/diseases reported in health personnel supports the hypothesis of a significant risk in these workers. However, the possible role of biomechanical overload, as much as that of stress or other personal factors, cannot be currently assessed. Practitioner Summary: Published studies support the hypothesis of a significant risk of upper limb musculoskeletal disorders in healthcare activities. The neck was the most frequently affected segment in dentists, the hand/wrist in dental hygienists and in laboratory technicians, and the neck and shoulders in nurses. Lower prevalence was reported in physiotherapists. A high prevalence of carpal tunnel syndrome was also observed in various healthcare activities. PMID:24840049

  14. Diagnosis and treatment of upper limb apraxia.

    PubMed

    Dovern, A; Fink, G R; Weiss, P H

    2012-07-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies. PMID:22215235

  15. Effect of limb immobilization on skeletal muscle

    NASA Technical Reports Server (NTRS)

    Booth, F. W.

    1982-01-01

    Current knowledge and questions remaining concerning the effects of limb immobilization on skeletal muscle is reviewed. The most dramatic of these effects is muscle atrophy, which has been noted in cases of muscles fixed at or below their resting length. Immobilization is also accompanied by a substantial decrease in motoneuronal discharges, which results in the conversion of slow-twitch muscle to muscle with fast-twitch characteristics. Sarcolemma effects include no change or a decrease in resting membrane potential, the appearance of extrajunctional acetylcholine receptors, and no change in acetylcholinesterase activity. Evidence of changes in motoneuron after hyperpolarization characteristics suggests that the muscle inactivity is responsible for neuronal changes, rather than vice versa. The rate of protein loss from atrophying muscles is determined solely by the first-order rate constant for degradation. Various other biochemical and functional changes have been noted, including decreased insulin responsiveness and protein synthesis. The model of limb immobilization may also be useful for related studies of muscle adaptation.

  16. Dissociated lower limb muscle involvement in amyotrophic lateral sclerosis.

    PubMed

    Simon, Neil G; Lee, Michael; Bae, Jong Seok; Mioshi, Eneida; Lin, Cindy S-Y; Pfluger, Casey M; Henderson, Robert D; Vucic, Steve; Swash, Michael; Burke, David; Kiernan, Matthew C

    2015-06-01

    It has been suggested that corticomotoneuronal drive to ankle dorsiflexors is greater than to ankle plantar flexor muscles, despite the finding that plantar flexors are no less active than TA during walking and standing. The present study was undertaken to determine whether there was differential involvement of distal lower limb muscles in amyotrophic lateral sclerosis (ALS), to elucidate pathophysiological mechanisms of selective muscle involvement. Prospective studies were undertaken in 52 ALS patients, including clinical assessment, disease staging (revised ALS functional rating scale), Medical Research Council sum score, and a scale of upper motor neurone (UMN) dysfunction. Motor unit number estimates (MUNE) and compound muscle action potentials (CMAP) from ankle dorsiflexors and plantar flexors were used to provide objective measures. A novel 'split leg index' was calculated as follows: SLI = CMAPDF ÷ CMAPPF. In ALS, there was significantly greater reduction of MUNE and CMAP amplitude recorded from plantar flexors when compared to dorsiflexors, suggesting preferential involvement of plantar flexor muscles, underpinning a 'split leg' appearance. The SLI correlated with clinical plantar flexor strength (R= -0.56, p < 0.001). In no patient did the SLI suggest preferential dorsiflexor involvement. In subgroup analyses, mean SLI was greatest in lower limb-onset ALS. In conclusion, the present study has established dissociated involvement of muscles acting around the ankle in ALS. We suggest this reflects underlying differences in cortical, descending or local spinal modulation of these muscles. PMID:25845764

  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. A Real-time EMG-based Assistive Computer Interface for the Upper Limb Disabled

    Microsoft Academic Search

    Changmok Choi; Jung Kim

    2007-01-01

    This paper presents the design of an assistive real-time system for the upper limb disabled to access a computer via residual muscle activities without standard computer interfaces (e.g. a mouse and a keyboard). For this purpose, electromyogram (EMG) signals from muscles in the lower arm were extracted and filtered using signal statistics (mean and variance). In order to control movement

  19. Electrical stimulation and iterative learning control for functional recovery in the upper limb post-stroke.

    PubMed

    Meadmore, Katie; Exell, Timothy; Freeman, Christopher; Kutlu, Mustafa; Rogers, Eric; Hughes, Ann-Marie; Hallewell, Emma; Burridge, Jane

    2013-06-01

    Therapies using functional electrical stimulation (FES) in conjunction with practice of everyday tasks have proven effective in facilitating recovery of upper limb function following stroke. The aim of the current study is to develop a multi-channel electrical stimulation system that precisely controls the assistance provided in goal-orientated tasks through use of advanced model-based 'iterative learning control' (ILC) algorithms to facilitate functional motor recovery of the upper limb post-stroke. FES was applied to three muscle groups in the upper limb (the anterior deltoid, triceps and wrist extensors) to assist hemiparetic, chronic stroke participants to perform a series of functional tasks with real objects, including closing a drawer, turning on a light switch and repositioning an object. Position data from the participants' impaired upper limb was collected using a Microsoft Kinect® and was compared to an ideal reference. ILC used data from previous attempts at the task to moderate the FES signals applied to each muscle group on a trial by trial basis to reduce performance error whilst supporting voluntary effort by the participant. The clinical trial is on-going. Preliminary results show improvements in performance accuracy for each muscle group, as well as improvements in clinical outcome measures pre and post 18 training sessions. Thus, the feasibility of applying precisely controlled FES to three muscle groups in the upper limb to facilitate functional reach and grasp movements post stroke has been demonstrated. PMID:24187178

  20. The Ipsilesional Upper Limb Can Be Affected following Stroke

    PubMed Central

    Kitsos, Gemma H.; Hubbard, Isobel J.; Kitsos, Alex R.; Parsons, Mark W.

    2013-01-01

    Objective. Neurological dysfunction commonly occurs in the upper limb contralateral to the hemisphere of the brain in which stroke occurs; however, the impact of stroke on function of the ipsilesional upper limb is not well understood. This study aims to systematically review the literature relating to the function of the ipsilesional upper limb following stroke and answer the following research question: Is the ipsilesional upper limb affected by stroke? Data Source. A systematic review was carried out in Medline, Embase, and PubMed. Review Methods. All studies investigating the ipsilesional upper limb following stroke were included and analysed for important characteristics. Outcomes were extracted and summarised. Results. This review captured 27 articles that met the inclusion criteria. All studies provided evidence that the ipsilesional upper limb can be affected following stroke. Conclusion. These findings demonstrate that clinicians should consider ipsilesional upper limb deficits in rehabilitation and address this reduced functional capacity. Furthermore, the ipsilesional upper limb should not be used as a “control” measure of recovery for the contralateral upper limb. PMID:24379748

  1. Upper limb cerebellar motor function in children with spina bifida

    PubMed Central

    Jewell, Derryn; Fletcher, Jack M.; Mahy, Caitlin E. V.; Hetherington, Ross; MacGregor, Daune; Drake, James M.; Salman, Michael S.

    2011-01-01

    Purpose To investigate upper limb cerebellar motor function in children with spina bifida myelomeningocele (SBM) and in typically developing controls. Methods Participants with SBM, who had either upper level spinal lesions (n=23) or lower level spinal lesions (n=65), and controls (n=37) completed four upper limb motor function tasks (posture, rebound, limb dysmetria, and diadochokinesis) under four different physical and cognitive challenge conditions. Functional independence was assessed by parental questionnaire. Results Fewer SBM participants were able to complete the posture task, and they were less likely than controls to obtain a perfect rebound score. Participants with SBM showed impaired performance in either time, accuracy, or both, on the limb dysmetria and diadochokinesis tasks but responded like controls to physical and cognitive challenges. Conclusions Because upper limb motor performance predicted aspects of functional independence, we conclude that upper limb impairments in children with SBM are significant and have direct implications for the level of independent functioning in children with SBM. PMID:19823846

  2. Musculoskeletal interventional ultrasonography: the upper limb.

    PubMed

    Vuillemin, V; Guerini, H; Morvan, G

    2012-09-01

    Forty percent of the 823 ultrasound-guided injections performed in our centre over a year and a half concerned the upper limb, injections involving the shoulder, for subacromial bursitis and the treatment of calcific tendinitis, being the prime indications (24%). The wrist represented 8% of the prescriptions, for treatment of tendinopathy, ganglion cysts, carpal tunnel syndrome and rhizarthrosis. Trigger finger, tenosynovitis and pulley ganglia made up 6% of the indications and the elbow 2.5%. Ultrasound improves the accuracy of the procedure by helping guide the path of the needle and allowing the distribution of the substance injected to be visualised. We shall give details of the technique used for each indication, with advice and hints and post-procedure recommendations. PMID:22921692

  3. Influence of Type of Muscle Contraction and Gender on Postactivation Potentiation of Upper and Lower Limb Explosive Performance in Elite Fencers

    PubMed Central

    Tsolakis, Charilaos; Bogdanis, Gregory C.; Nikolaou, Anni; Zacharogiannis, Elias

    2011-01-01

    The purpose of this study was to evaluate the postactivation potentiation (PAP) effect of isometric and plyometric contractions on explosive performance of the upper and the lower limbs in male and female elite athletes. Thirteen male and ten female international level fencers performed four protocols of either isometric (3 sets of 3 sec) or plyometric (3 sets of 5 repetitions) bench and leg press, in a within subject randomized design. Before and immediately after the PAP treatment and following 4, 8, 12 min, explosive performance was measured by performing a countermovement jump (CMJ) or a bench press throw. Statistical analysis revealed significant time effect for peak leg power during the CMJ (p < 0.001) only for men, with values after the isometric PAP treatment being lower than baseline at the 8 and 12 min time points (by 7.5% (CI95% = 3.9-11.2%) and 8.7% (CI95% = 6.0-11.5%, respectively), while after the plyometric PAP treatment peak leg power remained unchanged. A significant negative correlation was found between leg strength (as expressed by 1-RM leg press performance) and the change in peak leg power between baseline and after 12 min of recovery only in male fencers (r = -0.55, p < 0.05), suggesting that stronger individuals may show a greater decrease in peak leg power. Based on the above results we conclude that lower body power performance in international level fencers may be negatively affected after isometric contractions and thus they should be advised against using isometric exercises to induce PAP with the protocol prescribed in the present study. Furthermore, gender and strength level must be considered in the practical application of PAP. Key points Significantly lower values for peak power of the legs were noted in men at 8 and 12 min of recovery in response to the PAP protocol used in this study There is some evidence to suggest that stronger individuals may have a greater and longer lasting fatigue that may actually result in a decrease rather than increase of performance after a PAP protocol Fencers should be advised to avoid the use of isometric exercises in warm-up routines to augment explosive performance PMID:24150636

  4. Glucose uptake and glycogen synthesis in muscles from immobilized limbs

    NASA Technical Reports Server (NTRS)

    Nicholson, W. F.; Watson, P. A.; Booth, F. W.

    1984-01-01

    Defects in glucose metabolism in muscles of immobilized limbs of mice were related to alterations in insulin binding, insulin responsiveness, glucose supply, and insulin activation of glycogen synthase. These were tested by in vitro methodology. A significant lessening in the insulin-induced maximal response of 2-deoxyglucose uptake into the mouse soleus muscle occurred between the 3rd and 8th h of limb immobilization, suggesting a decreased insulin responsiveness. Lack of change in the specific binding of insulin to muscles of 24-h immobilized limbs indicates that a change in insulin receptor number did not play a role in the failure of insulin to stimulate glucose metabolism. Its inability to stimulate glycogen synthesis in muscle from immobilized limbs is due, in part, to a lack of glucose supply to glycogen synthesis and also to the ineffectiveness of insulin to increase the percentage of glycogen synthase in its active form in muscles from 24-h immobilized limbs.

  5. Upper Limb Ischemic Gangrene as a Complication of Hemodialysis Access

    PubMed Central

    Cawich, Shamir O.; Mohammed, Emil; Mencia, Marlon

    2015-01-01

    Upper limb ischemia is a well-recognized complication of dialysis access creation but progression to gangrene is uncommon. We report a case of upper limb ischemic gangrene and discuss the lessons learned during the management of this case. Clinicians must be vigilant for this complication and they should be reminded that it requires urgent management to prevent tissue loss. PMID:25810944

  6. Muscle activation patterns during walking from transtibial amputees recorded within the residual limb-prosthetic interface

    PubMed Central

    2012-01-01

    Background Powered lower limb prostheses could be more functional if they had access to feedforward control signals from the user’s nervous system. Myoelectric signals are one potential control source. The purpose of this study was to determine if muscle activation signals could be recorded from residual lower limb muscles within the prosthetic socket-limb interface during walking. Methods We recorded surface electromyography from three lower leg muscles (tibilias anterior, gastrocnemius medial head, gastrocnemius lateral head) and four upper leg muscles (vastus lateralis, rectus femoris, biceps femoris, and gluteus medius) of 12 unilateral transtibial amputee subjects and 12 non-amputee subjects during treadmill walking at 0.7, 1.0, 1.3, and 1.6 m/s. Muscle signals were recorded from the amputated leg of amputee subjects and the right leg of control subjects. For amputee subjects, lower leg muscle signals were recorded from within the limb-socket interface and from muscles above the knee. We quantified differences in the muscle activation profile between amputee and control groups during treadmill walking using cross-correlation analyses. We also assessed the step-to-step inter-subject variability of these profiles by calculating variance-to-signal ratios. Results We found that amputee subjects demonstrated reliable muscle recruitment signals from residual lower leg muscles recorded within the prosthetic socket during walking, which were locked to particular phases of the gait cycle. However, muscle activation profile variability was higher for amputee subjects than for control subjects. Conclusion Robotic lower limb prostheses could use myoelectric signals recorded from surface electrodes within the socket-limb interface to derive feedforward commands from the amputee’s nervous system. PMID:22882763

  7. Effort-Induced Venous Thrombosis of the Upper Limbs

    Microsoft Academic Search

    M. Y. Z. Youssef; T. Al Taweel; S. Asfar; N. Abdella

    2006-01-01

    Objective: To report 3 patients who presented with effort-induced thrombosis of the upper limbs. Case Presentations and Intervention: The 1st patient presented with a 2-week history of fever, shortness of breath, and increasing swelling of the neck after strenuous manual work. The 2nd patient presented with a 2-day history of pain, swelling, and discolouration of the right upper limb following

  8. Treatment for upper-limb and lower-limb lymphedema by professionals specializing in lymphedema care

    Microsoft Academic Search

    D. LANGBECKER; S. C. HAYES; B. NEWMAN; M. JANDA

    2008-01-01

    Up to 60% of patients with cancer of the vulva, and between 20 and 30% of patients with breast or abdominal cancers may develop lymphedema following treatment. The aims of this study were to assess health profes- sionals' knowledge about treatment, diagnostic procedures, advice and confidence in treatment of patients with either upper-limb (ULL) or lower-limb lymphoedema (LLL), and whether

  9. Experimental Study and Characterization of SEMG Signals for Upper Limbs

    NASA Astrophysics Data System (ADS)

    Veer, Karan

    2015-04-01

    Surface electromyogram (SEMG) is used to measure the activity of superficial muscles and is an essential tool to carry out biomechanical assessments required for prosthetic design. Many previous attempts suggest that, electromyogram (EMG) signals have random nature. Here, dual channel evaluation of EMG signals acquired from the amputed subjects using computational techniques for classification of arm motion are presented. After recording data from four predefined upper arm motions, interpretation of signal was done for six statistical features. The signals are classified by the neural network (NN) and then interpretation was done using statistical technique to extract the effectiveness of recorded signals. The network performances are analyzed by considering the number of input features, hidden layer, learning algorithm and mean square error. From the results, it is observed that there exists calculative difference in amplitude gain across different motions and have great potential to classify arm motions. The outcome indicates that NN algorithm performs significantly better than other algorithms with classification accuracy (CA) of 96.40%. Analysis of variance technique presents the results to validate the effectiveness of recorded data to discriminate SEMG signals. Results are of significant thrust in identifying the operations that can be implemented for classifying upper limb movements suitable for prostheses design.

  10. Effects of postural changes of the upper limb on reflex transmission in the lower limb. Cervicolumbar reflex interactions in man

    Microsoft Academic Search

    P J Delwaide; C Figiel; C Richelle

    1977-01-01

    The influence of passive changes in upper limb position on the excitability of three myotatic arc reflexes (soleus, quadriceps, and biceps femoris) of the lower limb has been explored on 42 volunteers. The results indicate that the excitability of the three myotatic arcs can be influenced at a distance by postural modifications of the upper limb. When the ipsilateral upper

  11. The map is not the territory: motor system reorganization in upper limb amputees.

    PubMed

    Gagné, Martin; Hétu, Sébastien; Reilly, Karen T; Mercier, Catherine

    2011-04-01

    It is generally considered that hand amputation changes primary motor cortex (M1) stump muscle representations. Transcranial magnetic stimulation (TMS) studies show that the corticospinal excitability of a stump muscle and its homologous muscle on the intact side is not equivalent, and that the resting level of excitability is higher in the stump muscle. Since changes in M1 stump muscle map characteristics (e.g., size and location) are identified by comparing stump and intact muscle maps, such changes might reflect between-side differences in corticospinal excitability rather than a true reorganization of the stump muscle's map. In eight above-elbow amputees we used TMS to map the M1 representation of a stump muscle and its homologous muscle on the intact side during rest and contraction. Importantly, the same relative stimulation intensity was used to construct each map; stimulation was performed at 120% of the motor threshold of each muscle (intact/amputated limb) measured in each condition (rest/active contraction). Resting motor threshold was lower in the stump muscle, but active motor thresholds did not differ. Motor-evoked potential amplitudes increased between the rest and muscle contraction conditions, but this increase was smaller for the stump muscle because its at-rest corticospinal excitability was higher than that of the intact muscle. When the between-side difference in excitability was considered no interhemispheric difference was found for map areas or for their medio-lateral locations. The present results challenge the view that after an upper limb amputation the stump representation moves laterally and occupies a larger M1 territory. PMID:21391244

  12. Acute-onset painful upper limb multifocal demyelinating motor neuropathy

    Microsoft Academic Search

    V. Peter Misra; Rodney W. H. Walker

    2000-01-01

    We report three patients who presented with acute onset of shoulder and upper arm pain followed within a few days by predominantly\\u000a distal upper limb weakness. Nerve conduction studies showed severe and unequivocal focal motor conduction block in the forearm\\u000a and\\/or upper arm along with slowing of motor conduction and prolonged F wave responses. Only very mild changes in sensory

  13. Upper limb malformations in DiGeorge syndrome

    SciTech Connect

    Cormier-Daire, V.; Iserin, L.; Sidi, D. [and others

    1995-03-13

    We report on upper limb anomalies in two children with a complete DiGeorge sequence: conotruncal defects, hypocalcemia, thymic aplasia, and facial anomalies. One child had preaxial polydactyly, and the other had club hands with hypoplastic first metacarpal. In both patients, molecular analysis documented a 22q11 deletion. To our knowledge, limb anomalies have rarely been reported in DiGeorge syndrome, and they illustrate the variable clinical expression of chromosome 22q11 deletions. 13 refs., 2 figs.

  14. Upper limb musculoskeletal disorders in highly repetitive industries: precise anatomical physical findings

    Microsoft Academic Search

    D. RANNEY; R. WELLS; A. MOORE

    1995-01-01

    Physical assessment of 146 female workers in highly repetitive jobs found 54% to have evidence of musculoskeletal disorders in the upper limb that are potentially work-related. Many workers had multiple problems, and many were affected bilaterally (33% of workers). Muscle pain and tenderness was the largest problem, both in the neck\\/shoulder area (31%) as expected and in the forearm\\/hand musculature

  15. Neuromodulation of effects of upper limb motor function and shoulder range of motion by functional electric stimulation (FES)

    Microsoft Academic Search

    Ray-Yau Wang

    Upper extremity motor impairment is a major contributing factor to functional disability of stroke patients. Functional electric\\u000a stimulation (FES) is one of the therapeutic regimens for the management of upper extremity dysfunction after stroke. This\\u000a review shows that therapeutic FES intervention on supraspinatus and posterior deltoid muscles for 6 weeks is effective to\\u000a speed up upper limb motor recovery in

  16. 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

  17. Exoskeleton for human upper-limb motion support

    Microsoft Academic Search

    Kazuo Kiguchi; Takakazu Tanaka; Keigo Watanabe; Toshio Fukudaa

    2003-01-01

    We have been developing exoskeletons (exoskeletal robots) for assisting the motion of physically weak persons such as elderly persons or slightly disabled persons in daily life. In this paper, we propose a 3 DOF exoskeleton and its control system to assist the human upper-limb motion (shoulder joint motion and elbow joint motion) of physically weak persons. The proposed robot automatically

  18. EMG changes in rat hind limb muscles following bilateral deafferentation

    Microsoft Academic Search

    P. Hník; R. Vejsada; S. Kasicki

    1982-01-01

    Bilateral section of dorsal roots was performed in 9 adult rats in order to ascertain whether the tendency to extension, the appearance of spontaneous electromyographic (EMG) activity in extensor muscles and other symptoms of postdenervation hypersensitivity after unilateral deafferentation are not due to the sensory inflow from the contralateral limb. EMG activity from the soleus (SOL) and tibialis anterior (TA)

  19. Shaping muscle bioarchitecture for the fin to limb transition

    PubMed Central

    Cole, Nicholas J.; Currie, Peter

    2012-01-01

    Our recent paper examined how pelvic fins and their musculature form developmentally and how these mechanisms have evolved within the vertebrate lineage, a process fundamental to the tetrapod transition. The transition from the water onto the land is among one of the most well studied steps in the evolutionary history of vertebrates, yet the genetic basis of this evolutionary transition is little studied and ill-defined. The advent of these terrestrial species resulted in a shift in locomotor strategies from the rhythmic undulating muscles of the fish body to a reliance upon powerful weight bearing muscles of the limbs to generate movement. We demonstrated that the pelvic fin muscles of bony fish are generated by a mechanism that has features of both of limb/fin muscle formation in tetrapods and primitive cartilaginous fish. We hypothesize that the adoption of the fully derived mode of hindlimb muscle formation, was a further modification of the mode of development deployed to generate pelvic fin muscles, a shift in overall muscle bioarchitecture we believe was critical to the success of the tetrapod transition. PMID:22880150

  20. Long-Duration Muscle Dedifferentiation during Limb Regeneration in Axolotls

    PubMed Central

    Wu, Cheng-Han; Huang, Ting-Yu; Chen, Bo-Sung; Chiou, Ling-Ling; Lee, Hsuan-Shu

    2015-01-01

    Although still debated, limb regeneration in salamanders is thought to depend on the dedifferentiation of remnant tissue occurring early after amputation and generating the progenitor cells that initiate regeneration. This dedifferentiation has been demonstrated previously by showing the fragmentation of muscle fibers into mononucleated cells and by revealing the contribution of mature muscle fibers to the regenerates by using lineage-tracing studies. Here, we provide additional evidence of dedifferentiation by showing that Pax7 (paired-box protein-7) transcripts are expressed at the ends of remnant muscle fibers in axolotls by using in situ hybridization and by demonstrating the presence of Pax7+ muscle-fiber nuclei in the early bud and mid-bud stages by means of immunohistochemical staining. During the course of regeneration, the remnant muscles did not progress; instead, muscle progenitors migrated out from the remnants and proliferated and differentiated in the new tissues at an early stage of differentiation. The regenerating muscles and remnant muscles were largely disconnected, and this left a gap between them until extremely late in the late stage of differentiation, at which point the new and old muscles connected together. Notably, Pax7 transcripts were detected in the regions of muscles that faced these gaps; thus, Pax7 expression might indicate dedifferentiation in the remnant-muscle ends and partial differentiation in the regenerating muscles. The roles of this long-duration dedifferentiation in the remnants remain unknown. However, the results presented here could support the hypothesis that long-duration muscle dedifferentiation facilitates the connection and fusion between the new and old muscles that are both in an immature state; this is because immature Pax7+ myoblasts readily fuse during developmental myogenesis. PMID:25671422

  1. Upper limb grafts for hemodialysis access.

    PubMed

    Shemesh, David; Goldin, Ilya; Verstandig, Anthony; Berelowitz, Daniel; Zaghal, Ibrahim; Olsha, Oded

    2015-01-01

    Arteriovenous (AV) grafts are required for hemodialysis access when options for native fistulas have been fully exhausted, where they continue to play an important role in hemodialysis patients, offering a better alternative to central vein catheters. When planning autogenous accesses using Doppler ultrasound, adequate arterial inflow and venous outflow must be consciously preserved for future access creation with grafts. Efforts to improve graft patency include changing graft configuration, graft biology and hemodynamics. Industry offers early cannulation grafts to reduce central catheter use and a bioengineered graft is undergoing clinical studies. Although the outcome of AV grafts is inferior to fistulas, grafts can provide long-term hemodialysis access that is a better alternative to central venous catheters. AV grafts have significant drawbacks, mainly poor patency, infection and cost but also have some advantages: early maturation, ease of creation and needling and widespread availability. The outcome of AV graft surgery is variable from center to center. The primary patency rate for AV grafts is 58% at 6 months and the secondary patency rate is 76% at 6 months and 55% at 18 months. There are centers of excellence that report a 1 year secondary patency rate of up to 91%. In this review of the use of AV grafts for hemodialysis access in the upper extremities, technical issues involved in planning the access and performing the surgery in its different configurations are discussed and the role of surveillance and maintenance with their attendant surgical and radiological interventions is described. PMID:25751548

  2. Motor Impairment Evaluation for Upper Limb in Stroke Patients on the Basis of a Microsensor

    ERIC Educational Resources Information Center

    Huang, Shuai; Luo, Chun; Ye, Shiwei; Liu, Fei; Xie, Bin; Wang, Caifeng; Yang, Li; Huang, Zhen; Wu, Jiankang

    2012-01-01

    There has been an urgent need for an effective and efficient upper limb rehabilitation method for poststroke patients. We present a Micro-Sensor-based Upper Limb rehabilitation System for poststroke patients. The wearable motion capture units are attached to upper limb segments embedded in the fabric of garments. The body segment orientation…

  3. Redundancy and Joint Limits of a Seven Degree of Freedom Upper Limb Exoskeleton

    E-print Network

    Rosen, Jacob

    Redundancy and Joint Limits of a Seven Degree of Freedom Upper Limb Exoskeleton Levi Makaio Miller. The human machine interface (HMI) is a critical part of these system and for upper limb exoskeletons], upper limb exoskeletons [6] [7] [1] [8], biomechanics [9] [10] [11], and much more. The seven DoF model

  4. 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

  5. Rare multiple variations in brachial plexus and related structures in the left upper limb of a Dravidian male cadaver

    PubMed Central

    Rathinam, Bertha A. D.

    2013-01-01

    Anatomical variations of the nerves, muscles, and vessels in the upper limb have been described in many anatomical studies; however, the occurrence of 6 variations in an ipsilateral limb is very rare. These variations occur in the following structures: the pectoralis minimus muscle, the communication between the external jugular vein and cephalic vein, axillary arch, the Struthers ligament, the medial, lateral, and posterior cords of the brachial plexus, and the common arterial trunk from the third part of the axillary artery. The relationship of these variations to each other and their probable clinical presentation is discussed. PMID:23869264

  6. Work-related musculoskeletal disorders of the upper limb

    Microsoft Academic Search

    Michel Aptel; Agnès Aublet-Cuvelier; Jean Claude Cnockaert

    2002-01-01

    Work-related musculoskeletal disorders of the upper limb (WRMSDs-UL) account for over two-thirds of all occupational disorders recognized in France. This broad term encompasses a vast array of disorders whose development is facilitated by environmental factors present at the workplace. Numerous epidemiological studies have established the key role of occupational activities in the genesis of WRMSDs-UL. This role is mediated by

  7. Quantification of upper limb kinetic asymmetries in front crawl swimming.

    PubMed

    Morouço, Pedro G; Marinho, Daniel A; Fernandes, Ricardo J; Marques, Mário C

    2015-04-01

    This study aimed at quantifying upper limb kinetic asymmetries in maximal front crawl swimming and to examine if these asymmetries would affect the contribution of force exertion to swimming performance. Eighteen high level male swimmers with unilateral breathing patterns and sprint or middle distance specialists, volunteered as participants. A load-cell was used to quantify the forces exerted in water by completing a 30s maximal front crawl tethered swimming test and a maximal 50 m free swimming was considered as a performance criterion. Individual force-time curves were obtained to calculate the mean and maximum forces per cycle, for each upper limb. Following, symmetry index was estimated and breathing laterality identified by questionnaire. Lastly, the pattern of asymmetries along the test was estimated for each upper limb using linear regression of peak forces per cycle. Asymmetrical force exertion was observed in the majority of the swimmers (66.7%), with a total correspondence of breathing laterality opposite to the side of the force asymmetry. Forces exerted by the dominant upper limb presented a higher decrease than from the non-dominant. Very strong associations were found between exerted forces and swimming performance, when controlling the isolated effect of symmetry index. Results point that force asymmetries occur in the majority of the swimmers, and that these asymmetries are most evident in the first cycles of a maximum bout. Symmetry index stood up as an influencing factor on the contribution of tethered forces over swimming performance. Thus, to some extent, a certain degree of asymmetry is not critical for short swimming performance. PMID:25591132

  8. Effect of maturation on muscle quality of the lower limb muscles in adolescent boys

    PubMed Central

    2014-01-01

    Background The purpose of this study was to clarify the effect of maturation on the muscle quality of the lower limb muscles around puberty. Methods Subjects were 117 Japanese boys age 12 to 15 years. The maturity status was assessed by using a self-assessment of stage of pubic hair development based on the criteria of Tanner. On the basis of the criteria, subjects were divided into the prepubescent or pubescent group. Muscle thickness of knee extensors and plantar flexors were measured by a B-mode ultrasound. Muscle volume index (MV) was calculated from muscle thickness and limb length. Maximal voluntary isometric joint toques (TQ) of knee extension and ankle plantar flexion were measured using a myometer. Muscle quality was derived from dividing TQ by MV (TQ/MV). Results In both muscles, TQ-MV relationships were also similar between the prepubescent and pubescent groups, and there was no significant difference in TQ/MV between the two groups when chronological age was statistically adjusted. Conclusion The current results indicate that, for adolescent boys, the muscle quality of the lower limb muscles is not significantly influenced by maturation. PMID:25239758

  9. The microwave limb sounder for the Upper Atmosphere Research Satellite

    NASA Technical Reports Server (NTRS)

    Waters, J. W.; Peckham, G. E.; Suttie, R. A.; Curtis, P. D.; Maddison, B. J.; Harwood, R. S.

    1988-01-01

    The Microwave Limb Sounder was designed to map the concentrations of trace gases from the stratosphere to the lower thermosphere, to improve understanding of the photochemical reactions which take place in this part of the atmosphere. The instrument will measure the intensity of thermal radiation from molecules in the atmosphere at frequencies corresponding to rotational absorption bands of chlorine monoxide, ozone, and water vapor. Molecular concentration profiles will be determined over a height range of 15 to 80 km (20 to 45 km for C10). The 57 deg inclination orbit proposed for the Upper Atmosphere Research Satellite will allow global coverage.

  10. A solitary fibrous tumor of the upper limb.

    PubMed

    Al-Shanawani, Bisher N; Al-Qattan, Mohammad M; Arafah, Maha M; Al-Motairi, Muhammed I

    2015-02-01

    Solitary fibrous tumors (SFT) of the upper limb are extremely rare, and we report this tumor in the arm of a 30-year-old male. He is presented with a 22 cm painless mass. Complete surgical excision was performed. The histological diagnosis of SFT was based on the presence of ectatic blood vessels and positive staining for CD34 and vimentin. He remains disease-free at the 3-year follow-up interval. The report aims to increase the awareness of the criteria for the histological diagnosis of SFT, as well as the principles of their surgical excision and follow-up.  PMID:25719592

  11. A solitary fibrous tumor of the upper limb

    PubMed Central

    Al-Shanawani, Bisher N.; Al-Qattan, Mohammad M.; Arafah, Maha M.; Al-Motairi, Muhammed I.

    2015-01-01

    Solitary fibrous tumors (SFT) of the upper limb are extremely rare, and we report this tumor in the arm of a 30-year-old male. He is presented with a 22 cm painless mass. Complete surgical excision was performed. The histological diagnosis of SFT was based on the presence of ectatic blood vessels and positive staining for CD34 and vimentin. He remains disease-free at the 3-year follow-up interval. The report aims to increase the awareness of the criteria for the histological diagnosis of SFT, as well as the principles of their surgical excision and follow-up. PMID:25719592

  12. Effect of Kayak Ergometer Elastic Tension on Upper Limb EMG Activity and 3D Kinematics

    PubMed Central

    Fleming, Neil; Donne, Bernard; Fletcher, David

    2012-01-01

    Despite the prevalence of shoulder injury in kayakers, limited published research examining associated upper limb kinematics and recruitment patterns exists. Altered muscle recruitment patterns on-ergometer vs. on-water kayaking were recently reported, however, mechanisms underlying changes remain to be elucidated. The current study assessed the effect of ergometer recoil tension on upper limb recruitment and kinematics during the kayak stroke. Male kayakers (n = 10) performed 4 by 1 min on-ergometer exercise bouts at 85%VO2max at varying elastic recoil tension; EMG, stroke force and three-dimensional 3D kinematic data were recorded. While stationary recoil forces significantly increased across investigated tensions (125% increase, p < 0.001), no significant differences were detected in assessed force variables during the stroke cycle. In contrast, increasing tension induced significantly higher Anterior Deltoid (AD) activity in the latter stages (70 to 90%) of the cycle (p < 0.05). No significant differences were observed across tension levels for Triceps Brachii or Latissimus Dorsi. Kinematic analysis revealed that overhead arm movements accounted for 39 ± 16% of the cycle. Elbow angle at stroke cycle onset was 144 ± 10°; maximal elbow angle (151 ± 7°) occurred at 78 ± 10% into the cycle. All kinematic markers moved to a more anterior position as tension increased. No significant change in wrist marker elevation was observed, while elbow and shoulder marker elevations significantly increased across tension levels (p < 0.05). In conclusion, data suggested that kayakers maintained normal upper limb kinematics via additional AD recruitment despite ergometer induced recoil forces. Key pointsKayak ergometer elastic tension significantly alters Anterior Deltoid recruitment patterns.Kayakers maintain optimal arm kinematics despite changing external forces via altered shoulder muscle recruitment.Overhead arm movements account for a high proportion of the kayak stroke cycle. PMID:24149350

  13. Effect of Kayak Ergometer Elastic Tension on Upper Limb EMG Activity and 3D Kinematics.

    PubMed

    Fleming, Neil; Donne, Bernard; Fletcher, David

    2012-01-01

    Despite the prevalence of shoulder injury in kayakers, limited published research examining associated upper limb kinematics and recruitment patterns exists. Altered muscle recruitment patterns on-ergometer vs. on-water kayaking were recently reported, however, mechanisms underlying changes remain to be elucidated. The current study assessed the effect of ergometer recoil tension on upper limb recruitment and kinematics during the kayak stroke. Male kayakers (n = 10) performed 4 by 1 min on-ergometer exercise bouts at 85%VO2max at varying elastic recoil tension; EMG, stroke force and three-dimensional 3D kinematic data were recorded. While stationary recoil forces significantly increased across investigated tensions (125% increase, p < 0.001), no significant differences were detected in assessed force variables during the stroke cycle. In contrast, increasing tension induced significantly higher Anterior Deltoid (AD) activity in the latter stages (70 to 90%) of the cycle (p < 0.05). No significant differences were observed across tension levels for Triceps Brachii or Latissimus Dorsi. Kinematic analysis revealed that overhead arm movements accounted for 39 ± 16% of the cycle. Elbow angle at stroke cycle onset was 144 ± 10°; maximal elbow angle (151 ± 7°) occurred at 78 ± 10% into the cycle. All kinematic markers moved to a more anterior position as tension increased. No significant change in wrist marker elevation was observed, while elbow and shoulder marker elevations significantly increased across tension levels (p < 0.05). In conclusion, data suggested that kayakers maintained normal upper limb kinematics via additional AD recruitment despite ergometer induced recoil forces. Key pointsKayak ergometer elastic tension significantly alters Anterior Deltoid recruitment patterns.Kayakers maintain optimal arm kinematics despite changing external forces via altered shoulder muscle recruitment.Overhead arm movements account for a high proportion of the kayak stroke cycle. PMID:24149350

  14. A survey on robotic devices for upper limb rehabilitation

    PubMed Central

    2014-01-01

    The existing shortage of therapists and caregivers assisting physically disabled individuals at home is expected to increase and become serious problem in the near future. The patient population needing physical rehabilitation of the upper extremity is also constantly increasing. Robotic devices have the potential to address this problem as noted by the results of recent research studies. However, the availability of these devices in clinical settings is limited, leaving plenty of room for improvement. The purpose of this paper is to document a review of robotic devices for upper limb rehabilitation including those in developing phase in order to provide a comprehensive reference about existing solutions and facilitate the development of new and improved devices. In particular the following issues are discussed: application field, target group, type of assistance, mechanical design, control strategy and clinical evaluation. This paper also includes a comprehensive, tabulated comparison of technical solutions implemented in various systems. PMID:24401110

  15. Long-term results after muscle-rib flap transfer for reconstruction of composite limb defects.

    PubMed

    Georgescu, Alexandru V; Ignatiadis, Ioannis; Ileana, Matei; Irina, Capota; Filip, Ardelean; Olariu, Radu

    2011-03-01

    The authors present the long-term results in a series of 44 cases with post-traumatic bone defects solved with muscle-rib flaps, between March 1997 and December 2007. In these cases, we performed 21 serratus anterior-rib flaps (SA-R), 10 latissimus dorsi-rib flaps (LD-R), and 13 LD-SA-R. The flaps were used in upper limb in 18 cases and in lower limb in 26 cases. With an overall immediate success rate of 95.4% (42 of 44 cases) and a primary bone union rate of 97.7% (43 of 44 cases), and despite the few partisans of this method, we consider that this procedure still remains very usefully for small and medium bone defects accompanied by large soft tissue defects. PMID:21400577

  16. Exercises using the upper limbs hyperinflate COPD patients more than exercises using the lower limbs at the same metabolic demand

    Microsoft Academic Search

    E. F. Porto; A. A. M. Castro; M. Velloso; O. Nascimento; F. Dal Maso; J. R. Jardim

    Exercises using the upper limbs hyperinflate COPD patients more than exercises using the lower limbs at the same metabolic demand. E.F. Porto, A.A.M. Castro, M. Velloso, O. Nascimento, F. Dal Maso, J.R. Jardim. Background. Lower and upper body exercise are mandatory constituents of a rehabilitation programme for patients with COPD. However, it is not known how much these exercises may

  17. Muscle Activation Patterns When Passively Stretching Spastic Lower Limb Muscles of Children with Cerebral Palsy

    PubMed Central

    Bar-On, Lynn; Aertbeliën, Erwin; Molenaers, Guy; Desloovere, Kaat

    2014-01-01

    The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP) these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n?=?35/19; 10.8±3.8 yrs; bilateral/unilateral involvement n?=? 32/22; Gross Motor Functional Classification Score I–IV) of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG) from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG) compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01). The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between incremental position zones during low velocity stretches was found to be the most sensitive in categorizing muscles into activation patterns (p<0.01). Future studies should investigate whether muscles with different patterns react differently to treatment. PMID:24651860

  18. Disuse osteoporosis of the upper limb: assessment of thirty patients

    PubMed Central

    Giannotti, Stefano; Bottai, Vanna; Dell’Osso, Giacomo; De Paola, Gaia; Bugelli, Giulia; Pini, Erica; Guido, Giulio

    2013-01-01

    Summary Osteoporosis is a multifactorial skeletal disorder characterized by the decrease of bone mass and the alteration of bone microarchitecture that leads to the increase of fracture risks. Traditionally, osteoporosis has been classified into primary and secondary osteoporosis. Primary osteoporosis refers to osteoporotic conditions which are not related to other chronic illnesses and is usually associated with aging and decreased gonadal function, such as decreased level of estrogen, whereas secondary osteoporosis is the type of osteoporosis caused by other health problems. Disuse is one of the many reasons inducing bone loss and resulting in secondary osteoporosis. The disuse osteoporosis appeared for the first time in the literature in 1974 when Minaire reported some histomorphometric analysis of iliac crest bone biopsies performed after a spinal cord injury. The most common skeleton sites in which disuse osteoporosis can be observed are knees and ankles. There are three clinical situation in which this disease can be observed: neurological or muscular disease that causes a pathological and prolonged immobilization. The most frequent is caused by a spinal cord injury, long term bed rest or space flight that causes the immobilization linked to changes in mechanical environment and experimental immobilizations in healthy subjects. Physical exercise is essential for increasing or maintaining bone mass and strength. In our study we wondered if the disuse of the upper limbs of a certain entity, lasting for a long time, can cause a decrease in BMD quantifiable with a densitometric evaluation of the distal radius and with an evaluation of the humeral cortical index such as to define a real osteoporosis from disuse. We analyzed 30 female patients without secondary osteoporosis older than 60 years: everyone underwent to vit D evaluation, densitometric exams of spine, hip and distal radius, Constant score and femoral and humeral cortical index evaluation. We observed that the distal radius BMD and humeral cortical index were worse in patients with low upper limb functionality than in patients with normal shoulder function. The results of this study suggest that humeral cortical index and radial BMD can be useful methods of upper limb bone density evaluation and that they can be useful to select a correct surgical treatment in orthopaedic and traumatologic diseases. PMID:24133531

  19. Motorised mobility scooters; upper limb fractures in elderly novice users

    PubMed Central

    Murphy, Colin G.; Murphy, Ian G.; O’Rourke, Kieran S.; O’Shea, Kieran

    2014-01-01

    Summary We describe three upper limb injuries admitted in one year to our institution resulting from falls from motorised mobility scooters (MMS) where all three users were novices, using their MMS for less than 6 weeks. They sustained injuries in close proximity to their homes, necessitating admission to hospital. None had received any formal training before commencing use of their respective devices. Use of MMS devices increases independence in mobility, enhances quality of life, improves self-esteem, facilitating social participation in everyday life. Use of these devices is not without risks, and no clear safety guidelines or competency testing exists for users. We believe these injuries in novice users highlights this deficiency, and should alert prescribers of these devices to advocate some form of driver training for new users. PMID:25285144

  20. EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients

    NASA Astrophysics Data System (ADS)

    Tan, Hock Guan; Shee, Cheng Yap; Kong, Keng He; Guan, Cuntai; Ang, Wei Tech

    2011-03-01

    This paper describes the Brain Computer Interface (BCI) system and the experiments to allow post-acute (<3 months) stroke patients to use electroencephalogram (EEG) to trigger neuromuscular electrical stimulation (NMES)-assisted extension of the wrist/fingers, which are essential pre-requisites for useful hand function. EEG was recorded while subjects performed motor imagery of their paretic limb, and then analyzed to determine the optimal frequency range within the mu-rhythm, with the greatest attenuation. Aided by visual feedback, subjects then trained to regulate their mu-rhythm EEG to operate the BCI to trigger NMES of the wrist/finger. 6 post-acute stroke patients successfully completed the training, with 4 able to learn to control and use the BCI to initiate NMES. This result is consistent with the reported BCI literacy rate of healthy subjects. Thereafter, without the loss of generality, the controller of the NMES is developed and is based on a model of the upper limb muscle (biceps/triceps) groups to determine the intensity of NMES required to flex or extend the forearm by a specific angle. The muscle model is based on a phenomenological approach, with parameters that are easily measured and conveniently implemented.

  1. Muscle endurance and mitochondrial function after chronic normobaric hypoxia: contrast of respiratory and limb muscles

    PubMed Central

    Gamboa, Jorge L; Andrade, Francisco H

    2012-01-01

    Skeletal muscle adaptation to chronic hypoxia includes loss of oxidative capacity and decrease in fiber size. However, the diaphragm may adapt differently since its activity increases in response to hypoxia. Thus, we hypothesized that chronic hypoxia would not affect endurance, mitochondrial function or fiber size in the mouse diaphragm. Adult male mice were kept in normoxia (Control) or hypoxia (Hypoxia, FIO2= 10%) for 4 weeks. After that time, muscles were collected for histological, biochemical and functional analyses. Hypoxia soleus muscles fatigued faster (fatigue index higher in Control, 21.5±2.6% vs. 13.4±2.4%, p<0.05), but there was no difference between Control and Hypoxia diaphragm bundles. Mean fiber cross sectional area was unchanged in Hypoxia limb muscles, but it was 25% smaller in diaphragm (p<0.001). Ratio of capillary length contact to fiber perimeter was significantly higher in Hypoxia diaphragm (28.6±1.2 vs. 49.3±1.4, Control and Hypoxia, p<0.001). Mitochondrial respiration rates in Hypoxia limb muscles were lower: state 2 decreased 19%, state 3 31% and state 4 18% vs. Control, p<0.05 for all comparisons. There were similar changes in Hypoxia diaphragm: state 3 decreased 29% and state 4 17%, p<0.05. After 4 weeks of hypoxia limb muscle mitochondria had lower content of complex IV (cytochrome c oxidase), while diaphragm mitochondria had higher content of complexes IV and V (F1/F0 ATP synthase) and less uncoupling protein 3 (UCP-3). These data demonstrate that diaphragm retains its endurance during chronic hypoxia, apparently due to a combination of morphometric changes and optimization of mitochondrial energy production. PMID:22113781

  2. A Novel Linear PID Controller for an Upper Limb Exoskeleton Wen Yu and Jacob Rosen

    E-print Network

    Rosen, Jacob

    A Novel Linear PID Controller for an Upper Limb Exoskeleton Wen Yu and Jacob Rosen Abstract-- An upper limb exoskeleton is a wearable robotic system that is physically linked to the arm of the human exoskeleton system (EXO-UL7). The simulation also verify the semi-global asymptotic stability of the system

  3. Golf and upper limb injuries: a summary and review of the literature

    Microsoft Academic Search

    Andrew J McHardy; Henry P Pollard

    2005-01-01

    BACKGROUND: Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. OBJECTIVE: To review the current literature on golf-related upper limb injuries and report on potential causes

  4. Unified preview control for humanoid postural stability and upper-limb interaction adaptation

    E-print Network

    Paris-Sud XI, Université de

    to translate these principles ob- served in humans to control whole-body movement coordina- tion of humanoid-actuated postural system and upper- limbs impedance subsystems Different frameworks for humanoid whole body motionsUnified preview control for humanoid postural stability and upper-limb interaction adaptation

  5. Muscle Co-Contraction Modulates Damping and Joint Stability in a Three-Link Biomechanical Limb

    PubMed Central

    Heitmann, Stewart; Ferns, Norm; Breakspear, Michael

    2012-01-01

    Computational models of neuromotor control require forward models of limb movement that can replicate the natural relationships between muscle activation and joint dynamics without the burdens of excessive anatomical detail. We present a model of a three-link biomechanical limb that emphasizes the dynamics of limb movement within a simplified two-dimensional framework. Muscle co-contraction effects were incorporated into the model by flanking each joint with a pair of antagonist muscles that may be activated independently. Muscle co-contraction is known to alter the damping and stiffness of limb joints without altering net joint torque. Idealized muscle actuators were implemented using the Voigt muscle model which incorporates the parallel elasticity of muscle and tendon but omits series elasticity. The natural force-length-velocity relationships of contractile muscle tissue were incorporated into the actuators using ideal mathematical forms. Numerical stability analysis confirmed that co-contraction of these simplified actuators increased damping in the biomechanical limb consistent with observations of human motor control. Dynamic changes in joint stiffness were excluded by the omission of series elasticity. The analysis also revealed the unexpected finding that distinct stable (bistable) equilibrium positions can co-exist under identical levels of muscle co-contraction. We map the conditions under which bistability arises and prove analytically that monostability (equifinality) is guaranteed when the antagonist muscles are identical. Lastly we verify these analytic findings in the full biomechanical limb model. PMID:22275897

  6. Upper Limb Function and Cortical Organization in Youth with Unilateral Cerebral Palsy

    PubMed Central

    Mackey, Anna; Stinear, Cathy; Stott, Susan; Byblow, Winston D.

    2014-01-01

    Aim: To explore the relationship between motor cortical and descending motor pathway reorganization, lesion type, and upper limb function in youth with unilateral cerebral palsy (CP). Methods: Twenty participants with unilateral CP (mean age 15?±?3?years; 11 males) completed a range of upper limb functional measures. Structural MRI, diffusion-weighted, and functional MRI were conducted to determine type and extent of brain lesion, descending white matter integrity, and whole-brain activity during affected hand use. Single pulse transcranial magnetic stimulation (TMS) (n?=?12) was used to examine functional integrity of the corticospinal pathway as well as primary motor cortex intracortical and interhemispheric inhibition from motor-evoked potentials and silent periods. Results: Fractional anisotropy measures within the posterior limb of the internal capsule were a predictor of upper limb function (R2?=?0.41, F?=?11.3, p?=?0.004). Participants with periventricular lesions tended to have better upper limb function [F(2, 17)?=?42.48, p?upper limb function. Deficits in intracortical and interhemispheric inhibitory mechanisms were found in participants with worse upper limb function (Melbourne Assessment of Unilateral Upper Limb Function: Mann Whitney p?=?0.02). Conclusion: Neuroimaging and TMS can provide useful information related to hand function of individuals with unilateral CP and may have potential to assist as a predictive tool and/or guide rehabilitation. PMID:25071705

  7. Analysis of Neurotrophic Factors in Limb and Extraocular Muscles of Mouse Model of Amyotrophic Lateral Sclerosis

    PubMed Central

    Harandi, Vahid M.; Lindquist, Susanne; Kolan, Shrikant Shantilal; Brännström, Thomas; Liu, Jing-Xia

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) is currently an incurable fatal motor neuron syndrome characterized by progressive weakness, muscle wasting and death ensuing 3–5 years after diagnosis. Neurotrophic factors (NTFs) are known to be important in both nervous system development and maintenance. However, the attempt to translate the potential of NTFs into the therapeutic options remains limited despite substantial number of approaches, which have been tested clinically. Using quantitative RT-PCR (qRT-PCR) technique, the present study investigated mRNA expression of four different NTFs: brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), neurotrophin-4/5 (NT-4) and glial cell line-derived neurotrophic factor (GDNF) in limb muscles and extraocular muscles (EOMs) from SOD1G93A transgenic mice at early and terminal stages of ALS. General morphological examination revealed that muscle fibres were well preserved in both limb muscles and EOMs in early stage ALS mice. However, in terminal ALS mice, most muscle fibres were either atrophied or hypertrophied in limb muscles but unaffected in EOMs. qRT-PCR analysis showed that in early stage ALS mice, NT-4 was significantly down-regulated in limb muscles whereas NT-3 and GDNF were markedly up-regulated in EOMs. In terminal ALS mice, only GDNF was significantly up-regulated in limb muscles. We concluded that the early down-regulation of NT-4 in limb muscles is closely associated with muscle dystrophy and dysfunction at late stage, whereas the early up-regulations of GDNF and NT-3 in EOMs are closely associated with the relatively well-preserved muscle morphology at late stage. Collectively, the data suggested that comparing NTFs expression between limb muscles and EOMs from different stages of ALS animal models is a useful method in revealing the patho-physiology and progression of ALS, and eventually rescuing motor neuron in ALS patients. PMID:25334047

  8. Benchmarking of dynamic simulation predictions in two software platforms using an upper limb musculoskeletal model.

    PubMed

    Saul, Katherine R; Hu, Xiao; Goehler, Craig M; Vidt, Meghan E; Daly, Melissa; Velisar, Anca; Murray, Wendy M

    2015-01-01

    Several opensource or commercially available software platforms are widely used to develop dynamic simulations of movement. While computational approaches are conceptually similar across platforms, technical differences in implementation may influence output. We present a new upper limb dynamic model as a tool to evaluate potential differences in predictive behavior between platforms. We evaluated to what extent differences in technical implementations in popular simulation software environments result in differences in kinematic predictions for single and multijoint movements using EMG- and optimization-based approaches for deriving control signals. We illustrate the benchmarking comparison using SIMM-Dynamics Pipeline-SD/Fast and OpenSim platforms. The most substantial divergence results from differences in muscle model and actuator paths. This model is a valuable resource and is available for download by other researchers. The model, data, and simulation results presented here can be used by future researchers to benchmark other software platforms and software upgrades for these two platforms. PMID:24995410

  9. Robotic unilateral and bilateral upper-limb movement training for stroke survivors afflicted by chronic hemiparesis.

    PubMed

    Simkins, Matt; Kim, Hyuchul; Abrams, Gary; Byl, Nancy; Rosen, Jacob

    2013-06-01

    Stroke is the leading cause of long-term neurological disability and the principle reason for seeking rehabilitative services in the US. Learning based rehabilitation training enables independent mobility in the majority of patients post stroke, however, restoration of fine manipulation, motor function and task specific functions of the hemiplegic arm and hand is noted in fewer than 15% of the stroke patients. Brain plasticity is the innate mechanism enabling the recovery of motor skills through neurological reorganization of the brain as a response to limbs' manipulation. The objective of this research was to evaluate the therapeutic efficacy for the upper limbs with a dual arm exoskeleton system (EXO-UL7) using three different modalities: bilateral mirror image with symmetric movements of both arms, unilateral movement of the affected arm and standard care. Five hemiparetic subjects were randomly assigned to each therapy modality. An upper limb exoskeleton was used to provide bilateral and unilateral treatments. Standard care was provided by a licensed physical therapist. Subjects were evaluated before and after the interventions using 13 different clinical measures. Following these treatments all of the subjects demonstrated significant improved of their fine motor control and gross control across all the treatment modalities. Subjects exhibited significant improvements in range of motion of the shoulder, and improved muscle strength for bilateral training and standard care, but not for unilateral training. In conclusion, a synergetic approach in which robotic treatments (unilateral and bilateral depending on the level of the motor control) are supplemented by the standard of care may maximize the outcome of the motor control recover following stroke. PMID:24187321

  10. Occupational disparities in upper limb disorders: the Pays de la Loire study Why are manual workers at high risk of upper limb disorders? The role of physical work

    E-print Network

    Paris-Sud XI, Université de

    -Maurice Cédex, France MeSH Headings: occupational status, musculoskeletal diseases, upper extremity, men, womenOccupational disparities in upper limb disorders: the Pays de la Loire study 1 Why are manual, occupational exposures, gestures, work Abbreviations: INSERM: Institut National de la Santé et de la Recherche

  11. Mechanical designs of active upper-limb exoskeleton robots: State-of-the-art and design difficulties

    Microsoft Academic Search

    R. A. R. C. Gopura; Kazuo Kiguchi

    2009-01-01

    Active upper-limb exoskeleton robots have been developing from 1960s. In recent years, the mechanical designs and control algorithms of active upper-limb exoskeleton robots were developed significantly. This paper reviews the state-of-the-art of active upper-limb exoskeleton robots that are applied in the areas of rehabilitation and assistive robotics. In addition, the main requirements of the active upper-limb exoskeleton robot are identified

  12. Backpack load affects lower limb muscle activity patterns of female hikers during prolonged load carriage

    Microsoft Academic Search

    Katrina M. Simpson; Bridget J. Munro; Julie R. Steele

    2011-01-01

    This study investigated the effect of prolonged load carriage on lower limb muscle activity displayed by female recreational hikers. Electromyography (EMG) signals from vastus lateralis (VL), biceps femoris (BF), semitendinosus (ST), tibialis anterior (TA) and gastrocnemius (GM) were recorded for fifteen female hikers carrying four loads (0%, 20%, 30% and 40% body weight (BW)) over 8km. Muscle burst duration, muscle

  13. Upper limb malformations in chromosome 22q11 deletions

    SciTech Connect

    Shalev, S.A.; Dar, H.; Barel, H.; Borochowitz, Z. [Bnai Zion Medical Center, Haifa (Israel)

    1996-03-29

    We read with interest the report of Cormier-Daire et al. in a recent issue of the journal, describing upper limb malformations in DiGeorge syndrome. We observed a family with this group of rare clinical expression of chromosome 22q11 deletions. The proposita was examined in our clinic when she was 4 years old. She was mildly mentally retarded. Clinical evaluation showed normal growth, long thin nose with squared tip, nasal speech, and abundant scalp hair and no cardiac anomalies. The girl was accompanied by her mother. Facial similarities were noted between the two. The mother reported to be treated with oral calcium due to hypoparathyroidism, diagnosed several years ago. Clinical evaluation showed wide flat face, short stature, mild mental retardation, slight hypertelorism, peculiar nose similar to her daughter`s, and nasal speech. No cardiac anomalies were found. Recently, a brother was born. Clinical examination documented large ventriculo-septal defect, retrognathia, narrow palpebral fissures, and long thin nose with squared tip. 1 ref.

  14. Work related upper limb disorders in telecommunication workers in Malaysia.

    PubMed

    Premalatha, G D; Noor Hassim, I

    1999-06-01

    A total of 323 workers from 5 different occupational groups in the telecommunication industry were studied in this cross sectional study, which sought to determine the prevalence of Work Related Upper Limb Disorders (WRULD) in 5 occupational groups; operators using the Video Display Terminals, switchboard operators, clerks, data entry processors and the supervisors. WRULD was also studied with regard to factors such as sex, race, height, age, stress and the discomfort perceived due to the work station design. The possibility of WRULD was determined from a self-administered questionnaire and confirmed by history and physical examination. Psychological stress and the discomfort due to the workstation were measured from the questionnaire. The overall prevalence was found to be 31.2% and the prevalence among the various occupations differed with it being the highest in the switchboard operators and data processors and the lowest in the supervisors. The older workers and the female workers were found to have higher prevalences of WRULD. It was also found that a higher stress score and a higher score of discomfort perceived at the work station were associated with higher prevalences of WRULD. PMID:10972037

  15. Temporal alignment of electrocorticographic recordings for upper limb movement.

    PubMed

    Talakoub, Omid; Popovic, Milos R; Navaro, Jessie; Hamani, Clement; Fonoff, Erich T; Wong, Willy

    2014-01-01

    The detection of movement-related components of the brain activity is useful in the design of brain-machine interfaces. A common approach is to classify the brain activity into a number of templates or states. To find these templates, the neural responses are averaged over each movement task. For averaging to be effective, one must assume that the neural components occur at identical times over repeated trials. However, complex arm movements such as reaching and grasping are prone to cross-trial variability due to the way movements are performed. Typically initiation time, duration of movement and movement speed are variable even as a subject tries to reproduce the same task identically across trials. Therefore, movement-related neural activity will tend to occur at different times across the trials. Due to this mismatch, the averaging of neural activity will not bring into salience movement-related components. To address this problem, we present a method of alignment that accounts for the variabilities in the way the movements are conducted. In this study, arm speed was used to align neural activity. Four subjects had electrocorticographic (ECoG) electrodes implanted over their primary motor cortex and were asked to perform reaching and retrieving tasks using the upper limb contralateral to the site of electrode implantation. The arm speeds were aligned using a non-linear transformation of the temporal axes resulting in average spectrograms with superior visualization of movement-related neural activity when compared to averaging without alignment. PMID:25628522

  16. Cancer cachexia decreases specific force and accelerates fatigue in limb muscle

    SciTech Connect

    Roberts, B.M. [1225 Center Drive, HPNP Building Room 1142, Department of Physical Therapy, University of Florida, Gainesville, FL 32610 (United States)] [1225 Center Drive, HPNP Building Room 1142, Department of Physical Therapy, University of Florida, Gainesville, FL 32610 (United States); Frye, G.S.; Ahn, B.; Ferreira, L.F. [1864 Stadium Road, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32610 (United States)] [1864 Stadium Road, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32610 (United States); Judge, A.R., E-mail: arjudge@phhp.ufl.edu [1225 Center Drive, HPNP Building Room 1142, Department of Physical Therapy, University of Florida, Gainesville, FL 32610 (United States)

    2013-06-07

    Highlights: •C-26 cancer cachexia causes a significant decrease in limb muscle absolute force. •C-26 cancer cachexia causes a significant decrease in limb muscle specific force. •C-26 cancer cachexia decreases fatigue resistance in the soleus muscle. •C-26 cancer cachexia prolongs time to peak twitch tension in limb muscle. •C-26 cancer cachexia prolongs one half twitch relaxation time in limb muscle. -- Abstract: Cancer cachexia is a complex metabolic syndrome that is characterized by the loss of skeletal muscle mass and weakness, which compromises physical function, reduces quality of life, and ultimately can lead to mortality. Experimental models of cancer cachexia have recapitulated this skeletal muscle atrophy and consequent decline in muscle force generating capacity. However, more recently, we provided evidence that during severe cancer cachexia muscle weakness in the diaphragm muscle cannot be entirely accounted for by the muscle atrophy. This indicates that muscle weakness is not just a consequence of muscle atrophy but that there is also significant contractile dysfunction. The current study aimed to determine whether contractile dysfunction is also present in limb muscles during severe Colon-26 (C26) carcinoma cachexia by studying the glycolytic extensor digitorum longus (EDL) muscle and the oxidative soleus muscle, which has an activity pattern that more closely resembles the diaphragm. Severe C-26 cancer cachexia caused significant muscle fiber atrophy and a reduction in maximum absolute force in both the EDL and soleus muscles. However, normalization to muscle cross sectional area further demonstrated a 13% decrease in maximum isometric specific force in the EDL and an even greater decrease (17%) in maximum isometric specific force in the soleus. Time to peak tension and half relaxation time were also significantly slowed in both the EDL and the solei from C-26 mice compared to controls. Since, in addition to postural control, the oxidative soleus is also important for normal locomotion, we further performed a fatigue trial in the soleus and found that the decrease in relative force was greater and more rapid in solei from C-26 mice compared to controls. These data demonstrate that severe cancer cachexia causes profound muscle weakness that is not entirely explained by the muscle atrophy. In addition, cancer cachexia decreases the fatigue resistance of the soleus muscle, a postural muscle typically resistant to fatigue. Thus, specifically targeting contractile dysfunction represents an additional means to counter muscle weakness in cancer cachexia, in addition to targeting the prevention of muscle atrophy.

