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1

Upper and Lower Limb Muscle Activation Is Bidirectionally and Ipsilaterally Coupled  

PubMed Central

Purpose There are neural connections between the upper and lower limbs of humans that enable muscle activation in one limb pair (upper or lower) to modulate muscle activation in the other limb pair (lower or upper, respectively). The aims of this study were to extend previous findings regarding submaximal exercise to maximal effort exercise and determine if there is an ipsilateral or contralateral bias to the neural coupling during a rhythmic locomotor-like task. Methods We measured upper and lower limb muscle activity, joint kinematics, and limb forces in neurologically intact subjects (n = 16) as they performed recumbent stepping using different combinations of upper and lower limb efforts. Results We found increased muscle activation in passive lower limbs during active upper limb effort compared to passive upper limb effort. Likewise, increased muscle activation in passive upper limbs occurred during active lower limb effort compared to passive lower limb effort, suggesting a bidirectional effect. Maximal muscle activation in the active lower limbs was not different between conditions with active upper limb effort and conditions with passive upper limb movement. Similarly, maximal muscle activation in the active upper limbs was not different between conditions with active lower limb effort and conditions with passive lower limb movement. Further comparisons revealed that neural coupling was primarily from active upper limb muscles to passive ipsilateral lower limb muscles. Conclusion These findings indicate that interlimb neural coupling affects muscle recruitment during maximal effort upper and lower limb rhythmic exercise and provide insight into the architecture of the neural coupling.

Huang, Helen J.; Ferris, Daniel P.

2009-01-01

2

Muscle architecture of the upper limb in the orangutan.  

PubMed

We dissected the left upper limb of a female orangutan and systematically recorded muscle mass, fascicle length, and physiological cross-sectional area (PCSA), in order to quantitatively clarify the unique muscle architecture of the upper limb of the orangutan. Comparisons of the musculature of the dissected orangutan with corresponding published chimpanzee data demonstrated that in the orangutan, the elbow flexors, notably M. brachioradialis, tend to exhibit greater PCSAs. Moreover, the digital II-V flexors in the forearm, such as M. flexor digitorum superficialis and M. flexor digitorum profundus, tend to have smaller PCSA as a result of their relatively longer fascicles. Thus, in the orangutan, the elbow flexors demonstrate a higher potential for force production, whereas the forearm muscles allow a greater range of wrist joint mobility. The differences in the force-generating capacity in the upper limb muscles of the two species might reflect functional specialization of muscle architecture in the upper limb of the orangutan for living in arboreal environments. PMID:18306980

Oishi, Motoharu; Ogihara, Naomichi; Endo, Hideki; Asari, Masao

2008-07-01

3

Free muscle flaps for reconstruction of upper limb defects.  

PubMed

Restoration of structure, function, and sensation are critical after trauma or tumor resection of the hand. Thorough debridement, reconstruction of functional structures, and immediate soft tissue coverage are most effectively performed in a single stage within approximately 24 hours of the injury. Skin flaps provide robust, pliable, and cosmetically appropriate tissue that is not prone to contracture and that facilitates secondary reconstructive work. Muscle flaps retain indications for complex defects with substantial initial contamination or dead space, or for reanimation. In this article, the indications, options, and surgical techniques for free muscle flap reconstruction of upper limb defects are reviewed. PMID:24731608

Schaverien, Mark V; Hart, Andrew M

2014-05-01

4

Reliability of EMG normalisation methods for upper-limb muscles.  

PubMed

The study investigated different electromyographic (EMG) normalisation methods for upper-limb muscles. This assessment aimed at comparing the EMG amplitude and the reliability of EMG values obtained with each method. Eighteen male tennis players completed isometric maximal voluntary contractions and dynamic strength exercises (push-ups and chin-ups) on three separate test sessions over at least 7 days. Surface EMG activity of nine upper body muscles was recorded. For each muscle, an analysis of variance for repeated measures was used to compare maximal EMG amplitudes between test conditions. The intra-class correlation coefficient, the coefficient of variation and the standard error of measurement were calculated to determine the EMG reliability of each condition. On the basis of a compromise between maximal EMG amplitude and high reliability, the chin-ups appeared to be the optimal normalisation method for M. latissimus dorsi, M. posterior deltoid, M. biceps brachii, M. flexor carpi radialis and M. extensor carpi radialis. The push-ups seemed relevant to normalise M. anterior deltoid and M. triceps brachii activity, while isometric maximal voluntary contraction remained the most appropriate method for M. pectoralis major and M. middle deltoid. Thus, original methods are proposed to normalise EMG signal of upper-limb muscles. PMID:23697512

Rota, Samuel; Rogowski, Isabelle; Champely, Stéphane; Hautier, Christophe

2013-01-01

5

Can testing of six individual muscles represent a screening approach to upper limb neuropathic conditions?  

PubMed Central

Background It has previously been demonstrated that an extensive upper limb neurological examination of individual muscle function, sensation in homonymous innervated territories, and nerve trunk allodynia is reliable and that the outcome reflects symptoms. Since this approach may appear complicated and time consuming, this study deals with the value of an examination limited to manual testing of only six muscles. Methods Two examiners blinded to symptom status performed manual muscle testing of six muscles in 82 upper limbs with or without pain, weakness, and/or numbness/tingling. The six muscles represent three antagonist pairs (pectoralis major/posterior deltoid, biceps/triceps, and radial flexor of wrist/short radial extensor of wrist). The inter-rater reliability of detecting muscular weaknesses and the relation of weakness to the mentioned symptoms were analysed by kappa-statistics. Results The two examiners recognized weaknesses in 48 and 55 limbs, respectively, with moderate agreement (median kappa?=?0.58). Out of these, 35 and 32 limbs, respectively, were symptomatic. There was good correlation between findings and symptoms for one examiner (kappa?=?0.61) and fair correlation for the other one (kappa?=?0.33). Both reached high sensitivity (0.92, 0.84) but less satisfactory specificity (0.70, 0.50). Weaknesses agreed upon by the two examiners correlated moderately with symptoms (kappa?=?0.57). Conclusions Weakness in one or more muscles was present in almost all symptomatic limbs but in many non-symptomatic limbs as well. Manual testing of six muscles may represent a useful screening approach to upper limb neuropathic conditions, but a confirmative diagnosis requires further assessment.

2014-01-01

6

Upper Limb Muscle and Brain Activity in Light Assembly Task on Different Load Levels  

NASA Astrophysics Data System (ADS)

A study was conducted to investigate the effect of load on upper limb muscles and brain activities in light assembly task. The task was conducted at two levels of load (Low and high). Surface electromyography (EMG) was used to measure upper limb muscle activities of twenty subjects. Electroencephalography (EEG) was simultaneously recorded with EMG to record brain activities from Fz, Pz, O1 and O2 channels. The EMG Mean Power Frequency (MPF) of the right brachioradialis and the left upper trapezius activities were higher on the high-load task compared to low-load task. The EMG MPF values also decrease as time increases, that reflects muscle fatigue. Mean power of the EEG alpha bands for the Fz-Pz channels were found to be higher on the high-load task compared to low-load task, while for the O1-O2 channels, they were higher on the low-load task than on the high-load task. These results indicated that the load levels effect the upper limb muscle and brain activities. The high-load task will increase muscle activities on the right brachioradialis and the left upper tapezius muscles, and will increase the awareness and motivation of the subjects. Whilst the low-load task can generate drowsiness earlier. It signified that the longer the time and the more heavy of the task, the subjects will be more fatigue physically and mentally.

Zadry, Hilma Raimona; Dawal, Siti Zawiah Md.; Taha, Zahari

2010-10-01

7

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

PubMed Central

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.

2014-01-01

8

Muscle variants of the upper and lower limb (with anatomical correlation).  

PubMed

Several accessory muscles in the upper and lower limb have been described in the medical literature. Most are asymptomatic and represent incidental findings at imaging. In some instances, however, these muscles may become clinically relevant producing palpable swelling, entrapment of neurovascular structures, or exercise-related pain. The diagnosis of accessory muscles is based on recognition of their typical location and on cross-sectional imaging features. Familiarity with their most common location and knowledge of the possible clinical syndromes caused by these supernumerary structures may aid in diagnosis and treatment. PMID:20486022

Martinoli, Carlo; Perez, Maribel Miguel; Padua, Luca; Valle, Maura; Capaccio, Enrico; Altafini, Luisa; Michaud, Johan; Tagliafico, Alberto

2010-06-01

9

Robotic arm for testing and demonstration of targeted muscle reinnervation with implications for low-cost upper-limb prostheses  

Microsoft Academic Search

Targeted Muscle Reinnervation is a relatively new surgical procedure that endeavors to make control of upper-limb prostheses more intuitive for amputees. This procedure reroutes residual nerve bundles from an amputated limb to muscles in the chest or proximal to the site of amputation in the arm, producing EMGs in response to motor commands. These EMGs are traditionally collected using surface

Rebecca A Bercich

2011-01-01

10

Characterizing upper limb muscle volume and strength in older adults: A comparison with young adults  

PubMed Central

Aging is associated with loss of muscle volume (MV) and force leading to difficulties with activities of daily living. However, the relationship between upper limb MV and joint strength has not been characterized for older adults. Quantifying this relationship may help our understanding of the functional upper limb declines older adults experience. Our objective was to assess the relationship between upper limb MV and maximal isometric joint moment-generating capacity (IJM) in a single cohort of healthy older adults (age?65 years) for 6 major functional groups (32 muscles). MV was determined from MRI for 18 participants (75.1±4.3 years). IJM at the shoulder (abduction/adduction), elbow (flexion/extension), and wrist (flexion/extension) was measured. MV and IJM measurements were compared to previous reports for young adults (28.6±4.5 years). On average older adults had 16.5% less total upper limb MV compared to young adults. Additionally, older adult wrist extensors composed a significantly increased percentage of upper limb MV. Older adult IJM was reduced across all joints, with significant differences for shoulder abductors (p<0.0001), adductors (p=0.01), and wrist flexors (p<0.0001). Young adults were strongest at the shoulder, which was not the case for older adults. In older adults, 40.6% of the variation in IJM was accounted for by MV changes (p?0.027), compared to 81.0% in young adults. We conclude that for older adults, MV and IJM are, on average, reduced but the significant linear relationship between MV and IJM is maintained. These results suggest that older adult MV and IJM cannot be simply scaled from young adults.

Vidt, Meghan E.; Daly, Melissa; Miller, Michael E.; Davis, Cralen C.; Marsh, Anthony P.; Saul, Katherine R.

2011-01-01

11

Aerobic exercise modulates intracortical inhibition and facilitation in a nonexercised upper limb muscle  

PubMed Central

Background Despite growing interest in the relationship between exercise and short-term neural plasticity, the effects of exercise on motor cortical (M1) excitability are not well studied. Acute, lower-limb aerobic exercise may potentially modulate M1 excitability in working muscles, but the effects on muscles not involved in the exercise are unknown. Here we examined the excitability changes in an upper limb muscle representation following a single session of lower body aerobic exercise. Investigating the response to exercise in a non-exercised muscle may help to determine the clinical usefulness of lower-body exercise interventions for upper limb neurorehabilitation. Methods In this study, transcranial magnetic stimulation was used to assess input–output curves, short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI) and intracortical facilitation (ICF) in the extensor carpi radialis muscle in twelve healthy individuals following a single session of moderate stationary biking. Additionally, we examined whether the presence of a common polymorphism of the brain-derived neurotrophic factor (BDNF) gene would affect the response of these measures to exercise. Results We observed significant increases in ICF and decreases in SICI following exercise. No changes in LICI were detected, and no differences were observed in input–output curves following exercise, or between BDNF groups. Conclusions The current results demonstrate that the modulation of intracortical excitability following aerobic exercise is not limited to those muscles involved in the exercise, and that while exercise does not directly modulate the excitability of motor neurons, it may facilitate the induction of experience-dependent plasticity via a decrease in intracortical inhibition and increase in intracortical facilitation. These findings indicate that exercise may create favourable conditions for adaptive plasticity in M1 and may be an effective adjunct to traditional training or rehabilitation methods.

2014-01-01

12

Trunk and upper limb muscle activation during flat and topspin forehand drives in young tennis players.  

PubMed

This study compared EMG activity of young tennis players' muscles during forehand drives in two groups, GD-those able to raise by more than 150% the vertical velocity of racket-face at impact from flat to topspin forehand drives, and GND, those not able to increase their vertical velocity to the same extent. Upper limb joint angles, racket-face velocities, and average EMGrms values, were studied. At similar joint angles, a fall in horizontal velocity and a rise in racket-face vertical velocity from flat to topspin forehand drives were observed. Shoulder muscle activity rose from flat to topspin forehand drives in GND, but not for drives in GD. Forearm muscle activity reduced from flat to topspin forehand drives in GD, but muscle activation was similar in GND. The results show that radial deviation increased racket-face vertical velocity more at impact from the flat to topspin forehand drives than shoulder abduction. PMID:21451178

Rogowski, Isabelle; Rouffet, David; Lambalot, Frederic; Brosseau, Olivier; Hautier, Christophe

2011-02-01

13

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

PubMed

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

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

2011-01-01

14

Effect of the Mandibular Orthopedic Repositioning Appliance on Trunk and Upper Limb Muscle Activation during Maximum Isometric Contraction  

PubMed Central

[Purpose] The purpose of this study was to measure the muscle activities of the trunk muscles and upper limb muscles during maximum isometric contraction when temporomandibular joint alignment was achieved with a mandibular orthopedic repositioning appliance in order provide basic data on the effects of mandibular orthopedic repositioning appliance on the entire body. [Subjects] The present study was conducted with healthy Korean adults in their 20s (males=10, females=10). [Methods] An 8 channel surface electromyography system was used to measure the muscle activities of the upper limb muscles and neck muscles of the subjects during maximum isometric contraction with and without use of a mandibular orthopedic repositioning appliance. [Results] The maximum isometric contractions of the trunk and upper limb muscles when mandibular orthopedic repositioning appliance were used were compared with those when no mandibular orthopedic repositioning appliance was used. The results showed that the sternocleidomastoid muscle, cervical and lumbar erector spinae, upper trapezius, biceps, triceps, rectus abdominis and internal oblique and external oblique muscles all showed significant increases in maximum isometric contractions with a mandibular orthopedic repositioning appliance. [Conclusion] The use of a mandibular orthopedic repositioning appliance is considered to be a method for normal adults to improve the stability of the entire body with the improvement of the stability of the TMJ. The proximal improvement in stability improves of the proximal thereby improving not only muscle strength with increased muscle activation but also stability during exercises.

Lee, Sang-Yeol; Hong, Min-Ho; Park, Min-Chull; Choi, Sung-Min

2013-01-01

15

Classification of upper limb motions from around-shoulder muscle activities: hand biofeedback.  

PubMed

Mining information from EMG signals to detect complex motion intention has attracted growing research attention, especially for upper-limb prosthetic hand applications. 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, therefore, relying only on the local information to recognize the body coordinated motion has many disadvantages because natural continuous arm-hand motions can't be realized. Also, achieving a dynamical coupling between the user and the prosthesis will not be possible. This study objective was to investigate whether it is possible to associate the around-shoulder muscles' Electromyogram (EMG) activities with the different hand grips and arm directions movements. Experiments were conducted to record the EMG of different arm and hand motions and the data were analyzed to decide the contribution of each sensor, in order to distinguish the arm-hand motions as a function of the reaching time. Results showed that it is possible to differentiate hand grips and arm position while doing a reaching and grasping task. Also, these results are of great importance as one step to achieve a close loop dynamical coupling between the user and the prosthesis. PMID:20721299

González, Jose; Horiuchi, Yuse; Yu, Wenwei

2010-01-01

16

Simulation of Upper Limb Movements  

NASA Astrophysics Data System (ADS)

The paper deals with controlling an upper limb prosthesis based on the measurement of myoelectric signals (MES) while drinking. MES signals have been measured on healthy limbs to obtain the same response for the prosthesis. To simulate the drinking motion of a healthy upper limb, the program ADAMS was used, with all degrees of freedom and a hand after trans-radial amputation with an existing hand prosthesis. Modification of the simulation has the exact same logic of control, where the muscle does not have to be strenuous all the time, but it is the impulse of the muscle which drives the motor even though the impulse disappears and passed away.

Uher?ík, Filip; Hu?ko, Branislav

2011-12-01

17

Upper-limb muscle responses to epidural, subdural and intraspinal stimulation of the cervical spinal cord  

NASA Astrophysics Data System (ADS)

Objective. Electrical stimulation of the spinal cord has potential applications following spinal cord injury for reanimating paralysed limbs and promoting neuroplastic changes that may facilitate motor rehabilitation. Here we systematically compare the efficacy, selectivity and frequency-dependence of different stimulation methods in the cervical enlargement of anaesthetized monkeys. Approach. Stimulating electrodes were positioned at multiple epidural and subdural sites on both dorsal and ventral surfaces, as well as at different depths within the spinal cord. Motor responses were recorded from arm, forearm and hand muscles. Main results. Stimulation efficacy increased from dorsal to ventral stimulation sites, with the exception of ventral epidural electrodes which had the highest recruitment thresholds. Compared to epidural and intraspinal methods, responses to subdural stimulation were more selective but also more similar between adjacent sites. Trains of stimuli delivered to ventral sites elicited consistent responses at all frequencies whereas from dorsal sites we observed a mixture of short-latency facilitation and long-latency suppression. Finally, paired stimuli delivered to dorsal surface and intraspinal sites exhibited symmetric facilitatory interactions at interstimulus intervals between 2-5 ms whereas on the ventral side interactions tended to be suppressive for near-simultaneous stimuli. Significance. We interpret these results in the context of differential activation of afferent and efferent roots and intraspinal circuit elements. In particular, we propose that distinct direct and indirect actions of spinal cord stimulation on motoneurons may be advantageous for different applications, and this should be taken into consideration when designing neuroprostheses for upper-limb function.

Sharpe, Abigail N.; Jackson, Andrew

2014-02-01

18

Upper-limb muscle responses to epidural, subdural and intraspinal stimulation of the cervical spinal cord  

PubMed Central

Objective Electrical stimulation of the spinal cord has potential applications following spinal cord injury for reanimating paralysed limbs and promoting neuroplastic changes that may facilitate motor rehabilitation. Here we systematically compare the efficacy, selectivity and frequency-dependence of different stimulation methods in the cervical enlargement of anaesthetized monkeys. Approach Stimulating electrodes were positioned at multiple epidural and subdural sites on both dorsal and ventral surfaces, as well as at different depths within the spinal cord. Motor responses were recorded from arm, forearm and hand muscles. Main results Stimulation efficacy increased from dorsal to ventral stimulation sites, with the exception of ventral epidural electrodes which had the highest recruitment thresholds. Compared to epidural and intraspinal methods, responses to subdural stimulation were more selective but also more similar between adjacent sites. Trains of stimuli delivered to ventral sites elicited consistent responses at all frequencies whereas from dorsal sites we observed a mixture of short-latency facilitation and long-latency suppression. Finally, paired stimuli delivered to dorsal surface and intraspinal sites exhibited symmetric facilitatory interactions at interstimulus intervals between 2–5 ms whereas on the ventral side interactions tended to be suppressive for near-simultaneous stimuli. Significance We interpret these results in the context of differential activation of afferent and efferent roots and intraspinal circuit elements. In particular, we propose that distinct direct and indirect actions of spinal cord stimulation on motoneurons may be advantageous for different applications, and this should be taken into consideration when designing neuroprostheses for upper-limb function.

Sharpe, Abigail N; Jackson, Andrew

2014-01-01

19

Three-dimensional reaching tasks: effect of reaching height and width on upper limb kinematics and muscle activity.  

PubMed

In previous studies, upper limb coordination was usually analyzed during two-dimensional (2D) arm movements. Based on joint kinematics and muscle activity, it has been demonstrated that the shoulder joint controls the multi-joint movement. This study focused on three-dimensional (3D) reaching tasks and examined if the coordination strategies previously described in 2D can be transferred to 3D movements and if reaching to different locations in space has an effect on kinematic and upper limb muscle strategies. Ten healthy subjects reached to nine different targets in 3D space placed at arm length. Kinematic data of the shoulder and elbow and electrical activity of 10 upper limb muscles were registered. Differences in kinematics and EMG were compared between different reaching conditions. Activity of shoulder muscles increased earlier than elbow muscles inducing shoulder elevation prior to elbow extension. Reaching at different widths only influenced shoulder kinematics, whereas reaching at different heights influenced both shoulder and elbow joints. Modulation of reaching height induced an immediate adaptation of elbow flexion followed by an adaptation of shoulder elevation. As previously described in 2D, the shoulder joint leads the movement during 3D reaching tasks. Changing the 3D nature of a reaching task influenced the interaction between shoulder and elbow joint, with reaching height primarily affecting the elbow coordination strategy. PMID:20729085

Vandenberghe, Annelies; Levin, Oron; De Schutter, Joris; Swinnen, Stephan; Jonkers, Ilse

2010-10-01

20

Strength and fatigability of selected muscles in upper limb: Assessing muscle imbalance relevant to tennis elbow  

Microsoft Academic Search

PurposeThe aetiology of tennis elbow has remained uncertain for more than a century. To examine muscle imbalance as a possible pathophysiological factor requires a reliable method of assessment. This paper describes the development of such a method and its performance in healthy subjects. We propose a combination of surface and fine-wire EMG of shoulder and forearm muscles and wrist strength

O. Alizadehkhaiyat; A. C. Fisher; G. J. Kemp; S. P. Frostick

2007-01-01

21

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

NASA Astrophysics Data System (ADS)

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.

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

2007-12-01

22

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

PubMed Central

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.

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

2008-01-01

23

Pattern recognition control outperforms conventional myoelectric control in upper limb patients with targeted muscle reinnervation.  

PubMed

Pattern recognition myoelectric control shows great promise as an alternative to conventional amplitude based control to control multiple degree of freedom prosthetic limbs. Many studies have reported pattern recognition classification error performances of less than 10% during offline tests; however, it remains unclear how this translates to real-time control performance. In this contribution, we compare the real-time control performances between pattern recognition and direct myoelectric control (a popular form of conventional amplitude control) for participants who had received targeted muscle reinnervation. The real-time performance was evaluated during three tasks; 1) a box and blocks task, 2) a clothespin relocation task, and 3) a block stacking task. Our results found that pattern recognition significantly outperformed direct control for all three performance tasks. Furthermore, it was found that pattern recognition was configured much quicker. The classification error of the pattern recognition systems used by the patients was found to be 16% ±(1.6%) suggesting that systems with this error rate may still provide excellent control. Finally, patients qualitatively preferred using pattern recognition control and reported the resulting control to be smoother and more consistent. PMID:24110008

Hargrove, Levi J; Lock, Blair A; Simon, Ann M

2013-01-01

24

Warm-up with weighted bat and adjustment of upper limb muscle activity in bat swinging under movement correction conditions.  

PubMed

The effects of weighted bat warm-up on adjustment of upper limb muscle activity were investigated during baseball bat swinging under dynamic conditions that require a spatial and temporal adjustment of the swinging to hit a moving target. Seven male college baseball players participated in this study. Using a batting simulator, the task was to swing the standard bat coincident with the arrival timing and position of a moving target after three warm-up swings using a standard or weighted bat. There was no significant effect of weighted bat warm-up on muscle activity before impact associated with temporal or spatial movement corrections. However, lower inhibition of the extensor carpi ulnaris muscle activity was observed in a velocity-changed condition in the weighted bat warm-up, as compared to a standard bat warm-up. It is suggested that weighted bat warm-up decreases the adjustment ability associated with inhibition of muscle activation under movement correction conditions. PMID:24724516

Ohta, Yoichi; Ishii, Yasumitsu; Ikudome, Sachi; Nakamoto, Hiroki

2014-02-01

25

Poststroke hypertonicity: upper limb assessment and treatment.  

PubMed

Hypertonicity is common in patients with upper limb dysfunction following hemiplegic stroke and is associated with greater impairment, worse function, and lower health-related quality of life. In addition to increased rest activity, abnormal patterns of muscle activation, such as spastic co-contraction, may contribute to disability. In the upper limb, flexor muscles are more commonly involved distally, and at the shoulder, spasticity of adductors, flexors, and internal rotators is most often observed. Prior to interventions, a history regarding prior interventions, comorbid diagnoses, and limitations imposed by abnormal tone should be elicited. Commonly used scales to assess hypertonicity include the Modified Ashworth, the Modified Tardieu, the Spasm Frequency, the Disability Assessment, the Fugl-Meyer, and the Motor Assessment Scales. Treatment interventions for upper limb hypertonicity include stretching, splinting, strengthening of antagonist muscles, oral medications, and focal injections (phenol or botulinum toxins). Intrathecal baclofen may also impact upper limb tone. For focal injections, correct identification of muscles contributing to problematic tone is evaluated by eliciting resistance to movement at rest and observation of patterns of tightness as the limb is used functionally. The botulinum toxins have been shown to decrease tone in stroke survivors and improve active and passive functioning. Because secondary changes such as contractures and weakness may occur with prolonged hypertonicity, therapy to improve range of motion, strengthen weakened muscles, and incorporate use of the limb should be considered following focal injections, oral medications, or intrathecal pump placement. PMID:21642056

Marciniak, Christina

2011-01-01

26

Less common upper limb mononeuropathies.  

PubMed

This article will focus on the less commonly injured nerves of the upper extremity. These nerves may be involved when trauma results in fractures, dislocations, or swelling with resultant nerve compression. Tumors and ganglions can also compress nerves, causing pain and, over time, demyelination or axon degeneration with weakness. Other mechanisms for upper limb nerve injury include participation in high-level sports, that is, those that generate torque about the arm and shoulder, abnormal stresses about the joints and muscles, or muscle hypertrophy, which may result in nerve injury. The goals of this review are to discuss the clinical presentation and possible causes of upper extremity nerve entrapments and to formulate an electrodiagnostic plan for evaluation. Descriptions of the appropriate nerve conduction studies or needle electromyographic protocols are included for specific nerves. The purpose of the electrodiagnostic examination is to evaluate the degree of nerve injury, axon loss over time, and later, evidence for reinnervation to assist with prognostication. The latter has implications for management of the neuropathy, including the type of exercises and therapy that may be indicated to help maintain the stability and motion of the involved joint(s) and promote strengthening over time as the nerve regenerates. PMID:23523706

Williams, Faren H; Kumiga, Bryan

2013-05-01

27

Influence of aging on isometric muscle strength, fat-free mass and electromyographic signal power of the upper and lower limbs in women.  

PubMed

Background: Aging is a multifactorial process that leads to changes in the quantity and quality of skeletal muscle and contributes to decreased levels of muscle strength. Objective: This study sought to investigate whether the isometric muscle strength, fat-free mass (FFM) and power of the electromyographic (EMG) signal of the upper and lower limbs of women are similarly affected by aging. Method: The sample consisted of 63 women, who were subdivided into three groups (young (YO) n=33, 24.7±3.5 years; middle age (MA) n=15, 58.6±4.2 years; and older adults (OA). n=15, 72.0±4.2 years). Isometric strength was recorded simultaneously with the capture of the electrical activity of the flexor muscles of the fingers and the vastus lateralis during handgrip and knee extension tests, respectively. FFM was assessed using dual-energy X-ray absorptiometry. Results: The handgrip strength measurements were similar among groups (p=0.523), whereas the FFM of the upper limbs was lower in group OA compared to group YO (p=0.108). The RMSn values of the hand flexors were similar among groups (p=0.754). However, the strength of the knee extensors, the FFM of the lower limbs and the RMSn values of the vastus lateralis were lower in groups MA (p=0.014, p=0.006 and p=0.013, respectively) and OA (p=0.000, p=0.000 and p<0.000, respectively) compared to group YO. Conclusions : The results of this study demonstrate that changes in isometric muscle strength in MLG and electromyographic activity of the lower limbs are more pronounced with the aging process of the upper limb. PMID:24676705

Amaral, Josária F; Alvim, Felipe C; Castro, Eliane A; Doimo, Leonice A; Silva, Marcus V; Novo Júnior, José M

2014-05-16

28

Soft-tissue anatomy of the primates: phylogenetic analyses based on the muscles of the head, neck, pectoral region and upper limb, with notes on the evolution of these muscles  

PubMed Central

Apart from molecular data, nearly all the evidence used to study primate relationships comes from hard tissues. Here, we provide details of the first parsimony and Bayesian cladistic analyses of the order Primates based exclusively on muscle data. The most parsimonious tree obtained from the cladistic analysis of 166 characters taken from the head, neck, pectoral and upper limb musculature is fully congruent with the most recent evolutionary molecular tree of Primates. That is, this tree recovers not only the relationships among the major groups of primates, i.e. Strepsirrhini {Tarsiiformes [Platyrrhini (Cercopithecidae, Hominoidea)]}, but it also recovers the relationships within each of these inclusive groups. Of the 301 character state changes occurring in this tree, ca. 30% are non-homoplasic evolutionary transitions; within the 220 changes that are unambiguously optimized in the tree, ca. 15% are reversions. The trees obtained by using characters derived from the muscles of the head and neck are more similar to the most recent evolutionary molecular tree than are the trees obtained by using characters derived from the pectoral and upper limb muscles. It was recently argued that since the Pan/Homo split, chimpanzees accumulated more phenotypic adaptations than humans, but our results indicate that modern humans accumulated more muscle character state changes than chimpanzees, and that both these taxa accumulated more changes than gorillas. This overview of the evolution of the primate head, neck, pectoral and upper limb musculature suggests that the only muscle groups for which modern humans have more muscles than most other extant primates are the muscles of the face, larynx and forearm.

Diogo, R; Wood, B

2011-01-01

29

High-frequency, low-intensity vibrations increase bone mass and muscle strength in upper limbs, improving autonomy in disabled children.  

PubMed

Disuse osteoporosis in children is a progressive disease that can affect quality of life. High-frequency, low-magnitude vibration (HFLMV) acts as an anabolic signal for bone and muscle. We undertook a prospective, randomized, double-blind, placebo-controlled clinical trial to assess the efficacy and safety of regional HFLMV in disabled children. Sixty-five children 6 to 9 year of age were randomized into three groups: placebo, 60 Hz, and 90 Hz. In the two active groups, a 0.3-g mechanical vibration was delivered to the radii and femurs for 5 minutes each day. After 6 months, the main endpoint was bone mineral density (BMD) at the ultradistal radius (UDR), 33% radii (33%R), and femoral necks (FN). Secondary endpoints were area and bone mineral content (BMC) at the UDR, 33%R, and FN; grip force of the upper and lower limbs; motor function; and PedsQL evaluation. An intention-to-treat analysis was used. Fifty-seven children (88%) completed the protocol. A significant increase was observed in the 60-Hz group relative to the other groups in BMD at the UDR (p =?.011), in grip force of the upper limbs (p =?.035), and in the "daily activities item" (p =?.035). A mixed model to evaluate the response to intervention showed a stronger effect of 60 Hz on patients with cerebral palsy on the UDR and that between-subject variability significantly affected the response. There were no reported side effects of the intervention. This work provides evidence that regional HFLMV is an effective and safe strategy to improve bone mass, muscle strength, and possibly independence in children with motor disabilities. PMID:21491486

Reyes, M Loreto; Hernández, Marta; Holmgren, Luz J; Sanhueza, Enrique; Escobar, Raúl G

2011-08-01

30

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

[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

Kang, Min-Hyeok; Kim, Man-Sig

2014-06-01

31

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

[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.

Kang, Min-Hyeok; Kim, Man-Sig

2014-01-01

32

An investigation of fatigue phenomenon in the upper limb muscle due to short duration pulses in an FES system  

NASA Astrophysics Data System (ADS)

Functional Electrical Stimulation (FES) is a method of artificially stimulating muscles or nerves in order to result in contraction or relaxation of muscles. Many studies have shown that FES system has helped patients to live a better lives especially those who are suffering from physical mobility. Unfortunately, one of the main limitations of an FES system besides of its high cost is largely due to muscle fatigue. Muscle fatigue will affect the training duration which could delay patients' recovery rate. In this paper, we analyzed the occurrence of this fatigue phenomenon in terms of stimulator parameters such as amplitude, frequency, pulse width and pulse shape. The objective of this investigation is to identify other key features of the FES system parameters in order to prolong the training duration among patients. The experiment has been done on a healthy person for the duration of one minute and later the muscles response will be observed. Resultant muscle response is recorded as force using force resistive sensor. The experimental results show muscles will get fatigue at a different rate as the frequency increases. The experiment also shows that the duty cycle is reciprocal to the resultant force.

Naeem, Jannatul; Wong Azman, Amelia; Khan, Sheroz; Mohd Mustafah, Yasir

2013-12-01

33

Neuroma in bilateral upper limb amputation.  

PubMed

To evaluate the prevalence of neuroma in bilateral upper limb amputees and investigate the effect of level of amputation on their pain, 86 patients with bilateral upper limb amputation were thoroughly examined by an orthopedic surgeon. Of 172 bilateral amputated upper limbs (86 victims of war) 17.1+/-6.1 years after injury, physical examination revealed that 26.2% had moderate to severe stump pain and clinical signs suggestive of neuroma. Statistical analysis showed no relation between level of amputation, prosthesis usage, and occurrence of neuroma. Although high occurrence of neuroma among traumatic bilateral upper limb amputation had no significant effects on wearing prosthesis, its treatment can deeply influence alleviation of their pain and subsequently their quality of life. PMID:19226072

Soroush, Mansoor; Modirian, Ehsan; Soroush, Mohamadreza; Masoumi, Mahdi

2008-12-01

34

Tourniquet use in upper limb surgery  

Microsoft Academic Search

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

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

2011-01-01

35

Upper limb musculoskeletal disorders in healthcare personnel.  

PubMed

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

Occhionero, Vincenzo; Korpinen, Leena; Gobba, Fabriziomaria

2014-08-01

36

Effects of coupled upper limbs movements on postural stabilisation.  

PubMed

The preference for in-phase association of coupled cyclic limbs movements is well described (mirror-symmetrical patterns) and this is demonstrated by the ease of performing in-phase movements compared to anti-phase ones. The hypothesis of this study is that the easiest movement patterns are those with minor postural activity. The aim of this study was to describe postural activity in standing subjects in the sagittal and frontal planes during the execution of three upper limbs tasks (single arm, in-phase, anti-phase) at four different frequencies (from 0.6 to 1.2Hz). We employed six infrared cameras for recording kinematics information, a force platform for measuring forces exerted on the ground, and a system for surface electromyography (SEMG). Outcome measures were: upper limb range of movement and relative-phase, centre of pressure displacement (COP), screw torque (Tz) exerted on the ground, and SEMG recordings of postural muscles (adductor longus, gluteus medius, rectus femoris, and biceps femoris). Our results show that in both the planes the in-phase task resulted in less COP displacement, torque production, and postural muscles involvement than the anti-phase and single arm tasks. This reduced need of postural control could explain the ease of performing in-phase coupled limb movements compared with anti-phase movements. PMID:23859889

Tettamanti, Andrea; Giordano, Martino; Gatti, Roberto

2013-10-01

37

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

PubMed

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

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

2012-04-01

38

Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation  

ERIC Educational Resources Information Center

This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…

Desmond, Deirdre M.; MacLachlan, Malcolm

2010-01-01

39

Neural machine interfaces for controlling multifunctional powered upper-limb prostheses.  

PubMed

This article investigates various neural machine interfaces for voluntary control of externally powered upper-limb prostheses. Epidemiology of upper limb amputation, as well as prescription and follow-up studies of externally powered upper-limb prostheses are discussed. The use of electromyographic interfaces and peripheral nerve interfaces for prosthetic control, as well as brain machine interfaces suitable for prosthetic control, are examined in detail along with available clinical results. In addition, studies on interfaces using muscle acoustic and mechanical properties and the problem of interfacing sensory information to the nervous system are discussed. PMID:17187470

Ohnishi, Kengo; Weir, Richard F; Kuiken, Todd A

2007-01-01

40

Rlative shoulder fexor and handgrip strength is related to upper limb function after stroke  

Microsoft Academic Search

Objective: To compare the relative strength of different muscle groups of the paretic upper limb and assess the relationship with motor performance.Design: Descriptive study.Setting: Secondary care rehabilitation centre.Subjects: A convenience sample of 13 chronic hemiparetic stroke subjects.Main outcome measures: The maximal active torques of fivemuscle groups were measured in both upper limbs (UL) and converted into relative strength (paretic\\/nonparetic). The

Catherine Mercierand; Daniel Bourbonnais

2004-01-01

41

Muscles of the Upper Extremity  

MedlinePLUS

... Citation Help Home » Cancer Registration & Surveillance Modules » Anatomy & Physiology » Muscular System » Muscle Groups » Upper Extremity Cancer Registration & Surveillance Modules Anatomy & Physiology Intro to the Human Body Body Functions & Life ...

42

Musculoskeletal interventional ultrasonography: the upper limb.  

PubMed

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

Vuillemin, V; Guerini, H; Morvan, G

2012-09-01

43

Surveillance case definitions for work related upper limb pain syndromes  

Microsoft Academic Search

OBJECTIVES: To establish consensus case definitions for several common work related upper limb pain syndromes for use in surveillance or studies of the aetiology of these conditions. METHODS: A group of healthcare professionals from the disciplines interested in the prevention and management of upper limb disorders were recruited for a Delphi exercise. A questionnaire was used to establish case definitions

J. M. Harrington; J. T. Carter; L. Birrell; D. Gompertz

1998-01-01

44

A novel myoelectric training device for upper limb prostheses.  

PubMed

A training system intended for myoelectric prosthetic hands for upper limb amputees was developed to assist in learning myoelectric control schemes and training muscle isolation. The trainer allowed a user to operate a remote controlled car by use of a control scheme commonly used in myoelectric prosthetic hands. The trainer was designed to be easy for therapists to use and more engaging for the user than current methods of signal training. Preliminary testing of the trainer was conducted with eight nonamputee adult volunteers. The results indicated that the trainer could be a useful tool for myoelectric training in upper limb amputees. All subjects' skill with the myoelectric control scheme improved over the course of testing, with the improvements being greater at the beginning of the training period than at the end. Whereas the individual subjects' performance varied greatly at the beginning of the training, the subjects had achieved a more uniform level of performance by the end of the training, approaching the minimum possible values for the assessments. PMID:24710835

Clingman, Ryan; Pidcoe, Peter

2014-07-01

45

Glucose uptake and glycogen synthesis in muscles from immobilized limbs  

NASA Technical Reports Server (NTRS)

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.

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

1984-01-01

46

The Upper Atmosphere Research Satellite Microwave Limb Sounder Instrument  

Microsoft Academic Search

The microwave limb sounder (MLS) on the Upper Atmosphere Research Satellite (UARS) is the first satellite experiment using limb sounding techniques at microwave frequencies. Primary measure- ment objectives are stratospheric C10, 03, H20, temperature, and pressure. Measurements are of thermal emission: all are performed simultaneously and continuously and are not degraded by ice clouds or volcanic aerosols. The instrument has

F. T. Barath; M. C. Chavez; R. E. Cofield; D. A. Flower; M. A. Frerking; M. B. Gram; W. M. Harris; J. R. Holden; R. F. Jarnot; W. G. Kloezeman; G. J. Klose; G. K. Lau; M. S. Loo; B. J. Maddison; R. J. Mattauch; R. P. McKlnney; G. E. Peckham; H. M. Pickett; G. Siebes; F. S. Soltis; R. A. Suttie; J. A. Tarsala; J. W. Waters; W. J. Wilson

1993-01-01

47

Upper- and lower-limb muscular fatigue during the 200-m front crawl.  

PubMed

The aim of this study was to investigate how upper- and lower-limb muscle fatigue evolves in a 200-m front crawl swimming race. Surface electromyography signals were collected from the flexor carpi radialis, biceps brachii, triceps brachii, pectoralis major, upper trapezius, tibialis anterior, biceps femoris, and rectus femoris muscles of 10 international-level swimmers; 4 underwater cameras were used for kinematic analysis. In addition, blood lactate was measured before and after the test using capillary blood samples. Swimming speed and stroke length decreased from the beginning to the end of the effort, whereas stroke frequency increased after an initial decrease to maintain speed. Concomitant with the decrease in speed, blood lactate increased to 11.12 (1.65) mmol·L(-1). The changes in stroke parameters were associated with an increase in integrated electromyography (20%-25%) and a decrease in spectral parameters (40%-60%) for all of the upper-limb muscles, indicating the reaching of submaximal fatigue. The fatigue process did not occur regularly during the 8 laps of the 200 m but was specific for each muscle and each subject. Lower-limb muscles did not present signals of fatigue, confirming their lower contribution to swimming propulsion. The test was conducted to individualize the training process to each muscle and each subject. PMID:23980729

Figueiredo, Pedro; Rouard, Annie; Vilas-Boas, João Paulo; Fernandes, Ricardo J

2013-07-01

48

Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation.  

PubMed

This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence of phantom limb pain during the week preceding assessment was 42.6% (60 of 141). Prevalence of residual limb pain was 43.3% (61 of 141). More than one third of these had some pain constantly or most days. Phantom limb pain was commonly described as 'discomforting' (31 of 60) and associated with 'a little bit' of lifestyle interference (23 of 60). Residual limb pain was most often described as 'discomforting' (27 of 61) or 'distressing' (19 of 61) and was typically associated with low to moderate levels of lifestyle interference. Assessment of multiple dimensions of postamputation pain in the long term after upper limb amputation is warranted. PMID:20101187

Desmond, Deirdre M; Maclachlan, Malcolm

2010-09-01

49

Design and preliminary evaluation of an exoskeleton for upper limb resistance training  

NASA Astrophysics Data System (ADS)

Resistance training is a popular form of exercise recommended by national health organizations, such as the American College of Sports Medicine (ACSM) and the American Heart Association (AHA). This form of training is available for most populations. A compact design of upper limb exoskeleton mechanism for homebased resistance training using a spring-loaded upper limb exoskeleton with a three degree-of-freedom shoulder joint and a one degree-of-freedom elbow joint allows a patient or a healthy individual to move the upper limb with multiple joints in different planes. It can continuously increase the resistance by adjusting the spring length to train additional muscle groups and reduce the number of potential injuries to upper limb joints caused by the mass moment of inertia of the training equipment. The aim of this research is to perform a preliminary evaluation of the designed function by adopting an appropriate motion analysis system and experimental design to verify our prototype of the exoskeleton and determine the optimal configuration of the spring-loaded upper limb exoskeleton.

Wu, Tzong-Ming; Chen, Dar-Zen

2012-06-01

50

Ubiquitous human upper-limb motion estimation using wearable sensors.  

PubMed

Human motion capture technologies have been widely used in a wide spectrum of applications, including interactive game and learning, animation, film special effects, health care, navigation, and so on. The existing human motion capture techniques, which use structured multiple high-resolution cameras in a dedicated studio, are complicated and expensive. With the rapid development of microsensors-on-chip, human motion capture using wearable microsensors has become an active research topic. Because of the agility in movement, upper-limb motion estimation has been regarded as the most difficult problem in human motion capture. In this paper, we take the upper limb as our research subject and propose a novel ubiquitous upper-limb motion estimation algorithm, which concentrates on modeling the relationship between upper-arm movement and forearm movement. A link structure with 5 degrees of freedom (DOF) is proposed to model the human upper-limb skeleton structure. Parameters are defined according to Denavit-Hartenberg convention, forward kinematics equations are derived, and an unscented Kalman filter is deployed to estimate the defined parameters. The experimental results have shown that the proposed upper-limb motion capture and analysis algorithm outperforms other fusion methods and provides accurate results in comparison to the BTS optical motion tracker. PMID:21659035

Zhang, Zhi-Qiang; Wong, Wai-Choong; Wu, Jian-Kang

2011-07-01

51

Cortical motor activity and reorganization following upper-limb amputation and subsequent targeted reinnervation?  

PubMed Central

Previous studies have postulated that the amount of brain reorganization following peripheral injuries may be correlated with negative symptoms or consequences. However, it is unknown whether restoring effective limb function may then be associated with further changes in the expression of this reorganization. Recently, targeted reinnervation (TR), a surgical technique that restores a direct neural connection from amputated sensorimotor nerves to new peripheral targets such as muscle, has been successfully applied to upper-limb amputees. It has been shown to be effective in restoring both peripheral motor and sensory functions via the reinnervated nerves as soon as a few months after the surgery. However, it was unclear whether TR could also restore normal cortical motor representations for control of the missing limb. To answer this question, we used high-density electroencephalography (EEG) to localize cortical activity related to cued motor tasks generated by the intact and missing limb. Using a case study of 3 upper-limb amputees, 2 of whom went through pre and post-TR experiments, we present unique quantitative evidence for the re-mapping of motor representations for the missing limb closer to their original locations following TR. This provides evidence that an effective restoration of peripheral function from TR can be linked to the return of more normal cortical expression for the missing limb. Therefore, cortical mapping may be used as a potential guide for monitoring rehabilitation following peripheral injuries.

Chen, Albert; Yao, Jun; Kuiken, Todd; Dewald, Julius P.A.

2013-01-01

52

Dynamic upper limb proprioception in multidirectional shoulder instability.  

PubMed

The ability of subjects with multidirectional shoulder instability to use proprioception to complete a series of upper limb repositioning tasks was investigated. Twelve subjects with multidirectional instability and 12 control subjects were blindfolded and instructed to use proprioception to reproduce a self-selected target position as accurately as possible. Subjects completed 10 repetitions for each limb using three distinct upper limb movements: overhead reaching, scapular plane pointing, and humeral external rotation with abduction. A three-dimensional video motion analysis system tracked limb position and determined spatial hand position error. Subjects with multidirectional shoulder instability showed significantly greater hand position error than control subjects. No hand position error differences were found between the symptomatic and the asymptomatic limbs of subjects in the instability group. Inter-repetition error for subjects in both groups improved significantly during the first three movement cycles. These results suggest that after movement initiation, dynamic proprioception was a factor in improving hand position accuracy in both groups, but to a lesser degree in subjects with multidirectional instability. Consequently, subjects with multidirectional instability may have a reduced capacity to use proprioception to refine and control the motor output of the upper limb. PMID:15057095

Barden, John M; Balyk, Robert; Raso, V James; Moreau, Marc; Bagnall, Keith

2004-03-01

53

The influence of stimulation pulse frequency on the generation of joint moments in the upper limb.  

PubMed

Six muscles of the upper limb were stimulated transcutaneously. This communication reports the influence of the stimulation pulse frequency on the isometric joint moment generated by each muscle. A lower frequency of stimulation, the critical fusion frequency, was found for each muscle at which contractions ceased to be tetanic. This fusion frequency was correlated with muscle function. The magnitude of the joint moment was examined as a function of the stimulation pulse frequency for the six muscles tested. Parabolic curves were found to best fit this relationship; the magnitude of the moment reaching a maximum at typically 50 Hz, and often decreasing at higher frequencies. The slope of the linear portion of the relationship between the generated joint moment and the stimulation current intensity was shown to be a function of the stimulation pulse frequency. This function was found to be similar to the form of the joint moment versus pulse frequency curve. Fatigue curves were plotted at different stimulation frequencies; demonstrating reduced fatigue at lower stimulation frequencies. A model was presented of the fatigue curve as an exponential function of time. We conclude that a stimulation frequency of 15 Hz is optimal for the upper limb muscles with a working range of 15-50 Hz where stimulation frequency is one of the parameters used to modulate the muscle contraction force. PMID:2329005

Nathan, R; Tavi, M

1990-03-01

54

Modulation of Stretch Reflexes of the Finger Flexors by Sensory Feedback From the Proximal Upper Limb Poststroke  

PubMed Central

Neural coupling of proximal and distal upper limb segments may have functional implications in the recovery of hemiparesis after stroke. The goal of the present study was to investigate whether the stretch reflex response magnitude of spastic finger flexor muscles poststroke is influenced by sensory input from the shoulder and the elbow and whether reflex coupling of muscles throughout the upper limb is altered in spastic stroke survivors. Through imposed extension of the metacarpophalangeal (MCP) joints, stretch of the relaxed finger flexors of the four fingers was imposed in 10 relaxed stroke subjects under different conditions of proximal sensory input, namely static arm posture (3 different shoulder/elbow postures) and electrical stimulation (surface stimulation of biceps brachii or triceps brachii, or none). Fast (300°/s) imposed stretch elicited stretch reflex flexion torque at the MCP joints and reflex electromyographic (EMG) activity in flexor digitorum superficialis. Both measures were greatest in an arm posture of 90° of elbow flexion and neutral shoulder position. Biceps stimulation resulted in greater MCP stretch reflex flexion torque. Fast imposed stretch also elicited reflex EMG activity in nonstretched heteronymous upper limb muscles, both proximal and distal. These results suggest that in the spastic hemiparetic upper limb poststroke, sensorimotor coupling of proximal and distal upper limb segments is involved in both the increased stretch reflex response of the finger flexors and an increased reflex coupling of heteronymous muscles. Both phenomena may be mediated through changes poststroke in the spinal reflex circuits and/or in the descending influence of supraspinal pathways.

Hoffmann, Gilles; Kamper, Derek G.; Kahn, Jennifer H.; Rymer, William Z.; Schmit, Brian D.

2009-01-01

55

The Effect of Lateral Epicondylosis on Upper Limb Mechanical Parameters  

PubMed Central

Background Lateral epicondylosis is a prevalent and costly musculoskeletal disorder characterized by degeneration of the common extensor tendon origin at the lateral epicondyle. Grip strength is commonly affected due to lateral epicondylosis. However, less is known about the effect of lateral epicondylosis on other functional parameters such as ability to react to rapid loading. Methods Twenty-nine lateral epicondylosis participants and ten controls participated in a case-control study comparing mechanical parameters (mass, stiffness and damping), magnetic resonance imaging signal intensity and grip strength of injured and uninjured limbs. A mixed effects model was used to assess the effect of dominance and injury on mechanical parameters and grip strength. Findings Significant effect of injury and dominance was observed on stiffness, damping and grip strength. An injured upper limb had, on average, 18% less stiffness (p<0.01, 95% CI [9.8%, 26%]), 21% less damping (p<0.01, 95% CI [11%, 31%]) and 50% less grip strength (p<0.01, 95% CI [37%, 61%]) than an uninjured upper limb. The dominant limb had on average 15% more stiffness (p<0.01, 95% CI [8.0%, 23%], 33% more damping (p<0.01, 95% CI [22%, 45%]), and 24% more grip strength (p<0.01, 95% CI [6.6%, 44%]) than the non-dominant limb. Interpretation Lower mechanical parameters are indicative of a lower capacity to oppose rapidly rising forces and quantify an important aspect of upper limb function. For individuals engaged in manual or repetitive activities involving the upper limb, a reduction in ability to oppose these forces may result in increased risk for injury or recurrence.

Chourasia, Amrish O.; Buhr, Kevin A.; Rabago, David P.; Kijowski, Richard

2011-01-01

56

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

PubMed

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

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

2011-04-01

57

Short-term reliability of transcranial magnetic stimulation motor maps in upper limb amputees.  

PubMed

The aim of this study was to verify the short-term reliability of transcranial magnetic stimulation (TMS) parameters for a damaged stump muscle in upper-limb amputees (n=6). The motor threshold, response latency and map center of gravity in the mediolateral plane showed good reliability, whereas the map volume measure was less stable. The stability of most TMS measures across time supports the use of TMS in studying cortical plasticity in amputees. PMID:21393001

Hétu, S; Gagné, M; Reilly, K T; Mercier, C

2011-05-01

58

Functional influence of botulinum neurotoxin type A treatment (Xeomin®) of multifocal upper and lower limb spasticity on chronic hemiparetic gait.  

PubMed

This report describes the modification of hemiplegic shoulder pain and walking velocity through injections of Xeomin®, a new botulinum neurotoxin type A formulation, in a 67-year-old woman with chronic residual left hemiparesis and hemiparetic gait attributable to stroke. Clinical evaluation included upper and lower limb spasticity, upper and lower limb pain, trunk control, upper and lower limb motricity index, visual gait analysis, and gait velocity. Assessments were performed before, 1 week after, and 1 month after treatment. Improvement was observed in all clinical parameters assessed. Amelioration of spasticity of the upper and lower limbs and shoulder pain was observed after 1 month. Trunk postural attitude and paraxial muscle recruitment recovered. No adverse events were observed and the patient shows significant improvement of functional impairment derived from chronic spasticity after treatment with Xeomin®. We also provide a simple and useful protocol for clinical evaluation of the treatment. PMID:23139852

Falso, Maurizio; Galluso, Rosalba; Malvicini, Andrea

2012-06-14

59

Vascular trauma of the upper limb and associated nerve injuries  

Microsoft Academic Search

In an analysis of vascular audit data on upper limb vascular trauma over a 10 year period in a major UK injury centre it was found that 15 patients required operation for subclavian or axillary artery injuries. Eleven cases were the result of blunt injury. Twelve patients had an ischaemic arm on presentation, all of whom had an associated brachial

A. D. Shaw; A. A. Milne; J. Christie; A. Mc L. Jenkins; J. A. Murie; C. V. Ruckley

1995-01-01

60

Botulinum toxin treatment in upper limb spasticity: Treatment consistency  

Microsoft Academic Search

This study assessed treatment consistency of botulinum toxin administration in spastic upper limbs under pragmatic conditions, as derived through stability of dosages and between injections intervals. Over a period of 8 years, 153 children (81 with bilateral spastic cerebral palsy, 72 with unilateral) were treated according to accepted, experience-based guidelines with Botox and Dysport. Treatment response was based on assessment

Antigone S. Papavasiliou; Irene Nikaina; Panagiotis Bouros; Ioanna Rizou; Constantine Filiopoulos

61

Prosthetic rehabilitation of the upper limb amputee  

PubMed Central

The loss of all or part of the arm is a catastrophic event for a patient and a significant challenge to rehabilitation professionals and prosthetic engineers. The large, upper extremity amputee population in India has, historically, been poorly served, with most having no access to support or being provided with ineffective prostheses. In recent years, the arrival of organisations like Otto Bock has made high quality service standards and devices accessible to more amputees. This review attempts to provide surgeons and other medical professionals with an overview of the multidisciplinary, multistage rehabilitation process and the solution options available. With worldwide upper extremity prosthesis rejection rates at significant levels, the review also describes some of the factors which influence the outcome. This is particularly relevant in the Indian context where the service can involve high cost investments. It is the responsibility of all contributing professionals to guide vulnerable patients through the process and try to maximise the benefit that can be obtained within the resources available.

O'Keeffe, Bernard

2011-01-01

62

Vascular anomalies of the upper limb  

PubMed Central

Vascular anomalies of the upper extremity are a surgical challenge to the hand surgeons. The treatment modality varies with respect to the presentation, extent of the lesion, progression and their complications. Based on our experience in treating patients with vascular malformations, a protocol has been formulated for their management, which we have found to be very useful and successful. With the use of the tumescent technique and good planning, haemangiomas are best excised in infancy or early childhood. Investigations like contrast computed tomography and magnetic resonance imaging have been found to be a useful tool in the diagnosis and planning of surgery for venous malformations. Embolisation seems to be a safe option in arteriovenous malformations.

Balakrishnan, G.

2011-01-01

63

Histological characteristics of the deep fascia of the upper limb.  

PubMed

Post-mortem specimens taken from the antebrachial and brachial fasciae of 20 upper limbs were studied by histological and immunohistochemical staining in order to evaluate collagen fibre bundle arrangement, the presence of elastic fibres, and the density of innervation in deep muscular fascia. The study demonstrated that the fasciae are formed of numerous layers of undulating collagen fibre bundles. In each layer, the bundles are parallel to each other, whereas adjacent layers show different orientations. Each layer is separated from the adjacent one by a thin layer of adipose tissue, like plywood. Many elastic fibres and a variety of both free and encapsulated nerve endings, especially Ruffini and Pacini corpuscles, are also present, suggesting a proprioceptive capacity of the deep fascia. Thanks to the undulating collagen fibre bundles and elastic fibres, the fasciae can adapt to stretching, but this is only possible within certain limits, beyond which nerve terminations are activated by stretching. This mechanism allows a sort of "gate control" on the normal activation of intrafascial receptors. The capacity of the various collagen layers to slide over each other may be altered in cases of over-use syndrome, trauma or surgery. In such cases, the amortising mechanism of the fascia on the nervous terminations is lost, causing incorrect paradoxical activation of nerve receptors within the fascia, resulting in the propagation of a nociceptive signal even in situations of normal physiological stretch. At the same time, the layered collagen fibres allow transmission of tension according to the various lines of force. This structure of the muscular fascia guarantees perceptive and directional continuity along a particular myokinetic chain, acting like a transmission belt between two adjacent joints and also between synergic muscle groups. PMID:16981399

Stecco, Carla; Porzionato, Andrea; Macchi, Veronica; Tiengo, Cesare; Parenti, Anna; Aldegheri, Roberto; Delmas, Vincent; De Caro, Raffaele

2006-01-01

64

Lymphedema after upper limb transplantation: scintigraphic study in 3 patients.  

PubMed

Lymphatic vasculature is known to spontaneously reconnect after hand replantation. Nonetheless, lymphatic outflow has not been specifically studied in hand transplantation.Lymphedema was studied clinically and scintigraphically in 3 bilateral upper limb transplants performed in Valencia, Spain, since 2006. Case 1 was a radiocarpal level, case 2 midforearm and proximal forearm, and case 3 was a transhumeral transplantation. Follow-up was 5, 4, and 3 years, respectively. Clinically, in case 1, there was a left-sided moderate lymphedema, case 2 was normal, and a right-sided moderate lymphedema was present in case 3. Lymphoscintigraphy results were consistent with the clinical findings. It was normal in the 4 nonedematous limbs. In the 2 affected limbs, there were scintigraphic findings of lymphatic block and lymphangiectasia.The study demonstrates objectively that lymphatic circulation can reconnect spontaneously in hand transplantations, although not in a homogeneously efficient way. PMID:23782850

Cavadas, Pedro C; Thione, Alessandro; Carballeira, Alexo; Dominguez, Pablo Caro

2013-07-01

65

Prediction of Gene Network Models in Limb Muscle Precursors  

PubMed Central

The ventrolateral dermomyotome gives rise to all muscles of the limbs through the delamination and migration of cells into the limb buds. These cells proliferate and form myoblasts, withdraw from the cell cycle and become terminally differentiated. The myogenic lineage colonizes pre-patterned regions to form muscle anlagen as muscle fibers are assembled. The regulatory mechanisms that control the later steps of this myogenic program are not well understood. The homeodomain transcription factor Pitx2 is expressed in the muscle lineage from the migration of precursors to adult muscle. Ablation of Pitx2 results in distortion, rather than loss, of limb muscle anlagen, suggesting that its function becomes critical during the colonization of, and/or fiber assembly in, the anlagen. Gene expression arrays were used to identify changes in gene expression in flow-sorted migratory muscle precursors, labeled by Lbx1EGFP, which resulted from the loss of Pitx2. Target genes of Pitx2 were clustered using the “David Bioinformatics Functional Annotation Tool” to bin genes according to enrichment of gene ontology keywords. This provided a way to both narrow the target genes and identify potential gene families regulated by Pitx2. Representative target genes in the most enriched bins were analyzed for the presence and evolutionary conservation of Pitx2 consensus binding sequence, TAATCY, on the ?20kb, intronic, and coding regions of the genes. Fifteen Pitx2 target genes were selected based on the above analysis and were identified as having functions involving cytoskeleton organization, tissue specification, and transcription factors. Data from these studies suggest that Pitx2 acts to regulate cell motility and expression of muscle specific genes in the muscle precursors during forelimb muscle development. This work provides a framework to develop the gene network leading to skeletal muscle development, growth and regeneration.

Campbell, Adam L; Eng, Diana; Gross, Michael K; Kioussi, Chrissa

2012-01-01

66

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

67

Robotic upper-limb neurorehabilitation in chronic stroke patients.  

PubMed

This pilot study tested the effectiveness of an intense, short-term upper-limb robotic therapy for improvement in motor outcomes among chronic stroke patients. We enrolled 30 subjects with upper-limb deficits due to stroke of at least 6 mo duration and with a Motor Power Assessment grade of 3 or less. Over 3 wk, 18 sessions of robot-assisted task-specific therapy were delivered with the use of a robotic exercise device that simulates a conventional therapy known as skateboard therapy. Primary outcome measures included reliable, validated impairment and disability measures of upper-limb motor function. Statistically significant improvements were observed for severely impaired participants when we compared baseline and posttreatment outcomes (p < 0.05). These results are important because they indicate that improvement is not limited to those with moderate impairments but is possible among severely impaired chronic stroke patients as well. Moderately and severely impaired patients in our study were able to tolerate a massed-practice therapy paradigm with intensive, frequent, and repetitive treatment. This information is useful in determining the optimal target population, intensity, and duration of robotic therapy and sample size for a planned larger trial. PMID:16680609

Macclellan, Leah R; Bradham, Douglas D; Whitall, Jill; Volpe, Bruce; Wilson, P David; Ohlhoff, Jill; Meister, Christine; Hogan, Neville; Krebs, Hermano I; Bever, Christopher T

2005-01-01

68

EMG changes in rat hind limb muscles following bilateral deafferentation  

Microsoft Academic Search

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)

P. Hník; R. Vejsada; S. Kasicki

1982-01-01

69

The relationship between limb muscle and endothelial cells migrating from single somite  

Microsoft Academic Search

Somites contribute myogenic and endothelial precursor cells to the limb bud. Transplantations of single somites have shown the pattern of muscle cell distribution from individual somites to individual limb muscles. However, the pattern of the endothelial cell distribution from individual somites to the limb has not been characterized. We have mapped quail muscle and endothelial cell distribution in the distal

Ruijin Huang; Qixia Zhi; Bodo Christ

2003-01-01

70

Muscle Flaps and Their Role in Limb Salvage  

PubMed Central

Muscle flaps have proved to be a valuable and versatile tool in the surgical treatment of the severely compromised lower extremity. Utilized as both local pedicle flaps and free tissue transfers, muscles have been successfully employed to cover complex wounds, manage osteomyelitis, salvage infected vascular grafts, treat recalcitrant venous stasis ulcers, preserve amputation levels, and restore motion following compartment syndrome. Free flap pedicles have also been used in a flow-through fashion to create a distal arterial bypass. This article explores the multipurpose role of muscle flaps in limb salvage surgery and their beneficial physiologic characteristics in hostile wound environments.

Klebuc, Michael; Menn, Zachary

2013-01-01

71

Virtual musculo-skeletal model for the biomechanical analysis of the upper limb.  

PubMed

In this paper, a musculo-skeletal model of the upper limb is presented. The limb is modelled as a three-dimensional 7 degrees-of-freedom system, linked to the shoulder, which has been considered as frame. The upper limb model is made up of four links corresponding to the most important body segments: the humerus, the ulna, the radius and the hand, considered as a single rigid body. Particular attention has been paid to the modelling of joints in order to mimic all the possible arm and forearm movements (including prono-supination). The model also includes 24 muscles. The mathematical model used to describe the muscles is that proposed by Zajac in 1989, modified by the authors. The kinematic analysis has been performed including an ergonomics index to take into account the posture and joint physical limits. Moreover an optimization criterion based on minimum activation pattern has been included in order to find muscular activation coefficients. The results of the proposed methodology concerning muscular activations have been compared to those coming from processed EMG signals, which have been acquired during experimental tests. PMID:16824531

Pennestrì, E; Stefanelli, R; Valentini, P P; Vita, L

2007-01-01

72

Decline in voluntary activation contributes to reduced maximal performance of fatigued human lower limb muscles.  

PubMed

In upper limb muscles, altered corticospinal excitability and reduction in neural drive are observed in parallel with peripheral fatigue during prolonged and/or repeated contractions. However, the fatigue-induced adaptations of central and peripheral elements and their relative contribution to lower limb muscle performance are yet to be fully explored. In the present study, corticospinal excitability and peripheral contractility of ankle flexor muscles were quantified before, during and after repeated brief unilateral maximal dorsiflexions to fatigue in eleven healthy volunteers. Transcranial magnetic stimulation of the motor cortex area related to lower limb muscles was performed, and the evoked twitch and EMG responses in tibialis anterior (TA) and soleus (SOL) were measured. The motor evoked potentials (MEPs) in fatigued TA during post-exercise maximal dorsiflexions were smaller (-20 ± 6 %, p = 0.026) and remained depressed for at least 5 min. Post-exercise MEPs in fatigued SOL and silent periods in TA and SOL were not different compared to pre-exercise. These changes were accompanied by lower voluntary torque (-8 ± 3 %, p = 0.013), estimated resting twitch (-36 ± 5 %, p = 0.003) and voluntary activation (-17 ± 9 %, p = 0.021) versus pre-exercise. During last versus first maximal contraction in the fatiguing protocol lower voluntary torque (-40 ± 4 %, p = 0.003), higher MEP amplitudes (>+49 %, p < 0.021) and longer silent periods (>+24 %, p < 0.004) were recorded in both muscles. Decreased corticospinal excitability contributes significantly to the reduced maximal performance of fatigued lower limb muscles. During prolonged intermittent maximal dorsiflexions the performance of ankle muscles declines despite enhanced corticospinal excitability presumably due to deficient descending drive and/or spinal motoneuron responsiveness to the cortical drive. PMID:22434254

Mileva, K N; Sumners, D P; Bowtell, J L

2012-12-01

73

Disinhibition in the human motor cortex is enhanced by synchronous upper limb movements.  

PubMed

The phasic modulation of wrist flexor corticomotor disinhibition has previously been demonstrated during the flexion phase of rhythmical passive flexion-extension of the human wrist. Here we ask if rhythmical bimanual flexion-extension movements of the wrists of neurologically intact subjects, modulate inhibitory activity in the motor cortex. In the first experiment intracortical inhibition was assessed when one wrist was passively flexed and extended on its own, with the addition of the opposite limb voluntarily moving synchronously in a mirror symmetric pattern, and also in a near-symmetric asynchronous pattern. Two subsequent experiments investigated firstly the modulation of spinal reflex pathway activity during the same three movement conditions, and secondly the effect of contralateral wrist movement alone on the excitability of corticomotoneuronal pathways to a static test limb. When the wrist flexors of both upper limbs were shortening simultaneously (i.e. synchronously), intracortical inhibition associated with flexor representations was suppressed to a greater extent than when the two muscles were shortening asynchronously. The results of the three experiments indicate that modulation of inhibitory activity was taking place at the cortical level. These findings may have further application in the study of rehabilitation procedures where the effects of simultaneous activation of affected and unaffected upper limbs in hemiparetic patients are to be investigated. PMID:12181301

Stinear, James W; Byblow, Winston D

2002-08-15

74

Shaping muscle bioarchitecture for the fin to limb transition  

PubMed Central

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.

Cole, Nicholas J.; Currie, Peter

2012-01-01

75

Advances in upper limb stroke rehabilitation: a technology push.  

PubMed

Strokes affect thousands of people worldwide leaving sufferers with severe disabilities affecting their daily activities. In recent years, new rehabilitation techniques have emerged such as constraint-induced therapy, biofeedback therapy and robot-aided therapy. In particular, robotic techniques allow precise recording of movements and application of forces to the affected limb, making it a valuable tool for motor rehabilitation. In addition, robot-aided therapy can utilise visual cues conveyed on a computer screen to convert repetitive movement practice into an engaging task such as a game. Visual cues can also be used to control the information sent to the patient about exercise performance and to potentially address psychosomatic variables influencing therapy. This paper overviews the current state-of-the-art on upper limb robot-mediated therapy with a focal point on the technical requirements of robotic therapy devices leading to the development of upper limb rehabilitation techniques that facilitate reach-to-touch, fine motor control, whole-arm movements and promote rehabilitation beyond hospital stay. The reviewed literature suggest that while there is evidence supporting the use of this technology to reduce functional impairment, besides the technological push, the challenge ahead lies on provision of effective assessment of outcome and modalities that have a stronger impact transferring functional gains into functional independence. PMID:21773806

Loureiro, Rui C V; Harwin, William S; Nagai, Kiyoshi; Johnson, Michelle

2011-10-01

76

Presynaptic inhibition of monosynaptic reflexes in the lower limbs of subjects with upper motoneuron disease.  