  17. The role of the extrinsic thoracic limb muscles in equine locomotion

    PubMed Central

    Payne, RC; Veenman, P; Wilson, AM

    2005-01-01

    Muscles have two major roles in locomotion: to generate force and to absorb/generate power (do work). Economical force generation is achieved by short-fibred pennate muscle while the maximum power output of a muscle is architecture independent. In this study we tested the hypothesis that there is an anatomical and structural separation between the force-generating anti-gravity muscles and the propulsive (limb/trunk moving) muscles of the equine forelimb. Muscle mass and fascicle length measurements were made on the thoracic limb extrinsic muscles of six fresh horse cadavers. Physiological cross-sectional area and maximum isometric force were then estimated. Maximum power was estimated from muscle volume and published contraction velocity data. The majority of extrinsic forelimb muscles were large with long fascicles arranged in parallel to the long axis of the muscle. Muscles arranged in this way are optimised for doing work. The architecture of serratus ventralis thoracis (SVT) was unique. It had short (48 ± 17 mm) fascicles, arranged at about 45° to the long axis of the muscle, which would suggest a force-generating, anti-gravity role. The muscle belly of SVT was sandwiched between two broad, thick sheets of aponeurosis. Hence, SVT could make a significant contribution to the overall elastic properties of the thoracic limb. PMID:15730484

  18. The role of the extrinsic thoracic limb muscles in equine locomotion

    PubMed Central

    Payne, R C; Veenman, P; Wilson, A M

    2004-01-01

    Muscles have two major roles in locomotion: to generate force and to absorb/generate power (do work). Economical force generation is achieved by short-fibred pennate muscle while the maximum power output of a muscle is architecture independent. In this study we tested the hypothesis that there is an anatomical and structural separation between the force-generating anti-gravity muscles and the propulsive (limb/trunk moving) muscles of the equine forelimb. Muscle mass and fascicle length measurements were made on the thoracic limb extrinsic muscles of six fresh horse cadavers. Physiological cross-sectional area and maximum isometric force were then estimated. Maximum power was estimated from muscle volume and published contraction velocity data. The majority of extrinsic forelimb muscles were large with long fascicles arranged in parallel to the long axis of the muscle. Muscles arranged in this way are optimised for doing work. The architecture of serratus ventralis thoracis (SVT) was unique. It had short (48 ± 17 mm) fascicles, arranged at about 45° to the long axis of the muscle, which would suggest a force-generating, anti-gravity role. The muscle belly of SVT was sandwiched between two broad, thick sheets of aponeurosis. Hence, SVT could make a significant contribution to the overall elastic properties of the thoracic limb. PMID:15610395

  19. MINIMAL TOURNIQUET PRESSURE TO MAINTAIN ARTERIAL CLOSURE IN UPPER LIMB SURGERY

    Microsoft Academic Search

    O. LEVY; Y. DAVID; M. HEIM; I. ELDAR; A. CHETRIT; J. ENGEL

    1993-01-01

    Complications of the pneumatic tourniquet used during limb surgery result from excessive direct pressure. Traditional recommendations suggests parameters for maximum pressure and time limits rather than the minimal effective pressure to achieve a bloodless field. A clinical study was undertaken to evaluate the pneumatic tourniquet setting required for adequate haemostasis in the upper limb. The correlations between several possible influencing

  20. The effect of perinatal brachial plexus lesion on upper limb development

    PubMed Central

    2014-01-01

    Background Deficiency in upper limb development is a sequel of the perinatal brachial plexus palsy. The purpose of this study was to evaluate the effect of brachial plexus birth lesion on upper limb development. Methods Forty-four patients with unilateral obstetric brachial plexus palsy underwent measurements of both upper extremities. The average age at the time of evaluation was 6.8 years. Active motion was assessed using Gilbert-Raimondi, the modified MRC, and Al-Qattan scales. Paired t test was used for statistical analysis. Correlation between limb length / circumference discrepancy and age / time of surgery was assessed using Pearson correlation coefficient. Results A decrease in the circumference and length was observed in all limbs with brachial plexus lesion. We found a statistically significant difference between degree of hand length and width decrease and its useful and useless function. We observed a statistically significant difference in measurement: forearm length, hand length and width dependent on the type of surgical procedure (neurolysis, reconstruction). We observed no correlation between age and limb length / circumference discrepancy. We also observed no correlation between time of surgery and limb length / circumference discrepancy. Conclusions The decrease in dimensions of the affected limbs occurred predominantly during the period of early childhood. Disparities in dimensions are observed in both cases of deficiency of useful function of upper limb and cases in which functional efficiency appears. PMID:24694070

  1. Standardising the intensity of upper limb treatment in rehabilitation medicine

    PubMed Central

    Wallace, A C; Talelli, P; Dileone, M; Oliver, R; Ward, N; Cloud, G; Greenwood, R; Di Lazzaro, V; Rothwell, J C; Marsden, J F

    2010-01-01

    Objective To describe a treatment protocol for the upper limb that standardises intensity of therapy input regardless of the severity of presentation. Design The protocol is described (part one) and feasibility and effect explored (part two). Subjects Participants (n=11) had a single ischaemic stroke in the middle cerebral artery territory more than one year previously, and had residual weakness of the hand with some extension present at the wrist and the ability to grasp. Interventions Following two baseline assessments, participants attended therapy one hour a day for 10 consecutive working days. Treatment consisted of a combination of strength and functional task training. Outcomes were measured immediately after training, at one month and three months. Outcome measures Intensity was measured with Borg ratings of perceived exertion. Secondary outcome measures included Action Research Arm Test (ARAT), nine-hole peg test, and goal attainment scale. Results Borg scores indicated that the level of intensity was appropriate and similar across all participants despite individual differences in the severity of their initial presentation (median (IQR) = 14 (13-15)). The mean ARAT score significantly increased by 6.8 points (X2(3)= 15.618, p<0.001), and was maintained at three month follow up (z= ?2.384, p= 0.016). The nine-hole peg test also showed a main effect of time and 88% of goals set were achieved. Conclusions The physiotherapy protocol standardised intensity of treatment by grading exercise and task-related practice according to the person’s residual ability, rather than simply standardising treatment times. It was feasible and well tolerated in this group. PMID:20237174

  2. Neuronox versus BOTOX in the Treatment of Post-Stroke Upper Limb Spasticity: A Multicenter Randomized Controlled Trial

    PubMed Central

    Seo, Han Gil; Paik, Nam-Jong; Lee, Shi-Uk; Oh, Byung-Mo; Chun, Min Ho; Kwon, Bum Sun; Bang, Moon Suk

    2015-01-01

    Background Botulinum toxin type A is widely used for treating spasticity. Neuronox (Neu-BoNT/A), a newly manufactured botulinum toxin a, has not yet been investigated for its efficacy and safety in the treatment of post-stroke upper limb spasticity. Objective We evaluated the efficacy and safety of Neuronox (Neu-BoNT/A) compared with BOTOX (onabotulinum toxin A) for treating post-stroke upper limb spasticity. Methods In total, 196 stroke patients with moderate to severe upper limb spasticity were randomly assigned to either Neuronox or BOTOX intervention. The wrist flexors were mandatory and elbow, finger, and thumb flexors were optional muscles to be injected. Assessments were performed at baseline and 4, 8, and 12 weeks after the intervention. The primary outcome measure was the change from baseline of the Modified Ashworth Scale (MAS) at the wrist flexors at week 4. Secondary outcome measures included the change of MAS at each visit, response rate, Disability Assessment Scale (DAS), Carer Burden Scale, and Global Assessment of treatment benefit. Results Primary outcome measures were -1.39±0.79 and -1.56±0.81 in the Neuronox and BOTOX groups, respectively. The difference was within the noninferiority margin of 0.45 (95% upper limit=0.40). There were no significant differences between the groups in the secondary outcome and safety measures, except the change of the MAS at the elbow flexors at week 12 (-0.88±0.75 in the Neuronox group, -0.65±0.74 in the BOTOX group; P=0.0429). Both groups showed significant improvements in the MAS, DAS, and Carer Burden Scale at weeks 4, 8, and 12. Conclusion Neuronox showed equivalent efficacy and safety compared with BOTOX for treating post-stroke upper limb spasticity. Trial Registration ClinicalTrials.gov NCT01313767 PMID:26030192

  3. Robotic Unilateral and Bilateral Upper-Limb Movement Training for Stroke Survivors Afflicted by

    E-print Network

    Rosen, Jacob

    for the upper limbs with a dual arm exoskeleton system (EXO-UL7) using three different modalities: bilateral exoskeleton was used to provide bilateral and unilateral treatments. Standard care was provided by a licensed

  4. Upper limb portable motion analysis system based on inertial technology for neurorehabilitation purposes.

    PubMed

    Pérez, Rodrigo; Costa, Úrsula; Torrent, Marc; Solana, Javier; Opisso, Eloy; Cáceres, César; Tormos, Josep M; Medina, Josep; Gómez, Enrique J

    2010-01-01

    Here an inertial sensor-based monitoring system for measuring and analyzing upper limb movements is presented. The final goal is the integration of this motion-tracking device within a portable rehabilitation system for brain injury patients. A set of four inertial sensors mounted on a special garment worn by the patient provides the quaternions representing the patient upper limb's orientation in space. A kinematic model is built to estimate 3D upper limb motion for accurate therapeutic evaluation. The human upper limb is represented as a kinematic chain of rigid bodies with three joints and six degrees of freedom. Validation of the system has been performed by co-registration of movements with a commercial optoelectronic tracking system. Successful results are shown that exhibit a high correlation among signals provided by both devices and obtained at the Institut Guttmann Neurorehabilitation Hospital. PMID:22163496

  5. Daily physical activity assessment: what is the importance of upper limb movements vs whole body movements?

    Microsoft Academic Search

    H Kumahara; H Tanaka; Y Schutz

    2004-01-01

    OBJECTIVE: The movement of the upper limbs (eg fidgeting-like activities) is a meaningful component of nonexercise activity thermogenesis (NEAT). This study examined the relationship between upper limb movements and whole body trunk movements, by simultaneously measuring energy expenditure during the course of the day.DESIGN: A cross-sectional study consisting of 88 subjects with a wide range in body mass index (17.3–32.5

  6. 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

  7. The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot.

    PubMed

    Hu, X L; Tong, K Y; Wei, X J; Rong, W; Susanto, E A; Ho, S K

    2013-10-01

    Loss of hand function and finger dexterity are main disabilities in the upper limb after stroke. An electromyography (EMG)-driven hand robot had been developed for post-stroke rehabilitation training. The effectiveness of the hand robot assisted whole upper limb training was investigated on persons with chronic stroke (n=10) in this work. All subjects attended a 20-session training (3-5times/week) by using the hand robot to practice object grasp/release and arm transportation tasks. Significant motor improvements were observed in the Fugl-Meyer hand/wrist and shoulder/elbow scores (p<0.05), and also in the Action Research Arm Test and Wolf Motor Function Test (p<0.05). Significant reduction in spasticity of the fingers as was measured by the Modified Ashworth Score (p<0.05). The training improved the muscle co-ordination between the antagonist muscle pair (flexor digitorum (FD) and extensor digitorum (ED)), associated with a significant reduction in the ED EMG level (p<0.05) and a significant decrease of ED and FD co-contraction during the training (p<0.05); the excessive muscle activities in the biceps brachii were also reduced significantly after the training (p<0.05). PMID:23932795

  8. Upper limb static-stretching protocol decreases maximal concentric jump performance.

    PubMed

    Marchetti, Paulo H; Silva, Fernando H D de Oliveira; Soares, Enrico G; Serpa, Erica P; Nardi, Priscyla S M; Vilela, Guanis de B; Behm, David G

    2014-12-01

    The purpose of the present study was to evaluate the acute effects of an upper limb static-stretching (SS) protocol on the maximal concentric jump performance. We recruited 25 young healthy, male, resistance trained individuals (stretched group, n = 15 and control group, n = 10) in this study. The randomized between group experimental protocol consisted of a three trials of maximal concentric jump task, before and after a SS of the upper limb. Vertical ground reaction forces (vGRF) and surface electromyography (sEMG) of both gastrocnemius lateralis (GL) and vastus lateralis (VL) were acquired. An extensive SS was employed consisting of ten stretches of 30 seconds, with 15 seconds of rest, and 70-90% of the point of discomfort (POD). ANOVA (2x2) (group x condition) was used for shoulder joint range of motion (ROM), vGRF and sEMG. A significant interaction for passive ROM of the shoulder joint revealed significant increases between pre- and post-SS protocol (p < 0.001). A significant interaction demonstrated decreased peak force and an increased peak propulsion duration between pre- and post-stretching only for stretch group (p = 0.021, and p = 0.024, respectively. There was a significant main effect between groups (stretch and control) for peak force for control group (p = 0.045). Regarding sEMG variables, there were no significant differences between groups (control versus stretched) or condition (pre-stretching versus post-stretching) for the peak amplitude of RMS and IEMG for both muscles (VL and GL). In conclusion, an acute extensive SS can increase the shoulder ROM, and negatively affect both the propulsion duration and peak force of the maximal concentric jump, without providing significant changes in muscle activation. Key pointsThe jump performance can be affected negatively by an intense extensive static-stretching protocol.An intense acute extensive SS protocol can affect positively the shoulder ROM.The intense acute extensive SS protocol does not change the level of muscle activation for vastus lateralis and gastrocnemius lateralis. PMID:25435789

  9. Connective tissue cells, but not muscle cells, are involved in establishing the proximo-distal outcome of limb regeneration in the axolotl.

    PubMed

    Nacu, Eugen; Glausch, Mareen; Le, Huy Quang; Damanik, Febriyani Fiain Rochel; Schuez, Maritta; Knapp, Dunja; Khattak, Shahryar; Richter, Tobias; Tanaka, Elly M

    2013-02-01

    During salamander limb regeneration, only the structures distal to the amputation plane are regenerated, a property known as the rule of distal transformation. Multiple cell types are involved in limb regeneration; therefore, determining which cell types participate in distal transformation is important for understanding how the proximo-distal outcome of regeneration is achieved. We show that connective tissue-derived blastema cells obey the rule of distal transformation. They also have nuclear MEIS, which can act as an upper arm identity regulator, only upon upper arm amputation. By contrast, myogenic cells do not obey the rule of distal transformation and display nuclear MEIS upon amputation at any proximo-distal level. These results indicate that connective tissue cells, but not myogenic cells, are involved in establishing the proximo-distal outcome of regeneration and are likely to guide muscle patterning. Moreover, we show that, similarly to limb development, muscle patterning in regeneration is influenced by ?-catenin signalling. PMID:23293283

  10. An Upper-Limb Power-Assist Exoskeleton Using Proportional Myoelectric Control

    PubMed Central

    Tang, Zhichuan; Zhang, Kejun; Sun, Shouqian; Gao, Zenggui; Zhang, Lekai; Yang, Zhongliang

    2014-01-01

    We developed an upper-limb power-assist exoskeleton actuated by pneumatic muscles. The exoskeleton included two metal links: a nylon joint, four size-adjustable carbon fiber bracers, a potentiometer and two pneumatic muscles. The proportional myoelectric control method was proposed to control the exoskeleton according to the user's motion intention in real time. With the feature extraction procedure and the classification (back-propagation neural network), an electromyogram (EMG)-angle model was constructed to be used for pattern recognition. Six healthy subjects performed elbow flexion-extension movements under four experimental conditions: (1) holding a 1-kg load, wearing the exoskeleton, but with no actuation and for different periods (2-s, 4-s and 8-s periods); (2) holding a 1-kg load, without wearing the exoskeleton, for a fixed period; (3) holding a 1-kg load, wearing the exoskeleton, but with no actuation, for a fixed period; (4) holding a 1-kg load, wearing the exoskeleton under proportional myoelectric control, for a fixed period. The EMG signals of the biceps brachii, the brachioradialis, the triceps brachii and the anconeus and the angle of the elbow were collected. The control scheme's reliability and power-assist effectiveness were evaluated in the experiments. The results indicated that the exoskeleton could be controlled by the user's motion intention in real time and that it was useful for augmenting arm performance with neurological signal control, which could be applied to assist in elbow rehabilitation after neurological injury. PMID:24727501

  11. An EMG-controlled neuroprosthesis for daily upper limb support: a preliminary study.

    PubMed

    Ambrosini, Emilia; Ferrante, Simona; Tibiletti, Marta; Schauer, Thomas; Klauer, Christian; Ferrigno, Giancarlo; Pedrocchi, Alessandra

    2011-01-01

    MUNDUS is an assistive platform for recovering direct interaction capability of severely impaired people based on upper limb motor functions. Its main concept is to exploit any residual control of the end-user, thus being suitable for long term utilization in daily activities. MUNDUS integrates multimodal information (EMG, eye tracking, brain computer interface) to control different actuators, such as a passive exoskeleton for weight relief, a neuroprosthesis for arm motion and small motors for grasping. Within this project, the present work integreted a commercial passive exoskeleton with an EMG-controlled neuroprosthesis for supporting hand-to-mouth movements. Being the stimulated muscle the same from which the EMG was measured, first it was necessary to develop an appropriate digital filter to separate the volitional EMG and the stimulation response. Then, a control method aimed at exploiting as much as possible the residual motor control of the end-user was designed. The controller provided a stimulation intensity proportional to the volitional EMG. An experimental protocol was defined to validate the filter and the controller operation on one healthy volunteer. The subject was asked to perform a sequence of hand-to-mouth movements holding different loads. The movements were supported by both the exoskeleton and the neuroprosthesis. The filter was able to detect an increase of the volitional EMG as the weight held by the subject increased. Thus, a higher stimulation intensity was provided in order to support a more intense exercise. The study demonstrated the feasibility of an EMG-controlled neuroprosthesis for daily upper limb support on healthy subjects, providing a first step forward towards the development of the final MUNDUS platform. PMID:22255280

  12. Estimation of Musculotendon Properties in the Human Upper Limb

    Microsoft Academic Search

    Brian A. Garner; Marcus G. Pandy

    2003-01-01

    The purpose of this study was to develop and apply a general method for estimating the architectural properties of human muscles in vivo. The method consists of a two-phase, nested optimization procedure in which the values of peak isometric force, optimal muscle-fiber length, and tendon slack length are calculated for each musculotendon actuator, knowing muscle volume and the minimum and

  13. SF/HGF is a mediator between limb patterning and muscle development.

    PubMed

    Scaal, M; Bonafede, A; Dathe, V; Sachs, M; Cann, G; Christ, B; Brand-Saberi, B

    1999-11-01

    Scatter factor/hepatocyte growth factor (SF/HGF) is known to be involved in the detachment of myogenic precursor cells from the lateral dermomyotomes and their subsequent migration into the newly formed limb buds. As yet, however, nothing has been known about the role of the persistent expression of SF/HGF in the limb bud mesenchyme during later stages of limb bud development. To test for a potential role of SF/HGF in early limb muscle patterning, we examined the regulation of SF/HGF expression in the limb bud as well as the influence of SF/HGF on direction control of myogenic precursor cells in limb bud mesenchyme. We demonstrate that SF/HGF expression is controlled by signals involved in limb bud patterning. In the absence of an apical ectodermal ridge (AER), no expression of SF/HGF in the limb bud is observed. However, FGF-2 application can rescue SF/HGF expression. Excision of the zone of polarizing activity (ZPA) results in ectopic and enhanced SF/HGF expression in the posterior limb bud mesenchyme. We could identify BMP-2 as a potential inhibitor of SF/HGF expression in the posterior limb bud mesenchyme. We further demonstrate that ZPA excision results in a shift of Pax-3-positive cells towards the posterior limb bud mesenchyme, indicating a role of the ZPA in positioning of the premuscle masses. Moreover, we present evidence that, in the limb bud mesenchyme, SF/HGF increases the motility of myogenic precursor cells and has a role in maintaining their undifferentiated state during migration. We present a model for a crucial role of SF/HGF during migration and early patterning of muscle precursor cells in the vertebrate limb. PMID:10518504

  14. The activity pattern of limb muscles in freely moving normal and deafferented newts

    Microsoft Academic Search

    Gy. Székely; G. Czéh; Gy. Vöeös

    1969-01-01

    Bipolar silver electrodes were implanted into eight forelimb muscles of normal and deafferented newts. In freely moving animals muscle potentials were recorded with the aid of a Hellige EEG apparatus combined with a set of transistorized preamplifiers of high input impedance. The steps, as the animals lifted up and put down the limb, were electrically signalled. The myograms revealed a

  15. Backpack load affects lower limb muscle activity patterns of female hikers during prolonged load carriage.

    PubMed

    Simpson, Katrina M; Munro, Bridget J; Steele, Julie R

    2011-10-01

    This study investigated the effect of prolonged load carriage on lower limb muscle activity displayed by female recreational hikers. Electromyography (EMG) signals from vastus lateralis (VL), biceps femoris (BF), semitendinosus (ST), tibialis anterior (TA) and gastrocnemius (GM) were recorded for fifteen female hikers carrying four loads (0%, 20%, 30% and 40% body weight (BW)) over 8 km. Muscle burst duration, muscle burst onset relative to initial contact and integrated EMG signals (iEMG) were calculated to evaluate muscle activity, whereas the shift in mean power frequency (MPF) was used to evaluate muscle fatigue. Increased walking distance significantly decreased the MPF of TA; decreased the iEMG for VL, ST and GM; and shortened VL muscle burst duration. Furthermore, carrying 20-40% BW loads significantly increased VL and GM iEMG and increased BF muscle burst duration, whereas a 40% BW load caused a later VL muscle burst onset. The differences observed in muscle activity with increased load mass seem to be adjustments aimed at maintaining balance and attenuating the increased loads placed on the lower limbs during gait. Based on the changes in muscle activity, a backpack load limit of 30% BW may reduce the risk of lower limb injury for female hikers during prolonged walking. PMID:21705231

  16. Analysis of arm trajectories of everyday tasks for the development of an upper-limb orthosis

    Microsoft Academic Search

    Rungun Ramanathan; Silvio P. Eberhardt; Tariq Rahman; Whitney Sample; Rami Seliktar; Michael Alexander

    2000-01-01

    Spatiotemporal arm and body movements of able-bodied subjects performing nine everyday tasks were recorded for the purpose of guiding the development of an upper-limb orthosis. To provide a user the opportunity to carry out these tasks with natural movements, the orthosis should allow replication of the measured trajectories. We outline the orthosis architecture, which supports the user's upper arm and

  17. Timing and the Control of Rhythmic Upper-Limb Movements

    Microsoft Academic Search

    Tal Shafir; Susan H. Brown

    2009-01-01

    Accurate timing of limb displacement is crucial for effective motor control. The authors examined the effects of movement velocity, duration, direction, added mass, and auditory cueing on timing, spatial, and trajectory variability of single- and multijoint rhythmic movements. During single-joint movements, increased velocity decreased timing and spatial variability, whereas increased movement duration increased timing variability but decreased spatial variability. For

  18. Thermographic patterns of the upper and lower limbs: baseline data.

    PubMed

    Gatt, Alfred; Formosa, Cynthia; Cassar, Kevin; Camilleri, Kenneth P; De Raffaele, Clifford; Mizzi, Anabelle; Azzopardi, Carl; Mizzi, Stephen; Falzon, Owen; Cristina, Stefania; Chockalingam, Nachiappan

    2015-01-01

    Objectives. To collect normative baseline data and identify any significant differences between hand and foot thermographic distribution patterns in a healthy adult population. Design. A single-centre, randomized, prospective study. Methods. Thermographic data was acquired using a FLIR camera for the data acquisition of both plantar and dorsal aspects of the feet, volar aspects of the hands, and anterior aspects of the lower limbs under controlled climate conditions. Results. There is general symmetry in skin temperature between the same regions in contralateral limbs, in terms of both magnitude and pattern. There was also minimal intersubject temperature variation with a consistent temperature pattern in toes and fingers. The thumb is the warmest digit with the temperature falling gradually between the 2nd and the 5th fingers. The big toe and the 5th toe are the warmest digits with the 2nd to the 4th toes being cooler. Conclusion. Measurement of skin temperature of the limbs using a thermal camera is feasible and reproducible. Temperature patterns in fingers and toes are consistent with similar temperatures in contralateral limbs in healthy subjects. This study provides the basis for further research to assess the clinical usefulness of thermography in the diagnosis of vascular insufficiency. PMID:25648145

  19. Thermographic Patterns of the Upper and Lower Limbs: Baseline Data

    PubMed Central

    Cassar, Kevin; Camilleri, Kenneth P.; De Raffaele, Clifford; Mizzi, Stephen; Cristina, Stefania

    2015-01-01

    Objectives. To collect normative baseline data and identify any significant differences between hand and foot thermographic distribution patterns in a healthy adult population. Design. A single-centre, randomized, prospective study. Methods. Thermographic data was acquired using a FLIR camera for the data acquisition of both plantar and dorsal aspects of the feet, volar aspects of the hands, and anterior aspects of the lower limbs under controlled climate conditions. Results. There is general symmetry in skin temperature between the same regions in contralateral limbs, in terms of both magnitude and pattern. There was also minimal intersubject temperature variation with a consistent temperature pattern in toes and fingers. The thumb is the warmest digit with the temperature falling gradually between the 2nd and the 5th fingers. The big toe and the 5th toe are the warmest digits with the 2nd to the 4th toes being cooler. Conclusion. Measurement of skin temperature of the limbs using a thermal camera is feasible and reproducible. Temperature patterns in fingers and toes are consistent with similar temperatures in contralateral limbs in healthy subjects. This study provides the basis for further research to assess the clinical usefulness of thermography in the diagnosis of vascular insufficiency. PMID:25648145

  20. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    PubMed Central

    Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F.; Cuesta-Gómez, A.; Ruiz, Oscar E.

    2014-01-01

    New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation. PMID:25110698

  1. Passive resting state and history of antagonist muscle activity shape active extensions in an insect limb

    PubMed Central

    Ache, Jan M.

    2012-01-01

    Limb movements can be driven by muscle contractions, external forces, or intrinsic passive forces. For lightweight limbs like those of insects or small vertebrates, passive forces can be large enough to overcome the effects of gravity and may even generate limb movements in the absence of active muscle contractions. Understanding the sources and actions of such forces is therefore important in understanding motor control. We describe passive properties of the femur-tibia joint of the locust hind leg. The resting angle is determined primarily by passive properties of the relatively large extensor tibiae muscle and is influenced by the history of activation of the fast extensor tibiae motor neuron. The resting angle is therefore better described as a history-dependent resting state. We selectively stimulated different flexor tibiae motor neurons to generate a range of isometric contractions of the flexor tibiae muscle and then stimulated the fast extensor tibiae motor neuron to elicit active tibial extensions. Residual forces in the flexor muscle have only a small effect on subsequent active extensions, but the effect is larger for distal than for proximal flexor motor neurons and varies with the strength of flexor activation. We conclude that passive properties of a lightweight limb make substantial and complex contributions to the resting state of the limb that must be taken into account in the patterning of neuronal control signals driving its active movements. Low variability in the effects of the passive forces may permit the nervous system to accurately predict their contributions to behavior. PMID:22357791

  2. Passive resting state and history of antagonist muscle activity shape active extensions in an insect limb.

    PubMed

    Ache, Jan M; Matheson, Thomas

    2012-05-01

    Limb movements can be driven by muscle contractions, external forces, or intrinsic passive forces. For lightweight limbs like those of insects or small vertebrates, passive forces can be large enough to overcome the effects of gravity and may even generate limb movements in the absence of active muscle contractions. Understanding the sources and actions of such forces is therefore important in understanding motor control. We describe passive properties of the femur-tibia joint of the locust hind leg. The resting angle is determined primarily by passive properties of the relatively large extensor tibiae muscle and is influenced by the history of activation of the fast extensor tibiae motor neuron. The resting angle is therefore better described as a history-dependent resting state. We selectively stimulated different flexor tibiae motor neurons to generate a range of isometric contractions of the flexor tibiae muscle and then stimulated the fast extensor tibiae motor neuron to elicit active tibial extensions. Residual forces in the flexor muscle have only a small effect on subsequent active extensions, but the effect is larger for distal than for proximal flexor motor neurons and varies with the strength of flexor activation. We conclude that passive properties of a lightweight limb make substantial and complex contributions to the resting state of the limb that must be taken into account in the patterning of neuronal control signals driving its active movements. Low variability in the effects of the passive forces may permit the nervous system to accurately predict their contributions to behavior. PMID:22357791

  3. Lower limb muscle impairment in myotonic dystrophy type 1: the need for better guidelines.

    PubMed

    Petitclerc, Émilie; Hébert, Luc J; Desrosiers, Johanne; Gagnon, Cynthia

    2015-04-01

    In myotonic dystrophy type 1 (DM1), leg muscle weakness is a major impairment. There are challenges to obtaining a clear portrait of muscle strength impairment. A systematic literature review was conducted on lower limb strength impairment in late-onset and adult phenotypes to document variables which affect strength measurement. Thirty-two articles were reviewed using the COSMIN guidelines. Only a third of the studies described a reproducible protocol. Only 2 muscle groups have documented reliability for quantitative muscle testing and only 1 total score for manual muscle testing. Variables affecting muscle strength impairment are not described in most studies. This review illustrates the variability in muscle strength assessment in relation to DM1 characteristics and the questionable validity of the results with regard to undocumented methodological properties. There is therefore a clear need to adopt a consensus on the use of a standardized muscle strength assessment protocol. PMID:25399769

  4. Effects of 8-week in-season plyometric training on upper and lower limb performance of elite adolescent handball players.

    PubMed

    Chelly, Mohamed Souhaiel; Hermassi, Souhail; Aouadi, Ridha; Shephard, Roy J

    2014-05-01

    We hypothesized that replacement of a part of the normal in-season regimen of top-level adolescent handball players by an 8-week biweekly course of lower and upper limb plyometric training would enhance characteristics important to competition, including peak power output (Wpeak), jump performance, muscle volume, and ball throwing velocity. Study participants (23 men, age: 17.4 ± 0.5 years, body mass: 79.9 ± 11.5 kg, height: 1.79 ± 6.19 m, body fat: 13.8 ± 2.1%) were randomly assigned between controls (C; n = 11) and an experimental group (E, n = 12). Measures preintervention and postintervention included force-velocity ergometer tests for upper (Wupper peak) and lower limbs (Wlower peak), force platform determinations of squat jump (SJ) and countermovement jump (CMJ) characteristics (jump height, maximal force, initial velocity, and average power), video filming of sprint velocities (first step [V1S], first 5 m [V5m], and 25-30 m [Vmax]), and anthropometric estimates of leg muscle volume. E showed gains relative to C in Wupper peak and Wlower peak (p < 0.01 and p < 0.001), SJ (height p < 0.01; force p ? 0.05), CMJ (height p < 0.01; force p < 0.01 and relative power p ? 0.05), and sprint velocities (p < 0.001 for V1S, V5m, and Vmax). E also showed increases in leg and thigh muscle volumes (p < 0.001), but arm muscle volumes did not differ from control. We conclude that introduction of biweekly plyometric training into the standard regimen improved components important to handball performance, particularly explosive actions, such as sprinting, jumping, and ball throwing velocity. PMID:24149768

  5. Prevention of upper limb symptoms and signs of nerve afflictions in computer operators: The effect of intervention by stretching

    PubMed Central

    Jepsen, Jorgen R; Thomsen, Gert

    2008-01-01

    Background In a previous study of computer operators we have demonstrated the relation of upper limb pain to individual and patterns of neurological findings (reduced function of muscles, sensory deviations from normal and mechanical allodynia of nerve trunks). The identified patterns were in accordance with neural afflictions at three specific locations (brachial plexus at chord level, posterior interosseous and median nerve on elbow level). We have introduced an intervention program aiming to mobilize nerves at these locations and tested its efficacy. Methods 125 and 59, respectively, computer operators in two divisions of an engineering consultancy company were invited to answer a questionnaire on upper limb symptoms and to undergo a blinded neurological examination. Participants in one division were subsequently instructed to participate in an upper limb stretching course at least three times during workdays in a six month period. Subjects from the other division served as controls. At the end of the intervention both groups were invited to a second identical evaluation by questionnaire and physical examination. Symptoms and findings were studied in the right upper limb. Perceived changes of pain were recorded and individual and patterns of physical findings assessed for both groups at baseline and at follow-up. In subjects with no or minimal preceding pain we additionally studied the relation of incident pain to the summarized findings for parameters contained in the definition of nerve affliction at the three locations. Results Summarized pain was significantly reduced in the intervention group but unchanged in controls. After the intervention, fewer neurological abnormalities in accordance with nerve affliction were recorded for the whole material but no conclusion could be drawn regarding the relation to the intervention of this reduction. Incident pain correlated to findings in accordance with the three locations of nerve affliction. Conclusion A six month course of stretching seems to reduce upper limb symptoms in computer operators but we could not demonstrate an influence on neurological physical findings in this sample. The relation of incident symptoms to identified neurological patterns provides additional support to the construct validity of the employed neurological examination. PMID:18179682

  6. Application of ultrasound imaging of upper lip orbicularis oris muscle

    PubMed Central

    Zhang, Wen-Hao; Chen, Yuan-Yuan; Liu, Jun-Jie; Liao, Xin-Hong; Du, Yang-Chun; Gao, Yong

    2015-01-01

    In this study, we aim to understand the morphology and structure of upper lip orbicularis oris muscle, and to provide clinical evidence for evaluating the effect of repair operation in cleft lip. Subjects included 106 healthy people and 36 postoperative patients of unilateral cleft lip. The upper lip orbicularis oris muscle was scanned using ultrasound in natural closure and pout states. Our results showed that the hierarchical structure of upper lip tissue was demonstrated clearly in ultrasonic images. After reconstruction of unilateral cleft lip, the left and right philtrum columns were still obviously asymmetric, their radian displayed clearly and showed better continuity. In the place of cleft lip side equivalent to philtrum columns, orbicularis oris muscle showed discontinuity and unclear hierarchical structure, which was replaced by hyperechoic scar tissue. The superficial layer would become thicker when pouting. In reconstructed unilateral cleft lip, the superficial layer was thinner than that of healthy controls. In normal upper lip orbicularis oris muscle, the superficial layer thickness was no less than 2.89 mm in philtrum dimple and no less than 3.92 mm in philtrum column, and the deep layer thickness was no less the 1.12 mm. Otherwise, the layer thickness less than above reference values may be considered as diagnostic criteria for dysplasia of upper lip orbicularis oris muscle. In conclusions, ultrasound imaging is able to clearly show the hierarchical structure of upper lip orbicularis oris muscle, and will be beneficial in guiding the upper lip repair and reconstruction surgery. PMID:26064229

  7. Venous pressures in the isolated upper limb during saline injection

    Microsoft Academic Search

    Barry A. Finegan; M. David Bukht

    1984-01-01

    Venous pressure changes were assessed in the antecubital vein of an isolated arm during saline injection via an intravenous\\u000a site on the dorsum of the hand. Although leak of contrast medium has been radiologically demonstrated in these circumstances,\\u000a the compliance of the venous system of the isolated and exsanguinated limb has not been investigated. In five male and five\\u000a female

  8. Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors

    PubMed Central

    Pundik, Svetlana; Falchook, Adam D.; McCabe, Jessica; Daly, Janis J.

    2014-01-01

    Background. Arm spasticity is a challenge in the care of chronic stroke survivors with motor deficits. In order to advance spasticity treatments, a better understanding of the mechanism of spasticity-related neuroplasticity is needed. Objective. To investigate brain function correlates of spasticity in chronic stroke and to identify specific regional functional brain changes related to rehabilitation-induced mitigation of spasticity. Methods. 23 stroke survivors (>6 months) were treated with an arm motor learning and spasticity therapy (5?d/wk for 12 weeks). Outcome measures included Modified Ashworth scale, sensory tests, and functional magnetic resonance imaging (fMRI) for wrist and hand movement. Results. First, at baseline, greater spasticity correlated with poorer motor function (P = 0.001) and greater sensory deficits (P = 0.003). Second, rehabilitation produced improvement in upper limb spasticity and motor function (P < 0.0001). Third, at baseline, greater spasticity correlated with higher fMRI activation in the ipsilesional thalamus (rho = 0.49, P = 0.03). Fourth, following rehabilitation, greater mitigation of spasticity correlated with enhanced fMRI activation in the contralesional primary motor (r = ?0.755, P = 0.003), premotor (r = ?0.565, P = 0.04), primary sensory (r = ?0.614, P = 0.03), and associative sensory (r = ?0.597, P = 0.03) regions while controlling for changes in motor function. Conclusions. Contralesional motor regions may contribute to restoring control of muscle tone in chronic stroke. PMID:25101190

  9. Upper limb function evaluation scales for individuals with cerebral palsy: a systematic review

    PubMed Central

    Santos, Cibele Almeida; Franco de Moura, Renata Calhes; Lazzari, Roberta Delasta; Dumont, Arislander Jonathan Lopes; Braun, Luiz Alfredo Ferreira; Oliveira, Claudia Santos

    2015-01-01

    [Purpose] The aim of the present study was to perform a systematic review of the literature on the scales and methods most often used for the evaluation of upper limb function in individuals with cerebral palsy. [Materials and Methods] Searches were conducted in the Medline, PEDro, Lilacs, Scielo, and PubMed databases. The following inclusion criteria were used for the selection of articles: randomized controlled study, evaluation of upper limb function in individuals with cerebral palsy, and publication between 2006 and 2014. The methodological quality of the articles was evaluated using the PEDro evidence scale. [Results] Five articles met the inclusion criteria and achieved 6 points or higher on the PEDro scale of methodological quality. [Conclusion] The studies analyzed used different evaluation scales, but no consensus has been reached thus far on which scale is the most appropriate. Thus, further studies are needed to establish an adequate method for the evaluation of upper limb function in individuals with cerebral palsy.

  10. Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation: A case report

    PubMed Central

    Yao, Jun; Chen, Albert; Kuiken, Todd; Carmona, Carolina; Dewald, Julius

    2015-01-01

    This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1) before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2) 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.

  11. Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation: A case report.

    PubMed

    Yao, Jun; Chen, Albert; Kuiken, Todd; Carmona, Carolina; Dewald, Julius

    2015-01-01

    This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1) before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2) 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR. PMID:26106558

  12. Mouse limb muscle is determined in the absence of the earliest myogenic factor myf-5.

    PubMed Central

    Tajbakhsh, S; Buckingham, M E

    1994-01-01

    myf-5 is the only member of the MyoD family of myogenic regulatory genes to be expressed in the mouse embryo prior to muscle cell differentiation. We have used the developing limb as a model in which to follow the formation of peripheral muscle, to address the question of whether myogenic precursor cells are already present in the limb bud before expression of myf-5. The lacZ reporter gene has been introduced into the myf-5 gene by homologous recombination so that its expression is under the control of the endogenous myf-5 locus. beta-Galactosidase (beta-gal) coloration provides a sensitive assay for myf-5+ cells. Embryos were generated from embryonic stem cells carrying this mutation, and the appearance of beta-gal+ (myf-5+) cells was followed during limb development in vivo. Limb buds, at a stage when they are beta-gal-, were cultured in vitro. After several days, beta-gal+ cells accumulated in the premuscle mass. We conclude that determined muscle precursor cells in the limb bud do not initially express any member of the MyoD family. Furthermore, myogenic precursor cells in the somite, which, according to the avian model, migrate from the ventral/lateral edge of the dermomyotome to form peripheral muscle masses, are also negative for these factors. Images Fig. 2 Fig. 3 PMID:8290594

  13. Management of upper limb dysfunction in children with cerebral palsy: a systematic review.

    PubMed

    Boyd, R N; Morris, M E; Graham, H K

    2001-11-01

    Effective use of the upper limb can impact on educational outcomes, participation in activities of daily living and vocational options for many children with cerebral palsy (CP). This article presents the results of a systematic review of the literature on the management of upper limb dysfunction in children with CP. The range of management options includes therapies such as physiotherapy, occupational therapy, neurodevelopmental therapy and conductive education; peripheral splinting and casting; focal or generalized pharmacotherapy; and surgery to improve upper limb function or correct deformity. A literature search identified 60 papers, of which four were randomized controlled trials and 44 were prospective studies with objective outcome measures. Principal studies undertaken for each type of treatment and the efficacy of the different types of treatment were critically evaluated. In addition, the current level of evidence for each study was evaluated according to Sackett's (1989) model and ICIDH-2 classification. A close examination of two relatively new treatments for upper limb spasticity, constraint induced movement therapy and botulinum toxin type A (BTX-A) was conducted with reference to more extensive data on the efficacy of BTX-A in the lower limb. PMID:11851744

  14. A Brain Motor Control Assessment (BMCA) Protocol for Upper Limb Function

    PubMed Central

    Zoghi, Maryam; Galea, Mary; Morgan, David

    2013-01-01

    The Brain Motor Control Assessment (BMCA) protocol is a surface electromyography (sEMG)-based measure of motor output from central nervous system during a variety of reflex and voluntary motor tasks performed under strictly controlled conditions. The aim of this study was to evaluate the BMCA protocol for upper limb with the addition of shoulder voluntary tasks. The voluntary response index (VRI) was calculated from quantitative analysis of sEMG data during defined voluntary movement in neurologically intact people for comparison with that of patients after neurological injuries. The BMCA protocol included one bilateral and 4 unilateral voluntary tasks at different joints of both arms. The VRI, measured from 19 neurologically intact participants, comprises the total muscle activity recorded for the voluntary motor task (magnitude). The calculated similarity index (SI) for each phase of each task show the similarity of “the distribution of activity across the recorded muscles” for that task in this group off participants. Results: The VRI magnitude values from right and left sides for different tasks showed no significant difference (ANOVA: FSide: 0.09, P?=?0.77). Therefore these values were pooled before calculating SI. SI values were higher for tasks against gravity: elbow flexion (0.99±0.03), wrist flexion with palm up (0.98±0.03) and wrist extension with palm down (0.97±0.07). On the other hand, the SI values were the lowest for bilateral shoulder abduction (0.84±0.08) and shoulder adduction (0.84±0.08). Conclusion: To validate this index for clinical use, serial studies on patients with neurological impairments should be performed. Tasks involving movement against gravity may be more suitable in future BMCAs. PMID:24223953

  15. The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study

    PubMed Central

    2014-01-01

    Background Functional electrical stimulation (FES) during repetitive practice of everyday tasks can facilitate recovery of upper limb function following stroke. Reduction in impairment is strongly associated with how closely FES assists performance, with advanced iterative learning control (ILC) technology providing precise upper-limb assistance. The aim of this study is to investigate the feasibility of extending ILC technology to control FES of three muscle groups in the upper limb to facilitate functional motor recovery post-stroke. Methods Five stroke participants with established hemiplegia undertook eighteen intervention sessions, each of one hour duration. During each session FES was applied to the anterior deltoid, triceps, and wrist/finger extensors to assist performance of functional tasks with real-objects, including closing a drawer and pressing a light switch. Advanced model-based ILC controllers used kinematic data from previous attempts at each task to update the FES applied to each muscle on the subsequent trial. This produced stimulation profiles that facilitated accurate completion of each task while encouraging voluntary effort by the participant. Kinematic data were collected using a Microsoft Kinect, and mechanical arm support was provided by a SaeboMAS. Participants completed Fugl-Meyer and Action Research Arm Test clinical assessments pre- and post-intervention, as well as FES-unassisted tasks during each intervention session. Results Fugl-Meyer and Action Research Arm Test scores both significantly improved from pre- to post-intervention by 4.4 points. Improvements were also found in FES-unassisted performance, and the amount of arm support required to successfully perform the tasks was reduced. Conclusions This feasibility study indicates that technology comprising low-cost hardware fused with advanced FES controllers accurately assists upper limb movement and may reduce upper limb impairments following stroke. PMID:24981060

  16. The Effect of Practice on Learning and Transferring Goal Directed Isometric Contractions across Ipsilateral Upper and Lower Limbs 

    E-print Network

    Kaur, Navneet

    2010-07-14

    accuracy were similar for the two limbs, however, two days later, retention of the force accuracy was better with the upper limb compared with the lower limb. Practice-induced reduction and practice-to-retention increase in force and time endpoint error...

  17. Bioelectrical activity of limb muscles during cold shivering of stimulation of the vestibular apparatus

    NASA Technical Reports Server (NTRS)

    Kuzmina, G. I.

    1980-01-01

    The effects of caloric and electric stimulation of the vestibular receptors on the EMG activity of limb muslces in anesthetized cats during cold induced shivering involved flexor muscles alone. Both types of stimulation suppressed bioelectrical activity more effectively in the ipsilateral muscles. The suppression of shivering activity seems to be due to the increased inhibitory effect of descending labyrinth pathways on the function of flexor motoneurons.

  18. An FNS-based system for generating upper limb function in the C4 quadriplegic

    Microsoft Academic Search

    R. H. Nathan

    1989-01-01

    A system is presented for generation of upper limb function in the totally paralysed arms of high level spinal cord lesion\\u000a subjects. The stimulation part of the system is voice operated, computer controlled, and uses high-resolution surface stimulation\\u000a to generate arm and hand movements. Splinting, suspension, and voluntary upper trunk and shoulder girdle movements complement\\u000a the stimulationgenerated movements. Eating, drinking

  19. Epaxial and limb muscle activity during swimming and terrestrial stepping in the adult newt, Pleurodeles waltl.

    PubMed

    Delvolvé, I; Bem, T; Cabelguen, J M

    1997-08-01

    We have investigated the patterns of activation of epaxial musculature during both swimming and overground stepping in an adult newt (Pleurodeles waltl) with the use of electromyographic (EMG) recordings from different sites of the myomeric muscle dorsalis trunci along the body axis. The locomotor patterns of some limb muscles have also been investigated. During swimming, the epaxial myomeres are rhythmically active, with a strict alternation between opposite myomeres located at the same longitudinal site. The pattern of intersegmental coordination consists of three successively initiated waves of EMG activity passing posteriorly along the anterior trunk, the midtrunk, and the posterior trunk, respectively. Swimming is also characterized by a tonic activation of forelimb (dorsalis scapulae and extensor ulnae) and hindlimb (puboischiotibialis and puboischiofemoralis internus) muscles and a rhythmic activation of muscles (latissimus dorsi and caudofemoralis) acting both on limb and body axis. The latter matched the activation pattern of epaxial myomeres at the similar vertebral level. During overground stepping, the midtrunk myomeres express single synchronous bursts whereas the myomeres of the anterior trunk and those of the posterior trunk display a double bursting pattern in the form of two waves of EMG activity propagating in opposite directions. During overground stepping, the limb muscles and muscles acting on both limb and body axis were found to be rhythmically active and usually displayed a double bursting pattern. The main conclusion of this investigation is that the patterns of intersegmental coordination during both swimming and overground stepping in the adult newt are related to the presence of limbs and that they can be considered as hybrid lampreylike patterns. Thus it is hypothesized that, in newt, a chain of coupled segmental oscillatory networks, similar to that which constitutes the central pattern generator (CPG) for swimming in the lamprey, can account for both trunk motor patterns if it is influenced by limb CPGs in a way depending on the locomotor mode. During swimming, the segmental networks located close to the girdles receive extra tonic excitation coming from the limb CPGs, whereas during stepping, the axial CPGs are entrained to some extent by the limb oscillators. PMID:9307101

  20. RISE Control for 2DOF Human Lower Limb with Antagonistic Bi-Articular Muscles

    E-print Network

    RISE Control for 2DOF Human Lower Limb with Antagonistic Bi-Articular Muscles Yasunori Kawai1, Hiroyuki Kawai2, and Masayuki Fujita3 Abstract-- This paper considers RISE control for two-degree- of. INTRODUCTION Rehabilitation robotics aims at developing novel solutions for assisted therapy and objective

  1. Influence of muscle preactivation of the lower limb on impact dynamics in case of frontal collision

    E-print Network

    Pithioux, M; Saint-Onge, N; Nicol, C; Pithioux, Martine; Chavet, Pascale; St-Onge, Nancy; Nicol, Caroline

    2005-01-01

    Accidentology or shock biomechanics are research domains mainly devoted to the development of safety conditions for the users of various transport modes in case of an accident. The objective of this study was to improve the knowledge of the biomechanical behaviour of the lower limb facing sudden dynamic loading during a frontal collision. We aimed at establishing the relationship between the level of muscular activity prior to impact, called 'preactivation', of the lower limb extensors and the mechanical characteristics of impact. Relationships were described between the level of preactivation, the impact peak force values, the minimum force after unloading and the associated loading and unloading rates. The existence of reflex mechanisms that were affected by the level of voluntary muscular preactivation for the lower limb muscles was demonstrated. In conclusion, the existence of specific mechanism acting mainly at the knee level may result from the level of preactivation. Muscle behavior has to be included ...

  2. Wii balance board exercise improves balance and lower limb muscle strength of overweight young adults

    PubMed Central

    Siriphorn, Akkradate; Chamonchant, Dannaovarat

    2015-01-01

    [Purpose] The potential health benefits of the Nintendo Wii balance board exercise have been widely investigated. However, no study has been conducted to examine the benefits of Wii exercise for overweight young adults. The aim of this study was to investigate the effect of exercise performed on a Nintendo Wii balance board on the balance and lower limb muscle strength in overweight young adults. [Subjects and Methods] Within-subject repeated measures analysis was used. Sixteen young adults (aged 21.87±1.13?years, body mass index 24.15 ± 0.50?kg/m2) were recruited. All subjects performed an exercise program on a Wii balance board for 8 weeks (30?min/session, twice a week for 8 weeks). A NeuroCom Balance Master and a hand-held dynamometer were used to measure balance performance and lower limb muscle strength. [Results] According to the comparison of pre- and post-intervention measurements, the Wii balance board exercise program significantly improved the limit of stability parameters. There was also a significant increase in strength of four lower-limb muscle groups: the hip flexor, knee flexor, ankle dorsiflexor and ankle plantarflexor. [Conclusion] These findings suggest that a Wii balance board exercise program can be used to improve the balance and lower limb muscle strength of overweight young adults. PMID:25642034

  3. Influence of muscle preactivation of the lower limb on impact dynamics in case of frontal collision.

    E-print Network

    Paris-Sud XI, Université de

    of specific mechanism acting mainly at the knee level may result from the level of preactivation. Muscle such as seatbelts and airbags for drivers in car occupants leads to an apparent increase of lower limb injuries on internal and external integrity of human body. Injuries inferred by the collision were most of the time

  4. Upper Limb Assessment in Tetraplegia: Clinical, Functional and Kinematic Correlations

    ERIC Educational Resources Information Center

    Cacho, Enio Walker Azevedo; de Oliveira, Roberta; Ortolan, Rodrigo L.; Varoto, Renato; Cliquet, Alberto

    2011-01-01

    The aim of this study was to correlate clinical and functional evaluations with kinematic variables of upper limp reach-to-grasp movement in patients with tetraplegia. Twenty chronic patients were selected to perform reach-to-grasp kinematic assessment using a target placed at a distance equal to the arm's length. Kinematic variables (hand peak…

  5. Constraining upper limb synergies of hemiparetic patients using a robotic exoskeleton in the perspective of neuro-rehabilitation

    E-print Network

    Constraining upper limb synergies of hemiparetic patients using a robotic exoskeleton--The aim of this article was to explore how an upper limb exoskeleton can be programmed to impose specific the exoskeleton during active-assisted exercises. An original feature of this controller is that the hand

  6. A 3-D rehabilitation system for upper limbs developed in a 5-year NEDO project and its clinical testing

    Microsoft Academic Search

    Junji Furusho; K. Koyanagi; Y. Imada; Y. Fujii; K. Nakanishi; K. Domen; K. Miyakoshi; U. Ryu; S. Takenaka; A. Inoue

    2005-01-01

    New training methods and exercises for upper limbs rehabilitation can be developed using robotics and virtual reality technologies. The technologies can make quantitative evaluations and enhance the qualitative effect of trainings. We have developed a 3D exercise machine for upper limbs (EMUL) with special actuators using electrorheological (ER) fluid. The ER actuator is composed of an ER clutch and its

  7. Occupational musculoskeletal disorders in the neck and upper limbs of forestry workers exposed to hand-arm vibration

    Microsoft Academic Search

    MASSIMO BOVENZI; ANTONELLA ZADINI; ANDREA FRANZINELLI; FLAVIO BORGOGNI

    1991-01-01

    An epidemiologic and clinical study of neck and upper limb musculoskeletal disorders was carried out on 65 vibration-exposed forestry operators using chain–saws and 31 comparable control subjects (maintenance workers) performing manual activity and not exposed to vibration. Upper limb function was evaluated by measuring finger and wrist circumference size, maximal hand grip strength and range of motion manoeuvres in both

  8. 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.

  9. The Impact of Upper Tropospheric Humidity from Microwave Limb Sounder on the Midlatitude Greenhouse Effect

    NASA Technical Reports Server (NTRS)

    Hu, Hua; Liu, W. Timothy

    1998-01-01

    This paper presents an analysis of upper tropospheric humidity, as measured by the Microwave Limb Sounder, and the impact of the humidity on the greenhouse effect in the midlatitudes. Enhanced upper tropospheric humidity and an enhanced greenhouse effect occur over the storm tracks in the North Pacific and North Atlantic. In these areas, strong baroclinic activity and the large number of deep convective clouds transport more water vapor to the upper troposphere, and hence increase greenhouse trapping. The greenhouse effect increases with upper tropospheric humidity in areas with a moist upper troposphere (such as areas over storm tracks), but it is not sensitive to changes in upper tropospheric humidity in regions with a dry upper troposphere, clearly demonstrating that there are different mechanisms controlling the geographical distribution of the greenhouse effect in the midlatitudes.

  10. Design of a 7 Degree-of-Freedom Upper-Limb Powered Exoskeleton

    Microsoft Academic Search

    Joel C. Perry; Jacob Rosen

    2006-01-01

    The exoskeleton is an external structural mechanism with joints and links corresponding to those of the human body. Worn by the human, the exoskeleton transmits torques from proximally located actuators through rigid exoskeletal links to the human joints. This paper presents the development of an anthropometric seven degree-of-freedom powered exoskeleton for the upper limb. The design was based on a

  11. PID Admittance Control for an Upper Limb Exoskeleton Wen Yu, Jacob Rosen, Xiaoou Li

    E-print Network

    Rosen, Jacob

    PID Admittance Control for an Upper Limb Exoskeleton Wen Yu, Jacob Rosen, Xiaoou Li Abstract-- The unique exoskeleton system (EXO-UL7) in UCSC is controlled in two levels. The lower-level uses standard a model-based impedance/admittance control when the model of the exoskeleton is unavailable. In this paper

  12. Design of a 7 Degree-of-Freedom Upper-Limb Powered Exoskeleton

    E-print Network

    Design of a 7 Degree-of-Freedom Upper-Limb Powered Exoskeleton Joel C. Perry(+), Jacob Rosen.ee.washington.edu .Abstract ­ The exoskeleton is an external structural mechanism with joints and links corresponding to those of the human body. Worn by the human, the exoskeleton transmits torques from proximally located actuators

  13. Admittance Control of an Upper Limb Exoskeleton Reduction of Energy Exchange

    E-print Network

    Rosen, Jacob

    Admittance Control of an Upper Limb Exoskeleton ­ Reduction of Energy Exchange Hyunchul Kim, Levi robot systems (e.g. exoskeletons) is enabled by a control algorithm that maximizes the transparency at the interface between the human arm and the exoskeleton system. The system performance was evaluated by five

  14. The 183 GHz water and ozone channels on the upper atmosphere research satellite microwave limb sounder†

    Microsoft Academic Search

    W. A. LAHOZ

    1991-01-01

    The Microwave Limb Sounder (MLS) to be carried on the Upper Atmosphere Research Satellite (UARS) will measure concentrations of a number of stratospheric constituents. In this paper sample calculations of the forward problem pertaining to the 183 GHz band of MLS are presented. This band is used to infer water vapour and ozone amounts from the 183·3 GHz and 184·4

  15. The anatomy and physiology of the sympathetic innervation to the upper limbs

    Microsoft Academic Search

    Yitzhak Schiller

    2003-01-01

    An overview of the autonomic nervous system is given. The sympathetic innervation of the upper limb is presented, with specific emphasis on segmental nervous supply and anatomical variations. In addition, the physiology and pharmacology of the sympathetic nervous system is introduced and discussed.

  16. "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

  17. Development of a Haptic Feedback Device for Upper Limb Amputees Andrew Erwin and Professor Frank Sup

    E-print Network

    Mountziaris, T. J.

    Development of a Haptic Feedback Device for Upper Limb Amputees Andrew Erwin and Professor Frank this problem haptic feedback devices have been explored. Haptic feedback is the use of a created stimulation modules has been developed that has the capability to create haptic feedback. Each module of the device

  18. Sensory nerve conduction in the upper limbs at various stages of diabetic neuropathy 1

    Microsoft Academic Search

    P. Noël

    1973-01-01

    In 59 diabetic patients, sensory nerve potentials were recorded at various sites along the course of the median nerve. Pathological responses were characterized by reduced amplitude, desynchronization and decreased conduction velocity (CV). Four groups of patients with increasingly severe nerve dysfunction were distinguished. The presence and severity of clinical neuropathy in the upper limbs could be related to decreased maximal

  19. The nature of work-related neck and upper limb musculoskeletal disorders

    Microsoft Academic Search

    Peter W Buckle; J Jason Devereux

    2002-01-01

    The nature of work-related musculoskeletal disorders of the neck and upper limbs is reviewed using both scientific data and the consensus view of experts, union bodies and government agencies across the European Union. Work-related musculoskeletal disorders describe a wide range of inflammatory and degenerative diseases and disorders. These conditions result in pain and functional impairment and may affect, besides others,

  20. Study on motion measurement of human upper limb based on electromagnetic tracking system

    Microsoft Academic Search

    Jianguo Zhang; Haiyan Song; Qiang Xue

    2008-01-01

    The measurement and analysis of human motion is widely used in rehabilitation, athletics, ergonomics, diagnosis, bionics and computer graphics etc. We have developed a motion measurement and analysis system for human upper limb based on Polhemus¿ electromagnetic tracking system in this paper. According to the skeleton structure of human, the joint coordinate systems were built in shoulder, elbow and wrist

  1. A neural tracking and motor control approach to improve rehabilitation of upper limb movements

    Microsoft Academic Search

    Michela Goffredo; Ivan Bernabucci; Maurizio Schmid; Silvia Conforto

    2008-01-01

    BACKGROUND: Restoration of upper limb movements in subjects recovering from stroke is an essential keystone in rehabilitative practices. Rehabilitation of arm movements, in fact, is usually a far more difficult one as compared to that of lower extremities. For these reasons, researchers are developing new methods and technologies so that the rehabilitative process could be more accurate, rapid and easily

  2. The principles of management of congenital anomalies of the upper limb

    PubMed Central

    Watson, S.