PubMed Central

Presynaptic inhibition of muscle spindle Ia afferents by group I afferents from the same and other muscles has been studied in the lower limbs of subjects with upper motoneuron lesions. The experiments utilised conditioning of soleus test monosynaptic reflexes during controlled voluntary contraction. The protocol was designed to isolate presynaptic inhibition from postsynaptic components. The relation between estimate of inhibition and test reflex amplitude was examined. The subjects showed less inhibition than controls at all levels of voluntary torque investigated (less than or equal 15 Nm). Two thirds had weak inhibition which did not show the decrease during muscle contraction characteristic of controls. The degree of difference from the normal situation correlated with severity of the clinical sign (weakness of voluntary ankle flexion).

Iles, J F; Roberts, R C

1986-01-01

77

Botulinum toxin a injections to the upper limbs in children with cerebral palsy: duration of effect.  

PubMed

We report our experience on the duration of effectiveness of botulinum toxin A injections to the upper extremities of children with cerebral palsy. A retrospective chart review was conducted on 30 consecutive patients (mean age, 9.9 ± 5.0 years) with spastic hemiparesis and quadriparesis. They received 1 to 5 treatments, totaling 56 treatments for the entire cohort. The injected muscles were the pronator teres (50/56), flexor carpi radialis (39/56), biceps (38/56), flexor carpi ulnaris (35/56), opponens (21/56), and adductor pollicis (17/56). Children were assessed for muscle tone and classified according to the Manual Ability Classification System before and after treatment. Functional improvement was apparent after 42 of 56 treatments, and muscle tone decreased significantly (P < .001). The mean duration of the effect was 7.0 ± 3.0 months. We conclude that the effect of botulinum toxin A to the upper limbs is retained for longer periods of time than those reported for lower limbs. PMID:20929909

Fattal-Valevski, Aviva; Sagi, Liora; Domenievitz, Dafna

2011-02-01

78

Comparative anatomy and muscle architecture of selected hind limb muscles in the Quarter Horse and Arab.  

PubMed

The Quarter Horse (bred for acceleration) and the Arab (bred for endurance) are situated at either end of the equine athletic spectrum. Studies into the form and function of the leg muscles in human sprint and endurance runners have demonstrated that differences exist in their muscle architecture. It is not known whether similar differences exist in the horse. Six Quarter Horse and six Arab fresh hind limb cadavers were dissected to gain information on the muscle mass and architecture of the following muscles: gluteus medius; biceps femoris; semitendinosus; vastus lateralis; gastrocnemius; tibialis cranialis and extensor digitorum longus. Specifically, muscle mass, fascicle length and pennation angle were quantified and physiological cross-sectional area (PCSA) and maximum isometric force were estimated. The hind limb muscles of the Quarter Horse were of a significantly greater mass, but had similar fascicle lengths and pennation angles when compared with those of the Arab; this resulted in the Quarter Horse hind limb muscles having greater PCSAs and hence greater isometric force potential. This study suggests that Quarter Horses as a breed inherently possess large strong hind limb muscles, with the potential to accelerate their body mass more rapidly than those of the Arab. PMID:18194205

Crook, T C; Cruickshank, S E; McGowan, C M; Stubbs, N; Wakeling, J M; Wilson, A M; Payne, R C

2008-02-01

79

Motor evoked potential monitoring during spinal surgery: responses of distal limb muscles to transcranial cortical stimulation with pulse trains  

Microsoft Academic Search

During spinal surgery, motor evoked potentials (MEPs) were recorded from distal upper and lower limb muscles following multipulse transcranial electrical stimulation of the cortex. Twenty-two patients, 9 of them myelopathic, were anaesthetised with propofol ± nitrous oxide. Using trains of 3–6 pulses separated by 2 ms, consistent responses generally measuring more than 100 ?V were obtained from every patient except

S. J. Jones; R. Harrison; K. F. Koh; N. Mendoza; H. A. Crockard

1996-01-01

80

Mechanisms of upper limb amyotrophy in spinal disorders.  

PubMed

Upper limb amyotrophy may occur as an indirect consequence of various spinal disorders, including ventral longitudinal intraspinal fluid collection, Hirayama disease and high cervical cord compression. We present patients who suffer from each of these and review the literature on the three conditions with emphasis on the pathogenesis of amyotrophy. We propose that pathology some distance from the lower cervical spinal cord may affect normal venous drainage, resulting in venous congestion and reduced perfusion pressure which, in turn, could result in anterior horn cell dysfunction in all three disorders. PMID:24702785

Foster, Emma; Tsang, Benjamin K-T; Kam, Anthony; Stark, Richard J

2014-07-01

81

The Upper Atmosphere Research Satellite microwave limb sounder instrument  

NASA Technical Reports Server (NTRS)

The microwave limb sounder (MLS) on the Upper Atmosphere Research Satellite (UARS) is the first satellite experiment using limb sounding techniques at microwave frequencies. Primary measurement objectives are stratospheric ClO, O3, H2O, temperature, and pressure. Measurements are of thermal emission: all are performed simultaneously and continuously and are not degraded by ice clouds or volcanic aerosols. The instrument has a 1.6-m mechanically scanning antenna system and contains heterodyne radiometers in spectral bands centred near 63, 183, and 205 GHz. The radiometers operate at ambient temperature and use Schottky-diode mixers with local oscillators derived from phase-locked Gunn oscillators. Frequency tripling by varactor multipliers generates the 183- and 205-GHz local oscillators, and quasi-optical techniques inject these into the mixers. Six 15-channel filter banks spectrally resolve stratospheric thermal emission lines and produce an output spectrum every 2 s. Thermal stability is sufficient for 'total power' measurements which do not require fast chopping. Radiometric calibration, consisting of measurements of cold space and an internal target, is performed every 65-s limb scan. Instrument in-orbit performance has been excellent, and all objectives are being met.

Barath, F. T.; Chavez, M. C.; Cofield, R. E.; Flower, D. A.; Frerking, M. A.; Gram, M. B.; Harris, W. M.; Holden, J. R.; Jarnot, R. F.; Kloezeman, W. G.

1993-01-01

82

Limb muscles are androgen targets in an acrobatic tropical bird.  

PubMed

Spectacular athleticism is a conspicuous feature of many animal courtship displays yet surprisingly little is known about androgen dependence of skeletal muscles underlying these displays. Testosterone (T) acts through androgen receptors (ARs) to stimulate muscular male Golden-collared manakins of Panama to perform a remarkably athletic courtship display that includes loud wingsnaps generated by the rapid and forceful lifting of the wings. We tested the hypothesis that androgen sensitivity, reflected in the expression levels of AR mRNA, is a muscular adaptation supporting these courtship displays. Quantitative PCR showed substantially greater AR mRNA expression in all limb muscles of wild male and female manakins compared with two other avian species that do not perform athletic displays, zebra finches and ochre-bellied flycatchers. AR expression levels in the massive skeletal muscles were comparable with the minute oscine syringeal muscle but greater than levels in nonmuscular androgen targets that did not differ across species. Compared with zebra finches, male manakins also had greater activity of the T-activating enzyme 5 alpha-reductase in a wing-lifting muscle. In addition, low levels of estrogen receptor alpha (ER) mRNA were detected in all muscles of control, T-treated, and estradiol-treated manakins. Treatment of manakins with T, but not estradiol, significantly increased skeletal muscle ER expression, suggesting that ER expression is AR-dependent. These results confirm manakin limb muscles as important androgen targets where T may act to promote the speed, force, and/or endurance required for the manakin display. Androgen-sensitive muscular phenotypes may adapt males of many species to perform impressive athletic displays. PMID:20080872

Feng, Ni Y; Katz, Amnon; Day, Lainy B; Barske, Julia; Schlinger, Barney A

2010-03-01

83

A survey on robotic devices for upper limb rehabilitation  

PubMed Central

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.

2014-01-01

84

Thoracoscopic Dorsal Sympathectomy for Upper Limb Buerger's Disease  

PubMed Central

Background and Objectives: Thromboangiitis obliterans is a common peripheral vascular disease in India. This study was conducted to assess the efficacy of thoracoscopic dorsal sympathectomy as a treatment for Buerger disease of the upper extremities. Methods: Thirty thoracoscopic dorsal sympathectomies (17 left- and 13 right-sided) were performed in a tertiary medical center in 5 women and 20 men (mean age, 41 years) between July 2010 and February 2013. Results: The mean operative time was 30 minutes, and the mean hospital stay was 52 hours. There were no complications. All patients had improvement in pain and were relapse-free after a mean follow-up period of 11.63 months. Discussion: Thoracoscopic dorsal sympathectomy reduces pain significantly by reducing peripheral resistance and promoting collateral development. The increased magnification of the thoracoscopic approach permits better visualization, ensuring complete excision and therefore good results. Thoracoscopic dorsal sympathectomy for Buerger disease of the upper limb is a safe and effective treatment.

Kothari, Reena; Thakur, Dileep Singh; Kumar, Vinod; Somashekar, Uday

2014-01-01

85

A survey on robotic devices for upper limb rehabilitation.  

PubMed

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

Maciejasz, Pawe?; Eschweiler, Jörg; Gerlach-Hahn, Kurt; Jansen-Troy, Arne; Leonhardt, Steffen

2014-01-01

86

Upper-limb Power Test in Rock-climbing.  

PubMed

The goal of the present study was to validate a new ecological power-test on athletes of different levels and to assess rock climbers' profiles (boulderers vs. route climbers). 34 athletes divided into novice, skilled and elite groups performed the arm-jump board test (AJ). Power, time, velocity, and efficiency index were recorded. Validity was assessed by comparing the distance with the value extracted from the accelerometer (500?Hz) and the reliability of intra- and inter-session scores. Moreover, a principal component analysis (PCA) was used to assess the climbers' profiles. The AJ test was quite valid, showing a low systematic bias of -0.88?cm (-1.25%) and low limits of agreement (<6%), and reliable ( Intra-class correlation coefficient=0.98 and CV<5%), and was able to distinguish between the 3 samples (p<0.0001). There was a good correlation between relative upper-limb power (r=0.70; p<0.01) and the AJ score. Moreover, the PCA revealed an explosive profile for boulderers and either a weak and quick or slow profile for route climbers, revealing a biomechanical signature of the sub-discipline. The AJ test provides excellent absolute and relative reliabilities for climbing, and can effectively distinguish between climbing athletes of different competitive levels. Thus, the AJ may be suitable for field assessment of upper limb strength in climbing practitioners. PMID:24554556

Laffaye, G; Collin, J-M; Levernier, G; Padulo, J

2014-07-01

87

Clinical evaluation of upper limb function: Patient's impairment, disability and health-related quality of life  

PubMed Central

Musculoskeletal disorders substantially impacts physical activity, mental state, and quality of life (QOL). Generally, comprehensive assessment of upper limb function requires measures of impairment or disability as well as health-related quality of life. A growing number of outcome instrument have been introduced to evaluate upper limb function and disability, and these measures can be categorized as patient- or clinician-based, and as condition specific or general health-related QOL evaluations. The upper limb outcome instruments reviewed in this article assess different aspect of upper limb conditions, and the measures are affected by differences in cultural, psychological, and gender aspect of illness perception and behavior. Therefore, physician should select/interpret the outcome instruments addressing their primary purpose of research. Information about regional instruments for upper limb condition and health-related QOL in upper limb disorder may help us in decision-making for treatment priority or in interpretation of the treatment outcomes.

Roh, Young Hak

2013-01-01

88

Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population  

Microsoft Academic Search

Objective: To explore the relationship in individuals with early rheumatoid arthritis (RA) between self-report upper limb function, therapist-assessed upper limb function and therapist-assessed measures of structural impairment (handgrip, active hand motion and metacarpophalangeal (MCP) joint ulnar deviation).Design: Thirty-six patients with early RA were recruited across seven outpatient occupational therapy departments.Outcome measures: Upper limb functional activity and ability was measured using

J Adams; J Burridge; M Mullee; A Hammond; C Cooper

2004-01-01

89

Botulinum toxin type A injection, followed by home-based functional training for upper limb hemiparesis after stroke.  

PubMed

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, followed by home-based functional training on not only the passive but also the active motor function of the affected spastic upper limb in poststroke hemiparetic patients. Eighty poststroke patients with spastic upper limb hemiparesis were studied. The severity of hemiparesis was categorized as Brunnstrom stage of 3 for hand-fingers in all patients. BoNT-A (maximum dose of 240 U) was injected into the target muscles of the affected upper limb after a clinical evaluation using the modified Ashworth scale, range of motion, Fugl-Meyer Assessment, and the Wolf Motor Function Test. Following the injection, occupational therapists provided home-based functional training for each patient on a one-to-one basis. The follow-up evaluation was performed 4 weeks after the injection. A significant improvement was found in the modified Ashworth scale and range of motion. The changes in the Fugl-Meyer Assessment and the Wolf Motor Function Test indicated a significant improvement in the active motor function of the affected upper limb. In conclusions, our proposed protocol of a BoNT-A injection, followed by home-based functional training seems to have the potential to improve the active motor function of the affected upper limb after stroke, although the efficacy should be confirmed in a randomized-controlled trial. PMID:22453625

Takekawa, Toru; Kakuda, Wataru; Taguchi, Kensuke; Ishikawa, Atsushi; Sase, Yousuke; Abo, Masahiro

2012-06-01

90

Furniture dimensions and postural overload for schoolchildren's head, upper back and upper limbs.  

PubMed

The aim of this study was to evaluate how the fixed furniture dimensions match with students' anthropometry and to describe head, upper back and upper limbs postures and movements. Evaluation was performed in 48 students from a Brazilian state school. Furniture dimensions were measured with metric tape, movements and postures by inclinometers (Logger Tecknologi, Åkarp, Sweden). Seat height was high for 21% and low for 36% of the students; seat length was short for 45% and long for 9% and table height was high for 53% and low for 28%. Regression analysis showed that seat/popliteal height quotient is explained by 90th percentile of upper back inclination (?=0.410) and 90th percentile of right upper arm elevation (?=-0.293). For seat/thigh length quotient the significant variables were 90th percentile of upper back velocity (?=-0.282) and 90th percentile of right upper arm elevation (?=0.410). This study showed a relationship between furniture mismatch and postural overload. When the seat height is low students increase upper back left inclination and right upper arm elevation; when the seat is short students decrease the upper back flexion velocity and increase right upper arm elevation. PMID:22317463

Batistão, Mariana Vieira; Sentanin, Anna Cláudia; Moriguchi, Cristiane Shinohara; Hansson, Gert-Åke; Coury, Helenice Jane Cote Gil; de Oliveira Sato, Tatiana

2012-01-01

91

High frequency energy absorption and the measurement of limb muscle.  

PubMed

High frequency energy absorption (HFEA) is being developed as a portable, inexpensive, non-invasive procedure for the measurement of muscle mass within cross-sections of limbs. The instrument consists of a flexible coil 2.5 cm wide of which the length can be adjusted over a 10 cm range. A series of coils of different lengths has been constructed that are jointly suitable for limbs with circumferences ranging from 20 to 75 cm. To measure HFEA, a coil of appropriate length is attached to a 9v battery that, through an oscillator, produces a frequency varying from 15 MHz (longest coil) to 40 MHz (shortest coil). Zero readings, with the coil set at the same circumference as the limb, are obtained before and after HFEA is measured and they are used to adjust the observed values. HFEA, in theory, is related to the number of electrolytes deep to the coil and almost all these electrolytes are in muscle. Good precision has been demonstrated and the instrument has been successfully validated against saline solutions. A previous model was validated against magnetic resonance images with good results (r2 about 0.8). Further validation of the present model against magnetic resonance images is almost complete; these findings are presented. PMID:24394283

Roche, A F; Wellens, R; Guo, S; Siervogel, R M; Boska, M D; Michaelsen, K F

1995-03-01

92

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

PubMed

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

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

2013-05-01

93

Surgical Treatment of Aneurysms in the Upper Limbs  

PubMed Central

Objective: The purpose of this study was to review the experience of aneurysms in the upper limbs treated with surgery and assess the outcomes. Materials and Methods: This study retrospectively reviewed the medical records of five patients with upper extremity aneurysms treated with surgical resection at Tokyo Medical and Dental University Hospital between March 2000 and February 2012. These patients were treated with excision surgery either with or without reconstructive surgery. Results: Two of the five patients were males and three were females with a mean age of 52 years (age range: 25–72 years). We treated 2 brachial, 2 ulnar, and 1 radial aneurysms. All aneurysms were excised, and two patients had reconstructive surgery. Three patients had false aneurysms, which included an ulnar artery aneurysm diagnosed as angiolymphoid hyperplasia with eosinophilia. During follow-up period, all grafts were clinically patent, and no cases had recurrent lesions. No patients had ischemic symptoms or any other postoperative complications. Conclusion: Arterial aneurysms of the upper extremities are uncommon, and were most commonly caused by non-traumatic etiology in this series. These aneurysms were excised with or without reconstructive surgery, because of the fear of rupture and embolization. Revascularization can be performed selectively.

2013-01-01

94

Microwave limb sounder. [measuring trace gases in the upper atmosphere  

NASA Technical Reports Server (NTRS)

Trace gases in the upper atmosphere can be measured by comparing spectral noise content of limb soundings with the spectral noise content of cold space. An offset Cassegrain antenna system and tiltable input mirror alternately look out at the limb and up at cold space at an elevation angle of about 22. The mirror can also be tilted to look at a black body calibration target. Reflection from the mirror is directed into a radiometer whose head functions as a diplexer to combine the input radiation and a local ocillator (klystron) beam. The radiometer head is comprised of a Fabry-Perot resonator consisting of two Fabry-Perot cavities spaced a number of half wavelengths apart. Incoming radiation received on one side is reflected and rotated 90 deg in polarization by the resonator so that it will be reflected by an input grid into a mixer, while the klystron beam received on the other side is also reflected and rotated 90 deg, but not without passing some energy to be reflected by the input grid into the mixer.

Gustincic, J. J. (inventor)

1981-01-01

95

Muscle phenotypic variability in limb girdle muscular dystrophy 2 G.  

PubMed

Limb girdle muscular dystrophy type 2 G (LGMD2G) is caused by mutations in the telethonin gene. Only few families were described presenting this disease, and they are mainly Brazilians. Here, we identified one additional case carrying the same common c.157C > T mutation in the telethonin gene but with an atypical histopathological muscle pattern. In a female patient with a long duration of symptoms (46 years), muscle biopsy showed, in addition to telethonin deficiency, the presence of nemaline rods, type 1 fiber predominance, nuclear internalization, lobulated fibers, and mitochondrial paracrystalline inclusions. Her first clinical signs were identified at 8 years old, which include tiptoe walking, left lower limb deformity, and frequent falls. Ambulation loss occurred at 41 years old, and now, at 54 years old, she presented pelvic girdle atrophy, winging scapula, foot deformity with incapacity to perform ankle dorsiflexion, and absent tendon reflexes. The presence of nemaline bodies could be a secondary phenomenon, possibly associated with focal Z-line abnormalities of a long-standing disease. However, these new histopathological findings, characteristic of congenital myopathies, expand muscle phenotypic variability of telethoninopathy. PMID:23479141

Paim, Julia F; Cotta, Ana; Vargas, Antonio P; Navarro, Monica M; Valicek, Jaquelin; Carvalho, Elmano; da-Cunha, Antonio L; Plentz, Estevão; Braz, Shelida V; Takata, Reinaldo I; Almeida, Camila F; Vainzof, Mariz

2013-06-01

96

Functional influence of botulinum neurotoxin type A treatment (Xeomin(R)) of multifocal upper and lower limb spasticity on chronic hemiparetic gait  

PubMed Central

This report describes the modification of hemiplegic shoulder pain and walking velocity through injections of Xeomin®, a new botulinum neurotoxin type A formulation, in a 67-year-old woman with chronic residual left hemiparesis and hemiparetic gait attributable to stroke. Clinical evaluation included upper and lower limb spasticity, upper and lower limb pain, trunk control, upper and lower limb motricity index, visual gait analysis, and gait velocity. Assessments were performed before, 1 week after, and 1 month after treatment. Improvement was observed in all clinical parameters assessed. Amelioration of spasticity of the upper and lower limbs and shoulder pain was observed after 1 month. Trunk postural attitude and paraxial muscle recruitment recovered. No adverse events were observed and the patient shows significant improvement of functional impairment derived from chronic spasticity after treatment with Xeomin®. We also provide a simple and useful protocol for clinical evaluation of the treatment.

Falso, Maurizio; Galluso, Rosalba; Malvicini, Andrea

2012-01-01

97

Dupuytren's Contracture Cosegregation with Limb-Girdle Muscle Dystrophy  

PubMed Central

Limb-girdle muscular dystrophies (LGMDs) is a heterogeneous group of muscular dystrophies that mostly affect the pelvic and shoulder girdle muscle groups. We report here a case of neuromuscular disease associated with Dupuytren's contracture, which has never been described before as cosegregating with an autosomal dominant type of inheritance. Dupuytren's contracture is a common disease, especially in Northern Europe. Comorbid conditions associated with Dupuytren's contracture are repetitive trauma to the hands, diabetes, and seizures, but it has never before been associated with neuromuscular disease. We hypothesize that patients may harbor mutations in genes with functions related to neuromuscular disease and Dupuytren's contracture development.

Lace, Baiba; Inashkina, Inna; Micule, Ieva; Vasiljeva, Inta; Naudina, Maruta Solvita; Jankevics, Eriks

2013-01-01

98

Effect of intensive functional electrical stimulation therapy on upper-limb motor recovery after stroke: case study of a patient with chronic stroke.  

PubMed

Purpose: Motivated by a prior successful randomized controlled trial showing that functional electrical stimulation (FES) therapy can restore voluntary arm and hand function in people with severe stroke, this study was designed to examine neuromuscular changes in the upper limb following intensive FES therapy, consisting of task-specific upper-limb movements with a combination of preprogrammed FES and manual assisted motion. Methods: The patient was a 22-year-old woman who had suffered a haemorrhagic stroke 2 years earlier. FES therapy was administered for 1 hour twice daily for 12 weeks, for a total of 108 treatment sessions. Results: While maximal voluntary contraction level of the upper-limb muscles did not show significant improvement, the ability to initiate and stop the muscle contraction voluntarily was regained in several upper-limb muscles (approx. 5%-15% of the maximum voluntary contraction of the same muscle in the less-affected arm). A reduction in arm spasticity was also observed, as indicated by the reduction of H-reflex in the wrist flexor muscle (82.1% to 45.0% in Hmax/Mmax) and decreased Modified Ashworth Scale scores (from 3 to 2 for the hand and 4 to 3 for the arm). Coordination between shoulder and elbow joints during the circle-drawing test improved considerably over the course of FES therapy: the patient was unable to draw a circle at all at baseline but was able to do so proficiently at discharge. Conclusion: Improvements in upper-limb function observed in people with severe stroke following intensive FES therapy can be attributed to (a) regained ability to voluntarily contract muscles of the affected arm, (b) reduced spasticity and improved muscle tone in the same muscles, and (c) increased range of motion of all joints. PMID:24381377

Kawashima, Noritaka; Popovic, Milos R; Zivanovic, Vera

2013-01-01

99

Development of upper limb prostheses: current progress and areas for growth.  

PubMed

Upper extremity prosthetic technology has significantly changed in recent years. The devices available and those under development are more and more able to approximate the function of the lost limb; however, other challenges remain. This article provides a brief perspective on the most advanced upper limb prostheses available and the challenges present for continued development of the technology. PMID:24361817

González-Fernández, Marlís

2014-06-01

100

Upper Limb-Hand 3D Display System for Biomimetic Myoelectric Hand Simulator.  

National Technical Information Service (NTIS)

A graphics system displaying both upper limb posture and opening- closing of a prosthetic hand was developed for realtime operation of our biomimetic myoelectric hand simulator, Posture of the upper limb was determined by 3D position of shoulder, elbow an...

G. G. Jimenez O. Ryuhei K. Akazawa

2001-01-01

101

Asymmetry in Volume Between Dominant and Nondominant Upper Limbs in Young Tennis Players  

Microsoft Academic Search

This study aimed at demonstrating the asymmetry in volume between the dominant and nondominant upper limbs in tennis players, controlled for maturity status. Upper limb volumes on both sides were calculated in 72 tennis players and 84 control subjects, using the truncated cone method. The participants' maturity status was determined using the predicted age at peak height velocity (PHV). The

Isabelle Rogowski; Gaële Ducher; Olivier Brosseau; Christophe Hautier

2008-01-01

102

Restlessness in right upper limb as sole presentation of restless legs syndrome.  

PubMed

Restless legs syndrome (RLS) rarely affects the upper limb during the initial course of disease. We present a patient who complained of symptoms suggesting RLS in the right upper limb as the sole manifestation of illness. Bilateral cervical ribs and depression were co-incidental findings. Patient responded well to dopaminergic therapy. PMID:23546363

Gupta, Ravi; Lahan, Vivekananda; Goel, Deepak

2013-01-01

103

Predictors of upper limb recovery after stroke: a systematic review and meta-analysis  

Microsoft Academic Search

Objective: To systematically review and summarize the current available literature on prognostic variables relating to upper limb recovery following stroke. To identify which, if any variables predict upper limb recovery following stroke.Data sources: We completed searches in MEDLINE, EMBASE, AMED, CINAHL and Cochrane CENTRAL databases. Searches were completed in November 2010.Review methods: Studies were included if predictor variables were measured

Fiona Coupar; Alex Pollock; Phil Rowe; Christopher Weir; Peter Langhorne

2012-01-01

104

Virtual musculo-skeletal model for the biomechanical analysis of the upper limb  

Microsoft Academic Search

In this paper, a musculo-skeletal model of the upper limb is presented. The limb is modelled as a three-dimensional 7 degrees-of-freedom system, linked to the shoulder, which has been considered as frame. The upper limb model is made up of four links corresponding to the most important body segments: the humerus, the ulna, the radius and the hand, considered as

E. Pennestrì; R. Stefanelli; P. P. Valentini; L. Vita

2007-01-01

105

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

NASA Astrophysics Data System (ADS)

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.

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

2011-03-01

106

Protein synthesis rates in atrophied gastrocnemius muscles after limb immobilization  

NASA Technical Reports Server (NTRS)

Noting that protein synthesis declines in the gastrocnemius 6 hr after immobilization, the study sought to detect an increase of protein synthesis when the limb was freed, and to examine the effects of exercise on the rate of increase. Rats were used as subjects, with their hind legs in plaster of Paris in plantar flexion to eliminate strain on the gastrocnemius. Periods of immobilization were varied and samples of blood from the muscle were taken to track protein synthesis rates for different groups in immobilization and exercise regimens (running and weightlifting). Synthesis rates declined 3.6% during time in the cast, then increased 6.3%/day after the casts were removed. Both running and weightlifting were found to increase the fractional rate of protein formation in the gastrocnemius muscle when compared with contralateral muscles that were not exercised and were used as controls, suggesting that the mechanism controlling protein synthesis in skeletal muscles is rapidly responsive to changes in muscular contractile activity.

Tucker, K. R.; Seider, M. J.; Booth, F. W.

1981-01-01

107

Biomechanical model of pronation efficiency: new insight into skeletal adaptation of the hominoid upper limb.  

PubMed

Despite considerable literature on the functional anatomy of the hominoid upper limb, there are no quantitative approaches relating to bone design and the resulting muscular-activity enhancement. The purpose of this study is to quantitatively analyze the relationship between the rotational efficiency of the pronator teres muscle and the design of the skeletal structures on which it acts. Using conventional scan images of a human forearm for three rotational positions, this study develops an original biomechanical model that defines rotational efficiency as a mathematical function expressing a geometrical relationship between the origin and insertion muscular sites. The results show that this parameter varies throughout the entire pronation range, being maximal when the forearm lies around its functional position. Moreover, the rotational-efficiency formula allows us to demonstrate, by several simulation conditions, that an improvement in pronation efficiency is derived from a large shaft radius curvature, a large humeral medial epicondyle, and a more proximal pronator teres radial attachment. The fact that forearm pronation efficiency can be inferred, even quantified, throughout the entire rotational range, by applying the biomechanical model developed here allows us to undertake anatomical approaches in the field of Evolutionary Anthropology, to interpret more precisely how skeletal design is related to upper-limb function in extant and fossil primate taxa. PMID:18000889

Galtés, Ignasi; Jordana, Xavier; Cos, Mònica; Malgosa, Assumpció; Manyosa, Joan

2008-03-01

108

Reliability of the Performance of Upper Limb assessment in Duchenne muscular dystrophy.  

PubMed

The Performance of Upper Limb was specifically designed to assess upper limb function in Duchenne muscular dystrophy. The aim of this study was to assess (1) a cohort of typically developing children from the age of 3years onwards in order to identify the age when the activities assessed in the individual items are consistently achieved, and (2) a cohort of 322 Duchenne children and young adults to establish the range of findings at different ages. We collected normative data for the scale validation on 277 typically developing subjects from 3 to 25years old. A full score was consistently achieved by the age of 5years. In the Duchenne cohort there was early involvement of the proximal muscles and a proximal to distal progressive involvement. The scale was capable of measuring small distal movements, related to activities of daily living, even in the oldest and weakest patients. Our data suggest that the assessment can be reliably used in both ambulant and non ambulant Duchenne patients in a multicentric setting and could therefore be considered as an outcome measure for future trials. PMID:24440357

Pane, Marika; Mazzone, Elena S; Fanelli, Lavinia; De Sanctis, Roberto; Bianco, Flaviana; Sivo, Serena; D'Amico, Adele; Messina, Sonia; Battini, Roberta; Scutifero, Marianna; Petillo, Roberta; Frosini, Silvia; Scalise, Roberta; Vita, Gianluca; Bruno, Claudio; Pedemonte, Marina; Mongini, Tiziana; Pegoraro, Elena; Brustia, Francesca; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bonfiglio, Serena; Rolle, Enrica; Colia, Giulia; Catteruccia, Michela; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Morandi, Lucia; Bertini, Enrico; Politano, Luisa; Sormani, MariaPia; Mercuri, Eugenio

2014-03-01

109

Comparison in eccentric exercise-induced muscle damage among four limb muscles.  

PubMed

This study tested the hypothesis that changes in indirect markers of muscle damage following maximal eccentric exercise would be smaller for the knee extensors (KE) and flexors (KF) compared with the elbow flexors (EF) and extensors (EE). A total of 17 sedentary men performed five sets of six maximal isokinetic (90° s(-1)) eccentric contractions of EF (range of motion, ROM: 90°-0°, 0 = full extension), EE (55°-145°), KF (90°-0°), and KE (30°-120°) using a different limb with a 4-5-week interval in a counterbalanced order. Changes in maximal isometric and concentric isokinetic strength, optimum angle, limb circumference, ROM, plasma creatine kinase activity and myoglobin concentration, muscle soreness, and echo-intensity of B-mode ultrasound images before and for 5 days following exercise were compared amongst the four exercises using two-way repeated-measures ANOVA. All variables changed significantly following EF, EE, and KF exercises, but KE exercise did not change the optimum angle, limb circumference, and echo-intensity. Compared with KF and KE, EF and EE showed significantly greater changes in all variables, without significant differences between EF and EE. Changes in all variables were significantly greater for KF than KE. For the same subjects, the magnitude of change in the dependent variables following exercise varied among the exercises. These results suggest that the two arm muscles are equally more susceptible to muscle damage than leg muscles, but KF is more susceptible to muscle damage than KE. The difference in the susceptibility to muscle damage seems to be associated with the use of muscles in daily activities. PMID:20852880

Chen, Trevor C; Lin, Kun-Yi; Chen, Hsin-Lian; Lin, Ming-Ju; Nosaka, Kazunori

2011-02-01

110

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

PubMed Central

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.

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

2014-01-01

111

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

PubMed Central

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.

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

2014-01-01

112

Functional analysis of limb recovery following autograft treatment of volumetric muscle loss in the quadriceps femoris.  

PubMed

Severe injuries to the extremities often result in muscle trauma and, in some cases, significant volumetric muscle loss (VML). These injuries continue to be challenging to treat, with few available clinical options, a high rate of complications, and often persistent loss of limb function. To facilitate the testing of regenerative strategies for skeletal muscle, we developed a novel quadriceps VML model in the rat, specifically addressing functional recovery of the limb. Our outcome measures included muscle contractility measurements to assess muscle function and gait analysis for evaluation of overall limb function. We also investigated treatment with muscle autografts, whole or minced, to promote regeneration of the defect area. Our defect model resulted in a loss of muscle function, with injured legs generating less than 55% of muscle strength from the contralateral uninjured control legs, even at 4 weeks post-injury. The autograft treatments did not result in significant recovery of muscle function. Measures of static and dynamic gait were significantly decreased in the untreated, empty defect group, indicating a decrease in limb function. Histological sections of the affected muscles showed extensive fibrosis, suggesting that this scarring of the muscle may be in part the cause of the loss of muscle function in this VML model. Taken together, these data are consistent with clinical findings of reduced muscle function in large VML injuries. This new model with quantitative functional outcome measures offers a platform on which to evaluate treatment strategies designed to regenerate muscle tissue volume and restore limb function. PMID:24280565

Li, Mon Tzu A; Willett, Nick J; Uhrig, Brent A; Guldberg, Robert E; Warren, Gordon L

2014-06-27

113

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

PubMed Central

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 limb is forwards or the contralateral backwards, a facilitation of both soleus and quadriceps tendon reflexes is observed while the biceps femoris reflexes are reduced. This pattern of facilitation and inhibition is reversed when the ipsilateral upper limb is backwards or the contralateral forwards. The facilitations as well as inhibitions of proximal myotatic arc reflexes are quantitatively more marked than that of the soleus reflex. Facilitation and inhibition are not linearly related to the angle of the arm with the trunk. Effects begin at a considerable angle, become maximal at 45 degrees, and progressively disappear for greater values. It is suggested that the distinct pattern of facilitation and inhibition which is exerted in reciprocal fashion on extensor and flexor motor nuclei might depend on the long propriospinal neurones connecting cervical and lumbar enlargements.

Delwaide, P J; Figiel, C; Richelle, C

1977-01-01

114

Entrapment neuropathies I: upper limb (carpal tunnel excluded).  

PubMed

Several entrapment neuropathies of the upper extremity can cause hypoechoic swelling and nerve compression as seen at ultrasound. The ulnar nerve can be compressed at the cubital tunnel of the elbow and Guyon's canal at the wrist. The deep branch of the radial nerve can be compressed at the supinator muscle at the elbow, and the superficial radial nerve may be compressed at the dorsal wrist (Wartenberg's syndrome). In addition to compression at the carpal tunnel, the median nerve may be compressed at the elbow, related to a supracondylar process or by the pronator teres. Knowledge of these key anatomical sites of potential nerve compression is essential for accurate diagnosis of entrapment neuropathies. PMID:21072726

Jacobson, Jon A; Fessell, David P; Lobo, Lucas Da Gama; Yang, Lynda J-S

2010-11-01

115

Sensory capacity of reinnervated skin after redirection of amputated upper limb nerves to the chest  

Microsoft Academic Search

Targeted reinnervation is a new neural-machine interface that has been developed to help improve the function of new- generation prosthetic limbs. Targeted reinnervation is a surgical procedure that takes the nerves that once innervated a severed limb and redirects them to proximal muscle and skin sites. The sensory afferents of the redirected nerves reinnervate the skin overlying the transfer site.

Paul D. Marasco; Aimee E. Schultz; Todd A. Kuiken

2009-01-01

116

Computationally efficient modeling of proprioceptive signals in the upper limb for prostheses: a simulation study  

PubMed Central

Accurate models of proprioceptive neural patterns could 1 day play an important role in the creation of an intuitive proprioceptive neural prosthesis for amputees. This paper looks at combining efficient implementations of biomechanical and proprioceptor models in order to generate signals that mimic human muscular proprioceptive patterns for future experimental work in prosthesis feedback. A neuro-musculoskeletal model of the upper limb with 7 degrees of freedom and 17 muscles is presented and generates real time estimates of muscle spindle and Golgi Tendon Organ neural firing patterns. Unlike previous neuro-musculoskeletal models, muscle activation and excitation levels are unknowns in this application and an inverse dynamics tool (static optimization) is integrated to estimate these variables. A proprioceptive prosthesis will need to be portable and this is incompatible with the computationally demanding nature of standard biomechanical and proprioceptor modeling. This paper uses and proposes a number of approximations and optimizations to make real time operation on portable hardware feasible. Finally technical obstacles to mimicking natural feedback for an intuitive proprioceptive prosthesis, as well as issues and limitations with existing models, are identified and discussed.

Williams, Ian; Constandinou, Timothy G.

2014-01-01

117

Computationally efficient modeling of proprioceptive signals in the upper limb for prostheses: a simulation study.  

PubMed

Accurate models of proprioceptive neural patterns could 1 day play an important role in the creation of an intuitive proprioceptive neural prosthesis for amputees. This paper looks at combining efficient implementations of biomechanical and proprioceptor models in order to generate signals that mimic human muscular proprioceptive patterns for future experimental work in prosthesis feedback. A neuro-musculoskeletal model of the upper limb with 7 degrees of freedom and 17 muscles is presented and generates real time estimates of muscle spindle and Golgi Tendon Organ neural firing patterns. Unlike previous neuro-musculoskeletal models, muscle activation and excitation levels are unknowns in this application and an inverse dynamics tool (static optimization) is integrated to estimate these variables. A proprioceptive prosthesis will need to be portable and this is incompatible with the computationally demanding nature of standard biomechanical and proprioceptor modeling. This paper uses and proposes a number of approximations and optimizations to make real time operation on portable hardware feasible. Finally technical obstacles to mimicking natural feedback for an intuitive proprioceptive prosthesis, as well as issues and limitations with existing models, are identified and discussed. PMID:25009463

Williams, Ian; Constandinou, Timothy G

2014-01-01

118

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

PubMed Central

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.

Gamboa, Jorge L; Andrade, Francisco H

2012-01-01

119

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

PubMed

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, FIO(2)?=?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?limb muscles, but it was 25% smaller in diaphragm (p?limb muscles were lower: state 2 decreased 19%, state 3 31%, and state 4 18% vs. control, p?limb muscle mitochondria had lower content of complex IV (cytochrome c oxidase), while diaphragm mitochondria had higher content of complexes IV and V (F (1)/F (0) 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

Gamboa, Jorge L; Andrade, Francisco H

2012-02-01

120

Treino de Corrida não Interfere no Desempenho de Força de Membros Superiores Endurance Exercise Bout Does Not Interfere in Strength Performance of Upper Limbs  

Microsoft Academic Search

Aim: the present study evaluated the effect of endurance exercise (running) on the subsequent strength performance of muscles of upper limbs and trunk. Methodology: Thirteen healthy female, university students, physically active were selected to compose the sample. The first phase of the experiment the subjects were submitted to an endurance exercise bout (treadmill), simulating a training session, with duration of

Leandro Luís Oliveira Raddi; Rodrigo Vitasovic Gomes; Mário Augusto Charro; Reury Frank; Pereira Bacurau; Marcelo Saldanha Aoki

2008-01-01

121

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

PubMed Central

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.

Heitmann, Stewart; Ferns, Norm; Breakspear, Michael

2012-01-01

122

Coordinated expression of Hoxa-11 and Hoxa-13 during limb muscle patterning.  

PubMed

The limb muscle precursor cells migrate from the somites and congregate into the dorsal and ventral muscle masses in the limb bud. Complex muscle patterns are formed by successive splitting of the muscle masses and subsequent growth and differentiation in a region-specific manner. Hox genes, known as key regulator genes of cartilage pattern formation in the limb bud, were found to be expressed in the limb muscle precursor cells. We found that HOXA-11 protein was expressed in the premyoblasts in the limb bud, but not in the somitic cells or migrating premyogenic cells in the trunk at stage 18. By stage 24, HOXA-11 expression began to decrease from the posterior halves of the muscle masses. HOXA-13 was expressed strongly in the myoblasts of the posterior part in the dorsal/ventral muscle masses and weakly in a few myoblasts of the anterior part of the dorsal muscle mass. Transplantation of the lateral plate of the presumptive wing bud to the flank induced migration of premyoblasts from somites to the graft. Under these conditions, HOXA-11 expression was induced in the migrating premyoblasts in the ectopic limb buds. Application of retinoic acid at the anterior margin of the limb bud causes duplication of the autopodal cartilage and transformation of the radius to the ulna, and at the same time induces duplication of the muscle pattern along the anteroposterior axis. Under these conditions, HOXA-13 was also induced in the anterior region of the ventral muscles in the zeugopod. These results suggest that Hoxa-11 and Hoxa-13 expression in the migrating premyoblasts is under the control of the limb mesenchyme and the polarizing signal(s). In addition, these results indicate that these Hox genes are involved in muscle patterning in the limb buds. PMID:9477331

Yamamoto, M; Gotoh, Y; Tamura, K; Tanaka, M; Kawakami, A; Ide, H; Kuroiwa, A

1998-04-01

123

Muscular performance modeling of the upper limb in static postures.  

PubMed

The purpose of the present paper is to describe and evaluate the polynomial models for predicting the muscular work capacity of the upper limb during sustained holding tasks. This research was concerned with the relationship between indicators of performance, i.e., specific posture or specific level of maximum voluntary contraction (MVC), and then modeling the functional data based on experimental results to estimate factors that may have an effect on task performance. To this end, we designed an experiment using 10 subjects in which each subject performed sustained isometric shoulder and elbow flexion endurance exercise under 27 conditions [3 shoulder angles (SA)x3 elbow angles (EA)x3 levels of %MVC]. Throughout all experiments, subjective perception of effort was assessed using the Borg scale, every 60, 30, and 10 s during the 20%, 40%, and 60% MVC tests, respectively. Proposal models were represented by three approaches: model A: estimation of endurance time (ET), with input variables such as SA, EA, and %MVC; model B: estimation of recommendation time (RT, the time during which the operator was able to maintain a position under the desired condition), with input variables such as SA, EA, %MVC, and required rate on the Borg scale; and model C: estimation of limit strength or %MVC, with input variables such as SA, EA, request limit time for work (LT), and required rate on the Borg scale. Statistical analysis indicated that the three proposal estimation models based on polynomial regression functions showed high significance (p<0.0001). The proposal models suggested and recommended the possibility of finding the best positions entailing the reduction and minimization of total muscular strain from manual material handling tasks in different work situations, with the consequent increase in work efficiency. PMID:12808228

Mamaghani, Nasser Koleini; Shimomura, Yoshihiro; Iwanaga, Koichi; Katsuura, Tetsuo

2003-05-01

124

Acupuncture in the Treatment of Upper-Limb Lymphedema  

PubMed Central

BACKGROUND Current treatments for lymphedema after breast cancer treatment are expensive and require ongoing intervention. Clinical experience and our preliminary published results suggest that acupuncture is safe and potentially useful. This study evaluates the safety and potential efficacy of acupuncture on upper-limb circumference in women with lymphedema. METHODS Women with a clinical diagnosis of breast cancer?related lymphedema (BCRL) for 0.5-5 years and with affected arm circumference ?2 cm larger than unaffected arm received acupuncture treatment twice weekly for 4 weeks. Affected and unaffected arm circumferences were measured before and after each acupuncture treatment. Response, defined as ?30% reduction in circumference difference between affected/unaffected arms, was assessed. Monthly follow-up calls for 6 months thereafter were made to document any complications and self-reported lymphedema status. RESULTS Among 37 enrolled patients, 33 were evaluated; 4 discontinued due to time constraints. Mean reduction in arm circumference difference was 0.90 cm (95% CI, 0.72-1.07; P < .0005). Eleven patients (33%) exhibited a reduction of ?30% after acupuncture treatment. Seventy-six percent of patients received all treatments; 21% missed 1 treatment, and another patient missed 2 treatments. During the treatment period, 14 of the 33 patients reported minor complaints, including mild local bruising or pain/tingling. There were no serious adverse events and no infections or severe exacerbations after 255 treatment sessions and 6 months of follow-up interviews. CONCLUSIONS Acupuncture for BCRL appears safe and may reduce arm circumference. Although these results await confirmation in a randomized trial, acupuncture can be considered for women with no other options for sustained arm circumference reduction. Cancer 2013;119:2455-2461. © 2013 American Cancer Society.

Cassileth, Barrie R; Van Zee, Kimberly J; Yeung, K Simon; Coleton, Marci I; Cohen, Sara; Chan, Yi H; Vickers, Andrew J; Sjoberg, Daniel D; Hudis, Clifford A

2013-01-01

125

Plasticity and recovery of skeletal muscle satellite cells during limb regeneration.  

PubMed

Salamander limb regeneration depends on local progenitors whose progeny are recruited to the new limb. We previously identified a Pax7(+) cell population in skeletal muscle whose progeny have the potential to contribute to the regenerating limb. However, the plasticity of individual Pax7(+) cells, as well as their recovery within the new limb, was unclear. Here, we show that Pax7(+) cells remain present after multiple rounds of limb amputation/regeneration. Pax7(+) cells are found exclusively within skeletal muscle in the regenerating limb and proliferate where the myofibers are growing. Pax7 is rapidly down-regulated in the blastema, and analyses of clonal derivatives show that Pax7(+) cell progeny are not restricted to skeletal muscle during limb regeneration. Our data suggest that the newt regeneration blastema is not entirely a composite of lineage-restricted progenitors. The results demonstrate that except for a transient and subsequently blunted increase, skeletal muscle satellite cells constitute a stable pool of reserve cells for multiple limb regeneration events.-Morrison, J. I., Borg, P., Simon, A. Plasticity and recovery of skeletal muscle satellite cells during limb regeneration. PMID:19887652

Morrison, Jamie I; Borg, Paula; Simon, András

2010-03-01

126

The effect of perinatal brachial plexus lesion on upper limb development  

PubMed Central

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.

2014-01-01

127

Muscle architecture and functional anatomy of the pelvic limb of the ostrich (Struthio camelus).  

PubMed

The functional anatomy of the pelvic limb of the ostrich (Struthio camelus) was investigated in order to assess musculoskeletal specialization related to locomotor performance. The pelvic limbs of ten ostriches were dissected and detailed measurements of all muscle tendon units of the pelvic limb were made, including muscle mass, muscle length, fascicle length, pennation angle, tendon mass and tendon length. From these measurements other muscle properties such as muscle volume, physiological cross-sectional area (PCSA), tendon cross-sectional area, maximum isometric muscle force and tendon stress were derived, using standard relationships and published muscle data. Larger muscles tended to be located more proximally and had longer fascicle lengths and lower pennation angles. This led to an expected proximal to distal reduction in total muscle mass. An exception to this trend was the gastrocnemius muscle, which was found to have the largest volume and PCSA and also had the highest capacity for both force and power production. Generally high-power muscles were located more proximally in the limb, while some small distal muscles (tibialis cranialis and flexor perforatus digiti III), with short fibres, were found to have very high force generation capacities. The greatest proportion of pelvic muscle volume was for the hip extensors, while the highest capacity for force generation was observed in the extensors of the ankle, many of which were also in series with long tendons and thus were functionally suited to elastic energy storage. PMID:17118064

Smith, N C; Wilson, A M; Jespers, K J; Payne, R C

2006-12-01

128

Mechanically Evoked Torque and Electromyographic Responses During Passive Elbow Extension in Upper Limb Tension Test Position.  

National Technical Information Service (NTIS)

In neural tension testing, it is critically important to establish a method to investigate the relative contribution of different neuromuscular mechanisms to resistance developed during and at the limit of the upper limb tension test 1 (ULTT1), Three male...

S. Jaberzadeh H. Nazeran A. Warden-Flood S. Scutter

2001-01-01

129

Computer-Based Clinical Instrumentation for Processing and Analysis of Electroneuromyographic Signals in the Upper Limb.  

National Technical Information Service (NTIS)

A computer-based clinical instrument was developed to simultaneously acquire, process, display, quantify and correlate electroneuromyographic (ENMG) activity in the upper limb in humans. This system was designed around AMLAB analog modules and software ob...

H. Nazeran S. Jaberzadeh K. Behbehani

2001-01-01

130

Use of botulinum toxin in stroke patients with severe upper limb spasticity  

Microsoft Academic Search

OBJECTIVES--Spasticity can contribute to poor recovery of upper limb function after stroke. This is a preliminary evaluation of the impact of botulinum toxin treatment on disability caused by upper limb spasticity after stroke. METHODS--Seventeen patients with severe spasticity and a non-functioning arm were treated with intramuscular botulinum A neurotoxin (median age at treatment 54.5 years; median time between onset of

B B Bhakta; J A Cozens; J M Bamford; M A Chamberlain

1996-01-01

131

Patients with non-specific neck disorders commonly report upper limb disability.  

PubMed

Patients with neck disorders can report difficulties with functional use of their upper limb because of their neck pain. Yet, there is little information on the frequency and specifically, the nature of these upper limb activities. This study surveyed patients with neck pain disorders (n = 103) presenting for management at private physiotherapy clinics in a large metropolitan area to investigate the frequency and nature of reduced upper limb function. Participants were asked to complete four questionnaires, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Neck Disability Index (NDI), Pictorial Fear of Activity Scale-Cervical (PFActS-C) and Patient Specific Functional Scale (PSFS). Approximately 80% of patients spontaneously reported that upper limb activities aggravated their neck pain (PSFS). Most frequently, these activities involved loading of the upper limb such as lifting. Eight activity items on the DASH were scored positive by ?50% of participants. Participants had mild to moderately severe neck pain (NDI: range 2-68%). The DASH and NDI were moderately-highly correlated (? = 0.669; p < 0.001), indicating the higher the neck pain severity the greater the upper limb functional restrictions. There was a low correlation between the NDI and PFActS-C (? = 0.319; p = 0.001). These findings provide evidence that upper limb function is often impaired in association with neck pain disorders and suggest clinicians should routinely question patients regarding upper limb function. The DASH could be used as a suitable outcome measure in its current or possibly a modified form. PMID:23726285

Osborn, William; Jull, Gwendolen

2013-12-01

132

Upper limb contributions to frontal plane balance control in rollator-assisted walking.  

PubMed

While assisting with balance is a primary reason for rollator use, few studies have examined how the upper limbs are used for balance. This study examines upper limb contributions to balance control during rollator-assisted walking. We hypothesized that there would be an increased upper limb contribution, measured by mean vertical loading (Fz) and variation in frontal plane center-of-pressure (COPhigh), when walking balance is challenged/impaired. Experiment 1 compared straight-line and beam-walking in young adults (n = 11). As hypothesized, Fz and COPhighincreased in beam-walking compared to baseline (mean Fz: 13.7 vs. 9.1% body weight (BW), p < 0.001, RMS COPhigh: 1.35 vs. 1.07 cm, p < 0.001). Experiment 2 compared older adults who regularly use rollators (RU, n = 10) to older adult controls (CTL, n = 10). The predicted higher upper limb contribution in the RU group was not supported. However, when individuals were grouped by balance impairment, those with the lowest Berg Balance scores (< 45) demonstrated greater speed-adjusted COPhigh than those with higher scores (p = 0.013). Furthermore, greater COPhigh and Fz were correlated to greater reduction in step width, supporting the role of upper limb contributions to frontal plane balance. This work will guide studies assessing reliance on rollators by providing a basis for measurement of upper limb balance contributions. PMID:24800450

Tung, James Y; Gage, William H; Poupart, Pascal; McIlroy, William E

2014-01-01

133

A STUDY OF STORAGE AND UTILIZATION OF ELASTIC ENERGY IN HUMAN LOWER LIMB MUSCLES  

Microsoft Academic Search

INTRODUCTION: In order to reveal how load, length of muscles, velocity of stretch and other factors affect the storage and the utilization of the elastic energy, lower limb muscular eccentric contraction in take-off phase of jumping were studied. In the past, Many studies about this topic was based on muscles in vitro, but this paper was based on muscles in

Yuqin Shi; Fuming Gu

134

Identification of muscle forces in human lower limbs during sagittal plane movements Part II: Computational algorithms  

Microsoft Academic Search

Using a sagittal model of human body developed in part I, the present paper deals with computational algorithms related to the inverse simulation problem - the determination of driving muscle forces in lower limbs using the measured motion characteristics as input data. The control problem is associated with muscle force redundancy and then affected by the fact that muscles always

WOJCIECH BLAJER; KRZYSZTOF DZIEWIECKI; ZENON MAZUR

135

Entrapment Neuropathies in the Upper and Lower Limbs: Anatomy and MRI Features  

PubMed Central

Peripheral nerve entrapment occurs at specific anatomic locations. Familiarity with the anatomy and the magnetic resonance imaging (MRI) features of nerve entrapment syndromes is important for accurate diagnosis and early treatment of entrapment neuropathies. The purpose of this paper is to illustrate the normal anatomy of peripheral nerves in the upper and lower limbs and to review the MRI features of common disorders affecting the peripheral nerves, both compressive/entrapment and noncompressive, involving the suprascapular nerve, the axillary nerve, the radial nerve, the ulnar nerve, and the median verve in the upper limb and the sciatic nerve, the common peroneal nerve, the tibial nerve, and the interdigital nerves in the lower limb.

Dong, Qian; Jacobson, Jon A.; Jamadar, David A.; Gandikota, Girish; Brandon, Catherine; Morag, Yoav; Fessell, David P.; Kim, Sung-Moon

2012-01-01

136

An upper-limb power-assist exoskeleton using proportional myoelectric control.  

PubMed

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

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

2014-01-01

137

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

PubMed Central

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.

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

2014-01-01

138

Cancer cachexia decreases specific force and accelerates fatigue in limb muscle  

SciTech Connect

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.

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

139

The role of the extrinsic thoracic limb muscles in equine locomotion  

PubMed Central

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.

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

2004-01-01

140

Gait and upper limb variability in Parkinson's disease patients with and without freezing of gait.  

PubMed

Patients with Parkinson's disease (PD) and freezing of gait (FOG) (freezers) demonstrate high gait variability. The objective of this study was to determine whether freezers display a higher variability of upper limb movements and elucidate if these changes correlate with gait. We were the first group to compare directly objectively measured gait and upper limb movement variability of freezers between freezing episodes. Patients with objectively verified FOG (n = 11) and PD patients without FOG (non-freezers) (n = 11) in a non-randomized medication condition (OFF/ON) were analyzed. Uncued antiphasic finger tapping and forearm diadochokinetic movements were analyzed via three-dimensional ultrasound kinematic measurements. Gait variability of straight gait was assessed using ground reaction forces. Freezers had shorter stride length (p = 0.004) and higher stride length variability (p = 0.005) in the medication OFF condition. Movement variability was not different during finger tapping or diadochokinesia between the groups. There was a trend towards more freezing of the upper limb during finger tapping for the freezers (p = 0.07). Variability in stride length generation and stride timing was not associated with variability of upper limb movement in freezers. Our findings demonstrate that: (1) freezers have a higher spatial gait variability between freezing episodes; (2) freezing-like episodes of the upper limb occur in PD patients, and tend to be more pronounced among freezers than non-freezers for finger tapping; (3) spatial and temporal upper extremity variability is equally affected in freezers and non-freezers in an uncued task. Upper limb freezing is not correlated to lower limb freezing, implicating a different pathophysiology. PMID:24305993

Barbe, Michael T; Amarell, Martin; Snijders, Anke H; Florin, Esther; Quatuor, Eva-Lotte; Schönau, Eckhard; Fink, Gereon R; Bloem, Bastiaan R; Timmermann, Lars

2014-02-01

141

Activity of extrinsic limb muscles in dogs at walk, trot and gallop.  

PubMed

The extrinsic limb muscles perform locomotor work and must adapt their activity to changes in gait and locomotor speed, which can alter the work performed by, and forces transmitted across, the proximal fulcra of the limbs where these muscles operate. We recorded electromyographic activity of 23 extrinsic forelimb and hindlimb muscles and one trunk muscle in dogs while they walked, trotted and galloped on a level treadmill. Muscle activity indicates that the basic functions of the extrinsic limb muscles - protraction, retraction and trunk support - are conserved among gaits. The forelimb retains its strut-like behavior in all gaits, as indicated by both the relative inactivity of the retractor muscles (e.g. the pectoralis profundus and the latissimus dorsi) during stance and the protractor muscles (e.g. the pectoralis superficialis and the omotransversarius) in the first half of stance. The hindlimb functions as a propulsive lever in all gaits, as revealed by the similar timing of activity of retractors (e.g. the biceps femoris and the gluteus medius) during stance. Excitation increased in many hindlimb muscles in the order walk-trot-gallop, consistent with greater propulsive impulses in faster gaits. Many forelimb muscles, in contrast, showed the greatest excitation at trot, in accord with a shorter limb oscillation period, greater locomotor work performed by the forelimb and presumably greater absorption of collisional energy. PMID:22189773

Deban, Stephen M; Schilling, Nadja; Carrier, David R

2012-01-15

142

An accelerometry-based study of lower and upper limb tremor in Parkinson's disease.  

PubMed

Over the past two decades, several studies have aimed to quantify the kinetic properties of tremor with primary focus on the upper limbs. However, there is a lack of investigation into the properties of tremor in the lower limbs. The objective of this preliminary study was to investigate the properties of oscillatory movement, at rest and in posture, in both the upper and lower limbs of Parkinson's disease (PD) patients with clinically undetectable to modest rest/postural tremor and healthy controls. PD patients (N = 16) and controls (N = 8) were examined clinically by a movement disorders specialist and oscillatory movements in all four extremities were evaluated using a portable biaxial accelerometer. While tremor intensity and frequency did not differ between groups, the intraindividual variability of rest and postural tremor frequency in the dexterity-dominant lower limb was lower in people living with PD than in healthy adults. Additionally, rest tremor frequency was discrepant between upper and lower limbs in PD. Our work introduces the possibility that minute variations in lower limb movements, which are imperceptible upon expert clinical exam, can be used to differentiate a diseased sample from a healthy one. These preliminary findings suggest that additional work using objective tremor measurement may improve our understanding of lower limb motor dysfunction in PD and lead to the refinement of current, and the development of new, metrics to enhance early diagnosis, differential diagnosis, and symptom quantification. PMID:23639618

Scanlon, Blake K; Levin, Bonnie E; Nation, Daniel A; Katzen, Heather L; Guevara-Salcedo, Alexandra; Singer, Carlos; Papapetropoulos, Spiridon

2013-06-01

143

Further evidence for treatment of recalcitrant neuropathy of the upper limb with autologous vein wrapping.  

PubMed

The treatment of entrapment neuropathy in the upper extremity with surgical decompression has generally provided good results. Recurrence of symptoms, however, is not uncommon, and its management is both challenging and difficult. Autologous vein graft wrapping is an alternative technique, and it is recommended for the treatment of recalcitrant upper limb nerve compression in which 2 or more previous surgical procedures have failed to resolve the problem. Each patient underwent both subjective and objective evaluation. To our knowledge, this is the largest reported single series of vein wrapping cases in the upper limb outside the United States and the first to report results using the well-validated patient evaluation measure. PMID:22868323

Mulgrew, Stephen; Kanabar, Gorande P; Papanastasiou, Stephanos

2012-09-01

144

Slow and Fast Muscle Fibers Are Preferentially Derived from Myoblasts Migrating into the Chick Limb Bud at Different Developmental Times  

Microsoft Academic Search

Avian limb myoblasts originate from somites and migrate into the periphery during limb bud formation. It is not known how these precursors become arranged into a stereotyped pattern of muscles and primary fiber types. We used in vivo surgical transplantation and anatomical analyses of thigh muscle patterns to ask whether myoblasts migrating into the limb bud at different developmental times

Jessie Van Swearingen; Cynthia Lance-Jones

1995-01-01

145

Changes in growth-related kinases in head, neck and limb muscles with age  

PubMed Central

Sarcopenia coincides with declines in several systemic processes that signal through the MAP kinase and Akt-mTOR-p70S6k cascades typically associated with muscle growth. Effects of aging on these pathways have primarily been examined in limb muscles, which experience substantial activity and neural changes in addition to systemic hormonal and metabolic changes. Head and neck muscles are reported to undergo reduced sarcopenia and disuse with age relative to limb muscles, suggesting muscle activity may contribute to maintaining mass with age. However many head and neck muscles derive from embryonic branchial arches, rather than the somites from which limb muscles originate, suggesting that developmental origin may be important. This study compares the expression and phosphorylation of MAP kinase and mTOR networks in head, neck, tongue, and limb muscles from 8- and 26-month old F344 rats to test the hypothesis that physical activity and developmental origin contribute to preservation of muscle mass with age. Phosphorylation of p38 was exaggerated in aged branchial arch muscles. Phosphorylation of ERK and p70S6k T421/S424 declined with age only in the biceps brachii. Expression of p70S6k declined in all head and neck, tongue and limb muscles although no change in phosphorylation of p70S6k on T389 could be resolved. A systemic change that results in a loss of p70S6k protein expression may reduce the capacity to respond to acute hypertrophic stimuli, while the exaggerated p38 signaling in branchial arch muscles may reflect more active muscle remodeling.

Rahnert, Jill A.; Luo, Qingwei; Balog, Edward M.; Sokoloff, Alan J.; Burkholder, Thomas J.

2010-01-01

146

Effect of Dipsaci radix on hind limb muscle atrophy of sciatic nerve transected rats.  

PubMed

It was reported that Dipsaci radix (DR) has a reinforcement effect on the bone-muscle dysfunction in the oriental medical classics and the experimental animal studies. The muscle atrophy was induced by unilateral transection of the sciatic nerve of the rats. Water-extract of DR was used as treatment once a day for 12 days. The muscle weights of the hind limb, atrophic changes, glycogen contents, compositions and cross-section areas of muscle fiber types in soleus and medial gastrocnemius were investigated. Muscle fiber type was classified to type-I and type-II with MHCf immunohistochemistry. Furthermore, Bax and Bcl-2 expressions were observed with immunohistochemiatry. DR treatment significantly increased muscle weights of soleus, medial gastrocnemius, lateral gastrocnemius, and posterior tibialis of the damaged hind limb. DR treatment reduced apoptotic muscle nuclei and hyaline-degenerated muscle fibers in soleus and medial gastrocnemius of the damaged hind limb. DR treatment also significantly increased glycogen contents in medial gastrocnemius of the damaged hind limb. DR treatment significantly attenuated the slow-to-fast shift in soleus of the damaged hind limb but not in medial gastrocnemius. DR treatment significantly increased cross-section areas of type-I and type-II fibers in soleus and medial gastrocnemius of the damaged hind limb. In soleus and medial gastrocnemius, DR treatment significantly reduced Bax positive muscle nuclei in the damaged hind limb. These results suggest that DR treatment has an anti-atrophic effect and an anti-apoptotic effect against myonuclear apoptosis induced by the peripheral nerve damage. PMID:19938217

Jung, Hyuk-Sang; Noh, Chung-Ku; Ma, Sun-Ho; Hong, Eun Ki; Sohn, Nak-Won; Kim, Yoon-Bum; Kim, Sung-Hoon; Sohn, Youngjoo

2009-01-01

147

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

PubMed

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

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

148

Effects of Robot-assisted therapy on upper limb recovery after stroke: A Systematic Review  

PubMed Central

Background and Purpose To present a systematic review of studies that investigates the effects of robot-assisted therapy on motor and functional recovery in patients with stroke. Summary of Review A database of articles published up to October 2006 was compiled using the following MEDLINE key words: cerebral vascular accident, cerebral vascular disorders, stroke, paresis, hemiplegia, upper extremity, arm and robot. References listed in relevant publications were also screened. Studies that satisfied the following selection criteria were included: (1) patients were diagnosed with cerebral vascular accident; (2) effects of robot-assisted therapy for the upper limb were investigated; (3) the outcome was measured in terms of motor and/or functional recovery of the upper paretic limb; (4) The study was a randomised clinical trial (RCT). For each outcome measure, the estimated effect size (ES) and the summary effect size (SES) expressed in standard deviation units (SDU) were calculated for motor recovery and functional ability (ADL) using fixed and random effect models. Ten studies, involving 218 patients, were included in the synthesis. Their methodological quality ranged from 4 to 8 on a (maximum) 10 point scale. Meta-analysis showed a non-significant heterogeneous SES in terms of upper limb motor recovery. Sensitivity analysis of studies involving only shoulder-elbow robotics subsequently demonstrated a significant homogeneous SES for motor recovery of the upper paretic limb. No significant SES was observed for functional ability (ADL). Conclusion As a result of marked heterogeneity in studies between distal and proximal arm robotics, no overall significant effect in favour of robot-assisted therapy was found in the present meta-analysis. However, subsequent sensitivity analysis showed a significant improvement in upper limb motor function after stroke for upper arm robotics. No significant improvement was found in ADL function. However, the administered ADL scales in the reviewed studies fail to adequately reflect recovery of the paretic upper limb and valid instruments that measure outcome of dexterity of the paretic arm and hand are mostly absent in selected studies. Future research on the effects of robot-assisted therapy should therefore distinguish between upper and lower robotics arm training and concentrate on kinematical analysis to differentiate between genuine upper limb motor recovery and functional recovery due to compensation strategies by proximal control of the trunk and upper limb.

Kwakkel, Gert; Kollen, Boudewijn J.; Krebs, Hermano I.

2009-01-01

149

Position-dependent torque coupling and associated muscle activation in the hemiparetic upper extremity  

PubMed Central

Previous studies have demonstrated abnormal joint torque coupling and associated muscle coactivations of the upper extremity in individuals with unilateral stroke. We investigated the effect of upper limb configuration on the expression of the well-documented patterns of shoulder abduction/elbow flexion and shoulder adduction/elbow extension. Maximal isometric shoulder and elbow torques were measured in stroke subjects in four different arm configurations. Additionally, an isometric combined torque task was completed where subjects were required to maintain various levels of shoulder abduction/adduction torque while attempting to maximize elbow flexion or extension torque. The dominant abduction/elbow flexion pattern was insensitive to changes in limb configuration while the elbow extension component of the adduction/extension pattern changed to elbow flexion at smaller shoulder abduction angles. This effect was not present in control subjects without stroke. The reversal of the torque-coupling pattern could not be explained by mechanical factors such as muscle length changes or muscle strength imbalances across the elbow joint. Potential neural mechanisms underlying the sensitivity of the adduction/elbow extension pattern to different somatosensory input resultant from changes in limb configuration are discussed along with the implications for future research.

Ellis, Michael D.; Acosta, Ana Maria; Yao, Jun

2010-01-01

150

Coupling of upper and lower limb pattern generators during human crawling at different arm/leg speed combinations.  

PubMed

A crawling paradigm was performed by healthy adults to examine inter-limb coupling patterns and to understand how central pattern generators (CPGs) for the upper and lower limbs are coordinated. Ten participants performed hands-and-feet crawling on two separate treadmills, one for the upper limbs and another one for the lower limbs, the speed of each of them being changed independently. A 1:1 frequency relationship was often maintained even when the treadmill speed was not matched between the upper and lower limbs. However, relative stance durations in the upper limbs were only affected by changes of the upper limb treadmill speed, suggesting that although absolute times are adjusted, the relative proportions of stances and swing do not adapt to changes in lower limb treadmill speeds. With large differences between treadmill speeds, changes in upper and lower limb coupling ratio tended to occur when the upper limbs stepped at slower speeds than the lower limbs, but more rarely the other way around. These findings are in sharp contrast with those in the cat, where forelimbs always follow the rhythm of the faster moving hindlimbs. However, the fact that an integer frequency ratio is often maintained between the upper and lower limbs supports evidence of coupled CPG control. We speculate that the preference for the upper limb to decrease step frequency at lower speeds in humans may be due to weaker ascending propriospinal connections and/or a larger influence of cortical control on the upper limbs which allows for an overriding of spinal CPG control. PMID:23241905

MacLellan, M J; Ivanenko, Y P; Catavitello, G; La Scaleia, V; Lacquaniti, F

2013-03-01

151

Myocytic androgen receptor controls the strength but not the mass of limb muscles.  