    2000-01-01

    Management of congenital anomalies of the upper limb is reviewed with reference to classification and aetiology, incidence, diagnosis before birth, broad principles of treatment, timing of x rays and scans, functional aims, cosmetic appearance, counselling of parents, therapists, scars, skin grafts, growth, and timing of surgery. Notes on 11 congenital hand conditions are given.?? PMID:10868991

  3. A novel motion tracking system for evaluation of functional rehabilitation of the upper limbs

    PubMed Central

    Gil-Agudo, Ángel; de los Reyes-Guzmán, Ana; Dimbwadyo-Terrer, Iris; Peñasco-Martín, Benito; Bernal-Sahún, Alberto; López-Monteagudo, Patricia; del Ama-Espinosa, Antonio; Pons, José Luis

    2013-01-01

    Upper limb function impairment is one of the most common sequelae of central nervous system injury, especially in stroke patients and when spinal cord injury produces tetraplegia. Conventional assessment methods cannot provide objective evaluation of patient performance and the tiveness of therapies. The most common assessment tools are based on rating scales, which are inefficient when measuring small changes and can yield subjective bias. In this study, we designed an inertial sensor-based monitoring system composed of five sensors to measure and analyze the complex movements of the upper limbs, which are common in activities of daily living. We developed a kinematic model with nine degrees of freedom to analyze upper limb and head movements in three dimensions. This system was then validated using a commercial optoelectronic system. These findings suggest that an inertial sensor-based motion tracking system can be used in patients who have upper limb impairment through data integration with a virtual reality-based neuroretation system. PMID:25206474

  4. Robot-Mediated Upper Limb Physiotherapy: Review and Recommendations for Future Clinical Trials

    ERIC Educational Resources Information Center

    Peter, Orsolya; Fazekas, Gabor; Zsiga, Katalin; Denes, Zoltan

    2011-01-01

    Robot-mediated physiotherapy provides a new possibility for improving the outcome of rehabilitation of patients who are recovering from stroke. This study is a review of robot-supported upper limb physiotherapy focusing on the shoulder, elbow, and wrist. A literature search was carried out in PubMed, OVID, and EBSCO for clinical trials with robots…

  5. Self reported symptoms in the neck and upper limbs in nurses

    Microsoft Academic Search

    M. J. Lusted; C. L. Carrasco; J. A. Mandryk; S. Healey

    1996-01-01

    This paper describes a cross-sectional study which examines musculoskeletal symptoms in nurses working in two similar units in a residential care centre for the developmentally disabled. Amongst the 30 nurses who were administered the Nordic Questionnaire, neck and upper limb symptoms had resulted in considerable inability to perform work. In contrast, a similar incidence of reported back symptoms in these

  6. Clinical Changes of Stroke Patients Using Robot Aided Techniques at the Upper Limb

    Microsoft Academic Search

    Pisano Fabrizio; Delconte Carmen; Pianca Danilo; Tommasi Maria Antonietta; Minuco Giuseppe Eng; Micera Silvestro; Colombo Roberto Eng

    We assessed the effects of robot-assisted movement training compared with conventional therapies in th e rehabi- litation of upper limb motor function after stroke. Clinical and biomechanical data were collected in 18 consecu- tive post stroke patients randomly allocated to rec eive either conventional therapies only (CT group) or conventi- onal therapies plus robot-assisted movement trainin g (R group). No

  7. Upper limb rehabilitation and evaluation of stroke patients using robot-aided techniques

    Microsoft Academic Search

    Roberto Colombo; Fabrizio Pisano; Silvestro Micera; Alessandra Mazzone; Carmen Delconte; M. Chiara Carrozza; Paolo Dario; Giuseppe Minuco

    2005-01-01

    This work presents two robot devices for use in the rehabilitation of upper limb movements and reports the quantitative parameters obtained to characterize the rate of improvement thus allowing a precise monitoring of the patient's recovery. Two groups of chronic post-stroke patients were enrolled in a 3-week rehabilitation program including standard physical therapy plus treatment by means of robot devices

  8. Mechanical Overloading Increases Maximal Force and Reduces Fragility in Hind Limb Skeletal Muscle from Mdx Mouse.

    PubMed

    Ferry, Arnaud; Parlakian, Ara; Joanne, Pierre; Fraysse, Bodvael; Mgrditchian, Takouhie; Roy, Pauline; Furling, Denis; Butler-Browne, Gillian; Agbulut, Onnik

    2015-07-01

    There is fear that mechanical overloading (OVL; ie, high-force contractions) accelerates Duchenne muscular dystrophy. Herein, we determined whether short-term OVL combined with wheel running, short-term OVL combined with irradiation, and long-term OVL are detrimental for hind limb mdx mouse muscle, a murine model of Duchene muscular dystrophy exhibiting milder dystrophic features. OVL was induced by the surgical ablation of the synergic muscles of the plantaris muscle, a fast muscle susceptible to contraction-induced muscle damage in mdx mice. We found that short-term OVL combined with wheel and long-term OVL did not worsen the deficit in specific maximal force (ie, absolute maximal force normalized to muscle size) and histological markers of muscle damage (percentage of regenerating fibers and fibrosis) in mdx mice. Moreover, long-term OVL did not increase the alteration in calcium homeostasis and did not deplete muscle cell progenitors expressing Pax 7 in mdx mice. Irradiation before short-term OVL, which is believed to inhibit muscle regeneration, was not more detrimental to mdx than control mice. Interestingly, short-term OVL combined with wheel and long-term OVL markedly improved the susceptibility to contraction-induced damage, increased absolute maximal force, induced hypertrophy, and promoted a slower, more oxidative phenotype. Together, these findings indicate that OVL is beneficial to mdx muscle, and muscle regeneration does not mask the potentially detrimental effect of OVL. PMID:26009153

  9. Upper Limb Dynamics during Manual Wheelchair Propulsion with Different Resistances

    Microsoft Academic Search

    S. H. Hwang; H. Y. Lee; Y. H. Kim

    \\u000a Kinematic and kinetic studies have been reported numerously to estimate the dynamic efforts over upper extremity joints during\\u000a manual wheelchair propulsion. In this study, Joint angles, EMGs and wheelchair axle torque during manual wheelchair propulsion\\u000a with different external loads were investigated. Four healthy males were volunteered for this study and their motions were\\u000a analyzed when they propelled the wheelchair. Three

  10. Development of adaptive pneumatic tourniquet systems based on minimal inflation pressure for upper limb surgeries

    PubMed Central

    2013-01-01

    Background Pneumatic tourniquets are medical devices that occlude blood flow to distal part of extremities and are commonly used in upper limb surgeries to provide a dry, clean and bloodless field. To decrease pressure-related injuries and potential risk of complications subjected to the high inflation pressure of pneumatic tourniquet, minimal inflation pressures are recommended. Methods A new occlusion pressure mathematical model for the upper limb was established based on the correlation analysis between several possible influencing parameters and the minimal pneumatic tourniquet pressure at which the peripheral pulse disappeared was recorded using a digital plethysmograph. A prototype of an adaptive pneumatic tourniquet which automatically varies the pressure in the tourniquet cuff according to the above prediction model was developed for the upper limb which used the lowest possible inflation pressure to achieve occlusion. The prototype comprises a blood pressure monitoring module, an inflatable tourniquet cuff, and a pressure relief mechanism to maintain an optimal cuff inflation pressure. Simulation experiments were conducted to verify the function and stability of the designed adaptive pneumatic tourniquet and clinical experiments using volunteers were undertaken to evaluate the performance of the prototype design in achieving adequate haemostasis in the upper limb. Results Results demonstrated that the mean arterial occlusion pressure was 152.3?±?16.7 mmHg, obviously below the 250 to 300 mmHg previously recommended (J Bone Joint Surg Br 68:625-628, 1986 and Arthroscopy 11:307–311, 1995). Conclusions In conclusion, this adaptive method and apparatus which can provide minimal inflation pressure may be a clinically practical alternative for upper limb surgery performed with pneumatic tourniquets. PMID:24053348

  11. Proposed equation between flexor carpi radialis H-reflex latency and upper limb length

    PubMed Central

    Khosrawi, Saeid; Taheri, Parisa; Hashemi, Seyed Hasan

    2015-01-01

    Background: H-reflex is a valuable electrophysiological technique for assessing nerve conduction through entire length of afferent and efferent pathways, especially nerve roots and proximal segments of peripheral nerves. The aim of this study was to investigate the relation between normal values of flexor carpi radialis (FCR) H-reflex latency, upper limb length and age in normal subjects, and to determine whether there is any regression equation between them. Methods: By considering the criteria of inclusion and exclusion, 120 upper limbs of 69 normal volunteers (68 hands of 39 men and 52 hands of 30 women) with the mean age of 39.8 ± 11.2 years participated in this study. FCR H-reflex was obtained by standard electrodiagnostic techniques, and its onset latency was recorded. Upper limb length and arm length were measured in defined position. The degree of association between these variables was determined with Pearson correlation and linear regression was used for obtaining the proposed relations. Results: Mean FCR H-reflex latency was found to be 15.88 ± 1.27 ms. There was a direct linear correlation between FCR H-reflex latency and upper limb length (r = 0.647) and also arm length (r = 0.574), but there was no significant correlation between age and FCR H-reflex latency (P = 0.260). Finally, based on our findings, we tried to formulate these relations by statistical methods. Conclusion: We found that upper limb length and arm length are good predictive values for estimation of normal FCR H-reflex latency but age, in the range of 20-60 years old, has no correlation with its latency. This estimation could have practical indications in pathologic conditions. PMID:25874056

  12. Distinct underlying mechanisms of limb and respiratory muscle fiber weaknesses in nemaline myopathy.

    PubMed

    Lindqvist, Johan; Cheng, Arthur J; Renaud, Guillaume; Hardeman, Edna C; Ochala, Julien

    2013-06-01

    Nemaline myopathy is the most common congenital myopathy and is caused by mutations in various genes such as ACTA1 (encoding skeletal ?-actin). It is associated with limb and respiratory muscle weakness. Despite increasing clinical and scientific interest, the molecular and cellular events leading to such weakness remain unknown, which prevents the development of specific therapeutic interventions. To unravel the potential mechanisms involved, we dissected lower limb and diaphragm muscles from a knock-in mouse model of severe nemaline myopathy expressing the ACTA1 His40Tyr actin mutation found in human patients. We then studied a broad range of structural and functional characteristics assessing single-myofiber contraction, protein expression, and electron microscopy. One of the major findings in the diaphragm was the presence of numerous noncontractile areas (including disrupted sarcomeric structures and nemaline bodies). This greatly reduced the number of functional sarcomeres, decreased the force generation capacity at the muscle fiber level, and likely would contribute to respiratory weakness. In limb muscle, by contrast, there were fewer noncontractile areas and they did not seem to have a major role in the pathogenesis of weakness. These divergent muscle-specific results provide new important insights into the pathophysiology of severe nemaline myopathy and crucial information for future development of therapeutic strategies. PMID:23656990

  13. Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries

    PubMed Central

    He, Bo; Zhu, Zhaowei; Zhu, Qingtang; Zhou, Xiang; Zheng, Canbin; Li, Pengliang; Zhu, Shuang; Liu, Xiaolin; Zhu, Jiakai

    2014-01-01

    OBJECTIVE: To investigate the factors associated with sensory and motor recovery after the repair of upper limb peripheral nerve injuries. DATA SOURCES: The online PubMed database was searched for English articles describing outcomes after the repair of median, ulnar, radial, and digital nerve injuries in humans with a publication date between 1 January 1990 and 16 February 2011. STUDY SELECTION: The following types of article were selected: (1) clinical trials describing the repair of median, ulnar, radial, and digital nerve injuries published in English; and (2) studies that reported sufficient patient information, including age, mechanism of injury, nerve injured, injury location, defect length, repair time, repair method, and repair materials. SPSS 13.0 software was used to perform univariate and multivariate logistic regression analyses and to investigate the patient and intervention factors associated with outcomes. MAIN OUTCOME MEASURES: Sensory function was assessed using the Mackinnon-Dellon scale and motor function was assessed using the manual muscle test. Satisfactory motor recovery was defined as grade M4 or M5, and satisfactory sensory recovery was defined as grade S3+ or S4. RESULTS: Seventy-one articles were included in this study. Univariate and multivariate logistic regression analyses showed that repair time, repair materials, and nerve injured were independent predictors of outcome after the repair of nerve injuries (P < 0.05), and that the nerve injured was the main factor affecting the rate of good to excellent recovery. CONCLUSION: Predictors of outcome after the repair of peripheral nerve injuries include age, gender, repair time, repair materials, nerve injured, defect length, and duration of follow-up. PMID:25206870

  14. Effects of immobilization on rat hind limb muscles under non-weight-bearing conditions

    NASA Technical Reports Server (NTRS)

    Jaspers, Stephen R.; Fagan, Julie M.; Satarug, Soisungwan; Cook, Paul H.; Tischler, Marc E.

    1988-01-01

    The effect of stretched and unstretched immobilization of a hind limb on the concentration and the metabolism of proteins in the hind-limb muscles of rats was investigated. The animals were divided into three groups: (1) weight-bearing controls, (2) tail-cast-suspended, and (3) suspended, with one hind limb immobilized with the ankle in dorsiflexion (30-40 deg angle) and the other freely moving. It was found that unloading the hind limbs for 6 days by tail cast suspension caused soleus to atrophy and reduced growth of the gastrocnemius and plantaris muscles; unloading resulted in a higher degradation rate and lower synthesis rate in both in vitro and in vivo. Chronic stretch of the unloaded soleus not only prevented its atrophy but led to significant hypertrophy, relative to weight-bearing controls, with increases in both the sarcoplasmic and myofibrillar protein fractions. Immobilizing one ankle in dorsiflexion prevented the inhibition of growth in the plantaris and gastrocnemius muscles due to unloading.

  15. An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P. N. Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R.; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N. A.; Janssens, Wim; Polkey, Micheal I.; Roca, Josep; Saey, Didier; Schols, Annemie M. W. J.; Spruit, Martijn A.; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D.

    2014-01-01

    Background: Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. Purpose: The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. Methods: An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. Results: We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Conclusions: Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem. Strategies for early detection and specific treatments for this condition are also needed. PMID:24787074

  16. Congenital form of spinal muscular atrophy predominantly affecting the lower limbs: a clinical and muscle MRI study

    Microsoft Academic Search

    E. Mercuri; S. Messina; M. Kinali; C. Cini; C. Longman; R. Battini; G. Cioni; F. Muntoni

    2004-01-01

    We describe clinical and muscle magnetic resonance imaging (MRI) findings in 11 cases (three familial and eight sporadic) with the form of spinal muscular atrophy characterised by predominant involvement of the lower limbs with weakness of the proximal and distal muscles and marked atrophy of the distal leg and foot muscles. All patients presented at birth with talipes, which were

  17. A Neuroanatomical Framework for Upper Limb Synergies after Stroke

    PubMed Central

    McMorland, Angus J. C.; Runnalls, Keith D.; Byblow, Winston D.

    2015-01-01

    Muscle synergies describe common patterns of co- or reciprocal activation that occur during movement. After stroke, these synergies change, often in stereotypical ways. The mechanism underlying this change reflects damage to key motor pathways as a result of the stroke lesion, and the subsequent reorganization along the neuroaxis, which may be further detrimental or restorative to motor function. The time course of abnormal synergy formation seems to lag spontaneous recovery that occurs in the initial weeks after stroke. In healthy individuals, motor cortical activity, descending via the corticospinal tract (CST) is the predominant driver of voluntary behavior. When the CST is damaged after stroke, other descending pathways may be up-regulated to compensate. The contribution of these pathways may emerge as new synergies take shape at the chronic stage after stroke, as a result of plasticity along the neuroaxis. The location of the stroke lesion and properties of the secondary descending pathways and their regulation are then critical for shaping the synergies in the remaining motor behavior. A consideration of the integrity of remaining descending motor pathways may aid in the design of new rehabilitation therapies. PMID:25762917

  18. Use of Evans blue dye to compare limb muscles in exercised young and old mdx mice.

    PubMed

    Wooddell, Christine I; Zhang, Guofeng; Griffin, Jacob B; Hegge, Julia O; Huss, Thierry; Wolff, Jon A

    2010-04-01

    Evans blue dye (EBD) is used to mark damaged and permeable muscle fibers in mouse models of muscular dystrophy and as an endpoint in therapeutic trials. We counted EBD-positive muscle fibers and extracted EBD from muscles sampled throughout the hindlimbs in young adult and old mdx mice to determine if the natural variability in morphology would allow measurement of a functional improvement in one limb compared to the contralateral limb. Following one bout of rotarod or treadmill exercise that greatly increased serum creatine kinase levels, the number of EBD(+) muscle fibers in 12-19-month-old mdx mice increased 3-fold, EBD in the muscles increased, and, importantly, contralateral pairs of muscles contained similar amounts of EBD. In contrast, the intra- and interlimb amounts of EBD in 2-7-month-old mdx mice were much too variable. A therapeutic effect can more readily be measured in old mdx mice. These results will be useful in the design of therapy protocols using the mdx mouse. PMID:19813196

  19. Jose L. Pons c08.tex V1 -22nd November 2007 11:34 A.M. Page 259 Case Study: An Upper Limb Powered Exoskeleton 259

    E-print Network

    Rosen, Jacob

    Study: An Upper Limb Powered Exoskeleton 259 Figure 8.14 The first version of the NEUROExos 8.5 CASE STUDY: AN UPPER LIMB POWERED EXOSKELETON J. C. Perry and J. Rosen Department of Electrical Engineering generation of an upper limb powered exoskeleton. Previous generations included a 1 DoF system (elbow joint

  20. Dynamics of goat distal hind limb muscle–tendon function in response to locomotor grade

    PubMed Central

    McGuigan, M. Polly; Yoo, Edwin; Lee, David V.; Biewener, Andrew A.

    2009-01-01

    Summary The functional roles of the lateral gastrocnemius (LG), medial gastrocnemius (MG) and superficial digital flexor (SDF) muscle–tendon units (MTUs) in domestic goats (N=6) were studied as a function of locomotor grade, testing the hypothesis that changes in distal limb muscle work would reflect changes in mechanical work requirements while goats walked or trotted on the level, 15 deg. decline and 15 deg. incline. As steep terrain-adapted animals, changes in muscle work output are expected to be particularly important for goats. In vivo muscle–tendon forces, fascicle length changes and muscle activation were recorded via tendon force buckles, sonomicrometry and electromyography to evaluate the work performance and elastic energy recovery of the three distal MTUs. These recordings confirmed that fascicle strain and force within goat distal hind limb muscles are adjusted in response to changes in mechanical work demand associated with locomotor grade. In general, muscle work was modulated most consistently by changes in fascicle strain, with increased net shortening (P<0.001) observed as goats switched from decline to level to incline locomotion. Peak muscle stresses increased as goats increased speed from a walk to a trot within each grade condition (P<0.05), and also increased significantly with grade (P<0.05 to P<0.01). Due to the increase in net fascicle shortening and muscle force, net muscle work per cycle also increased significantly (P<0.05 to P<0.005) as goats switched from decline to level to incline conditions (LG work: 20 mJ to 56 mJ to 209 mJ; MG work: –7 mJ to 34 mJ to 179 mJ; SDF work: –42 mJ to 14 mJ to 71 mJ, at a 2.5 ms–1 trot). Although muscle work was modulated in response to changes in grade, the amount of work produced by these three distal pennate muscles was small (being <3%) in comparison with the change in mechanical energy required of the limb as a whole. Elastic energy recovery in the SDF and gastrocnemius (GA) tendons was substantial across all three grades, with the SDF tendon recovering 2.4 times more energy, on average, than the GA tendon. In parallel with the increase in muscle–tendon force, tendon energy recovery also increased as goats increased speed and changed gait, reaching the highest levels when goats trotted on an incline at 2.5 ms–1 (GA: 173 mJ; SDF: 316 mJ). In general, tendon elastic energy exceeded net muscle work across all grade and gait conditions. These results demonstrate, for the first time in a quadruped, similar findings to those observed in ankle extensor muscles in humans, wallabies, turkeys and guinea fowl, suggesting that distal muscle–tendon architecture more generally favors a design for economic force production and tendon elastic energy recovery, with the majority of limb work during incline or decline running performed by larger proximal muscles. PMID:19525436

  1. Comparison of laterality index of upper and lower limb movement using brain activated fMRI

    NASA Astrophysics Data System (ADS)

    Harirchian, Mohammad Hossein; Oghabian, Mohammad Ali; Rezvanizadeh, Alireza; Bolandzadeh, Niousha

    2008-03-01

    Asymmetry of bilateral cerebral function, i.e. laterality, is an important phenomenon in many brain actions such as motor functions. This asymmetry maybe altered in some clinical conditions such as Multiple Sclerosis (MS). The aim of this study was to delineate the laterality differences for upper and lower limbs in healthy subjects to compare this pattern with subjects suffering from MS in advance. Hence 9 Male healthy subjects underwent fMRI assessment, while they were asked to move their limbs in a predetermined pattern. The results showed that hands movement activates the brain with a significant lateralization in pre-motor cortex in comparison with lower limb. Also, dominant hands activate brain more lateralized than the non-dominant hand. In addition, Left basal ganglia were observed to be activated regardless of the hand used, While, These patterns of Brain activation was not detected in lower limbs. We hypothesize that this difference might be attributed to this point that hand is usually responsible for precise and fine voluntary movements, whereas lower limb joints are mainly responsible for locomotion, a function integrating voluntary and automatic bilateral movements.

  2. Effect of exercise at light loads with manipulative resistance on infraspinatus, trapezius (upper fiber) and deltoid (middle fiber) muscle activities in shoulder joint elevation

    PubMed Central

    Nanba, Yoshifumi; Miyamoto, Shigenori; Takemasa, Seiichi; Uesugi, Masayuki; Inoue, Yuri; Ootani, Yoshitaka; Fujii, Shun; Hirotsu, Takaaki; Tanaka, Hideki

    2015-01-01

    [Purpose] To clarify rotator cuff muscular activity in the raised position of the closed kinetic chain (CKC) exercise. [Subjects] Twenty-nine cases were studied, 19 men and 10 women (average age 21.5 ±4.7?years old, average body weight 60.1?kg ±11.4). [Methods] To determine the effects of the closed kinetic chain exercise on the upper limb, we measured the surface EMG of the infraspinatus muscle, the trapezius (upper fiber) and the deltoid (middle fiber) with the arm elevated. [Results] Our results show that at an elevation angle of 150° in the scapular plane of the upper limb, with 5% body weight load, the EMG activities of the infraspinatus muscle are approximately 30% of maximum voluntary contraction (MVC). [Conclusion] The raised position of the CKC exercise is effective in physical therapy for functional recovery of the infraspinatus muscle. PMID:25931695

  3. Isometric Arm Strength and Subjective Rating of Upper Limb Fatigue in Two-Handed Carrying Tasks

    PubMed Central

    Li, Kai Way; Chiu, Wen-Sheng

    2015-01-01

    Sustained carrying could result in muscular fatigue of the upper limb. Ten male and ten female subjects were recruited for measurements of isometric arm strength before and during carrying a load for a period of 4 minutes. Two levels of load of carrying were tested for each of the male and female subjects. Exponential function based predictive equations for the isometric arm strength were established. The mean absolute deviations of these models in predicting the isometric arm strength were in the range of 3.24 to 17.34 N. Regression analyses between the subjective ratings of upper limb fatigue and force change index (FCI) for the carrying were also performed. The results indicated that the subjective rating of muscular fatigue may be estimated by multiplying the FCI with a constant. The FCI may, therefore, be adopted as an index to assess muscular fatigue for two-handed carrying tasks. PMID:25794159

  4. Proprioceptive Rehabilitation of Upper Limb Dysfunction in Movement Disorders: A Clinical Perspective

    PubMed Central

    Abbruzzese, Giovanni; Trompetto, Carlo; Mori, Laura; Pelosin, Elisa

    2014-01-01

    Movement disorders (MDs) are frequently associated with sensory abnormalities. In particular, proprioceptive deficits have been largely documented in both hypokinetic (Parkinson’s disease) and hyperkinetic conditions (dystonia), suggesting a possible role in their pathophysiology. Proprioceptive feedback is a fundamental component of sensorimotor integration allowing effective planning and execution of voluntary movements. Rehabilitation has become an essential element in the management of patients with MDs, and there is a strong rationale to include proprioceptive training in rehabilitation protocols focused on mobility problems of the upper limbs. Proprioceptive training is aimed at improving the integration of proprioceptive signals using “task-intrinsic” or “augmented feedback.” This perspective article reviews the available evidence on the effects of proprioceptive stimulation in improving upper limb mobility in patients with MDs and highlights the emerging innovative approaches targeted to maximizing the benefits of exercise by means of enhanced proprioception. PMID:25505402

  5. Functional and aesthetic outcome of a complex upper-limb reconstruction after criminal caustic injection.

    PubMed

    Lazar, Calin Constantin; Revol, M; Servant, J-M

    2009-05-01

    Extensive upper-limb injuries are usually secondary to accidental partial or complete avulsions or massive burns. Caustic injections are an exceptional etiology, with terrible lesions that present therapeutic challenges and major aftereffects. We report the case of a 41-year-old patient presenting with a large and deep anterior necrosis of the upper-limb anterior tissues, after a criminal intravenous injection of caustic soda on the inner side of his left elbow. Reconstruction methods consisted of a homolateral latissimus dorsi pediculated flap, a humeroulnar vascular bypass, a medial nerve autograft, and a secondary palliative Brand 1 procedure. Final functional and aesthetic results, obtained after long-term physiotherapy, were unexpectedly good. In conclusion, reconstructive surgery of such major lesions cannot be considered without a multidisciplinary approach. Moreover, patients have to be well informed about the necessity of multiple surgical interventions, the risk of major handicap, and the unpredictable nature of the final outcome. PMID:19061155

  6. [Cross-hand replantation in bilateral upper limb amputation: An anatomical emergency].

    PubMed

    Andre, A; Rongieres, M; Laffosse, J-M; Pailhe, R; Lauwers, F; Grolleau, J-L

    2015-08-01

    Bilateral amputations of upper limbs are excessively rare clinical situations. We report an exceptional clinical case of bilateral amputation of upper limbs at different levels: destruction of the right hand and left transhumeral amputation in a patient after an attempted suicide on train lines. This special situation led us to perform a cross-hand replantation of the left hand to the right forearm. Only 4 other similar cases have been published in the literature. Once the surgical indication had been formulated collectively, and taking into account all the ethical issues surrounding such a decision, we had to solve the issue of inverting anatomical structures in emergency. We have provided a detailed description of our surgical technique. The aim was to save at least one organ used for grasping. The result obtained is presented and reviewed. PMID:25498535

  7. Corticospinal Dysgenesis and Upper-Limb Deficits in Congenital Hemiplegia: A Diffusion Tensor Imaging Study

    Microsoft Academic Search

    Yannick Bleyenheuft; B. Grandin; Guy Cosnard; Etienne Olivier; Jean-Louis Thonnard

    2010-01-01

    OBJECTIVES.Precision grasping critically relies on the integrity of the corticospinal tract as evidenced in congenital hemiplegia by the correlation found between corticospinal dysgenesis and hand-movement deficits. Therefore, corticospinal dysgenesis could be used to anticipate upper-limb deficits in young infants with congenital hemiplegia. However, most studies have quantified corticospinal dysgenesis by measuring the cross-sectional area of cerebral peduncles on T1 MRI,

  8. Effects of Upper-Limb Posture on Endpoint Stiffness during Force Targeting Tasks

    Microsoft Academic Search

    Pei-Rong Wang; Ju-Ying Chang; Kao-Chi Chung

    Endpoint stiffness is characterized as the relationship between externally imposed displacements of the hand and the elastic\\u000a forces generated in response and can be estimated during the application of short-term perturbations to endpoint based on\\u000a measured force and position data. This research was aimed to investigate biomechanical properties via estimation of upper\\u000a limb endpoint stiffness and joint torques during force

  9. Nerve conduction velocity study of the upper limb in Raynaud's phenomenon

    Microsoft Academic Search

    M. Mondelli; C. Romano; R. De Stefano; R. Cioni

    2000-01-01

    A prospective study of upper limb nerve conduction velocity was performed in 39 subjects (9 males, 30 females, mean age 46.8?years)\\u000a with idiopathic Raynaud's phenomenon (RP) and 18 patients (3 males, 15 females, mean age 49.9?years) with RP secondary to\\u000a systemic sclerosis (SS). Five subjects with idiopathic RP (13%) showed slowing of sensory conduction velocity (SCV) of the\\u000a distal median

  10. 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

  11. Variable structure pantograph mechanism with spring suspension system for comprehensive upper-limb haptic movement training.

    PubMed

    Perry, Joel C; Oblak, Jakob; Jung, Je H; Cikajlo, Imre; Veneman, Jan F; Goljar, Nika; Bizovi?ar, Nataša; Matja?i?, Zlatko; Keller, Thierry

    2011-01-01

    Numerous haptic devices have been developed for upper-limb neurorehabilitation, but their widespread use has been largely impeded because of complexity and cost. Here, we describe a variable structure pantograph mechanism combined with a spring suspension system that produces a versatile rehabilitation robot, called Universal Haptic Pantograph, for movement training of the shoulder, elbow, and wrist. The variable structure is a 5-degree-of-freedom (DOF) mechanism composed of 7 joints, 11 joint axes, and 3 configurable joint locks that reduce the number of system DOFs to between 0 and 3. The resulting device has eight operational modes: Arm, Wrist, ISO (isometric) 1, ISO 2, Reach, Lift 1, Lift 2, and Steer. The combination of available work spaces (reachable areas) shows a high suitability for movement training of most upper-limb activities of daily living. The mechanism, driven by series elastic actuators, performs similarly in all operational modes, with a single control scheme and set of gains. Thus, a single device with minimal setup changes can be used to treat a variety of upper-limb impairments that commonly afflict veterans with stroke, traumatic brain injury, or other direct trauma to the arm. With appropriately selected design parameters, the developed multimode haptic device significantly reduces the costs of robotic hardware for full-arm rehabilitation while performing similarly to that of single-mode haptic devices. We conducted case studies with three patients with stroke who underwent clinical training using the developed mechanism in Arm, Wrist, and/or Reach operational modes. We assessed outcomes using Fugl-Meyer Motor Assessment and Wolf Motor Function Test scores showing that upper-limb ability improved significantly following training sessions. PMID:21674386

  12. Reliability and Validity of the Upper Limb Physician's Rating Scale in Children with Cerebral Palsy

    PubMed Central

    Park, Eun Sook; Joo, Ji-Woon; Kim, Seon Ah; Rha, Dong-Wook

    2015-01-01

    Purpose The Upper Limb Physician's Rating Scale (ULPRS) is a tool that assesses movement quality of the upper limbs. It is used as an outcome measure after botulinum toxin type A injection in children with cerebral palsy (CP). This study aimed to investigate the reliability and validity of the ULPRS in children with spastic CP. Materials and Methods Thirty children with spastic CP (M:F=17:13) aged 5 to 13 years old were recruited. The ULPRS was scored based on recorded videotapes by four physicians on two separate occasions. The Melbourne Assessment of Unilateral Upper Limb Function (MUUL) was scored by an occupational therapist. Intraclass correlation coefficients (ICCs), 95% confidence intervals and weighted kappa statistics were calculated for the scores of ULPRS to obtain interrater and intrarater reliability. The relationship between ULPRS and MUUL was assessed using Pearson correlation coefficients. Results The ICCs for the total ULPRS scores were 0.94 between raters and 0.99 to 1.00 within raters. The weighted kappa statistics for subitem scores for the ULPRS ranged from 0.67 to 1.00 within raters and from 0.46 to 0.86 between raters. The relationship between ULPRS and MUUL was strong (Pearson correlation coefficient=0.751; p<0.05). Conclusion The results demonstrated the high reliability of the total ULPRS score within and between raters. A significant concurrent validity between ULPRS and MUUL also supports the clinical utility of the ULPRS as an outcome measure of spastic upper limb in children with CP. PMID:25510774

  13. A comparison of three measures of upper limb function in Friedreich ataxia

    Microsoft Academic Search

    L. A. Corben; G. Tai; C. Wilson; V. Collins; A. J. Churchyard; M. B. Delatycki

    2010-01-01

    Friedreich Ataxia (FRDA) is the commonest inherited ataxia. Clinical trials of pharmaceuticals are increasingly being conducted\\u000a in this condition. This requires the most accurate outcome measures to enable trials to be conducted with a minimum number\\u000a of subjects in the shortest time frame and to minimize the risk of false negative results. Upper limb function is a major\\u000a area of

  14. Two anatomic resources of canine pelvic limb muscles based on CT and MRI.

    PubMed

    Sunico, Sarena K; Hamel, Corentin; Styner, Martin; Robertson, Ian D; Kornegay, Joe N; Bettini, Chris; Parks, Jerry; Wilber, Kathy; Smallwood, J Edgar; Thrall, Donald E

    2012-01-01

    Advances in magnetic resonance (MR) imaging and three-dimensional (3D) modeling software provide the tools necessary to create sophisticated, interactive anatomic resources that can assist in the interpretation of MR images of extremities, and learning the structure and function of limb musculature. Modeling provides advantages over dissection or consultation of print atlases because of the associated speed, flexibility, 3D nature, and elimination of superimposed arrows and labels. Our goals were to create a diagnostic atlas of pelvic limb muscles that will facilitate interpretation of MR images of patients with muscle injury and to create a 3D model of the canine pelvic limb musculature to facilitate anatomic learning. To create these resources, we used structural segmentation of MR images, a process that groups image pixels into anatomically meaningful regions. The Diagnostic Atlas is an interactive, multiplanar, web-based MR atlas of the canine pelvic limb musculature that was created by manually segmenting clinically analogous MR sequences. Higher resolution volumetric MR and computed tomography (CT) data were segmented into separately labeled volumes of data and then transformed into a multilayered 3D computer model. The 3D Model serves as a resource for students of gross anatomy, encouraging integrative learning with its highly interactive and selective display capabilities. For clinicians, the 3D Model also serves to bridge the gap between topographic and tomographic anatomy, displaying both formats alongside, or even superimposed over each other. Both projects are hosted on an open-access website, http://3dvetanatomy.ncsu.edu/ PMID:22360713

  15. Effects of 5 weeks of lower limb suspension on muscle size and strength

    NASA Technical Reports Server (NTRS)

    Tesch, P. A.; Ploutz, L. L.; Dudley, G. A.

    1994-01-01

    Lack of weight-bearing, as occurs in space, appears to be associated with reductions in strength and mass of skeletal muscle. Very limited data, however, is at hand describing changes in skeletal muscle size and function following manned space missions. Our current knowledge therefore is mainly based on studies of space flown rats. It is obvious though that this information, only in part can be extrapolated to humans. A few bed rest studies have demonstrated that decreases in strength and muscle size are substantial. At this time, however, the magnitude or time course of such changes either in response to space flight or simulations of microgravity have not been defined. In the last few years we have employed a human model to simulate unloading of lower limb skeletal muscles that occurs in microgravity. This model was essentially adopted from the rat hindlimb suspension technique. The purpose of this study was to assess the magnitude of decreases in muscle strength and size as a result of five weeks of unilateral lower limb suspension.

  16. Effects of upper-limb exercise on lower-limb cutaneous microvascular function in post-surgical varicose-vein patients

    Microsoft Academic Search

    Markos Klonizakis; Garry A. Tew; Jonathan A. Michaels; John M. Saxton

    2010-01-01

    Regular walking exercise attenuates lower-limb cutaneous microvascular endothelial dysfunction in post-surgical varicose-vein\\u000a patients. This study assessed the effects of upper-limb exercise training on lower-limb cutaneous microvascular function in\\u000a this patient group. Six post-surgical (4–5 weeks) varicose-vein patients completed an 8-week arm-crank exercise training programme.\\u000a Changes in cutaneous microvascular function of the lower leg were assessed using laser Doppler flowmetry and iontophoretic

  17. Loss of FGF Receptor 1 Signaling Reduces Skeletal Muscle Mass and Disrupts Myofiber Organization in the Developing Limb

    Microsoft Academic Search

    Heather Flanagan-Steet; Kevin Hannon; Michael J. McAvoy; Ronald Hullinger; Bradley B. Olwin

    2000-01-01

    The identities of extracellular growth factors that regulate skeletal muscle development in vivo are largely unknown. We asked if FGFs, which act as repressors of myogenesis in culture, play a similar role in vivo by ectopically expressing in the developing limb a truncated FGF receptor 1 (dnFGFR1) that acts as a dominant negative mutant. Hind limbs and the adjacent somites

  18. Comparative study of upper limb load assessment and occurrence of musculoskeletal disorders at repetitive task workstations.

    PubMed

    Roman-Liu, Danuta; Bugajska, Joanna; Tokarski, Tomasz

    2014-01-01

    This study explored the relationship between subjectively assessed complaints of pain in the arm, forearm and hand, and musculoskeletal load caused by repetitive tasks. Workers (n=942) were divided into 22 subgroups, according to the type of their workstations. They answered questions on perceived musculoskeletal pain of upper limbs. Basic and aggregate indices from a questionnaire on the prevalence, intensity and frequency of pain were compared with an upper limb load indicator (repetitive task index, RTI) calculated with the recently developed Upper Limb Risk Assessment (ULRA). There was relatively strong correlation of RTI and general intensity and frequency of pain in the arm, and general intensity and frequency of pain in the arm and forearm or prevalence of pain in the arm. Frequency and intensity of pain in the arm were weakly correlated. An aggregate indicator of evaluation of MSDs, which was calculated on the basis of the prevalence, intensity and frequency of pain, was to a higher degree associated with the musculoskeletal load of a task than basic evaluative parameters. Thus, such an aggregate indicator can be an alternative in comparing subjectively assessed MSDs with task-related musculoskeletal load and in establishing limit levels for that load. PMID:24975106

  19. Assessing Movement Factors in Upper Limb Kinematics Decoding from EEG Signals

    PubMed Central

    Úbeda, Andrés; Hortal, Enrique; Iáñez, Eduardo; Perez-Vidal, Carlos; Azorín, Jose M.

    2015-01-01

    The past decades have seen the rapid development of upper limb kinematics decoding techniques by performing intracortical recordings of brain signals. However, the use of non-invasive approaches to perform similar decoding procedures is still in its early stages. Recent studies show that there is a correlation between electroencephalographic (EEG) signals and hand-reaching kinematic parameters. From these studies, it could be concluded that the accuracy of upper limb kinematics decoding depends, at least partially, on the characteristics of the performed movement. In this paper, we have studied upper limb movements with different speeds and trajectories in a controlled environment to analyze the influence of movement variability in the decoding performance. To that end, low frequency components of the EEG signals have been decoded with linear models to obtain the position of the volunteer’s hand during performed trajectories grasping the end effector of a planar manipulandum. The results confirm that it is possible to obtain kinematic information from low frequency EEG signals and show that decoding performance is significantly influenced by movement variability and tracking accuracy as continuous and slower movements improve the accuracy of the decoder. This is a key factor that should be taken into account in future experimental designs. PMID:26020525

  20. Traumatic upper limb injuries during the Men's Field Hockey Junior World Cup 2009.

    PubMed

    Mukherjee, Swarup

    2013-01-01

    This study was a prospective epidemiological investigation of upper limb injuries during the Men's Field Hockey Junior World Cup 2009. Three hundred twenty-four players were observed in 58 matches of the tournament. Twenty-eight upper limb-related injuries were documented. The injury incidence was 0.48 per match and 19 per 1,000 match hours. Most injuries were due to contact with the ball, and the left hand was the most commonly injured part. Contusion was the most common type of injury. The odds ratio for hand and wrist injuries in players not wearing gloves was 4.01 (95% CI, 0.52-30.62), and the relative risk of hand and wrist injuries in players wearing gloves was 0.26 (95% CI, 0.03-1.92). Male youth hockey players are at a high risk of upper limb, especially hand and wrist, injuries during major international tournaments and that use of protective gloves can provide significant protection against hand and wrist injuries in the sport. PMID:24067118

  1. Comparative Study of Upper Limb Load Assessment and Occurrence of Musculoskeletal Disorders at Repetitive Task Workstations

    PubMed Central

    ROMAN-LIU, Danuta; BUGAJSKA, Joanna; TOKARSKI, Tomasz

    2014-01-01

    This study explored the relationship between subjectively assessed complaints of pain in the arm, forearm and hand, and musculoskeletal load caused by repetitive tasks. Workers (n=942) were divided into 22 subgroups, according to the type of their workstations. They answered questions on perceived musculoskeletal pain of upper limbs. Basic and aggregate indices from a questionnaire on the prevalence, intensity and frequency of pain were compared with an upper limb load indicator (repetitive task index, RTI) calculated with the recently developed Upper Limb Risk Assessment (ULRA). There was relatively strong correlation of RTI and general intensity and frequency of pain in the arm, and general intensity and frequency of pain in the arm and forearm or prevalence of pain in the arm. Frequency and intensity of pain in the arm were weakly correlated. An aggregate indicator of evaluation of MSDs, which was calculated on the basis of the prevalence, intensity and frequency of pain, was to a higher degree associated with the musculoskeletal load of a task than basic evaluative parameters. Thus, such an aggregate indicator can be an alternative in comparing subjectively assessed MSDs with task-related musculoskeletal load and in establishing limit levels for that load. PMID:24975106

  2. Effects of craniocervical flexion exercise on upper-limb postural stability during a goal-directed pointing task

    PubMed Central

    Yong, Min-Sik; Lee, Hae-Yong; Ryu, Young-Uk; Lee, Mi-Young

    2015-01-01

    [Purpose] This study investigated the effects of craniocervical flexion exercise on upper-limb postural stability by measuring upper-limb postural tremor during a goal-directed pointing task. [Subjects and Methods] Twenty-four subjects were randomly assigned to the exercise or control group. The exercise group performed craniocervical flexion exercise four days per week for five weeks. Upper-limb postural tremor was measured by using a three-dimensional electromagnetic motion tracking system (trakSTAR™, Ascension Technology Corporation, Burlington, VT, USA) during a goal-directed pointing task. [Results] In the exercise group, the range and velocity of the trajectories of the shoulder, wrist, and finger in the lateral direction improved significantly. However, no significant changes were observed in the control group. [Conclusion] Craniocervical flexion exercise reduces the range and velocity of upper-limb postural tremor, thereby increasing postural stability. PMID:26180368

  3. A comparison of three measures of upper limb function in Friedreich ataxia.

    PubMed

    Corben, L A; Tai, G; Wilson, C; Collins, V; Churchyard, A J; Delatycki, M B

    2010-04-01

    Friedreich Ataxia (FRDA) is the commonest inherited ataxia. Clinical trials of pharmaceuticals are increasingly being conducted in this condition. This requires the most accurate outcome measures to enable trials to be conducted with a minimum number of subjects in the shortest time frame and to minimize the risk of false negative results. Upper limb function is a major area of morbidity in FRDA. We therefore have compared the performance of three tests of upper limb function in FRDA: the Nine Hole Peg Test (9HPT), Box and Blocks Test (BBT) and Jebsen Taylor Hand Function Test (JTHFT). This study was undertaken to ascertain the best test for inclusion in a Friedreich Ataxia Functional Composite (FAFC) test for use in clinical studies and therapeutic trials. The three tests were administered to the dominant and non-dominant upper limbs of 38 individuals with genetically proven FRDA on two occasions, 12 months apart. The results of testing were correlated with the following disease parameters; age at disease onset, disease duration and score for the Friedreich Ataxia Rating Scale (FARS). The responsiveness to change of each test was assessed by measuring the effect size and calculations of the number of subjects required for similarly powered therapeutic trials. Results for all tests correlated significantly with disease duration and FARS score. The only test scores that changed significantly over 12 months were those for the non-dominant 9HPT and BBT. Scores for these two tests also had the largest effect sizes and required the fewest subjects for similarly powered therapeutic trials. We conclude, therefore, that the non-dominant 9HPT and BBT are the best tests for inclusion in a FAFC. Since the 9HPT has already been suggested for inclusion in a FAFC, we recommend that this test is used but that it is the non-dominant limb that is tested. PMID:19823893

  4. Upper limb reconstructive surgery uptake for persons with tetraplegia in New Zealand: a retrospective case review 2001–2005

    Microsoft Academic Search

    J A Dunn; E J C Hay-Smith; L C Whitehead; S Keeling; A G Rothwell

    2010-01-01

    Study design:Retrospective case series.Objective:To describe the uptake of upper limb surgery by individuals with tetraplegia in New Zealand (NZ).Setting:New Zealand.Methods:The clinical notes of all individuals who sustained a cervical spinal cord injury between 1 January 2001 and 31 December 2005 were retrospectively reviewed for those who met the clinical criteria to undergo upper limb surgery. Cases were cross-referenced to the

  5. Viscoelastic model for redundancy resolution of the human arm via the swivel angle: applications for upper limb exoskeleton control.

    PubMed

    Kim, Hyunchul; Roldan, Jay Ryan; Li, Zhi; Rosen, Jacob

    2012-01-01

    One of the key research efforts associated with a redundant seven degree of freedom (7-DOF) upper limb exoskeleton robot that is mechanically coupled to the human body is to develop high and low level control algorithms that enable the system to become a natural extension of the human body. Improving the synergistic relationship between the exoskeleton and the operator is manifested in part by decreasing the force exchange between the two entities. Such a reduction is accomplished in part by developing criteria for resolving the human arm redundancy. The redundancy may be represented by a swivel angle which is defined as the angular rotation of the elbow around an axis that passes through the shoulder and wrist joints. The proposed criteria for defining the swivel angle takes into account the dynamics of the human arm along with a viscoelastic muscle-like model with variable damping. The swivel angle is estimated using the pseudo-inverse of the Jacobian with a secondary objective function that estimates the desired joint angles during human arm movement. The result is then fed to the muscle model to create a more realistic human motion. The estimated swivel angle is then compared with the actual swivel angle measured experimentally by a motion capture system. Results indicate that the average error between the estimated and measured swivel joint angle is 4.4 degrees (in the range [3.7-6] degrees), which are lower than the kinematically based redundant resolution criterion. PMID:23367411

  6. Influence of mechanical ventilation and sepsis on redox balance in diaphragm, myocardium, limb muscles, and lungs.

    PubMed

    Chacon-Cabrera, Alba; Rojas, Yeny; Martínez-Caro, Leticia; Vila-Ubach, Monica; Nin, Nicolas; Ferruelo, Antonio; Esteban, Andrés; Lorente, José A; Barreiro, Esther

    2014-12-01

    Mechanical ventilation (MV), using high tidal volumes (V(T)), causes lung (ventilator-induced lung injury [VILI]) and distant organ injury. Additionally, sepsis is characterized by increased oxidative stress. We tested whether MV is associated with enhanced oxidative stress in sepsis, the commonest underlying condition in clinical acute lung injury. Protein carbonylation and nitration, antioxidants, and inflammation (immunoblotting) were evaluated in diaphragm, gastrocnemius, soleus, myocardium, and lungs of nonseptic and septic (cecal ligation and puncture 24 hours before MV) rats undergoing MV (n = 7 per group) for 150 minutes using 3 different strategies (low V(T) [V(T) = 9 mL/kg], moderate V(T) [V(T) = 15 mL/kg], and high V(T) [V(T) = 25 mL/kg]) and in nonventilated control animals. Compared with nonventilated control animals, in septic and nonseptic rodents (1) diaphragms, limb muscles, and myocardium of high-V(T) rats exhibited a decrease in protein oxidation and nitration levels, (2) antioxidant levels followed a specific fiber-type distribution in slow- and fast-twitch muscles, (3) tumor necrosis factor ? (TNF-?) levels were higher in respiratory and limb muscles, whereas no differences were observed in myocardium, and (4) in lungs, protein oxidation was increased, antioxidants were rather decreased, and TNF-? remained unmodified. In this model of VILI, oxidative stress does not occur in distant organs or skeletal muscles of rodents after several hours of MV with moderate-to-high V(T), whereas protein oxidation levels were increased in the lungs of the animals. Inflammatory events were moderately expressed in skeletal muscles and lungs of the MV rats. Concomitant sepsis did not strongly affect the MV-induced effects on muscles, myocardium, or lungs in the rodents. PMID:25168016

  7. Alterations in small arterioles precede changes in limb skeletal muscle after myocardial infarction.

    PubMed

    Thomas, D P; Hudlicka, O; Brown, M D; Deveci, D

    1998-09-01

    We tested the hypothesis that alterations in arterioles in locomotor skeletal muscles in rats with myocardial infarction (MI), but before development of congestive heart failure (CHF), precede structural and functional changes commonly observed in limb muscle in association with CHF. Resting diameters of third- (A3) and fourth-order arterioles (A4) in extensor digitorum longus (EDL) muscle were significantly smaller in rats with nonfailing small and medium-sized MI compared with control animals. Dilation of A4 in response to 10(-4) M adenosine was significantly attenuated in both groups (P < 0.05), whereas dilation of A3 was unaltered. Microvessels from both groups of infarcted rats constricted to all doses of acetylcholine (10(-9), 10(-8), and 10(-7) M) and showed a significantly exaggerated vasoconstrictor response to norepinephrine (10(-9), 10(-8), and 10(-7) M) compared with microvessels in control rats (P < 0.05). Peak isometric tension of combined tibialis anterior and EDL muscles and muscle fatigue (final/peak tension x 100), measured during 5-min isometric supramaximal twitch contractions at 4 Hz, were similar in control and MI rats (218 +/- 7 vs. 213 +/- 15 g/g muscle and 52 +/- 1 vs. 51 +/- 9%, respectively; n = 5 for both). There was also no difference with respect to the proportion of oxidative fibers or capillary-to-fiber ratios. Our results indicate that, in rats with left ventricular dysfunction but without failure, decreased diameter and perturbations in reactivity of small arterioles precede alterations in skeletal muscle performance often seen at a later date in association with CHF. These findings are consistent with the notion of aberrant endothelial and smooth muscle function and may contribute to the maintenance of blood pressure after MI but before CHF. PMID:9724310

  8. Links between nurses’ organisational work environment and upper limb musculoskeletal symptoms: Independently of effort–reward imbalance! The ORSOSA study

    Microsoft Academic Search

    Fabrice Herin; Christophe Paris; Aude Levant; Marie-Chantal Vignaud; Annie Sobaszek; Jean-Marc Soulat

    2011-01-01

    The role of psychosocial factors in the development of upper limb musculoskeletal disorders has now been clearly demonstrated. However, only a few studies have analysed the association between the organisational work environment and musculoskeletal disorders in health care workers. The main goal of this study was to test the hypothesis that some specific organisational constraints may be related to upper

  9. Muscle architecture and out-force potential of the thoracic limb in the Eastern mole (Scalopus aquaticus).

    PubMed

    Rose, Jacob A; Sandefur, Mark; Huskey, Steve; Demler, Jennifer L; Butcher, Michael T

    2013-11-01

    Moles have modified thoracic limbs with hypertrophied pectoral girdle muscles that allow them to apply remarkably high lateral out-forces during the power stroke when burrowing. To further understand the high force capabilities of mole forelimbs, architectural properties of the thoracic limb muscles were quantified in the Eastern mole (Scalopus aquaticus). Architectural properties measured included muscle mass, moment arm, belly length, fascicle length, and pennation angle, and these were used to provide estimates of maximum isometric force, joint torque, and power. Measurements of muscle moment arms and limb lever lengths were additionally used to analyze the out-force contributions of the major pectoral girdle muscles. Most muscles have relatively long fascicles and little-to-no pennation. The humeral abductor/rotators as a functional group are massive and are capable of relatively high force, power, and joint torque. Of this group, the bipennate m. teres major is the most massive and has the capacity to produce the highest force and joint torque to abduct and axially rotate the humerus. In general, the distal limb muscles are relatively small, but have the capacity for high force and mechanical work by fascicle shortening. The muscle architectural properties of the elbow extensors (e.g., m. triceps brachii) and carpal flexors (e.g., m. palmaris longus) are consistent with the function of these muscles to augment lateral out-force application. The humeral abductor/rotators m. latissimus dorsi, m. teres major, m. pectoralis, and m. subscapularis are calculated to contribute 13.9 N to out-force during the power stroke, and this force is applied in a 'frontal' plane causing abduction of the humerus about the sternoclavicular joint. Moles have several specializations of their digging apparatus that greatly enhance the application of out-force, and these morphological features suggest convergence on limb form and burrowing function between New and Old World moles. PMID:23907929

  10. Reliability and diagnostic characteristics of clinical tests of upper limb motor function.

    PubMed

    Amer, M; Hubert, G; Sullivan, S J; Herbison, P; Franz, E A; Hammond-Tooke, G D

    2012-09-01

    There is a paucity of information on the inter-rater reliability and predictive value of components of the neurological examination. Selected tests of upper limb motor function were studied in 34 patients with Parkinson's disease, upper motor neuron disease or cerebellar disease and in 25 control participants. Video recordings were independently evaluated and scored by two clinicians to determine inter-rater reliability (kappa) and predictive values. Kappa values ranged from 0.00 to 0.73. Highest positive predictive values (PPV) were obtained for the Barré test, arm raise, forearm rolling and finger nose tests. Negative predictive values (NPV) were mostly low, with highest values for unimanual sequential finger tap and rhythmic tap. The combined tests had PPV of 0.58 and NPV of 0.73. This study demonstrates that these clinical tests have poor inter-rater reliability and low negative predictive value when used in isolation. PMID:22705136

  11. Lower limb conduit artery endothelial responses to acute upper limb exercise in spinal cord injured and able-bodied men

    PubMed Central

    Totosy de Zepetnek, Julia O; Au, Jason S; Ditor, David S; MacDonald, Maureen J

    2015-01-01

    Vascular improvements in the nonactive regions during exercise are likely primarily mediated by increased shear rate (SR). Individuals with spinal cord injury (SCI) experience sublesional vascular deconditioning and could potentially benefit from upper body exercise-induced increases in lower body SR. The present study utilized a single bout of incremental arm-crank exercise to generate exercise-induced SR changes in the superficial femoral artery in an effort to evaluate the acute postexercise impact on superficial femoral artery endothelial function via flow-mediated dilation (FMD), and determine regulatory factors in the nonactive legs of individuals with and without SCI. Eight individuals with SCI and eight age, sex, and waist-circumference-matched able-bodied (AB) controls participated. Nine minutes of incremental arm-crank exercise increased superficial femoral artery anterograde SR (P = 0.02 and P < 0.01), retrograde SR (P < 0.01 and P < 0.01), and oscillatory shear index (OSI) (P < 0.001 and P < 0.001) in both SCI and AB, respectively. However, these SR alterations resulted in acute postexercise increases in FMD in the AB group only (SCI 6.0 ± 1.2% to 6.3 ± 2.7%, P = 0.74; AB 7.5 ± 1.4% to 11.2 ± 1.4%, P = 0.03). While arm exercise has many cardiovascular benefits and results in changes in SR patterns in the nonactive legs, these changes are not sufficient to induce acute changes in FMD among individuals with SCI, and therefore are less likely to stimulate exercise training-associated improvements in nonactive limb endothelial function. Understanding the role of SR patterns on FMD brings us closer to designing effective strategies to combat impaired vascular function in both healthy and clinical populations. PMID:25847920

  12. Wearable kinesthetic system for capturing and classifying upper limb gesture in post-stroke rehabilitation

    PubMed Central

    Tognetti, Alessandro; Lorussi, Federico; Bartalesi, Raphael; Quaglini, Silvana; Tesconi, Mario; Zupone, Giuseppe; De Rossi, Danilo

    2005-01-01

    Background Monitoring body kinematics has fundamental relevance in several biological and technical disciplines. In particular the possibility to exactly know the posture may furnish a main aid in rehabilitation topics. In the present work an innovative and unobtrusive garment able to detect the posture and the movement of the upper limb has been introduced, with particular care to its application in post stroke rehabilitation field by describing the integration of the prototype in a healthcare service. Methods This paper deals with the design, the development and implementation of a sensing garment, from the characterization of innovative comfortable and diffuse sensors we used to the methodologies employed to gather information on the posture and movement which derive from the entire garments. Several new algorithms devoted to the signal acquisition, the treatment and posture and gesture reconstruction are introduced and tested. Results Data obtained by means of the sensing garment are analyzed and compared with the ones recorded using a traditional movement tracking system. Conclusion The main results treated in this work are summarized and remarked. The system was compared with a commercial movement tracking system (a set of electrogoniometers) and it performed the same accuracy in detecting upper limb postures and movements. PMID:15743530

  13. Design of a rotational hydroelastic actuator for a powered exoskeleton for upper limb rehabilitation.

    PubMed

    Stienenw, Arno H A; Hekman, Edsko E G; ter Braak, Huub; Aalsma, Arthur M M; van der Helm, Frans C T; van der Kooij, Herman

    2010-03-01

    The goal of this study was to validate the suitability of a novel rotational hydroelastic actuator (rHEA) for use in our new rehabilitation exoskeleton for the upper limbs, the Limpact. The rHEA consists of a rotational hydraulic actuator and a custom-designed symmetric torsion spring in a series-elastic configuration. For rehabilitation therapy and impairment quantification, both compliant impedance control and stiff admittance control modes are possible. In the validation experiments, the torque bandwidth of the rHEA was limited to 18 Hz for a desired 20 N m reference signal (multisine, constant spectrum) due the transport delays in the long flexible tubes between the valve and cylinder. These transport delays also required changes to existing theoretical models to better fit the models on the measured frequency response functions. The (theoretical) measurable torque resolution was better than 0.01 N m and the (validated) delivered torque resolution below 1 N m. After the validation experiments, further iterative improvements resulted in a spring design capable of a maximum output torque of 50 N m with an intrinsic stiffness of 150 N . m/rad and a slightly higher bandwidth. With the design locked, the maximum measurable isometric torque is 100 N m. In conclusion, the rHEA is suitable for upper limb rehabilitation therapy as it matches the desired performance. PMID:19362903

  14. A Pre-Clinical Framework for Neural Control of a Therapeutic Upper-Limb Exoskeleton

    PubMed Central

    Blank, Amy; O’Malley, Marcia K.; Francisco, Gerard E.; Contreras-Vidal, Jose L.

    2014-01-01

    In this paper, we summarize a novel approach to robotic rehabilitation that capitalizes on the benefits of patient intent and real-time assessment of impairment. Specifically, an upper-limb, physical human-robot interface (the MAHI EXO-II robotic exoskeleton) is augmented with a non-invasive brain-machine interface (BMI) to include the patient in the control loop, thereby making the therapy ‘active’ and engaging patients across a broad spectrum of impairment severity in the rehabilitation tasks. Robotic measures of motor impairment are derived from real-time sensor data from the MAHI EXO-II and the BMI. These measures can be validated through correlation with widely used clinical measures and used to drive patient-specific therapy sessions adapted to the capabilities of the individual, with the MAHI EXO-II providing assistance or challenging the participant as appropriate to maximize rehabilitation outcomes. This approach to robotic rehabilitation takes a step towards the seamless integration of BMIs and intelligent exoskeletons to create systems that can monitor and interface with brain activity and movement. Such systems will enable more focused study of various issues in development of devices and rehabilitation strategies, including interpretation of measurement data from a variety of sources, exploration of hypotheses regarding large scale brain function during robotic rehabilitation, and optimization of device design and training programs for restoring upper limb function after stroke. PMID:24887296

  15. Lower limb muscle activity and kinematics of an unanticipated cutting manoeuvre: a gender comparison.

    PubMed

    Beaulieu, Mélanie L; Lamontagne, Mario; Xu, Lanyi

    2009-08-01

    This investigation compared the amplitude and the timing of the muscle activity of the lower limb, as well as the three-dimensional kinematics of the hip, knee and ankle joints, of male and female elite soccer players performing an unanticipated cutting manoeuvre. These data were recorded for 15 female and 15 male participants for five successful cutting manoeuvres. For this manoeuvre to be performed in an unanticipated manner, the participants were instructed to execute one of three tasks, which were signalled to them with a target board composed of three different coloured lights. Female participants performed the cutting manoeuvre with greater lateral gastrocnemius activity in comparison with the male participants. It was also observed that they contracted their vastus lateralis to a greater extent than their vastus medialis, whereas the men adopted the opposite strategy. These neuromuscular control strategies adopted by the female athletes may elucidate the reasons for which women struck the ground with a more abducted knee during the cutting task. Given that this knee position places greater strain on the anterior cruciate ligament, a restoration of the medial/lateral activation balance of the lower limb muscles may reduce one's risk of injury. PMID:19495727

  16. Activity of lower limb muscles during treadmill running at different velocities

    PubMed Central

    Tsuji, Keiichi; Ishida, Hiroyasu; Oba, Kaori; Ueki, Tsutomu; Fujihashi, Yuichiro

    2015-01-01

    [Purpose] The present study aimed to determine changes in muscle activity while moving on a treadmill at various speeds. [Subjects] The activities of the left vastus lateralis, vastus medialis, hip adductors, lateral head of gastrocnemius, medial head gastrocnemius, soleus, and tibialis anterior of 10 healthy male university students were analyzed. [Methods] University students walked, jogged, and ran for 10 minutes each in random order, and then myogenic potentials were measured 10 minutes later for 30 seconds. The flexion angle of the lower limb upon initial contact, mid stance, and toe off were measured. [Results] The average walking, jogging, and running speeds were 3.6 ± 0.4, 6.7 ± 0.6, and 10.4 ± 1.3?km/h, respectively. The average electromyographic activities of the vastus medial, tibialis anterior, medial head of gastrocnemius, and lateral head of gastrocnemius significantly differed. All muscles were more active during jogging and running than walking. Only the soleus was more active during running than walking, and the activities of the hip adductors and vastus lateralis did not significantly differ. [Conclusion] Velocity is faster and the angles of the lower limbs and ground reaction force (GRF) are larger during running than walking. The vastus medialis and soleus worked more easily according to the angle of the knee joint, whereas the tibialis anterior worked more easily at faster velocities and the medial and lateral heads of the gastrocnemius worked more easily with an increased GRF. PMID:25729166

  17. Effect of recovery mode following hind-limb suspension on soleus muscle composition in the rat

    NASA Technical Reports Server (NTRS)

    McNulty, A. L.; Otto, A. J.; Kasper, C. E.; Thomas, D. P.

    1992-01-01

    The purpose of this study was to compare the effects of two different recovery modes from hind-limb suspension-induced hypodynamia on whole body and muscle (soleus) growth as well as soleus composition and size changes of different fiber types within this same muscle. Following 28 days of tail-suspension, rats were returned to their cages and sedentarily recovered (HS), or were exercised by running on a treadmill 5 days/wk, at progressively increasing workloads (HR) for one month. Sedentary and running control groups of animals (CS, CR) were also evaluated for comparative purposes. The exercise program, which was identical for CR and HR groups, had no effect on body wt., soleus wt., soleus muscle composition or fiber size in CR rats. Atrophied soleus muscle and reduced soleus wt./body wt. ratio (both 60% of control) had returned to control values by day 7 of recovery in both suspended groups despite the fact that whole body wt. gain was significantly reduced (p less than 0.05) in HR as compared to HS rats. Atrophied soleus Type I fiber mean cross-sectional area in both HR and HS groups demonstrated similar and significant (p less than 0.01) increases during recovery. Increases in Type IIa and IIc fiber area during this same period were significant only in the HR group. While the percentage area of muscle composed of Type I fibers increased in both hypodynamic groups during recovery, the reduction in area percentage of muscle made up of Type IIa fibers was again only significant in the HR group.(ABSTRACT TRUNCATED AT 250 WORDS).

  18. Developing a multi-joint upper limb exoskeleton robot for diagnosis, therapy, and outcome evaluation in neurorehabilitation.

    PubMed

    Ren, Yupeng; Kang, Sang Hoon; Park, Hyung-Soon; Wu, Yi-Ning; Zhang, Li-Qun

    2013-05-01

    Arm impairments in patients post stroke involve the shoulder, elbow and wrist simultaneously. It is not very clear how patients develop spasticity and reduced range of motion (ROM) at the multiple joints and the abnormal couplings among the multiple joints and the multiple degrees-of-freedom (DOF) during passive movement. It is also not clear how they lose independent control of individual joints/DOFs and coordination among the joints/DOFs during voluntary movement. An upper limb exoskeleton robot, the IntelliArm, which can control the shoulder, elbow, and wrist, was developed, aiming to support clinicians and patients with the following integrated capabilities: 1) quantitative, objective, and comprehensive multi-joint neuromechanical pre-evaluation capabilities aiding multi-joint/DOF diagnosis for individual patients; 2) strenuous and safe passive stretching of hypertonic/deformed arm for loosening up muscles/joints based on the robot-aided diagnosis; 3) (assistive/resistive) active reaching training after passive stretching for regaining/improving motor control ability; and 4) quantitative, objective, and comprehensive neuromechanical outcome evaluation at the level of individual joints/DOFs, multiple joints, and whole arm. Feasibility of the integrated capabilities was demonstrated through experiments with stroke survivors and healthy subjects. PMID:23096119

  19. Characteristics of the muscle activities of the elderly for various pressures in the pneumatic actuator of lower limb orthosis

    NASA Astrophysics Data System (ADS)

    Kim, Kyong; Yu, Chang-Ho; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

    2005-12-01

    There developed a lower limb orthosis with a pneumatic rubber actuator, which can assist and improve the muscular activities in the lower limb of the elderly. For this purpose, the characteristics of the lower limbs muscle activities for various pressures in the pneumatic actuator for the lower limb orthosis was investigated. To find out the characteristics of the muscle activities for various pneumatic pressures, it analyzed the flexing and extending movement of the knees, and measured the lower limbs muscular power. The subjects wearing the lower limbs orthosis were instructed to perform flexing and extending movement of the knees. The variation in the air pressure of the pneumatic actuator was varies from one kgf/cm2 to four kgf/cm2. The muscular power was measured by monitoring electromyogram using MP100 (BIOPAC Systems, Inc.) and detailed three-dimensional motions of the lower limbs were collected by APAS 3D Motion Analysis system. Through this study, it expected to find the most suitable air pressure for the improvement of the muscular power of the aged.

  20. Classification of Posture in Poststroke Upper Limb Spasticity: A Potential Decision Tool for Botulinum Toxin A Treatment?

    ERIC Educational Resources Information Center

    Hefter, Harald; Jost, Wolfgang H.; Reissig, Andrea; Zakine, Benjamin; Bakheit, Abdel Magid; Wissel, Jorg

    2012-01-01

    A significant percentage of patients suffering from a stroke involving motor-relevant central nervous system regions will develop a spastic movement disorder. Hyperactivity of different muscle combinations forces the limbs affected into abnormal postures or movement patterns. As muscular hyperactivity can effectively and safely be treated with…

  1. The influence of inspiratory muscle work history and specific inspiratory muscle training upon human limb muscle fatigue

    Microsoft Academic Search

    Alison K. McConnell; Michelle Lomax

    2006-01-01

    The purpose of this study was to assess the influence of the work history of the inspiratory muscles upon the fatigue characteristics of the plantar flexors (PF). We hypothesized that under conditions where the inspiratory muscle metaboreflex has been elicited, PF fatigue would be hastened due to peripheral vasoconstriction. Eight volunteers undertook seven test conditions, two of which followed 4

  2. Upper limb joint motion of two different user groups during manual wheelchair propulsion

    NASA Astrophysics Data System (ADS)

    Hwang, Seonhong; Kim, Seunghyeon; Son, Jongsang; Lee, Jinbok; Kim, Youngho

    2013-02-01

    Manual wheelchair users have a high risk of injury to the upper extremities. Recent studies have focused on kinematic and kinetic analyses of manual wheelchair propulsion in order to understand the physical demands on wheelchair users. The purpose of this study was to investigate upper limb joint motion by using a motion capture system and a dynamometer with two different groups of wheelchair users propelling their wheelchairs at different speeds under different load conditions. The variations in the contact time, release time, and linear velocity of the experienced group were all larger than they were in the novice group. The propulsion angles of the experienced users were larger than those of the novices under all conditions. The variances in the propulsion force (both radial and tangential) of the experienced users were larger than those of the novices. The shoulder joint moment had the largest variance with the conditions, followed by the wrist joint moment and the elbow joint moment. The variance of the maximum shoulder joint moment was over four times the variance of the maximum wrist joint moment and eight times the maximum elbow joint moment. The maximum joint moments increased significantly as the speed and load increased in both groups. Quick and significant manipulation ability based on environmental changes is considered an important factor in efficient propulsion. This efficiency was confirmed from the propulsion power results. Sophisticated strategies for efficient manual wheelchair propulsion could be understood by observation of the physical responses of each upper limb joint to changes in load and speed. We expect that the findings of this study will be utilized for designing a rehabilitation program to reduce injuries.

  3. A robotic extremities muscle rehabilitation system for quadriplegia

    Microsoft Academic Search

    Dongxiao Wang; Xueshan Gao; Yunhui Liu

    2011-01-01

    A novel robotic assistive rehabilitation system for both lower-limbs and upper-limbs muscle rehabilitation to general paralysis or quadriplegia and paraplegia patients has been developed. The system is featured with the ability to drive patients to do active and passive exercises which are the most important exercises for the limb weakness from early rehabilitation of the general paralysis, limb spasmodic movements

  4. Local perforator flaps in soft tissue reconstruction of the upper limb.

    PubMed

    Innocenti, M; Baldrighi, C; Delcroix, L; Adani, R

    2009-12-01

    The quality of reconstruction of soft tissue defects in the upper extremity, resulting either from traumatic injury or tumor excision, has relevant implications both from functional and aesthetic standpoints. Various local and free flaps with more or less consistent donor-site morbidity have been described in the past. The recent introduction of the perforator-based flap concept, has led to an evolution in upper extremity reconstruction, optimizing results at the recipient site whilst minimizing damage to the donor site and, performing this in the simplest way possible. In this study between 2001 and 2008, 31 patients having post-traumatic or post-tumor excision soft tissue defects of the upper limb, were treated using local perforator flaps raised according to two different modalities: "pedicled fasciocutaneous" and "transposition fasciocutaneous/cutaneous". Complete and stable coverage of the soft tissue losses was obtained in all cases with an inconspicuous, only aesthetic, donor-site defect. Superficial or partial necrosis of the tip of the flap, due to venous congestion, was observed in 2 cases of "pedicled fasciocutaneous flap". An additional surgical procedure was required in only one of these cases. In our series all 9 patients who had a transposition flap, underwent routinely a preoperative echo color Doppler investigation to identify the main perforators. In only one case did the Doppler investigation fail to accurately locate the perforator. Local perforator flaps allow the coverage of medium size defects in the upper extremity, can be raised with a relatively simple surgical technique, have a high success rate and good aesthetic results without functional impairment. In the light of this they can be considered among the surgical choices to resurface complex soft tissue defects of the upper extremity. Preoperative identification of the perforators in case of "transposition flaps" greatly facilitates the operation. In our experience echo color Doppler investigations provided reliable results. PMID:20024864

  5. Projection to cerebral cortex of Group I muscle afferents from the cat's hind limb

    PubMed Central

    Landgren, S.; Silfvenius, H.

    1969-01-01

    1. Muscle afferent projections from the contralateral hind limb to the postsigmoid gyrus of the cerebral cortex were investigated in cats anaesthetized with chloralose. The evoked potentials were recorded from the cortical surface or from deeper layers by penetrating micro-electrodes. Graded electrical stimulation of the nerves was used. 2. Group Ia as well as Ib muscle afferents from the contralateral quadriceps, posterior biceps-semitendinosus, gastrocnemius-soleus and deep peroneal muscles projected to two different loci in the postsigmoid gyrus. One of these was located on the dorsal surface of the hemisphere 4-5 mm lateral to the mid line and 1-3 mm posterior to the cruciate sulcus, thus rostro-medial to the postcruciate dimple. The other was located on the medial surface of the hemisphere adjacent to the cruciate sulcus. There was no overlap between the two loci. 3. There was no significant difference in thresholds or latencies of the Group I responses in the two loci. The latency was short and similar to that of the potential evoked by the cutaneous afferents in the somatosensory primary projection areas. 4. The Group Ib path was largely independent of the Ia path, because a maximal Group I volley evoked a response, when the Ia path was made refractory by simultaneous stimulation with a maximal Ia volley at 20 per second. 5. The cortical potentials evoked by the Group I muscle afferents from the contralateral hind limb did not change after transection of the dorsal columns at C1-C3 levels but disappeared after a superficial section in the dorsolateral fascicle at C1 level. The responses were not affected by cerebellectomy. It was concluded that the path travelled with the dorsal spinocerebellar tract or utilized brain stem collaterals of this tract. 6. Group II muscle afferents evoked a response near the border of the Group I loci, but not in the positions where the Group I responses were maximal in amplitude. 7. The receptor origin of the stimulated Group I afferents, the location of the medullary relay in the Group I path and the destination of the efferent outflow from the Group I loci were discussed. ImagesPlate 1 PMID:5764405

  6. EOS Microwave Limb Sounder observations of upper stratospheric BrO: Implications for total bromine

    NASA Astrophysics Data System (ADS)

    Livesey, Nathaniel J.; Kovalenko, Laurie J.; Salawitch, Ross J.; MacKenzie, Ian A.; Chipperfield, Martyn P.; Read, William G.; Jarnot, Robert F.; Waters, Joe W.

    2006-10-01

    This paper describes new total stratospheric inorganic bromine (Bry) abundance estimates inferred from the first global observations of upper stratospheric BrO, made by the EOS Microwave Limb Sounder on the Aura satellite. Our `best estimate' of total upper stratospheric bromine loading (based on JPL-2002 kinetics with the addition of a BrONO2 + O reaction) is 18.6 +/- 5.5 pptv, for the period September 2004 to August 2005, from 55° S to 55° N. This implies a contribution of 3.0 +/- 5.5 pptv from sources other than long lived CH3Br and halons. The possibility of such other sources has been raised by balloon, aircraft and satellite observations of BrO in the lower and middle stratosphere. These upper stratospheric observations provide new information to help resolve the current uncertainty in stratospheric bromine loading. The abundance of bromine, particularly in the lower stratosphere, is a significant factor in the budget of stratospheric O3.

  7. Efficacy of a Modified Bier's Block in Patients Undergoing Upper Limb Bone Surgery

    PubMed Central

    Jafarian, Aliakbar; Hassani, Valiollah; Jesmi, Fatemeh; Ramezani, Koosha; Javaheri, Fereydoun; Shariatzadeh, Hooman

    2015-01-01

    Background: Intravenous regional block, called the Bier's block, refers to an analgesic technique applied for soft tissue surgeries and closed bone manipulations of the limbs. There are a number of complications in traditional method of block, including pain in tourniquet site, immediate return of pain after tourniquet deflation, wound hemostasis and some others. Objectives: The aim of this study was to assess the outcomes and complications of our new method of blockage. Patients and Methods: In this experimental study, twenty-five patients undergoing hand surgery were prospectively studied. Induced anesthesia was a modification of the Bier's block with two concurrent changes including insertion of the intravenous cannula at the antecubital region rather than distal and the proximal anesthetic direction by an elastic band wrapped tightly around the proximal forearm distal to the cannulation site. The pain relief was measured by the verbal descriptive scale at intervals after block, during the operation, after deflation of the tourniquet and one hour after the operation. Results: This study showed the presence of analgesia at surgical and tourniquet sites during the operation in 96% of patients, as well as considerable pain relief at surgical site during one hour after deflation of the tourniquet. Conclusions: The study indicated advantages of this modified Bier's block compared to the traditional one including ability to perform surgery on upper limb bones and considerable pain relief at surgical and tourniquet sites during the operation until one hour thereafter. PMID:25789235

  8. [Diseases caused by repetitive trauma of the upper limbs: epidemiology, diagnosis, prevention. Epidemiological aspects].

    PubMed

    Molteni, G; De Vito, G

    2001-01-01

    The association between occupational risk factors and musculo-skeletal disorders due to biomechanical overload (WMSDs) has been focused on numerous research projects, ranging from those simple observing the different pathological findings reported among workers performing particular tasks, down to the latest studies actually quantifying the exposure of workers to basic risk factors, as force, awkward posture, repetition and to modifying factors as duration, intensity, temporal profile and cold temperatures. The critical review of the epidemiological studies, taking into account their quality, showed a clear relationship between basic and modifying risk factors and upper limb pathologies. In particular, force exertion has been shown strongly related to neck, elbow and hand-wrist pathologies; repetition showed some convincing evidence of causal relationship to neck, shoulder and hand-wrist pathologies. Insufficient evidence of work relatedness has been shown between both repetition and awkward posture and elbow pathologies. PMID:11505771

  9. Robotic Upper Limb Rehabilitation after Acute Stroke by NeReBot: Evaluation of Treatment Costs

    PubMed Central

    Stefano, Masiero; Patrizia, Poli; Mario, Armani; Ferlini, Gregorio; Rizzello, Roberto

    2014-01-01

    Stroke is the first cause of disability. Several robotic devices have been developed for stroke rehabilitation. Robot therapy by NeReBot is demonstrated to be an effective tool for the treatment of poststroke paretic upper limbs, able to improve the activities of daily living of stroke survivors when used both as additional treatment and in partial substitution of conventional rehabilitation therapy in the acute and subacute phases poststroke. This study presents the evaluation of the costs related to delivering such therapy, in comparison with conventional rehabilitation treatment. By comparing several NeReBot treatment protocols, made of different combinations of robotic and nonrobotic exercises, we show that robotic technology can be a valuable and economically sustainable aid in the management of poststroke patient rehabilitation. PMID:24967345

  10. Robotic upper limb rehabilitation after acute stroke by NeReBot: evaluation of treatment costs.

    PubMed

    Stefano, Masiero; Patrizia, Poli; Mario, Armani; Ferlini, Gregorio; Rizzello, Roberto; Rosati, Giulio

    2014-01-01

    Stroke is the first cause of disability. Several robotic devices have been developed for stroke rehabilitation. Robot therapy by NeReBot is demonstrated to be an effective tool for the treatment of poststroke paretic upper limbs, able to improve the activities of daily living of stroke survivors when used both as additional treatment and in partial substitution of conventional rehabilitation therapy in the acute and subacute phases poststroke. This study presents the evaluation of the costs related to delivering such therapy, in comparison with conventional rehabilitation treatment. By comparing several NeReBot treatment protocols, made of different combinations of robotic and nonrobotic exercises, we show that robotic technology can be a valuable and economically sustainable aid in the management of poststroke patient rehabilitation. PMID:24967345

  11. Adaptive control of 5 DOF upper-limb exoskeleton robot with improved safety.

    PubMed

    Kang, Hao-Bo; Wang, Jian-Hui

    2013-11-01

    This paper studies an adaptive control strategy for a class of 5 DOF upper-limb exoskeleton robot with a special safety consideration. The safety requirement plays a critical role in the clinical treatment when assisting patients with shoulder, elbow and wrist joint movements. With the objective of assuring the tracking performance of the pre-specified operations, the proposed adaptive controller is firstly designed to be robust to the model uncertainties. To further improve the safety and fault-tolerance in the presence of unknown large parameter variances or even actuator faults, the adaptive controller is on-line updated according to the information provided by an adaptive observer without additional sensors. An output tracking performance is well achieved with a tunable error bound. The experimental example also verifies the effectiveness of the proposed control scheme. PMID:23906739

  12. Tracing the pathways of the upper limb of the North Atlantic Meridional Overturning Circulation

    NASA Astrophysics Data System (ADS)

    Burkholder, Kristin C.; Lozier, M. Susan

    2014-06-01

    The warm sea surface temperatures (SSTs) of the eastern subpolar gyre (ESG) in the North Atlantic have been widely linked to the climate and climate variability of Great Britain and northwestern Europe. The source of the ESG waters, and its heat, has long been identified as surface subtropical waters that flow into the subpolar gyre as part of the upper limb of the Meridional Overturning Circulation. Recent studies, however, have cast doubt on that identification. Here we use synthetic floats launched in a high-resolution ocean general circulation model to identify the supply waters to the ESG and to determine the influence of those pathways on SSTs in that climatically important region. The synthetic floats reveal two pathways: a dominant subsurface subtropical to subpolar pathway and a less traveled surface pathway carrying recirculated waters eastward from the western subpolar gyre. The former pathway supplies anomalously warm water to the region; the latter pathway supplies anomalously cool water.

  13. Early influence of auditory stimuli on upper-limb movements in young human infants: an overview

    PubMed Central

    Ferronato, Priscilla A. M.; Domellöf, Erik; Rönnqvist, Louise

    2014-01-01

    Given that the auditory system is rather well developed at the end of the third trimester of pregnancy, it is likely that couplings between acoustics and motor activity can be integrated as early as at the beginning of postnatal life. The aim of the present mini-review was to summarize and discuss studies on early auditory-motor integration, focusing particularly on upper-limb movements (one of the most crucial means to interact with the environment) in association with auditory stimuli, to develop further understanding of their significance with regard to early infant development. Many studies have investigated the relationship between various infant behaviors (e.g., sucking, visual fixation, head turning) and auditory stimuli, and established that human infants can be observed displaying couplings between action and environmental sensory stimulation already from just after birth, clearly indicating a propensity for intentional behavior. Surprisingly few studies, however, have investigated the associations between upper-limb movements and different auditory stimuli in newborns and young infants, infants born at risk for developmental disorders/delays in particular. Findings from studies of early auditory-motor interaction support that the developing integration of sensory and motor systems is a fundamental part of the process guiding the development of goal-directed action in infancy, of great importance for continued motor, perceptual, and cognitive development. At-risk infants (e.g., those born preterm) may display increasing central auditory processing disorders, negatively affecting early sensory-motor integration, and resulting in long-term consequences on gesturing, language development, and social communication. Consequently, there is a need for more studies on such implications. PMID:25278927

  14. Quantitative analysis of upper-limb ataxia in patients with spinocerebellar degeneration.

    PubMed

    Ueda, Naohisa; Hakii, Yasuhito; Koyano, Shigeru; Higashiyama, Yuichi; Joki, Hideto; Baba, Yasuhisa; Suzuki, Yume; Kuroiwa, Yoshiyuki; Tanaka, Fumiaki

    2014-07-01

    Spinocerebellar degeneration (SCD) is a progressive neurodegenerative disorder in which cerebellar ataxia causes motor disability. There are no widely applicable methods for objective evaluation of ataxia in SCD. An objective system to evaluate ataxia is necessary for use in clinical trials of newly developed medication and rehabilitation. The aim of this study was to develop a simple method to quantify the degree of upper-limb ataxia. Forty-nine patients with SCD participated in this study. Patients were instructed to trace an Archimedean spiral template, and the gap between the template spiral and the drawn spiral (gap area; GA) was measured using Image J software. Ataxia was rated using the Scale for the Assessment and Rating of Ataxia (SARA) and cerebellar volume was evaluated in 37 patients using an axial cross-section of magnetic resonance images that were obtained within 6 months of clinical evaluation. Regression analysis was performed to assess the relation between GA and patient age, disease duration, SARA score, and cerebellar volume. GA was significantly related to total SARA score (r = 0.660, p < 0.001), the posture and gait (r = 0.551, p < 0.001), speech (r = 0.527, p < 0.001), hand movements (r = 0.553, p < 0.001), and heel-shin slide (r = 0.367, p = 0.036) SARA subscores, and cerebellar volume (r = 0.577, p < 0.001) but was not related to patient age (r = 0.176, p = 0.227) or disease duration (r = 0.236, p = 0.103). GA is a simple, useful method to objectively quantify the degree of cerebellar ataxia, especially upper-limb ataxia, and can be widely adopted in various settings, including clinical trials. PMID:24781836

  15. Course review: the 4th Bob Huffstadt upper and lower limb flap dissection course.

    PubMed

    Dunne, Jonathan A

    2014-12-01

    The Bob Huffstadt course is a 2-day upper and lower limb flap dissection course held in Groningen, the Netherlands. The course is in English, with an international faculty of senior consultants from the Netherlands, Belgium, and United Kingdom. Faculty to participant ratio is 2:1, with 2 participants at each dissection table. The course is aimed at trainees in plastic surgery of all levels, and a comprehensive DVD is provided before the course, which demonstrates dissection of 35 flaps, ensuring those with little experience to have an understanding before dissection.This course offered a comprehensive overview with plenty of practical application. The course can greatly develop operative and theoretical knowledge, while also demonstrating a commitment for those wishing to pursue a career in plastic surgery. Longer courses are available; however, the 2-day course can already provide an excellent introduction for junior trainees. There are few flap courses in the United Kingdom and senior trainees may have difficulty acquiring a place as they book up well in advance. With reductions in operating time, trainees may welcome further experience and development of techniques in the dissection room.Most of both days were spent in the dissection room, raising flaps and receiving teaching from the faculty. Dissections included Foucher, Moberg, Becker, radial forearm, anterolateral thigh, and fibula flaps. Dissection specimens were fresh-frozen preparation, and 9 upper limb flaps were raised on the first day and 5 lower limb flaps on the second day. The faculty provided live demonstrations of perforator dissection, use of the hand-held Doppler, and tips and tricks. The last 2 hours of each day were spent with 2 lectures, including topics from the history of flaps and developments to challenging cases and reconstructive options.The course fee was 1000 euros, including a 5-course dinner, lunch on both days, and a drinks reception on the final evening. I would recommend this course unreservedly to trainees new to flaps, or those with greater experience. The course was supportive, friendly, and provided an excellent basis to develop reconstructive skills. There is a world-class faculty who can improve the knowledge and techniques of any trainee in attendance. PMID:24135639

  16. Physiological properties of tandem muscle spindles in neck and hind-limb muscles.

    PubMed

    Price, R F; Dutia, M B

    1989-01-01

    Although tandem muscle spindle complexes are found in small but significant numbers in most muscles, experimental investigation of their properties has been problematic because of the difficulty of distinguishing their afferents from those of "normal" single spindles. Of particular interest are the afferents from b2c capsules of tandem spindles, which unlike normal spindles contain only a static b2 nuclear bag fibre and some nuclear chain fibres. The absence of a dynamic b1 nuclear bag fibre from b2c spindles has engendered much speculation as to their response properties and their possible role in motor control. We have recently developed a method for the identification of afferents from b2c spindles in electrophysiological experiments, using infusion or topical application of succinylcholine (SCh). SCh causes the contraction of the dynamic b1 and static b2 nuclear bag intrafusal fibres, and paralyses the nuclear chain fibres. Afferents from b2c spindles are characterized by a strong "biasing" of their discharge rate to about 100 impulses per second (i.p.s.) when activated by SCh (reflecting the contraction of the static b2 fibre), while primary afferents from normal b1b2c spindles show a large increase in dynamic sensitivity as well as "biasing" (reflecting the contraction of both dynamic b1 and static b2 bag fibres). Histological examination of tenuissimus spindles activated by SCh has confirmed this relationship between the pattern of activation by SCh and the number of intrafusal nuclear bag fibres in the spindle. In this paper we review the value of SCh as a means of testing spindle afferents for functional inputs from sensory terminals on the nuclear bag fibres, and discuss the properties of b2c afferents from tandem spindles in the context of their possible function. PMID:2699377

  17. side and 2 gill rakers on the upper limb of the sec-ond gill arch on the blind side, it is referred to A.

    E-print Network

    side and 2 gill rakers on the upper limb of the sec- ond gill arch on the blind side, it is referred to A. stomias. The other two anomalous specimens also had 2 gill rakers on the upper limbs of the second gill arch of the blind side and were also recorded as A. stomias. Discussion From this study

  18. Viscoelastic Model for Redundancy Resolution of the Human Arm via the Swivel Angle: Applications for Upper Limb Exoskeleton Control

    E-print Network

    Rosen, Jacob

    for Upper Limb Exoskeleton Control Hyunchul Kim, Jay Ryan Roldan, Zhi Li, and Jacob Rosen Abstract-- One exoskeleton robot that is mechanically coupled to the human body is to develop high and low level control relationship between the exoskeleton and the operator is manifested in part by decreasing the force exchange

  19. Differences between Experts and Trainees in the Motion Pattern of the Dominant Upper Limb during Intracorporeal Endoscopic Knotting

    Microsoft Academic Search

    Tarek A. Emam; George B. Hanna; Chris Kimber; Alfred Cuschieri

    2000-01-01

    Background: Very little research has been carried out on the ergonomics of surgeon-instrument interface. The aim of this study is to investigate the effect of experience on the motion pattern of the dominant upper limb during endoscopic intracorporeal knot tying. Methods: Two groups of 5 surgeons (expert consultants and higher surgical trainees) tied 360 surgeon’s knots inside an endoscopic trainer

  20. Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles.

    PubMed

    Levin, Mindy F; Weiss, Patrice L; Keshner, Emily A

    2015-03-01

    The primary focus of rehabilitation for individuals with loss of upper limb movement as a result of acquired brain injury is the relearning of specific motor skills and daily tasks. This relearning is essential because the loss of upper limb movement often results in a reduced quality of life. Although rehabilitation strives to take advantage of neuroplastic processes during recovery, results of traditional approaches to upper limb rehabilitation have not entirely met this goal. In contrast, enriched training tasks, simulated with a wide range of low- to high-end virtual reality-based simulations, can be used to provide meaningful, repetitive practice together with salient feedback, thereby maximizing neuroplastic processes via motor learning and motor recovery. Such enriched virtual environments have the potential to optimize motor learning by manipulating practice conditions that explicitly engage motivational, cognitive, motor control, and sensory feedback-based learning mechanisms. The objectives of this article are to review motor control and motor learning principles, to discuss how they can be exploited by virtual reality training environments, and to provide evidence concerning current applications for upper limb motor recovery. The limitations of the current technologies with respect to their effectiveness and transfer of learning to daily life tasks also are discussed. PMID:25212522

  1. Three-Dimensional Upper Limb Movement Characteristics in Children with Hemiplegic Cerebral Palsy and Typically Developing Children

    ERIC Educational Resources Information Center

    Jaspers, Ellen; Desloovere, Kaat; Bruyninckx, Herman; Klingels, Katrijn; Molenaers, Guy; Aertbelien, Erwin; Van Gestel, Leen; Feys, Hilde

    2011-01-01

    The aim of this study was to measure which three-dimensional spatiotemporal and kinematic parameters differentiate upper limb movement characteristics in children with hemiplegic cerebral palsy (HCP) from those in typically developing children (TDC), during various clinically relevant tasks. We used a standardized protocol containing three reach…

  2. Feasibility and efficacy of upper limb robotic rehabilitation in a1 sub-acute cervical spinal cord injury population2

    E-print Network

    Popovic, Milos R.

    Feasibility and efficacy of upper limb robotic rehabilitation in a1 sub-acute cervical spinal cord, Switzerland) in a sub-acute cervical spinal cord injury (SCI) population.5 Setting: Two Canadian inpatient rehabilitation centres.6 Methods: Twelve subjects (motor level C4-C6, AIS A-D) completed training, which

  3. Redundancy resolution of the human arm and an upper limb exoskeleton.

    PubMed

    Kim, Hyunchul; Miller, Levi Makaio; Byl, Nancy; Abrams, Gary M; Rosen, Jacob

    2012-06-01

    The human arm has 7 degrees of freedom (DOF) while only 6 DOF are required to position the wrist and orient the palm. Thus, the inverse kinematics of an human arm has a nonunique solution. Resolving this redundancy becomes critical as the human interacts with a wearable robot and the inverse kinematics solution of these two coupled systems must be identical to guarantee an seamless integration. The redundancy of the arm can be formulated by defining the swivel angle, the rotation angle of the plane defined by the upper and lower arm around a virtual axis that connects the shoulder and wrist joints. Analyzing reaching tasks recorded with a motion capture system indicates that the swivel angle is selected such that when the elbow joint is flexed, the palm points to the head. Based on these experimental results, a new criterion is formed to resolve the human arm redundancy. This criterion was implemented into the control algorithm of an upper limb 7-DOF wearable robot. Experimental results indicate that by using the proposed redundancy resolution criterion, the error between the predicted and the actual swivel angle adopted by the motor control system is less then 5°. PMID:22510944

  4. Budget impact analysis of botulinum toxin A therapy for upper limb spasticity in the United Kingdom

    PubMed Central

    Abogunrin, Seye; Hortobagyi, Linda; Remak, Edit; Dinet, Jerome; Gabriel, Sylvie; Bakheit, Abdel Magid O

    2015-01-01

    Background Botulinum toxin A (BoNT-A) is an effective treatment for patients with upper limb spasticity (ULS), which is a debilitating feature of upper motor neuron lesions. BoNT-A preparations available in the UK are associated with different costs. Methods We developed a budget impact model to assess the effect of changing market shares of different BoNT-A formulations – abobotulinumtoxinA, onabotulinumtoxinA, and incobotulinumtoxinA – and best supportive care, from the UK payer perspective, over a 5-year time horizon. Epidemiological and resource use data were derived from published literature and clinical expert opinion. One-way sensitivity analyses were performed to determine parameters most influential on budget impact. Results Base-case assumptions showed that an increased uptake of abobotulinumtoxinA resulted in a 5-year savings of £6,283,829. Treatment with BoNT-A costs less than best supportive care per patient per year, although treating a patient with onabotulinumtoxinA (£20,861) and incobotulinumtoxinA (£20,717) cost more per patient annually than with abobotulinumtoxinA (£19,800). Sensitivity analyses showed that the most influential parameters on budget were percentage of cerebral palsy and stroke patients developing ULS, and the prevalence of stroke. Conclusion Study findings suggest that increased use of abobotulinumtoxinA for ULS in the UK could potentially reduce total ULS cost for the health system and society. PMID:25878510

  5. 3D Cortical electrophysiology of ballistic upper limb movement in humans.

    PubMed

    Ofori, Edward; Coombes, Stephen A; Vaillancourt, David E

    2015-07-15

    Precise motor control requires the ability to scale the parameters of movement. Theta oscillations across the cortex have been associated with changes in memory, attention, and sensorimotor processing. What has proven more elusive is pinpointing the region-specific frequency band oscillations that are associated with specific parameters of movement during the acceleration and deceleration phases. We report a study using 3D analytic techniques for high density electroencephalography that examines electrocortical dynamics while participants produce upper limb movements to different distances at varying rates. During fast ballistic movements, we observed increased theta band activity in the left motor area contralateral to the moving limb during the acceleration phase of the movement, and theta power correlated with the acceleration of movement. In contrast, beta band activity scaled with the type of movement during the deceleration phase near the end of the movement and correlated with movement time. In the ipsilateral motor and somatosensory area, alpha band activity decreased with the type of movement near the end of the movement, and gamma band activity in visual cortex increased with the type of movement near the end of the movement. Our results suggest that humans use distinct lateralized cortical activity for distance and speed dependent arm movements. We provide new evidence that a temporary increase in theta band power relates to movement acceleration and is important during movement execution. Further, the theta power increase is coupled with desychronization of beta band power and alpha band power which are modulated by the task near the end of movement. PMID:25929620

  6. Toward the characterization of upper tropospheric clouds using Atmospheric Infrared Sounder and Microwave Limb Sounder observations

    NASA Astrophysics Data System (ADS)

    Kahn, Brian H.; Eldering, Annmarie; Braverman, Amy J.; Fetzer, Eric J.; Jiang, Jonathan H.; Fishbein, Evan; Wu, Dong L.

    2007-03-01

    We estimate the accuracy of cloud top altitude (Z) retrievals from the Atmospheric Infrared Sounder (AIRS) and Advanced Microwave Sounding Unit (AMSU) observing suite (ZA) on board the Earth Observing System Aqua platform. We compare ZA with coincident measurements of Z derived from the micropulse lidar and millimeter wave cloud radar at the Atmospheric Radiation Measurement (ARM) program sites of Nauru and Manus islands (ZARM) and the inferred Z from vertically resolved Microwave Limb Sounder (MLS) ice water content (IWC) retrievals. The mean difference in ZA minus ZARM plus or minus one standard deviation ranges from -2.2 to 1.6 km ± 1.0 to 4.2 km for all cases of AIRS effective cloud fraction (fA) > 0.15 at Manus Island using the cloud radar only. The range of mean values results from using different approaches to determine ZARM, day/night differences, and the magnitude of fA; the variation about the mean decreases for increasing values of fA. Analysis of ZARM from the micropulse lidar at Nauru Island for cases restricted to 0.05 ? fA ? 0.15 indicates a statistically significant improvement in ZA - ZARM over the cloud radar-derived values at Manus Island. In these cases the ZA - ZARM difference is -1.1 to 2.1 km ± 3.0 to 4.5 km. These results imply that the operational ZA is quantitatively useful for constraining cirrus altitude despite the nominal 45 km horizontal resolution. Mean differences of cloud top pressure (PCLD) inferred from coincident AIRS and MLS ice water content (IWC) retrievals depend upon the method of defining AIRS PCLD (as with the ARM comparisons) over the MLS spatial scale, the peak altitude and maximum value of MLS IWC, and fA. AIRS and MLS yield similar vertical frequency distributions when comparisons are limited to fA > 0.1 and IWC > 1.0 mg m-3. Therefore the agreement depends upon the opacity of the cloud, with decreased agreement for optically tenuous clouds. Further, the mean difference and standard deviation of AIRS and MLS PCLD are highly dependent on the MLS tangent altitude. For MLS tangent altitudes greater than 146 hPa, the strength of the limb technique, the disagreement becomes statistically significant. This implies that AIRS and MLS "agree" in a statistical sense at lower tangent altitudes and "disagree" at higher tangent altitudes. These results provide important insights on upper tropospheric cloudiness as observed by nadir-viewing AIRS and limb-viewing MLS.

  7. Effects of age on muscle activity and upper body kinematics during a repetitive forearm supination task

    Microsoft Academic Search

    Zongliang Jiang; Yu Shu; Jonathan Drum; Stephanie Reid; Gary A. Mirka

    2006-01-01

    The principal objective of this study was to assess the effects of age on upper extremity muscle activation patterns and upper body kinematics during a forearm supination task. Age-related physiological and biomechanical changes in the musculoskeletal system have been documented in the literature. It was hypothesized that these changes may have an impact on muscle recruitment and work technique (postural\\/kinematic)

  8. Three-dimensional kinematic analysis of upper and lower limb motion during gait of post-stroke patients.

    PubMed

    Carmo, A A; Kleiner, A F R; Costa, P H Lobo da; Barros, R M L

    2012-06-01

    The aim of this study was to analyze the alterations of arm and leg movements of patients during stroke gait. Joint angles of upper and lower limbs and spatiotemporal variables were evaluated in two groups: hemiparetic group (HG, 14 hemiparetic men, 53 ± 10 years) and control group (CG, 7 able-bodied men, 50 ± 4 years). The statistical analysis was based on the following comparisons (P ? 0.05): 1) right versus left sides of CG; 2) affected (AF) versus unaffected (UF) sides of HG; 3) CG versus both the affected and unaffected sides of HG, and 4) an intracycle comparison of the kinematic continuous angular variables between HG and CG. This study showed that the affected upper limb motion in stroke gait was characterized by a decreased range of motion of the glenohumeral (HG: 6.3 ± 4.5, CG: 20.1 ± 8.2) and elbow joints (AF: 8.4 ± 4.4, UF: 15.6 ± 7.6) on the sagittal plane and elbow joint flexion throughout the cycle (AF: 68.2 ± 0.4, CG: 46.8 ± 2.7). The glenohumeral joint presented a higher abduction angle (AF: 14.2 ± 1.6, CG: 11.5 ± 4.0) and a lower external rotation throughout the cycle (AF: 4.6 ± 1.2, CG: 22.0 ± 3.0). The lower limbs showed typical alterations of the stroke gait patterns. Thus, the changes in upper and lower limb motion of stroke gait were identified. The description of upper limb motion in stroke gait is new and complements gait analysis. PMID:22473324

  9. Comparative architectural properties of limb muscles in Crocodylidae and Alligatoridae and their relevance to divergent use of asymmetrical gaits in extant Crocodylia.

    PubMed

    Allen, Vivian; Molnar, Julia; Parker, William; Pollard, Andrea; Nolan, Grant; Hutchinson, John R

    2014-12-01

    Crocodiles and their kin (Crocodylidae) use asymmetrical (bounding and galloping) gaits when moving rapidly. Despite being morphologically and ecologically similar, it seems alligators and their kin (Alligatoridae) do not. To investigate a possible anatomical basis for this apparent major difference in locomotor capabilities, we measured relative masses and internal architecture (fascicle lengths and physiological cross-sectional areas) of muscles of the pectoral and pelvic limbs of 40 individuals from six representative species of Crocodylidae and Alligatoridae. We found that, relative to body mass, Crocodylidae have significantly longer muscle fascicles (increased working range), particularly in the pectoral limb, and generally smaller muscle physiological cross-sectional areas (decreased force-exerting capability) than Alligatoridae. We therefore hypothesise that the ability of some crocodylians to use asymmetrical gaits may be limited more by the ability to make large, rapid limb motions (especially in the pectoral limb) than the ability to exert large limb forces. Furthermore, analysis of scaling patterns in muscle properties shows that limb anatomy in the two clades becomes more divergent during ontogeny. Limb muscle masses, fascicle lengths and physiological cross-sectional areas scale with significantly larger coefficients in Crocodylidae than Alligatoridae. This combination of factors suggests that inter-clade disparity in maximal limb power is highest in adult animals. Therefore, despite their apparent morphological similarities, both mean values and scaling patterns suggest that considerable diversity exists in the locomotor apparatus of extant Crocodylia. PMID:25418112

  10. Study design and methods of the BoTULS trial: a randomised controlled trial to evaluate the clinical effect and cost effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

    Microsoft Academic Search

    Helen Rodgers; Lisa Shaw; Christopher Price; Frederike van Wijck; Michael Barnes; Laura Graham; Gary Ford; Phil Shackley; Nick Steen

    2008-01-01

    BACKGROUND: Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and

  11. Characteristics of upper limb muscular strength in male wheelchair tennis players

    PubMed Central

    Moon, Hyo-Bin; Park, Seung-Jae; Kim, Al-Chan; Jang, Jee-Hun

    2013-01-01

    The purpose of this study was to identify the characteristics of muscular strength in upper limb and to present the preliminary information for development of sports injury prevention program and exercise rehabilitation program in wheelchair tennis players. Participants were 12 male wheelchair tennis players. Muscular strength was measured in shoulder and elbow joints with isokinetic dynamometer. Ipsilateral (IR) and bilateral (BR) balance ratio were calculated with isokinetic strength at 60°/sec. As a result, extension strength (ES) was significantly higher than flexion strength (FS) (P< 0.001), and IR in both sides and BR in ES were maintained within normal range whereas BR in FS was lower than normal range in shoulder joint. In elbow joint FS was significantly higher than ES (P< 0.05), and IR and BR were lower than normal range. Consequently, the different tendency in IR between shoulder and elbow joints and lower IR and BR in elbow joints could be the characteristics in male wheelchair tennis players. It is suggested that flexor strengthening program in nondominant shoulder joint, extensor strengthening program in both elbow joint, and flexor strengthening program in non-dominant elbow joint should be introduced for male wheelchair tennis players. PMID:24278887

  12. Characteristics of upper limb muscular strength in male wheelchair tennis players.

    PubMed

    Moon, Hyo-Bin; Park, Seung-Jae; Kim, Al-Chan; Jang, Jee-Hun

    2013-01-01

    The purpose of this study was to identify the characteristics of muscular strength in upper limb and to present the preliminary information for development of sports injury prevention program and exercise rehabilitation program in wheelchair tennis players. Participants were 12 male wheelchair tennis players. Muscular strength was measured in shoulder and elbow joints with isokinetic dynamometer. Ipsilateral (IR) and bilateral (BR) balance ratio were calculated with isokinetic strength at 60°/sec. As a result, extension strength (ES) was significantly higher than flexion strength (FS) (P< 0.001), and IR in both sides and BR in ES were maintained within normal range whereas BR in FS was lower than normal range in shoulder joint. In elbow joint FS was significantly higher than ES (P< 0.05), and IR and BR were lower than normal range. Consequently, the different tendency in IR between shoulder and elbow joints and lower IR and BR in elbow joints could be the characteristics in male wheelchair tennis players. It is suggested that flexor strengthening program in nondominant shoulder joint, extensor strengthening program in both elbow joint, and flexor strengthening program in non-dominant elbow joint should be introduced for male wheelchair tennis players. PMID:24278887

  13. Robot training of upper limb in multiple sclerosis: comparing protocols with or without manipulative task components.

    PubMed

    Carpinella, Ilaria; Cattaneo, Davide; Bertoni, Rita; Ferrarin, Maurizio

    2012-05-01

    In this pilot study, we compared two protocols for robot-based rehabilitation of upper limb in multiple sclerosis (MS): a protocol involving reaching tasks (RT) requiring arm transport only and a protocol requiring both objects' reaching and manipulation (RMT). Twenty-two MS subjects were assigned to RT or RMT group. Both protocols consisted of eight sessions. During RT training, subjects moved the handle of a planar robotic manipulandum toward circular targets displayed on a screen. RMT protocol required patients to reach and manipulate real objects, by moving the robotic arm equipped with a handle which left the hand free for distal tasks. In both trainings, the robot generated resistive and perturbing forces. Subjects were evaluated with clinical and instrumental tests. The results confirmed that MS patients maintained the ability to adapt to the robot-generated forces and that the rate of motor learning increased across sessions. Robot-therapy significantly reduced arm tremor and improved arm kinematics and functional ability. Compared to RT, RMT protocol induced a significantly larger improvement in movements involving grasp (improvement in Grasp ARAT sub-score: RMT 77.4%, RT 29.5%, p=0.035) but not precision grip. Future studies are needed to evaluate if longer trainings and the use of robotic handles would significantly improve also fine manipulation. PMID:22623407

  14. HEMOGLOBIN ATTENUATES THE EFFECTS OF INSPIRED OXYGEN ON PLASMA ISOFURANS IN HUMANS DURING UPPER LIMB SURGERY

    PubMed Central

    Corcoran, Tomas B; Barden, Anne E; Mas, Emilie; Grape, Sina; Koren, Viktoria; Phillips, Michael; Roberts, L Jackson; Mori, Trevor A

    2011-01-01

    Reperfusion injury is characterised by significant oxidative stress. F2-isoprostanes (F2-IsoPs) and isofurans (IsoFs), the latter preferentially produced during increased oxygen tension, are recognised markers of in-vivo oxidative stress. We aimed to determine whether increasing oxygen tension during reperfusion modified levels of plasma total IsoFs and F2-IsoPs. Forty five patients undergoing upper limb surgery were randomised to receive inspired oxygen concentrations of 30%, 50% or 80% during the last 15 minutes of surgery. Venous blood samples were taken before the change in inspired oxygen, after 10 minutes (before reperfusion) and after 15 minutes (5 minutes after reperfusion). IsoFs and F2-IsoPs were measured by gas chromatography-mass spectrometry. Venous oxygen tension and hemoglobin concentrations were also measured. Plasma IsoFs and F2-IsoP levels in the 50% and 80% O2 groups were not significantly different from the 30% O2 group. In secondary analyses, using data combining all groups, levels of IsoFs, but not F2-IsoPs, associated with higher venous oxygen tension (P=0.038). Hemoglobin negatively modified the influence of oxygen tension on levels of IsoFs (P=0.014). This study has shown for the first time, that plasma IsoFs levels associate with higher oxygen tension in a human model of reperfusion, and this effect is significantly attenuated by hemoglobin. PMID:21763419

  15. Time pressure and attention allocation effect on upper limb motion steadiness.

    PubMed

    Liu, Sicong; Eklund, Robert C; Tenenbaum, Gershon

    2015-01-01

    Following ironic process theory (IPT), the authors aimed at investigating how attentional allocation affects participants' upper limb motion steadiness under low and high levels of mental load. A secondary purpose was to examine the validity of skin conductance level in measuring perception of pressure. The study consisted of 1 within-participant factor (i.e., phase: baseline, test) and 4 between-participant factors (i.e., gender: male, female; mental load: fake time constraints, no time constraints; attention: positive, suppressive; order: baseline???test, test??baseline). Eighty college students (40 men and 40 women, Mage = 20.20 years, SDage = 1.52 years) participated in the study. Gender-stratified random assignment was employed in a 2 × 2 × 2 × 2 × 2 mixed experimental design. The findings generally support IPT but its predictions on motor performance under mental load may not be entirely accurate. Unlike men, women's performance was not susceptible to manipulations of mental load and attention allocation. The validity of skin conductance readings as an index of pressure perception was called into question. PMID:25425341

  16. Energy Harvesting from Upper-Limb Pulling Motions for Miniaturized Human-Powered Generators.

    PubMed

    Yeo, Jeongjin; Ryu, Mun-Ho; Yang, Yoonseok

    2015-01-01

    The human-powered self-generator provides the best solution for individuals who need an instantaneous power supply for travel, outdoor, and emergency use, since it is less dependent on weather conditions and occupies less space than other renewable power supplies. However, many commercial portable self-generators that employ hand-cranking are not used as much as expected in daily lives although they have enough output capacity due to their intensive workload. This study proposes a portable human-powered generator which is designed to obtain mechanical energy from an upper limb pulling motion for improved human motion economy as well as efficient human-mechanical power transfer. A coreless axial-flux permanent magnet machine (APMM) and a flywheel magnet rotor were used in conjunction with a one-way clutched power transmission system in order to obtain effective power from the pulling motion. The developed prototype showed an average energy conversion efficiency of 30.98% and an average output power of 0.32 W with a maximum of 1.89 W. Its small form factor (50 mm × 32 mm × 43.5 mm, 0.05 kg) and the substantial electricity produced verify the effectiveness of the proposed method in the utilization of human power. It is expected that the developed generator could provide a mobile power supply. PMID:26151204

  17. Robot-mediated upper limb physiotherapy: review and recommendations for future clinical trials.

    PubMed

    Péter, Orsolya; Fazekas, Gábor; Zsiga, Katalin; Dénes, Zoltán

    2011-09-01

    Robot-mediated physiotherapy provides a new possibility for improving the outcome of rehabilitation of patients who are recovering from stroke. This study is a review of robot-supported upper limb physiotherapy focusing on the shoulder, elbow, and wrist. A literature search was carried out in PubMed, OVID, and EBSCO for clinical trials with robots providing shoulder, elbow, or wrist therapy. Results concerning motor control, spasticity, functional outcome, and the main features of the studies were evaluated. A total of 178 papers were found. On the basis of inclusion/exclusion criteria, 30 studies remained for evaluation. In these trials, a total of 493 patients received robot-aided therapy. The Fugl-Meyer assessment was the most commonly used motor scale, and in 24 of 27 trials, motor function improved significantly. The application of the Modified Ashworth Scale showed that spasticity decreased significantly in nine of 21 trials. Functional scales were only examined in one-third of the studies with significant changes being found in half of them. The intensity and duration of the interventions as well as the elapsed time poststroke were varied. There are several scales, which were used in only a few trials. Unifying the methodology in robotic trials is desirable. Clarification of the acute/subacute/chronic categories, standardizing the application of certain scales for outcome measure in each trial, use of functional scales, and a clearer description of the interventions are recommended. PMID:21543990

  18. Prevalence of work-related upper limbs symptoms (WRULS) among office workers.

    PubMed

    Zairina Abdul Rahman; Abdul Sallam Atiya

    2009-07-01

    An analytical cross-sectional study was carried out to determine the prevalence of work-related upper limbs symptoms (WRULS) among office workers and factors associated with it. A self-administered questionnaire was used to collect the information. A total of 463 (87.7%) office workers from selected government agencies participated in this study. The mean age of the respondents was 34.1 years (range = 18-55 years). Majority (91.6%) were Malay and female (72.8%), and 58.1% were from clerical group. Mean duration of work was 8.7 years. This study found that prevalence of WRULS was 33.0% (95% CI [confidence interval] = 28.8%, 37.3%). Computer users at work had 2.0 (95% CI = 1.1, 3.4) higher odds ratio of developing WRULS and those who used it for 5 hours and more per day had 7.5 (95% CI = 2.3, 24.2) higher odds ratio of developing WRULS. Hand-intensive hobbies and higher education were also found to be associated with WRULS. PMID:19546127

  19. Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial

    PubMed Central

    Shackley, Phil; Shaw, Lisa; Price, Christopher; van Wijck, Frederike; Barnes, Michael; Graham, Laura; Ford, Gary A.; Steen, Nick; Rodgers, Helen

    2012-01-01

    Stroke imposes significant burdens on health services and society, and as such there is a growing need to assess the cost-effectiveness of stroke treatment to ensure maximum benefit is derived from limited resources. This study compared the cost-effectiveness of treating post-stroke upper limb spasticity with botulinum toxin type A plus an upper limb therapy programme against the therapy programme alone. Data on resource use and health outcomes were prospectively collected for 333 patients with post-stroke upper limb spasticity taking part in a randomized trial and combined to estimate the incremental cost per quality adjusted life year (QALY) gained of botulinum toxin type A plus therapy relative to therapy alone. The base case incremental cost-effectiveness ratio (ICER) of botulinum toxin type A plus therapy was £93,500 per QALY gained. The probability of botulinum toxin type A plus therapy being cost-effective at the England and Wales cost-effectiveness threshold value of £20,000 per QALY was 0.36. The point estimates of the ICER remained above £20,000 per QALY for a range of sensitivity analyses, and the probability of botulinum toxin type A plus therapy being cost-effective at the threshold value did not exceed 0.39, regardless of the assumptions made. PMID:23342679

  20. On the use of information theory for detecting upper limb motor dysfunction: An application to Parkinson’s disease

    NASA Astrophysics Data System (ADS)

    de Oliveira, M. Elias; Menegaldo, L. L.; Lucarelli, P.; Andrade, B. L. B.; Büchler, P.

    2011-11-01

    Parkinson’s disease (PD) is a chronic neurodegenerative disorder characterized by a selective loss of dopaminergic neurons in the substantia nigra, decreased striatal dopamine levels, and consequent extrapyramidal motor dysfunctions. Several potential early diagnostic markers of PD have been proposed. Since they have not been validated in presymptomatic PD, the diagnosis and monitoring of the disease is based on subjective clinical assessment of cognitive and motor symptoms. In this study, we investigated interjoint coordination synergies in the upper limb of healthy and parkinsonian subjects during the performance of unconstrained linear-periodic movements in a horizontal plane using the mutual information (MI). We found that the MI is a sensitive metric in detecting upper limb motor dysfunction, thus suggesting that this method might be applicable to quantitatively evaluating the effects of the antiparkinsonian medication and to monitor the disease progression.

  1. The effects of progressive functional training on lower limb muscle architecture and motor function in children with spastic cerebral palsy

    PubMed Central

    Lee, MiHye; Ko, YoungJun; Shin, Mary Myong Sook; Lee, Wanhee

    2015-01-01

    [Purpose] To investigate the effects of progressive functional training on lower limb muscle architecture and motor function of children with spastic cerebral palsy (CP). [Subjects] The subjects of this study were 26 children with spastic CP. [Methods] Thirteen subjects in the experimental group performed general neurodevelopmental treatment (NDT) and additional progressive functional trainings and 13 subjects in the control group performed only general NDT 3 times a week for 6 weeks. Ultrasonography, gross motor function measurement (GMFM) and the mobility questionnaire (MobQue) were evaluated. [Results] After the intervention, the muscle thickness of the quadriceps femoris (QF), cross-sectional area of the rectus femoris (RF), pennation angle of the gastrocnemius (GCM) and the MobQue score of the experimental group were significantly greater than those of the control group. The muscle thickness of QF correlated with the cross-sectional area (CSA) of RF and the pennation angle of GCM, and GMFM score correlated with the pennation angle of GCM. [Conclusion] Progressive functional training can increase muscle thickness, CSA, and the pennation angle of the lower limb muscles, and improve the mobility of spastic CP children making it useful as a practical adjunct to rehabilitation therapy.

  2. Stress-Shielding Effect of Nitinol Swan-Like Memory Compressive Connector on Fracture Healing of Upper Limb

    Microsoft Academic Search

    Q. G. Fu; X. W. Liu; S. G. Xu; M. Li; C. C. Zhang

    2009-01-01

    In this article, the stress-shielding effect of a Nitinol swan-like memory compressive connector (SMC) is evaluated. Patients with fracture healing of an upper limb after SMC internal fixation or stainless steel plate fixation were randomly selected and observed comparatively. With the informed consent of the SMC group, minimal cortical bone under the swan-body and swan-neck was harvested; and in the

  3. Stress-Shielding Effect of Nitinol Swan-Like Memory Compressive Connector on Fracture Healing of Upper Limb

    Microsoft Academic Search

    Q. G. Fu; X. W. Liu; S. G. Xu; M. Li; C. C. Zhang

    2009-01-01

    In this article, the stress-shielding effect of a Nitinol swan-like memory compressive connector (SMC) is evaluated. Patients\\u000a with fracture healing of an upper limb after SMC internal fixation or stainless steel plate fixation were randomly selected\\u000a and observed comparatively. With the informed consent of the SMC group, minimal cortical bone under the swan-body and swan-neck\\u000a was harvested; and in the

  4. Continuous theta-burst stimulation combined with occupational therapy for upper limb hemiparesis after stroke: a preliminary study.

    PubMed

    Yamada, Naoki; Kakuda, Wataru; Kondo, Takahiro; Shimizu, Masato; Sageshima, Masashi; Mitani, Sugao; Abo, Masahiro

    2014-12-01

    The purpose of this study was to assess the safety, feasibility and efficacy of continuous theta-burst stimulation (cTBS) combined with intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Ten patients with history of stroke and upper limb hemiparesis (age 62.0 ± 11.1 years, time since stroke 95.7 ± 70.2 months, mean ± SD) were studied. Each patient received 13 sessions, each comprising 160 s of cTBS applied to the skull on the area of the non-lesional hemisphere (using a 70-mm figure-8 coil, three pulse bursts at 50 Hz, repeated every 200 ms, i.e., 5 Hz, with total stimulation of 2,400 pulses), followed by intensive OT (comprising 120-min one-to-one training and 120-min self-training) during 15-day hospitalization. The motor function of the affected upper limb was evaluated by Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT) on the days of admission and discharge. All patients completed the 15-day protocol without any adverse effects. Treatment significantly increased the FMA score (from 46.6 ± 8.7 to 51.6 ± 8.2 points, p < 0.01) and shortened the log performance time of WMFT (from 2.5 ± 1.1 to 2.2 ± 1.2 s, p < 0.01). The 15-day protocol of cTBS combined with intensive OT is a safe and potentially useful therapeutic modality for upper limb hemiparesis after stroke. PMID:24696408

  5. Upper limb children action-observation training (UP-CAT): a randomised controlled trial in Hemiplegic Cerebral Palsy

    Microsoft Academic Search

    Giuseppina Sgandurra; Adriano Ferrari; Giuseppe Cossu; Andrea Guzzetta; Laura Biagi; Michela Tosetti; Leonardo Fogassi; Giovanni Cioni

    2011-01-01

    Background  Rehabilitation for children with hemiplegic cerebral palsy (HCP) aimed to improve function of the impaired upper limb (UL)\\u000a uses a wide range of intervention programs. A new rehabilitative approach, called Action-Observation Therapy, based on the\\u000a recent discovery of mirror neurons, has been used in adult stroke but not in children. The purpose of the present study is\\u000a to design a

  6. Case of Complex Craniofacial Anomalies, Bilateral Nasal Proboscides, Palatal Pituitary, Upper Limbs Reduction, and Amnion Rupture Sequence: Disorganization Phenotype?

    Microsoft Academic Search

    Jerzy Stanek; Gabrielle de Courten-Myers; Abbot G. Spaulding; William Strub; Robert J. Hopkin

    2001-01-01

    We report a case of a dizygotic twin with complex abnormalities of head, body, and limbs. The anomalies include the following:\\u000a lateral and midline cleft upper lip, ectopic palatal pituitary, natal teeth, bilateral nasal proboscides with an absent nose,\\u000a left microphthalmia with conjunctival-lined cyst, right ocular dysgenesis, bilateral retinal dysplasia, platybasia with skull\\u000a asymmetry, hydrocephalus secondary to aqueductal atresia, brain

  7. Modifications in activation of lower limb muscles as a function of initial foot position in cycling.

    PubMed

    Padulo, Johnny; Powell, Douglas W; Ardigò, Luca P; Viggiano, Davide

    2015-08-01

    Cyclic movements, such as walking/cycling, require the activity of spinal-circuits, the central-pattern-generators (CPG). To our knowledge little work has been done to investigate the activation of these circuits, e.g., the muscular and kinematic activity during cycling initiation. This study aims to detail the muscle output properties as a function of the initial lower limb-position using a simple cycling paradigm. Therefore, subjects were required to pedal on a cycle-ergometer in seated position starting at different-crank-angles (0-150°). Surface-electromyography was recorded from the gluteus major (GL), vastus lateralis (VL), and gastrocnemius medialis (GM), while crank position was recorded using a linear-encoder. Gluteus major peak-activity (PA) occurred at 65.0±12.4° when starting with 0° initial crank position (ICP), while occurred maximally at 110.5±2.9 when starting with 70° ICP. Vastus lateralis PA occurred at 40.7±8.8° with 0° ICP, whereas with 70° ICP PA occurred at 103.4±4.0°. Similarly, GM PA occurred at 112.0±10.7° with 0° ICP, whereas with 70° ICP PA occurred at 142.5±4.2° PA. Gluteus major and gastrocnemius medialis showed similar PA phase shifts, which may suggest they are controlled by same local circuitry, in agreement with their common spinal origin, i.e., motoneurons pool in S1-S2. PMID:25921852

  8. Effects of upper limb robot-assisted therapy on motor recovery in subacute stroke patients

    PubMed Central

    2014-01-01

    Background and purpose There is little evidence available on the use of robot-assisted therapy in subacute stroke patients. A randomized controlled trial was carried out to evaluate the short-time efficacy of intensive robot-assisted therapy compared to usual physical therapy performed in the early phase after stroke onset. Methods Fifty-three subacute stroke patients at their first-ever stroke were enrolled 30?±?7 days after the acute event and randomized into two groups, both exposed to standard therapy. Additional 30 sessions of robot-assisted therapy were provided to the Experimental Group. Additional 30 sessions of usual therapy were provided to the Control Group. The following impairment evaluations were performed at the beginning (T0), after 15 sessions (T1), and at the end of the treatment (T2): Fugl-Meyer Assessment Scale (FM), Modified Ashworth Scale-Shoulder (MAS-S), Modified Ashworth Scale-Elbow (MAS-E), Total Passive Range of Motion-Shoulder/Elbow (pROM), and Motricity Index (MI). Results Evidence of significant improvements in MAS-S (p?=?0.004), MAS-E (p?=?0.018) and pROM (p?upper limb rehabilitation treatment can contribute to increasing motor recovery in subacute stroke patients. Focusing on the early phase of stroke recovery has a high potential impact in clinical practice. PMID:24946799

  9. A study of computer-related upper limb discomfort and computer vision syndrome.

    PubMed

    Sen, A; Richardson, Stanley

    2007-12-01

    Personal computers are one of the commonest office tools in Malaysia today. Their usage, even for three hours per day, leads to a health risk of developing Occupational Overuse Syndrome (OOS), Computer Vision Syndrome (CVS), low back pain, tension headaches and psychosocial stress. The study was conducted to investigate how a multiethnic society in Malaysia is coping with these problems that are increasing at a phenomenal rate in the west. This study investigated computer usage, awareness of ergonomic modifications of computer furniture and peripherals, symptoms of CVS and risk of developing OOS. A cross-sectional questionnaire study of 136 computer users was conducted on a sample population of university students and office staff. A 'Modified Rapid Upper Limb Assessment (RULA) for office work' technique was used for evaluation of OOS. The prevalence of CVS was surveyed incorporating a 10-point scoring system for each of its various symptoms. It was found that many were using standard keyboard and mouse without any ergonomic modifications. Around 50% of those with some low back pain did not have an adjustable backrest. Many users had higher RULA scores of the wrist and neck suggesting increased risk of developing OOS, which needed further intervention. Many (64%) were using refractive corrections and still had high scores of CVS commonly including eye fatigue, headache and burning sensation. The increase of CVS scores (suggesting more subjective symptoms) correlated with increase in computer usage spells. It was concluded that further onsite studies are needed, to follow up this survey to decrease the risks of developing CVS and OOS amongst young computer users. PMID:18572794

  10. 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

  11. Proprioceptive performance of bilateral upper and lower limb joints: side-general and site-specific effects.

    PubMed

    Han, Jia; Anson, Judith; Waddington, Gordon; Adams, Roger

    2013-05-01

    Superiority of the left upper limb in proprioception tasks performed by right-handed individuals has been attributed to better utilization of proprioceptive information by a non-preferred arm/hemisphere system. However, it is undetermined whether this holds for multiple upper and lower limb joints. Accordingly, the present study tested active movement proprioception at four pairs of upper and lower limb joints, after selecting twelve participants with both strong right arm and right leg preference. A battery of versions of the active movement extent discrimination apparatus were employed to generate the stimuli for movements of different extents at the ankle, knee, shoulder and fingers on the right and left sides of the body, and discrimination scores were derived from participants' responses. Proprioceptive performance on the non-preferred left side was significantly better than the preferred right side at all four joints tested (overall F 1, 11 = 36.36, p < 0.001, partial ? (2) = 0.77). In the 8 × 8 matrix formed by all joints, only correlations between the proprioceptive accuracy scores for the right and left sides at the same joint were significant (ankles 0.93, knees 0.89, shoulders 0.87, fingers 0.91, p ? 0.001; all others r ? 0.40, p ? 0.20). The results point to both a side-general effect and a site-specific effect in the integration of proprioceptive information during active movement tasks, whereby the non-preferred limb/hemisphere system is specialized in the utilization of the best proprioceptive sources available at each specific joint, but the combination of sources employed differs between body sites. PMID:23423167

  12. Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma

    Microsoft Academic Search

    Johan S. Rietman; Pieter U. Dijkstra; Jan H. B. Geertzen; Peter Baas; Jaap de Vries; Wil Dolsma; Johan W. Groothoff; Willem H. Eisma; Harald J. Hoekstra

    2003-01-01

    BACKGROUND. The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment-related upper-limb morbidity. In the current prospec- tive study, short-term upper-limb morbidity was assessed after SLNB and\\/or ALND. METHODS. The study comprised 204 patients with Stage I\\/II breast carcinoma. Mean patient age was 55.6 years (standard

  13. Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke

    Microsoft Academic Search

    Peter S. Lum; Charles G. Burgar; Peggy C. Shor; Matra Majmundar; Machiel Van der Loos

    2002-01-01

    Lum PS, Burgar CG, Shor PC, Majmundar M, Van der Loos M. Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Arch Phys Med Rehabil 2002;83:952-9. Objective: To compare the effects of robot-assisted movement training with conventional techniques for the rehabilitation of upper-limb motor function after stroke. Design: Randomized controlled trial, 6-month

  14. FAST INdiCATE Trial protocol. Clinical efficacy of functional strength training for upper limb motor recovery early after stroke: Neural correlates and prognostic indicators

    PubMed Central

    Pomeroy, Valerie M; Ward, Nick S; Johansen-Berg, Heidi; van Vliet, Paulette; Burridge, Jane; Hunter, Susan M; Lemon, Roger N; Rothwell, John; Weir, Christopher J; Wing, Alan; Walker, Andrew A; Kennedy, Niamh; Barton, Garry; Greenwood, Richard J; McConnachie, Alex

    2014-01-01

    Rationale Functional strength training in addition to conventional physical therapy could enhance upper limb recovery early after stroke more than movement performance therapy plus conventional physical therapy. Aims To determine (a) the relative clinical efficacy of conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy for upper limb recovery; (b) the neural correlates of response to conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy; (c) whether any one or combination of baseline measures predict motor improvement in response to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Design Randomized, controlled, observer-blind trial. Study The sample will consist of 288 participants with upper limb paresis resulting from a stroke that occurred within the previous 60 days. All will be allocated to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Functional strength training and movement performance therapy will be undertaken for up to 1·5 h/day, five-days/week for six-weeks. Outcomes and Analysis Measurements will be undertaken before randomization, six-weeks thereafter, and six-months after stroke. Primary efficacy outcome will be the Action Research Arm Test. Explanatory measurements will include voxel-wise estimates of brain activity during hand movement, brain white matter integrity (fractional anisotropy), and brain–muscle connectivity (e.g. latency of motor evoked potentials). The primary clinical efficacy analysis will compare treatment groups using a multilevel normal linear model adjusting for stratification variables and for which therapist administered the treatment. Effect of conventional physical therapy combined with functional strength training versus conventional physical therapy combined with movement performance therapy will be summarized using the adjusted mean difference and 95% confidence interval. To identify the neural correlates of improvement in both groups, we will investigate associations between change from baseline in clinical outcomes and each explanatory measure. To identify baseline measurements that independently predict motor improvement, we will develop a multiple regression model. PMID:24025033

  15. 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

  16. Upper limb performance and the structuring of joint movement in teenagers with cerebral palsy: the reciprocal role of task demands and action capabilities.