PubMed

The anabolic effects of androgens on skeletal muscles are thought to be mediated predominantly through the androgen receptor (AR), a member of the ligand-dependent nuclear receptor superfamily. However, despite numerous studies performed in men and in rodents, these effects remain poorly understood. To characterize androgen signaling in skeletal muscles, we generated mice in which the AR is selectively ablated in myofibers. We show that myocytic AR controls androgen-induced insulin-like growth factor IEa (IGF-IEa) expression in the highly androgen-sensitive perineal muscles and that it mediates androgen-stimulated postnatal hypertrophy of these muscles. In contrast, androgen-dependent postnatal hypertrophy of limb muscle fibers is independent of myocytic AR. Thus, androgens control perineal and limb muscle mass in male mice through myocytic AR-dependent and -independent pathways, respectively. Importantly, we also show that AR deficiency in limb myocytes impairs myofibrillar organization of sarcomeres and decreases muscle strength, thus demonstrating that myocytic AR controls key pathways required for maximum force production. These distinct androgen signaling pathways in perineal and limb muscles may allow the design of screens to identify selective androgen modulators of muscle strength. PMID:20660752

Chambon, Céline; Duteil, Delphine; Vignaud, Alban; Ferry, Arnaud; Messaddeq, Nadia; Malivindi, Rocco; Kato, Shigeaki; Chambon, Pierre; Metzger, Daniel

2010-08-10

152

Myocytic androgen receptor controls the strength but not the mass of limb muscles  

PubMed Central

The anabolic effects of androgens on skeletal muscles are thought to be mediated predominantly through the androgen receptor (AR), a member of the ligand-dependent nuclear receptor superfamily. However, despite numerous studies performed in men and in rodents, these effects remain poorly understood. To characterize androgen signaling in skeletal muscles, we generated mice in which the AR is selectively ablated in myofibers. We show that myocytic AR controls androgen-induced insulin-like growth factor IEa (IGF-IEa) expression in the highly androgen-sensitive perineal muscles and that it mediates androgen-stimulated postnatal hypertrophy of these muscles. In contrast, androgen-dependent postnatal hypertrophy of limb muscle fibers is independent of myocytic AR. Thus, androgens control perineal and limb muscle mass in male mice through myocytic AR-dependent and -independent pathways, respectively. Importantly, we also show that AR deficiency in limb myocytes impairs myofibrillar organization of sarcomeres and decreases muscle strength, thus demonstrating that myocytic AR controls key pathways required for maximum force production. These distinct androgen signaling pathways in perineal and limb muscles may allow the design of screens to identify selective androgen modulators of muscle strength.

Chambon, Celine; Duteil, Delphine; Vignaud, Alban; Ferry, Arnaud; Messaddeq, Nadia; Malivindi, Rocco; Kato, Shigeaki; Chambon, Pierre; Metzger, Daniel

2010-01-01

153

Rapid intravascular injection into limb skeletal muscle: a damage assessment study.  

PubMed

We have recently developed a simple and highly efficient methodology for delivering plasmid DNA (pDNA) to skeletal muscle cells of mammalian limbs. The procedure involves the rapid intravascular injection of a large volume of saline (containing pDNA) into the vasculature of the distal limb. As a result of the robust delivery methodology involved, it is important to understand the effects of the injection procedure on the skeletal muscle tissue in the targeted limb. In previous studies, only modest and transient muscle damage was noted. In this study we quantitatively assessed the degree of muscle damage in rat limbs following intravascular injections using muscle histology (H&E staining), membrane integrity (Evans blue staining), and leukocyte infiltration (immunohistochemistry) assays. The rapid extravasation of fluid during the injection process resulted in edema of the muscle tissue of the targeted limb; however, the edema was transient and resolved within 24 h. Consistent with observations from previous studies, minimal levels of myofiber damage were detected. Immunohistochemical labeling indicated that increased numbers of neutrophils (CD43+) and macrophages (ED1+ and ED2+) were present in the muscle tissue interstitium shortly after injection but that elevations were relatively modest and resolved by 2 weeks postinjection. PMID:16185934

Toumi, Hechmi; Hegge, Julia; Subbotin, Vladimir; Noble, Mark; Herweijer, Hans; Best, Thomas M; Hagstrom, James E

2006-01-01

154

Development of upper limb proprioceptive accuracy in children and adolescents.  

PubMed

This study was designed to determine differences in the proprioceptively guided movements of children (8-10 years) and adolescents (16-18 years). Participants were blindfolded and asked to actively match passively determined target positions of the elbow joint under three matching conditions. Overall, children were less accurate than adolescents in all matching tasks and utilized different kinematic strategies for making the matching movements. Specifically, children made larger absolute errors and utilized matching movements which, compared to adolescents, were of shorter duration and less irregular in terms of their velocity profiles. An assessment of limb asymmetry was also performed revealing a non-dominant arm matching advantage but only for children and only in the task requiring interhemispheric transfer of a memory-based model of limb position. The proprioceptive differences observed in this study are likely the result of experience-driven refinement in the utilization of somatosensory feedback throughout childhood and into adolescence. PMID:16043248

Goble, Daniel J; Lewis, Colleen A; Hurvitz, Edward A; Brown, Susan H

2005-04-01

155

Chiropractic management of work-related upper limb disorder complicated by intraosseous ganglion cysts: a case report  

PubMed Central

Objective Work-related upper limb disorder (WRULD) encompasses a broad array of occupational upper limb injuries, the most common being carpal tunnel syndrome (CTS). Carpal tunnel syndrome occasionally presents with concomitant ganglion cysts. The purpose of this case report is to describe the chiropractic management of a patient with bilateral WRULD complicated by ganglion cysts. Clinical Features The patient was diagnosed previously with bilateral CTS and presented with common CTS symptoms that were nonresponsive to several previous courses of care. Magnetic resonance imaging revealed bilateral ganglion cysts, and electrodiagnostic studies found left CTS and bilateral radial neuralgia. Right limb findings appeared more consistent with nonspecific arm pain. Intervention and Outcome Chiropractic manipulative therapy, soft-tissue approaches, and physiotherapy modalities were applied to the arms and wrists over a 3-month period. Home care included exercises using elastic tubing and a gyroscopic handheld device. Chiropractic manipulative therapy and other conservative approaches resulted in subjective improvements of decreased hand paresthesias and muscle weakness and objective improvements in range of motion and neurologic deficits. Although the patient's symptoms and function improved, she remained with a level of permanent impairment. Conclusion This case demonstrates successful chiropractic management of a patient with WRULD complicated by ganglion cysts. Further larger-scale studies are recommended to determine if chiropractic management demonstrates positive outcomes for this condition.

Crafts, Glenn J.; Snow, Gregory J.; Ngoc, Kim Hong

2011-01-01

156

Activation of upper airway muscles during breathing and swallowing.  

PubMed

The upper airway is a complex muscular tube that is used by the respiratory and digestive systems. The upper airway is invested with several small and anatomically peculiar muscles. The muscle fiber orientations and their nervous innervation are both extremely complex, and how the activity of the muscles is initiated and adjusted during complex behaviors is poorly understood. The bulk of the evidence suggests that the entire assembly of tongue and laryngeal muscles operate together but differently during breathing and swallowing, like a ballet rather than a solo performance. Here we review the functional anatomy of the tongue and laryngeal muscles, and their neural innervation. We also consider how muscular activity is altered as respiratory drive changes, and briefly address upper airway muscle control during swallowing. PMID:24092695

Fregosi, Ralph F; Ludlow, Christy L

2014-02-01

157

Restoration of upper limb movement via artificial corticospinal and musculospinal connections in a monkey with spinal cord injury  

PubMed Central

Functional loss of limb control in individuals with spinal cord injury or stroke can be caused by interruption of corticospinal pathways, although the neural circuits located above and below the lesion remain functional. An artificial neural connection that bridges the lost pathway and connects cortical to spinal circuits has potential to ameliorate the functional loss. We investigated the effects of introducing novel artificial neural connections in a paretic monkey that had a unilateral spinal cord lesion at the C2 level. The first application bridged the impaired spinal lesion. This allowed the monkey to drive the spinal stimulation through volitionally controlled power of high-gamma activity in either the premotor or motor cortex, and thereby to acquire a force-matching target. The second application created an artificial recurrent connection from a paretic agonist muscle to a spinal site, allowing muscle-controlled spinal stimulation to boost on-going activity in the muscle. These results suggest that artificial neural connections can compensate for interrupted descending pathways and promote volitional control of upper limb movement after damage of descending pathways such as spinal cord injury or stroke.

Nishimura, Yukio; Perlmutter, Steve I.; Fetz, Eberhard E.

2013-01-01

158

Upper limb kinematical analysis of an elite weight lifter in the squat snatch.  

PubMed

The kinematical parameters such as translational acceleration and angular acceleration in the upper limb of a weightlifter may change regularly during different phases of squat snatch. This study aims to make this question clear. At first, the joint coordinate system (JCS) of human upper limb based on the anatomical landmarks is defined. Then a novel method for calculating the kinematical parameters was brought forward, which was based on analyzing the relative position of the JCS to world coordinate system during an instantaneous situation and the relationship among each JCS at different times during squat snatch. Motion capture system is used to gather the data of the upper limb in an elite weightlifter during squat snatch (the mass of the barbell is 20 kg) and the method mentioned before is applied to analyze the data. Finally, the law of the change of kinematical parameters in each phase of squat snatch is found. PMID:22800497

Tang, Gang; Qian, Liwei; Wang, Dongmei; Wei, Gaofeng; Chang, Daofang; Wang, Chengtao; Mi, Weijian

2012-07-16

159

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

PubMed

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

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

2014-05-01

160

Limb congestion enhances the synchronization of sympathetic outflow with muscle contraction  

NASA Technical Reports Server (NTRS)

In this report, we examined if the synchronization of muscle sympathetic nerve activity (MSNA) with muscle contraction is enhanced by limb congestion. To explore this relationship, we applied signal-averaging techniques to the MSNA signal obtained during short bouts of forearm contraction (2-s contraction/3-s rest cycle) at 40% maximal voluntary contraction for 5 min. We performed this analysis before and after forearm venous congestion; an intervention that augments the autonomic response to sustained static muscle contractions via a local effect on muscle afferents. There was an increased percentage of the MSNA noted during second 2 of the 5-s contraction/rest cycles. The percentage of total MSNA seen during this particular second increased from minute 1 to 5 of contraction and was increased further by limb congestion (control minute 1 = 25.6 +/- 2.0%, minute 5 = 32.8 +/- 2.2%; limb congestion minute 1 = 29.3 +/- 2.1%, minute 5 = 37.8 +/- 3.9%; exercise main effect <0.005; limb congestion main effect P = 0.054). These changes in the distribution of signal-averaged MSNA were seen despite the fact that the mean number of sympathetic discharges did not increase over baseline. We conclude that synchronization of contraction and MSNA is seen during short repetitive bouts of handgrip. The sensitizing effect of contraction time and limb congestion are apparently due to feedback from muscle afferents within the exercising muscle.

Mostoufi-Moab, S.; Herr, M. D.; Silber, D. H.; Gray, K. S.; Leuenberger, U. A.; Sinoway, L. I.

2000-01-01

161

A haptic-robotic platform for upper-limb reaching stroke therapy: Preliminary design and evaluation results  

PubMed Central

Background It has been shown that intense training can significantly improve post-stroke upper-limb functionality. However, opportunities for stroke survivors to practice rehabilitation exercises can be limited because of the finite availability of therapists and equipment. This paper presents a haptic-enabled exercise platform intended to assist therapists and moderate-level stroke survivors perform upper-limb reaching motion therapy. This work extends on existing knowledge by presenting: 1) an anthropometrically-inspired design that maximizes elbow and shoulder range of motions during exercise; 2) an unobtrusive upper body postural sensing system; and 3) a vibratory elbow stimulation device to encourage muscle movement. Methods A multi-disciplinary team of professionals were involved in identifying the rehabilitation needs of stroke survivors incorporating these into a prototype device. The prototype system consisted of an exercise device, postural sensors, and a elbow stimulation to encourage the reaching movement. Eight experienced physical and occupational therapists participated in a pilot study exploring the usability of the prototype. Each therapist attended two sessions of one hour each to test and evaluate the proposed system. Feedback about the device was obtained through an administered questionnaire and combined with quantitative data. Results Seven of the nine questions regarding the haptic exercise device scored higher than 3.0 (somewhat good) out of 4.0 (good). The postural sensors detected 93 of 96 (97%) therapist-simulated abnormal postures and correctly ignored 90 of 96 (94%) of normal postures. The elbow stimulation device had a score lower than 2.5 (neutral) for all aspects that were surveyed, however the therapists felt the rehabilitation system was sufficient for use without the elbow stimulation device. Conclusion All eight therapists felt the exercise platform could be a good tool to use in upper-limb rehabilitation as the prototype was considered to be generally well designed and capable of delivering reaching task therapy. The next stage of this project is to proceed to clinical trials with stroke patients.

Lam, Paul; Hebert, Debbie; Boger, Jennifer; Lacheray, Herve; Gardner, Don; Apkarian, Jacob; Mihailidis, Alex

2008-01-01

162

The sensitivity of a lower limb model to axial rotation offsets and muscle bounds at the knee  

PubMed Central

Soft tissue artifacts during motion capture can lead to errors in kinematics and incorrect estimation of joint angles and segment motion. The aim of this study was to evaluate the effect of shank segment axial rotation and knee rotator muscle bounds on predicted muscle and joint forces in a musculoskeletal model of the lower limb. A maximal height jump for ten subjects was analysed using the original motion data and then modified for different levels of internal and external rotation, and with the upper force bound doubled for five muscles. Both externally rotating the shank and doubling the muscle bounds increased the ability of the model to find a solution in regions of high loading. Muscle force levels in popliteus and tensor fascia latae showed statistically significant differences, but less so in plantaris, sartorius or gracilis. The shear and patellofemoral joint forces were found to be significantly affected by axial rotation during specific phases of the motion and were dependent on the amount of rotation. Fewer differences were observed when doubling the muscle bounds, except for the patellofemoral force and plantaris and sartorius muscle force, which were significantly increased in many of the jump phases. These results give an insight into the behaviour of the model and give an indication of the importance of accurate kinematics and subject-specific geometry.

Cleather, Daniel J; Weinert-Aplin, Robert A; Bull, Anthony MJ

2012-01-01

163

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

PubMed Central

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.

Ache, Jan M.

2012-01-01

164

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

PubMed Central

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.

2014-01-01

165

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

ERIC Educational Resources Information Center

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…

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

2011-01-01

166

Calibration of the Microwave Limb Sounder on the Upper Atmosphere Research Satellite  

NASA Technical Reports Server (NTRS)

The Microwave Limb Sounder (MLS) is a three-radiometer, passive, limb emission instrument onboard the Upper Atmosphere Research Satellite (UARS). Radiometric, spectral and field-of-view calibrations of the MLS instrument are described in this paper. In-orbit noise performance, gain stability, spectral baseline and dynamic range are described, as well as use of in-flight data for validation and refinement of prelaunch calibrations. Estimated systematic scaling uncertainties (3 sigma) on calibrated limb radiances from prelaunch calibrations are 2.6% in bands 1 through 3, 3.4% in band 4, and 6% in band 5. The observed systematic errors in band 6 are about 15%, consistent with prelaunch calibration uncertainties. Random uncertainties on individual limb radiance measurements are very close to the levels predicted from measured radiometer noise temperature, with negligible contribution from noise and drifts on the regular in-flight gain calibration measurements.

Jarnot, R. F.; Cofield, R. E.; Waters, J. W.; Flower, D. A.; Peckham, G. E.

1996-01-01

167

Effect of limb muscle fatigue on perception of respiratory effort in healthy subjects.  

PubMed

The role of nonrespiratory peripheral afferents in dyspnea perception has not been fully elucidated yet. Our hypothesis is that fatigue-induced activation of limb muscle metaboreceptors served by group IV fine afferent fibers may impact on respiratory effort perception. We studied 12 healthy subjects breathing against progressive inspiratory resistive loads (10, 18, 30, 40, and 90 cmH(2)O x l(-1) x s) before and after inducing low-frequency fatigue of quadriceps muscle by repeating sustained contractions at > or = 80% of maximal voluntary contraction. Subjects also underwent a sham protocol while performing two loaded breathing runs without muscle fatigue in between. During the loaded breathing, while subjects mimicked the quiet breathing pattern using a visual feedback, ventilation, tidal volume, respiratory frequency, pleural pressure swings, arterial oxygen saturation, end-tidal partial pressure of CO(2), and dyspnea by a Borg scale were recorded. Compared with prefatigue, limb muscle fatigue resulted in a higher increase in respiratory effort perception for any given ventilation, tidal volume, respiratory frequency, pleural pressure swings, end-tidal partial pressure of CO(2), and arterial oxygen saturation. No difference between the two runs was observed with the sham protocol. The present data support the hypothesis that fatigue of limb muscles increases respiratory effort perception associated with loaded breathing, likely by the activation of limb muscle metaboreceptors. PMID:20489040

Grippo, Antonello; Carrai, Riccardo; Chiti, Linda; Bruni, Giulia Innocenti; Scano, Giorgio; Duranti, Roberto

2010-08-01

168

Basis for an FCE Methodology for Patients With Work-Related Upper Limb Disorders  

Microsoft Academic Search

A reported reduction in work-related functional capacity in Work-related Upper Limb Disorders (WRULD) patients is among the most common problems in WRULD. The extent to which this reduction in functional capacity can be objectified remains unknown. A validated instrument to test functional capacity in this patient group is unavailable. The objective of this study was to design a Functional Capacity

M. F. Reneman; R. Soer; E. H. J. Gerrits

2005-01-01

169

Chronic compartment syndrome, an important cause of work-related upper limb disorder  

Microsoft Academic Search

Objectives. Work-related upper limb disorders (WRULD) are common and disabling complaints in industry, but a tissue diagnosis can be difficult where the pain is diffuse and variable, and this prevents effective treatment. Diffuse arm pain is frequently found in those doing rapid or strenuous repetitive work, such as factory assembly workers or keyboard operators. Similar symptoms occur in the legs

M. H. Pritchard; R. L. Williams; J. P. Heath

2005-01-01

170

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

Microsoft Academic Search

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

Michela Goffredo; Ivan Bernabucci; Maurizio Schmid; Silvia Conforto

2008-01-01

171

[Anatomic bases of surgical approaches to the nerves of the upper limb: tips for young surgeons].  

PubMed

Peripheral nerve surgery requires a certain level of specialization. Surgeons must have solid knowledge of morphological anatomy of the different segments to be explored, decompressed, repaired, or even neurotized. This paper describes the most common approaches to the peripheral nerves of the upper limb. PMID:19783016

Rigoard, P; Buffenoir-Billet, K; Giot, J-P; Delmotte, A; d'Houtaud, S; Lapierre, F

2009-10-01

172

Animation of 3D Avatars for Rehabilitation of the Upper Limbs  

Microsoft Academic Search

The paper presents a 3D Virtual Environment (VE) for neurorehabilitation of the upper limb. Patients move one of their arms trying to simulate concrete daily actions, such as grasping a bottle, opening a door or putting a book on a shelve. They wear a special garment that integrates four inertial sensors providing in real time information on the orientation of

Sergio Moya; Sergi Grau; Dani Tost; Ricard Campeny; Marcel Ruiz

2011-01-01

173

Evaluation of Spasticity in Upper Limbs of Hemiplegic Subjects Using a Mathematical Model.  

National Technical Information Service (NTIS)

The purpose of this study is to propose a new technique for evaluating spasticity in the upper limbs of hemiplegic patients. Each subject lay on a bed, and his forearm was supported with a jig to measure the elbow joint angle. The subject was instructed t...

T. Uchiyama C. Fukuyo R. Uchida

2001-01-01

174

Self reported symptoms in the neck and upper limbs in nurses  

Microsoft Academic Search

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

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

1996-01-01

175

Association between Severe Upper Limb Spasticity and Brain Lesion Location in Stroke Patients  

PubMed Central

Association between the site of brain injury and poststroke spasticity is poorly understood. The present study investigated whether lesion analysis could document brain regions associated with the development of severe upper limb poststroke spasticity. A retrospective analysis was conducted on 39 chronic stroke patients. Spasticity was assessed at the affected upper limb with the modified Ashworth scale (shoulder, elbow, wrist, and fingers). Brain lesions were traced from magnetic resonance imaging performed within the first 7 days after stroke and region of interest images were generated. The association between severe upper limb spasticity (modified Ashworth scale ?2) and lesion location was determined with the voxel-based lesion-symptom mapping method implemented in MRIcro software. Colored maps representing the z statistics were generated and overlaid onto the automated anatomical labeling and the Johns Hopkins University white matter templates provided with MRIcron. Thalamic nuclei were identified with the Talairach Daemon software. Injuries to the insula, the thalamus, the basal ganglia, and white matter tracts (internal capsule, corona radiata, external capsule, and superior longitudinal fasciculus) were significantly associated with severe upper limb poststroke spasticity. Further advances in our understanding of the neural correlates of spasticity may lead to early targeted rehabilitation when key regions are damaged.

Picelli, Alessandro; Tamburin, Stefano; Gajofatto, Francesca; Zanette, Giampietro; Praitano, Marialuigia; Saltuari, Leopold; Corradini, Claudio; Smania, Nicola

2014-01-01

176

An integrated computer-based system to study neuromuscular disorders of the upper limb  

Microsoft Academic Search

A multi-channel computer-based clinical instrument was developed to simultaneously acquire, process, display, quantify and correlate electromyographic (EMG) activity, resistive torque, range of motion (ROM), and pain levels in the upper limbs of humans. Each channel consisted of a time and frequency domain block, a torque and angle measurement block, an experiment number counter block and a data storage and retrieval

H. Nazeran; S. Jaberzadeh

2002-01-01

177

Computer-based clinical instrumentation for processing and analysis of electroneuromyographic signals in the upper limb  

Microsoft Academic Search

A computer-based clinical instrument was developed to simultaneously acquire, process, display, quantify and correlate electroneuromyographic (ENMG) activity in the upper limb in humans. This system was designed around AMLAB® analog modules and software objects called ICAMs. The system consists of a nerve stimulator block, a time domain, EMG block with evoked response averaging capability, a counter block and a data

H. Nazeran; S. Jaberzadeh; K. Behbehani

2001-01-01

178

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

ERIC Educational Resources Information Center

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…

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

2011-01-01

179

Association between Severe Upper Limb Spasticity and Brain Lesion Location in Stroke Patients.  

PubMed

Association between the site of brain injury and poststroke spasticity is poorly understood. The present study investigated whether lesion analysis could document brain regions associated with the development of severe upper limb poststroke spasticity. A retrospective analysis was conducted on 39 chronic stroke patients. Spasticity was assessed at the affected upper limb with the modified Ashworth scale (shoulder, elbow, wrist, and fingers). Brain lesions were traced from magnetic resonance imaging performed within the first 7 days after stroke and region of interest images were generated. The association between severe upper limb spasticity (modified Ashworth scale ?2) and lesion location was determined with the voxel-based lesion-symptom mapping method implemented in MRIcro software. Colored maps representing the z statistics were generated and overlaid onto the automated anatomical labeling and the Johns Hopkins University white matter templates provided with MRIcron. Thalamic nuclei were identified with the Talairach Daemon software. Injuries to the insula, the thalamus, the basal ganglia, and white matter tracts (internal capsule, corona radiata, external capsule, and superior longitudinal fasciculus) were significantly associated with severe upper limb poststroke spasticity. Further advances in our understanding of the neural correlates of spasticity may lead to early targeted rehabilitation when key regions are damaged. PMID:24963473

Picelli, Alessandro; Tamburin, Stefano; Gajofatto, Francesca; Zanette, Giampietro; Praitano, Marialuigia; Saltuari, Leopold; Corradini, Claudio; Smania, Nicola

2014-01-01

180

Acquisition and Interpretation of Upper Limbs Tremor Signal in Parkinsonian Disease  

Microsoft Academic Search

The paper describes a method for measurement and visualization of upper limbs tremor, making use of digital camcorders for registration of moving point light sources. The measurement is done separately for the three principal planes of the Cartesian coordinate system. The present work contains a description of the measurement stand and measurement method, the obtained results and the prospects for

ANDRZEJ IZWORSKI; RYSZARD TADEUSIEWICZ; IRENEUSZ WOCHLIK

181

A 6DOF Gait Rehabilitation Robot With Upper and Lower Limb Connections That Allows Walking Velocity Updates on Various Terrains  

Microsoft Academic Search

This paper presents a 6-DOF gait rehabilitation robot that allows patients to update their walking velocity on various terrain types and navigate in virtual environments (VEs) through upper and lower limb connections. This robot is composed of an upper limb device, a sliding device, two footpad devices, and a body support system. The footpad device on the sliding device generates

Jungwon Yoon; Bondhan Novandy; Chul-Ho Yoon; Ki-Jong Park

2010-01-01

182

Movement variability in stroke patients and controls performing two upper limb functional tasks: a new assessment methodology  

Microsoft Academic Search

BACKGROUND: In the evaluation of upper limb impairment post stroke there remains a gap between detailed kinematic analyses with expensive motion capturing systems and common clinical assessment tests. In particular, although many clinical tests evaluate the performance of functional tasks, metrics to characterise upper limb kinematics are generally not applicable to such tasks and very limited in scope. This paper

Sibylle B Thies; Phil A Tresadern; Laurence P Kenney; Joel Smith; David Howard; John Y Goulermas; Christine Smith; Julie Rigby

2009-01-01

183

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

Microsoft Academic Search

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

MASSIMO BOVENZI; ANTONELLA ZADINI; ANDREA FRANZINELLI; FLAVIO BORGOGNI

1991-01-01

184

Timing training in three children with diplegic cerebral palsy: short- and long-term effects on upper-limb movement organization and functioning.  

PubMed

Despite the great need of interventions to maintain and improve motor functions in children with diplegic cerebral palsy (DCP), scientific evaluations of existing training methods are rare. This study aimed to explore individual effects of synchronized metronome training (SMT) on motor timing, spatio-temporal movement organization, and subjective experiences of changes in upper-limb functions in three children with DCP. All children participated in an individualized 4-week/12 session SMT training regime. Measurements before training (Pre), after training (Post1), and at 6?months post completed training (Post2) were made by the applied SMT training equipment, optoelectronic registrations of goal-directed upper-limb movements, and a questionnaire assessing subjective experiences of changes in upper-limb functions and usability. In general, the training regime was shown to have little effect on motor timing. However, some positive changes in spatio-temporal movement organization were found. Two children also reported substantial long-lasting positive changes in subjective experiences of hand/arm functionality in terms of increased movement control and reduced muscle tone. For these children, parallel kinematic findings also indicated smoother and faster movement trajectories that remained at Post2. Although highly individualized, the shown improvements in upper-limb kinematics and subjective experiences of improved functionality of the hands/arms for two of the cases warrant further explorations of SMT outcomes in children with DCP. PMID:24744747

Johansson, Anna-Maria; Domellöf, Erik; Rönnqvist, Louise

2014-01-01

185

Timing Training in Three Children with Diplegic Cerebral Palsy: Short- and Long-Term Effects on Upper-Limb Movement Organization and Functioning  

PubMed Central

Despite the great need of interventions to maintain and improve motor functions in children with diplegic cerebral palsy (DCP), scientific evaluations of existing training methods are rare. This study aimed to explore individual effects of synchronized metronome training (SMT) on motor timing, spatio-temporal movement organization, and subjective experiences of changes in upper-limb functions in three children with DCP. All children participated in an individualized 4-week/12 session SMT training regime. Measurements before training (Pre), after training (Post1), and at 6?months post completed training (Post2) were made by the applied SMT training equipment, optoelectronic registrations of goal-directed upper-limb movements, and a questionnaire assessing subjective experiences of changes in upper-limb functions and usability. In general, the training regime was shown to have little effect on motor timing. However, some positive changes in spatio-temporal movement organization were found. Two children also reported substantial long-lasting positive changes in subjective experiences of hand/arm functionality in terms of increased movement control and reduced muscle tone. For these children, parallel kinematic findings also indicated smoother and faster movement trajectories that remained at Post2. Although highly individualized, the shown improvements in upper-limb kinematics and subjective experiences of improved functionality of the hands/arms for two of the cases warrant further explorations of SMT outcomes in children with DCP.

Johansson, Anna-Maria; Domellof, Erik; Ronnqvist, Louise

2014-01-01

186

Nature and incidence of upper limb injuries in professional cricket players a prospective observation  

PubMed Central

Introduction Cricket is the most popular sport in India, and is gaining in importance in all south-east Asian countries. The purpose of this study was to prospectively investigate the incidence, nature, and site of acute upper limb injuries sustained by professional cricketers of north India over a period of one year. Material & methods 95 cricket players (mean age 18.9 years) were prospectively evaluated for nature and incidence of upper limb injuries from 1st November 2008 to 31st October 2009. For the purpose of comparison the calculated injury incidence included injuries sustained during match as well as practice. Injuries were also grouped according to the type of cricket activities such as batting or fielding. Results Out of 95 players evaluated, 24 were bowlers, 19 were batsmen, 8 were wicket keepers and the other 44 cricketers declared themselves as all rounders. There were a total of 16 upper limb injuries in 16 (16.8%) players. The majority of injuries (10/16) occurred while fielding. Out of 16 injuries, 11 were seen in hand, 3 were observed in elbow, while 2 patients suffered from shoulder problem. Twelve were acute injuries while 4 were classified as repetitive stress injuries (RSI). Conclusion The incidence of upper limb injuries in cricketers at the professional and semi-professional level is significant, causing them to miss matches or practice for a significant number of days. This is the first study of Indian cricketers which documents the high incidence of upper limb injuries. The study highlights the importance of injury surveillance for Indian cricket. It is a concern which needs to be addressed by the players, coaches, teachers, administrators and medical personnel involved with cricket.

2012-01-01

187

Controlling a multi-degree of freedom upper limb prosthesis using foot controls: user experience.  

PubMed

Abstract Purpose: The DEKA Arm, a pre-commercial upper limb prosthesis, funded by the DARPA Revolutionizing Prosthetics Program, offers increased degrees of freedom while requiring a large number of user control inputs to operate. To address this challenge, DEKA developed prototype foot controls. Although the concept of utilizing foot controls to operate an upper limb prosthesis has been discussed for decades, only small-sized studies have been performed and no commercial product exists. The purpose of this paper is to report amputee user perspectives on using three different iterations of foot controls to operate the DEKA Arm. Method: Qualitative data was collected from 36 subjects as part of the Department of Veterans Affairs (VA) Study to Optimize the DEKA Arm through surveys, interviews, audio memos, and videotaped sessions. Three major, interrelated themes were identified using the constant comparative method: attitudes towards foot controls, psychomotor learning and physical experience of using foot controls. Results: Feedback about foot controls was generally positive for all iterations. The final version of foot controls was viewed most favorably. Conclusions: Our findings indicate that foot controls are a viable control option that can enable control of a multifunction upper limb prosthesis (the DEKA Arm). Implications for Rehabilitation Multifunction upper limb prostheses require many user control inputs to operate. Foot controls offer additional control input options for such advanced devices, yet have had minimal study. This study found that foot controls were a viable option for controlling multifunction upper limb prostheses. Most of the 36 subjects in this study were willing to adopt foot controls to control the multiple degrees of freedom of the DEKA Arm. With training and practice, all users were able to develop the psychomotor skills needed to successfully operate food controls. Some had initial difficulty, but acclimated over time. PMID:23902465

Resnik, Linda; Klinger, Shana Lieberman; Etter, Katherine; Fantini, Christopher

2014-07-01

188

Eccentric exercise affects the upper limbs more than the lower limbs in position sense and reaction angle.  

PubMed

In this study, we investigated the effect of eccentric exercise on position sense and reaction angle of the elbow and knee flexors. Twelve males underwent two eccentric exercise sessions involving a randomized crossover design. In the first session participants used their elbow flexors and in the other session their knee flexors. Muscle damage indices, position sense, and joint reaction angle to release of the elbow and knee flexors were measured before, immediately after, and up to 7 days after exercise. Exercise induced greater muscle damage in the elbow flexors than knee flexors. Exercise disturbed position sense of the elbow and knee joint. For both limbs, the participants adopted a more extended position than the reference angle. The elbow and knee joint reaction angles to release increased after exercise for both the elbow and knee flexors. The disturbances in position sense and reaction angle after exercise were greater in the elbow flexors than knee flexors. The elbow flexors remained more accurate and faster than the knee flexors at all time points. These results may be explained by the higher density of muscle spindles and the lower innervation ratio of the elbow flexors compared with the knee flexors, as well as the fact that the arms are more accustomed than the legs to perform fast and accurate movements. PMID:20013463

Paschalis, Vassilis; Nikolaidis, Michalis G; Theodorou, Anastasios A; Giakas, Giannis; Jamurtas, Athanasios Z; Koutedakis, Yiannis

2010-01-01

189

Hands in motion: an upper-limb-selective area in the occipitotemporal cortex shows sensitivity to viewed hand kinematics.  

PubMed

Regions in the occipitotemporal cortex (OTC) show clear selectivity to static images of human body parts, and upper limbs in particular, with respect to other object categories. Such selectivity was previously attributed to shape aspects, which presumably vary across categories. Alternatively, it has been proposed that functional selectivity for upper limbs is driven by processing of their distinctive motion features. In the present study we show that selectivity to static upper-limb images and motion processing go hand in hand. Using resting-state and task-based functional MRI, we demonstrate that OTC voxels showing greater preference to static images of arms and hands also show stronger functional connectivity with motion coding regions within the human middle temporal complex (hMT+), but not with shape-selective midtier areas, such as hV4 or LO-1, suggesting a tight link between upper-limb selectivity and motion processing. To test this directly, we created a set of natural arm-movement videos where kinematic patterns were parametrically manipulated, while keeping shape information constant. Using multivariate pattern analysis, we show that the degree of (dis)similarity in arm-velocity profiles across the video set predicts, to a significant extent, the degree of (dis)similarity in multivoxel activation patterns in both upper-limb-selective OTC regions and the hMT+. Together, these results suggest that the functional specificity of upper-limb-selective regions may be partially determined by their involvement in the processing of upper-limb dynamics. We propose that the selectivity to static upper-limb images in the OTC may be a result of experience-dependent association between shape elements, which characterize upper limbs, and upper-limb-specific motion patterns. PMID:24695707

Orlov, Tanya; Porat, Yuval; Makin, Tamar R; Zohary, Ehud

2014-04-01

190

The role of upper limb segment rotations in the development of spin in the tennis forehand.  