    PubMed

    Figueiredo, Priscilla Rezende Pereira; Silva, Paula Lanna; Avelar, Bruna Silva; da Fonseca, Sérgio Teixeira; Bootsma, Reinoud J; Mancini, Marisa Cotta

    2015-04-01

    Individuals with unilateral cerebral palsy (CP) demonstrate reduced performance in upper limb tasks compared to typically developing (TD) peers. We examined whether task conditions modify differences between teenagers with and without CP during a reciprocal aiming task. Twenty teenagers (nine CP and 11 TD) moved a pointer between two targets as fast as possible without missing a target. Task conditions were manipulated by changing the targets' size, by modifying the inertial properties of the pointer and by varying the upper limb used to perform the task (preferred/non-affected and non-preferred/affected upper limbs). While compared to TD peers, CP teenagers exhibited lower performance (longer movement times). Such differences were attenuated when the task was performed with the preferred upper limb and when accuracy requirements were less stringent. CP teenagers were not differentially affected by the pointer inertia manipulation. Task conditions not only affected performance but also joint kinematics. CP teenagers revealed less movement at the elbow and more movement at the shoulder when performing the task with their less skilled upper limb. However, both CP and TD teenagers demonstrated a larger contribution of trunk movement when facing more challenging task conditions. The overall pattern of results indicated that the joint kinematics employed by individuals with unilateral CP constituted adaptive responses to task requirements. Thus, the explanation of the effects of unilateral CP on upper limb behavior needs to go beyond a context-indifferent manifestation of the brain injury to include the interaction between task demands and action capabilities. PMID:25579662

  17. Differential skeletal muscle gene expression after upper or lower motor neuron transection

    Microsoft Academic Search

    Richard J. Zeman; Jingbo Zhao; Yuangfei Zhang; Weidong Zhao; Xialing Wen; Yong Wu; Jiangping Pan; William A. Bauman; Christopher Cardozo

    2009-01-01

    Causes of disuse atrophy include loss of upper motor neurons, which occurs in spinal cord injury (SCI) or lower motor neurons\\u000a (denervation). Whereas denervation quickly results in muscle fibrillations, SCI causes delayed onset of muscle spasticity.\\u000a To compare the influence of denervation or SCI on muscle atrophy and atrophy-related gene expression, male rats had transection\\u000a of either the spinal cord

  18. 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

  19. Mechanism of Kinect-based virtual reality training for motor functional recovery of upper limbs after subacute stroke

    PubMed Central

    Bao, Xiao; Mao, Yurong; Lin, Qiang; Qiu, Yunhai; Chen, Shaozhen; Li, Le; Cates, Ryan S.; Zhou, Shufeng; Huang, Dongfeng

    2013-01-01

    The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patients with lower limb dysfunctions. However, the underlying mechanism remains unclear. In this study, 18 healthy subjects and five patients after subacute stroke were included. The five patients were scanned using functional MRI prior to training, 3 weeks after training and at a 12-week follow-up, and then compared with healthy subjects. The Fugl-Meyer Assessment and Wolf Motor Function Test scores of the hemiplegic upper limbs of stroke patients were significantly increased 3 weeks after training and at the 12-week follow-up. Functional MRI results showed that contralateral primary sensorimotor cortex was activated after Kinect-based virtual reality training in the stroke patients compared with the healthy subjects. Contralateral primary sensorimotor cortex, the bilateral supplementary motor area and the ipsilateral cerebellum were also activated during hand-clenching in all 18 healthy subjects. Our findings indicate that Kinect-based virtual reality training could promote the recovery of upper limb motor function in subacute stroke patients, and brain reorganization by Kinect-based virtual reality training may be linked to the contralateral sensorimotor cortex. PMID:25206611

  20. The development of an adaptive upper-limb stroke rehabilitation robotic system

    PubMed Central

    2011-01-01

    Background Stroke is the primary cause of adult disability. To support this large population in recovery, robotic technologies are being developed to assist in the delivery of rehabilitation. This paper presents an automated system for a rehabilitation robotic device that guides stroke patients through an upper-limb reaching task. The system uses a decision theoretic model (a partially observable Markov decision process, or POMDP) as its primary engine for decision making. The POMDP allows the system to automatically modify exercise parameters to account for the specific needs and abilities of different individuals, and to use these parameters to take appropriate decisions about stroke rehabilitation exercises. Methods The performance of the system was evaluated by comparing the decisions made by the system with those of a human therapist. A single patient participant was paired up with a therapist participant for the duration of the study, for a total of six sessions. Each session was an hour long and occurred three times a week for two weeks. During each session, three steps were followed: (A) after the system made a decision, the therapist either agreed or disagreed with the decision made; (B) the researcher had the device execute the decision made by the therapist; (C) the patient then performed the reaching exercise. These parts were repeated in the order of A-B-C until the end of the session. Qualitative and quantitative question were asked at the end of each session and at the completion of the study for both participants. Results Overall, the therapist agreed with the system decisions approximately 65% of the time. In general, the therapist thought the system decisions were believable and could envision this system being used in both a clinical and home setting. The patient was satisfied with the system and would use this system as his/her primary method of rehabilitation. Conclusions The data collected in this study can only be used to provide insight into the performance of the system since the sample size was limited. The next stage for this project is to test the system with a larger sample size to obtain significant results. PMID:21679457

  1. 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

  2. Effects of the Racket Polar Moment of Inertia on Dominant Upper Limb Joint Moments during Tennis Serve

    PubMed Central

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

    2014-01-01

    This study examined the effect of the polar moment of inertia of a tennis racket on upper limb loading in the serve. Eight amateur competition tennis players performed two sets of 10 serves using two rackets identical in mass, position of center of mass and moments of inertia other than the polar moment of inertia (0.00152 vs 0.00197 kg.m2). An eight-camera motion analysis system collected the 3D trajectories of 16 markers, located on the thorax, upper limbs and racket, from which shoulder, elbow and wrist net joint moments and powers were computed using inverse dynamics. During the cocking phase, increased racket polar moment of inertia was associated with significant increases in the peak shoulder extension and abduction moments, as well the peak elbow extension, valgus and supination moments. During the forward swing phase, peak wrist extension and radial deviation moments significantly increased with polar moment of inertia. During the follow-through phase, the peak shoulder adduction, elbow pronation and wrist external rotation moments displayed a significant inverse relationship with polar moment of inertia. During the forward swing, the magnitudes of negative joint power at the elbow and wrist were significantly larger when players served using the racket with a higher polar moment of inertia. Although a larger polar of inertia allows players to better tolerate off-center impacts, it also appears to place additional loads on the upper extremity when serving and may therefore increase injury risk in tennis players. PMID:25117871

  3. High intensity physical exercise and pain in the neck and upper limb among slaughterhouse workers: cross-sectional study.

    PubMed

    Sundstrup, Emil; Jakobsen, Markus D; Jay, Kenneth; Brandt, Mikkel; Andersen, Lars L

    2014-01-01

    Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49-0.997), whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers. PMID:24527440

  4. High Intensity Physical Exercise and Pain in the Neck and Upper Limb among Slaughterhouse Workers: Cross-Sectional Study

    PubMed Central

    Sundstrup, Emil; Jakobsen, Markus D.; Jay, Kenneth; Brandt, Mikkel; Andersen, Lars L.

    2014-01-01

    Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49–0.997), whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers. PMID:24527440

  5. Lingual Muscle Activity Across Sleep–Wake States in Rats with Surgically Altered Upper Airway

    PubMed Central

    Rukhadze, Irma; Kalter, Julie; Stettner, Georg M.; Kubin, Leszek

    2014-01-01

    Obstructive sleep apnea (OSA) patients have increased upper airway muscle activity, including such lingual muscles as the genioglossus (GG), geniohyoid (GH), and hyoglossus (HG). This adaptation partially protects their upper airway against obstructions. Rodents are used to study the central neural control of sleep and breathing but they do not naturally exhibit OSA. We investigated whether, in chronically instrumented, behaving rats, disconnecting the GH and HG muscles from the hyoid (H) apparatus would result in a compensatory increase of other upper airway muscle activity (electromyogram, EMG) and/or other signs of upper airway instability. We first determined that, in intact rats, lingual (GG and intrinsic) muscles maintained stable activity levels when quantified based on 2?h-long recordings conducted on days 6 through 22 after instrumentation. We then studied five rats in which the tendons connecting the GH and HG muscles to the H apparatus were experimentally severed. When quantified across all recording days, lingual EMG during slow-wave sleep (SWS) was modestly but significantly increased in rats with surgically altered upper airway [8.6?±?0.7% (SE) vs. 6.1?±?0.7% of the mean during wakefulness; p?=?0.012]. Respiratory modulation of lingual EMG occurred mainly during SWS and was similarly infrequent in both groups, and the incidence of sighs and central apneas also was similar. Thus, a weakened action of selected lingual muscles did not produce sleep-disordered breathing but resulted in a relatively elevated activity in other lingual muscles during SWS. These results encourage more extensive surgical manipulations with the aim to obtain a rodent model with collapsible upper airway. PMID:24803913

  6. Normalization of surface EMG amplitude from the upper trapezius muscle in ergonomic studies — A review

    Microsoft Academic Search

    S. E. Mathiassen; J. Winkel; G. M. Hägg

    1995-01-01

    Surface electromyographic (EMG) amplitude from the upper trapezius muscle is widely used as a measure of shoulder-neck load in ergonomic studies. A variety of methods for normalizing EMG amplitude from the upper trapezius (EMGamput) have been presented in the literature. This impedes meta-analyses of, for instance, upper trapezius load in relation to development of shoulder-neck disorders. The review offers a

  7. [160 activities analyzed by the risk of biomechanical overload on the upper limbs in small industry, handicrafts, services and agriculture].

    PubMed

    Caselli, Ugo; Breschi, Chiara; Compagnonil, Raffaella; De Filippo, Laura; Gogliettino, Maria Angela; Guerrera, Elena; Mameli, Marina; Mastrominico, Eleonora; Mochi, Silvia; Sarto, Daniela

    2014-01-01

    We analyzed 160 work activities in the sectors of small industries, handicrafts, services and agriculture to evaluate the risk of biomnechanical overload of the upper limbs with the OCRA Checklist. The aim was to provide a tool available for the risk assessment in activities generally underestimnated for this risk and typical of the Italian production. The information was provided in the form of cards containing easily accessible data, risk scenarios in different timing, along with some of the key prevention interventions that can be realized. PMID:25558731

  8. Reversible changes of motor cortical outputs following immobilization of the upper limb

    Microsoft Academic Search

    Giampietro Zanette; Michele Tinazzi; Claudio Bonato; Alfonsina di Summa; Paolo Manganotti; Alberto Polo; Antonio Fiaschi

    1997-01-01

    We mapped the cortical representations of the abductor pollicis brevis, flexor carpi radialis, biceps and deltoid muscles in six subjects with unilateral wrist fractures, immediately after the removal of the splint. This was repeated 1 month later in three out of the six subjects. Duration of immobilization was 1 month. Muscle maps were obtained by delivering four focal magnetic pulses

  9. Segmental Impedance Thresholds for Early Detection of Unilateral Upper Limb Swelling.

    PubMed

    Svensson, B J; Dylke, E S; Ward, L C; Kilbreath, S L

    2014-05-16

    Abstract Background: Detection of early lymphedema is important for effective treatment outcome and reduction of disease burden. The aims of this study were to determine normal inter-limb variance in the hand and four segments of the arm using bioimpedance spectroscopy (BIS) to provide diagnostic thresholds for detection of early lymphedema development, to determine the intra-rater reliability of these measurements, and to compare the inter-limb BIS ratios to differences based on arm circumference measures. Methods and results: One hundred women, aged 49.1 (SD 13.8) years without history of breast cancer or lymphedema participated. Impedance measures for the hand and four 10?cm length arm segments were used to determine the inter-limb segment BIS ratios. Circumference difference and segment volumes were calculated from circumference measures obtained with a tape measure. A subgroup of women was measured on two occasions, one week apart. Thresholds were determined for the dominant and nondominant limb, based on two and three standard deviations (SD) above the mean. The 2SD and 3SD thresholds for the dominant arm ranged from 1.121 to 1.150 and 1.172 to 1.209, respectively, and for the nondominant limb ranged from 1.057 to 1.107 and 1.103 to 1.169, respectively. Intra-rater reliability was high (ICC: 0.945-0.983). BIS ratio and circumference-based measures did not identify the same segments as being over threshold. Conclusions: BIS diagnostic thresholds for the hand and four segments of the arm, based on normative data, taking into consideration arm dominance have been developed. Segmental BIS has been shown to be highly reliable. PMID:24837521

  10. bioLights: Light emitting wear for visualizing lower-limb muscle activity

    Microsoft Academic Search

    Naoto Igarashi; Kenji Suzuki; Hiroaki Kawamoto; Yoshiyuki Sankai

    2010-01-01

    Analysis of muscle activity by electrophysiological techniques is commonly used to analyze biomechanics. Although the simultaneous and intuitive understanding of both muscle activity and body motion is important in various fields, it is difficult to realize. This paper proposes a novel technique for visualizing physiological signals related to muscle activity by means of surface electromyography. We developed a wearable light-emitting

  11. Muscle precursor cells in the developing limbs of two isopods (Crustacea, Peracarida): an immunohistochemical study using a novel monoclonal antibody against myosin heavy chain.

    PubMed

    Kreissl, S; Uber, A; Harzsch, S

    2008-05-01

    In the hot debate on arthropod relationships, Crustaceans and the morphology of their appendages play a pivotal role. To gain new insights into how arthropod appendages evolved, developmental biologists recently have begun to examine the expression and function of Drosophila appendage genes in Crustaceans. However, cellular aspects of Crustacean limb development such as myogenesis are poorly understood in Crustaceans so that the interpretative context in which to analyse gene functions is still fragmentary. The goal of the present project was to analyse muscle development in Crustacean appendages, and to that end, monoclonal antibodies against arthropod muscle proteins were generated. One of these antibodies recognises certain isoforms of myosin heavy chain and strongly binds to muscle precursor cells in malacostracan Crustacea. We used this antibody to study myogenesis in two isopods, Porcellio scaber and Idotea balthica (Crustacea, Malacostraca, Peracarida), by immunohistochemistry. In these animals, muscles in the limbs originate from single muscle precursor cells, which subsequently grow to form multinucleated muscle precursors. The pattern of primordial muscles in the thoracic limbs was mapped, and results compared to muscle development in other Crustaceans and in insects. PMID:18443823

  12. Muscle precursor cells in the developing limbs of two isopods (Crustacea, Peracarida): an immunohistochemical study using a novel monoclonal antibody against myosin heavy chain

    PubMed Central

    Kreissl, S.; Uber, A.

    2008-01-01

    In the hot debate on arthropod relationships, Crustaceans and the morphology of their appendages play a pivotal role. To gain new insights into how arthropod appendages evolved, developmental biologists recently have begun to examine the expression and function of Drosophila appendage genes in Crustaceans. However, cellular aspects of Crustacean limb development such as myogenesis are poorly understood in Crustaceans so that the interpretative context in which to analyse gene functions is still fragmentary. The goal of the present project was to analyse muscle development in Crustacean appendages, and to that end, monoclonal antibodies against arthropod muscle proteins were generated. One of these antibodies recognises certain isoforms of myosin heavy chain and strongly binds to muscle precursor cells in malacostracan Crustacea. We used this antibody to study myogenesis in two isopods, Porcellio scaber and Idotea balthica (Crustacea, Malacostraca, Peracarida), by immunohistochemistry. In these animals, muscles in the limbs originate from single muscle precursor cells, which subsequently grow to form multinucleated muscle precursors. The pattern of primordial muscles in the thoracic limbs was mapped, and results compared to muscle development in other Crustaceans and in insects. Electronic supplementary material The online version of this article (doi:10.1007/s00427-008-0216-1) contains supplementary material, which is available to authorized users. PMID:18443823

  13. Proposal of Method for Control of Muscle Activation Level for Limbs during Motion and Application of this Method in Strength Training

    NASA Astrophysics Data System (ADS)

    Komada, Satoshi; Murakami, Yosuke; Hirai, Junji

    With an increase in the number of elderly people in our society, the need for equipments that ensure activities of daily living and that can be used in strength training for reducing the need for nursing care is increasing. In this paper, we propose a method for controlling the level of muscle activation for a particular muscle group without EMG sensors; the force exerted by the tips of the limbs during motion is used to control the level of muscle activation. The method is based on a musculoskeletal model for limbs called functionally different effective muscles of three antagonistic pairs of six muscles in 2D space. Hill's equation is incorporated in the method to consider force-velocity characteristics of muscles. EMG measurement results for two muscles under isokinetic contraction in the lower limbs of a subject show that difference between the achieved activation level and the desired activation level is less than the error of the output force distribution. Moreover, the control method is applied to strength training. A manipulator that can facilitate the isokinetic contraction with more than the desired activation level for a specific muscle group is developed.

  14. Correlations in between EAWS and OCRA Index concerning the repetitive loads of the upper limbs in automobile manufacturing industries.

    PubMed

    Lavatelli, Ivan; Schaub, Karlheinz; Caragnano, Gabriele

    2012-01-01

    Upper limbs repetitive tasks are one of the main sources of risk for the workers of the manufacturing industries and the standards ISO 11228-3 and EN 1005-5 addressed this issue since 2007. EAWS (European Assembly Worksheet) is a 1st level ergonomic risk assessment method and it provides in its 4th section a score to measure the load level for the upper limbs based on a traffic light scheme. According to the relevant ISO/CEN standards, the OCRA Index is the preferred system to refer to in the evaluation of the biomechanical stress of hand-harm-shoulder system. This correlation study is based on a 45 workstations sample coming from the automobile manufacturing industry. According to the results, EAWS4 shows an excellent correlation with OCRA index (Spearman's rho correlation index 0.95). Being EAWS based on biometric statistical data distribution, its typical application is the process design phase, but adopting a conservative approach in the interpretation of EAWS4 score for risk mapping purposes, it provides an equivalent "reaction" pattern (countermeasures to be taken in the production phase) with respect of OCRA Index with an Odds Ratio ranging from 0.89 (OR-matched) to 1.00 (OR-conservative). PMID:22317403

  15. Computational models of upper-limb motion during functional reaching tasks for application in FES-based stroke rehabilitation.

    PubMed

    Freeman, Chris; Exell, Tim; Meadmore, Katie; Hallewell, Emma; Hughes, Ann-Marie

    2015-06-01

    Functional electrical stimulation (FES) has been shown to be an effective approach to upper-limb stroke rehabilitation, where it is used to assist arm and shoulder motion. Model-based FES controllers have recently confirmed significant potential to improve accuracy of functional reaching tasks, but they typically require a reference trajectory to track. Few upper-limb FES control schemes embed a computational model of the task; however, this is critical to ensure the controller reinforces the intended movement with high accuracy. This paper derives computational motor control models of functional tasks that can be directly embedded in real-time FES control schemes, removing the need for a predefined reference trajectory. Dynamic models of the electrically stimulated arm are first derived, and constrained optimisation problems are formulated to encapsulate common activities of daily living. These are solved using iterative algorithms, and results are compared with kinematic data from 12 subjects and found to fit closely (mean fitting between 63.2% and 84.0%). The optimisation is performed iteratively using kinematic variables and hence can be transformed into an iterative learning control algorithm by replacing simulation signals with experimental data. The approach is therefore capable of controlling FES in real time to assist tasks in a manner corresponding to unimpaired natural movement. By ensuring that assistance is aligned with voluntary intention, the controller hence maximises the potential effectiveness of future stroke rehabilitation trials. PMID:25355246

  16. The neural correlates of upper limb motor blocks in Parkinson's disease and their relation to freezing of gait.

    PubMed

    Vercruysse, S; Spildooren, J; Heremans, E; Wenderoth, N; Swinnen, S P; Vandenberghe, W; Nieuwboer, A

    2014-12-01

    Due to basal ganglia dysfunction, bimanual motor performance in Parkinson patients reportedly relies on compensatory brain activation in premotor-parietal-cerebellar circuitries. A subgroup of Parkinson's disease (PD) patients with freezing of gait (FOG) may exhibit greater bimanual impairments up to the point that motor blocks occur. This study investigated the neural mechanisms of upper limb motor blocks and explored their relation with FOG. Brain activation was measured using functional magnetic resonance imaging during bilateral finger movements in 16 PD with FOG, 16 without FOG (PD + FOG and PD - FOG), and 16 controls. During successful movement, PD + FOG showed decreased activation in right dorsolateral prefrontal cortex (PFC), left dorsal premotor cortex (PMd), as well as left M1 and bilaterally increased activation in dorsal putamen, pallidum, as well as subthalamic nucleus compared with PD - FOG and controls. On the contrary, upper limb motor blocks were associated with increased activation in right M1, PMd, supplementary motor area, and left PFC compared with successful movement, whereas bilateral pallidum and putamen activity was decreased. Complex striatofrontal activation changes may be involved in the difficulties of PD + FOG to perform bimanual movements, or sequential movements in general. These novel results suggest that, whatever the exact underlying cause, PD + FOG seem to have reached a saturation point of normal neural compensation and respond belatedly to actual movement breakdown. PMID:23861319

  17. [Denervation of mimic muscles during endoscopic lifting of the upper part of face].

    PubMed

    Pinchuk, V D; Tkach, O S

    2013-08-01

    Endoscopic lifting of the upper part of face carry out in 28 patients Chemical or surgical denervation had been done for decreasing of mimic muscles activity. Medical glue with folic acid had been used for tissues fixation. Use of medical glue in conjunction with preliminary chemical denervation of mimic muscles with botulin toxin application decreases surgery duration, prevents complications and increases satisfaction of patients. PMID:24171296

  18. Shared reflex pathways of group I afferents of different cat hind-limb muscles.

    PubMed Central

    Harrison, P J; Jankowska, E; Johannisson, T

    1983-01-01

    The convergence of group I muscle afferents of different muscle origin onto interneurones in spinal reflex pathways has been investigated using the technique of spatial facilitation of the transmission from afferents to motoneurones. The investigated pathways are those of non-reciprocal inhibition and of oligosynaptic excitation of motoneurones. Extensive convergence has been found of group I afferents from muscles operating at the same and different joints onto the interneurones interposed in both excitatory and inhibitory, disynaptic and trisynaptic pathways to motoneurones. Convergence has been found between muscle spindle Ia and/or tendon organ Ib afferents from different muscles, thereby extending observations on convergence of these subgroups of group I afferents from the same muscles. The results show that group I afferents of different muscles influence motoneurones via shared neuronal pathways and that transmission from these afferents is influenced by afferents originating in other muscles. The afferent information forwarded to individual motoneurones is therefore the ensemble picture of the length and tension of many muscles. PMID:6308242

  19. Anatomical and biomechanical traits of broiler chickens across ontogeny. Part II. Body segment inertial properties and muscle architecture of the pelvic limb

    PubMed Central

    Tickle, Peter G.; Rankin, Jeffery W.; Codd, Jonathan R.; Hutchinson, John R.

    2014-01-01

    In broiler chickens, genetic success for desired production traits is often shadowed by welfare concerns related to musculoskeletal health. Whilst these concerns are clear, a viable solution is still elusive. Part of the solution lies in knowing how anatomical changes in afflicted body systems that occur across ontogeny influence standing and moving. Here, to demonstrate these changes we quantify the segment inertial properties of the whole body, trunk (legs removed) and the right pelvic limb segments of five broilers at three different age groups across development. We also consider how muscle architecture (mass, fascicle length and other properties related to mechanics) changes for selected muscles of the pelvic limb. All broilers used had no observed lameness, but we document the limb pathologies identified post mortem, since these two factors do not always correlate, as shown here. The most common leg disorders, including bacterial chondronecrosis with osteomyelitis and rotational and angular deformities of the lower limb, were observed in chickens at all developmental stages. Whole limb morphology is not uniform relative to body size, with broilers obtaining large thighs and feet between four and six weeks of age. This implies that the energetic cost of swinging the limbs is markedly increased across this growth period, perhaps contributing to reduced activity levels. Hindlimb bone length does not change during this period, which may be advantageous for increased stability despite the increased energetic costs. Increased pectoral muscle growth appears to move the centre of mass cranio-dorsally in the last two weeks of growth. This has direct consequences for locomotion (potentially greater limb muscle stresses during standing and moving). Our study is the first to measure these changes in the musculoskeletal system across growth in chickens, and reveals how artificially selected changes of the morphology of the pectoral apparatus may cause deficits in locomotion. PMID:25071996

  20. Children’s daily living activities during immobilization of upper-limb fractures with an above- or below-elbow cast

    Microsoft Academic Search

    Barak Aviv; Elhanan Bar-On; Daniel Weigl; Tal Becker; Kalman Katz

    2008-01-01

    Background  The purpose of this prospective study was to assess the impact of cast immobilization on the activities of daily living in\\u000a children with fractured upper limbs.\\u000a \\u000a \\u000a \\u000a Methods  Using the Activities Scale for Kids (ASK), 52 consecutive children (17 girls, 35 boys), aged 5–15 years (mean, 9 years), with\\u000a upper limb fractures treated by means of above- or below-elbow casts were assessed. The files

  1. Control of support limb muscles in recovery after tripping in young and older subjects

    Microsoft Academic Search

    Mirjam Pijnappels; Maarten F. Bobbert; Jaap H. van Dieën

    2005-01-01

    Older people fall more often after tripping than young people due to a slower development of mechanical responses. This might be due to age-related changes in muscle properties, but also to changes in motor control. The purpose of the present study was to determine whether (a) timing and sequencing of muscle activation and (b) the magnitude and rate of development

  2. The Relationship Between Lower Limb Bone and Muscle in Military Recruits, Response to Physical Training, and Influence of Smoking Status

    PubMed Central

    Puthucheary, Zudin; Kordi, Mehdi; Rawal, Jai; Eleftheriou, Kyriacos I.; Payne, John; Montgomery, Hugh E.

    2015-01-01

    The relationship between bone and skeletal muscle mass may be affected by physical training. No studies have prospectively examined the bone and skeletal muscle responses to a short controlled exercise-training programme. We hypothesised that a short exercise-training period would affect muscle and bone mass together. Methods: Femoral bone and Rectus femoris Volumes (RFVOL) were determined by magnetic resonance imaging in 215 healthy army recruits, and bone mineral density (BMD) by Dual X-Ray Absorptiometry (DXA) and repeated after 12 weeks of regulated physical training. Results: Pre-training, RFVOL was smaller in smokers than non-smokers (100.9 ± 20.2 vs. 108.7 ± 24.5, p = 0.018; 96.2 ± 16.9 vs. 104.8 ± 21.3, p = 0.002 for dominant/non-dominant limbs), although increases in RFVOL with training (of 14.2 ± 14.5% and 13.2 ± 15.6%] respectively, p < 0.001) were independent of prior smoking status. Pre-training RFVOL was related to bone cortical volume (r2 = 0.21 and 0.30, p < 0.001 for dominant and non-dominant legs), and specifically to periosteal (r2 = 0.21 and 0.23, p < 0.001) volume. Pre-training dominant RFVOL was independently associated with Total Hip BMD (p < 0.001). Training-related increases in RFVOL and bone volumes were related. Whilst smokers demonstrated lower muscle mass than non-smokers, differences were abolished with training. Training-related increases in muscle mass were related to increases in periosteal bone volume in both dominant and non-dominant legs. PMID:25792356

  3. Influence of muscle preactivation of the lower limb on impact dynamics in case of frontal collision

    Microsoft Academic Search

    Martine Pithioux; Pascale Chavet; Nancy St-Onge; Caroline Nicol

    2005-01-01

    Accidentology or shock biomechanics are research domains mainly devoted to the development of safety conditions for the users of various transport modes in case of an accident. The objective of this study was to improve the knowledge of the biomechanical behaviour of the lower limb facing sudden dynamic loading during a frontal collision. We aimed at establishing the relationship between

  4. THE EFFECT OF MAGNESIUM SULPHATE ON THE BLOOD VESSELS OF THE UPPER LIMB IN MAN

    Microsoft Academic Search

    DB Frewin; YF Teh; RF Whelan

    1971-01-01

    Magnesium sulphate, given into the brachial artery, has been shown to have a dilator action on the blood vessels of the human forearm.The dilatation affects the vessels of both skin and muscle and is not due to stimulation of the ?-receptors to a cholinergic mechanism or to the release of histamine.The vasodilator action of magnesium sulphate on the forearm does

  5. A New Calibration Methodology for Thorax and Upper Limbs Motion Capture in Children Using Magneto and Inertial Sensors

    PubMed Central

    Ricci, Luca; Formica, Domenico; Sparaci, Laura; Lasorsa, Francesca Romana; Taffoni, Fabrizio; Tamilia, Eleonora; Guglielmelli, Eugenio

    2014-01-01

    Recent advances in wearable sensor technologies for motion capture have produced devices, mainly based on magneto and inertial measurement units (M-IMU), that are now suitable for out-of-the-lab use with children. In fact, the reduced size, weight and the wireless connectivity meet the requirement of minimum obtrusivity and give scientists the possibility to analyze children's motion in daily life contexts. Typical use of magneto and inertial measurement units (M-IMU) motion capture systems is based on attaching a sensing unit to each body segment of interest. The correct use of this setup requires a specific calibration methodology that allows mapping measurements from the sensors' frames of reference into useful kinematic information in the human limbs' frames of reference. The present work addresses this specific issue, presenting a calibration protocol to capture the kinematics of the upper limbs and thorax in typically developing (TD) children. The proposed method allows the construction, on each body segment, of a meaningful system of coordinates that are representative of real physiological motions and that are referred to as functional frames (FFs). We will also present a novel cost function for the Levenberg–Marquardt algorithm, to retrieve the rotation matrices between each sensor frame (SF) and the corresponding FF. Reported results on a group of 40 children suggest that the method is repeatable and reliable, opening the way to the extensive use of this technology for out-of-the-lab motion capture in children. PMID:24412901

  6. Determination of the chronaxie and rheobase of denervated limb muscles in conscious rabbits.

    PubMed

    Ashley, Zoe; Sutherland, Hazel; Lanmuller, Hermann; Unger, Ewald; Li, Feng; Mayr, Winfried; Kern, Helmut; Jarvis, Jonathan C; Salmons, Stanley

    2005-03-01

    Measurements of the rheobase and chronaxie can be used to define the excitability of nerves and muscles. The aim of this study was to obtain a record over many weeks of changes in the rheobase and chronaxie of denervated rabbit tibialis anterior muscle (TA). A custom-built electronic stimulator was implanted into the peritoneal cavity of New Zealand White rabbits. Large stainless steel electrodes were placed on the denervated TA muscle. Rheobase and chronaxie were measured noninvasively at weekly intervals by means of a laptop PC, which communicated with the stimulator via a radio-frequency link. At each setting the denervated TA was palpated manually to detect the response of the muscle. During the first few days after denervation the rheobase increased transiently to 0.8 +/- 0.13 mA, approximately twice the value for normal innervated muscle, then decreased to normal for the remainder of the experimental period. Chronaxie underwent a significant 3-fold increase from 4.5 +/- 1.1 ms to 14.1 +/- 1.1 ms during the first two weeks of denervation and remained elevated throughout. The custom-built implantable electronic stimulator allowed changes in muscle excitability to be studied over a long period of denervation within individual animals, providing an accurate assessment of the time course of denervation-induced changes in muscle excitability. PMID:15725219

  7. A case of monomelic amyotrophy of the upper limb: MRI findings and the implication on its pathogenesis.

    PubMed

    Li, Yuebing; Remmel, Krista

    2012-06-01

    Monomelic amyotrophy of the upper limb or Hirayama disease is mostly considered as an anterior horn disorder resulting from local ischemia, triggered by arterial compression from an anterior shifting of the posterior cervical dura upon neck flexion. However, such a dural shifting is not universally seen. We report on a Caucasian male patient who developed a slowly progressive unilateral distal hand weakness in his teens. His clinical and electromyographic findings were consistent with Hirayama disease. Local anterior cervical cord atrophy was observed without dural shifting on the dynamic magnetic resonance imaging. Axial magnetic resonance imaging demonstrated signal changes of "snake-eye" appearance in the cervical anterior horn region, similar to ischemic myelopathies caused by various etiologies. This case illustrated that even without dural shifting, a mechanism of anterior spinal cord ischemia could still be responsible for the pathogenesis of Hirayama disease. PMID:22622169

  8. Histological Indications of a Progressive Snorers Disease in an Upper Airway Muscle

    Microsoft Academic Search

    DANIELLE FRIBERG; TOR ANSVED; KRISTIAN BORG; BRITT CARLSSON-NORDLANDER; HÅKAN LARSSON; EVA SVANBORG

    1998-01-01

    The etiology of upper airway collapsibility in patients with snoring and obstructive sleep apnea (OSA) remains unclear. Local muscular abnormalities, including neurogenic lesions, could be a contributory factor. The aim of this study was to histologically evaluate the hypothesis of a progressive snorers dis- ease. Biopsies of palatopharyngeal muscle were obtained from 21 patients with habitual snoring and different degrees

  9. Analysis of the forearm rotational efficiency in extant hominoids: new insights into the functional implications of upper limb skeletal structure.

    PubMed

    Ibáñez-Gimeno, Pere; Galtés, Ignasi; Manyosa, Joan; Malgosa, Assumpció; Jordana, Xavier

    2014-11-01

    The greatly diversified locomotor behaviors in the Hominoidea impose different mechanical requirements in the upper limb of each species. As forearm rotation has a major role in locomotion, the skeletal structures involved in this movement may display differences among taxa that reflect functional adaptations. To test this, we use a biomechanical model that quantifies the rotatory capacity of pronator teres (rotational efficiency) from skeletal measurements. Using a large sample of hominoids, we aim to identify the morphological adaptations that confer differences in the mechanics of forearm motion and to assess the functional advantage of these adaptations. Forearm positions along the pronation-supination range where rotational efficiency is maximal depend on the orientation of the humeral medial epicondyle and differ among taxa. Our results indicate that these are related to locomotor mode. Knuckle-walkers exhibit a medial epicondyle more posteriorly directed, which, in elbow angles close to extension, causes rotational efficiency to be maximal in pronated positions of the forearm. Species with a significant amount of arboreal locomotion, such as vertical climbing, i.e., Pongo spp., Pan troglodytes and Gorilla gorilla, display more proximally oriented epicondyles, which, in elbow flexion, leads to maximum rotational efficiencies in supinated positions of the forearm. Hylobatidae, with the less posteriorly and proximally oriented epicondyle, show their maximum rotational efficiencies closer to the forearm neutral position throughout most of the flexion-extension range, which may be linked to brachiation in this taxon. In humans, the epicondylar orientation and thus the positions of the maximum rotational efficiencies fall between arboreal and terrestrial hominoids. This may be related to the enhanced manipulative skills of the upper limb. In conclusion, the current analysis indicates that the orientation of the humeral medial epicondyle is linked to the locomotor habits of extant hominoids and therefore can be used for locomotor inferences in fossil taxa. PMID:25277440

  10. Kinematic data analysis for post-stroke patients following bilateral versus unilateral rehabilitation with an upper limb wearable robotic system.

    PubMed

    Kim, Hyunchul; Miller, Levi Makaio; Fedulow, Irina; Simkins, Matt; Abrams, Gary M; Byl, Nancy; Rosen, Jacob

    2013-03-01

    Robot-assisted stroke rehabilitation has become popular as one approach to helping patients recover function post-stroke. Robotic rehabilitation requires four important elements to match the robot to the patient: realistic biomechanical robotic elements, an assistive control scheme enabled through the human-robot interface, a task oriented rehabilitation program based on the principles of plasticity, and objective assessment tools to monitor change. This paper reports on a randomized clinical trial utilizing a complete robot-assisted rehabilitation system for the recovery of upper limb function in patients post-stroke. In this study, a seven degree-of-freedom (DOF) upper limb exoskeleton robot (UL-EXO7) is applied in a rehabilitation clinical trial for patients stable post-stroke (greater than six months). Patients had a Fugl-Meyer Score between 16-39, were mentally alert (> 19 on the VA Mini Mental Status Exam) and were between 27 and 70 years of age. Patients were randomly assigned to three groups: bilateral robotic training, unilateral robotic training, and usual care. This study is concerned with the changes in kinematics in the two robotic groups. Both patient groups played eight therapeutic video games over 12 sessions (90 min, two times a week). In each session, patients intensively played the different combination of video games that directly interacted with UL-EXO7 under the supervision of research assistant. At each session, all of the joint angle data was recorded for the evaluation of therapeutic effects. A new assessment metric is reported along with conventional metrics. The experimental result shows that both groups of patients showed consistent improvement with respect to the proposed and conventional metrics. PMID:22855233

  11. Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review

    PubMed Central

    2014-01-01

    Robot-mediated post-stroke therapy for the upper-extremity dates back to the 1990s. Since then, a number of robotic devices have become commercially available. There is clear evidence that robotic interventions improve upper limb motor scores and strength, but these improvements are often not transferred to performance of activities of daily living. We wish to better understand why. Our systematic review of 74 papers focuses on the targeted stage of recovery, the part of the limb trained, the different modalities used, and the effectiveness of each. The review shows that most of the studies so far focus on training of the proximal arm for chronic stroke patients. About the training modalities, studies typically refer to active, active-assisted and passive interaction. Robot-therapy in active assisted mode was associated with consistent improvements in arm function. More specifically, the use of HRI features stressing active contribution by the patient, such as EMG-modulated forces or a pushing force in combination with spring-damper guidance, may be beneficial. Our work also highlights that current literature frequently lacks information regarding the mechanism about the physical human-robot interaction (HRI). It is often unclear how the different modalities are implemented by different research groups (using different robots and platforms). In order to have a better and more reliable evidence of usefulness for these technologies, it is recommended that the HRI is better described and documented so that work of various teams can be considered in the same group and categories, allowing to infer for more suitable approaches. We propose a framework for categorisation of HRI modalities and features that will allow comparing their therapeutic benefits. PMID:25012864

  12. Self-Perceived Utilization of the Paretic Arm in Chronic Stroke Requires High Upper Limb Functional Ability

    PubMed Central

    Fleming, Melanie K.; Newham, Di J.; Roberts-Lewis, Sarah F.; Sorinola, Isaac O.

    2014-01-01

    Objective To explore potential predictors of self-reported paretic arm use at baseline and after task-specific training (TST) in survivors of stroke. Design Data were obtained from a randomized controlled trial of somatosensory stimulation and upper limb TST in chronic stroke. Setting University laboratory. Participants Chronic (?3mo) survivors of stroke (N=33; mean age, 62y; mean stroke duration, 38mo). Interventions Participants received 12 sessions of TST preceded by either active (n=16) or sham (n=17) somatosensory stimulation to all 3 peripheral nerves. Main Outcome Measures Demographic and clinical characteristics were entered stepwise into multiple linear regression analyses to determine the factors that best predict baseline Motor Activity Log (MAL) amount of use rating and change 3 months after TST. Results The Action Research Arm Test (ARAT) score predicted the amount of use at baseline (R2=.47, P<.001); in using this model, an ARAT score of 54 (maximum of 57) is required to score 2.5 on the MAL (use described as between rarely and sometimes). After TST the change in the ARAT score predicted the change in the amount of use (R2=.31, P=.001). The predictive power of the model for change at 3 months increased if the Fugl-Meyer Assessment wrist component score was added (R2=.41, P=.001). Conclusions Utilization of the paretic upper limb in activities of daily living requires high functional ability. The increase in self-reported arm use after TST is dependent on the change in functional ability. These results provide further guidance for rehabilitation decisions. PMID:24480335

  13. 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

  14. Evaluation by lymphoscintigraphy of the effect of a micronized flavonoid fraction (Daflon 500 mg) in the treatment of upper limb lymphedema.

    PubMed

    Pecking, A P

    1995-09-01

    Upper limb lymphedema after conventional treatment of breast cancer occurs in about 20% of all treated cases, even after conservative therapy. Women with mild to severe upper limb lymphedema expect a decongestive therapy, which usually associates physiotherapy and medical treatment. Upper limb lymphoscintigraphy using rhenium colloids labelled with technetium 99m can be used as a lymphatic functional test in order to evaluate the efficacy of a therapy. We report here the results of a pilot, open study carried out on 10 female patients, age ranging from 44 to 64 years, previously treated for a breast cancer. The average time delay for the occurrence [correction of occurence] of lymphedema was 17 +/- 7 months. All patients received 500 mg twice daily of a micronized flavonoid fraction (Daflon 500 mg) for 6 months. At the end of the study, all patients had a clinical improvement of symptoms and limb volume and the mean decrease in volume of the swollen limb reached 6.80%. Functional parameters (half-life, clearance and lymphatic speed of the colloid) assessed with scintigraphy were significantly improved. These preliminary results suggest that this therapy is effective for the treatment of lymphedemas. PMID:8919264

  15. Temporal disruption of upper-limb anticipatory postural adjustments in cerebellar ataxic patients.

    PubMed

    Bruttini, Carlo; Esposti, Roberto; Bolzoni, Francesco; Vanotti, Alessandra; Mariotti, Caterina; Cavallari, Paolo

    2015-01-01

    Voluntary movements induce postural perturbations, which are counteracted by anticipatory postural adjustments (APAs) that preserve body equilibrium. Little is known about the neural structures generating APAs, but several studies suggested a role of sensory-motor areas, basal ganglia, supplementary motor area and thalamus. However, the role of the cerebellum still remains an open question. The aim of this present paper is to shed further light on the role of cerebellum in APAs organization. Thus, APAs that stabilize the arm when the index finger is briskly flexed were recorded in 13 ataxic subjects (seven sporadic cases, four dominant ataxia type III and two autosomal recessive), presenting a slowly progressive cerebellar syndrome with four-limb dysmetria, and compared with those obtained in 13 healthy subjects. The pattern of postural activity was similar in the two groups [excitation in triceps and inhibition in biceps and anterior deltoid (AD)], but apparent modifications in timing were observed in all ataxic subjects in which, on average, triceps brachii excitation lagged the onset of the prime mover flexor digitorum superficialis by about 27 ms and biceps and AD inhibition were almost synchronous to it. Instead, in normal subjects, triceps onset was synchronous to the prime mover and biceps and AD anticipated it by about 40 ms. The observed disruption of the intra-limb APA organization confirms that the cerebellum is involved in APA control and, considering cerebellar subjects as a model of dysmetria, also supports the view that a proper APA chain may play a crucial role in refining movement metria. PMID:25245658

  16. EVALUATION OF THE GO METHOD WITHIN THE UPPER LIMB KINEMATICS ANALYSIS

    E-print Network

    Paris-Sud XI, Université de

    analysis thanks to simulated movements and artefacts. METHODS Model The upper part of the human body in "Journal of Biomechanics 35, 9 (2002) 1279-83" #12;INTRODUCTION Kinematics measurement techniques attached to a body segment (Chèze, et al., 1995; Soderkvist and Wedin, 1993; Spoor and Veldpaus, 1980

  17. Results from the Upper Limb International Spasticity Study-II (ULIS-II): a large, international, prospective cohort study investigating practice and goal attainment following treatment with botulinum toxin A in real-life clinical management

    PubMed Central

    Turner-Stokes, Lynne; Fheodoroff, Klemens; Jacinto, Jorge; Maisonobe, Pascal

    2013-01-01

    Objective To describe real-life practice and person-centred outcomes in the treatment of poststroke upper limb spasticity with botulinum toxin A (BoNT-A). Design Observational, prospective study. Setting 84 secondary care centres in 22 countries. Participants 456 adults (?18?years) with poststroke upper limb spasticity treated with one cycle of BoNT-A. Methods/outcomes Muscle selection, BoNT-A preparation, injection technique and timing of follow-up were conducted according to routine practice for each centre. Primary outcome: achievement of the patient's primary goal for treatment using goal-attainment scaling (GAS). Measurements of spasticity, standardised outcome measures and global benefits were also recorded. Results The median number of injected muscles was 5 (range 1–15) and the most frequently injected muscles were the long finger flexors, followed by biceps and brachioradialis. The median (range) follow-up time was 14 (2.6 to 32.3) weeks. The common primary treatment goals were passive function (132 (28.9%)), active function (104 (22.8%)), pain (61 (13.4%)), impairment (105 (23%)), involuntary movement (41 (9%)) and mobility (10 (2.2%)). Overall, 363 (79.6%) (95% CI 75.6% to 83.2%) patients achieved (or overachieved) their primary goal and 355 (75.4%) (95% CI 71.2% to 79.2%) achieved their secondary goal. Mean (SD) change from baseline in GAS T-scores was 17.6 (11.0) (95% CI 16.4 to 18.8; p<0.001). GAS T-scores were strongly correlated with global benefit and other standard measures (correlations of 0.38 and 0.63, respectively; p<0.001). Conclusions BoNT-A demonstrated a clinically significant effect on goal attainment for the real-life management of upper-limb spasticity following stroke. The study confirms the feasibility of a common international data set to collect systematic prospective data, and of using GAS to capture person-centred outcomes relating to passive and active functions and to pain. Registration ClinicalTrials.gov identifier: NCT01020500 PMID:23794582

  18. Enhancements in lower stratospheric CH3CN observed by the upper atmosphere research Sattellite Microwave Limb Sounder following boreal forest fires

    NASA Technical Reports Server (NTRS)

    Livesey, N. J.; Fromm, M. D.; Waters, J. W.; Manney, G. L.; Santee, M. L.; Read, W. G.

    2004-01-01

    On 25 August 1992, the Microwave Limb Sounder (MLS) on the Upper Atmosphere Research Satellite observed a significant enhancement in the abundance of lower stratospheric methyl cyanide (CH3CN) at 100??hPa (16??km altitude) in a small region off the east coast of Florida.

  19. The effects of task-oriented versus repetitive bilateral arm training on upper limb function and activities of daily living in stroke patients

    PubMed Central

    Song, Gui Bin

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of task-oriented bilateral arm training and repetitive bilateral arm training on upper limb function and activities of daily living in stroke patients. [Subjects] Forty patients with hemiplegia resulting from stroke were divided into a task orientied bilateral arm training group (n=20) and a repetitive bilateral arm training group (n=20). [Methods] The task-oriented group underwent bilateral arm training with 5 functional tasks, and the repetitive group underwent bilateral arm training with rhythmin auditory cueing for 30 minutes/day, 5 times/week, for 12 weeks. [Results] The upper limb function and the ability to perform activities of daily living improved significantly in both groups. Although there were significant differences between the groups, the task-oriented group showed greater improvement in upper limb function and activities of daily living. [Conclusion] We recommend bilateral arm training as well as adding functional task training as a clinical intervention to improve upper limb function activities of daily living in patients with hemiplegia.

  20. Low-Frequency Repetitive Transcranial Magnetic Stimulation and Intensive Occupational Therapy for Poststroke Patients with Upper Limb Hemiparesis: Preliminary Study of a 15-Day Protocol

    ERIC Educational Resources Information Center

    Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Ishikawa, Atsushi; Ito, Hiroshi; Tominaga, Ayumi

    2010-01-01

    The purpose of the study was to determine the safety and feasibility of a 15-day protocol of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy (OT) on motor function and spasticity in hemiparetic upper limbs in poststroke patients. Fifteen poststroke patients (age at study entry 55 [plus…

  1. Evolution of Charcot-Marie-Tooth disease type 1A duplication: a 2-year clinico-electrophysiological and lower-limb muscle MRI longitudinal study.

    PubMed

    Pelayo-Negro, Ana L; Gallardo, Elena; García, Antonio; Sánchez-Juan, Pascual; Infante, Jon; Berciano, José

    2014-04-01

    The objective of this study was to analyze Charcot-Marie-Tooth disease type 1A (CMT1A) evolution. We conducted a 2-year longitudinal study in 14 CMT1A patients and 14 age- and sex-matched controls. In the patients, we performed neurological examination with hand-held dynamometry, electrophysiology, and lower-limb muscle MRI, both at baseline and 2 years later, while controls were examined at baseline only. Patients' ages ranged from 12 to 51 years. Outstanding manifestations on initial evaluation included pes cavus, areflexia, lower-limb weakness, and foot hypopallesthesia. In evaluating muscle power, good correlation was observed between manual testing and dynamometry. Compared to controls, Lunge, 10-Meter-Walking, and 9-Hole-Peg tests were impaired. Their CMT neuropathy score and functional disability scale showed that patients exhibited mild phenotype and at most slight walking difficulty. Electrophysiology revealed marked nerve conduction slowing and variable compound muscle action potential amplitude reduction. On lower-limb muscle MRI, there was distally accentuated fatty infiltration accompanied by edema in calf muscles. All these clinico-electrophysiological and imaging findings remained almost unaltered during monitoring. Using multivariate analysis, no significant predictors of progression associated to the disease were obtained. We conclude that in the 2-year period of study, CMT1A patients showed mild progression with good concordance between clinico-electrophysiological and imaging findings. PMID:24449066

  2. Evaluation of fatigue of respiratory and lower limb muscles during prolonged aerobic exercise.

    PubMed

    Nadiv, Yaara; Vachbroit, Ricki; Gefen, Amit; Elad, David; Zaretsky, Uri; Moran, Dani; Halpern, Pinchas; Ratnovsky, Anat

    2012-05-01

    The respiratory muscles may fatigue during prolonged exercises and thereby become a factor that limits extreme physical activity. The aim of the current study was to determine whether respiratory muscle fatigue imposes a limitation on extreme physical activity of well-trained young men. Electromyography (EMG) signals of respiratory (external intercostal and sternomastoid) and calf muscles (gastrocnemius) were measured (N = 8) during 1 hr of treadmill marching at a speed of 8 km/hr with and without a 15 kg backpack. The root mean square (RMS) and the mean power frequency of the EMG signals were evaluated for calculating fatigue indices. The EMG RMS revealed that the respiratory and calf muscles did not fatigue during the marching without a backpack load. The study did show, however, a significant rise in the EMG values when a backpack was carried with respect to the no-load condition (p < .05), which suggests that respiratory muscles should be trained in military recruits who are required to carry loaded backpacks while marching. PMID:22723112

  3. 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

  4. The 4-Day Wave as Observed from the Upper Atmosphere Research Satellite Microwave Limb Sounder.

    NASA Astrophysics Data System (ADS)

    Allen, D. R.; Stanford, J. L.; Elson, L. S.; Fishbein, E. F.; Froidevaux, L.; Waters, J. W.

    1997-02-01

    The `4-day wave' is an eastward moving quasi-nondispersive feature with period near 4 days occurring near the winter polar stratopause. This paper presents evidence of the 4-day feature in Microwave Limb Sounder (MLS) temperature, geopotential height, and ozone data from the late southern winters of 1992 and 1993. Space-time spectral analyses reveal a double-peaked temperature structure consisting of one peak near the stratopause and another in the lower mesosphere, with an out-of-phase relationship between the two peaks. This double-peaked structure is reminiscent of recent three-dimensional barotropic/baroclinic instability model predictions and is observed here for the first time. The height variation of the 4-day ozone signal is shown to compare well with a linear advective-photochemical tracer model. Negative regions of quasigeostrophic potential vorticity (PV) gradient and positive Eliassen-Palm flux divergence are shown to occur, consistent with instability dynamics playing a role in wave forcing. Spectral analyses of PV derived from MLS geopotential height fields reveal a 4-day signal peaking near the polar stratopause. The three-dimensional structure of the 4-day wave resembles the potential vorticity `charge' concept, wherein a PV anomaly in the atmosphere (analogous to an electrical charge in a dielectric material) induces a geopotential field, a vertically oriented temperature dipole, and circulation about the vertical axis.

  5. EMGD-FE: an open source graphical user interface for estimating isometric muscle forces in the lower limb using an EMG-driven model

    PubMed Central

    2014-01-01

    Background This paper describes the “EMG Driven Force Estimator (EMGD-FE)”, a Matlab® graphical user interface (GUI) application that estimates skeletal muscle forces from electromyography (EMG) signals. Muscle forces are obtained by numerically integrating a system of ordinary differential equations (ODEs) that simulates Hill-type muscle dynamics and that utilises EMG signals as input. In the current version, the GUI can estimate the forces of lower limb muscles executing isometric contractions. Muscles from other parts of the body can be tested as well, although no default values for model parameters are provided. To achieve accurate evaluations, EMG collection is performed simultaneously with torque measurement from a dynamometer. The computer application guides the user, step-by-step, to pre-process the raw EMG signals, create inputs for the muscle model, numerically integrate the ODEs and analyse the results. Results An example of the application’s functions is presented using the quadriceps femoris muscle. Individual muscle force estimations for the four components as well the knee isometric torque are shown. Conclusions The proposed GUI can estimate individual muscle forces from EMG signals of skeletal muscles. The estimation accuracy depends on several factors, including signal collection and modelling hypothesis issues. PMID:24708668

  6. Congenital Epidermoid Cyst Results in Muscle Fusion Defect in the Upper Lip

    PubMed Central

    Dogan, Fatih; Bucak, Ibrahim Hakan

    2014-01-01

    Epidermoid cysts are rarely detected malformations in the oral cavity. Their development sites are the sublingual, submaxillary, and submandibular spaces. In this paper, we report a three-month-old infant who was admitted to our hospital due upper lip swelling. Magnetic resonance imaging showed that she had a two-centimeter cystic lesion and fusion defects of orbicularis oris muscle. The cyst was surgically removed and histopathological diagnosis was “epidermoid cyst.” In recent literature, we could not find reports related to orbicularis oris muscle fusion defects because of epidermoid cyst. PMID:25628908

  7. Upper limb international spasticity study: rationale and protocol for a large, international, multicentre prospective cohort study investigating management and goal attainment following treatment with botulinum toxin A in real-life clinical practice

    PubMed Central

    Turner-Stokes, Lynne; Fheodoroff, Klemens; Jacinto, Jorge; Maisonobe, Pascal; Zakine, Benjamin

    2013-01-01

    Objectives This article provides an overview of the Upper Limb International Spasticity (ULIS) programme, which aims to develop a common core dataset for evaluation of real-life practice and outcomes in the treatment of upper-limb spasticity with botulinum toxin A (BoNT-A). Here we present the study protocol for ULIS-II, a large, international cohort study, to describe the rationale and steps to ensure the validity of goal attainment scaling (GAS) as the primary outcome measure. Methods and analysis design An international, multicentre, observational, prospective, before-and-after study, conducted at 84 centres in 22 countries across three continents. Participants 468 adults presenting with poststroke upper limb spasticity in whom a decision had already been made to inject BoNT-A (5–12 consecutive participants recruited per centre). Interventions Physicians were free to choose targeted muscles, BoNT-A preparation, injected doses/technique and timing of follow-up in accordance with their usual practice and the goals for treatment. Primary outcome measure: GAS. Secondary outcomes: Measurements of spasticity, standardised outcome measures and global benefits. Steps to ensure validity included: (1) targeted training of all investigators in the use of GAS; (2) within-study validation of goal statements and (3) establishment of an electronic case report form with an in-built tracking facility for separation of baseline/follow-up data. Analysis Efficacy population: all participants who had (1) BoNT-A injection and (2) subsequent assessment of GAS. Primary efficacy variable: percentage (95% CI) achievement of the primary goal from GAS following one BoNT-A injection cycle. Ethics and dissemination This non-interventional study is conducted in compliance with guidelines for good pharmacoepidemiology practices. Appropriate ethical approvals were obtained according to local regulations. ULIS-II will provide important information regarding treatment and outcomes from BoNT-A in real-life upper limb spasticity management. The results will be published separately. Registration ClinicalTrials.gov identifier: NCT01020500. PMID:23512837

  8. A palmar pressure sensor for measurement of upper limb weight bearing by the hands during transfers by paraplegics.

    PubMed

    Kunju, Nissan; Ojha, Rajdeep; Devasahayam, Suresh R

    2013-10-01

    Paraplegic patients have to effect transfer from one seat to another by using their upper limbs. In this process the hands bear almost the entire weight of the body in at least some phases of the transfer. It is desirable to train patients, especially those who are elderly and otherwise weak, to distribute their weight so as to avoid large forces being sustained on any one hand for an extended period. It is also desirable to evaluate the effectiveness of assistive devices like lower limb FES in sharing the load on the hand. This study presents a simple and versatile method of measuring palmar hand force during transfers by paraplegic patients. It is important that this force sensor should not interfere with the grasping and stabilizing properties of the hands and should permit normal transferring. The force sensor comprises an air-filled pouch or pillow that can be placed on any surface. This pneumatic sensor feels like upholstery padding on the surface on which it is placed. The sensor integrates the total pressure applied to the surface of the pouch, thereby obtaining the total force exerted by the palm/hand. The fabrication of the sensor is described, as well as the associated measurement circuit. The static calibration shows that the sensor is linear up to 350?N and the dynamic calibration shows that it has a bandwidth of 13?Hz. The sensor was fabricated using an inflated inelastic airbag attached to a pressure transducer. An automatic offset correction circuit in the preamplifier module ensures that any offset due to initial pressure or sensor drift is removed and the output is zero under no load condition. The key to this sensor arrangement is the ease of fitting it into the intended location without disturbing the existing arrangement for the subject's activities of daily living (ADL). PMID:23964668

  9. A robot hand testbed designed for enhancing embodiment and functional neurorehabilitation of body schema in subjects with upper limb impairment or loss.

    PubMed

    Hellman, Randall B; Chang, Eric; Tanner, Justin; Helms Tillery, Stephen I; Santos, Veronica J

    2015-01-01

    Many upper limb amputees experience an incessant, post-amputation "phantom limb pain" and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF), rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech "rubber hand" illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the "BairClaw" presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger-object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced cognitive burden. PMID:25745391

  10. A Robot Hand Testbed Designed for Enhancing Embodiment and Functional Neurorehabilitation of Body Schema in Subjects with Upper Limb Impairment or Loss

    PubMed Central

    Hellman, Randall B.; Chang, Eric; Tanner, Justin; Helms Tillery, Stephen I.; Santos, Veronica J.

    2015-01-01

    Many upper limb amputees experience an incessant, post-amputation “phantom limb pain” and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF), rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech “rubber hand” illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the “BairClaw” presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger–object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced cognitive burden. PMID:25745391

  11. The dopaminergic system in upper limb motor blocks (ULMB) investigated during bimanual coordination in Parkinson's disease (PD).

    PubMed

    Brown, Matt J N; Almeida, Quincy J; Rahimi, Fariborz

    2015-01-01

    Upper limb motor blocks (ULMB) (inability to initiate or sudden discontinue in voluntary movements) have been identified in both unimanual and bimanual tasks in individuals with Parkinson's disease (PD). In particular, ULMB have been observed during rhythmic bimanual coordination when switching between phase patterns which is required (e.g. between in-phase and anti-phase). While sensory-perceptual mechanisms have recently been suggested to be involved in lower limb freezing, there has been no consensus on the mechanism that evokes ULMB or whether motor blocks respond to dopamine replacement like other motor symptoms of PD. The current study investigated the occurrence of ULMB in PD participants without ('off') and with ('on') dopamine replacement using bimanual wrist flexion-extension with external auditory cues. In Experiment 1, coordination was performed in either in-phase (simultaneous flexion and extension) or anti-phase (asymmetrical flexion and extension between the limbs) in one of three sensory conditions: no vision, normal vision or augmented vision. Cycle frequency was increased within each trial across seven cycle frequencies (0.75-2 Hz). In Experiment 2, coordination was initiated in either phase pattern and participants were cued to make an intentional switch between phases in the middle of trials. Trials were performed at one of two cycle frequencies (1 or 2 Hz) and one of two sensory conditions: no vision or normal vision. Healthy age-matched control participants were also investigated in both experiments for the occurrence of motor blocks that were measured using automated detection from a computer algorithm. The results from Experiment 1 indicated that increasing cycle frequency resulted in more ULMB in individuals with PD during continuous coordinated movement, regardless of dopaminergic status, phase pattern or sensory condition. Experiment 2 also confirmed an increased occurrence of ULMB with increased cycle frequency. Furthermore, a large amount of ULMB were observed when initiating anti-phase coordination at 2 Hz, as well as after both externally-cued switches and in 'catch trials' with distracting auditory cues when no switch was required. Dopamine replacement was not found to influence the frequency of ULMB in either experiment. Therefore, ULMB likely result from non-hypodopaminergic impairments associated with PD. Specifically, ULMB may be caused by an inability to shift attentional control under increased cognitive demand that could be associated with hypoactivation in motor and prefrontal areas. PMID:25280861

  12. Low back and lower-limb muscle performance in male and female recreational runners with chronic low back pain.

    PubMed

    Cai, Congcong; Kong, Pui W

    2015-06-01

    Study Design Controlled laboratory study, cross-sectional. Objective To compare lumbar extensor muscle fatigability, lumbar stabilizing muscle activation, and lower-limb strength between male and female runners with chronic low back pain (LBP) and healthy runners. Background Little is known about muscle performance in runners with chronic LBP. Methods Eighteen recreational runners with chronic LBP (9 men, 9 women; mean age, 27.8 years) and 18 healthy recreational runners (9 men, 9 women; mean age, 24.6 years) were recruited. The median frequency slopes for bilateral iliocostalis and longissimus were calculated from electromyographic signals captured during a 2-minute Sorensen test. The thickness changes of the transversus abdominis and lumbar multifidus between resting and contraction were measured using an ultrasound scanner. Peak concentric torques of the bilateral hip extensors, hip abductors, and knee extensors were measured using an isokinetic dynamometer at 60°/s. The average values for both sides were used for statistical analysis. Results When averaged across sexes, peak knee extensor torque was 12.2% lower in the LBP group compared to the healthy group (mean difference, 0.29 Nm/kg; 95% confidence interval: 0.06, 0.53; P = .016). Male runners with chronic LBP exhibited smaller lumbar multifidus thickness changes compared to healthy male runners (mean difference, 0.13 cm; 95% confidence interval: 0.01, 0.25; P = .033). No other group differences were observed. Conclusion Runners with chronic LBP exhibited diminished knee extensor strength compared to healthy runners. Male runners with chronic LBP demonstrated additional deficits in lumbar multifidus activation. J Orthop Sports Phys Ther 2015;45(6):436-443. Epub 21 Apr 2015. doi:10.2519/jospt.2015.5460. PMID:25899213

  13. 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

  14. Tailored exercise program reduces symptoms of upper limb work-related musculoskeletal disorders in a group of metalworkers: A randomized controlled trial.

    PubMed

    Rasotto, Chiara; Bergamin, Marco; Simonetti, Alberto; Maso, Stefano; Bartolucci, Giovanni B; Ermolao, Andrea; Zaccaria, Marco

    2015-02-01

    Work-related musculoskeletal disorders (WRMDs) are a leading cause of work-related disability and loss of productivity in the developed countries; these disorders may concur with the indirect costs of an illness or injury included losses of potential output. Literature on workplace physical activity program provided a mixed but positive impact on health and important worksite outcomes. Therefore, programs of physical activity organized and performed in the workplace could reveal as essential tool to reduce musculoskeletal symptoms. This investigation aimed to assess the effectiveness of a tailored physical activity program, performed in a work-environment, to reduce the symptoms in upper extremities and neck with the novelty in personalizing the approach applied to the exercise protocol, basing on pain and disability levels, to reduce the onset and symptoms in upper extremity and neck WRMDs increasing upper-limb strength and flexibility. 68 metalworkers were recruited, 34 were randomly allocated to an intervention group (IG), while the other 34 to a control group. Primary outcomes concerned pain symptoms measured with visual analog scales while disability was measured by DASH (Disability of the Arm, Shoulder and Hand), and NPDS-I (Neck Pain and Disability Scale) questionnaires. Grip strength, upper-limb mobility, neck and shoulder range of motion were also assessed. After the 9-month intervention, IG reduced pain symptoms on neck, shoulders, elbows and on wrists. Grip strength and upper-limb mobility improved as well as scores on questionnaires. This protocol suggests that performing a tailored physical activity program is beneficial to reduce pain and disability on upper-limb WRMDs. PMID:25027479

  15. Upper limb children action-observation training (UP-CAT): a randomised controlled trial in Hemiplegic Cerebral Palsy

    PubMed Central

    2011-01-01

    Background Rehabilitation for children with hemiplegic cerebral palsy (HCP) aimed to improve function of the impaired upper limb (UL) uses a wide range of intervention programs. A new rehabilitative approach, called Action-Observation Therapy, based on the recent discovery of mirror neurons, has been used in adult stroke but not in children. The purpose of the present study is to design a randomised controlled trial (RCT) for evaluating the efficacy of Action-Observation Therapy in improving UL activity in children with HCP. Methods/Design The trial is designed according to CONSORT Statement. It is a randomised, evaluator-blinded, match-pair group trial. Children with HCP will be randomised within pairs to either experimental or control group. The experimental group will perform an Action-Observation Therapy, called UP-CAT (Upper Limb-Children Action-Observation Training) in which they will watch video sequences showing goal-directed actions, chosen according to children UL functional level, combined with motor training with their hemiplegic UL. The control group will perform the same tailored actions after watching computer games. A careful revision of psychometric properties of UL outcome measures for children with hemiplegia was performed. Assisting Hand Assessment was chosen as primary measure and, based on its calculation power, a sample size of 12 matched pairs was established. Moreover, Melbourne and ABILHAND-Kids were included as secondary measures. The time line of assessments will be T0 (in the week preceding the onset of the treatment), T1 and T2 (in the week after the end of the treatment and 8 weeks later, respectively). A further assessment will be performed at T3 (24 weeks after T1), to evaluate the retention of effects. In a subgroup of children enrolled in both groups functional Magnetic Resonance Imaging, exploring the mirror system and sensory-motor function, will be performed at T0, T1 and T2. Discussion The paper aims to describe the methodology of a RCT for evaluating the efficacy of Action-Observation Therapy in improving UL activity in children with hemiplegia. This study will be the first to test this new type of treatment in childhood. The paper presents the theoretical background, study hypotheses, outcome measures and trial methodology. Trial Registration NCT01016496 PMID:21711525

  16. Soft Tissue Reconstruction of Open Fractures of the Lower Limb: muscle versus fasciocutaneous flaps

    PubMed Central

    Chan, James K-K; Harry, Lorraine; Williams, Garry; Nanchahal, Jagdeep

    2012-01-01

    Early vascularized soft tissue closure has long been recognized to be essential in achieving eventual infection free union. The question of whether muscle or fasciocutaneous tissue is superior in terms of promoting fracture healing remains unresolved. Here we review the experimental and clinical evidence for the different tissue types and advocate that the biological role of flaps should be included as a key consideration during flap selection. PMID:22842425

  17. Desensitization of the cough reflex during limb muscle contraction in anesthetized rabbits.

    PubMed

    Poussel, Mathias; Bosser, Gilles; Varechova, Silvia; Demoulin, Bruno; Chalon, Bernard; Ruckebusch, Odile; Tiotiu, Angelica; Renaud, Pierre; Schweitzer, Cyril; Chenuel, Bruno

    2014-02-01

    The 'cough network' exhibits plasticity at the sensor and integration levels leading to modulation of the strength or pattern of the cough reflex. Little is known about the interactions between cough and human activities, especially during exercise. The present study was designed to determine whether exercise, mimicked by electrically induced muscle contractions, can modify the incidence and/or strength of cough following mechanical stimulation of the trachea in anesthetized rabbits. Thirteen anesthetized, tracheotomized rabbits were studied by a total of 311 tracheal stimulations: 196 at rest and 115 during exercise. During muscle contractions, the incidence of the cough reflex (CR) decreased and the expiration reflex (ER) increased (p < 0.0001). The sensitivity of the CR and ER both decreased during exercise compared to the sensitivity of the CR at rest (p < 0.02), while the strength of the expulsive response remained unchanged. These results indicate that adjustments occurring during muscle contractions likely downregulate tracheal defensive reflexes in anesthetized rabbits. PMID:23891778

  18. Detecting Movement Intent from Scalp EEG in a Novel Upper Limb Robotic Rehabilitation System for Stroke

    PubMed Central

    Venkatakrishnan, Anusha; Yozbatiran, Nuray; Francisco, Gerard E.; O’Malley, Marcia K.; Contreras-Vidal, Jose L.

    2015-01-01

    Stroke can be a source of significant upper extremity dysfunction and affect the quality of life (QoL) in survivors. In this context, novel rehabilitation approaches employing robotic rehabilitation devices combined with brain-machine interfaces can greatly help in expediting functional recovery in these individuals by actively engaging the user during therapy. However, optimal training conditions and parameters for these novel therapeutic systems are still unknown. Here, we present preliminary findings demonstrating successful movement intent detection from scalp electroencephalography (EEG) during robotic rehabilitation using the MAHI Exo-II in an individual with hemiparesis following stroke. These findings have strong clinical implications for the development of closed-loop brain-machine interfaces to robotic rehabilitation systems. PMID:25570900

  19. 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

  20. Report of an unusual combination of arterial, venous and neural variations in a cadaveric upper limb

    PubMed Central

    2014-01-01

    In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery. Multiple variations in typical axillary artery branches were present including existence of inferior pectoral artery. Cephalic vein was absent. A variety of interventions, from relative simple as central venous catheter placement to most complicated as brachial plexus injury repair demand thorough knowledge of area’s regional anatomy. Familiarity with anatomic variations allows more precise and careful interventions. Research on these variations is valuable for anatomists and embryologists but also for clinicians because it may provide useful information for non - typical cases but also helps in raising a high level of suspicion. PMID:24495850

  1. 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

  2. Upper versus lower limb exercise training in patients with intermittent claudication: a systematic review.

    PubMed

    Tompra, Nefeli; Foster, Carl; Sanchis-Gomar, Fabian; de Koning, Jos J; Lucia, Alejandro; Emanuele, Enzo

    2015-04-01

    Lower extremity (LE) exercise training has been shown to contribute to improvements in Maximum Walking Distance (MWD), Claudication Distance (CD), peak oxygen uptake (VO2peak) and Quality of Life (QoL) in patients with intermittent claudication (IC). However, little is known regarding the efficacy of upper extremity (UE) exercise training in comparison to the widely used LE training. The objective of this systematic literature review is to identify and synthesize the available literature on the effects of UE versus LE exercises using the International Classification of Functioning (ICF) conceptual framework. A total of 6 randomized controlled trials comparing UE to LE exercises were included in this study. Two of the articles were considered to be of high quality using the PEDro grading list. Both UE and LE training groups demonstrated significant improvements in MWD, CD, VO2peak and QoL in comparison to the control group but LE was not better than UE training. This supports the use of UE training as an alternative to LE, which could provide symptomatic relief to patients with IC without the discomfort caused during the LE training. PMID:25734983

  3. Development of a model osseo-magnetic link for intuitive rotational control of upper-limb prostheses.

    PubMed

    Rouse, Elliott J; Nahlik, David C; Peshkin, Michael A; Kuiken, Todd A

    2011-04-01

    The lack of proprioceptive feedback is a serious deficiency of current prosthetic control systems. The Osseo-Magnetic Link (OML) is a novel humeral or wrist rotation control system that could preserve proprioception. It utilizes a magnet implanted within the residual bone and sensors mounted in the prosthetic socket to detect magnetic field vectors and determine the bone's orientation. This allows the use of volitional bone rotation to control a prosthetic rotator. We evaluated the performance of the OML using a physical model of a transhumeral residual limb. A small Neodymium-Iron-Boron magnet was placed in a model humerus, inside a model upper arm. Four three-axis Hall-effect sensors were mounted on a ring 3 cm distal to the magnet. An optimization algorithm based on Newton's method determined the position and orientation of the magnet within the model humerus under various conditions, including bone translations, interference, and magnet misalignment. The orientation of the model humerus was determined within 3° for rotations centered in the arm; an additional 6° error was found for translations 20 mm from center. Adjustments in sensor placement may reduce these errors. The results demonstrate that the OML is a feasible solution for providing prosthesis rotation control while preserving rotational proprioception. PMID:21193382

  4. Use of Fourier transforms for asynoptic mapping: Applications to the Upper Atmosphere Research Satellite microwave limb sounder

    NASA Technical Reports Server (NTRS)

    Elson, Lee S.; Froidevaux, Lucien

    1993-01-01

    Fourier analysis has been applied to data obtained from limb viewing instruments on the Upper Atmosphere Research Satellite. A coordinate system rotation facilitates the efficient computation of Fourier transforms in the temporal and longitudinal domains. Fields such as ozone (O3), chlorine monoxide (ClO), temperature, and water vapor have been transformed by this process. The transforms have been inverted to provide maps of these quantities at selected times, providing a method of accurate time interpolation. Maps obtained by this process show evidence of both horizontal and vertical transport of important trace species such as O3 and ClO. An examination of the polar regions indicates that large-scale planetary variations are likely to play a significant role in transporting midstratospheric O3 into the polar regions. There is also evidence that downward transport occurs, providing a means of moving O3 into the polar vortex at lower altitudes. The transforms themselves show the structure and propagation characteristics of wave variations.

  5. Development of a model Osseo-Magnetic Link for intuitive rotational control of upper-limb prostheses

    PubMed Central

    Rouse, Elliott; Nahlik, David; Peshkin, Michael; Kuiken, Todd

    2014-01-01

    The lack of proprioceptive feedback is a serious deficiency of current prosthetic control systems. The Osseo-Magnetic Link (OML) is a novel humeral or wrist rotation control system that could preserve proprioception. It utilizes a magnet implanted within the residual bone and sensors mounted in the prosthetic socket to detect magnetic field vectors and determine the bone's orientation. This allows the use of volitional bone rotation to control a prosthetic rotator. We evaluated the performance of the OML using a physical model of a transhumeral residual limb. A small Neodymium-Iron-Boron magnet was placed in a model humerus, inside a model upper arm. Four 3-axis Hall-effect sensors were mounted on a ring 3 cm distal to the magnet. An optimization algorithm based on Newton's method determined the position and orientation of the magnet within the model humerus under various conditions, including bone translations, interference, and magnet misalignment. The orientation of the model humerus was determined within 3° for rotations centered in the arm; an additional 6° error was found for translations 20 mm from center. Adjustments in sensor placement may reduce these errors. The results demonstrate that the OML is a feasible solution for providing prosthesis rotation control while preserving rotational proprioception. PMID:21193382

  6. Short-term and long-term outcomes of serial robotic training for improving upper limb function in chronic stroke.

    PubMed

    Sale, Patrizio; Bovolenta, Federica; Agosti, Maurizio; Clerici, Pierina; Franceschini, Marco

    2014-03-01

    The aim of this study was to determine short-term and long-term changes in motor function in patients with chronic hemiparesis who underwent robot training and to evaluate its long-term benefit after 6 months. This was a longitudinal study with a 6-month follow-up. The 15 patients included in this study underwent the Fugl-Meyer test, the Ashworth Scale test, the Frenchay Arm test, and the Box and Block test according to the following schedule: immediately before (T1, T3) and after each treatment (T2, T4), and 6 months after T4 (T5). There were statistically significant improvements in Fugl-Meyer test between T1 and T2 and between T1 and T4; the score increased in the Ashworth Scale test for Shoulder between T1 and T3 and between T1 and T5; a statistically significant decrease was found between T1 and T2 and between T1 and T4, in the Box and Block test between T1 and T4, and also between T1 and T5. This original rehabilitation treatment may contribute toward increasing upper limb motor recovery in stable chronic stroke patients. PMID:24126253

  7. Assessment and prediction of inter-joint upper limb movement correlations based on kinematic analysis and statistical regression

    NASA Astrophysics Data System (ADS)

    Toth-Tascau, Mirela; Balanean, Flavia; Krepelka, Mircea

    2013-10-01

    Musculoskeletal impairment of the upper limb can cause difficulties in performing basic daily activities. Three dimensional motion analyses can provide valuable data of arm movement in order to precisely determine arm movement and inter-joint coordination. The purpose of this study was to develop a method to evaluate the degree of impairment based on the influence of shoulder movements in the amplitude of elbow flexion and extension based on the assumption that a lack of motion of the elbow joint will be compensated by an increased shoulder activity. In order to develop and validate a statistical model, one healthy young volunteer has been involved in the study. The activity of choice simulated blowing the nose, starting from a slight flexion of the elbow and raising the hand until the middle finger touches the tip of the nose and return to the start position. Inter-joint coordination between the elbow and shoulder movements showed significant correlation. Statistical regression was used to fit an equation model describing the influence of shoulder movements on the elbow mobility. The study provides a brief description of the kinematic analysis protocol and statistical models that may be useful in describing the relation between inter-joint movements of daily activities.

  8. Organization of pontine reticulospinal inputs to motoneurons controlling axial and limb muscles in the neonatal mouse.

    PubMed

    Sivertsen, Magne S; Glover, Joel C; Perreault, Marie-Claude

    2014-10-01

    Using optical recording of synaptically mediated calcium transients and selective spinal lesions, we investigated the pattern of activation of spinal motoneurons (MNs) by the pontine reticulospinal projection in isolated brain stem-spinal cord preparations from the neonatal mouse. Stimulation sites throughout the region where the pontine reticulospinal neurons reside reliably activated MNs at cervical, thoracic, and lumbar levels. Activation was similar in MNs ipsi- and contralateral to the stimulation site, similar in medial and lateral motor columns that contain trunk and limb MNs, respectively, and similar in the L2 and L5 segments that predominantly contain flexor and extensor MNs, respectively. In nonlesioned preparations, responses in both ipsi- and contralateral MNs followed individual stimuli in stimulus trains nearly one-to-one (with few failures). After unilateral hemisection at C1 on the same side as the stimulation, responses had substantially smaller magnitudes and longer latencies and no longer followed individual stimuli. After unilateral hemisection at C1 on the side opposite to the stimulation, the responses were also smaller, but their latencies were not affected. Thus we distinguish two pontine reticulospinal pathways to spinal MNs, one uncrossed and the other crossed, of which the uncrossed pathway transmits more faithfully and appears to be more direct. PMID:24944221

  9. 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

  10. Histochemical classification of neck and limb muscle fibers in a turtle,Pseudemys scripta: A study using microphotometry and cluster analysis techniques

    Microsoft Academic Search

    R. J. Callister; E. H. Peterson

    1989-01-01

    We have attempted to develop an objective, semiquantitative classification of fiber types in turtle neck and limb muscle using micropho- tometry and multivariate statistical techniques. We first stained serial sec- tions for myosin adenosine triphosphatase (ATPase) (with acid and alkaline preincubation and without preincubation), NADH-diaphorase, and two gly- colysis-associated markers, a-glycerophosphate dehydrogenase (a-GPDH) and glycogen phosphorylase A (GPA). This allowed

  11. Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study

    PubMed Central

    2014-01-01

    Background Ischemic or volatile anesthetic preconditioning is defined as tissue protection from impending ischemic cell damage by repetitive short periods of tissue exposure to ischemia or volatile anesthetics. Objective of this study was to elucidate, if ischemic preconditioning and pharmacological preconditioning with sevoflurane have effects on muscle tissue oxygen saturation in patients undergoing surgical revascularization of the lower limb. Methods In this prospective randomized pilot study ischemic and pharmacological (sevoflurane) preconditioning was performed in 40 patients with lower limb arterial occlusive disease undergoing surgical revascularization. Sevoflurane preconditioning was performed in one group (N?=?20) by repetitive application of sevoflurane for six minutes interspersed by six minutes of washout. Thereafter, ischemic preconditioning was performed in all patients (N?=?40) by repetitive clamping of the femoral artery for six minutes interspersed by six minutes of reperfusion. The effect of both procedures on leg muscle tissue oxygen saturation (rSO2) was measured by near-infrared spectroscopy during both procedures and during surgery and reperfusion (INVOS® 5100C Oxymeter with Small Adult SomaSensor® SAFB-SM, Somanetics, Troy, Michigan, USA). Results Repetitive clamping and reperfusion of the femoral artery resulted in significant cyclic decrease and increase of muscle rSO2 (p?limb muscle tissue and pharmacological preconditioning with sevoflurane have an effect on tissue oxygenation in patients with lower limb occlusive arterial disease. Trial registration The trial has been registrated at http://www.ClinicalTrial.gov, Trial Number: NCT02038062 at 14 January 2014. PMID:25132803

  12. A Novel Intronic Single Nucleotide Polymorphism in the Myosin heavy polypeptide 4 Gene Is Responsible for the Mini-Muscle Phenotype Characterized by Major Reduction in Hind-Limb Muscle Mass in Mice

    PubMed Central

    Kelly, Scott A.; Bell, Timothy A.; Selitsky, Sara R.; Buus, Ryan J.; Hua, Kunjie; Weinstock, George M.; Garland, Theodore; Pardo-Manuel de Villena, Fernando; Pomp, Daniel

    2013-01-01

    Replicated artificial selection for high levels of voluntary wheel running in an outbred strain of mice favored an autosomal recessive allele whose primary phenotypic effect is a 50% reduction in hind-limb muscle mass. Within the High Runner (HR) lines of mice, the numerous pleiotropic effects (e.g., larger hearts, reduced total body mass and fat mass, longer hind-limb bones) of this hypothesized adaptive allele include functional characteristics that facilitate high levels of voluntary wheel running (e.g., doubling of mass-specific muscle aerobic capacity, increased fatigue resistance of isolated muscles, longer hind-limb bones). Previously, we created a backcross population suitable for mapping the responsible locus. We phenotypically characterized the population and mapped the Minimsc locus to a 2.6-Mb interval on MMU11, a region containing ?100 known or predicted genes. Here, we present a novel strategy to identify the genetic variant causing the mini-muscle phenotype. Using high-density genotyping and whole-genome sequencing of key backcross individuals and HR mice with and without the mini-muscle mutation, from both recent and historical generations of the HR lines, we show that a SNP representing a C-to-T transition located in a 709-bp intron between exons 11 and 12 of the Myosin heavy polypeptide 4 (Myh4) skeletal muscle gene (position 67,244,850 on MMU11; assembly, December 2011, GRCm38/mm10; ENSMUSG00000057003) is responsible for the mini-muscle phenotype, Myh4Minimsc. Using next-generation sequencing, our approach can be extended to identify causative mutations arising in mouse inbred lines and thus offers a great avenue to overcome one of the most challenging steps in quantitative genetics. PMID:24056412

  13. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS)-II Study

    PubMed Central

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-01-01

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001), contractures (soft tissue shortening [STS]) (p = 0.006) and spasticity (p = 0.02) than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001), contracture (p < 0.0001), spasticity (p < 0.001) and shorter time since stroke (p = 0.001). Patients setting goals for pain were older (p = 0.01) with more contractures (p = 0.008). The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (?1 year) vs. longer-term (>1 year)) post-stroke (80.0% vs. 79.2%) or presence or absence of severe contractures (76.7% vs. 80.6%), although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment. PMID:25856546

  14. Treatment-Related Upper Limb Morbidity 1 Year after Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection for Stage I or II Breast Cancer

    Microsoft Academic Search

    J. S. Rietman; P. U. Dijkstra; J. H. B. Geertzen; P. Baas; J. de Vries; W. V. Dolsma; J. W. Groothoff; W. H. Eisma; H. J. Hoekstra

    2004-01-01

    Background: In a prospective study, upper limb morbidity and perceived disability\\/activities of daily life (ADLs) were assessed before and 1 year after sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND).Methods: A total of 204 patients with stage I\\/II breast cancer (mean age, 55.6 years; SD, 11.6 years) entered the study, and 189 patients (93%) could be evaluated

  15. A PC-based battery of tests for quantitative assessment of upper-limb sensory-motor function in brain disorders

    Microsoft Academic Search

    Richard D. Jones; N. B. Sharman; Russell W. Watson; S. R. Muir

    1993-01-01

    Abstracf - A comprehensive battery of tests has been developed for quantitative assessment of the upper-limb sensorymotor system. The system is PC-based and replacs an earlier version based around a PDP-11\\/34. Hardware comprises a 386\\/486 PC, two screens, and three input devices - steering wheel, floor-mounted joystick, and a dlinger tapping sensor. All tests are run and analyzed by the

  16. Comparison of dosage of intensive upper limb therapy for children with unilateral cerebral palsy: how big should the therapy pill be?

    PubMed

    Sakzewski, Leanne; Provan, Kerry; Ziviani, Jenny; Boyd, Roslyn N

    2015-02-01

    This study aimed to compare efficacy of two dosages of modified constraint induced movement therapy (mCIMT) and bimanual therapy on upper limb and individualized outcomes for children with unilateral cerebral palsy. This secondary analysis included two separate randomized trials that compared equal doses (high or low) of mCIMT to bimanual therapy; Study 1 (full dose--60 h) n=64 and; Study 2 (half dose--30 h) n=18 for children aged five to 16 years with unilateral cerebral palsy. Outcomes for both studies included the Melbourne Assessment of Unilateral Upper Limb Function, Assisting Hand Assessment, Jebsen Taylor Test of Hand Function and Canadian Occupational Performance Measure which were administered at baseline, three and 26 weeks. Mixed linear modelling was used to compare between dose (e.g. "full dose" to "half dose" of either mCIMT or bimanual therapy) on outcomes at three and 26 weeks post-intervention. There were no significant differences between groups at baseline, however, on average the half dose mCIMT group was younger with better hand function compared to the other groups. The full compared to half dose mCIMT group achieved greater gains in bimanual performance at three weeks and dexterity and quality of movement at 26 weeks. There were no between group differences for bimanual therapy doses. Half dose groups receiving either mCIMT or bimanual therapy did not make significant within group gains on any upper limb motor outcome, however gains in occupational performance were clinically meaningful. These results suggest that a half dose (30 h) of either mCIMT or bimanual therapy may not be sufficient to impact upper limb outcomes, but made clinically meaningful gains in occupational performance for school aged children with UCP. PMID:25460215

  17. Low-dose\\/high-concentration localized botulinum toxin A improves upper limb movement and function in children with hemiplegic cerebral palsy

    Microsoft Academic Search

    Kevin Lowe; Iona Novak; Anne Cusick

    2006-01-01

    The objective was to determine the effects of low-dose, high-concentration, dual localized botulinum toxin A (BTX-A) injections on upper limb movement quality and function. Study design was an evaluator-blinded, randomized, controlled trial. Forty-two children (31 males, 11 females; range 2–8y, mean 4y [SD 1.6]) with hemiplegic cerebral palsy (Gross Motor Function Classification System level I) participated. All received occupational therapy.

  18. Muscle-specific variations in use-dependent crossed-facilitation of corticospinal pathways mediated by transcranial direct current (DC) stimulation

    Microsoft Academic Search

    Richard G. Carson; Niamh C. Kennedy; Mark A. Linden; Lisa Britton

    2008-01-01

    The tendency for contractions of muscles in the upper limb to give rise to increases in the excitability of corticospinal projections to the homologous muscles of the opposite limb is well known. Although the suppression of this tendency is integral to tasks of daily living, its exploitation may prove to be critical in the rehabilitation of acquired hemiplegias. Transcranial direct

  19. Postural adjustments associated with voluntary contraction of leg muscles in standing man

    Microsoft Academic Search

    A. Nardone; M. Schieppati

    1988-01-01

    The postural adjustments associated with a voluntary contraction of the postural muscles themselves have been studied in the legs of normal standing men. We focussed on the following questions. Do postural adjustments precede the focal movement as in the case of movements of the upper limb? Which muscle(s) are involved in the task of stabilizing posture? Can the same postural

  20. Mechanisms contributing to the response of upper-airway muscles to changes in airway pressure.

    PubMed

    Carberry, Jayne C; Hensen, Hanna; Fisher, Lauren P; Saboisky, Julian P; Butler, Jane E; Gandevia, Simon C; Eckert, Danny J

    2015-05-15

    This study assessed the effects of inhaled lignocaine to reduce upper airway surface mechanoreceptor activity on 1) basal genioglossus and tensor palatini EMG, 2) genioglossus reflex responses to large pulses (?10 cmH2O) of negative airway pressure, and 3) upper airway collapsibility in 15 awake individuals. Genioglossus and tensor palatini muscle EMG and airway pressures were recorded during quiet nasal breathing and during brief pulses (250 ms) of negative upper-airway pressure. Lignocaine reduced peak inspiratory (5.6 ± 1.5 vs. 3.8 ± 1.1% maximum; mean ± SE, P < 0.01) and tonic (2.8 ± 0.8 vs. 2.1 ± 0.7% maximum; P < 0.05) genioglossus EMG during quiet breathing but had no effect on tensor palatini EMG (5.0 ± 0.8 vs. 5.0 ± 0.5% maximum; P = 0.97). Genioglossus reflex excitation to negative pressure pulses decreased after anesthesia (60.9 ± 20.7 vs. 23.6 ± 5.2 ?V; P < 0.05), but not when expressed as a percentage of the immediate prestimulus baseline. Reflex excitation was closely related to the change in baseline EMG following lignocaine (r(2) = 0.98). A short-latency genioglossus reflex to rapid increases from negative to atmospheric pressure was also observed. The upper airway collapsibility index (%difference) between nadir choanal and epiglottic pressure increased after lignocaine (17.8 ± 3.7 vs. 28.8 ± 7.5%; P < 0.05). These findings indicate that surface receptors modulate genioglossus but not tensor palatini activity during quiet breathing. However, removal of input from surface mechanoreceptors has minimal effect on genioglossus reflex responses to large (?10 cmH2O), sudden changes in airway pressure. Changes in pressure rather than negative pressure per se can elicit genioglossus reflex responses. These findings challenge previous views and have important implications for upper airway muscle control. PMID:25749447

  1. The effect of different skin-ankle brace application pressures on quiet single-limb balance and electromyographic activation onset of lower limb muscles

    Microsoft Academic Search

    Emmanuel S Papadopoulos; Christos Nikolopoulos; Athanasios Badekas; George Vagenas; Stamatios A Papadakis; Spyros Athanasopoulos

    2007-01-01

    BACKGROUND: Several studies have been carried out in order to investigate the effect of ankle bracing on ankle joint function and performance. However, no study so far has examined the role of skin-brace interface pressure in neuromuscular control. The aim of this study was to investigate the effect of different skin-ankle brace interface pressures on quiet single limb balance and

  2. The reliability of the ELEPAP clinical protocol for the 3D kinematic evaluation of upper limb function.

    PubMed

    Vanezis, Athanasios; Robinson, Mark A; Darras, Nikolaos

    2015-02-01

    Upper limb (UL) kinematic assessment protocols are becoming integrated into clinical practice due to their development over the last few years. We propose the ELEPAP UL protocol, a contemporary UL kinematic protocol that can be applied to different pathological conditions. This model is based on ISB modeling recommendations, uses functional joint definitions, and models three joints of the shoulder girdle. The specific aim of this study was to determine the within and between session reliability of the ELEPAP UL model. Ten healthy subjects (mean age: 13.6±4.3 years) performed four reach-to-grasp and five functional tasks, which included a novel throwing task to assess a wide spectrum of motor skills. Three trials of every task in two different sessions were analyzed. The reliability of angular waveforms was evaluated by measurement error (?) and coefficient of multiple correlation (CMC). Spatiotemporal parameters were assessed by standard error of measurement (SEM). Generally joint kinematics presented low ?w and ?b errors (<100). A selection of angular waveforms errors was presented to inspect error fluctuation in different phases, which was found to be related to the demands of the different movements. CMCw and CMCb values (>0.60) were found, demonstrating good to excellent reliability especially in joints with larger ranges of motion. The throwing task proved equally reliable, enhancing the universal application of the protocol. Compared to the literature, this study demonstrated higher reliability of the thorax, scapula and wrist joints. This was attributed to the highly standardized procedure and the implementation of recent methodological advancements. In conclusion, ELEPAP protocol was proved a reliable tool to analyze UL kinematics. PMID:25534948

  3. Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy.

    PubMed

    Preston, Nick; Weightman, Andrew; Gallagher, Justin; Holt, Raymond; Clarke, Michael; Mon-Williams, Mark; Levesley, Martin; Bhakta, Bipinchandra

    2014-06-25

    Abstract Introduction: We investigated the feasibility of using computer-assisted arm rehabilitation (CAAR) computer games in schools. Outcomes were children's preference for single player or dual player mode, and changes in arm activity and kinematics. Method: Nine boys and two girls with cerebral palsy (6-12 years, mean 9 years) played assistive technology computer games in single-user mode or with school friends in an AB-BA design. Preference was determined by recording the time spent playing each mode and by qualitative feedback. We used the ABILHAND-kids and Canadian Occupational Performance Measure to evaluate activity limitation, and a portable laptop-based device to capture arm kinematics. Results: No difference was recorded between single-user and dual-user modes (median daily use 9.27 versus 11.2?min, p?=?0.214). Children reported dual-user mode was preferable. There were no changes in activity limitation (ABILHAND-kids, p?=?0.424; COPM, p?=?0.484) but we found significant improvements in hand speed (p?=?0.028), smoothness (p?=?0.005) and accuracy (p?=?0.007). Conclusion: School timetables prohibit extensive use of rehabilitation technology but there is potential for its short-term use to supplement a rehabilitation program. The restricted access to the rehabilitation games was sufficient to improve arm kinematics but not arm activity. Implications for Rehabilitation School premises and teaching staff present no obstacles to the installation of rehabilitation gaming technology. Twelve minutes per day is the average amount of time that the school time table permits children to use rehabilitation gaming equipment (without disruption to academic attendance). The use of rehabilitation gaming technology for an average of 12 minutes daily does not appear to benefit children's functional performance, but there are improvements in the kinematics of children's upper limb. PMID:24964205

  4. Automatic real-time monitoring and assessment of tremor parameters in the upper limb from orientation data

    PubMed Central

    Lambrecht, Stefan; Gallego, Juan A.; Rocon, Eduardo; Pons, Jose L.

    2014-01-01

    Upper limb tremor is the most prevalent movement disorder and, unfortunately, it is not effectively managed in a large proportion of the patients. Neuroprostheses that stimulate the sensorimotor pathways are one of the most promising alternatives although they are still under development. To enrich the interpretation of data recorded during long-term tremor monitoring and to increase the intelligence of tremor suppression neuroprostheses we need to be aware of the context. Context awareness is a major challenge for neuroprostheses and would allow these devices to react more quickly and appropriately to the changing demands of the user and/or task. Traditionally kinematic features are used to extract context information, with most recently the use of joint angles as highly potential features. In this paper we present two algorithms that enable the robust extraction of joint angle and related features to enable long-term continuous monitoring of tremor with context awareness. First, we describe a novel relative sensor placement identification technique based on orientation data. We focus on relative rather than absolute sensor location, because in many medical applications magnetic and inertial measurement units (MIMU) are used in a chain stretching over adjacent segments, or are always placed on a fixed set of locations. Subsequently we demonstrate how tremor parameters can be extracted from orientation data using an adaptive estimation algorithm. Relative sensor location was detected with an accuracy of 94.12% for the 4 MIMU configuration, and 100% for the 3 MIMU configurations. Kinematic tracking error values with an average deviation of 8% demonstrate our ability to estimate tremor from orientation data. The methods presented in this study constitute an important step toward more user-friendly and context-aware neuroprostheses for tremor suppression and monitoring. PMID:25120424

  5. Effect of head and limb orientation on trunk muscle activation during abdominal hollowing in chronic low back pain

    PubMed Central

    2014-01-01

    Background Individuals with chronic low back pain (CLBP) have altered activations patterns of the anterior trunk musculature when performing the abdominal hollowing manœuvre (attempt to pull umbilicus inward and upward towards the spine). There is a subgroup of individuals with CLBP who have high neurocognitive and sensory motor deficits with associated primitive reflexes (PR). The objective of the study was to determine if orienting the head and extremities to positions, which mimic PR patterns would alter anterior trunk musculature activation during the hollowing manoeuvre. Methods This study compared surface electromyography (EMG) of bilateral rectus abdominis (RA), external oblique (EO), and internal obliques (IO) of 11 individuals with CLBP and evident PR to 9 healthy controls during the hollowing manoeuvre in seven positions of the upper quarter. Results Using magnitude based inferences it was likely (>75%) that controls had a higher ratio of left IO:RA activation with supine (cervical neutral), asymmetrical tonic neck reflex (ATNR) left and right, right cervical rotation and cervical extension positions. A higher ratio of right IO:RA was detected in the cervical neutral and ATNR left position for the control group. The CLBP group were more likely to show higher activation of the left RA in the cervical neutral, ATNR left and right, right cervical rotation and cervical flexion positions as well as in the cervical neutral and cervical flexion position for the right RA. Conclusions Individuals with CLBP and PR manifested altered activation patterns during the hollowing maneuver compared to healthy controls and that altering cervical and upper extremity position can diminish the group differences. Altered cervical and limb positions can change the activation levels of the IO and EO in both groups. PMID:24558971

  6. Carbon monoxide and temperature in the upper atmosphere of Venus from VIRTIS/Venus Express non-LTE limb measurements

    NASA Astrophysics Data System (ADS)

    Gilli, G.; López-Valverde, M. A.; Peralta, J.; Bougher, S.; Brecht, A.; Drossart, P.; Piccioni, G.

    2015-03-01

    The upper mesosphere and the lower thermosphere of Venus (from 90 to 150 km altitude) seems to play a transition region in photochemistry, dynamics and radiation, but is still very poorly constrained observationally. Since 2006 VIRTIS on board Venus Express has been obtaining limb observations of CO fluorescent infrared emissions in a systematic manner. This study represents the scientific exploitation of this dataset and reports new information on the composition and temperature at those altitudes. This work is focused on the 4.7 ? m emission of CO as observed by VIRTIS, which contains two emission bands, the fundamental and the first hot of the main CO isotope. A specific scheme for a simultaneous retrieval of CO and temperature is proposed, based on results of a comprehensive non-LTE model of these molecular emissions. A forward model containing such non-LTE model is used at the core of an inversion scheme that consists of two steps: (i) a minimization procedure of model-data differences and (ii) a linear inversion around the solution of the first step. A thorough error analysis is presented, which shows that the retrievals of CO and temperature are very noisy but can be improved by suitable averaging of data. These averages need to be consistent with the non-LTE nature of the emissions. Unfortunately, the data binning process reduced the geographical coverage of the results. The obtained retrieval results indicate a global distribution of the CO in the Venus dayside with a maximum around the sub-solar point, and a decrease of a factor 2 towards high latitudes. Also a gradient from noon to the morning and evening sides is evident in the equator, this being smaller at high latitudes. No morning-afternoon differences in the CO concentration are observed, or are comparable to our retrieval errors. All this argues for a CO distribution controlled by dynamics in the lower thermosphere, with a dominant sub-solar to anti-solar gradient. Similar variations are found with the Venus Thermospheric General Circulation Model (VTGCM), but the VIRTIS CO is systematically larger than in the model. The thermal structure obtained by VIRTIS presents a hint of local maximum around 115 km near the terminator at equatorial latitudes, but not at noon, in clear contrast to VTGCM predictions and to an upper mesosphere in pure radiative balance. A few tentative ideas to explain these model-data discrepancies are discussed.

  7. Stable human standing with lower-limb muscle afferents providing the only sensory input.

    PubMed Central

    Fitzpatrick, R; Rogers, D K; McCloskey, D I

    1994-01-01

    1. This study investigated the sources of sensory information upon which normal subjects' ability to stand depends. 2. An 'equivalent body' was used to simulate the physical properties of each subject's body during standing. The modulation of ankle torque required to support the equivalent body in an upright position was similar to that required to support the subject's own body when standing. However, when balancing the equivalent body, vestibular inputs were excluded from directing the appropriate changes in ankle torque. Thus, stability of stance could be studied with (normal stance) and without (balancing equivalent body) modulation by vestibular inputs. Vision could be excluded by closing the eyes. Sensory input from the feet and ankles could be removed by local anaesthesia from prolonged ischaemia, induced by occluding blood flow with inflated pneumatic cuffs just above the ankles. With vestibular, visual and peripheral sensory inputs negated, standing could rely only upon remaining sensory inputs, notably those from sensory receptors in the leg muscles. 3. Unlike the human body, the equivalent body used to negate vestibular inputs is not segmented. Therefore, the effects on stability of having a segmented body were determined by splinting subjects during standing so that only ankle movement was possible. This was done in the presence and absence of visual stabilization. 4. For each experimental task, either standing or balancing the equivalent body, sway was recorded while posture was unperturbed. Root mean square values of sway amplitude and power spectra were used to compare conditions. 5. Every subject could balance the equivalent body in a stable way when the eyes were closed, and when the feet were anaesthetized.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 1 Figure 3 PMID:7869254

  8. Phasic mechanoreceptor stimuli can induce phasic activation of upper airway muscles in humans

    PubMed Central

    Akahoshi, Toshiki; White, David P; Edwards, Jill K; Beauregard, Josee; Shea, Steven A

    2001-01-01

    Upper airway dilator muscles are phasically activated throughout breathing by respiratory pattern generator neurons. Studies have shown that non-physiological upper airway mechanoreceptive stimuli (e.g. rapidly imposed pulses of negative pressure) also activate these muscles. Such reflexes may become activated during conditions that alter airway resistance in order to stabilise airway patency. To determine the contribution of ongoing mechanoreceptive reflexes to phasic activity of airway dilators, we assessed genioglossal electromyogram (GG EMG: rectified with moving time average of 100 ms) during slow (physiological) oscillations in negative pressure generated spontaneously and passively (negative pressure ventilator). Nineteen healthy adults were studied while awake, during passive mechanical ventilation across normal physiological ranges of breathing rates (13–19 breaths min?1) and volumes (0.5–1.0 l) and during spontaneous breathing across the physiological range of end-tidal carbon dioxide (PET,CO2; 32–45 mmHg). Within-breath phasic changes in airway mechanoreceptor stimuli (negative pressure or flow) were highly correlated with within-breath phasic genioglossal activation, probably representing a robust mechanoreceptive reflex. These reflex relationships were largely unchanged by alterations in central drive to respiratory pump muscles or the rate of mechanical ventilation within the ranges studied. A multivariate model revealed that tonic GG EMG, PET,CO2 and breath duration provided no significant independent information in the prediction of inspiratory peak GG EMG beyond that provided by epiglottic pressure, which alone explained 93 % of the variation in peak GG EMG across all conditions. The overall relationship was: Peak GG EMG = 79.7 ? (11.3 x Peak epiglottic pressure), where GG EMG is measured as percentage of baseline, and epiglottic pressure is in cmH2O. These data provide strong evidence that upper airway dilator muscles can be activated throughout inspiration via ongoing mechanoreceptor reflexes. Such a feedback mechanism is likely to be active on a within-breath basis to protect upper airway patency in awake humans. This mechanism could mediate the increased genioglossal activity observed in patients with obstructive sleep apnoea (i.e. reflex compensation for an anatomically smaller airway). PMID:11251050

  9. A flexible electrode array for muscle impedance measurements in the mouse hind limb: A tool to speed research in neuromuscular disease

    NASA Astrophysics Data System (ADS)

    Li, J.; Rutkove, S. B.

    2013-04-01

    Electrical impedance myography (EIM) is a bioelectrical impedance technique focused on the assessment of neuromuscular diseases using tetrapolar surface arrays. Recently, we have shown that reproducible and sensitive EIM measurements can be made on the gastrocnemius muscle of the mouse hind limb and that these are sensitive to disease alterations. A dedicated array would help speed data acquisition and provide additional sensitivity to disease-induced alterations. A flexible electrode array was developed with electrode sizes of 1mm × 1mm by Parlex, Inc. Tetrapolar electrode sets were arranged both parallel to (longitudinal) and orthogonally to (transverse) the major muscle fiber direction of the gastrocnemius muscle. Measurements were made with a dedicated EIM system. A total of 11 healthy animals and 7 animals with spinal muscular atrophy (a form of motor neuron disease) were evaluated after the fur was completely removed with a depilatory agent from the hind limb. Standard electrophysiologic testing (compound motor action potential amplitude and motor unit number estimation) was also performed. The flexible electrode array demonstrated high repeatability in both the longitudinal and transverse directions in the healthy and diseased animals (with intraclass correlation coefficients of 0.94 and 0.89, respectively, for phase angle measured transversely). In addition, differences between healthy and diseased animals were identifiable. For example, the 50 kHz transverse phase angle was higher in the healthy as compared to the SMA animals (16.8° ± 0.5 vs. 14.3° ± 0.7, respectively) at 21 weeks of age (p = 0.01). Differences in anisotropy were also identifiable. Correlations to several standard neurophysiologic parameters also appeared promising. This novel flexible tetrapolar electrode array can be used on the mouse hind limb and provides multidirectional data that can be used to assess muscle health. This technique has the potential of finding widespread use in the evaluation of drug therapies in neuromuscular animal disease models.

  10. Myofascial trigger points and innervation zone locations in upper trapezius muscles

    PubMed Central

    2013-01-01

    Background Myofascial trigger points (MTrPs) are hyperirritable spots located in taut bands of muscle fibres. Electrophysiological studies indicate that abnormal electrical activity is detectable near MTrPs. This phenomenon has been described as endplate noise and it has been purported to be associated MTrP pathophysiology. Thus, it is suggested that MTrPs will be overlap the innervation zone (IZ). The purpose of this work was to describe the location of MTrPs and the IZ in the right upper trapezius. Methods We screened 71 individuals and eventually enrolled 24 subjects with neck pain and active MTrPs and 24 neck pain-free subjects with latent MTrPs. Surface electromyography (sEMG) signals were detected using an electrode matrix during isometric contraction of the upper trapezius. A physiotherapist subsequently examined the subject’s trapezius to confirm the presence of MTrPs and establish their location. IZ locations were identified by visual analysis of sEMG signals. IZ and MTrPs locations were described using an anatomical coordinate system (ACS), with the skin area covered by the matrix divided into four quadrants. Results No significant difference was observed between active and latent MTrPs locations (P = 0.6). Forty-five MTrPs were in the third quadrant of the ACS, and 3 were included in second quadrant. IZs were located approximately midway between the seventh cervical vertebrae and the acromial angle in a limited area in the second and third quadrants. The mean distance between MTrP and IZ was 10.4 ± 5.8 mm. Conclusions According to the acquired results, we conclude that IZ and MTrPs are located in well-defined areas in upper trapezius muscle. Moreover, MTrPs in upper trapezius are proximally located to the IZ but not overlapped. PMID:23758854

  11. The Cerebral Palsy Kinematic Assessment Tool (CPKAT): feasibility testing of a new portable tool for the objective evaluation of upper limb kinematics in children with cerebral palsy in the non-laboratory setting.

    PubMed

    Preston, Nick; Weightman, Andrew; Culmer, Peter; Levesley, Martin; Bhakta, Bipin; Mon-Williams, Mark

    2014-08-21

    Abstract Purpose: Efficacy of treatment to improve upper-limb activity of children with cerebral palsy (CP) is typically evaluated outside clinical/laboratory environments through functional outcome measures (e.g. ABILHAND kids). This study evaluates CPKAT, a new portable laptop-based tool designed to objectively measure upper-limb kinematics in children with CP. Methods: Seven children with unilateral CP (2 females; mean age 10 years 2 months (SD 2 years 3 months), median age 9 years 6 months, range 6 years 5 months, MACS II-IV) were evaluated on copying, tracking and tracing tasks at their homes using CPKAT. CPKAT recorded parameters relating to spatiotemporal hand movement: path length, movement time, smoothness, path accuracy and root mean square error. The Wilcoxon signed ranks test explored whether CPKAT could detect differences between the affected and less-affected limb. Results: CPKAT detected intra-limb differences for movement time and smoothness (aiming), and path length (tracing). No intra-limb tracking differences were found, as hypothesised. These findings are consistent with other studies showing that movements of the impaired upper limb in unilateral CP are slower and less smooth. Conclusion: CPKAT provides a potential solution for home-based assessment of upper limb kinematics in children with CP to supplement other measures and assess functional intervention outcomes. Further validation is required. Implications for Rehabilitation This paper demonstrates the feasibility of evaluating upper limb kinematics in home using CPKAT, a portable laptop-based evaluation tool. We found that CPKAT is easy to set-up and use in home environments and yields useful kinematic measures of upper limb function. CPKAT can complement less responsive patient reported or subjectively evaluated functional measures for a more complete evaluation of children with cerebral palsy. Thus, CPKAT can help guide a multi-disciplinary team to more effective intervention and rehabilitation for children with cerebral palsy. PMID:25144388

  12. Avaliação da bomba muscular da panturrilha em pacientes portadores de varizes primárias dos membros inferiores através da pletismografia a ar Assessment of calf muscle pump in patients with primary varicose veins of the lower limbs by air plethysmography

    Microsoft Academic Search

    André de Araújo Sacchi; Aldemar Araújo Castro; Guilherme Benjamin; Brandão Pitta; Fausto Miranda Junior

    Objective: This article aims at assessing the influence of calf muscle vein reflux (sural and genicular veins) on calf muscle pump function in patients with primary varicose veins of the lower limbs. Methods: Cross-sectional and prospective study assessing 120 patients divided into two groups (60 subjects each) by physical examination, duplex scan and air plethysmography. The first group showed calf

  13. Is salamander limb regeneration really perfect? Anatomical and morphogenetic analysis of forelimb muscle regeneration in GFP-transgenic axolotls as a basis for regenerative, developmental, and evolutionary studies.

    PubMed

    Diogo, R; Nacu, E; Tanaka, E M

    2014-06-01

    The axolotl Ambystoma mexicanum is one of the most commonly used model organisms in developmental and regenerative studies because it can reconstitute what is believed to be a completely normal anatomical and functional forelimb/hindlimb after amputation. However, to date it has not been confirmed whether each regenerated forelimb muscle is really a "perfect" copy of the original muscle. This study describes the regeneration of the arm, forearm, hand, and some pectoral muscles (e.g., coracoradialis) in transgenic axolotls that express green fluorescent protein (GFP) in muscle fibers. The observations found that: (1) there were muscle anomalies in 43% of the regenerated forelimbs; (2) however, on average in each regenerated forelimb there are anomalies in only 2.5% of the total number of muscles examined, and there were no significant differences observed in the specific insertion and origin of the other muscles analyzed; (3) one of the most notable and common anomalies (seen in 35% of the regenerated forelimbs) was the presence of a fleshy coracoradialis at the level of the arm; this is a particularly outstanding configuration because in axolotls and in urodeles in general this muscle only has a thin tendon at the level of the arm, and the additional fleshy belly in the regenerated arms is strikingly similar to the fleshy biceps brachii of amniotes, suggesting a remarkable parallel between a regeneration defect and a major phenotypic change that occurred during tetrapod limb evolution; (4) during forelimb muscle regeneration there was a clear proximo-distal and radio-ulnar morphogenetic gradient, as seen in normal development, but also a ventro-dorsal gradient in the order of regeneration, which was not previously described in the literature. These results have broader implications for regenerative, evolutionary, developmental and morphogenetic studies. PMID:24692358

  14. Botulinum Toxin Type a Injection, Followed by Home-Based Functional Training for Upper Limb Hemiparesis after Stroke

    ERIC Educational Resources Information Center

    Takekawa, Toru; Kakuda, Wataru; Taguchi, Kensuke; Ishikawa, Atsushi; Sase, Yousuke; Abo, Masahiro

    2012-01-01

    Botulinum toxin type A (BoNT-A) has been reported to be an effective treatment for limb spasticity after stroke. However, the reduction in the spasticity after BoNT-A injection alone does not ensure an improvement in the active motor function of the affected limb. The aim of this study was to clarify the clinical effects of a BoNT-A injection,…

  15. Use of the Halstead Category Test as a cognitive predictor of functional recovery in the hemiplegic upper limb: a cross-validation study.

    PubMed

    Barreca, S R; Finlayson, M A; Gowland, C A; Basmajian, J V

    1999-05-01

    Current motor learning theory suggests that recovery in the hemiplegic upper limb partially depends on the client's cognitive ability to maximize sensory feedback in order to activate appropriate efferent motor pathways. Study 1 investigated the use of the Category Test as a predictor of functional recovery. Initial scores on the Upper Extremity Function Test and the Category Test explained 81% of the variance of the discharge Upper Extremity Function score (N = 29). Psychological factors such as the client's attitude and motivation were less significant than more direct measures of the biological event. Study 2 (N = 16) confirmed these results and also found that stroke survivors who made fewer errors on the Category Test performed better on a functional disability test. Survivors making the fewest errors on the Category Test also showed the greatest amount of change in arm and hand function. The results are discussed in terms of the role of cognitive and biological factors that might influence recovery. PMID:10949158

  16. The extensor digitorum brevis muscle flap for the reconstruction of soft tissue defects in the lower limb

    Microsoft Academic Search

    A. D. Mandrekas; G. J. Zambacos; T. M. Grivas

    1995-01-01

    The use of the extensor digitorum brevis muscle as a local muscle island flap for the cover of soft tissue defects in the lower extremity is presented. The anatomy of the muscle, the blood supply, the elevation, and use of the extensor digitorum brevis muscle flap in the lower extremity are discussed. This flap offers a mean area of 27

  17. Reproducibility of MUAP properties in array surface EMG recordings of the upper trapezius and sternocleidomastoid muscle.

    PubMed

    Kallenberg, Laura A C; Preece, Stephen; Nester, Chris; Hermens, Hermie J

    2009-12-01

    The use of array surface EMG recordings for detailed assessment of motor control and muscle properties is increasing. Motor unit action potentials (MUAPs) and their properties can be extracted from these recordings. The objective of this study was to determine the reproducibility of variables obtained from array surface EMG recordings of the shoulder and neck muscles during different functional tasks. Eight-channel linear arrays were placed on the upper trapezius (UT) and sternocleidomastoid (SCM) muscles of 12 healthy subjects. Subjects performed 3 tasks: shoulder abduction (90 degrees), ironing (repetitively touching two ends of a horizontal bar in front of the subject), and 90 degrees head turning. The protocol was performed twice while electrodes remained on and repeated a third time a week later. Three global and six MUAP-related variables were calculated. Intra-class correlation coefficients (ICC) were calculated to assess reliability and smallest detectable changes (SDC) were calculated to assess agreement. In general, the EMG variables showed high levels of reliability which suggests they may be effective for differentiating between-subjects. SDC was found to be considerably lower for the frequency-related (5-23%) than for the amplitude-related variables (15-78%), indicating that the frequency-related variables may be more suitable for investigating interventions which aim to modify motor control. There was no difference in reproducibility between global and MUAP-related variables, which justifies their complementary use. PMID:19138534

  18. A variation of the cords of the brachial plexus on the right and a communication between the musculocutaneous and median nerves on the left upper limb: a unique case.

    PubMed

    Kirazl?, Özlem; Tatarl?, Necati; Ceylan, Davut; Hac?o?lu, Hüsniye; Uygun, Seda; ?eker, A?k?n; Kele?, Evren; Çavdar, Safiye

    2013-12-01

    During routine anatomical dissection of the upper extremity of a 64-year-old cadaver for educational purposes, we observed variations in the brachial plexus on each side. On the right an anomaly of cord formation was present and on the left there was a communication between the musculocutaneous nerve (MCN) and median nerve (MN). On the right side the brachial plexus showed two trunks, superior (C5 and C6) and inferior (C7, C8, and T1); the middle trunk was absent. The superior trunk bifurcated into anterior and posterior divisions, the anterior division continued as the lateral cord forming the MCN. The posterior division gave off the subscapular branch. The inferior trunk trifurcated into radial, median, and ulnar nerves. The radial nerve gave off the axillary and thoracodorsal nerves. The ulnar nerve gave off the median cutaneous nerves of the arm and forearm. The median nerve received a small ascending branch from the MCN. On the right side, there was a communicating branch from the MCN to the MN in the lower third of the arm region. This communicating branch also gave rise to a muscular branch to the brachialis muscle and the lateral cutaneous nerve of forearm. No additional heads of the biceps brachii muscle were observed in either upper limb. Knowledge of the variations of the brachial plexus in humans can be valuable for operations of the shoulder joint and its repair for providing an effective block or treatment for anesthetists and also for explaining otherwise incomprehensible clinical signs for neurologists. PMID:23444130

  19. Quality parameters for a multimodal EEG/EMG/kinematic brain-computer interface (BCI) aiming to suppress neurological tremor in upper limbs

    PubMed Central

    Grimaldi, Giuliana; Manto, Mario; Jdaoudi, Yassin

    2014-01-01

    Tremor is the most common movement disorder encountered during daily neurological practice. Tremor in the upper limbs causes functional disability and social inconvenience, impairing daily life activities. The response of tremor to pharmacotherapy is variable. Therefore, a combination of drugs is often required. Surgery is considered when the response to medications is not sufficient. However, about one third of patients are refractory to current treatments. New bioengineering therapies are emerging as possible alternatives. Our study was carried out in the framework of the European project “Tremor” (ICT-2007-224051). The main purpose of this challenging project was to develop and validate a new treatment for upper limb tremor based on the combination of functional electrical stimulation (FES; which has been shown to reduce upper limb tremor) with a brain-computer interface (BCI). A BCI-driven detection of voluntary movement is used to trigger FES in a closed-loop approach. Neurological tremor is detected using a matrix of EMG electrodes and inertial sensors embedded in a wearable textile. The identification of the intentionality of movement is a critical aspect to optimize this complex system. We propose a multimodal detection of the intentionality of movement by fusing signals from EEG, EMG and kinematic sensors (gyroscopes and accelerometry). Parameters of prediction of movement are extracted in order to provide global prediction plots and trigger FES properly. In particular, quality parameters (QPs) for the EEG signals, corticomuscular coherence and event-related desynchronization/synchronization (ERD/ERS) parameters are combined in an original algorithm which takes into account the refractoriness/responsiveness of tremor. A simulation study of the relationship between the threshold of ERD/ERS of artificial EEG traces and the QPs is also provided. Very interestingly, values of QPs were much greater than those obtained for the corticomuscular module alone. PMID:25339986

  20. SEMG analysis of astronaut upper arm during isotonic muscle actions with normal standing posture

    NASA Astrophysics Data System (ADS)

    Qianxiang, Zhou; Chao, Ma; Xiaohui, Zheng

    sEMG analysis of astronaut upper arm during isotonic muscle actions with normal standing posture*1 Introduction Now the research on the isotonic muscle actions by using Surface Electromyography (sEMG) is becoming a pop topic in fields of astronaut life support training and rehabilitations. And researchers paid more attention on the sEMG signal processes for reducing the influence of noise which is produced during monitoring process and the fatigue estimation of isotonic muscle actions with different force levels by using the parameters which are obtained from sEMG signals such as Condition Velocity(CV), Median Frequency(MDF), Mean Frequency(MNF) and so on. As the lucubrated research is done, more and more research on muscle fatigue issue of isotonic muscle actions are carried out with sEMG analysis and subjective estimate system of Borg scales at the same time. In this paper, the relationship between the variable for fatigue based on sEMG and the Borg scale during the course of isotonic muscle actions of the upper arm with different contraction levels are going to be investigated. Methods 13 young male subjects(23.4±2.45years, 64.7±5.43Kg, 171.7±5.41cm) with normal standing postures were introduced to do isotonic actions of the upper arm with different force levels(10% MVC, 30%MVC and 50%MVC). And the MVC which means maximal voluntary contraction was obtained firstly in the experiment. Also the sEMG would be recorded during the experiments; the Borg scales would be recorded for each contraction level. By using one-third band octave method, the fatigue variable (p) based on sEMG were set up and it was expressed as p = i g(fi ) · F (fi ). And g(fi ) is defined as the frequent factor which was 0.42+0.5 cos(? fi /f0 )+0.08 cos(2? fi /f0 ), 0 < FI fi 0, orf0 ?> f0 . According to the equations, the p could be computed and the relationship between variable p and the Borg scale would be investigated. Results In the research, three kinds of fitted curves between variable p and Borg scale were done, which were the quadratic curve, quintic curve and exponent curve. And 1 * Foundation Item: Supported by National Nature Science Foundation (60673013) the results showed that the relationship could be expressed as quadratic curve curves in certain scales. From the results it could concluded that the variable based on sEMG with one-third band octave method could really reflected the changes of fatigue caused by different isotonic contraction force levels; the variable and the Borg scale could be fitted with conic curves. And the continuous study could be done for learning the numerical relations between fatigue and sEMG during isometric actions with different force levels. Also it would be better for the supports training and rehabilitation training and other involved issues. References 1. Coorevits P, Danneels L, Cambier D, et al. Correlations between short-time Fourier-and continuous wavelet transforms in the analysis of localized back and hip muscle fatigue during isometric contractions[J]. Journal of Electromyography and Kinesiology. 2008, 18(??): 637-644. 2. Ryan E D, Cramer J T, Egan A D, et al. Time and frequency domain responses of the mechanomyogram and electromyogram during isometric ramp contractions: A comparison of the short-time Fourier and continuous wavelet transforms[J]. Journal of Electromyog-raphy and Kinesiology. 2008, 18(??): 54-67. 3. Coorevits P,danneels L, Cambier D E A. Correlations between short-time Fourier-and continuous wavelet transforms in the analysis of localized back and hip muscle fatigue during isometric contractions[J]. Journal of Electromyography and Kinesiology. 2008, 18(??): 637-644. 4. Dimitrova N A, Arabadzhiev T I, Hogrel J Y E A. Fatigue analysis of interference EMG signals obtained from biceps brachii during isometric voluntary contraction at various force levels[J]. Journal of Electromyography and Kinesiology. 2009, 19(??): 252-258. 5. Troiano A, Mesin L, Naddeo F, et al. Assessment of force and fatigue in isometric contractions of upper trapezius muscle by perceived exertion

  1. Evaluating potential biomarkers of cachexia and survival in skeletal muscle of upper gastrointestinal cancer patients

    PubMed Central

    Stephens, Nathan A; Skipworth, Richard J E; Gallagher, Iain J; Greig, Carolyn A; Guttridge, Denis C; Ross, James A; Fearon, Kenneth C H

    2015-01-01

    Background In order to grow the potential therapeutic armamentarium in the cachexia domain of supportive oncology, there is a pressing need to develop suitable biomarkers and potential drug targets. This pilot study evaluated several potential candidate biomarkers in skeletal muscle biopsies from a cohort of upper gastrointestinal cancer (UGIC) patients. Methods One hundred seven patients (15 weight-stable healthy controls (HC) and 92 UGIC patients) were recruited. Mean (standard deviation) weight-loss of UGIC patients was 8.1 (9.3%). Cachexia was defined as weight-loss ?5%. Rectus?abdominis muscle was obtained at surgery and was analysed by western blotting or quantitative real-time–polymerase chain reaction. Candidate markers were selected according to previous literature and included Akt and phosphorylated Akt (pAkt, n?=?52), forkhead box O transcription factors (n?=?59), ubiquitin E3 ligases (n?=?59, control of muscle anabolism/catabolism), BNIP3 and GABARAPL1 (n?=?59, as markers of autophagy), myosin heavy-chain (MyHC, n?=?54), dystrophin (n?=?39), ?-dystroglycan (n?=?52), and ?-sarcoglycan (n?=?52, as markers of structural alteration in a muscle). Patients were followed up for an average of 1255?days (range 581–1955?days) or until death. Patients were grouped accordingly and analysed by (i) all cancer patients vs. HC; (ii) cachectic vs. non-cachectic cancer patients; and (iii) cancer patients surviving ?1 vs. >1?year post operatively. Results Cancer compared with HC patients had reduced mean (standard deviation) total Akt protein [0.49 (0.31) vs. 0.89 (0.17), P?=?0.001], increased ratio of phosphorylated to total Akt [1.33 (1.04) vs. 0.32 (0.21), P?=?0.002] and increased expression of GABARAPL1 [1.60 (0.76) vs. 1.10 (0.57), P?=?0.024]. ?-Dystroglycan levels were higher in cachectic compared with non-cachectic cancer patients [1.01 (0.16) vs. 0.87 (0.20), P?=?0.007]. Survival was shortened in patients with low compared with high MyHC levels (median 316 vs. 1326?days, P?=?0.023) and dystrophin levels (median 341 vs. 660?days, P?=?0.008). Conclusions The present study has identified intramuscular protein level of ?-dystroglycan as a potential biomarker of cancer cachexia. Changes in the structural elements of muscle (MyHC or dystrophin) appear to be survival biomarkers. PMID:26136412

  2. Evaluation of upper body muscle activity during cardiopulmonary resuscitation performance in simulated microgravity

    NASA Astrophysics Data System (ADS)

    Waye, A. B.; Krygiel, R. G.; Susin, T. B.; Baptista, R.; Rehnberg, L.; Heidner, G. S.; de Campos, F.; Falcão, F. P.; Russomano, T.