PubMed

Increased topspin in the tennis forehand is produced by maintaining a perpendicular racket-face to the court surface at impact and increasing the trajectory and vertical velocity of the racket-head. These modifications to stroke technique from those previously identified in the flat forehand drive are the result of changes to the movement patterns of the segments of the upper limb. The contributions that the upper limb segment's anatomical rotations make to racket-head velocity at impact depend on both their angular velocity and the instantaneous position of the racket with respect to these movements. Six high performance tennis players were filmed at a nominal rate of 200 Hz by three Photosonics cameras while hitting flat (no spin) and topspin groundstrokes and a forehand topspin lob. The three-dimensional (3-D) displacement histories of 16 selected landmarks were then calculated using the direct linear transformation approach and 3-D individual segment rotations for the upper limb were calculated using vector equations. Significant differences were recorded in the effect that the various segment rotations made to the x-direction (forward) and y-direction (upward) impact velocities of the racket-head. These differences were not reflected in the contributions to racket-head velocity when the absolute velocities were expressed relative to the impact velocity. Trunk rotation, upper arm flexion/abduction, upper arm internal rotation, hand palmar and ulnar flexion all played integral roles in producing impact racket speed. PMID:9040900

Takahashi, K; Elliott, B; Noffal, G

1996-12-01

191

ELECTRICAL ACTIVITY AND RELATIVE LENGTH CHANGES OF DOG LIMB MUSCLES AS A FUNCTION OF SPEED AND GAIT  

Microsoft Academic Search

SUMMARY Electrical activity and length changes of 11 muscles of the fore- and hind- limbs of dogs walking, running, and galloping on a treadmill, were measured as a function of forward speed and gait. Our purpose was to find out whether the activity patterns of the major limb muscles were consistent with the two mechanisms proposed for storage and recovery

G. E. GOSLOW; H. J. SEEHERMANf; C. R. TAYLOR

1981-01-01

192

Effect of Systemic Inflammation on Inspiratory and Limb Muscle Strength and Bulk in Cystic Fibrosis  

Microsoft Academic Search

inflammation. Objectives: To assess the impact of systemic inflammation on diaphragm and limb muscle strength and bulk in adult patients with CF. Methods: In 38 stable patients with CF and 20 matched control subjects, we measured fat-free mass (FFM), inspiratory muscle strength, diaphragm thickness, quadriceps and biceps strength and cross-sectional area, and circulating levels of leukocytes, C-reactive protein, IL-6, IL-8,

Valerie Dufresne; Christiane Knoop; Alain Van Muylem; Anne Malfroot; M. Lamotte; Christian Opdekamp; G. Deboeck; M. Cassart; Bernard Stallenberg; Georges Casimir; Jean Duchateau; Marc Estenne

2009-01-01

193

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

NASA Technical Reports Server (NTRS)

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.

Kuzmina, G. I.

1980-01-01

194

Examination of Force Discrimination in Human Upper Limb Amputees With Reinnervated Limb Sensation Following Peripheral Nerve Transfer  

PubMed Central

Artificial limbs allow amputees to manipulate objects, but the loss of a limb severs the sensory link between a subject and objects they touch. A novel surgical technique we term targeted reinnervation (TR) allows severed cutaneous nerves to reinnervate skin on a different portion of the body. This technique provides a physiologically appropriate portal to the sensory pathways of the missing limb through the reinnervated skin. This study quantified the ability of three amputee subjects who had undergone TR surgery on the chest (two subjects) and upper arm (one subject) to discriminate changes in graded force on their reinnervated skin over a range of 1–4 N using a stochastic staircase approach. These values were compared to those from sites on their intact contralateral skin and index fingers, and from the chests and index fingers of a control population (n = 10). Weber’s ratio (WR) was used to examine the subjects’ abilities to discriminate between a baseline force and subsequent forces of different magnitudes. WRs of 0.22, 0.25, and 0.12 were measured on the reinnervated skin of the three TR subjects, whereas WRs of 0.25,0.23, and 0.12 were measured on their contralateral skin. TR subjects did not have substantially different WRs on their reinnervated versus their contralateral normal side and did not appear to exhibit a trend towards impaired sensation. No significant difference was found between the WR of the chest and index finger of the control subjects, which ranged between 0.09 and 0.21. WR of reinnervated skin for TR subjects were within the 95% confidence interval of the control group. These data suggest that subjects with targeted reinnervation have unimpaired ability to discriminate gradations in force.

Sensinger, Jonathon W.; Schultz, Aimee E.; Kuiken, Todd A.

2011-01-01

195

The influence of footwear on the electromyographic activity of selected lower limb muscles during walking.  

PubMed

The purpose of this study was to compare the effects of a standard flexible shoe and a stability running shoe on lower limb muscle activity during walking. Twenty-eight young asymptomatic adults with flat-arched feet were recruited. While walking, electromyographic (EMG) activity was recorded from tibialis posterior and peroneus longus via intramuscular electrodes; and from tibialis anterior and medial gastrocnemius via surface electrodes. Three experimental conditions were assessed: (i) barefoot, (ii) a standard flexible shoe, (iii) a stability running shoe. Results showed significant differences for the peak amplitude and the time of peak amplitude for tibialis anterior, peroneus longus and medial gastrocnemius when comparing the three experimental conditions (p < 0.05). Significant differences were detected primarily between the barefoot and shoe conditions and with relatively small effect sizes for peroneus longus, tibialis anterior and medial gastrocnemius. Few significant differences were found between the two shoe styles. We discuss how these changes are most likely associated with the shoe upper bracing the foot, the shape of the shoe outer-sole and weight of the shoes. Further research is needed to investigate differences between these shoe styles when participants walk for longer distances (i.e. over 1000 m) and following fatigue. PMID:22835487

Scott, Lisa A; Murley, George S; Wickham, James B

2012-12-01

196

Electroacupuncture for decorticate rigidity of the upper limbs in a patient with anoxic brain damage.  

PubMed

Decorticate rigidity is a type of abnormal posturing that can make it difficult to move a patient and to change the patient's position to prevent a decubitus ulcer. This condition poses a latent risk of bed sores. To prevent those complications, we used electroacupuncutre for decorticate rigidity of the upper limbs in a patient with anoxic brain damage. A 51-year-old man complained of rigidity of both of the upper and lower extremities due to anoxic brain damage. His rigidity was exhibited as flexed arms and extended legs, which are the typical positions in decorticate rigidity. Prior to electroacupuncture, his decorticate rigidity was treated with dantrolene sodium and baclofen. However, his rigidity had not improved. This patient received total 41 sessions of electroacupuncture. The patient's Modified Ashworth's Scale changed from 4 at baseline to 2 after the treatment, indicating an improvement in the rigidity of the upper limbs. Preston's Hypertonicity Scale and passive ROM of the elbow joints also improved. We report the observed effects of electroacupuncture for decorticate rigidity of the upper limbs in a patient with anoxic brain damage. Further controlled studies are needed to determine whether electroacupuncture is a useful alternative treatment for decorticate rigidity in patients with anoxic brain damage. PMID:24198837

Jung, Woosang; Kwon, Seungwon; Park, Seonguk; Moon, Sangkwan; Park, Jungmi; Ko, Changnam; Cho, Kiho

2013-01-01

197

Electroacupuncture for Decorticate Rigidity of the Upper Limbs in a Patient with Anoxic Brain Damage  

PubMed Central

Decorticate rigidity is a type of abnormal posturing that can make it difficult to move a patient and to change the patient's position to prevent a decubitus ulcer. This condition poses a latent risk of bed sores. To prevent those complications, we used electroacupuncutre for decorticate rigidity of the upper limbs in a patient with anoxic brain damage. A 51-year-old man complained of rigidity of both of the upper and lower extremities due to anoxic brain damage. His rigidity was exhibited as flexed arms and extended legs, which are the typical positions in decorticate rigidity. Prior to electroacupuncture, his decorticate rigidity was treated with dantrolene sodium and baclofen. However, his rigidity had not improved. This patient received total 41 sessions of electroacupuncture. The patient's Modified Ashworth's Scale changed from 4 at baseline to 2 after the treatment, indicating an improvement in the rigidity of the upper limbs. Preston's Hypertonicity Scale and passive ROM of the elbow joints also improved. We report the observed effects of electroacupuncture for decorticate rigidity of the upper limbs in a patient with anoxic brain damage. Further controlled studies are needed to determine whether electroacupuncture is a useful alternative treatment for decorticate rigidity in patients with anoxic brain damage.

Jung, WooSang; Kwon, SeungWon; Park, SeongUk; Moon, SangKwan; Park, JungMi; Ko, ChangNam; Cho, KiHo

2013-01-01

198

Low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy for poststroke patients with upper limb hemiparesis: preliminary study of a 15-day protocol.  

PubMed

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 ± 17years, time after stroke 57± 55 months) with upper limb hemiparesis categorized as Brunnstrom stages 3–5 forhand–fingers were recruited. They were considered to have reached a plateau state at study entry, based on the lack of any increase in Fugl–Meyer Assessment (FMA) Score inthe last 3 months. During the 15-day hospitalization, each patient received 22 sessions of rTMS with 1 Hz applied to the contralesional cerebral hemisphere, followed by intensive OT (one-to-one training including shaping techniques and self training). Upper limb motor function was evaluated by FMA and Wolf Motor Function Test at admission and discharge. The spasticity of finger flexors,wrist flexors and elbow flexors in the affected upper limb was also evaluated with Modified Ashworth Scale. The15-day protocol was well tolerated by all patients. Atdischarge, the FMA Score was increased in all 15 patients(17–57 to 18–61 points). Shortening of performance time on Wolf Motor Function Test was noted in 12 patients(44–1584 to 39–1485 s). The Modified Ashworth ScaleScore for some flexor muscles decreased in 12 patients.In conclusion, our 15-day protocol of low-frequency rTMS combined with intensive OT seems feasible not only for improving motor function, but also for reducing spasticity in the affected upper limb in post stroke hemiparetic patients. PMID:20613547

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

2010-12-01

199

Acquisition of the lateral inconsistency in involuntary behaviour of upper limbs in 12-year-old children during walking at moderate speed.  

PubMed

The aim of this work was to investigate possible lateralisation in the behaviour of periodic motion of the human upper limb, during normal walking at a comfortable speed of locomotion. Ten healthy pre-adolescent, strongly right-handed, 12-year-old males participated in the experiment. Participants were walking on a treadmill with a standardised velocity of 1.1m/s (comfortable speed for all of them). A video analysis system with Silicon software was used to synchronically measure various angles of arms and forearms. The initial, final and interim angular positions of both arms and forearms in 10 cycles of each participant were compared in terms of variations (cycle to cycle) between both upper extremities at corresponding phases of each cycle for distal and proximal segments, respectively. We compared the coefficients of variation in relation to the spatial and temporal data of both limbs and their angular velocities. In addition we investigated the level of cycle-to-cycle regularity (constancy) of behaviour in relation to various positions, periods and velocities of movement of upper extremities (specifically arms and forearms) using the Eta non-linear method of correlation. All participants exhibited a lower level of regularity for the distal segments. The spatial and temporal variations in the dominant limb were also greater than the non-dominant limb for all participants. This may be due to a larger contribution from the right-sided muscles that are considered to be the main contributing factor to the motion of the dominant upper limb during walking, rather than simply gravity force acting alone. A possible practical application of this information may be useful in the objective clinical identification of the level of dominance of the upper extremity (arm plus forearm), in addition to 'traditional' handedness. PMID:16458730

Gutnik, B; Degabriele, R; Bailey, K; Hudson, G

2006-01-01

200

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

PubMed

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

Delvolvé, I; Bem, T; Cabelguen, J M

1997-08-01

201

Use of Electrically Stimulated Muscle as a Controlled Actuator of a Limb.  

National Technical Information Service (NTIS)

The feasibility of inducing controlled movement of a paralyzed limb by means of applying electric currents is discussed. This is preceded by a functional description of muscle and its electrical excitability and the musculo-skeletal system of the human ar...

W. J. Crochetiere

1967-01-01

202

P-31 Magnetic Resonance Spectroscopy (MRS) of Limb Muscles during Bedrest with Exercise Countermeasures.  

National Technical Information Service (NTIS)

Nineteen volunteers in bed with head down tilt (-6 deg) for 1 month and doing or not exercise training while in bed (lido or ergometer) had their limb muscle studied by magnetic resonance spectroscopy. A protocol of repetitive exercise in the magnet was s...

P. Berry I. Berry S. Arnaud M. Moseley

1987-01-01

203

Heterogeneous atrophy occurs within individual lower limb muscles during 60 days of bed rest.  

PubMed

To better understand disuse muscle atrophy, via magnetic resonance imaging, we sequentially measured muscle cross-sectional area along the entire length of all individual muscles from the hip to ankle in nine male subjects participating in 60-day head-down tilt bed rest (2nd Berlin BedRest Study; BBR2-2). We hypothesized that individual muscles would not atrophy uniformly along their length such that different regions of an individual muscle would atrophy to different extents. This hypothesis was confirmed for the adductor magnus, vasti, lateral hamstrings, medial hamstrings, rectus femoris, medial gastrocnemius, lateral gastrocnemius, tibialis posterior, flexor hallucis longus, flexor digitorum longus, peroneals, and tibialis anterior muscles (P ? 0.004). In contrast, the hypothesis was not confirmed in the soleus, adductor brevis, gracilis, pectineus, and extensor digitorum longus muscles (P ? 0.20). The extent of atrophy only weakly correlated (r = -0.30, P < 0.001) with the location of greatest cross-sectional area. The rate of atrophy during bed rest also differed between muscles (P < 0.0001) and between some synergists. Most muscles recovered to their baseline size between 14 and 90 days after bed rest, but flexor hallucis longus, flexor digitorum longus, and lateral gastrocnemius required longer than 90 days before recovery occurred. On the basis of findings of differential atrophy between muscles and evidence in the literature, we interpret our findings of intramuscular atrophy to reflect differential disuse of functionally different muscle regions. The current work represents the first lower-limb wide survey of intramuscular differences in disuse atrophy. We conclude that intramuscular differential atrophy occurs in most, but not all, of the muscles of the lower limb during prolonged bed rest. PMID:22984243

Miokovic, Tanja; Armbrecht, Gabriele; Felsenberg, Dieter; Belavý, Daniel L

2012-11-01

204

Development of rehabilitation training support system for occupational therapy of upper limb motor function  

NASA Astrophysics Data System (ADS)

In this paper we propose a new rehabilitation training support system for upper limbs. The proposed system enables therapists to quantitatively evaluate the therapeutic effect of upper limb motor function during training, to easily change the load of resistance of training and to easily develop a new training program suitable for the subjects. For this purpose we develop control algorithms of training programs in the 3D force display robot. The 3D force display robot has parallel link mechanism with three motors. The control algorithm simulating sanding training is developed for the 3D force display robot. Moreover the teaching/training function algorithm is developed. It enables the therapists to easily make training trajectory suitable for subject's condition. The effectiveness of the developed control algorithms is verified by experiments.

Morita, Yoshifumi; Hirose, Akinori; Uno, Takashi; Uchid, Masaki; Ukai, Hiroyuki; Matsui, Nobuyuki

2007-12-01

205

Characteristics of human knee muscle coordination during isometric contractions in a standing posture: the effect of limb task.  

PubMed

Different functional roles for the hands have been demonstrated, however leg control is not as well understood. The purpose of the present study was to evaluate bilateral knee neuromuscular control to determine if the limb receiving greater attention would have more well-tuned control compared to an unattended limb. Surface electrodes were placed on seven muscles of each limb, before standing on two force platforms. Visual feedback was given of the forces and moments of the "focus limb," but not the "unattended limb." Static isometric forces were matched with their focus limb, requiring their unattended limb to push in the opposite direction, using a combination of forward-backward-medial-lateral shear forces while muscle activity was collected bilaterally. There was a significant main effect for limb task (p = 0.02), with the medial hamstrings being more specific (p = 0.001) while performing the unattended limb and the lateral hamstring being more well-tuned (p = 0.007) while performing the focus limb task. The focus limb's medial and lateral gastrocnemius were principally active in the forwards direction, but only the unattended limb's lateral gastrocnemius was active in the backwards direction. Findings suggest unique neuromuscular control strategies are used for the legs depending on limb task. PMID:23790392

MacLeod, Toran D; Manal, Kurt; Silbernagel, Karin Grävare; Snyder-Mackler, Lynn; Buchanan, Thomas S

2013-12-01

206

Physical workload on neck and upper limb using two CAD applications  

Microsoft Academic Search

The aim was to evaluate (1) the physical workload on neck and upper limb in computer-aided design (CAD) work; (2) the impact of two applications (PROFESSIONAL-CADAM® and PRO\\/Engineering®) and (3) two input devices (computer mouse and keyboard), as well as (4) sitting and standing work positions. Fifteen CAD operators were interviewed and examined physically. For nine subjects, the physical workload

Jeannette Unge Byström; Gert-Åke Hansson; Lars Rylander; Kerstina Ohlsson; Gabriella Källrot; Staffan Skerfving

2002-01-01

207

Coordination between upper- and lower-limb movements is different during overground and treadmill walking  

Microsoft Academic Search

Locomotion studies employ either treadmill (TW) or overground walking (OW), considering that differences between them are\\u000a negligible. The present study tests this notion by comparing coordination between upper- and lower-limb movements in healthy\\u000a individuals during OW and TW at matched speeds. Results indicated that TW induced a higher cadence, which highly influenced\\u000a interlimb coordination, in terms of frequency coupling and

Ilaria Carpinella; Paolo Crenna; Marco Rabuffetti; Maurizio Ferrarin

2010-01-01

208

Deviations in upper-limb function of the less-affected side in congenital hemiparesis  

Microsoft Academic Search

In the present study we examined upper-limb function of the less-affected side in young adolescents with congenital hemiparesis (cerebral palsy: CP). Five participants with hemiparetic CP and five control participants performed a cyclical reach-and-grasp task with the less-affected hand towards targets placed at 60%, 100%, and 140% of the participant's arm-length. Trunk involvement, end-effector kinematics and activation of the biceps

Bert Steenbergen; Ruud G. J. Meulenbroek

2006-01-01

209

P-31 Magnetic Resonance Spectroscopy (MRS) of limb muscles during bedrest with exercise countermeasures  

NASA Technical Reports Server (NTRS)

Nineteen volunteers in bed with head down tilt (-6 deg) for 1 month and doing or not exercise training while in bed (lido or ergometer) had their limb muscle studied by magnetic resonance spectroscopy. A protocol of repetitive exercise in the magnet was set and a wooden probe designed to support the limb and to allow exercise. Spectra were recorded continuously during the protocol. In each spectrum, inorganic phosphate, phosphocreatin, adenosin triphosphate, and pH were measured. All the subjects were studied before, after bedrest, and 6 weeks later. After 1 month, the lido group show no changes in the spectra of their leg muscles while the group doing no exercise or ergometer do. For the arms, a loss of muscle function is only seen in the group doing no exercise.

Berry, P.; Berry, I.; Arnaud, S.; Moseley, M.

1987-01-01

210

Tuning Algorithms for Control Interfaces for Users with Upper Limb Impairments  

PubMed Central

Objective Approximately 40% of Americans with disabilities cannot operate wheeled mobility devices and computers adequately due to diminished upper-limb motor control, sensory limitations, and cognitive impairments. We developed tuning software that can customize control interfaces for individuals with upper limb impairments. This study compared differences in each parameter among different diagnostic groups. Design Subjects ranged from 18 to 80 years. Athetoid Cerebral Palsy (ACP), Spastic Cerebral Palsy (SCP), Multiple Sclerosis (MS), Upper Limb Spasticity (ULS) and Control groups were used. We used a validated tuning software protocol to customize an isometric joystick prior to a virtual tracing or driving task. Tuning parameters were then compared across groups. Results Seventy-five subjects were included. Gain, the parameter responsible for force to output ratios, in each directional axis (leftward gain: p=0.018, rightward gain: p=0.003, reverse gain: p=0.007, forward gain: p=0.014) was significant across diagnostic groups. Post-hoc analyses showed that the control group required smaller leftward gain than SCP, MS and ULS groups and smaller gain in all other directions compared to SCP. Conclusions Gain may be a useful parameter for tuning by clinicians and efforts aimed at gain customization may aid the development of commercially available tuning software packages.

Guirand, Alcinto S.; Dicianno, Brad E.; Mahajan, Harshal; Cooper, Rory A.

2011-01-01

211

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

PubMed Central

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

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

2014-01-01

212

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

PubMed

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

Mukherjee, Swarup

2013-01-01

213

Gesture recognition in upper-limb prosthetics: a viability study using dynamic time warping and gyroscopes.  

PubMed

One of the significant challenges in the upper-limb-prosthetics research field is to identify appropriate interfaces that utilize the full potential of current state-of-the-art neuroprostheses. As the new generation of such prostheses paces towards approximating the human physiological performance in terms of movement dexterity and sensory feedback, it is clear that current non-invasive interfaces are still severely limited. Surface electromyography, the interface ubiquitously used in the field, is riddled with several shortcomings. Gesture recognition, an interface pervasively used in wearables and mobile devices, shows a strong potential as a non-invasive upper-limb prosthetic interface. This study aims at showcasing its potential in the field by using gyroscope sensors. To this end, we (1) explore the viability of Dynamic Time Warping as a classification method for upper-limb prosthetics and (2) look for appropriate sensor locations on the body. Results indicate an optimal classification rate of 97.53%, ? = 8.74 using a sensor located proximal to the endpoint performing a gesture. PMID:22255345

Dermitzakis, Konstantinos; Arieta, Alejandro Hernandez; Pfeifer, Rolf

2011-01-01

214

Effects of levodopa on upper limb mobility and gait in Parkinson's disease  

PubMed Central

Objectives: To evaluate the correlation between dopa induced gait improvement and upper limb motor improvement using a rapid and simple method; and to evaluate the correlation between gait improvement and UPDRS III improvement. Methods: A finger tapping test and a simple walking test were used to measure the OFF-ON variations of upper limb motor function and gait in 23 patients with Parkinson's disease. The UPDRS motor score and the Hoehn and Yahr stage were measured in the OFF and the ON state. Results: There was no correlation between OFF-ON variation of the number of hits with the finger tapping test and OFF-ON variation in the gait variables. OFF-ON variation in the UPDRS motor score was not correlated with OFF-ON variation in the gait variables. Conclusions: There was a dissociation between the effect of levodopa on upper limb and gait. The findings suggest that simple measures like the finger tapping test and a walking test should be included in the usual evaluation of patients with Parkinson's disease.

Vokaer, M; Azar, N; de Beyl, D Z.

2003-01-01

215

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

PubMed

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

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

2014-01-01

216

Targeted muscle reinnervation in the initial management of traumatic upper extremity amputation injury.  

PubMed

Targeted muscle reinnervation (TMR) was initially designed to provide cortical control of upper limb prostheses through a series of novel nerve transfers. Early experience has suggested that TMR may also inhibit symptomatic neuroma formation. We present the first report of TMR performed at the time of a traumatic shoulder disarticulation. The procedure was done to prevent painful neuroma pain and allow for myoelecteric prosthetic use in the future. Eight months post-operatively, the patient demonstrates multiple successful nerve transfers and exhibits no evidence of neuroma pain on clinical exam. Using the Patient Reported Outcomes Measurement Information System (PROMIS), the patient demonstrates minimal pain interference or pain behavior. Targeted muscle reinnervation may be considered in the acute trauma setting to prevent neuroma pain and to prepare patients for myoelectric prostheses in the future. PMID:24839430

Cheesborough, Jennifer E; Souza, Jason M; Dumanian, Gregory A; Bueno, Reuben A

2014-06-01

217

[Plastering: assessment of risk for upper limb biomechanical overload and of energy expenditure].  

PubMed

This work analyzes the activities carried out by a plaster construction worker, describing the data obtained from the assessment of risk for upper limb biomechanical overload, through the application of checklist and the OCRA method, and the operator's energy expenditure, measured using portable calorimeter. By analyzing the pattern of energy expenditure in relation to the actions performed we observe a direct correlation between posture, force employed, and metabolic rate. The activity of plastering involves biomechanical overload of upper extremity and high energy expenditure. PMID:23393846

Santini, M; Buratti, G; Dellera, L; Bresciani, M; Riva, M M; Mosconi, G

2011-01-01

218

On the potential of lower limb muscles to accelerate the body's centre of mass during walking.  

PubMed

Quantification of lower limb muscle function during gait or other common activities may be achieved using an induced acceleration analysis, which determines the contributions of individual muscles to the accelerations of the body's centre of mass. However, this analysis is reliant on a mathematical optimisation for the distribution of net joint moments among muscles. One approach that overcomes this limitation is the calculation of a muscle's potential to accelerate the centre of mass based on either a unit-force or maximum-activation assumption. Unit-force muscle potential accelerations are determined by calculating the accelerations induced by a 1 N muscle force, whereas maximum-activation muscle potential accelerations are determined by calculating the accelerations induced by a maximally activated muscle. The aim of this study was to describe the acceleration potentials of major lower limb muscles during normal walking obtained from these two techniques, and to evaluate the results relative to absolute (optimisation-based) muscle-induced accelerations. Dynamic simulations of walking were generated for 10 able-bodied children using musculoskeletal models, and potential- and absolute induced accelerations were calculated using a perturbation method. While the potential accelerations often correctly identified the major contributors to centre-of-mass acceleration, they were noticeably different in magnitude and timing from the absolute induced accelerations. Potential induced accelerations predicted by the maximum-activation technique, which accounts for the force-generating properties of muscle, were no more consistent with absolute induced accelerations than unit-force potential accelerations. The techniques described may assist treatment decisions through quantitative analyses of common gait abnormalities and/or clinical interventions. PMID:22372586

Correa, Tomas A; Pandy, Marcus G

2013-01-01

219

Intuitive, online, simultaneous, and proportional myoelectric control over two degrees-of-freedom in upper limb amputees.  

PubMed

We propose an approach for online simultaneous and proportional myoelectric control of two degrees-of-freedom (DoF) of the wrist, using surface electromyographic signals. The method is based on the nonnegative matrix factorization (NMF) of the wrist muscle activation to extract low-dimensional control signals translated by the user into kinematic variables. This procedure does not need a training set of signals for which the kinematics is known (labeled dataset) and is thus unsupervised (although it requires an initial calibration without labeled signals). The estimated control signals using NMF are used to directly control two DoFs of wrist. The method was tested on seven subjects with upper limb deficiency and on seven able-bodied subjects. The subjects performed online control of a virtual object with two DoFs to achieve goal-oriented tasks. The performance of the two subject groups, measured as the task completion rate, task completion time, and execution efficiency, was not statistically different. The approach was compared, and demonstrated to be superior to the online control by the industrial state-of-the-art approach. These results show that this new approach, which has several advantages over the previous myoelectric prosthetic control systems, has the potential of providing intuitive and dexterous control of artificial limbs for amputees. PMID:23996582

Jiang, Ning; Rehbaum, Hubertus; Vujaklija, Ivan; Graimann, Bernhard; Farina, Dario

2014-05-01

220

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

NASA Technical Reports Server (NTRS)

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.

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

1988-01-01

221

Relationship Between Tip Nasal Muscles and the Short Upper Lip  

Microsoft Academic Search

Since 1993 the authors have been using a new approach to the treatment of the muscles intimately related with the nasal tip and the upper lip, today known as dynamic rhinoplasty. With the idea of improving the dorsum-tip-labial relationship, the dynamic rhinoplasty technique is based on performing an intraoral zetaplasty at the labial frenum, allowing the access to the local

Ewaldo Bolivar de Souza Pinto

2003-01-01

222

Synthetic Float Analysis of Upper-Limb Meridional Overturning Circulation Interior Ocean Pathways in the Tropical/Subtropical Atlantic.  

National Technical Information Service (NTIS)

Synthetic floats are released in an ocean general circulation model to study fluid pathways followed by the upper limb of the meridional overturning circulation from the subtropical South Atlantic to the subtropical North Atlantic. The floats are designed...

D. A. Mayer J. G. Halliwell R. H. Weisberg

2003-01-01

223

The impact of workplace risk factors on the occurrence of neck and upper limb pain: a general population study  

PubMed Central

Background Work-related neck and upper limb pain has mainly been studied in specific occupational groups, and little is known about its impact in the general population. The objectives of this study were to estimate the prevalence and population impact of work-related neck and upper limb pain. Methods A cross-sectional survey was conducted of 10 000 adults in North Staffordshire, UK, in which there is a common local manual industry. The primary outcome measure was presence or absence of neck and upper limb pain. Participants were asked to give details of up to five recent jobs, and to report exposure to six work activities involving the neck or upper limbs. Psychosocial measures included job control, demand and support. Odds ratios (ORs) and population attributable fractions were calculated for these risk factors. Results The age-standardized one-month period prevalence of neck and upper limb pain was 44%. There were significant independent associations between neck and upper limb pain and: repeated lifting of heavy objects (OR = 1.4); prolonged bending of neck (OR = 2.0); working with arms at/above shoulder height (OR = 1.3); little job control (OR = 1.6); and little supervisor support (OR = 1.3). The population attributable fractions were 0.24 (24%) for exposure to work activities and 0.12 (12%) for exposure to psychosocial factors. Conclusion Neck and upper limb pain is associated with both physical and psychosocial factors in the work environment. Inferences of cause-and-effect from cross-sectional studies must be made with caution; nonetheless, our findings suggest that modification of the work environment might prevent up to one in three of cases of neck and upper limb pain in the general population, depending on current exposures to occupational risk.

Sim, Julius; Lacey, Rosie J; Lewis, Martyn

2006-01-01

224

A double-blind placebo-controlled study of botulinum toxin in upper limb spasticity after stroke or head injury  

Microsoft Academic Search

Objective: To assess dose–response relationships to a single dose of botulinum toxin ‘A’ in upper limb spasticity associated with stroke or head injury.Design: A double-blind placebo-controlled randomized dose ranging study.Setting: A regional centre for neuroscience and a neurorehabilitation outpatient clinic.Subjects: Twenty-one hemiplegic patients with troublesome upper limb spasticity. Nineteen with stroke and two with head injury.Main outcome measures: Spasticity (modified

S J Smith; E. Ellis; S. White; A P Moore

2000-01-01

225

A virtual tabletop workspace for upper-limb rehabilitation in Traumatic Brain Injury (TBI): A multiple case study evaluation  

Microsoft Academic Search

Deficits in upper limb function are common among patients with traumatic brain injury (TBI). Accordingly, new technologies, such as virtual reality (VR), are being developed to further upper limb rehabilitation. The study described here successfully trialed a table-top VR-based system (called Elements). Two patients with TBI participated in case-studies using a multiple-baseline, AB time-sequence design; the intervention consisted of 12

Nick Mumford; Jonathan Duckworth; Ross Eldridge; Mark Guglielmetti; Patrick Thomas; David Shum; Heiko Rudolph; Gavin Williams; Peter H. Wilson

2008-01-01

226

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

PubMed

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

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

2010-04-01

227

Human limb-specific and non-limb-specific brain representations during kinesthetic illusory movements of the upper and lower extremities.  

PubMed

Sensing movements of the upper and lower extremities is important in controlling whole-body movements. We have shown that kinesthetic illusory hand movements activate motor areas and right-sided fronto-parietal cortices. We investigated whether illusions for the upper and lower extremities, i.e. right or left hand or foot, activate the somatotopical sections of motor areas, and if an illusion for each limb engages the right-sided cortices. We scanned the brain activity of 19 blindfolded right-handed participants using functional magnetic resonance imaging (fMRI) while they experienced an illusion for each limb elicited by vibrating its tendon at 110 Hz (ILLUSION). As a control, we applied identical stimuli to the skin over a nearby bone, which does not elicit illusions (VIBRATION). The illusory movement (ILLUSION vs. VIBRATION) of each immobile limb activated limb-specific sections of the contralateral motor cortex (along with somatosensory area 3a), dorsal premotor cortex (PMD), supplementary motor area (SMA), cingulate motor area (CMA), and the ipsilateral cerebellum, which normally participate in execution of movements of the corresponding limb. We found complex non-limb-specific representations in rostral parts of the bilateral SMA and CMA, and illusions for all limbs consistently engaged concentrated regions in right-sided fronto-parietal cortices and basal ganglia. This study demonstrated complete sets of brain representations related to kinesthetic processing of single-joint movements of the four human extremities. The kinesthetic function of motor areas suggests their importance in somatic perception of limb movement, and the non-limb-specific representations indicate high-order kinesthetic processing related to human somatic perception of one's own body. PMID:17553017

Naito, Eiichi; Nakashima, Tokuro; Kito, Tomonori; Aramaki, Yu; Okada, Tomohisa; Sadato, Norihiro

2007-06-01

228

Disability following combat-sustained nerve injury of the upper limb.  

PubMed

Injuries to the limb are the most frequent cause of permanent disability following combat wounds. We reviewed the medical records of 450 soldiers to determine the type of upper limb nerve injuries sustained, the rate of remaining motor and sensory deficits at final follow-up, and the type of Army disability ratings granted. Of 189 soldiers with an injury of the upper limb, 70 had nerve-related trauma. There were 62 men and eight women with a mean age of 25 years (18 to 49). Disabilities due to nerve injuries were associated with loss of function, neuropathic pain or both. The mean nerve-related disability was 26% (0% to 70%), accounting for over one-half of this cohort's cumulative disability. Patients injured in an explosion had higher disability ratings than those injured by gunshot. The ulnar nerve was most commonly injured, but most disability was associated with radial nerve trauma. In terms of the final outcome, at military discharge 59 subjects (84%) experienced persistent weakness, 48 (69%) had a persistent sensory deficit and 17 (24%) experienced chronic pain from scar-related or neuropathic pain. Nerve injury was the cause of frequent and substantial disability in our cohort of wounded soldiers. PMID:24493193

Rivera, J C; Glebus, G P; Cho, M S

2014-02-01

229

A comparison of the moment arms of pelvic limb muscles in horses bred for acceleration (Quarter Horse) and endurance (Arab)  

PubMed Central

Selective breeding for performance has resulted in distinct breeds of horse, such as the Quarter Horse (bred for acceleration) and the Arab (bred for endurance). Rapid acceleration, seen during Quarter Horse racing, requires fast powerful muscular contraction and the generation of large joint torques, particularly by the hind limb muscles. This study compared hind limb moment arm lengths in the Quarter Horse and Arab. We hypothesized that Quarter Horse hind limb extensor muscles would have longer moment arms when compared to the Arab, conferring a greater potential for torque generation at the hip, stifle and tarsus during limb extension. Six Quarter Horse and six Arab hind limbs were dissected to determine muscle moment arm lengths for the following muscles: gluteus medius, biceps femoris, semitendinosus, vastus lateralis, gastrocnemius (medialis and lateralis) and tibialis cranialis. The moment arms of biceps femoris (acting at the hip) and gastrocnemius lateralis (acting at the stifle) were significantly longer in the Quarter Horse, although the length of the remaining muscle moment arms were similar in both breeds of horse. All the Quarter Horse muscles were capable of generating greater muscle moments owing to their greater physiological cross-sectional area (PCSA) and therefore greater isometric force potential, which suggests that PCSA is a better determinant of muscle torque than moment arm length in these two breeds of horse. With the exception of gastrocnemius and tibialis cranialis, the observed muscle fascicle length to moment arm ratio (MFL : MA ratio) was greater for the Arab horse muscles. It appears that the Arab muscles have the potential to operate at slower velocities of contraction and hence generate greater force outputs when compared to the Quarter Horse muscles working over a similar range of joint motion; this would indicate that Arab hind limb muscles are optimized to function at maximum economy rather than maximum power output.