    2013-09-01

    Performance of efficient single-person cardiopulmonary resuscitation (CPR) is vital to maintain cardiac and cerebral perfusion during the 2-4 min it takes for deployment of advanced life support during a space mission. The aim of the present study was to investigate potential differences in upper body muscle activity during CPR performance at terrestrial gravity (+1Gz) and in simulated microgravity (?G). Muscle activity of the triceps brachii, erector spinae, rectus abdominis and pectoralis major was measured via superficial electromyography in 20 healthy male volunteers. Four sets of 30 external chest compressions (ECCs) were performed on a mannequin. Microgravity was simulated using a body suspension device and harness; the Evetts-Russomano (ER) method was adopted for CPR performance in simulated microgravity. Heart rate and perceived exertion via Borg scores were also measured. While a significantly lower depth of ECCs was observed in simulated microgravity, compared with +1Gz, it was still within the target range of 40-50 mm. There was a 7.7% decrease of the mean (±SEM) ECC depth from 48 ± 0.3 mm at +1Gz, to 44.3 ± 0.5 mm during microgravity simulation (p < 0.001). No significant difference in number or rate of compressions was found between the two conditions. Heart rate displayed a significantly larger increase during CPR in simulated microgravity than at +1Gz, the former presenting a mean (±SEM) of 23.6 ± 2.91 bpm and the latter, 76.6 ± 3.8 bpm (p < 0.001). Borg scores were 70% higher post-microgravity compressions (17 ± 1) than post +1Gz compressions (10 ± 1) (p < 0.001). Intermuscular comparisons showed the triceps brachii to have significantly lower muscle activity than each of the other three tested muscles, in both +1Gz and microgravity. As shown by greater Borg scores and heart rate increases, CPR performance in simulated microgravity is more fatiguing than at +1Gz. Nevertheless, no significant difference in muscle activity between conditions was found, a result that is favourable for astronauts, given the inevitable muscular and cardiovascular deconditioning that occurs during space travel.

  3. Active biofeedback changes the spatial distribution of upper trapezius muscle activity during computer work.

    PubMed

    Samani, Afshin; Holtermann, Andreas; Søgaard, Karen; Madeleine, Pascal

    2010-09-01

    The aim of this study was to investigate the spatio-temporal effects of advanced biofeedback by inducing active and passive pauses on the trapezius activity pattern using high-density surface electromyography (HD-EMG). Thirteen healthy male subjects performed computer work with superimposed feedback either eliciting passive (rest) or active (approximately 30% MVC) pauses based on fuzzy logic design and a control session with no feedback. HD-EMG signals of upper trapezius were recorded using a 5 x 13 multichannel electrode grid. From the HD-EMG recordings, two-dimensional maps of root mean square (RMS), relative rest time (RRT) and permuted sample entropy (PeSaEn) were obtained. The centre of gravity (CoG) and entropy of maps were used to quantify changes in the spatial distribution of muscle activity. PeSaEn as a measure of temporal heterogeneity for each channel, decreased over the whole map in response to active pause (P < 0.05) underlining a more homogenous activation pattern. Concomitantly, the CoG of RRT maps moved in caudal direction and the entropy of RMS maps as a measure of spatial heterogeneity over the whole recording grid, increased in response to active pause session compared with control session (no feedback) (P < 0.05). Active pause compared with control resulted in more heterogeneous coordination of trapezius compared with no feedback implying a more uneven spatial distribution of the biomechanical load. The study introduced new aspects in relation to the potential benefit of superimposed muscle contraction in relation to the spatial organization of muscle activity during computer work. PMID:20512502

  4. The use of bone morphogenic protein-7 (OP-1) in the management of resistant non-unions in the upper and lower limb.

    PubMed

    Papanna, M C; Al-Hadithy, N; Somanchi, B V; Sewell, M D; Robinson, P M; Khan, S A; Wilkes, R A

    2012-07-01

    The aim of the present study was to investigate the safety and efficacy of local implantation of BMP-7 for the treatment of resistant non-unions in the upper and lower limb. Fifty-two patients (30 males, mean age 52.8 years; range 20-81) were treated with local BMP-7 implantation in a bovine bone-derived collagen paste with or without revision of fixation. Thirty-six patients had closed injuries, ten had open injuries and six had infected non-unions. Patients had undergone a mean of 2 (1-5) operations prior to implantation of BMP-7. Clinical and radiological union was achieved in 94% at a mean time of 5.6 months (3-19). Two patients with subtrochanteric femoral fractures failed to achieve union secondary to inadequate fracture stabilisation, persistent unfavourable biological environment and systemic co-morbidities. One patient developed synostosis attributed to the BMP-7 application. This study demonstrates BMP-7 implanted in a bovine-derived collagen paste is an effective adjunctive treatment for resistant non-unions in the upper and lower limb. PMID:22465515

  5. Effect of caffeine ingestion on maximal voluntary contraction strength in upper- and lower-body muscle groups.

    PubMed

    Timmins, Tomas D; Saunders, David H

    2014-11-01

    The effect of caffeine on strength-power performance is equivocal, especially with regard to maximal voluntary contraction (MVC) strength. This is partly related to differences in upper- and lower-body musculature. However, there is no evidence to suggest whether this is a product of muscle group location, muscle group size, or both. Consequently, the primary aim of this study was to establish whether the effect of caffeine ingestion on MVC strength in upper- and lower-body muscle groups is significantly different, and if so, to determine whether this is a product of muscle group size. In a randomized, subject-blind crossover manner, 16 resistance-trained men (estimated caffeine intake [mean ± SD] 95.4 ± 80.0 mg·d) received either 6 mg·kg of caffeine (CAF) or a placebo (PLA). Isokinetic peak torque of the knee extensors, ankle plantar flexors, elbow flexors and wrist flexors were measured at an angular velocity of 60°·s. Statistical analyses revealed a significant increase in isokinetic peak torque from PLA to CAF (p = 0.011) and a significant difference in isokinetic peak torque between muscle groups (p < 0.001). However, there was no significant treatment × muscle group interaction (p = 0.056). Nonetheless, the %improvement in isokinetic peak torque with caffeine increased with muscle group size. In conclusion, a moderate dose of caffeine improves MVC strength in resistance-trained men regardless of muscle group location, whereas the influence of muscle group size remains uncertain. This research may be useful for competitive and recreational athletes aiming to increase strength-power performance. PMID:25144133

  6. Quantitative Estimation of Muscle Shear Elastic Modulus of the Upper Trapezius with Supersonic Shear Imaging during Arm Positioning

    PubMed Central

    Leong, Hio-Teng; Ng, Gabriel Yin-fat; Leung, Vivian Yee-fong; Fu, Siu Ngor

    2013-01-01

    Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age?=?29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC?=?0.87–0.97) and inter-observer (ICC?=?0.78–0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders. PMID:23825641

  7. Quantitative estimation of muscle shear elastic modulus of the upper trapezius with supersonic shear imaging during arm positioning.

    PubMed

    Leong, Hio-Teng; Ng, Gabriel Yin-Fat; Leung, Vivian Yee-Fong; Fu, Siu Ngor

    2013-01-01

    Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age?=?29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC?=?0.87-0.97) and inter-observer (ICC?=?0.78-0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders. PMID:23825641

  8. 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

  9. Clinical features and a mutation with late onset of limb girdle muscular dystrophy 2B

    PubMed Central

    Takahashi, Toshiaki; Aoki, Masashi; Suzuki, Naoki; Tateyama, Maki; Yaginuma, Chikako; Sato, Hitomi; Hayasaka, Miho; Sugawara, Hitomi; Ito, Mariko; Abe-Kondo, Emi; Shimakura, Naoko; Ibi, Tohru; Kuru, Satoshi; Wakayama, Tadashi; Sobue, Gen; Fujii, Naoki; Saito, Toshio; Matsumura, Tsuyoshi; Funakawa, Itaru; Mukai, Eiichiro; Kawanami, Toru; Morita, Mitsuya; Yamazaki, Mineo; Hasegawa, Takashi; Shimizu, Jun; Tsuji, Shoji; Kuzuhara, Shigeki; Tanaka, Hiroyasu; Yoshioka, Masaru; Konno, Hidehiko; Onodera, Hiroshi; Itoyama, Yasuto

    2013-01-01

    Objective and methods Dysferlin encoded by DYSF deficiency leads to two main phenotypes, limb girdle muscular dystrophy (LGMD) 2B and Miyoshi myopathy. To reveal in detail the mutational and clinical features of LGMD2B in Japan, we observed 40 Japanese patients in 36 families with LGMD2B in whom dysferlin mutations were confirmed. Results and conclusions Three mutations (c.1566C>G, c.2997G>T and c.4497delT) were relatively more prevalent. The c.2997G>T mutation was associated with late onset, proximal dominant forms of dysferlinopathy, a high probability that muscle weakness started in an upper limb and lower serum creatine kinase (CK) levels. The clinical features of LGMD2B are as follows: (1) onset in the late teens or early adulthood, except patients homozygous for the c.2997G>T mutation; (2) lower limb weakness at onset; (3) distal change of lower limbs on muscle CT at an early stage; (4) impairment of lumbar erector spinal muscles on muscle CT at an early stage; (5) predominant involvement of proximal upper limbs; (6) preservation of function of the hands at late stage; (7) preservation of strength in neck muscles at late stage; (8) lack of facial weakness or dysphagia; (9) avoidance of scoliosis; (10) hyper-Ckaemia; (11) preservation of cardiac function; and (12) a tendency for respiratory function to decline with disease duration. It is important that the late onset phenotype is found with prevalent mutations. PMID:23243261

  10. Development of a Physics-based Target Shooting Game to Train Amputee Users of Multijoint Upper Limb Prostheses

    E-print Network

    Loeb, Gerald E.

    movements by the prosthetic arm and the primitive control strategies produce unnatural robot-like #12 different sets of residual muscles to rotate the forearm, to flex the wrist, and then close the hand, which

  11. 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

  12. 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

  13. The effect of muscle weakness on the capability gap during gross motor function: a simulation study supporting design criteria for exoskeletons of the lower limb

    PubMed Central

    2014-01-01

    Background Enabling persons with functional weaknesses to perform activities of daily living (ADL) is one of the main challenges for the aging society. Powered orthoses, or exoskeletons, have the potential to support ADL while promoting active participation of the user. For this purpose, assistive devices should be designed and controlled to deliver assistance as needed (AAN). This means that the level of assistance should bridge the capability gap, i.e. the gap between the capabilities of the subjects and the task requirements. However, currently the actuators of exoskeletons are mainly designed using inverse dynamics (ID) based calculations of joint moments. The goal of the present study is to calculate the capability gap for the lower limb during ADL when muscle weakness is present, which is needed for appropriate selection of actuators to be integrated in exoskeletons. Methods A musculoskeletal model (MM) is used to calculate the joint kinematics, joint kinetics and muscle forces of eight healthy subjects during ADL (gait, sit-to-stand, stand-to-sit, stair ascent, stair descent). Muscle weakness was imposed to the MM by a stepwise decrease in maximal isometric force imposed to all muscles. Muscle forces were calculated using static optimization. In order to compensate for muscle weakness, ideal moment actuators that represent the motors of an exoskeleton in the simulation were added to deliver AAN required to perform the task. Results The ID approach overestimates the required assistance since it relies solely on the demands of the task, whereas the AAN approach incorporates the capabilities of the subject. Furthermore, the ID approach delivers continuous support whereas the AAN approach targets the period where a capability gap occurs. The level of muscle weakness for which the external demands imposed by ADL can no longer be met by active muscle force production, is respectively 40%, 70%, 80% and 30%. Conclusions The present workflow allows estimating the AAN during ADL for different levels of muscle weakness, which can be used in the mechatronic design and control of powered exoskeletons. The AAN approach is a more physiological approach than the ID approach, since the MM accounts for the subject-specific capabilities of the user. PMID:25092209

  14. Distal and scapuloperoneal distributions of muscle involvement occurring within a family with type I hereditary motor and sensory neuropathy

    Microsoft Academic Search

    A. E. Harding; P. K. Thomas

    1980-01-01

    Davidenkow's syndrome has been defined as a hereditary disorder characterized by proximal muscle weakness and wasting in the upper limbs with distal weakness in the lower, and associated with distal sensory loss in all four limbs. It has been assumed to be genetically distinct. A family is described in which the index case displayed these features. Motor nerve conduction velocity

  15. Influence of duty cycle on the time course of muscle fatigue and the onset of neuromuscular compensation during exhaustive dynamic isolated limb exercise.

    PubMed

    Sundberg, Christopher W; Bundle, Matthew W

    2015-07-01

    We investigated the influence of altered muscle duty cycle on the performance decrements and neuromuscular responses occurring during constant-load, fatiguing bouts of knee extension exercise. We experimentally altered the durations of the muscularly inactive portion of the limb movement cycle and hypothesized that greater relative durations of inactivity within the same movement task would 1) reduce the rates and extent of muscle performance loss and 2) increase the forces necessary to trigger muscle fatigue. In each condition (duty cycle = 0.6 and 0.3), male subjects [age = 25.9 ± 2.0 yr (SE); mass = 85.4 ± 2.6 kg], completed 9-11 exhaustive bouts of two-legged knee extension exercise, at force outputs that elicited failure between 4 and 290 s. The novel duty cycle manipulation produced two primary results; first, we observed twofold differences in both the extent of muscle performance lost (DC0.6 = 761 ± 35 N vs. DC0.3 = 366 ± 49 N) and the time course of performance loss. For example, exhaustive trials at the midpoint of these force ranges differed in duration by more than 30 s (t0.6 = 36 ± 2.6 vs. t0.3 = 67 ± 4.3 s). Second, both the minimum forces necessary to exceed the peak aerobic capacity and initiate a reliance on anaerobic metabolism, and the forces necessary to elicit compensatory increases in electromyogram activity were 300% greater in the lower vs. higher duty cycle condition. These results indicate that the fatigue-induced compensatory behavior to recruit additional motor units is triggered by a reliance on anaerobic metabolism for ATP resynthesis and is independent of the absolute level or fraction of the maximum force produced by the muscle. PMID:25876654

  16. Whole-body vibration increases upper and lower body muscle activity in older adults: potential use of vibration accessories.

    PubMed

    Marín, Pedro J; Santos-Lozano, Alejandro; Santin-Medeiros, Fernanda; Vicente-Rodriguez, German; Casajús, Jose A; Hazell, Tom J; Garatachea, Nuria

    2012-06-01

    The current study examined the effects of whole-body vibration (WBV) on upper and lower body muscle activity during static muscle contractions (squat and bicep curls). The use of WBV accessories such as hand straps attached to the platform and a soft surface mat were also evaluated. Surface electromyography (sEMG) was measured for the medial gastrocnemius (MG), vastus lateralis (VL), and biceps brachii (BB) muscles in fourteen healthy older adults (74.8±4.5 years; mean±SD) with a WBV stimulus at an acceleration of 40 m s(-2) (30 Hz High, 2.5 mm or 46 Hz Low, 1.1 mm). WBV increased lower body (VL and MG) sEMG vs baseline (no WBV) though this was decreased with the use of the soft mat. The addition of the bicep curl with hand straps had no effect on lower body sEMG. WBV also increased BB sEMG vs baseline which was further increased when using the hand straps. There was no upper body effect of the soft mat. This study demonstrates WBV increases both lower and upper body muscle activity in healthy older adults. Moreover, WBV accessories such as hand straps attached to the platform or a soft surface mat may be used to alter exercise intensity. PMID:22406015

  17. The Classification of Swanson for Congenital Anomalies of Upper Limb Modified by the Japanese Society for Surgery of the Hand (JSSH).

    PubMed

    Iba, Kousuke; Horii, Emiko; Ogino, Toshihiko; Kazuki, Kenichi; Kashiwa, Katsuhiko

    2015-06-01

    The aim of this study is to introduce the classification of Swanson for congenital anomalies of upper limb modified by the Japanese Society for Surgery of the Hand (the JSSH modification) in English. The Swanson classification has been widely accepted by most hand surgeons. However, several authors have suggested that complex cases, particularly those involving the complex spectrum of cleft hand and symbrachydactyly, are difficult to classify into the classification schemes. In the JSSH modification, brachysyndactyly, so-called atypical cleft hand and transverse deficiency are included under the same concept of transverse deficiency. Cleft hand, central polydactyly, and syndactyly are included in the same category of abnormal induction of digital rays. We believe that the JSSH modification system is effective in providing hand surgeons with the clinical features and conditions for congenital anomalies. PMID:26094485

  18. Impact of experience when using the Rapid Upper Limb Assessment to assess postural risk in children using information and communication technologies.

    PubMed

    Chen, Janice D; Falkmer, Torbjörn; Parsons, Richard; Buzzard, Jennifer; Ciccarelli, Marina

    2014-05-01

    The Rapid Upper Limb Assessment (RULA) is an observation-based screening tool that has been used to assess postural risks of children in school settings. Studies using eye-tracking technology suggest that visual search strategies are influenced by experience in the task performed. This study investigated if experience in postural risk assessments contributed to differences in outcome scores on the RULA and the visual search strategies utilized. While wearing an eye-tracker, 16 student occupational therapists and 16 experienced occupational therapists used the RULA to assess 11 video scenarios of a child using different mobile information and communication technologies (ICT) in the home environment. No significant differences in RULA outcome scores, and no conclusive differences in visual search strategies between groups were found. RULA can be used as a screening tool for postural risks following a short training session regardless of the assessor's experience in postural risk assessments. PMID:23735750

  19. Connecting Surface Emissions, Convective Uplifting, and Long-Range Transport of Carbon Monoxide in the Upper Troposphere: New Observations from the Aura Microwave Limb Sounder

    NASA Technical Reports Server (NTRS)

    Jiang, Jonathan H.; Livesey, Nathaniel J.; Su, Hui; Neary, Lori; McConnell, John C.; Richards, Nigel A. D.

    2007-01-01

    Two years of observations of upper tropospheric (UT) carbon monoxide (CO) from the Aura Microwave Limb Sounder are analyzed; in combination with the CO surface emission climatology and data from the NCEP analyses. It is shown that spatial distribution, temporal variation and long-range transport of UT CO are closely related to the surface emissions, deep-convection and horizontal winds. Over the Asian monsoon region, surface emission of CO peaks in boreal spring due to high biomass burning in addition to anthropogenic emission. However, the UT CO peaks in summer when convection is strongest and surface emission of CO is dominated by anthropogenic source. The long-range transport of CO from Southeast Asia across the Pacific to North America, which occurs most frequently during boreal summer, is thus a clear imprint of Asian anthropogenic pollution influencing global air quality.

  20. Kinematic Metrics Based on the Virtual Reality System Toyra as an Assessment of the Upper Limb Rehabilitation in People with Spinal Cord Injury

    PubMed Central

    Trincado-Alonso, Fernando; Dimbwadyo-Terrer, Iris; de los Reyes-Guzmán, Ana; López-Monteagudo, Patricia; Bernal-Sahún, Alberto; Gil-Agudo, Ángel

    2014-01-01

    The aim of this study was to develop new strategies based on virtual reality that can provide additional information to clinicians for the rehabilitation assessment. Virtual reality system Toyra has been used to record kinematic information of 15 patients with cervical spinal cord injury (SCI) while performing evaluation sessions using the mentioned system. Positive correlation, with a moderate and very strong association, has been found between clinical scales and kinematic data, considering only the subscales more closely related to the upper limb function. A set of metrics was defined combining these kinematic data to obtain parameters of reaching amplitude, joint amplitude, agility, accuracy, and repeatability during the evaluation sessions of the virtual reality system Toyra. Strong and moderate correlations have been also found between the metrics reaching and joint amplitude and the clinical scales. PMID:24895627

  1. Managing type II work-related upper limb disorders in keyboard and mouse users who remain at work: a case series report.

    PubMed

    Povlsen, Bo; Rose, Robyn-Lee

    2008-01-01

    Work-related upper limb disorders (WRULDs) are difficult to diagnose due to the limited availability of recognized objective assessment methods. This case series report demonstrates the use of the "typing capacity cycle" test and standardized clinical tests as outcome measures to assess work capacity in four high-intensity keyboard and mouse users who remain at work before and after the implementation of a six-month treatment program. Pain intensity, the duration of pain before treatment, the duration of treatment, type of work, and the location of the pain were recorded for each patient. Function was assessed before and after treatment using the Functional Grading Scale. The assessment results were analyzed to determine any improvements made after rehabilitation. The outcomes indicate that all patients improved their resting pain and work capacity with the three-phase rehabilitation program. PMID:18215754

  2. Tbx4 and Tbx5 acting in connective tissue are required for limb muscle and tendon patterning

    PubMed Central

    Hasson, Peleg; DeLaurier, April; Bennett, Michael; Grigorieva, Elena; Naiche, L. A.; Papaioannou, Virginia E.; Mohun, Timothy J.; Logan, Malcolm P.O.

    2010-01-01

    Summary Proper functioning of the musculo-skeletal system requires the precise integration of bones, muscles and tendons. Complex morphogenetic events ensure that these elements are linked together in the appropriate 3D configuration. It has been difficult, however, to tease apart the mechanisms that regulate tissue morphogenesis. We find that deletion of Tbx5 in forelimb (or Tbx4 in hindlimbs) specifically affects muscle and tendon patterning without disrupting skeletal development thus suggesting that distinct cues regulate these processes. We identify muscle connective tissue as the site of action of these transcription factors and show that N-Cadherin and ?-Catenin are key downstream effectors acting in muscle connective tissue regulating soft-tissue morphogenesis. In humans, TBX5 mutations lead to Holt-Oram syndrome, which is characterised by forelimb musculo-skeletal defects. Our results suggest that a focus on connective tissue is required to understand the aetiology of diseases affecting soft tissue formation. PMID:20152185

  3. Effect of Acute Inspiratory Muscle Exercise on Blood Flow of Resting and Exercising Limbs and Glucose Levels in Type 2 Diabetes

    PubMed Central

    Corrêa, Ana Paula dos Santos; Antunes, Cristiano Fetter; Figueira, Franciele Ramos; de Castro, Marina Axmann; Schaan, Beatriz D’Agord

    2015-01-01

    To evaluate the effects of inspiratory loading on blood flow of resting and exercising limbs in patients with diabetic autonomic neuropathy. Ten diabetic patients without cardiovascular autonomic neuropathy (DM), 10 patients with cardiovascular autonomic neuropathy (DM-CAN) and 10 healthy controls (C) were randomly assigned to inspiratory muscle load of 60% or 2% of maximal inspiratory pressure (PImax) for approximately 5 min, while resting calf blood flow (CBF) and exercising forearm blood flow (FBF) were measured. Reactive hyperemia was also evaluated. From the 20 diabetic patients initially allocated, 6 wore a continuous glucose monitoring system to evaluate the glucose levels during these two sessions (2%, placebo or 60%, inspiratory muscle metaboreflex). Mean age was 58 ± 8 years, and mean HbA1c, 7.8% (62 mmol/mol) (DM and DM-CAN). A PImax of 60% caused reduction of CBF in DM-CAN and DM (P<0.001), but not in C, whereas calf vascular resistance (CVR) increased in DM-CAN and DM (P<0.001), but not in C. The increase in FBF during forearm exercise was blunted during 60% of PImax in DM-CAN and DM, and augmented in C (P<0.001). Glucose levels decreased by 40 ± 18.8% (P<0.001) at 60%, but not at 2%, of PImax. A negative correlation was observed between reactive hyperemia and changes in CVR (Beta coefficient = -0.44, P = 0.034). Inspiratory muscle loading caused an exacerbation of the inspiratory muscle metaboreflex in patients with diabetes, regardless of the presence of neuropathy, but influenced by endothelial dysfunction. High-intensity exercise that recruits the diaphragm can abruptly reduce glucose levels. PMID:25803283

  4. ?-Hydroxy-?-methylbutyrate reduces myonuclear apoptosis during recovery from hind limb suspension-induced muscle fiber atrophy in aged rats.

    PubMed

    Hao, Yanlei; Jackson, Janna R; Wang, Yan; Edens, Neile; Pereira, Suzette L; Alway, Stephen E

    2011-09-01

    ?-Hydroxy-?-methylbutyrate (HMB) is a leucine metabolite shown to reduce protein catabolism in disease states and promote skeletal muscle hypertrophy in response to loading exercise. In this study, we evaluated the efficacy of HMB to reduce muscle wasting and promote muscle recovery following disuse in aged animals. Fisher 344×Brown Norway rats, 34 mo of age, were randomly assigned to receive either Ca-HMB (340 mg/kg body wt) or the water vehicle by gavage (n = 32/group). The animals received either 14 days of hindlimb suspension (HS, n = 8/diet group) or 14 days of unloading followed by 14 days of reloading (R; n = 8/diet group). Nonsuspended control animals were compared with suspended animals after 14 days of HS (n = 8) or after R (n = 8). HMB treatment prevented the decline in maximal in vivo isometric force output after 2 wk of recovery from hindlimb unloading. The HMB-treated animals had significantly greater plantaris and soleus fiber cross-sectional area compared with the vehicle-treated animals. HMB decreased the amount of TUNEL-positive nuclei in reloaded plantaris muscles (5.1% vs. 1.6%, P < 0.05) and soleus muscles (3.9% vs. 1.8%, P < 0.05). Although HMB did not significantly alter Bcl-2 protein abundance compared with vehicle treatment, HMB decreased Bax protein abundance following R, by 40% and 14% (P < 0.05) in plantaris and soleus muscles, respectively. Cleaved caspase-3 was reduced by 12% and 9% (P < 0.05) in HMB-treated reloaded plantaris and soleus muscles, compared with vehicle-treated animals. HMB reduced cleaved caspase-9 by 14% and 30% (P < 0.05) in reloaded plantaris and soleus muscles, respectively, compared with vehicle-treated animals. Although, HMB was unable to prevent unloading-induced atrophy, it attenuated the decrease in fiber area in fast and slow muscles after HS and R. HMB's ability to protect against muscle loss may be due in part to putative inhibition of myonuclear apoptosis via regulation of mitochondrial-associated caspase signaling. PMID:21697520

  5. A realistic implementation of ultrasound imaging as a human-machine interface for upper-limb amputees

    PubMed Central

    Sierra González, David; Castellini, Claudio

    2013-01-01

    In the past years, especially with the advent of multi-fingered hand prostheses, the rehabilitation robotics community has tried to improve the use of human-machine interfaces to reliably control mechanical artifacts with many degrees of freedom. Ideally, the control schema should be intuitive and reliable, and the calibration (training) short and flexible. This work focuses on medical ultrasound imaging as such an interface. Medical ultrasound imaging is rich in information, fast, widespread, relatively cheap and provides high temporal/spatial resolution; moreover, it is harmless. We already showed that a linear relationship exists between ultrasound image features of the human forearm and the hand kinematic configuration; here we demonstrate that such a relationship also exists between similar features and fingertip forces. An experiment with 10 participants shows that a very fast data collection, namely of zero and maximum forces only and using no force sensors, suffices to train a system that predicts intermediate force values spanning a range of about 20 N per finger with average errors in the range 10–15%. This training approach, in which the ground truth is limited to an “on-off” visual stimulus, constitutes a realistic scenario and we claim that it could be equally used by intact subjects and amputees. The linearity of the relationship between images and forces is furthermore exploited to build an incremental learning system that works online and can be retrained on demand by the human subject. We expect this system to be able in principle to reconstruct an amputee's imaginary limb, and act as a sensible improvement of, e.g., mirror therapy, in the treatment of phantom-limb pain. PMID:24155719

  6. sEMG-based joint force control for an upper-limb power-assist exoskeleton robot.

    PubMed

    Li, Zhijun; Wang, Baocheng; Sun, Fuchun; Yang, Chenguang; Xie, Qing; Zhang, Weidong

    2014-05-01

    This paper investigates two surface electromyogram (sEMG)-based control strategies developed for a power-assist exoskeleton arm. Different from most of the existing position control approaches, this paper develops force control methods to make the exoskeleton robot behave like humans in order to provide better assistance. The exoskeleton robot is directly attached to a user's body and activated by the sEMG signals of the user's muscles, which reflect the user's motion intention. In the first proposed control method, the forces of agonist and antagonist muscles pair are estimated, and their difference is used to produce the torque of the corresponding joints. In the second method, linear discriminant analysis-based classifiers are introduced as the indicator of the motion type of the joints. Then, the classifier's outputs together with the estimated force of corresponding active muscle determine the torque control signals. Different from the conventional approaches, one classifier is assigned to each joint, which decreases the training time and largely simplifies the recognition process. Finally, the extensive experiments are conducted to illustrate the effectiveness of the proposed approaches. PMID:24235314

  7. Limb bud and flank mesoderm have distinct "physical phenotypes" that may contribute to limb budding

    E-print Network

    Newman, Stuart A.

    Limb bud and flank mesoderm have distinct "physical phenotypes" that may contribute to limb budding 2008 Available online 20 June 2008 Keywords: Limb bud Surface tension Active response -smooth muscle actin Limb bud outgrowth in chicken embryos is initiated during the third day of development

  8. Motor control and cardiovascular responses during isoelectric contractions of the upper trapezius muscle: evidence for individual adaptation strategies

    Microsoft Academic Search

    S. E. Mathiassen; T. Aminoff

    1997-01-01

    Ten females (25–50 years of age) performed isometric shoulder flexions, holding the right arm straight and in a horizontal\\u000a position. The subjects were able to see the rectified surface electromyogram (EMG) from either one of two electrode pairs\\u000a above the upper trapezius muscle and were instructed to keep its amplitude constant for 15 min while gradually unloading the\\u000a arm against

  9. Functional specialisation of pelvic limb anatomy in horses (Equus caballus)

    PubMed Central

    Payne, RC; Hutchinson, JR; Robilliard, JJ; Smith, NC; Wilson, AM

    2005-01-01

    We provide quantitative anatomical data on the muscle–tendon units of the equine pelvic limb. Specifically, we recorded muscle mass, fascicle length, pennation angle, tendon mass and tendon rest length. Physiological cross sectional area was then determined and maximum isometric force estimated. There was proximal-to-distal reduction in muscle volume and fascicle length. Proximal limb tendons were few and, where present, were relatively short. By contrast, distal limb tendons were numerous and long in comparison to mean muscle fascicle length, increasing potential for elastic energy storage. When compared with published data on thoracic limb muscles, proximal pelvic limb muscles were larger in volume and had shorter fascicles. Distal limb muscle architecture was similar in thoracic and pelvic limbs with the exception of flexor digitorum lateralis (lateral head of the deep digital flexor), the architecture of which was similar to that of the pelvic and thoracic limb superficial digital flexors, suggesting a functional similarity. PMID:15960766

  10. Primary deep vein thrombosis in the upper limb: A retrospective study with emphasis on pathogenesis and late sequelae

    Microsoft Academic Search

    T. Arnhjort; L. M. Persson; S. Rosfors; U. Ludwigs; G. Lärfars

    2007-01-01

    BackgroundThrombosis of the upper extremity (UEDVT) is an uncommon disease with an incidence of 2–3% of all deep vein thromboses. The aim of this study was to determine the frequency of thrombophilia, post-thrombotic symptoms (PTS), and the rate of complications and recurrences in patients with primary UEDVT, which includes idiopathic and effort-related thrombosis.

  11. Comparison of ultrasound-guided supraclavicular, infraclavicular and below-C6 interscalene brachial plexus block for upper limb surgery: a randomised, observer-blinded study.

    PubMed

    Bharti, N; Bhardawaj, N; Wig, J

    2015-07-01

    This prospective, randomised, observer-blinded study was conducted to compare the ease of performance and surgical effectiveness of interscalene block below the C6 nerve root with supraclavicular and infraclavicular techniques of brachial plexus block for upper arm and forearm surgery. Sixty adult patients of American Society of Anesthesiologists grade 1 to 3, undergoing upper limb surgery, were randomly allocated into three groups. Group SC received supraclavicular blockade, group IC received infraclavicular blockade and Group IS received interscalene blockade. All blocks were guided by ultrasound with nerve stimulator confirmation. The anaesthetic mixture consisted of 0.5 ml/kg of equal volumes of 0.75% ropivacaine and 2% lignocaine-adrenaline. The imaging and block performance time, onset time, success rate, duration of block, and duration of postoperative analgesia were recorded by a blinded observer. The onset time was significantly longer in the interscalene group as compared with supraclavicular and infraclavicular approaches. The imaging time and block performance time were comparable between groups. No significant differences were observed between the three groups in terms of block-related pain scores, success rates, duration of block or of postoperative analgesia. Two patients in the interscalene group developed clinically detectable phrenic nerve palsy. Our findings indicate that, although interscalene block below the C6 nerve root can provide surgical anaesthesia for forearm and hand surgery, it appears to have a longer onset time than supra- and infraclavicular approaches and an unacceptable incidence of phrenic nerve palsy. PMID:26099758

  12. The effect of unilateral hockey bag carriage on the muscle activities of the trunk and lower limb of young healthy males during gait.

    PubMed

    Corrigan, Liam Patrick; Li, Jing Xian

    2014-01-01

    This study explored the trunk and lower limb muscle activity of 15 males during unilateral hockey bag carriage of 10%, 20%, and 30% of one's body weight (BW) compared with without a load during walking. The electromyography (EMG) activities of the left and right erector spinae, rectus abdominis, gluteus maximus, rectus femoris, vastus medialis, biceps femoris, semitendinosus, and the medial gastrocnemius were studied. A 2-way repeated measures analysis of variance (ANOVA) was used to examine the differences between the load weight and muscle side. Results showed significant increase in peak EMG and iEMG in the carrying side vastus medialis, rectus abdominis, semitendinosus, and gastrocnemii (p < 0.05) at the 30% BW load. The noncarrying side showed a greater peak EMG in the semitendinosus and rectus femoris at the 30% BW load when compared with the carrying side (p < 0.05). It was concluded that unilateral hockey bag carriage is similar to both backpack and side-pack carriage styles. PMID:24392769

  13. 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

  14. Telescope-optical system performance analysis for the Cryogenic Limb Array Etalon Spectrometer (CLAES) on the Upper Atmospheric Research Satellite

    NASA Technical Reports Server (NTRS)

    Roche, A. E.; Forney, P. B.; Morrow, H. E.; Anapol, M.

    1983-01-01

    A first-order performance analysis of the CLAES telescope-optical system is presented. The experiment involves the passive measurement of earth-limb radiance over a 10-60 km tangent altitude range, and is based on a solid Fabry-Perot spectrometer which provides spectral resolution of 0.25/cm for atmospheric emission spectroscopy over the 3.5-12 micron IR range. The optical system is required to provide a high degree of off-axis rejection and stray-light control, primarily to suppress intense emission from the earth surface. The astigmatism and other geometric aberrations are corrected by a secondary mirror which produces an excellent image of the primary one, allowing for location of a diffraction control or Lyot stop. The off-axis scattering performance of the telescope is examined in terms of the mirror scatter coefficient and point source rejection ratio. A mirror bidirectional reflectance distribution function of 0.0001 at 1 deg with a 1/theta-squared roll-off between 1 and 0.2 deg is realizable based on recent measurements. This results in an off-axis radiance term that is generally small in comparison with the system-limiting NER.

  15. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    ERIC Educational Resources Information Center

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

  16. 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

  17. Lower limb asymmetry in mechanical muscle function: A comparison between ski racers with and without ACL reconstruction.

    PubMed

    Jordan, M J; Aagaard, P; Herzog, W

    2015-06-01

    Due to a high incidence of anterior cruciate ligament (ACL) re-injury in alpine ski racers, this study aims to assess functional asymmetry in the countermovement jump (CMJ), squat jump (SJ), and leg muscle mass in elite ski racers with and without anterior cruciate ligament reconstruction (ACL-R). Elite alpine skiers with ACL-R (n?=?9; 26.2?±?11.8 months post-op) and uninjured skiers (n?=?9) participated in neuromuscular screening. Vertical ground reaction force during the CMJ and SJ was assessed using dual force plate methodology to obtain phase-specific bilateral asymmetry indices (AIs) for kinetic impulse (CMJ and SJ phase-specific kinetic impulse AI). Dual x-ray absorptiometry scanning was used to assess asymmetry in lower body muscle mass. Compared with controls, ACL-R skiers had increased AI in muscle mass (P?muscle mass and AI in the CMJ concentric phase (r?=?0.57, P?

  18. Upper limb joint kinetics of three sitting pivot wheelchair transfer techniques in individuals with spinal cord injury.

    PubMed

    Kankipati, Padmaja; Boninger, Michael L; Gagnon, Dany; Cooper, Rory A; Koontz, Alicia M

    2014-08-17

    Study design Repeated measures design. Objective This study compared the upper extremity (UE) joint kinetics between three transfer techniques. Setting Research laboratory. Methods Twenty individuals with spinal cord injury performed three transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head-hips method with leading hand position close (HH-I) and far (HH-A) from the body, and the third technique with the trunk upright (TU) and hand far from body. Motion analysis equipment recorded upper body movements and force sensors recorded their hand and feet reaction forces during the transfers. Results Several significant differences were found between HH-A and HH-I and TU and HH-I transfers indicating that hand placement was a key factor influencing the UE joint kinetics. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm (P < 0.036) and lower at the leading arm (P < 0.021), compared to the HH-I technique. Conclusion Always trailing with the same arm if using HH-A or TU could predispose that arm to overuse related pain and injuries. Technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement. PMID:25130053

  19. Optimization of Muscle Activity for Task-Level Goals Predicts Complex Changes in Limb Forces across Biomechanical Contexts

    Microsoft Academic Search

    J. Lucas McKay; Lena H. Ting

    2012-01-01

    Optimality principles have been proposed as a general framework for understanding motor control in animals and humans largely based on their ability to predict general features movement in idealized motor tasks. However, generalizing these concepts past proof-of-principle to understand the neuromechanical transformation from task-level control to detailed execution-level muscle activity and forces during behaviorally-relevant motor tasks has proved difficult. In

  20. Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb

    PubMed Central

    Devereux, J; Vlachonikolis, I; Buckle, P

    2002-01-01

    Objectives: To investigate potential interactions between physical and psychosocial risk factors in the workplace that may be associated with symptoms of musculoskeletal disorder of the neck and upper limb. Methods: 891 of 1514 manual handlers, delivery drivers, technicians, customer services computer operators, and general office staff reported on physical and psychosocial working conditions and symptoms of neck and upper limb disorders using a self administered questionnaire (59% return rate). Of the 869 valid questionnaire respondents, 564 workers were classified in to one of four exposure groups: high physical and high psychosocial, high physical and low psychosocial, low physical and high psychosocial, and low physical and low psychosocial. Low physical and low psychosocial was used as an internal reference group. The exposure criteria were derived from the existing epidemiological literature and models for physical and psychosocial work factors. The frequency and amplitude of lifting and the duration spent sitting while experiencing vibration were used as physical exposure criteria. Ordinal values of mental demands, job control, and social support with managers and coworkers were used as psychosocial exposure criteria. Results: In the multivariate analyses, the highest and significant increase in risk was found in the high physical and high psychosocial exposure group for symptoms of hand or wrist and upper limb disorders after adjusting for years at the job, age, and sex. A potential interaction effect was found for the symptoms of the hand or wrist and upper limb disorders but not for the neck symptoms. Conclusion: This study showed that workers highly exposed to both physical and psychosocial workplace risk factors were more likely to report symptoms of musculoskeletal disorders than workers highly exposed to one or the other. The results suggest an interaction between physical and psychosocial risk factors in the workplace that increased the risk of reporting symptoms in the upper limbs. Psychosocial risk factors at work were more important when exposure to physical risk factors at work were high than when physical exposure was low. Ergonomic intervention strategies that aim to minimise the risks of work related musculoskeletal disorders of the upper limb should not only focus on physical work factors but also psychosocial work factors. PMID:11934955

  1. [Evaluation of the risk of developing lymphoedema of the upper limb in women subjected to motor rehabilitation after radical mastectomy].

    PubMed

    Kopa?ski, Zbigniew; Zyznawska, Joanna; Pieta, Renata; Tymendorf, Grzegorz

    2008-01-01

    The analysis included 86 women in whom lymphoedema occurred in the upper limn (ULL) after radical mastectomy. The analysis were carried out in this group of patients, as well as in a control group (patients without ULL) 14 somatic parameters were examined. These parameters were evaluated before the intervention. It was established that among the anthropometric traits examined, only the body mass, hip width, hip-shoulder index, Chest flattening index, BMI index, WHR index, Quetelet's index, Rohrer's index, Pignet-Verwaeck's index assume average values in women with ULL in the preoperative period (statistically significantly different from those which occur in women without this complication(. It was shown that the dispensary group of women ill with breast cancer with a statistically significantly high risk of developing ULL was made up of patients with a large mass (>69.2 kg), WHR (>0.94), Quetele's (>448.7), Rohrer's (>1.76) and Pignet-Verwaeck's (107.7). A slim body build and low indexe values appear to be a factor protecting from this occurrence of the complication. PMID:18853648

  2. Critical upper limb ischemia due to thrombus in the right subclavian artery: An uncommon complication of right internal jugular vein cannulation

    PubMed Central

    Vemuri, Nagendra Nath; Narendra, P. L.

    2015-01-01

    Internal jugular catheterization is associated with arterial puncture in 6.3–9.4% of cases and subclavian artery (SCA) injuries are probably under-reported. Several complications like hemothorax, delayed presentation of hemomediastinum due to SCA injury have been reported. We report a case of critical upper limb ischemia due to SCA thrombosis developing a few hours after a difficult right internal jugular vein cannulation without any evidence of initial arterial injury with the finder or introducer needle and which was successfully treated by surgical thrombectomy. Arterial trauma should be kept in mind during subsequent manipulations and at all stages, particularly if a technical difficulty arises during the procedure. Although the ultrasound (US) was not used in this case, US should be used not just to identify the vein, but also to verify guide-wire and catheter insertion. High index of suspicion is necessary for detection of postprocedure thrombosis of SCA. Close monitoring for neurologic and vascular sequelae after the procedure is suggested in all difficult catheter insertions, even without a direct arterial puncture. PMID:25886431

  3. Occupational risk factors for upper-limb and neck musculoskeletal disorder among health-care staff in nursing homes for the elderly in France.

    PubMed

    Pelissier, Carole; Fontana, Luc; Fort, Emmanuel; Agard, Jean Pierre; Couprie, Francoise; Delaygue, Beatrice; Glerant, Valerie; Perrier, Catherine; Sellier, Brigitte; Vohito, Michel; Charbotel, Barbara

    2014-01-01

    This study investigated the relation between working conditions, in terms of physical and psychological demand, and upper-limb and neck musculoskeletal disorders (ULNMD) in female staff working in direct contact with the elderly in nursing homes. A cross-sectional survey was conducted in 105 nursing homes in France. Data on nursing-home working conditions were collected by questionnaire from occupational physicians and by self-administered questionnaire from staff. Psychosocial demand at work was assessed on Siegrist's questionnaire and ULNMD on the Nordic questionnaire. 2,328 employees were included: 628 housekeepers, 1,372 nursing assistants and 328 nurses. During the previous 12 months, 50% of the subjects (1,160) had presented with a musculoskeletal complaint concerning the neck, 38% (881) the shoulders, 10% (246) the elbows and 22% (520) the wrists. 9% (219) reported effort/reward imbalance on the 2004 Siegrist questionnaire and 42% were in a situation of over-commitment. ULNMD complaints were associated not only with physical occupational factors but also with psychosocial factors (effort/reward imbalance and over-commitment), both before and after adjustment on individual and occupational factors. Prospective studies are needed to clarify the causal role of occupational, including, organizational, psychosocial factors in ULNMD outcomes. Preventive approaches should take account of both physical and psychosocial occupational factors. PMID:24807124

  4. Repeatability and Minimal Detectable Change in Longitudinal Median Nerve Excursion Measures During Upper Limb Neurodynamic Techniques in a Mixed Population: A Pilot Study Using Musculoskeletal Ultrasound Imaging.

    PubMed

    Paquette, Philippe; Lamontagne, Martin; Higgins, Johanne; Gagnon, Dany H

    2015-07-01

    This study determined test-retest reliability and minimum detectable change in longitudinal median nerve excursion during upper limb neurodynamic tests (ULNTs). Seven participants with unilateral or bilateral carpal tunnel syndrome and 11 healthy participants were randomly tested with two ULNTs (i.e., tensioner and slider). Each ULNT was performed three times each at 45° and 90° of shoulder abduction on two separate visits. Video sequences of median nerve excursion, recorded by a physical therapist using ultrasound imaging, were quantified using computer software. The generalizability theory, encompassing a G-Study and a D-study, measured the dependability coefficient (?) along with standard error of measurement (SEM) accuracy and allowed various testing protocols to be proposed. The highest reliability (? = 0.84) and lowest minimal measurement error (SEM = 0.58 mm) of the longitudinal median nerve excursion were reached during the ULNT-slider performed with 45° of shoulder abduction and when measures obtained from three different image sequences recorded during a single visit were averaged. It is recommended that longitudinal median nerve excursion measures computed from three separate image sequences recorded during a single visit be averaged in clinical practice. Ideally, adding a second visit (six image sequences) is also suggested in research protocols. PMID:25868536

  5. Time course for strength and muscle thickness changes following upper and lower body resistance training in men and women.

    PubMed

    Abe, T; DeHoyos, D V; Pollock, M L; Garzarella, L

    2000-02-01

    The purpose of this study was to investigate the time course of skeletal muscle adaptations resulting from high-intensity, upper and lower body dynamic resistance training (WT). A group of 17 men and 20 women were recruited for WT, and 6 men and 7 women served as a control group. The WT group performed six dynamic resistance exercises to fatigue using 8-12 repetition maximum (RM). The subjects trained 3 days a week for 12 weeks. One-RM knee extension (KE) and chest press (CP) exercises were measured at baseline and at weeks 2, 4, 6, 8, and 12 for the WT group. Muscle thickness (MTH) was measured by ultrasound at eight anatomical sites. One-RM CP and KE strength had increased significantly at week 4 for the female WT group. For the men in the WT group, 1 RM had increased significantly at week 2 for KE and at week 6 for CP. The mean relative increases in KE and CP strength were 19% and 19% for the men and 19% and 27% for the women, respectively, after 12 weeks of WT. Resistance training elicited a significant increase in MTH of the chest and triceps muscles at week 6 in both sexes. There were non-significant trends for increases in quadriceps MTH for the WT groups. The relative increases in upper and lower body MTH were 12%-21% and 7%-9% in the men and 10%-31% and 7%-8% in the women respectively, after 12 weeks of WT. These results would suggest that increases in MTH in the upper body are greater and occur earlier compared to the lower extremity, during the first 12 weeks of a total body WT programme. The time-course and proportions of the increase in strength and MTH were similar for both the men and the women. PMID:10638374

  6. Evidence for altered upper extremity muscle synergies in chronic stroke survivors with mild and moderate impairment.

    PubMed

    Roh, Jinsook; Rymer, William Z; Beer, Randall F

    2015-01-01

    Previous studies indicate that motor coordination may be achieved by assembling task-dependent combinations of a few muscle synergies, defined here as fixed patterns of activation across a set of muscles. Our recent study of severely impaired chronic stroke survivors showed that some muscle synergies underlying isometric force generation at the hand are altered in the affected arm. However, whether similar alterations are evident in stroke survivors with lesser impairment remains unclear. Accordingly, we examined muscle synergies underlying spatial patterns of elbow and shoulder muscle activation recorded during an isometric force target matching protocol performed by 16 chronic stroke survivors, evenly divided across mild and moderate impairment levels. We applied non-negative matrix factorization to identify the muscle synergies and compared their structure across groups, including previously collected data from six age-matched control subjects and eight severely impaired stroke survivors. For all groups, EMG spatial patterns were well explained by task-dependent combinations of only a few (typically 4) muscle synergies. Broadly speaking, elbow-related synergies were conserved across stroke survivors, regardless of impairment level. In contrast, the shoulder-related synergies of some stroke survivors with mild and moderate impairment differed from controls, in a manner similar to severely impaired subjects. Cluster analysis of pooled synergies for the 30 subjects identified seven distinct clusters (synergies). Subsequent analysis confirmed that the incidences of three elbow-related synergies were independent of impairment level, while the incidences of four shoulder-related synergies were systematically correlated with impairment level. Overall, our results suggest that alterations in the shoulder muscle synergies underlying isometric force generation appear prominently in mild and moderate stroke, as in most cases of severe stroke, in an impairment level-dependent manner. PMID:25717296

  7. Upper trapezius muscle activation patterns in neck–shoulder pain patients and healthy controls

    Microsoft Academic Search

    G. E. Voerman; M. M. R. Vollenbroek-Hutten; H. J. Hermens

    2007-01-01

    This study aimed at investigating whether patients with neck–shoulder complaints from different aetiologies (work-related\\u000a musculo-skeletal disorders, WMSD; whiplash associated disorders, WAD) show comparable muscle activation patterns, characterised\\u000a by higher activation and lower relaxation levels of the trapezius muscles compared to healthy controls. Twenty healthy controls,\\u000a 21 WMSD and 20 WAD patients with non-acute neck-shoulder pain were recruited for this cross-sectional

  8. Evidence for altered upper extremity muscle synergies in chronic stroke survivors with mild and moderate impairment

    PubMed Central

    Roh, Jinsook; Rymer, William Z.; Beer, Randall F.

    2015-01-01

    Previous studies indicate that motor coordination may be achieved by assembling task-dependent combinations of a few muscle synergies, defined here as fixed patterns of activation across a set of muscles. Our recent study of severely impaired chronic stroke survivors showed that some muscle synergies underlying isometric force generation at the hand are altered in the affected arm. However, whether similar alterations are evident in stroke survivors with lesser impairment remains unclear. Accordingly, we examined muscle synergies underlying spatial patterns of elbow and shoulder muscle activation recorded during an isometric force target matching protocol performed by 16 chronic stroke survivors, evenly divided across mild and moderate impairment levels. We applied non-negative matrix factorization to identify the muscle synergies and compared their structure across groups, including previously collected data from six age-matched control subjects and eight severely impaired stroke survivors. For all groups, EMG spatial patterns were well explained by task-dependent combinations of only a few (typically 4) muscle synergies. Broadly speaking, elbow-related synergies were conserved across stroke survivors, regardless of impairment level. In contrast, the shoulder-related synergies of some stroke survivors with mild and moderate impairment differed from controls, in a manner similar to severely impaired subjects. Cluster analysis of pooled synergies for the 30 subjects identified seven distinct clusters (synergies). Subsequent analysis confirmed that the incidences of three elbow-related synergies were independent of impairment level, while the incidences of four shoulder-related synergies were systematically correlated with impairment level. Overall, our results suggest that alterations in the shoulder muscle synergies underlying isometric force generation appear prominently in mild and moderate stroke, as in most cases of severe stroke, in an impairment level-dependent manner. PMID:25717296

  9. Human skeletal muscle biochemical diversity

    PubMed Central

    Tirrell, Timothy F.; Cook, Mark S.; Carr, J. Austin; Lin, Evie; Ward, Samuel R.; Lieber, Richard L.

    2012-01-01

    SUMMARY The molecular components largely responsible for muscle attributes such as passive tension development (titin and collagen), active tension development (myosin heavy chain, MHC) and mechanosensitive signaling (titin) have been well studied in animals but less is known about their roles in humans. The purpose of this study was to perform a comprehensive analysis of titin, collagen and MHC isoform distributions in a large number of human muscles, to search for common themes and trends in the muscular organization of the human body. In this study, 599 biopsies were obtained from six human cadaveric donors (mean age 83 years). Three assays were performed on each biopsy – titin molecular mass determination, hydroxyproline content (a surrogate for collagen content) and MHC isoform distribution. Titin molecular mass was increased in more distal muscles of the upper and lower limbs. This trend was also observed for collagen. Percentage MHC-1 data followed a pattern similar to collagen in muscles of the upper extremity but this trend was reversed in the lower extremity. Titin molecular mass was the best predictor of anatomical region and muscle functional group. On average, human muscles had more slow myosin than other mammals. Also, larger titins were generally associated with faster muscles. These trends suggest that distal muscles should have higher passive tension than proximal ones, and that titin size variability may potentially act to ‘tune’ the protein's mechanotransduction capability. PMID:22786631

  10. OnabotulinumtoxinA muscle injection patterns in adult spasticity: a systematic literature review

    PubMed Central

    2013-01-01

    Background OnabotulinumtoxinA has demonstrated significant benefit in adult focal spasticity. This study reviews the injection patterns (i.e., muscle distribution, dosing) of onabotulinumtoxinA for treatment of adult spasticity, as reported in published studies. Methods A systematic review of clinical trials and observational studies published between 1990 and 2011 reporting data on muscles injected with onabotulinumtoxinA in adult patients treated for any cause of spasticity. Results 28 randomized, 5 nonrandomized, and 37 single-arm studies evaluating 2,163 adult patients were included. The most frequently injected upper-limb muscles were flexor carpi radialis (64.0% of patients), flexor carpi ulnaris (59.1%), flexor digitorum superficialis (57.2%), flexor digitorum profundus (52.5%), and biceps brachii (38.8%). The most frequently injected lower-limb muscles were the gastrocnemius (66.1% of patients), soleus (54.7%), and tibialis posterior (50.5%). The overall dose range reported was 5–200 U for upper-limb muscles and 10–400 U for lower-limb muscles. Conclusions The reviewed evidence indicates that the muscles most frequently injected with onabotulinumtoxinA in adults with spasticity were the wrist, elbow, and finger flexors and the ankle plantar flexors. OnabotulinumtoxinA was injected over a broad range of doses per muscle among the studies included in this review, but individual practitioners should be mindful of local regulatory approvals and regulations. PMID:24011236

  11. Effects of light finger touch to the upper legs on postural sway and muscle activity during quiet standing.

    PubMed

    Oshita, Kazushige; Yano, Sumio

    2013-01-01

    The purpose of the present study was to investigate the effects of light finger touch (LT) to one's own body on postural sway and ankle muscle activity during quiet standing. In the first part of the present study, 24 healthy men (19 ± 1 years) stood upright with their eyes closed on a pneumatic balance disk under 3 different conditions. In the first condition, the participants kept their hands in loose fists, and contact between the fingers/palms and the legs was avoided. In the second condition, the participants touched the lateral sides of upper legs lightly (without applying force for mechanical support) with all fingers. In the third condition, the participants again held their hands in loose fists. Postural sway was significantly decreased during second condition compared to first condition. Further, it also tended to decrease in third condition (P = 0.08). The second part of the present study was designed to investigate the mechanisms underlying the association between postural sway and LT by analyzing electromyographic data. Data were obtained from 12 healthy men (20 ± 1 years). During quiet stance on the stable surface, soleus activity did not significantly change by LT. However, tibialis-anterior activity significantly decreased with LT. These results suggest that LT to the upper part of one's own legs decreases postural sway (during and after touching) during a still stance by decreasing co-activation of the ankle muscles. PMID:24111470

  12. Lower limb access.

    PubMed

    Wilmink, Teun

    2014-01-01

    Lower limb vascular access is used as an access site in patients in whom all upper limb possibilities for arteriovenous access creation are exhausted or with bilateral upper limb central vein occlusions. Autologous arteriovenous fistulae (AVF) using the greater saphenous vein have disappointing results apart from the isolated success. Autologous AVF using the femoral vein transposition have good results both in terms of long-term patency and are associated with a 10-fold reduction in infection risk compared with arteriovenous grafts (AVGs). However, a femoral vein transposition is a major undertaking and is associated with an increased risk of ischaemic complications. It is not a good option for patients with established peripheral arterial disease, but may be a good alternative for the younger patient with a high infection risk. The type of lower-extremity vascular access should be carefully tailored to the individual patient. PMID:24817470

  13. [Investigation in a slaughter house and processing of pork meat. Repetitive task work and osteo-articular and musculotendinous pathology of the upper limbs].

    PubMed

    Rovetta, S; Bosco, M G; Tornese, C; Rischia, G; Emili, A; Morino, S

    1996-01-01

    The investigation concerned 47 workers (43 males and 4 females), whose average age was 41.5 years and average length of service 12 years. The aim of the study was to quantify the presence in an abattoir and meat processing plant of risk factors represented by repetitive movements requiring the use of force, and to describe the work-related musculo-skeletal disorders (WMSDs) of the upper limbs found in a group of workers exposed to such risk factors. The work was found to feature high speeds and very particular operations which, for most of the workers, required highly repetitive actions often associated with the use of force. Almost all the tasks had duration cycles of less than 30 seconds and a medium-high rate of actions/minute (from 20 to 60), with peak rates reached in the boning operations; the postural involvement was also considerable, particularly for the right wrist. The amount of force employed-calculated as a percentage of the Maximum Voluntary Contraction-averaged 50%. With very few exceptions, there were no significant pauses during the cycle. The group displayed a high prevalence of pain and paraesthesia and joint disorders, particularly in the over 35 age groups; statistically significant differences emerged with respect to the data from a matched population sample given the same anamnestic and clinical protocol. The group also exhibited significantly different Carpal Tunnel Syndromes with respect to the control population: 7 right-hand CTSs and five left-hand. CTS affected two out of every three women aged over 35 and 3 out of every 23 men over 35. The authors discuss the results in the light of previous studies and of the definition of CTS. The study concludes that investigating and preventing WMSDs in the meat processing industry is a justified, albeit very difficult, task whilst the protection afforded by current legislation appears to be most inadequate. PMID:9148126

  14. Effect of Baseline Spastic Hemiparesis on Recovery of Upper-Limb Function Following Botulinum Toxin Type A Injections and Postinjection Therapy

    PubMed Central

    Chang, Chia-Lin; Munin, Michael C.; Skidmore, Elizabeth R.; Niyonkuru, Christian; Huber, Lynne M.; Weber, Douglas J.

    2015-01-01

    Objective To determine whether baseline hand spastic hemiparesis assessed by the Chedoke-McMaster Assessment influences functional improvement after botulinum toxin type A (BTX-A) injections and postinjection therapy. Design Prospective cohort study. Setting Outpatient spasticity clinic. Participants Participants (N = 14) with spastic hemiparesis divided into 2 groups: Chedoke-McMaster Assessment Hand-Higher Function (stage?4, n = 5) and Chedoke-McMaster Assessment Hand-Lower Function (stage = 2 or 3, n = 9). Interventions Upper-limb BTX-A injections followed by 6 weeks of postinjection therapy. Main Outcome Measures Primary outcomes were Motor Activity Log-28 and Motor Activity Log items. Secondary outcomes were Action Research Arm Test (ARAT), Motor Activity Log-Self-Report, and Modified Ashworth Scale (MAS). Measures were assessed at baseline (preinjection), 6 weeks, 9 weeks, and 12 weeks postinjection. Results Primary and secondary outcomes improved significantly over time in both groups. Although no significant differences in ARAT or MAS change scores were noted between groups, Chedoke-McMaster Assessment Hand-Higher Function group demonstrated greater change on Motor Activity Log-28 (P = .013) from baseline to 6 weeks and Motor Activity Log items (P = .006) from baseline to 12 weeks compared to Chedoke-McMaster Assessment Hand-Lower Function group. Conclusions BTX-A injections and postinjection therapy improved hand function and reduced spasticity for both Chedoke-McMaster Assessment Hand-Higher Function and Chedoke-McMaster Assessment Hand-Lower Function groups. Clinicians should expect to see larger gains for persons with less baseline impairment. PMID:19735772

  15. Upper Limb Evaluation and One-Year Follow Up of Non-Ambulant Patients with Spinal Muscular Atrophy: An Observational Multicenter Trial

    PubMed Central

    Canal, Aurélie; Decostre, Valérie; Diebate, Oumar; Le Moing, Anne Gaëlle; Gidaro, Teresa; Deconinck, Nicolas; Van Parys, Frauke; Vereecke, Wendy; Wittevrongel, Sylvia; Annoussamy, Mélanie; Mayer, Michèle; Maincent, Kim; Cuisset, Jean-Marie; Tiffreau, Vincent; Denis, Severine; Jousten, Virginie; Quijano-Roy, Susana; Voit, Thomas; Hogrel, Jean-Yves; Servais, Laurent

    2015-01-01

    Assessment of the upper limb strength in non-ambulant neuromuscular patients remains challenging. Although potential outcome measures have been reported, longitudinal data demonstrating sensitivity to clinical evolution in spinal muscular atrophy patients are critically lacking. Our study recruited 23 non-ambulant patients, 16 patients (males/females = 6/10; median age 15.4 years with a range from 10.7 to 31.1 years) with spinal muscular atrophy type II and 7 patients (males/females = 2/5; median age 19.9 years with a range from 8.3 to 29.9 years) with type III. The Brooke functional score was on median 3 with a range from 2 to 6. The average total vital capacity was 46%, and seven patients required non-invasive ventilation at night. Patients were assessed at baseline, 6 months, and 1 year using the Motor Function Measure and innovative devices MyoGrip, MyoPinch, and MoviPlate, which assess handgrip strength, key pinch strength, and hand/finger extension-flexion function, respectively. The study demonstrated the feasibility and reliability of these measures for all patients, and sensitivity to negative changes after the age of 14 years. The younger patients showed an increase of the distal force in the follow-up period. The distal force measurements and function were correlated to different functional scales. These data represent an important step in the process of validating these devices as potential outcome measures for future clinical trials. Trial Registration ClinicalTrials.gov NCT00993161 PMID:25861036

  16. Treatment of gummy smile: Gingival recontouring with the containment of the elevator muscle of the upper lip and wing of nose. A surgery innovation technique.

    PubMed

    Storrer, Carmen Lucia Mueller; Valverde, Fabiane Kristine Bochenek; Santos, Felipe Rychuv; Deliberador, Tatiana Miranda

    2014-09-01

    The containment of the elevator muscle of the upper lip and wing of nose was used for the treatment of patients with gummy smile. This technique had corrected esthetic alterations of smile, reducing the upper lip elevation, which results in a smaller gingival display. An upper lip lengthening as well as a reduction in the upper lip shortening when the patient smiled could be observed. The high smile line was corrected without compromising the labial harmony. This study presents an innovative and effective therapeutic option to obtain a natural and harmonious smile. The patient expressed a high degree of satisfaction. PMID:25425832

  17. Treatment of gummy smile: Gingival recontouring with the containment of the elevator muscle of the upper lip and wing of nose. A surgery innovation technique

    PubMed Central

    Storrer, Carmen Lucia Mueller; Valverde, Fabiane Kristine Bochenek; Santos, Felipe Rychuv; Deliberador, Tatiana Miranda

    2014-01-01

    The containment of the elevator muscle of the upper lip and wing of nose was used for the treatment of patients with gummy smile. This technique had corrected esthetic alterations of smile, reducing the upper lip elevation, which results in a smaller gingival display. An upper lip lengthening as well as a reduction in the upper lip shortening when the patient smiled could be observed. The high smile line was corrected without compromising the labial harmony. This study presents an innovative and effective therapeutic option to obtain a natural and harmonious smile. The patient expressed a high degree of satisfaction. PMID:25425832

  18. Effect of the cervical flexion angle during smart phone use on muscle fatigue of the cervical erector spinae and upper trapezius

    PubMed Central

    Lee, Sangyong; Lee, Daehee; Park, Jungseo

    2015-01-01

    [Purpose] The purpose of this study was to examine the influence of the cervical flexion angle when using a smart phone on muscle fatigue of the cervical erector spinae (CES) and upper trapezius (UT). [Subjects] This study recruited 12 healthy adults. [Methods] Each subject sat on a chair, with his/her back against the wall and held a smart phone with both hands. Fatigue of the neck and shoulder muscles at different cervical flexion angles (0°, 30°, and 50°) was measured by electromyography. The following muscles were assessed: the right upper trapezius (RtUT), left upper trapezius (LtUT), right cervical erector spinae (RtCES), and left cervical erector spinae (LtCES). A cervical range of motion instrument was attached to the subjects’ heads to measure the cervical angle during the experiment. [Results] The RtUT and LtUT showed the highest muscle fatigue at a cervical flexion angle of 50° and the lowest fatigue at an angle of 30°. There was no significant difference in the muscle fatigue of the RtCES and LtCES at any of the cervical flexion angles. [Conclusion] UT muscle fatigue depends on the cervical flexion angle when using a smart phone.

  19. Re-emergence of hand-muscle representations in human motor cortex after hand allograft

    PubMed Central

    Vargas, Claudia D.; Aballéa, Antoine; Rodrigues, Érika C.; Reilly, Karen T.; Mercier, Catherine; Petruzzo, Palmina; Dubernard, Jean M.; Sirigu, Angela

    2009-01-01

    The human primary motor cortex (M1) undergoes considerable reorganization in response to traumatic upper limb amputation. The representations of the preserved arm muscles expand, invading portions of M1 previously dedicated to the hand, suggesting that former hand neurons are reassigned to the control of remaining proximal upper limb muscles. Hand allograft offers a unique opportunity to study the reversibility of such long-term cortical changes. We used transcranial magnetic stimulation in patient LB, who underwent bilateral hand transplantation 3 years after a traumatic amputation, to longitudinally track both the emergence of intrinsic (from the donor) hand muscles in M1 as well as changes in the representation of stump (upper arm and forearm) muscles. The same muscles were also mapped in patient CD, the first bilateral hand allograft recipient. Newly transplanted intrinsic muscles acquired a cortical representation in LB's M1 at 10 months postgraft for the left hand and at 26 months for the right hand. The appearance of a cortical representation of transplanted hand muscles in M1 coincided with the shrinkage of stump muscle representations for the left but not for the right side. In patient CD, transcranial magnetic stimulation performed at 51 months postgraft revealed a complete set of intrinsic hand-muscle representations for the left but not the right hand. Our findings show that newly transplanted muscles can be recognized and integrated into the patient's motor cortex. PMID:19366678

  20. Forced oscillation measurements do not affect upper airway muscle tone or sleep in clinical studies

    Microsoft Academic Search

    J. R. Badia; R. Farré; J. Rigau; M. E. Uribe; D. Navajas; J. M. Montserrat

    2001-01-01

    Upper airway obstruction in the sleep apnoea\\/hypopnoea syndrome (SAHS) can be easily assessed by measuring respiratory impedance with the forced oscillation technique (FOT). This methodology has been proposed as a useful clinical tool both for the diagnosis of sleep breathing disorders and for continuous positive airway pressure (CPAP) titration. However, previous studies suggest that the application of high-frequency pressure oscillation

  1. Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance

    Microsoft Academic Search

    Dean H Watson; Patricia H Trott

    1993-01-01

    In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' headache and a questionnaire was used to establish a profile of the headache population.

  2. Comparison of Upper Trapezius, Anterior Deltoid, and Serratus Anterior Muscle Activity during Push-up plus Exercise on Slings and a Stable Surface

    PubMed Central

    Jeong, So Young; Chung, Sin Ho; Shim, Jae Hun

    2014-01-01

    [Purpose] The purpose of this study was to identify effects of push-up plus exercise on different support surfaces on upper extremity muscular activity. [Subjects] The subjects were 28 students (10 males, 18 females) at B University. [Methods] The subjects performed push-up plus exercises either on slings or on a fixed support. [Results] Push-up plus exercises on slings showed significant increases in the muscle activity of the trapezius (upper fiber), deltoid (anterior fiber), and serratus anterior muscles compared with stabilization exercises on a fixed support. [Conclusion] Based on these results, it is considered that performance of the push-up plus exercise on slings will increase scapular muscle activity. PMID:25013300

  3. 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

  4. Scientists Bioengineer First Artificial Animal Limb

    MedlinePLUS

    ... news/fullstory_152909.html Scientists Bioengineer First Artificial Animal Limb Rat forelimb designed and grown in lab ... appropriate fibers of muscle cells. When transplanted into animals, blood circulated through the vascular system, and electrical ...

  5. Genetics Home Reference: Limb-girdle muscular dystrophy

    MedlinePLUS

    ... or the removal of potentially toxic wastes from muscle cells. Limb-girdle muscular dystrophy is classified based on ... gene ; hypertrophy ; inheritance ; inheritance pattern ; inherited ; joint ; lordosis ; muscle cells ; muscular dystrophy ; mutation ; population ; prevalence ; protein ; proximal ; recessive ; ...

  6. Skeletal muscle responses to unloading with special reference to man

    NASA Technical Reports Server (NTRS)

    Dudley, G. A.; Hather, B. M.; Buchanan, P.

    1992-01-01

    The limited space flight data suggest that exposure to microgravity decreases muscle strength in humans and muscle mass in lower mammals. Several earth-based models have been used to address the effect of unloading on the human neuromuscular system due to the limited access of biological research to long-term space flight. Bedrest eliminates body weight bearing of both lower limbs. Unilateral lower limb suspension (ULLS), where all ambulatory activity is performed on crutches with an elevated sole on the shoe of one foot, has recently been used to unload one lower limb. The results from studies using these two models support their efficacy. The decrease in strength of m. quadriceps femoris, for example, after four to six weeks of bedrest, ULLS or space flight is 20 to 25 percent. The results from the earth-based studies show that this response can be attributed in part to a decrease in the cross-sectional area of the KE which reflects muscle fiber atrophy. The results from the ground based studies also support the limited flight data and show that reductions in strength are larger in lower than upper limbs and in extensor than flexor muscle groups. They also raise issue with the generally held concept that postural muscle is most affected by unweighting. Slow-twitch fibers in lower limb muscles of mixed fiber type composition and muscle composed mainly of slow-twitch fibers do not preferentially atrophy after bedrest or ULLS. Taken together, the data suggest that unloading causes remarkable adaptations in the neuromuscular system of humans. It should be appreciated, however, that this area of research is in its infancy.

  7. Arousal from Sleep Does Not Lead to Reduced Dilator Muscle Activity or Elevated Upper Airway Resistance on Return to Sleep in Healthy Individuals

    PubMed Central

    Jordan, Amy S.; Cori, Jennifer M.; Dawson, Andrew; Nicholas, Christian L.; O'Donoghue, Fergal J.; Catcheside, Peter G.; Eckert, Danny J.; McEvoy, R. Doug; Trinder, John

    2015-01-01

    Study Objectives: To compare changes in end-tidal CO2, genioglossus muscle activity and upper airway resistance following tone-induced arousal and the return to sleep in healthy individuals with small and large ventilatory responses to arousal. Design: Observational study. Setting: Two sleep physiology laboratories. Patients or Participants: 35 men and 25 women with no medical or sleep disorders. Interventions: Auditory tones to induce 3-s to 15-s cortical arousals from sleep. Measurements and Results: During arousal from sleep, subjects with large ventilatory responses to arousal had higher ventilation (by analytical design) and tidal volume, and more marked reductions in the partial pressure of end-tidal CO2 compared to subjects with small ventilatory responses to arousal. However, following the return to sleep, ventilation, genioglossus muscle activity, and upper airway resistance did not differ between high and low ventilatory response groups (Breath 1 on return to sleep: ventilation 6.7 ± 0.4 and 5.5 ± 0.3 L/min, peak genioglossus activity 3.4% ± 1.0% and 4.8% ± 1.0% maximum, upper airway resistance 4.7 ± 0.7 and 5.5 ± 1.0 cm H2O/L/s, respectively). Furthermore, dilator muscle activity did not fall below the pre-arousal sleeping level and upper airway resistance did not rise above the pre-arousal sleeping level in either group for 10 breaths following the return to sleep. Conclusions: Regardless of the magnitude of the ventilatory response to arousal from sleep and subsequent reduction in PETCO2, healthy individuals did not develop reduced dilator muscle activity nor increased upper airway resistance, indicative of partial airway collapse, on the return to sleep. These findings challenge the commonly stated notion that arousals predispose to upper airway obstruction. Citation: Jordan AS, Cori JM, Dawson A, Nicholas CL, O'Donoghue FJ, Catcheside PG, Eckert DJ, McEvoy RD, Trinder J. Arousal from sleep does not lead to reduced dilator muscle activity or elevated upper airway resistance on return to sleep in healthy individuals. SLEEP 2015;38(1):53–59. PMID:25325511

  8. Applying a brain-computer interface to support motor imagery practice in people with stroke for upper limb recovery: a feasibility study

    Microsoft Academic Search

    Girijesh Prasad; Pawel Herman; Damien Coyle; Suzanne McDonough; Jacqueline Crosbie

    2010-01-01

    BACKGROUND: There is now sufficient evidence that using a rehabilitation protocol involving motor imagery (MI) practice in conjunction with physical practice (PP) of goal-directed rehabilitation tasks leads to enhanced functional recovery of paralyzed limbs among stroke sufferers. It is however difficult to confirm patient engagement during an MI in the absence of any on-line measure. Fortunately an EEG-based brain-computer interface

  9. One: Microphysics of frost metamorphism: Applications to Triton and Mars. Two: A global analysis of the ozone deficit in the upper stratosphere and lower mesosphere. Three: The diabatic circulation in the stratosphere as diagnosed from Microwave Limb Sounder data

    NASA Astrophysics Data System (ADS)

    Eluszkiewicz, Janusz Bronistaw

    The present thesis is devoted to two broad subjects, planetary frost metamorphism and the terrestrial middle atmosphere, and consists of three papers. Paper 1 considers frost metamorphism on the surfaces of Triton and Mars. Based on an analysis of the microphysical processes involved in the pressureless sintering, it is concluded that fine-grained nitrogen and carbon dioxide frosts can undergo seasonal metamorphism into semitransparent layers on the surface of Triton and in the Martian seasonal polar caps, respectively. The presence of such layers explains a host of facts about Triton's surface and about the Martian seasonal caps. Paper 2 is devoted to elucidating a long-standing issue in the terrestrial middle atmosphere chemistry, the so-called 'ozone deficit problem.' Based on an analysis of data acquired by the Limb Infrared Monitor of the Stratosphere (LIMS) instrument between October 1978 and May 1979, it is concluded that current photochemical models systematically underestimate observed ozone abundances in the upper stratosphere and lower mesosphere. Three modifications to the accepted photochemical scheme, capable of providing a global solution to this problem, are proposed and discussed. Paper 3 differs from the other two in that it reports on results from an ongoing research effort. It considers the diabatic circulation in the stratosphere and lower mesosphere, using ozone and temperature measurements acquired by the Microwave Limb Sounder (MLS) instrument onboard the Upper Atmosphere Research Satellite (UARS). The present study extends past analyses of the diabatic circulation by considering a full annual cycle, November 1991-November 1992, and by taking advantage of the high vertical resolution of MLS data. In the tropical upper stratosphere and lower mesosphere, a semiannual oscillation (SAO) is observed in the computed circulation, with the region of downwelling reaching maximum spatial extent approximately 1 month before the equinox. The projected lifetime of UARS should enable the present analysis to be extended to several SAO cycles.

  10. Lipotyphla limb myology comparison.

    PubMed

    Neveu, Pauline; Gasc, Jean-Pierre

    2002-05-01

    Fore- and hindlimb muscles were dissected in four species of Lipotyphla: the western European hedgehog Erinaceus europaeus (Erinaceidae, Erinaceinae); the moonrat Echinosorex gymnura (Erinaceidae, Hylomyinae or Galericinae); the tailless tenrec Tenrec ecaudatus (Tenrecidae, Tenrecinae); and the common European white-toothed shrew Crocidura russula (Soricidae, Soricinae). This work completely reviews the limb musculature of these walking mammals. Twelve myological characters were evaluated in order to disclose phylogenetic relationships. The cladogram obtained supported previous ones based on cranial and dental characters. This study shows that myological characters are valuable in phylogenetic analyses. PMID:11921044

  11. Caring for muscle spasticity or spasms

    MedlinePLUS

    High muscle tone - care; Increased muscle tension - care; Upper motor neuron syndrome - care; Muscle stiffness - care ... Muscle spasticity, or spasms, causes your muscles to become stiff or rigid. It can also cause exaggerated, ...

  12. Open-loop tracking performance of a limb joint controlled by random, periodic, and abrupt electrical stimulation inputs to the antagonist muscle pair

    Microsoft Academic Search

    Bing-He Zhou; Richard V. Baratta; M. Solomonov; Noboru Matsushita; R. D. D'Ambrosia

    1998-01-01

    The ability of the cat's ankle joint to track various input signals when controlled by electrically elicited motor unit recruitment, firing rate and antagonist muscle coactivation was examined. Pseudo-random, sinusoidal and staircase signals were used to control the soleus and tibialis anterior muscles isometrically and with a 250-g pendulum. Tracking was evaluated through cross correlation for pseudo-random and sinusoidal signals,

  13. Modulation of Myoblast Fusion by Caveolin-3 in Dystrophic Skeletal Muscle Cells: Implications for Duchenne Muscular Dystrophy and Limb-Girdle Muscular Dystrophy1C

    Microsoft Academic Search

    Daniela Volonte; Aaron J. Peoples; Ferruccio Galbiati

    2003-01-01

    Caveolae are vesicular invaginations of the plasma membrane. Caveolin-3 is the principal structural component of caveolae in skeletal muscle cells in vivo. We have recently generated caveolin-3 transgenic mice and demonstrated that overexpression of wild-type caveolin-3 in skeletal muscle fibers is sufficient to induce a Duchenne-like muscular dystrophy phenotype. In addition, we have shown that caveolin-3 null mice display mild

  14. Skeletal muscle contractility, self-reported pain and tissue sensitivity in females with neck/shoulder pain and upper Trapezius myofascial trigger points– a randomized intervention study

    PubMed Central

    2012-01-01

    Background In relation to Myofascial Triggerpoints (MFTrPs) of the upper Trapezius, this study explored muscle contractility characteristics, the occurrence of post-intervention muscle soreness and the effect of dry needling on muscle contractile characteristics and clinical outcomes. Methods Seventy-seven female office workers (25-46yrs) with and without neck/shoulder pain were observed with respect to self-reported pain (NRS-101), pressure-pain threshold (PPT), maximum voluntary contraction (Fmax) and rate of force development (RFD) at baseline (pre-intervention), immediately post-intervention and 48 hours post-intervention. Symptomatic and asymptomatic participant groups were each randomized into two treatment sub-groups (superficial (SDN) and deep dry needling (DDN)) after baseline testing. At 48 hours post-intervention participants were asked whether delayed onset muscle soreness (DOMS) and/or post-needling soreness had developed. Results Muscle contractile characteristics did not differ between groups at baseline. Forty-six individuals developed muscle soreness (39 from mechanical testing and seven from needling). No inter-group differences were observed post-intervention for Fmax or RFD for the four sub-groups. Over the observation period, symptomatic participants reported less pain from both SDN (p= 0.003) and DDN (p=0.011). However, PPT levels were reduced for all participants (p=0.029). Those reporting DOMS experienced significant decreases in PPT, irrespective of symptom state or intervention (p=0.001). Conclusions In selected female neck/shoulder pain sufferers, maximum voluntary contraction and rapid force generation of the upper Trapezius was not influenced by clinically relevant self-reported pain or the presence of diagnostically relevant MFTrPs. Dry needling, deep or superficial, did not affect measured functional outcomes over the 48-hour observation period. DOMS affected participants uniformly irrespective of pain, MFTrP status or intervention type and therefore is like to act as a modifier. Trial registration Clinical Trials.gov- NCT01710735 Significance and Innovations The present investigation is one of the first to examine the hypothesis of gross muscle contractile inhibition due to the presence of diagnostically relevant MFTrPs. Individuals suffering from clinically relevant levels of self-reported pain are able to tolerate maximum voluntary contraction testing, but delayed onset muscle soreness (DOMS) is a likely side-effect irrespective of symptom status. As a consequence, its confounding effect during subsequent testing must be taken into account. PMID:23176709

  15. Extracellular Control of Limb Regeneration

    NASA Astrophysics Data System (ADS)

    Calve, S.; Simon, H.-G.

    Adult newts possess the ability to completely regenerate organs and appendages. Immediately after limb loss, the extracellular matrix (ECM) undergoes dramatic changes that may provide mechanical and biochemical cues to guide the formation of the blastema, which is comprised of uncommitted stem-like cells that proliferate to replace the lost structure. Skeletal muscle is a known reservoir for blastema cells but the mechanism by which it contributes progenitor cells is still unclear. To create physiologically relevant culture conditions for the testing of primary newt muscle cells in vitro, the spatio-temporal distribution of ECM components and the mechanical properties of newt muscle were analyzed. Tenascin-C and hyaluronic acid (HA) were found to be dramatically upregulated in the amputated limb and were co-expressed around regenerating skeletal muscle. The transverse stiffness of muscle measured in situ was used as a guide to generate silicone-based substrates of physiological stiffness. Culturing newt muscle cells under different conditions revealed that the cells are sensitive to both matrix coating and substrate stiffness: Myoblasts on HA-coated soft substrates display a rounded morphology and become more elongated as the stiffness of the substrate increases. Coating of soft substrates with matrigel or fibronectin enhanced cell spreading and eventual cell fusion.

  16. Ultrasound-Guided Myofascial Trigger Point Injection Into Brachialis Muscle for Rotator Cuff Disease Patients With Upper Arm Pain: A Pilot Study

    PubMed Central

    Suh, Mi Ri; Chang, Won Hyuk; Choi, Hyo Seon

    2014-01-01

    Objective To assess the efficacy of trigger point injection into brachialis muscle for rotator cuff disease patients with upper arm pain. Methods A prospective, randomized, and single-blinded clinical pilot trial was performed at university rehabilitation hospital. Twenty-one patients clinically diagnosed with rotator cuff disease suspected of having brachialis myofascial pain syndrome (MPS) were randomly allocated into two groups. Effect of ultrasound (US)-guided trigger point injection (n=11) and oral non-steroidal anti-inflammatory drug (NSAID) (n=10) was compared by visual analog scale (VAS). Results US-guided trigger point injection of brachialis muscle resulted in excellent outcome compared to the oral NSAID group. Mean VAS scores decreased significantly after 2 weeks of treatment compared to the baseline in both groups (7.3 vs. 4.5 in the injection group and 7.4 vs. 5.9 in the oral group). The decrease of the VAS score caused by injection (?VAS=-2.8) was significantly larger than caused by oral NSAID (?VAS=-1.5) (p<0.05). Conclusion In patients with rotator cuff disease, US-guided trigger point injection of the brachialis muscle is safe and effective for both diagnosis and treatment when the cause of pain is suspected to be originated from the muscle. PMID:25379497

  17. The Effects of Nitric Oxide Donor Molsidomine on Skeletal Muscle Damage in a Rat Hind Limb Model of Ischemia-Reperfusion

    Microsoft Academic Search

    K. Öztürk; H. Ozyurt; A. Somay; C. Karaca

    2009-01-01

    Background: In this experimental study, we aimed to examine the protective effect of molsidomine (MS), a nitric oxide (NO) donor, against ischemia-reperfusion (I-R) injury in a rat skeletal muscle model. Methods: Ischemia was achieved by application of an elastic rubber band as high as possible on the left thigh of the rats. Group 1: the control group received a sham

  18. Limb temperature and human tremors.

    PubMed Central

    Lakie, M; Walsh, E G; Arblaster, L A; Villagra, F; Roberts, R C

    1994-01-01

    The changes in postural tremor of the hand produced by moderate cooling of the muscles of one forearm have been investigated in 16 normal subjects and in 16 patients with essential tremor. In both groups, cooling produced a profound long lasting decrease in tremor level of the ipsilateral hand. In normal subjects, although cooling reduced the tremor size, the EMG of the active muscle clearly increased. Warming the limb in normal subjects produced an increase in tremor level and decrease in EMG. Cooling or warming the limb did not, however, significantly change the peak frequency which was quite stable for each subject. The results of cooling were compared with a brief period of ischaemia, which also reduces tremor size. Local cooling may be a useful manoeuvre for patients with essential tremor, and for others who wish to reduce their tremor temporarily in order to improve dexterity. PMID:8301303

  19. A gross anatomical study of the pectoral limb of the Atlantic bottlenose dolphin (Tursiops truncatus) 

    E-print Network

    Schwab, Ethan Gregory Lee

    1988-01-01

    Teres major muscle Coracobrachialis muscle Subscapular is muscle Triceps muscle ( long head) Deltoideus Muscle. - The deltoideus muscle was thick and triangular in shape. It originated on the cranial 2/3 of the dorsal border of the scapula..., and inserted on the lateral surface of the humeral diaphysis, covering approximately 2/3 of the scapula's lateral surface. Probable actions of the muscle include abduction and cranial advancement of the pectoral limb. The cranial edge of the muscle...

  20. Distribution of muscle weakness of central and peripheral origin

    PubMed Central

    Thijs, R; Notermans, N; Wokke, J; van der Graaf, Y; van Gijn, J

    1998-01-01

    According to the established clinical tradition about the distribution of weakness, the ratios of flexor/extensor strength of patients with upper motor neuron lesions are expected to be relatively high for the elbow and wrist and low for the knee. To assess the diagnostic value of these patterns of weakness, muscle strength of 70 patients with limb weakness of central or peripheral origin was measured with a hand held dynamometer. The ratios of flexor/extensor strength at the knee, elbow, and wrist did not differ significantly between patients with central or peripheral origin of muscle weakness. The examination of tendon jerks proved to be of more value as a localising feature. The traditional notion about the distribution of weakness in upper motor neuron lesions may be explained by an intrinsically greater strength in antigravity muscles, together with the effects of hypertonia.?? PMID:9810962

  1. Comparison of Breast Cancer-Related Lymphedema (Upper Limb Swelling) Prevalence Estimated Using Objective and Subjective Criteria and Relationship with Quality of Life

    PubMed Central

    Gaal, Susanne; Coutts, Fiona; Jack, Wilma; Chetty, Udi; Barber, Matthew; Tan, Chee-Wee

    2013-01-01

    This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling); percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference); and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4). Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95–10.03) and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema. PMID:23853774

  2. Comparison of breast cancer-related lymphedema (upper limb swelling) prevalence estimated using objective and subjective criteria and relationship with quality of life.

    PubMed

    Bulley, Catherine; Gaal, Susanne; Coutts, Fiona; Blyth, Christine; Jack, Wilma; Chetty, Udi; Barber, Matthew; Tan, Chee-Wee

    2013-01-01

    This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling); percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference); and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4). Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95-10.03) and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema. PMID:23853774

  3. Limb ischemia: cardiovascular diagnosis and management from head to toe.

    PubMed

    Vemulapalli, Sreekanth; Patel, Manesh R; Jones, W Schuyler

    2015-07-01

    Peripheral arterial disease (PAD) affects an estimated 27 million people in Europe and North America. Limb ischemia, defined as ischemic rest pain, ischemic ulcerations, or ischemic gangrene, represents the most severe manifestation of PAD and is associated with significant cardiovascular and limb morbidity and mortality. Critical limb ischemia (CLI), defined as limb ischemia symptoms for greater than 2 weeks, is characterized by a cascade of hemodynamically significant macrovascular atherosclerotic obstruction and microvascular changes culminating in decreased muscle perfusion, disrupted muscle energy metabolism, and inflammation. In contrast, acute limb ischemia (ALI) is defined as limb ischemia symptoms characterized by sudden onset of less than 2 weeks duration resulting in hemodynamically compromised limb perfusion. Diagnosis of both ALI and CLI is dependent on history, physical examination, and a combination of anatomic and hemodynamic assessment of the limb. Given that the risk factors for ALI and CLI overlap with risk factors for atherosclerotic coronary and neurovascular disease, the management of limb ischemia is focused on both endovascular or surgical limb salvage and cardiovascular risk factor control. Despite advancements in endovascular and surgical revascularization techniques, limb morbidity remains high; clinical trials of angiogenic and cell-based therapies are ongoing. Cardiovascular risk reduction in patients with limb ischemia also remains suboptimal and future studies will focus on novel antiplatelet agents. PMID:26031674

  4. Physically Based Modelling of Human Limbs Lee Cooper \\Lambda

    E-print Network

    Maddock, Steve

    simulated in a synthetic environment. A limb model is proposed that incorporates a simple skeleton joint, muscle tissue, non­muscle tissue (e.g. fat), tendons and a skin layer. The only input parameters to the model are for simple low­level control of muscle activation, with the re­ sulting motion and deformation

  5. [Diagnostic muscle MRI abnormality in a patient with inclusion body myositis].

    PubMed

    Ono, K; Takizawa, Y; Komai, K; Nitta, E; Takamori, M

    1998-05-01

    A 64-year-old woman was admitted to our hospital because of muscle weakness and atrophy in the extremities. Four years before admission, he was noticed to have elevated creatine kinase (CK) level, but had no further evaluation. Two years later, she became difficult in standing up and needed a wheelchair. Six months before admission, she noticed muscle wasting in the buttock, thigh, bilateral forearms, and weakness in the upper limbs. On neurologic examination, she had weakness in sternocleidomastoid and all limb muscles, predominantly in the distal portion of the upper extremities. Laboratory study revealed elevated CK, LDH, and aldolase levels, and myogenic change with fibrillation on needle EMG. Muscle biopsy showed myopathic changes with infiltration of mononuclear cells and rimmed vacuoles. The clinical manifestations as well as poor response to corticosteroids therapy were supportive of the diagnosis of inclusion body myositis. However, the distribution of muscle weakness in her wrist, weaker in the extensors than in the flexors, was not characteristic to IBM. This problem was solved by the right forearm MRI which showed a high signal intensity area in flexor muscles, but not in extensors on T1 and T2 weighted images. Accordingly, the muscle MRI of forearm was a diagnostic aid of IBM in this patient. PMID:9805998

  6. Limb Loss Statistics

    MedlinePLUS

    ... Limb Loss Statistics > Limb Loss Statistics Limb Loss Statistics There are nearly 2 million people living with ... Disease Control and Prevention, National Center for Health Statistics; 1998. HCUP Nationwide Inpatient Sample (NIS). Healthcare Cost ...

  7. Upper Eyelid Retraction in the Absence of Other Evidence for Progressive Ophthalmopathy is Associated with Eye Muscle Autoantibodies

    Microsoft Academic Search

    Mario Salvi; Debbie Scalise; Carol Stolarski; Bryan Arthurs; Susan Lindley; Jack Kennerdell; Jack R. Wall

    1995-01-01

    We have studied 25 clinically euthyroid patients with eyelid lag and retraction referred to thyroid\\/eye clinic for clinical and orbital imaging evidence of extraocular eye muscle (EM) involvement, evidence of progressive ophthalmopathy and serum antibodies reactive with EM membrane antigens in immunoblotting. Fourteen patients had Graves' hyperthyroidism, 5 had Hashimoto's thyroiditis, and 6 had euthyroid Graves' disease. By carrying out

  8. Distribution of nestin in the developing mouse limb bud in vivo and in micro-mass cultures of cells isolated from limb buds

    Microsoft Academic Search

    Joanna Wroblewski; Marianne Engström; Caroline Edwall-Arvidsson; Gunnar Sjöberg; Thomas Sejersen; Urban Lendahl

    1997-01-01

    Early skeletal muscle development is accompanied by changes in the composition of the cytoskeleton. In this report we analyze the distribution of the intermediate filament nestin in the developing mouse limb buds in vivo and in mesenchymal cells isolated from limb buds in vitro. The subcellular distribution of nestin mRNA and protein in muscle cells was also analyzed. We find

  9. Tendon palpation during agonist contraction and antagonist co-contraction to assess wrist flexor and extensor muscle function.

    PubMed

    Bertelli, J A

    2015-04-01

    The aim of this study was to validate direct tendon palpation during agonist contraction and antagonist co-contraction as a method to assess wrist flexor and extensor muscle function in cases of upper limb paralysis. On one occasion, five doctors examined 17 patients with partial paralysis of the upper limb resulting from brachial plexus or cervical spinal cord injury. We asked examiners to determine if the extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor carpi ulnaris (ECU), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU) and palmaris longus (PL) were paralyzed, weak or strong in each patient. Examiners tested flexion - extension and radial - ulnar deviation against resistance and palpated wrist motor tendons. While palpating tendons, co-contractions were encouraged by soliciting finger extension to evaluate the FCU, thumb extension to evaluate the ECU, and finger flexion to evaluate the ECRB. Kappa values were 0.8 for the ECRL, 0.7 for the ECRB, 0.5 for the ECU, 0.8 for the FCR, 0.6 for the PL, and 0.8 for the FCU, indicating moderate to almost perfect agreement between examiners. Tendon palpation during muscle examination was adequate to identify complete paralysis, as well as weak and strong muscle contractions. This assessment helps to identify muscles that could be used during nerve or tendon transfer for reconstruction of extensive upper limb paralysis. PMID:25765117

  10. Rhythmic arm swing enhances patterned locomotor-like muscle activity in passively moved lower extremities.

    PubMed

    Ogawa, Tetsuya; Sato, Takahiko; Ogata, Toru; Yamamoto, Shin-Ichiro; Nakazawa, Kimitaka; Kawashima, Noritaka

    2015-03-01

    The use of driven gait orthosis (DGO) has drawn attention in gait rehabilitation for patients after central nervous system (CNS) lesions. By imposing a passive locomotor-like kinematic pattern, the neural mechanisms responsible for locomotion can be activated as in a normal gait. To further enhance this activity, discussions on possible intervention are necessary. Given the possible functional linkages between the upper and lower limbs, we investigated in healthy subjects the degree of modification in the lower limb muscles during DGO-induced passive gait by the addition of swing movement in the upper extremity. The results clearly showed that muscle activity in the ankle dorsiflexor TA muscle was significantly enhanced when the passive locomotor-like movement was accompanied by arm swing movement. The modifications in the TA activity were not a general increase through the stride cycles, but were observed under particular phases as in normal gaits. Voluntary effort to swing the arms may have certain effects on the modification of the muscle activity. The results provide clinical implications regarding the usefulness of voluntary arm swing movement as a possible intervention in passive gait training using DGO, since ordinary gait training using DGO does not induce spontaneous arm swing movement despite its known influence on the lower limb movement. PMID:25742956

  11. Six1 is not involved in limb tendon development, but is expressed in limb connective tissue under Shh regulation

    Microsoft Academic Search

    Marie-Ange Bonnin; Christine Laclef; Régis Blaise; Sophie Eloy-Trinquet; Frédéric Relaix; Pascal Maire; Delphine Duprez

    2005-01-01

    Mice deficient for the homeobox gene Six1 display defects in limb muscles consistent with the Six1 expression in myogenic cells. In addition to its myogenic expression domain, Six1 has been described as being located in digit tendons and as being associated with connective tissue patterning in mouse limbs. With the aim of determining a possible involvement of Six1 in tendon

  12. Neuromuscular function in limb girdle dystrophy.

    PubMed Central

    Belanger, A Y; McComas, A J

    1985-01-01

    The contractile properties of ankle dorsiflexor and plantarflexor muscles in 20 patients with limb girdle muscular dystrophy have been compared with those in matched controls. Twitch and voluntary torques were significantly smaller in the patient population and in nine patients it was impossible to record a twitch from tibialis anterior, a dorsiflexor muscle studied in detail. The disease process evidently ran a more rapid course in tibialis anterior than in plantarflexor muscles and this susceptibility was related to some aspect of the muscle other than its fibre type composition. Surviving fibres in dorsiflexor and plantarflexor muscles did not reveal evidence of excitation-contraction uncoupling; they exhibited normal post-activation potentiation and fatigue properties. Some patients were initially incapable of exciting their motor units maximally during voluntary contractions. A finding of possible pathogenetic significance was that one patient, with prominent calves, developed exceptionally large voluntary torque in his plantarflexor muscles. PMID:4087001

  13. Afferent Limb of the Myotatic Reflex Arc

    Microsoft Academic Search

    A. K. McIntyre

    1951-01-01

    WITHIN the past decade, the use of electronic methods has laid bare much of the mechanism underlying the myotatic, or stretch, reflex of mammalian striated muscle. Outstanding among these advances are Lloyd's demonstration of the monosynaptic nature of the myotatic reflex pathway, and his disclosure that fibres of large diameter (Group I fibres) constitute the afferent limb of this reflex

  14. A Model of the Lower Limb for Analysis of Human Movement

    PubMed Central

    Arnold, Edith M.; Ward, Samuel R.; Lieber, Richard L.; Delp, Scott L.

    2010-01-01

    Computer models that estimate the force generation capacity of lower limb muscles have become widely used to simulate the effects of musculoskeletal surgeries and create dynamic simulations of movement. Previous lower limb models are based on severely limited data describing limb muscle architecture (i.e., muscle fiber lengths, pennation angles, and physiological cross-sectional areas). Here, we describe a new model of the lower limb based on data that quantifies the muscle architecture of 21 cadavers. The model includes geometric representations of the bones, kinematic descriptions of the joints, and Hill-type models of 44 muscle–tendon compartments. The model allows calculation of muscle–tendon lengths and moment arms over a wide range of body positions. The model also allows detailed examination of the force and moment generation capacities of muscles about the ankle, knee, and hip and is freely available at www.simtk.org. PMID:19957039

  15. Exposure assessment of upper limb repetitive movements: a consensus document developed by the Technical Committee on Musculoskeletal Disorders of International Ergonomics Association (IEA) endorsed by International Commission on Occupational Health (ICOH).

    PubMed

    Colombini, D; Occhipinti, E; Delleman, N; Fallentin, N; Kilbom, A; Grieco, A

    2001-01-01

    This consensus document intends to supply a set of definitions, criteria and procedures useful to describe and, wherever possible, to assess the work conditions that can represent a physical overload for the upper limbs. The document is aimed at all the operators, i.e. occupational doctors but mainly technicians, who are, involved in risk exposure assessment and management. The document intends to provide methods and procedures easily applicable in the field, possibly not requiring sophisticated instrumentation and when possible based on observation procedures. The proposed methods shall be based as far as possible on knowledge and data from scientific literature: should they be contradictory or deficient, reference will be made to standards or pre-standards issued by national and international agencies and bodies, with the experience of researchers involved and common sense. In this regard, it is to be emphasized that the potential users increasingly demand an easily applicable method for description and assessment of work with repetitive movements. The group intends to give a response even if there are still uncertainties from a strictly scientific standpoint: however the group commits itself to perform subsequent validations especially of as yet unconsolidated issues. This document focuses specifically on identification of risk factors and describes some of the methods that have been developed for evaluating them. There is a rapidly developing body of literature on job analysis and not yet agreement on a single best way to analyze jobs. Professional judgement is required to select the appropriate methods. Analysis and design of jobs should to be integrated into an ongoing ergonomics program that includes management commitment, training, health surveillance, and medical case management. In summing up this report, space must be given to the check lists that are so often seen in the medical press, although this is not the occasion to propose a detailed analytical review. PMID:11505774

  16. Fgf4 Positively Regulates scleraxis and Tenascin Expression in Chick Limb Tendons

    Microsoft Academic Search

    Frédérique Edom-Vovard; Bernadette Schuler; Marie-Ange Bonnin; Marie-Aimée Teillet; Delphine Duprez

    2002-01-01

    In vertebrates, tendons connect muscles to skeletal elements. Surgical experiments in the chick have underlined developmental interactions between tendons and muscles. Initial formation of tendons occurs autonomously with respect to muscle. However, further tendon development requires the presence of muscle. The molecular signals involved in these interactions remain unknown. In the chick limb, Fgf4 transcripts are located at the extremities

  17. Musculoskeletal modelling of an ostrich (Struthio camelus) pelvic limb: influence of limb orientation on muscular capacity during locomotion

    PubMed Central

    Rankin, Jeffery W.; Rubenson, Jonas; Rosenbluth, Kate H.; Siston, Robert A.; Delp, Scott L.

    2015-01-01

    We developed a three-dimensional, biomechanical computer model of the 36 major pelvic limb muscle groups in an ostrich (Struthio camelus) to investigate muscle function in this, the largest of extant birds and model organism for many studies of locomotor mechanics, body size, anatomy and evolution. Combined with experimental data, we use this model to test two main hypotheses. We first query whether ostriches use limb orientations (joint angles) that optimize the moment-generating capacities of their muscles during walking or running. Next, we test whether ostriches use limb orientations at mid-stance that keep their extensor muscles near maximal, and flexor muscles near minimal, moment arms. Our two hypotheses relate to the control priorities that a large bipedal animal might evolve under biomechanical constraints to achieve more effective static weight support. We find that ostriches do not use limb orientations to optimize the moment-generating capacities or moment arms of their muscles. We infer that dynamic properties of muscles or tendons might be better candidates for locomotor optimization. Regardless, general principles explaining why species choose particular joint orientations during locomotion are lacking, raising the question of whether such general principles exist or if clades evolve different patterns (e.g., weighting of muscle force–length or force–velocity properties in selecting postures). This leaves theoretical studies of muscle moment arms estimated for extinct animals at an impasse until studies of extant taxa answer these questions. Finally, we compare our model’s results against those of two prior studies of ostrich limb muscle moment arms, finding general agreement for many muscles. Some flexor and extensor muscles exhibit self-stabilization patterns (posture-dependent switches between flexor/extensor action) that ostriches may use to coordinate their locomotion. However, some conspicuous areas of disagreement in our results illustrate some cautionary principles. Importantly, tendon-travel empirical measurements of muscle moment arms must be carefully designed to preserve 3D muscle geometry lest their accuracy suffer relative to that of anatomically realistic models. The dearth of accurate experimental measurements of 3D moment arms of muscles in birds leaves uncertainty regarding the relative accuracy of different modelling or experimental datasets such as in ostriches. Our model, however, provides a comprehensive set of 3D estimates of muscle actions in ostriches for the first time, emphasizing that avian limb mechanics are highly three-dimensional and complex, and how no muscles act purely in the sagittal plane. A comparative synthesis of experiments and models such as ours could provide powerful synthesis into how anatomy, mechanics and control interact during locomotion and how these interactions evolve. Such a framework could remove obstacles impeding the analysis of muscle function in extinct taxa.

  18. Neuromodulation of lower limb motor control in restorative neurology

    PubMed Central

    Minassian, Karen; Hofstoetter, Ursula; Tansey, Keith; Mayr, Winfried

    2012-01-01

    One consequence of central nervous system injury or disease is the impairment of neural control of movement, resulting in spasticity and paralysis. To enhance recovery, restorative neurology procedures modify altered, yet preserved nervous system function. This review focuses on functional electrical stimulation (FES) and spinal cord stimulation (SCS) that utilize remaining capabilities of the distal apparatus of spinal cord, peripheral nerves and muscles in upper motor neuron dysfunctions. FES for the immediate generation of lower limb movement along with current rehabilitative techniques is reviewed. The potential of SCS for controlling spinal spasticity and enhancing lower limb function in multiple sclerosis and spinal cord injury is discussed. The necessity for precise electrode placement and appropriate stimulation parameter settings to achieve therapeutic specificity is elaborated. This will lead to our human work of epidural and transcutaneous stimulation targeting the lumbar spinal cord for enhancing motor functions in spinal cord injured people, supplemented by pertinent human research of other investigators. We conclude that the concept of restorative neurology recently received new appreciation by accumulated evidence for locomotor circuits residing in the human spinal cord. Technological and clinical advancements need to follow for a major impact on the functional recovery in individuals with severe damage to their motor system. PMID:22464657

  19. Visual Feedback of the Non-Moving Limb Improves Active Joint-Position Sense of the Impaired Limb in Spastic Hemiparetic Cerebral Palsy

    ERIC Educational Resources Information Center

    Smorenburg, Ana R. P.; Ledebt, Annick; Deconinck, Frederik J. A.; Savelsbergh, Geert J. P.

    2011-01-01

    This study examined the active joint-position sense in children with Spastic Hemiparetic Cerebral Palsy (SHCP) and the effect of static visual feedback and static mirror visual feedback, of the non-moving limb, on the joint-position sense. Participants were asked to match the position of one upper limb with that of the contralateral limb. The task…

  20. Transcranial direct current stimulation improves ipsilateral selective muscle activation in a frequency dependent manner.

    PubMed

    Uehara, Kazumasa; Coxon, James P; Byblow, Winston D

    2015-01-01

    Failure to suppress antagonist muscles can lead to movement dysfunction, such as the abnormal muscle synergies often seen in the upper limb after stroke. A neurophysiological surrogate of upper limb synergies, the selectivity ratio (SR), can be determined from the ratio of biceps brachii (BB) motor evoked potentials to transcranial magnetic stimulation prior to forearm pronation versus elbow flexion. Surprisingly, cathodal transcranial direct current stimulation (c-TDCS) over ipsilateral primary motor cortex (M1) reduces (i.e. improves) the SR in healthy adults, and chronic stroke patients. The ability to suppress antagonist muscles may be exacerbated at high movement rates. The aim of the present study was to investigate whether the selective muscle activation of the biceps brachii (BB) is dependent on altering frequency demands, and whether the c-tDCS improvement of SR is dependent on task frequency. Seventeen healthy participants performed repetitive isometric elbow flexion and forearm pronation at three rates, before and after c-tDCS or sham delivered to ipsilateral left M1. Ipsilateral c-tDCS improved the SR in a frequency dependent manner by selectively suppressing BB antagonist excitability. Our findings confirm that c-tDCS is an effective tool for improving selective muscle activation, and provide novel evidence for its efficacy at rates of movement where it is most likely to benefit task performance. PMID:25816204

  1. Physiological effects of selective tibial neurotomy on lower limb spasticity

    Microsoft Academic Search

    A Fève; P Decq; P Filipetti; J Verroust; A Harf; J P N’Guyen; Y Keravel

    1997-01-01

    OBJECTIVESTo assess by electrophysiology the effect of tibial selective neurotomy on muscle imbalance of the spastic ankle.METHODThe amplitudes of the H reflexes, M responses (muscle contractions recorded after stimulation of the tibial nerve), and Hmax:Mmax ratio were recorded in 12 patients with chronic lower limb spasticity, before and one month after tibial selective neurotomy. Recordings were done on medial and

  2. Anatomy of sartorius muscle.

    PubMed

    Dziedzic, D; Bogacka, U; Ciszek, B

    2014-08-01

    A sartorius muscle is the longest muscle of the human system. It runs over 2 joints- hip and knee joints. In the study 10 sartorius muscles were examined. They were dissected free of lower human limbs. Dimensions of limbs which these muscles come from and dimensions of the muscles and their component parts were examined. The attention was paid mainly to parts of tendon located inside the muscle belly. The results show that they are either of a comparable length (distal tendon) or several times longer (proximal tendon) than visible parts located outside of the muscle. Moreover, a complex structure of the distal tendon which includes 2 tracts of different places of insertion was stated. Inferior tract inserted in the same place as muscle tendons: semitendinosus and gracilis. The superior tract inserted transversely against the former one. The tendon of the sartorius muscle forms additionally an aponeurosis whose fibres enter into the deep fascia of crus. The muscle belly is characterised with various width on different levels of its length. In half of casess word-like distal segment of belly is formed. PMID:25242250

  3. Fundamental ratios and logarithmic periodicity in human limb bones

    PubMed Central

    Pietak, Alexis; Ma, Siyan; Beck, Caroline W; Stringer, Mark D

    2013-01-01

    Fundamental mathematical relationships are widespread in biology yet there is little information on this topic with regard to human limb bone lengths and none related to human limb bone volumes. Forty-six sets of ipsilateral upper and lower limb long bones and third digit short bones were imaged by computed tomography. Maximum bone lengths were measured manually and individual bone volumes calculated from computed tomography images using a stereologic method. Length ratios of femur : tibia and humerus : ulna were remarkably similar (1.21 and 1.22, respectively) and varied little (<7%) between individuals. The volume ratio of femur : tibia was approximately half that of humerus : ulna (1.58 and 3.28, respectively; P < 0.0001). Lower limb bone volume ratios varied much more than upper limb ratios. The relationship between bone length and volume was found to be well described by power laws, with R2 values ranging from 0.983 to 0.995. The most striking finding was a logarithmic periodicity in bone length moving from distal to proximal up the limb (upper limb ? = 0.72, lower limb ? = 0.93). These novel data suggest that human limb bone lengths and volumes follow fundamental and highly conserved mathematical relationships, which may contribute to our understanding of normal and disordered growth, stature estimation, and biomechanics. PMID:23521756

  4. Chronic Stimulation-Induced Changes in the Rodent Thyroarytenoid Muscle

    ERIC Educational Resources Information Center

    McMullen, Colleen A.; Butterfield, Timothy A.; Dietrich, Maria; Andreatta, Richard D.; Andrade, Francisco H.; Fry, Lisa; Stemple, Joseph C.

    2011-01-01

    Purpose: Therapies for certain voice disorders purport principles of skeletal muscle rehabilitation to increase muscle mass, strength, and endurance. However, applicability of limb muscle rehabilitation to the laryngeal muscles has not been tested. In this study, the authors examined the feasibility of the rat thyroarytenoid muscle to remodel as a…

  5. 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

  6. Lbx1 expression and frog limb development.

    PubMed

    Sabo, Michelle C; Nath, Kimberly; Elinson, Richard P

    2009-12-01

    In order to identify prospective limb muscle cells in a frog, we cloned Lbx1 from the direct developing frog Eleutherodactylus coqui. Like in embryos of the frog Xenopus laevis but unlike in other vertebrates, EcLbx1 is expressed in all trunk somites. Like in embryos of chick, mouse, and zebrafish, cells expressing EcLbx1 are then found in limb buds, consistent with migration of those cells from somites. EcLbx1 is also expressed in the dorsal spinal cord as in other vertebrates. PMID:20091319

  7. Validation of UARS Microwave Limb Sounder ozone

    Microsoft Academic Search

    L. Froidevaux; W. G. Read; T. A. Lungu; R. E. Coileld; E. F. Fishbein; D. A. Flower; R. F. Jarnot; B. P. Ridenoure; Z. Shippony; J. W. Waters; J. J. Margitan; I. S. McDermid; R. A. Stachnik; G. E. Peckham

    1996-01-01

    This paper describes the validation of ozone data from the Upper Atmosphere Research Satellite (UARS) Microwave Limb Sounder (MLS). The MLS ozone retrievals are obtained from the calibrated microwave radiances (emission spectra) in two separate bands, at frequencies near 205 and 183 GHz. Analyses described here focus on the MLS Version 3 data (the first set of files made publicly

  8. Internal models of limb dynamics and the encoding of limb state

    NASA Astrophysics Data System (ADS)

    Hwang, Eun Jung; Shadmehr, Reza

    2005-09-01

    Studies of reaching suggest that humans adapt to novel arm dynamics by building internal models that transform planned sensory states of the limb, e.g., desired limb position and its derivatives, into motor commands, e.g., joint torques. Earlier work modeled this computation via a population of basis elements and used system identification techniques to estimate the tuning properties of the bases from the patterns of generalization. Here we hypothesized that the neural representation of planned sensory states in the internal model might resemble the signals from the peripheral sensors. These sensors normally encode the limb's actual sensory state in which movement errors occurred. We developed a set of equations based on properties of muscle spindles that estimated spindle discharge as a function of the limb's state during reaching and drawing of circles. We then implemented a simulation of a two-link arm that learned to move in various force fields using these spindle-like bases. The system produced a pattern of adaptation and generalization that accounted for a wide range of previously reported behavioral results. In particular, the bases showed gain-field interactions between encoding of limb position and velocity, very similar to the gain fields inferred from behavioral studies. The poor sensitivity of the bases to limb acceleration predicted behavioral results that were confirmed by experiment. We suggest that the internal model of limb dynamics is computed by the brain with neurons that encode the state of the limb in a manner similar to that expected of muscle spindle afferents.

  9. 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

  10. The pharmacological management of post-stroke muscle spasticity.

    PubMed

    Bakheit, Abdel Magid O

    2012-12-01

    Muscle hypertonia following upper motor neurone lesions (referred to here as 'spasticity') is a common problem in patients with neurological disease, and its management is one of the major challenges in clinical practice. Understanding the pathogenesis and clinical course of spasticity is essential for the effective management of this condition. The hypertonia initially results from increased excitability of the alpha motor neurones due to an imbalance between the excitatory and inhibitory influences of the vestibulospinal and reticulospinal tracts. This is the 'neural component' of muscle hypertonia. However, usually within 3-4 weeks, changes in the structure and mechanical properties of the paralysed muscles and the effect of thixotropy also contribute to the hypertonia. The selection of the optimal treatment option is often influenced by whether the neural or the non-neural component is more pronounced. Muscle spasticity often interferes with motor function or causes distressing symptoms, such as painful muscle spasms. If untreated, spasticity may also lead to soft tissue shortening (fixed contractures). However, spasticity can also be beneficial to patients. For example, despite severe leg muscle weakness, most hemiplegic patients are able to walk because the spasticity of the extensor muscles braces the lower limb in a rigid pillar. Other reported benefits of spasticity include the maintenance of muscle bulk and bone mineral density and possibly a reduced risk of lower limb deep vein thrombosis. Several factors, such as skin pressure sores, faecal impaction, urinary tract infections and stones in the urinary bladder, can aggravate muscle spasticity. These factors should always be looked for as their adequate treatment is often sufficient to reduce muscle tone without the need for specific antispasticity medication. Therefore, a careful evaluation of the patient's symptoms and their impact on function, and the setting of clear and realistic therapy goals are important prerequisites to treatment. The best treatment outcomes are usually achieved when pharmacological and non-pharmacological treatment modalities are used in tandem. Different drugs are available for the management of spasticity, including oral muscle relaxants, anticonvulsant drugs, intrathecal baclofen, cannabis extract, phenol and alcohol (for peripheral nerve blocks) and botulinum toxin injections. Similarly, there is a range of non-pharmacological methods of treatment, e.g. regular muscle stretching, the use of splints and orthoses, electrical stimulation, etc. Although these are not discussed here, this should not detract from the importance of combining them with antispasticity drugs in order to maximize the clinical benefit of treatment. PMID:23138834

  11. Differences in plantarflexor function during a stretch-shortening cycle task due to limb preference.

    PubMed

    Furlong, Laura-Anne M; Harrison, Andrew J

    2015-01-01

    Most healthy humans move symmetrically at gross limb level but large kinetic and kinematic asymmetries have been observed at joint level during locomotion. The aim of this study was to assess muscle function asymmetries in healthy, active adults using an adapted force sledge apparatus which isolates the plantarflexors during a stretch-shortening cycle (SSC) task. Peak force, rate of force development and SSC function of preferred and non-preferred limbs were assessed in 21 healthy, active individuals using the adapted sledge and three-dimensional motion analysis. Between-limb differences and relationships were determined using paired t-tests/Wilcoxon Signed-rank test, Cohen's dz, absolute symmetry index and Pearson's r/Spearman's rho. Significant differences with moderate effect size (ES) were observed in peak force (ES: 0.66), rate of peak force development (ES: 0.78), rate of force development in the first 50 ms (ES: 0.76), flight time (ES: 0.64) and SSC function (0.68), with no difference in contact time or duration of eccentric loading. A small ES (0.56) was observed in rate of force development in the first 30 ms. The upper range of asymmetry observed (up to 44.6%) was larger than previously reported for healthy individuals, indicating compensations occur at proximal joints during locomotion to ensure symmetrical movement. PMID:24877621

  12. 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

  13. Effects of preservation methods of muscle tissue from upper-trophic level reef fishes on stable isotope values (?13C and ?15N)

    PubMed Central

    Nelson, James A.; Rozar, Katherine L.; Adams, Charles S.; Wall, Kara R.; Switzer, Theodore S.; Winner, Brent L.; Hollander, David J.

    2015-01-01

    Research that uses stable isotope analysis often involves a delay between sample collection in the field and laboratory processing, therefore requiring preservation to prevent or reduce tissue degradation and associated isotopic compositions. Although there is a growing literature describing the effects of various preservation techniques, the results are often contextual, unpredictable and vary among taxa, suggesting the need to treat each species individually. We conducted a controlled experiment to test the effects of four preservation methods of muscle tissue from four species of upper trophic-level reef fish collected from the eastern Gulf of Mexico (Red Grouper Epinephelus morio, Gag Mycteroperca microlepis, Scamp Mycteroperca phenax, and Red Snapper Lutjanus campechanus). We used a paired design to measure the effects on isotopic values for carbon and nitrogen after storage using ice, 95% ethanol, and sodium chloride (table salt), against that in a liquid nitrogen control. Mean offsets for both ?13C and ?15N values from controls were lowest for samples preserved on ice, intermediate for those preserved with salt, and highest with ethanol. Within species, both salt and ethanol significantly enriched the ?15N values in nearly all comparisons. Ethanol also had strong effects on the ?13C values in all three groupers. Conversely, for samples preserved on ice, we did not detect a significant offset in either isotopic ratio for any of the focal species. Previous studies have addressed preservation-induced offsets in isotope values using a mass balance correction that accounts for changes in the isotope value to that in the C/N ratio. We tested the application of standard mass balance corrections for isotope values that were significantly affected by the preservation methods and found generally poor agreement between corrected and control values. The poor performance by the correction may have been due to preferential loss of lighter isotopes and corresponding low levels of mass loss with a substantial change in the isotope value of the sample. Regardless of mechanism, it was evident that accounting for offsets caused by different preservation methods was not possible using the standard correction. Caution is warranted when interpreting the results from specimens stored in either ethanol or salt, especially when using those from multiple preservation techniques. We suggest the use of ice as the preferred preservation technique for muscle tissue when conducting stable isotope analysis as it is widely available, inexpensive, easy to transport and did not impart a significant offset in measured isotopic values. Our results provide additional evidence that preservation effects on stable isotope analysis can be highly contextual, thus requiring their effects to be measured and understood for each species and isotopic ratio of interest before addressing research questions. PMID:25834776

  14. Mercury and arsenic in muscle and liver of the golden cownose ray, Rhinoptera steindachneri, Evermann and Jenkins, 1891, from the upper Gulf of California, México.

    PubMed

    Gutiérrez-Mejía, E; Lares, M L; Sosa-Nishizaki, O

    2009-08-01

    Mercury and arsenic levels in muscle and liver of Rhinoptera steindachneri were determined in organisms collected in 2006. Element concentrations in both tissues were directly related to size. Maxima mean concentrations of Hg and As (0.41 and 59.9 microg g(-1) dry wt, respectively) were found in adults muscle. Mercury concentrations were significantly different between juveniles and adults in muscle and liver. For As concentrations, differences between juveniles and adults were found only in muscle. Mercury concentrations were higher in muscle of juveniles and adults. Arsenic concentrations were higher in liver of juveniles, and in muscle of adults. Maximum Hg concentration in muscle (0.65 microg g(-1) dry wt) was below the safe limit established by Mexican regulations for seafood. PMID:19434357

  15. [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

  16. Optimizing muscle power after stroke: a cross-sectional study

    PubMed Central

    2012-01-01

    Background Stroke remains a leading cause of disability worldwide and results in muscle performance deficits and limitations in activity performance. Rehabilitation aims to address muscle dysfunction in an effort to improve activity and participation. While muscle strength has an impact on activity performance, muscle power has recently been acknowledged as contributing significantly to activity performance in this population. Therefore, rehabilitation efforts should include training of muscle power. However, little is known about what training parameters, or load, optimize muscle power performance in people with stroke. The purpose of this study was to investigate lower limb muscle power performance at differing loads in people with and without stroke. Methods A cross-sectional study design investigated muscle power performance in 58 hemiplegic and age matched control participants. Lower limb muscle power was measured using a modified leg press machine at 30, 50 and 70% of one repetition maximum (1-RM) strength. Results There were significant differences in peak power between involved and uninvolved limbs of stroke participants and between uninvolved and control limbs. Peak power was greatest when pushing against a load of 30% of 1RM for involved, uninvolved and control limbs. Involved limb peak power irrespective of load (Mean:220?±?SD:134 W) was significantly lower (p?limb (Mean:466?±?SD:220 W). Both the involved and uninvolved limbs generated significantly lower peak power (p?limb (Mean:708?±?SD:289 W). Conclusions Significant power deficits were seen in both the involved and uninvolved limbs after stroke. Maximal muscle power was produced when pushing against lighter loads. Further intervention studies are needed to determine whether training of both limbs at lighter loads (and higher velocities) are preferable to improve both power and activity performance after stroke. PMID:23013672

  17. Mechanical efficiency of limb swing during walking and running in guinea fowl (Numida meleagris)

    PubMed Central

    Rubenson, Jonas; Marsh, Richard L.

    2009-01-01

    Understanding the mechanical determinants of the energy cost of limb swing is crucial for refining our models of locomotor energetics, as well as improving treatments for those suffering from impaired limb-swing mechanics. In this study, we use guinea fowl (Numida meleagris) as a model to explore whether mechanical work at the joints explains li