Crook, T C; Cruickshank, S E; McGowan, C M; Stubbs, N; Wilson, A M; Hodson-Tole, E; Payne, R C

2010-01-01

230

A comparison of the moment arms of pelvic limb muscles in horses bred for acceleration (Quarter Horse) and endurance (Arab).  

PubMed

Selective breeding for performance has resulted in distinct breeds of horse, such as the Quarter Horse (bred for acceleration) and the Arab (bred for endurance). Rapid acceleration, seen during Quarter Horse racing, requires fast powerful muscular contraction and the generation of large joint torques, particularly by the hind limb muscles. This study compared hind limb moment arm lengths in the Quarter Horse and Arab. We hypothesized that Quarter Horse hind limb extensor muscles would have longer moment arms when compared to the Arab, conferring a greater potential for torque generation at the hip, stifle and tarsus during limb extension. Six Quarter Horse and six Arab hind limbs were dissected to determine muscle moment arm lengths for the following muscles: gluteus medius, biceps femoris, semitendinosus, vastus lateralis, gastrocnemius (medialis and lateralis) and tibialis cranialis. The moment arms of biceps femoris (acting at the hip) and gastrocnemius lateralis (acting at the stifle) were significantly longer in the Quarter Horse, although the length of the remaining muscle moment arms were similar in both breeds of horse. All the Quarter Horse muscles were capable of generating greater muscle moments owing to their greater physiological cross-sectional area (PCSA) and therefore greater isometric force potential, which suggests that PCSA is a better determinant of muscle torque than moment arm length in these two breeds of horse. With the exception of gastrocnemius and tibialis cranialis, the observed muscle fascicle length to moment arm ratio (MFL : MA ratio) was greater for the Arab horse muscles. It appears that the Arab muscles have the potential to operate at slower velocities of contraction and hence generate greater force outputs when compared to the Quarter Horse muscles working over a similar range of joint motion; this would indicate that Arab hind limb muscles are optimized to function at maximum economy rather than maximum power output. PMID:20492428

Crook, T C; Cruickshank, S E; McGowan, C M; Stubbs, N; Wilson, A M; Hodson-Tole, E; Payne, R C

2010-07-01

231

Myofascial force transmission between antagonistic rat lower limb muscles: Effects of single muscle or muscle group lengthening  

Microsoft Academic Search

Effects of lengthening of the whole group of anterior crural muscles (tibialis anterior and extensor hallucis longus muscles (TA+EHL) and extensor digitorum longus (EDL)) on myofascial interaction between synergistic EDL and TA+EHL muscles, and on myofascial force transmission between anterior crural and antagonistic peroneal muscles, were investigated. All muscles were either passive or maximally active. Peroneal muscles were kept at

Hanneke J. M. Meijer; Josina M. Rijkelijkhuizen; Peter A. Huijing

2007-01-01

232

Fatigue-related firing of distal muscle nociceptors reduces voluntary activation of proximal muscles of the same limb.  

PubMed

With fatiguing exercise, firing of group III/IV muscle afferents reduces voluntary activation and force of the exercised muscles. These afferents can also act across agonist/antagonist pairs, reducing voluntary activation and force in nonfatigued muscles. We hypothesized that maintained firing of group III/IV muscle afferents after a fatiguing adductor pollicis (AP) contraction would decrease voluntary activation and force of AP and ipsilateral elbow flexors. In two experiments (n = 10) we examined voluntary activation of AP and elbow flexors by measuring changes in superimposed twitches evoked by ulnar nerve stimulation and transcranial magnetic stimulation of the motor cortex, respectively. Inflation of a sphygmomanometer cuff after a 2-min AP maximal voluntary contraction (MVC) blocked circulation of the hand for 2 min and maintained firing of group III/IV muscle afferents. After a 2-min AP MVC, maximal AP voluntary activation was lower with than without ischemia (56.2 ± 17.7% vs. 76.3 ± 14.6%; mean ± SD; P < 0.05) as was force (40.3 ± 12.8% vs. 57.1 ± 13.8% peak MVC; P < 0.05). Likewise, after a 2-min AP MVC, elbow flexion voluntary activation was lower with than without ischemia (88.3 ± 7.5% vs. 93.6 ± 3.9%; P < 0.05) as was torque (80.2 ± 4.6% vs. 86.6 ± 1.0% peak MVC; P < 0.05). Pain during ischemia was reported as Moderate to Very Strong. Postfatigue firing of group III/IV muscle afferents from the hand decreased voluntary drive and force of AP. Moreover, this effect decreased voluntary drive and torque of proximal unfatigued muscles, the elbow flexors. Fatigue-sensitive group III/IV muscle nociceptors act to limit voluntary drive not only to fatigued muscles but also to unfatigued muscles within the same limb. PMID:24356522

Kennedy, David S; McNeil, Chris J; Gandevia, Simon C; Taylor, Janet L

2014-02-15

233

The reorganization of tremulous movements in the upper limb due to finger tracking maneuvers.  

PubMed

In light of the interplay between limb oscillatory outputs and the outcome performance of movement effectors, this study was undertaken to investigate neuromotor control in the upper limb during position tracking and posture holding. Sixteen volunteers conducted a postural pointing task and two index tracking maneuvers at 0.3 and 0.6 Hz with an outstretched arm. Limb acceleration in the index finger, hand, forearm, arm, and C7 spinal process were monitored to correlate functionally with the accuracy of index rhythmic displacements. The results showed that index oscillatory activity multiplied with tracking speed, but hand oscillatory activity declined during tracking movement. The tracking maneuvers also altered spectral distribution of the tremulous activities in the context of a lower spectral peak in the range of 8-12 Hz and suppression of spectral peaks at 2-4 Hz, in reference to that already presented in posture tremor. Consisting of three local maxima around 2-4, 8-12, and 18-22 Hz, the coherence of tremulous activity between the finger and hand during position tracking was nearly identical, but inferior to high coherence below 12 Hz during posture holding. Functionally, better tracking performance was associated with a smaller tremulous activity in the finger and hand, entailing sophisticated release of mechanical couplings in the finger-hand and hand-forearm. In conclusion, inversely related to tracking performance, limb tremulous movements were task-dependently organized, and speed-invariant coherence of limb tremulous movement specified an inter-segmental coordination, which is physiological evidence of the generalized motor program for position tracking. PMID:16896728

Hwang, Ing-Shiou; Wu, Pei-Shan

2006-09-01

234

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

PubMed

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

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

235

Cytoskeletal and extracellular matrix alterations in limb girdle muscular dystrophy 2I muscle fibers.  

PubMed

In this detailed muscle biopsy study of a patient with molecularly confirmed diagnosis of limb-girdle muscular dystrophy 2I (LGMD2I) we show some new data, that is the presence of altered expression pattern of costamere components as integrin ?7B and integrin ?1D associated with vinculin costameric derangement and basal lamina ultrastructural abnormalities as detachments and discontinuities suggesting that different cellular compartments are involved in LGMD2I and the altered basement membrane-plasmalemma-cytoskeleton binding can underlie muscle degeneration. PMID:23135029

Sabatelli, Patrizia; Pellegrini, Camilla; Faldini, Cesare; Merlini, Luciano

2012-01-01

236

Task-specific changes in motor evoked potentials of lower limb muscles after different training interventions  

Microsoft Academic Search

This study aimed to identify sites and mechanisms of long-term plasticity following lower limb muscle training. Two groups performing either a postural stability maintenance training (SMT) or a ballistic ankle strength training (BST) were compared to a non-training group. The hypothesis was that practicing of a self-initiated voluntary movement would facilitate cortico-spinal projections, while practicing fast automatic adjustments during stabilization

S. Beck; W. Taube; M. Gruber; F. Amtage; A. Gollhofer; M. Schubert

2007-01-01

237

A comparison between handgrip strength, upper limb fat free mass by segmental bioelectrical impedance analysis (SBIA) and anthropometric measurements in young males  

NASA Astrophysics Data System (ADS)

The mechanical function and size of a muscle may be closely linked. Handgrip strength (HGS) has been used as a predictor of functional performing. Anthropometric measurements have been made to estimate arm muscle area (AMA) and physical muscle mass volume of upper limb (ULMMV). Electrical volume estimation is possible by segmental BIA measurements of fat free mass (SBIA-FFM), mainly muscle-mass. Relationship among these variables is not well established. We aimed to determine if physical and electrical muscle mass estimations relate to each other and to what extent HGS is to be related to its size measured by both methods in normal or overweight young males. Regression analysis was used to determine association between these variables. Subjects showed a decreased HGS (65.5%), FFM, (85.5%) and AMA (74.5%). It was found an acceptable association between SBIA-FFM and AMA (r2 = 0.60) and poorer between physical and electrical volume (r2 = 0.55). However, a paired Student t-test and Bland and Altman plot showed that physical and electrical models were not interchangeable (pt<0.0001). HGS showed a very weak association with anthropometric (r2 = 0.07) and electrical (r2 = 0.192) ULMMV showing that muscle mass quantity does not mean muscle strength. Other factors influencing HGS like physical training or nutrition require more research.

Gonzalez-Correa, C. H.; Caicedo-Eraso, J. C.; Varon-Serna, D. R.

2013-04-01

238

Inflammatory cells and apoptosis in respiratory and limb muscles of patients with COPD.  

PubMed

Discrepancies exist regarding the involvement of cellular inflammation and apoptosis in the muscle dysfunction of chronic obstructive pulmonary disease (COPD) patients with preserved body composition. We explored whether levels of inflammatory cells and apoptosis were increased in both respiratory and limb muscles of COPD patients without nutritional abnormalities. In the vastus lateralis, external intercostals, and diaphragms of severe and moderate COPD patients with normal body composition, and in healthy subjects, intramuscular leukocytes and macrophage levels were determined (immunohistochemistry). Muscle structure was also evaluated. In the diaphragm and vastus lateralis of severe and moderate COPD patients and controls, apoptotic nuclei were explored using the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay, electron microscopy, and caspase-3 expression. In COPD patients compared with controls, diaphragm and intercostal levels of inflammatory cells were extremely low and not significantly different. However, in the vastus lateralis of the severe patients, inflammatory cell counts, although also very low, were significantly greater. In those patients, TUNEL-positive nuclei levels were also significantly greater in diaphragms and vastus lateralis. A significant inverse relationship was found between quadriceps TUNEL-positive nuclei levels and muscle force. Ultrastructural apoptotic nuclei revealed no differences in respiratory or limb muscles between COPD patients and controls. Muscle caspase-3 expression did not differ between patients and controls. In severe COPD patients with preserved body composition, while increased apoptotic nuclei seems to be a contributor to their muscle dysfunction, cellular inflammation does not. The increased numbers of TUNEL-positive nuclei in their muscles suggest that they may also be exposed to a continuous repair/remodeling process. PMID:21636562

Barreiro, Esther; Ferrer, Dolores; Sanchez, Francisco; Minguella, Joan; Marin-Corral, Judith; Martinez-Llorens, Juana; Lloreta, Josep; Gea, Joaquim

2011-09-01

239

Potential of lower-limb muscles to accelerate the body during cerebral palsy gait.  

PubMed

Two of the most common gait patterns in children with spastic diplegic cerebral palsy (CP) are termed 'crouch gait' and 'jump gait'. While outcomes of surgical interventions designed to improve functional mobility are generally positive, many children displaying these gait patterns show minimal or no improvement post-surgery. A poor response to treatment may be partially attributable to incorrect interpretations of muscle function. Computational techniques that assess muscle function may help address this issue, but before studying specific surgeries, the gait patterns themselves must be better understood. The aim of this study was to identify differences in lower-limb muscle function when comparing crouch, jump and able-bodied gait patterns by quantifying the potential of lower-limb muscles to accelerate the body's center of mass. A muscle's potential acceleration was defined as the acceleration induced by a unit of muscle force. Dynamic simulations of walking using musculoskeletal models were developed for eight children with crouch gait, ten with jump gait, and ten controls. There were significant differences (p<0.05) in muscle potential accelerations between crouch and able-bodied gait patterns, and between jump and able-bodied gait patterns, for most of the major muscles of the hip, knee, and ankle. One important outcome was the identification of the significantly reduced potential of gluteus medius to extend the hip in both crouch gait and jump gait. Potential acceleration analyses appear to be suitable for evaluating differences between common gait patterns and may also be applied to study the effects of surgical treatments. The results of such studies may lead to improved treatment outcomes for individuals with impaired mobility. PMID:22522045

Correa, Tomas A; Schache, Anthony G; Graham, H Kerr; Baker, Richard; Thomason, Pam; Pandy, Marcus G

2012-06-01

240

Complex muscle vibration patterns to induce gait-like lower-limb movements: Proof of concept.  

PubMed

Muscle vibrations can induce motor responses and illusions of complex movements. However, inducing gait-like cyclical movements and illusions requires the application of multiple fast alternating vibrations to lower-limb muscles. The objectives were (1) to test the feasibility of delivering complex vibrations in a time-organized manner and (2) to illustrate the possibility of inducing alternate gait-in-place-like movements using these vibrations. Patterns of vibration, produced by 12 vibrators applied bilaterally on the flexor and extensor muscle groups of the lower limbs, were based on normal gait kinematics. We tested 1 s and 2 s cycle patterns of vibration. Vibrator responses were assessed using auto- and crosscorrelations and frequency analyses based on accelerometry measurements, and compared between patterns. High auto- (>0.8) and crosscorrelation (>0.6) coefficients demonstrated a good response by the vibrators to the control signal. Vibrations induced cyclical, low-amplitude stepping-in-place movements that mimicked alternate walking movements with both legs, with 1 s and 2 s cycle durations, in one nondisabled participant and one participant with American Spinal Injury Association Impairment Scale B spinal cord injury standing, relaxed, with body-weight support. Electromechanical vibrators can deliver complex cyclical vibrations and trigger gait-like lower-limb movements. These results warrant the application of these vibration patterns on individuals with sensorimotor impairments to test their potential in gait rehabilitation. PMID:24933722

Duclos, Cyril; Kemlin, Claire; Lazert, David; Gagnon, Dany; Dyer, Joseph-Omer; Forget, Robert

2014-05-01

241

Disorders of the neck and upper limbs in women in the fish processing industry.  

PubMed Central

OBJECTIVE--The aim was to study the association between personal factors and physical and psychosocial work environment factors and disorders of the neck or upper limbs among women in the fish processing industry. METHODS--A cross sectional study was performed on 206 women in the fish processing industry and 208 control women. Several physical and psychosocial work environment factors were evaluated. Subjective complaints about the neck or upper limbs were assessed by questionnaire and by a clinical examination. RESULTS--The study showed a high prevalence (35%) of diagnoses in the neck or shoulders of the exposed women. All prevalence odds ratios (POR's) were substantially higher in young women. There was a pronounced dose-response relation between disorders of the neck or shoulders and duration of employment for women < 45 years old. When studying 322 former workers, the proportion who claimed musculoskeletal complaints as the reason for leaving was highest among the older women. Muscular tension, stress or worry, work strain, and the largest fraction of the work time spent with highly repetitive work tasks were clearly associated with disorders of the neck or shoulders. The measurements of the wrist movements also showed that the work was performed almost without any pauses and that the median flexion and extension velocity was high (41 degree/s). The results of observation showed good agreement with the measurements of wrist motion. CONCLUSION--Work in the fish processing industry is a risk factor for disorders of the neck and upper limbs. Due to the homogenity of the physical work load in the exposed group, we could not show any associations between the objective measurements and disorders. In cross sectional studies the risk may be underestimated due to a healthy worker effect.

Ohlsson, K; Hansson, G A; Balogh, I; Stromberg, U; Palsson, B; Nordander, C; Rylander, L; Skerfving, S

1994-01-01

242

Gesture therapy: an upper limb virtual reality-based motor rehabilitation platform.  

PubMed

Virtual reality platforms capable of assisting rehabilitation must provide support for rehabilitation principles: promote repetition, task oriented training, appropriate feedback, and a motivating environment. As such, development of these platforms is a complex process which has not yet reached maturity. This paper presents our efforts to contribute to this field, presenting Gesture Therapy, a virtual reality-based platform for rehabilitation of the upper limb. We describe the system architecture and main features of the platform and provide preliminary evidence of the feasibility of the platform in its current status. PMID:24760913

Sucar, Luis Enrique; Orihuela-Espina, Felipe; Velazquez, Roger Luis; Reinkensmeyer, David J; Leder, Ronald; Hernandez-Franco, Jorge

2014-05-01

243

A Kinect-based upper limb rehabilitation system to assist people with cerebral palsy.  

PubMed

This study assessed the possibility of rehabilitating two adolescents with cerebral palsy (CP) using a Kinect-based system in a public school setting. The system provided 3 degrees of freedom for prescribing a rehabilitation program to achieve customized treatment. This study was carried out according to an ABAB reversal replication design in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their motivation for upper limb rehabilitation, thus improving exercise performance during the intervention phases. Practical and developmental implications of the findings are discussed. PMID:24012594

Chang, Yao-Jen; Han, Wen-Ying; Tsai, Yu-Chi

2013-11-01

244

Experimental development of a sensory control system for an upper limb myoelectric prosthesis with cosmetic covering.  

PubMed

A sensory control system based on the force-sensing resistor (FSR) for an upper limb prosthesis has been designed for application to a commercial prosthetic hand of proven reliability. In particular, FSR sensors have been used to control the strength of the grip on objects. Moreover, the problem of the object possibly slipping from the grip has been addressed by a system based on an optical sensor for detecting movement. Tests on different everyday objects have shown the feasibility of the above approach, given the constraints of the limited dimensions of the prosthesis and the presence of a cosmetic glove. PMID:9505249

Tura, A; Lamberti, C; Davalli, A; Sacchetti, R

1998-01-01

245

Sensory capacity of reinnervated skin after redirection of amputated upper limb nerves to the chest  

PubMed Central

Targeted reinnervation is a new neural-machine interface that has been developed to help improve the function of new-generation prosthetic limbs. Targeted reinnervation is a surgical procedure that takes the nerves that once innervated a severed limb and redirects them to proximal muscle and skin sites. The sensory afferents of the redirected nerves reinnervate the skin overlying the transfer site. This creates a sensory expression of the missing limb in the amputee's reinnervated skin. When these individuals are touched on this reinnervated skin they feel as though they are being touched on their missing limb. Targeted reinnervation takes nerves that once served the hand, a skin region of high functional importance, and redirects them to less functionally relevant skin areas adjacent to the amputation site. In an effort to better understand the sensory capacity of the reinnervated target skin following this procedure, we examined grating orientation thresholds and point localization thresholds on two amputees who had undergone the targeted reinnervation surgery. Grating orientation thresholds and point localization thresholds were also measured on the contralateral normal skin of the targeted reinnervation amputees and on analogous sites in able-bodied controls. Grating orientation thresholds for the reinnervated skin of the targeted reinnervation amputees were found to be similar to normal ranges for both the amputees’ contralateral skin and also for the control population. Point localization thresholds for these amputees were found to be lower for their reinnervated skin than for their contralateral skin. Reinnervated point localization thresholds values were also lower in comparison to homologous chest sites on the control population. Mechanisms appear to be in place to maximize re-established touch input in targeted reinnervation amputees. It seems that sound sensory function is provided to the denervated skin of the residual limb when connected to afferent pathways once serving highly functionally relevant regions of the brain. This suggests that tactile interface devices could be used to give a physiologically appropriate sense of touch to a prosthetic limb, which would likely help with better functional utilization of the prosthetic device and possibly help to more effectively integrate the device with the user's self-image.

Schultz, Aimee E.; Kuiken, Todd A.

2009-01-01

246

Feasibility of Video Clip Analysis on Effect of Botulinum Toxin-A Injection for Post-Stroke Upper Limb Spasticity  

PubMed Central

Existing functional evaluation tools do not accurately reveal the improved function following botulinum toxin A (BTX-A) injection for post-stroke upper limb spasticity. With the aim of developing an alternate method of measuring functional improvement following BTX-A injection, this study tested the feasibility, validity and reliability of video clip analysis performed by the clinicians. Seventy-nine patients administered BTX-A due to post-stroke upper limb spasticity, were retrospectively evaluated using video clip analysis. Pre- and post-injection video clips recorded at 1-month intervals were randomly allocated and sent to three blinded physician evaluators who were asked to choose the one that seemed more improved in terms of hand motion and associated upper limb reaction during gait. The three physicians chose the post-injection video clip as depicting improved hand motion (82.3%, 79.7%, and 72.2%) and associated upper limb reaction during gait (73.4%, 70.9%, and 70.9%). Kappa and intraclass correlation coefficient as a measure of interrater reliability among the three physicians was 0.86 and 0.79 for the hand, and 0.92 and 0.92 for associated upper limb reaction during gait, respectively. The percent overall agreement of the physicians was 78.1% and 71.7% for hand function and associated upper limb reaction, respectively. Retrospective pre- and post-BTX-A injection video clip analyses is a clinically feasible alternative method to evaluate the improvement following BTX-A injection for post-stroke upper limb spasticity, especially in busy clinical practice setting.

Kim, Woo-Jin; Kumthornthip, Witsanu; Oh, Byung Mo; Yang, Eun Joo; Paik, Nam-Jong

2013-01-01

247

Magnetic resonance imaging-monitored plasmid DNA delivery in primate limb muscle.  

PubMed

The purpose of this work is to investigate the use of magnetic resonance imaging (MRI) to monitor the effects of high-pressure naked plasmid DNA (pDNA) intravascular injections in primate limbs, studying both the distribution of the injected solution in the muscle space, as well as the effects on the vascular system. The distal portion of the four limbs of each of six rhesus monkeys were hydrodynamically injected with naked pDNA, which expressed the luciferase reporter gene. Three-dimensional (3D) T1-weighted gradient echo and 2D multislice T2-weighted fast spin echo (FSE) series were acquired before and immediately after the injection to confirm the volume of solution injected into the limb, and to study the distribution of the injected solution in the individual muscle groups. Time-resolved contrast-enhanced 3D magnetic resonance angiography (MRA) was performed several days before, immediately after, and in a follow-up examination after the pDNA injection to study the effects of the procedure on the primate peripheral vascular system. T1-weighted gradient echo imaging confirmed the delivery of the majority of the solution after successful pDNA injections. T2-weighted FSE imaging demonstrated the distribution of the saline solution in individual muscles in the target limbs, with enhancement showing a weak but significant correlation with the level of gene expression. Time-resolved contrast-enhanced MRA demonstrated effects of the injection procedure on the arterial and venous vascular systems, and the intramuscular compartments; and these effects largely returned to normal on short-term follow-up. PMID:17376006

Vigen, Karl K; Hegge, Julia O; Zhang, Guofeng; Mukherjee, Rajat; Braun, Serge; Grist, Thomas M; Wolff, Jon A

2007-03-01

248

Control of upper limb prostheses: terminology and proportional myoelectric control-a review.  

PubMed

The recent introduction of novel multifunction hands as well as new control paradigms increase the demand for advanced prosthetic control systems. In this context, an unambiguous terminology and a good understanding of the nature of the control problem is important for efficient research and communication concerning the subject. Thus, one purpose of this paper is to suggest an unambiguous taxonomy, applicable to control systems for upper limb prostheses and also to prostheses in general. A functionally partitioned model of the prosthesis control problem is also presented along with the taxonomy. In the second half of the paper, the suggested taxonomy has been exploited in a comprehensive literature review on proportional myoelectric control of upper limb prostheses. The review revealed that the methods for system training have not matured at the same pace as the novel multifunction prostheses and more advanced intent interpretation methods. Few publications exist regarding the choice of training method and the composition of the training data set. In this context, the notion of outcome measures is essential. By definition, system training involves optimization, and the quality of the results depends heavily on the choice of appropriate optimization criteria. In order to further promote the development of proportional myoelectric control, these topics need to be addressed. PMID:22665514

Fougner, Anders; Stavdahl, Oyvind; Kyberd, Peter J; Losier, Yves G; Parker, Philip A

2012-09-01

249

Upper limb disability in Norwegian workers with hand-arm vibration syndrome  

PubMed Central

Background Hand-arm vibration syndrome (HAVS) is a well-known disease among workers using hand-held vibrating tools. These patients experience major symptoms from their upper limbs. However, there are few studies on disability in this patient group. In this study we wanted to describe the disability of HAVS patients. Methods All HAVS patients diagnosed at Haukeland University Hospital in Bergen, Norway in a five-year period were invited. The disabilities of the arm, shoulder and hand (DASH) questionnaire was sent by mail. Clinical data were extracted from their hospital journals. Descriptive statistics and regression analyses were performed. Results Thirty-eight patients were recruited. Mean DASH score was 41.2, while the mean of a normal population is 10. Ability to perform tasks related to work and everyday life was affected in these patients. We found a significant association between the DASH score, hand grip strength and tendinitis, also after adjustment for age and smoking in pack-years. Conclusion HAVS patients demonstrate a high level of upper limb disability as assessed by the DASH score. Ability to perform tasks related to work and everyday life was affected. We found a significant association between the DASH score, hand grip strength and tendinitis. This should be focused upon in future research.

2014-01-01

250

Using virtual reality environment to facilitate training with advanced upper-limb prosthesis.  

PubMed

Technological advances in upper-limb prosthetic design offer dramatically increased possibilities for powered movement. The DEKA Arm system allows users 10 powered degrees of movement. Learning to control these movements by utilizing a set of motions that, in most instances, differ from those used to obtain the desired action prior to amputation is a challenge for users. In the Department of Veterans Affairs "Study to Optimize the DEKA Arm," we attempted to facilitate motor learning by using a virtual reality environment (VRE) program. This VRE program allows users to practice controlling an avatar using the controls designed to operate the DEKA Arm in the real world. In this article, we provide highlights from our experiences implementing VRE in training amputees to use the full DEKA Arm. This article discusses the use of VRE in amputee rehabilitation, describes the VRE system used with the DEKA Arm, describes VRE training, provides qualitative data from a case study of a subject, and provides recommendations for future research and implementation of VRE in amputee rehabilitation. Our experience has led us to believe that training with VRE is particularly valuable for upper-limb amputees who must master a large number of controls and for those amputees who need a structured learning environment because of cognitive deficits. PMID:21938657

Resnik, Linda; Etter, Katherine; Klinger, Shana Lieberman; Kambe, Charles

2011-01-01

251

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

PubMed Central

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.

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

2014-01-01

252

Transcranial direct current stimulation and EEG-based motor imagery BCI for upper limb stroke rehabilitation.  

PubMed

Clinical studies had shown that EEG-based motor imagery Brain-Computer Interface (MI-BCI) combined with robotic feedback is effective in upper limb stroke rehabilitation, and transcranial Direct Current Stimulation (tDCS) combined with other rehabilitation techniques further enhanced the facilitating effect of tDCS. This motivated the current clinical study to investigate the effects of combining tDCS with MI-BCI and robotic feedback compared to sham-tDCS for upper limb stroke rehabilitation. The stroke patients recruited were randomized to receive 20 minutes of tDCS or sham-tDCS prior to 10 sessions of 1-hour MI-BCI with robotic feedback for 2 weeks. The online accuracies of detecting motor imagery from idle condition were assessed and offline accuracies of classifying motor imagery from background rest condition were assessed from the EEG of the evaluation and therapy parts of the 10 rehabilitation sessions respectively. The results showed no evident differences between the online accuracies on the evaluation part from both groups, but the offline analysis on the therapy part yielded higher averaged accuracies for subjects who received tDCS (n=3) compared to sham-tDCS (n=2). The results suggest towards tDCS effect in modulating motor imagery in stroke, but a more conclusive result can be drawn when more data are collected in the ongoing study. PMID:23366836

Ang, Kai Keng; Guan, Cuntai; Phua, Kok Soon; Wang, Chuanchu; Teh, Irvin; Chen, Chang Wu; Chew, Effie

2012-01-01

253

Work related upper limb disorder: the relationship between pain, cumulative load, disability, and psychological factors.  

PubMed Central

Repetitive strain injury, or work related upper limb disorder, provides an interesting paradigm for the study of the relative contribution of physical and psychological factors to the resulting pain and disability. Sixty three subjects were studied, comprising the work-force of a subsection of a large local industrial company, in whom pain in the arm related to work was known to be common. Ergonomic data were obtained by estimating the cumulative daily load on the wrist joint for each of four identified tasks. Data on the occurrence of pain, treatment sought, and disability were obtained by a structured self administered questionnaire. Psychological data were obtained by administering the Hospital Anxiety and Depression (HAD) scale, a self reported measure of anxiety and depression, and the Bradford Somatic Inventory (BSI), an inventory of somatic symptoms associated with anxiety and depression. The employment specific period prevalence of work related upper limb disorder was 81%, with 30% of the subjects having pain at the time of the study. Domestic disability was minimal in all but two subjects, though the use of devices such as jar openers at home was common (12 of 51 subjects). Medical advice was seldom sought. Twenty per cent of subjects had received anti-inflammatory drugs, 10% had received physiotherapy, and 47% had wrist splints. Pain was related to the tasks with the highest estimated daily loads, but a history of pain and current pain were associated with higher scores on the HAD and BSI scales, suggesting an interaction between physical and psychological factors.

Helliwell, P S; Mumford, D B; Smeathers, J E; Wright, V

1992-01-01

254

Ultrasound-guided supraclavicular brachial plexus block in upper limb surgery: outcomes and patient satisfaction.  

PubMed

We examined the outcomes and levels of patient satisfaction in 202 consecutive cases of ultrasound-guided supraclavicular brachial plexus block (SBPB) in upper limb surgery performed between September 2007 and March 2010. All blocks were performed by orthopaedic surgeons using ultrasound visualisation with a high-frequency linear probe. The probe was placed in the coronal-oblique plane in the supraclavicular fossa, and the puncture was 'in-plane' from lateral to medial. Most of the blocks were performed with 0.75% ropivacaine/1% lidocaine (1:1), with or without adrenaline in 1:200 000 dilution. In 201 patients (99.5%) the brachial plexus block permitted surgery without conversion to general anaesthesia. The mean procedure time for block was 3.9 min (2 to 12), the mean waiting time for surgery was 34.1 min (10 to 64), the mean surgical time was 75.2 min (6 to 232), and the mean duration of post-anaesthetic analgesia was 437 min (171 to 992). A total of 20 patients (10%) developed a transient Horner's syndrome. No nerve injury, pneumothorax, arterial puncture or systemic anaesthetic toxicity were recorded. Most patients (96.7%) were satisfied with ultrasound-guided SBPB. This study demonstrates the efficacy and safety of ultrasound-guided SBPB for orthopaedic surgery on the upper limb. Cite this article: Bone Joint J 2014;96-B:795-9. PMID:24891581

Gamo, K; Kuriyama, K; Higuchi, H; Uesugi, A; Nakase, T; Hamada, M; Kawai, H

2014-06-01

255

Relationship between upper and lower limb conduit artery vasodilator function in humans.  

PubMed

Brachial artery flow-mediated dilation (FMD) is a strong predictor of future cardiovascular disease and is believed to represent a "barometer" of systemic endothelial health. Although a recent study [Padilla et al. Exp Biol Med (Maywood) 235: 1287-1291, 2010] in pigs confirmed a strong correlation between brachial and femoral artery endothelial function, it is unclear to what extent brachial artery FMD represents a systemic index of endothelial function in humans. We conducted a retrospective analysis of data from our laboratory to evaluate relationships between the upper (i.e., brachial artery) vs. lower limb (superficial femoral n = 75; popliteal artery n = 32) endothelium-dependent FMD and endothelium-independent glyceryl trinitrate (GTN)-mediated dilation in young, healthy individuals. We also examined the relationship between FMD assessed in both brachial arteries (n = 42). There was no correlation between brachial and superficial femoral artery FMD (r(2) = 0.008; P = 0.46) or between brachial and popliteal artery FMD (r(2) = 0.003; P = 0.78). However, a correlation was observed in FMD between both brachial arteries (r(2) = 0.34; P < 0.001). Brachial and superficial femoral artery GTN were modestly correlated (r(2) = 0.13; P = 0.007), but brachial and popliteal artery GTN responses were not (r(2) = 0.08; P = 0.11). Collectively, these data indicate that conduit artery vasodilator function in the upper limbs (of healthy humans) is not predictive of that in the lower limbs, whereas measurement of FMD in one arm appears to be predictive of FMD in the other. These data do not support the hypothesis that brachial artery FMD in healthy humans represents a systemic index of endothelial function. PMID:21512151

Thijssen, Dick H J; Rowley, Nicola; Padilla, Jaume; Simmons, Grant H; Laughlin, M Harold; Whyte, Greg; Cable, N Timothy; Green, Daniel J

2011-07-01

256

Sonic hedgehog (SHH) specifies muscle pattern at tissue and cellular chick level, in the chick limb bud.  

PubMed

Development of the musculature in chick limbs involves tissue and cellular patterning. Patterning at the tissue level leads to the precise arrangement of specific muscles; at the cellular level patterning gives rise to the fibre type diversity in muscles. Although the data suggests that the information controlling muscle patterning is localised within the limb mesenchyme and not in the somitic myogenic precursor cells themselves, the mechanisms underlying muscle organisation have still to be elucidated. The anterior-posterior axis of the limb is specified by a group of cells in the posterior region of the limb mesenchyme, called the zone of polarizing activity (ZPA). When polarizing-region cells are grafted to the anterior margin of the bud, they cause mirror-image digit duplications to be produced. The effect of ZPA grafts can be reproduced by application of retinoic acid (RA) beads and by grafting sonic hedgehog (SHH)-expressing cells to the anterior margin of the limb. Although most previous studies have looked at changes of the skeletal patterning, ZPA and RA also affect muscle patterning. In this report, we investigated the role of SHH in tissue and cellular patterning of forearm wing muscles. Ectopic application of a localised source of SHH to the anterior margin of the wing, leading to complete digit duplication, is able to transform anterior forearm muscles into muscles with a posterior identity. Moreover, the ectopic source of SHH induces a mirror image duplication of the normal posterior muscles fibre types in the new posterior muscles. The reorganisation of the slow fibres can be detected before muscle mass cleavage has started; suggesting that the appropriate fibre type arrangement is in place before the splitting process can be observed. PMID:10354479

Duprez, D; Lapointe, F; Edom-Vovard, F; Kostakopoulou, K; Robson, L

1999-04-01

257

Kinetics of the upper limb during table tennis topspin forehands in advanced and intermediate players.  

PubMed

The purpose of this study was to determine the significance of mechanical energy generation and transfer in the upper limb in generating the racket speed during table tennis topspin forehands. Nine advanced and eight intermediate table tennis players performed the forehand stroke at maximum effort against light and heavy backspin balls. Five high-speed video cameras operating at 200 fps were used to record the motions of the upper body of the players. The joint forces and torques of the racket arm were determined with inverse dynamics, and the amount of mechanical energy generated and transferred in the arm was determined. The shoulder internal rotation torque exerted by advanced players was significantly larger than that exerted by the intermediate players. Owing to a larger shoulder internal rotation torque, the advanced players transferred mechanical energy from the trunk of the body to the upper arm at a higher rate than the intermediate players could. Regression of the racket speed at ball impact on the energy transfer to the upper arm suggests that increase in the energy transfer may be an important factor for enabling intermediate players to generate a higher racket speed at impact in topspin forehands. PMID:22303787

Iino, Yoichi; Kojima, Takeji

2011-11-01

258

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

PubMed Central

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 accepted by the patient. This paper introduces the proof of concept for a new non-invasive FES-assisted rehabilitation system for the upper limb, called smartFES (sFES), where the electrical stimulation is controlled by a biologically inspired neural inverse dynamics model, fed by the kinematic information associated with the execution of a planar goal-oriented movement. More specifically, this work details two steps of the proposed system: an ad hoc markerless motion analysis algorithm for the estimation of kinematics, and a neural controller that drives a synthetic arm. The vision of the entire system is to acquire kinematics from the analysis of video sequences during planar arm movements and to use it together with a neural inverse dynamics model able to provide the patient with the electrical stimulation patterns needed to perform the movement with the assisted limb. Methods The markerless motion tracking system aims at localizing and monitoring the arm movement by tracking its silhouette. It uses a specifically designed motion estimation method, that we named Neural Snakes, which predicts the arm contour deformation as a first step for a silhouette extraction algorithm. The starting and ending points of the arm movement feed an Artificial Neural Controller, enclosing the muscular Hill's model, which solves the inverse dynamics to obtain the FES patterns needed to move a simulated arm from the starting point to the desired point. Both position error with respect to the requested arm trajectory and comparison between curvature factors have been calculated in order to determine the accuracy of the system. Results The proposed method has been tested on real data acquired during the execution of planar goal-oriented arm movements. Main results concern the capability of the system to accurately recreate the movement task by providing a synthetic arm model with the stimulation patterns estimated by the inverse dynamics model. In the simulation of movements with a length of ± 20 cm, the model has shown an unbiased angular error, and a mean (absolute) position error of about 1.5 cm, thus confirming the ability of the system to reliably drive the model to the desired targets. Moreover, the curvature factors of the factual human movements and of the reconstructed ones are similar, thus encouraging future developments of the system in terms of reproducibility of the desired movements. Conclusion A novel FES-assisted rehabilitation system for the upper limb is presented and two parts of it have been designed and tested. The system includes a markerless motion estimation algorithm, and a biologically inspired neural controller that drives a biomechanical arm model and provides the stimulation patterns that, in a future development, could be used to drive a smart Functional Electrical Stimulation system (sFES). The system is envisioned to help in the rehabilitation of post stroke hemiparetic patients, by assisting the movement of the paretic upper limb, once trained with a set of movements performed by the therapist or in virtual reality. Future work will include the application and testing of the stimulation patterns in real conditions.

Goffredo, Michela; Bernabucci, Ivan; Schmid, Maurizio; Conforto, Silvia

2008-01-01

259

Effect of whole body vibration applied on upper extremity muscles.  

PubMed

The acute residual effect of whole body vibration (WBV) on upper extremity muscles and testosterone secretion was studied. Eight highly (G1), nine moderately trained gymnasts (G2) and seven physically active persons (CG) were recruited for the investigation. The intervention occurred in push-up position with the elbow flexed at 90°. G1 and G2 received 30 s, 30 Hz and 6 mm amplitude vibration repeated five times. Subjects were tested before and after one and ten minutes intervention in push-up movement. Contact time (Tc), fly time (Tf), TF/Tc ratio and impulse was measured from the ground reaction force-time curves recorded during self-selected (SSRM) and full range of motion (FRM). Testosterone level in urine was also determined. Tf increased significantly in SSRM for G1 and decreased in SSRM and FRM for G2. Tf/Tc ratio in FRM and impulse in SSRM increased significantly for G1 only. No significant alteration in testosterone level was observed. We concluded that WBV is a reasonable training modality for influencing dynamic work of upper extremity muscle, but the reaction to WBV is training and individual dependent. It seems that WBV do not influence dynamic work through increased testosterone secretion because of the relatively low mass of the involved muscles. PMID:23232701

Gyulai, G; Rácz, L; Di Giminiani, R; Tihanyi, József

2013-03-01

260

Neck, trunk and limb muscle responses during postural perturbations in humans.  

PubMed

This study examined the EMG onsets of leg, trunk, and neck muscles in 10 standing human subjects in response to support surface anterior and posterior translations, and to plantar and dorsiflexion rotations. The objective of the study was to test the hypothesis that the responses radiating upward from distal leg muscles represent part of a large ascending synergy encompassing axial muscles along the entire length of the body. If these responses are not ascending, then the muscles of the neck, and possibly the trunk, can be independently activated by vestibular, proprioceptive or visual inputs. We analysed the timing of postural muscle responses within and between body segments in order to determine whether they maintained a consistent temporal relationship under translational and rotational platform movement paradigms. Our results did not strongly support an ascending pattern of activation in all directions of platform perturbation. Temporal differences between activation patterns to platform perturbations in the forward or backward directions were revealed. In response to posterior platform translations we observed an ascending pattern of muscle responses along the extensor surface of the body. In addition, responses elicited in the neck flexor and abdominal muscles occurred as early as those of the stretched ankle muscles. This pattern of upward radiation from stretched ankle muscles was not as clear for anterior platform displacements, where early neck flexor muscle responses were observed during the ascending sequence on the flexor surface of the body. Platform rotations caused fewer responses in the neck and upper trunk muscles than translations, and all muscles responses occurred simultaneously rather than sequentially. Probable differences in the stimulation of vestibular and neck proprioceptive inputs and the mechanical demands of the rotation and translation paradigms are discussed. PMID:3416963

Keshner, E A; Woollacott, M H; Debu, B

1988-01-01

261

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

PubMed

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

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

2013-05-01

262

Limb position sense, proprioceptive drift and muscle thixotropy at the human elbow joint.  

PubMed

These experiments on the human forearm are based on the hypothesis that drift in the perceived position of a limb over time can be explained by receptor adaptation. Limb position sense was measured in 39 blindfolded subjects using a forearm-matching task. A property of muscle, its thixotropy, a contraction history-dependent passive stiffness, was exploited to place muscle receptors of elbow muscles in a defined state. After the arm had been held flexed and elbow flexors contracted, we observed time-dependent changes in the perceived position of the reference arm by an average of 2.8° in the direction of elbow flexion over 30 s (Experiment 1). The direction of the drift reversed after the arm had been extended and elbow extensors contracted, with a mean shift of 3.5° over 30 s in the direction of elbow extension (Experiment 2). The time-dependent changes could be abolished by conditioning elbow flexors and extensors in the reference arm at the test angle, although this led to large position errors during matching (±10°), depending on how the indicator arm had been conditioned (Experiments 3 and 4). When slack was introduced in the elbow muscles of both arms, by shortening muscles after the conditioning contraction, matching errors became small and there was no drift in position sense (Experiments 5 and 6). These experiments argue for a receptor-based mechanism for proprioceptive drift and suggest that to align the two forearms, the brain monitors the difference between the afferent signals from the two arms. PMID:24665096

Tsay, A; Savage, G; Allen, T J; Proske, U

2014-06-15

263

Creatine monohydrate supplementation on lower-limb muscle power in Brazilian elite soccer players  

PubMed Central

Background Studies involving chronic creatine supplementation in elite soccer players are scarce. Therefore, the aim of this study was to examine the effects of creatine monohydrate supplementation on lower-limb muscle power in Brazilian elite soccer players (n?=?14 males) during pre-season training. Findings This was a randomized, double-blind, placebo-controlled parallel-group study. Brazilian professional elite soccer players participated in this study. During the pre-season (7 weeks), all the subjects underwent a standardized physical and specific soccer training. Prior to and after either creatine monohydrate or placebo supplementation, the lower-limb muscle power was measured by countermovement jump performance. The Jumping performance was compared between groups at baseline (p?=?0.99). After the intervention, jumping performance was lower in the placebo group (percent change?=?- 0.7%; ES?=?- 0.3) than in the creatine group (percent change?=?+ 2.4%; ES?=?+ 0.1), but it did not reach statistical significance (p?=?0.23 for time x group interaction). Fisher’s exact test revealed that the proportion of subjects that experienced a reduction in jumping performance was significantly greater in the placebo group than in the creatine group (5 and 1, respectively; p?=?0.05) after the training. The magnitude-based inferences demonstrated that placebo resulted in a possible negative effect (50%) in jumping performance, whereas creatine supplementation led to a very likely trivial effect (96%) in jumping performance in the creatine group. Conclusions Creatine monohydrate supplementation prevented the decrement in lower-limb muscle power in elite soccer players during a pre-season progressive training.

2014-01-01

264

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

PubMed

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

Kang, Hao-Bo; Wang, Jian-Hui

2013-11-01

265

The application of shape memory actuators in anthropomorphic upper limb prostheses.  

PubMed

In recent years, single crystal Cu-Al-Ni alloys with shape memory behavior (SMB) became generally commercialized. They achieved the level of extended application, including upper limb human prosthesis with anthropomorphic characteristics. An actuator based in single crystal Cu-Al-Ni alloy was tested as a prototype for prosthetic actuators. Their thermal cycle times remarkably define the actuator dynamics and the idea of preheating to reduce its response time was tested. To elaborate the heating conditions, the chemical composition of martensitic and austenitic single crystals, Cu-Al-Ni alloy samples were examined. The dynamic response of a martensitic actuator made with SMB and the power consumed with preheating was analyzed. It demonstrates that the presence of more elements in alloys may be fundamental to displace the heating diagram and to reduce the power consumed. PMID:12752212

dos Santos, Christian Mariani Lucas; da Cunha, Fransergio Leite; Dynnikov, Vladimir Ivanovitch

2003-05-01

266

Development of an upper limb patient simulator for physical therapy exercise.  

PubMed

Physical therapist plays an important role to help people to regain the social life from disease and physical handicap. However, they can obtain their skills only from their practical experiences. The physical therapist trainee can enrich is experience only from the clinical practical training and this opportunity is limited. Therefore, we have been developing the upper limb patient simulator, which reproduce the stiffness of elbow joint to allow trainees to increase the opportunities to obtain the practical exercise of the physical therapy. The system reproduces the diseases by generating stiffness of the elbow joint, when the trainee tries to flex the elbow joint of the patient. We developed a mechanical part and a control system to realize the patient conditions and the full system has been evaluated by veteran physical therapists. PMID:22275706

Takhashi, Yoshiyuki; Komeda, Takashi; Koyama, Hiroyuki; Yamamoto, S-Ichiro; Arimatsu, Takayuki; Kawakami, Yukio; Inoue, Kaoru; Ito, Yuko

2011-01-01

267

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

PubMed Central

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.

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

2014-01-01

268

Electromyogram whitening for improved classification accuracy in upper limb prosthesis control.  

PubMed

Time and frequency domain features of the surface electromyogram (EMG) signal acquired from multiple channels have frequently been investigated for use in controlling upper-limb prostheses. A common control method is EMG-based motion classification. We propose the use of EMG signal whitening as a preprocessing step in EMG-based motion classification. Whitening decorrelates the EMG signal and has been shown to be advantageous in other EMG applications including EMG amplitude estimation and EMG-force processing. In a study of ten intact subjects and five amputees with up to 11 motion classes and ten electrode channels, we found that the coefficient of variation of time domain features (mean absolute value, average signal length and normalized zero crossing rate) was significantly reduced due to whitening. When using these features along with autoregressive power spectrum coefficients, whitening added approximately five percentage points to classification accuracy when small window lengths were considered. PMID:23475374

Liu, Lukai; Liu, Pu; Clancy, Edward A; Scheme, Erik; Englehart

2013-09-01

269

Popliteal pterygium associated with complete amelia of upper limb: early surgical treatment.  

PubMed

We report a 5-year clinical follow-up and the operative details of a patient who was born with popliteal pterygium and ipsilateral upper amelia. There were no craniofacial, genitourinary, or other extremity abnormalities, other than severe pes equinovarus. At age 3 weeks, excision of the pterygium and partial release of the hind foot had accomplished a significant but incomplete release of the knee contracture. At age 11 months, a second release of the pterygium, combined with complete reconstruction of the foot, accomplished a straight limb. Presently at the age of 5, the boy has 40 degrees limitation to full extension at the knee but walks, runs, and behaves like all the other children in the nursery school. This combination of congenital malformations and early surgical intervention has never been described in the orthopedic literature. PMID:7745103

Porat, S; Mosheiff, R; Peyser, A

1995-01-01

270

Development of Quasi-3DOF upper limb rehabilitation system using ER brake: PLEMO-P1  

NASA Astrophysics Data System (ADS)

In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. However, almost all the devices are active-type (motor-driven) haptic devices and they basically require high-cost safety system compared to passive-type (brake-based) devices. In this study, we developed a new practical haptic device 'PLEMO-P1'; this system adopted ER brakes as its force generators. In this paper, the mechanism of PLEMO-P1 and its software for a reaching rehabilitation are described.

Kikuchi, T.; Fukushima, K.; Furusho, J.; Ozawa, T.

2009-02-01

271

Intraobserver reliability of the modified Tardieu scale in the upper limb of children with hemiplegia.  

PubMed

This study investigated the reliability of the modified Tardieu scale in the assessment of biceps spasticity in the upper limbs of children with hemiplegic cerebral palsy (CP). Ten children, with hemiplegic CP participated in the study: six males (mean age 9 years, SD 4 years) and four females (mean age 12 years, SD 3 years). Blinded, duplicate measures of dynamic elbow extension were performed on the hemiplegic arm at time 0 and 7 days later, using the three angular velocities described in the Tardieu scale (V1, slow; V2, speed of gravity; V3, as fast as possible). The resulting elbow joint angles were defined as R1, the angle of catch following a fast velocity stretch at either V2 or V3; and R2, the passive range of movement achieved following a slow velocity stretch at V1. Both elbow joint angle and movement angular velocity were measured by three-dimensional kinematics. Median error in measured elbow joint angle within one session ranged from 3 to 5 degrees. Between sessions median absolute differences in measured elbow joint angle ranged from 4 to 13 degrees, with measurement errors of up to 25 to 30 degrees in some participants at the fastest velocity (V3). The therapist was able to apply three significantly different angular velocities as required for the Tardieu scale (p<0.001). However, the ranges of the three angular velocities overlapped, with fast velocities for some participants being equivalent to slow velocities for other participants. Three out of 10 participants had an intersessional difference in their R2-R1 score of more than 20 degrees. From this study, we concluded that the R2-R1 value determined from the modified Tardieu scale may be of limited value in assessing biceps spasticity the upper limbs in children with hemiplegic CP. PMID:15077704

Mackey, Anna H; Walt, Sharon E; Lobb, Glenis; Stott, N Susan

2004-04-01

272

Venous adenosine content and vascular responses in dog hind-limb skeletal muscles during twitch contraction.  

PubMed

In dogs anaesthetized with pentobarbitone sodium and chloralose and artificially ventilated, the skeletal muscles of a hind limb were vascularly and neurally isolated and perfused at a constant flow of 150% of the resting blood flow (5.8 +/- 0.3 ml.min-1.100g-1 muscle tissue, mean +/- S.E.M., n = 6) obtained after denervation of the limb. Electrical stimulation of the cut peripheral ends of the femoral and sciatic nerves for 20 min resulted in muscle contraction and a decrease in arterial perfusion pressure to a new steady level (59.7 +/- 8.6% decrease in vascular resistance) within 2 min; the pressure remained constant throughout the remaining 20 min. Similarly venous oxygen tension decreased from 38.2 +/- 1.3 (control) to 16.4 +/- 1.7 mmHg (n = 5) during contractions. The concentration of adenosine in arterial plasma did not change significantly during muscle contraction (122.5 +/- 28 nM, n = 8). However, the adenosine concentrations in venous plasma increased significantly (P less than 0.05) from a control value of 94.8 +/- 33 nM (n = 8) to 256 +/- 82 nM (n = 8) after 10 min and 235 +/- 31 nM (n = 8) after 20 min of muscle contraction. During infusion of adenosine into the femoral artery to give a range of arterial plasma concentrations between 0.17 and 90 microM, 89.2 +/- 2.8% (n = 20) of the infused adenosine was removed (taken up by tissues) from the blood before it reached the vein. Infusion of adenosine caused dose-dependent decreases in vascular resistance ranging between 7 and 79%; 5.58 +/- 1.50 microM adenosine caused a decrease in resistance of 36.1 +/- 7.1% (n = 10) and 51.7 +/- 7.4 microM adenosine caused a decrease of 51.2 +/- 4.1% (n = 9). Comparison of venous plasma adenosine concentrations during adenosine infusions with those seen during contractions suggests that the released adenosine can contribute about 60% of the total vasodilatation seen during contractions of the muscle. These results show that adenosine appears in the venous blood during muscle contraction and is likely to contribute to exercise hyperaemia. PMID:3423195

Ballard, H J; Cotterrell, D; Karim, F

1987-10-01

273

A facile nonviral method for delivering genes and siRNAs to skeletal muscle of mammalian limbs.  

PubMed

Delivery is increasingly being recognized as the critical hurdle holding back the tremendous promise of nucleic acid-based therapies that include gene therapy and more recently siRNA-based therapeutics. While numerous candidate genes (and siRNA sequences) with therapeutic potential have been identified, their utility has not yet been realized because of inefficient and/or unsafe delivery technologies. We now describe an intravascular, nonviral methodology that enables efficient and repeatable delivery of nucleic acids to muscle cells (myofibers) throughout the limb muscles of mammals. The procedure involves the injection of naked plasmid DNA or siRNA into a distal vein of a limb that is transiently isolated by a tourniquet or blood pressure cuff. Nucleic acid delivery to myofibers is facilitated by its rapid injection in sufficient volume to enable extravasation of the nucleic acid solution into muscle tissue. High levels of transgene expression in skeletal muscle were achieved in both small and large animals with minimal toxicity. Evidence of siRNA delivery to limb muscle was also obtained. The simplicity, effectiveness, and safety of the procedure make this methodology well suited to limb muscle gene therapy applications. PMID:15294185

Hagstrom, James E; Hegge, Julia; Zhang, Guofeng; Noble, Mark; Budker, Vladimir; Lewis, David L; Herweijer, Hans; Wolff, Jon A

2004-08-01

274

An EEG-based study of discrete isometric and isotonic human lower limb muscle contractions  

PubMed Central

Background Electroencephalography (EEG) combined with independent component analysis enables functional neuroimaging in dynamic environments including during human locomotion. This type of functional neuroimaging could be a powerful tool for neurological rehabilitation. It could enable clinicians to monitor changes in motor control related cortical dynamics associated with a therapeutic intervention, and it could facilitate noninvasive electrocortical control of devices for assisting limb movement to stimulate activity dependent plasticity. Understanding the relationship between electrocortical dynamics and muscle activity will be helpful for incorporating EEG-based functional neuroimaging into clinical practice. The goal of this study was to use independent component analysis of high-density EEG to test whether we could relate electrocortical dynamics to lower limb muscle activation in a constrained motor task. A secondary goal was to assess the trial-by-trial consistency of the electrocortical dynamics by decoding the type of muscle action. Methods We recorded 264-channel EEG while 8 neurologically intact subjects performed isometric and isotonic, knee and ankle exercises at two different effort levels. Adaptive mixture independent component analysis (AMICA) parsed EEG into models of underlying source signals. We generated spectrograms for all electrocortical source signals and used a naïve Bayesian classifier to decode exercise type from trial-by-trial time-frequency data. Results AMICA captured different electrocortical source distributions for ankle and knee tasks. The fit of single-trial EEG to these models distinguished knee from ankle tasks with 80% accuracy. Electrocortical spectral modulations in the supplementary motor area were significantly different for isometric and isotonic tasks (p?limb motor tasks. Using a broad distribution of electrocortical signals may improve classification of human lower limb movements from single-trial EEG.

2012-01-01

275

Localization of exogenous DNA to mitochondria in skeletal muscle following hydrodynamic limb vein injection.  

PubMed

Mitochondrial genetic disorders are a major cause of mitochondrial diseases. It is therefore likely that mitochondrial gene therapy will be useful for the treatment of such diseases. Here, we report on the possibility of mitochondrial gene delivery in skeletal muscle using hydrodynamic limb vein (HLV) injection. The HLV injection procedure, a useful method for transgene expression in skeletal muscle, involves the rapid injection of a large volume of naked plasmid DNA (pDNA) into the distal vein of a limb. We hypothesized that the technique could be used to deliver pDNA not only to nuclei but also to mitochondria, since cytosolic pDNA that is internalized by the method may be able to overcome mitochondrial membrane. We determined if pDNA could be delivered to myofibrillar mitochondria by HLV injection by PCR analysis. Mitochondrial toxicity assays showed that the HLV injection had no influence on mitochondrial function. These findings indicate that HLV injection promises to be a useful technique for in vivo mitochondrial gene delivery. PMID:24100263

Yasuzaki, Yukari; Yamada, Yuma; Kanefuji, Tsutomu; Harashima, Hideyoshi

2013-12-28

276

Is there a competition for oxygen availability between respiratory and limb muscles?  

PubMed

If a competition between the oxygen demands of limb and respiratory muscles happens, hypoxia may favor redistribution of blood flow from peripheral to respiratory muscles during heavy exercise. This hypothesis was tested in eighteen lowlanders and 27 highlanders at 4350m altitude. During an incremental exercise, the regional tissue oxygen saturation (rSO2) and tissue hemoglobin concentration ([Hbt]) of the intercostal muscles and vastus medialis were monitored simultaneously by NIRS. The intercostal and vastus medialis rSO2 values were lower at altitude than at sea level (-10%, p<0.001) and decreased similarly during incremental exercise (p<0.001) while [Hbt] values increased. At maximal exercise, the intercostal rSO2 was lower than the vastus medialis rSO2 in lowlanders (-7%, p<0.001). In highlanders the time patterns were similar but intercostal rSO2 was less decreased at exercise (p<0.05). Maximal exercise performed in hypoxia did not alter the kinetics of rSO2 and [Hbt] in peripheral muscles. These findings do not favor the hypothesis of blood flow redistribution. PMID:24582718

de Bisschop, C; Beloka, S; Groepenhoff, H; van der Plas, M N; Overbeek, M J; Naeije, R; Guenard, H

2014-06-01

277

Relationship between Lower Limb Muscle Structure and Function in Cerebral Palsy  

PubMed Central

[Purpose] The purpose of the study was to provide information for intervention by comparing lower limb muscle thickness, gross motor function and functional level of activity daily living between cerebral palsy (CP) and mental retardation (MR). [Subjects] Sixty subjects participated: 38 CP and 9 MR subjects and 13 normally developing infants. [Methods] Ultrasonography and a manual muscle tester were used for measuring the thickness and strength of knee extensor and ankle plantar flexor muscles. The Gross Motor Function Measure (GMFM) and Wee Functional Independence Measure (WeeFIM) were used to evaluate level of gross motor and independence level. [Results] Knee extensor thicknesses of CP and MR subjects were thinner than those of normally developing infants. Strengths of knee extensor and ankle plantar flexor showed differences being strongest in normally developing infants, followed by MR, and CP. Subjects in the examination of GMFM, there were no significant differences between CP and MR. A decline in social cognition of MR subjects was found in the examination of WeeFIM. [Conclusion] CP and MR subjects had smaller muscle thicknesses and strengths than those of normally developing infants, and lower gross motor function and functional independent level.

Ko, In-Hee; Kim, Jung-Hee; Lee, Byoung-Hee

2014-01-01

278

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

NASA Technical Reports Server (NTRS)

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).

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

1992-01-01

279

Assessment of upper limb motor function in patients with multiple sclerosis using the Virtual Peg Insertion Test: a pilot study.  

PubMed

Quantifying and tracking upper limb impairment is of key importance to the understanding of disease progress, establishing patient-tailored therapy protocols and for optimal care provision. This paper presents the results of a pilot study on the assessment of upper limb motor function in patients with multiple sclerosis (MS) with the Virtual Peg Insertion Test (VPIT). The test consists in a goal-directed reaching task using a commercial haptic display combined with an instrumented handle and virtual environment, and allows for the extraction of objective kinematic and dynamic parameters. Ten MS patients and eight age-matched healthy subjects performed five repetitions of the VPIT with their dominant and non-dominant hand. Upper limb movements were found to be significantly slower, less smooth and less straight compared to healthy controls, and the time to complete the VPIT was well correlated with the conventional Nine Hole Peg Test (r=0.658, p<0.01). Tremor in the range of 3-5 Hz could be detected and quantified using a frequency analysis in patients featuring intention tremor. These preliminary results illustrate the feasibility of using the VPIT with MS patients, and underline the potential of this test to evaluate upper limb motor function and discriminate characteristic MS related impairments. PMID:24187309

Lambercy, Olivier; Fluet, Marie-Christine; Lamers, Ilse; Kerkhofs, Lore; Feys, Peter; Gassert, Roger

2013-06-01

280

Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system  

Microsoft Academic Search

BACKGROUND: Clinical tests to assess peripheral nerve disorders can be classified into two categories: tests for afferent\\/efferent nerve function such as nerve conduction (bedside neurological examination) and tests for increased mechanosensitivity (e.g. upper limb neurodynamic tests (ULNTs) and nerve palpation). Reliability reports of nerve palpation and the interpretation of neurodynamic tests are scarce. This study therefore investigated the intertester reliability

Annina B Schmid; Florian Brunner; Hannu Luomajoki; Ulrike Held; Lucas M Bachmann; Sabine Künzer; Michel W Coppieters

2009-01-01

281

Sports Adaptations for Unilateral and Bilateral Upper-Limb Amputees: Archery/Badminton/Baseball/Softball/Bowling/Golf/Table Tennis.  

ERIC Educational Resources Information Center

The booklet discusses sports adaptations for unilateral and bilateral upper limb amputees. Designs for adapted equipment are illustrated and information on adaptations are described for archery (including an archery release aid and a stationary bow holder); badminton (serving tray); baseball/softball (adaptations for catching, throwing, and…

Cowart, Jim

1979-01-01

282

Effects of intensive repetition of a new facilitation technique on motor functional recovery of the hemiplegic upper limb and hand  

PubMed Central

Objective To study the effects on the hemiplegic upper limb of repetitive facilitation exercises (RFEs) using a novel facilitation technique, in which the patient's intention to move the hemiplegic upper limb or finger was followed by realization of the movement using multiple sensory stimulations. Methods Twenty-three stroke patients were enrolled in a cross-over study in which 2-week RFE sessions (100 repetitions each of five-to-eight types of facilitation exercise per day) were alternated with 2-week conventional rehabilitation (CR) sessions, for a total of four sessions. Treatments were begun with the 2-week RFE session in one group and the 2-week CR session in the second group. Results After the first 2-week RFE session, both groups showed improvements in the Brunnstrom stages of the upper limb and the hand, in contrast to the small improvements observed during the first CR session. The Simple Test for Evaluating Hand Function (STEF) score, which evaluates the ability of manipulating objects, in both groups improved during both sessions. After the second 2-week RFE and CR sessions, both groups showed little further improvement except in the STEF score. Conclusion The novel RFEs promoted the functional recovery of the hemiplegic upper limb and hand to a greater extent than the CR sessions.

Kawahira, Kazumi; Shimodozono, Megumi; Etoh, Seiji; Kamada, Katsuya; Noma, Tomokazu; Tanaka, Nobuyuki

2010-01-01

283

Determining Specificity of Motor Imagery Training for Upper Limb Improvement in Chronic Stroke Patients: A Training Protocol and Pilot Results  

ERIC Educational Resources Information Center

Motor imagery (MI) refers to the mental rehearsal of a movement without actual motor output. MI training has positive effects on upper limb recovery after stroke. However, until now it is unclear whether this effect is specific to the trained task or a more general motor skill improvement. This study was set up to advance our insights into the…

Craje, Celine

2010-01-01

284

A synthetic float analysis of upper-limb meridional overturning circulation interior ocean pathways in the tropical\\/subtropical Atlantic  

Microsoft Academic Search

Synthetic floats are released in an ocean general circulation model to study fluid pathways followed by the upper limb of the meridional overturning circulation from the subtropical South Atlantic to the subtropical North Atlantic. The floats are designed to track this fundamentally three-dimensional, non-isentropic flow while sampling water properties and all terms of the equation governing the vertical component of

G. R. Halliwell; R. H. Weisberg; D. A. Mayer

2003-01-01

285

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

ERIC Educational Resources Information Center

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…

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

2011-01-01

286

Classification systems of soft tissue disorders of the neck and upper limb: Do they satisfy methodological guidelines?  

Microsoft Academic Search

A critical appraisal of existing classifications of soft tissue disorders of the neck and upper limb was performed utilizing methodological criteria including appropriateness for purpose, validity, reliability, feasibility, and generalizability. Five classifications were assessed independently by three raters using standardized forms. For those criteria that can be assessed by inspection of the classification itself, none of the classification systems appeared

Rachelle Buchbinder; Vivek Goel; Claire Bombardier; Sheilah Hogg-Johnson

1996-01-01

287

Effect of position feedback during task-oriented upper-limb training after stroke: five-case pilot study  

Microsoft Academic Search

Feedback is an important element in motor learning during rehabilitation therapy following stroke. The objective of this pilot study was to better understand the effect of position feedback during task-oriented reach training of the upper limb in people with chronic stroke. Five subjects participated in the training for 30 minutes three times a week for 6 weeks. During training, subjects

Birgit I. Molier; Gerdienke B. Prange; Thijs Krabben; Arno H. A. Stienen; Kooij van der Herman; Jaap H. Buurke; Michiel J. A. Jannink; Hermie J. Hermens

2011-01-01

288

Electromyographic amplitude ratio of serratus anterior and upper trapezius muscles during modified push-ups and bench press exercises.  

PubMed

Imbalance and weakness of the serratus anterior and upper trapezius force couple have been described in patients with shoulder dysfunction. There is interest in identifying exercises that selectively activate these muscles and including it in rehabilitation protocols. This study aims to verify the UT/SA electromyographic (EMG) amplitude ratio, performed in different upper limb exercises and on two bases of support. Twelve healthy men were tested (average age = 22.8 +/- 3.1 years), and surface EMG was recorded from the upper trapezius and serratus anterior using single differential surface electrodes. Volunteers performed isometric contractions over a stable base of support and on a Swiss ball during the wall push-up (WP), bench press (BP), and push-up (PU) exercises. All SEMG data are reported as a percentage of root mean square or integral of linear envelope from the maximal value obtained in one of three maximal voluntary contractions for each muscle studied. A linear mixed-effect model was performed to compare UT/SA ratio values. The WP, BP, and PU exercises showed UT/SA ratio mean +/- SD values of 0.69 +/- 0.72, 0.14 +/- 0.12, and 0.39 +/- 0.37 for stable surfaces, respectively, whereas for unstable surfaces, the values were 0.73 +/- 0.67, 0.43 +/- 0.39, and 0.32 +/- 0.30. The results demonstrate that UT/SA ratio was influenced by the exercises and by the upper limb base of support. The practical application is to show that BP on a stable surface is the exercise preferred over WP and PU on either surfaces for serratus anterior muscle training in patients with imbalance between the UT/SA force couple or serratus anterior weakness. PMID:18550963

Martins, Jaqueline; Tucci, Helga T; Andrade, Rodrigo; Araújo, Rodrigo C; Bevilaqua-Grossi, Débora; Oliveira, Anamaria S

2008-03-01

289

A feasibility study of an upper limb rehabilitation system using Kinect and computer games.  

PubMed

A new low-cost system for rehabilitation of the impaired upper limb for stroke survivors is presented. A computer game was developed specifically for this purpose and the user's impaired upper extremity is tracked using a downward-pointed Kinect, an inexpensive motion capture system commercially available from Microsoft. A Kalman filter was implemented to reduce data jittering. Patients are required to move their impaired arm, sliding it on top of a transparent support, in order to play the game. The game is personalized to the patient through specific settings that adapt to the patient's range of motion and motor control at the start of the game as well as performance during the game. The final score is proportional to the arm's movement speed. A feasibility study was carried out with one stroke survivor. The game was played for ten days and usability surveys were answered before and after the study. The patient was engaged with the game, found it easy to understand and reported willingness to use it in the home environment and enjoyment of the use in the clinic. PMID:23366134

Pastor, Isaac; Hayes, Heather A; Bamberg, Stacy J M

2012-01-01

290

Comparison in eccentric exercise-induced muscle damage among four limb muscles  

Microsoft Academic Search

This study tested the hypothesis that changes in indirect markers of muscle damage following maximal eccentric exercise would\\u000a be smaller for the knee extensors (KE) and flexors (KF) compared with the elbow flexors (EF) and extensors (EE). A total of\\u000a 17 sedentary men performed five sets of six maximal isokinetic (90° s?1) eccentric contractions of EF (range of motion, ROM: 90°–0°,

Trevor C. Chen; Kun-Yi Lin; Hsin-Lian Chen; Ming-Ju Lin; Kazunori Nosaka

2011-01-01

291

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

NASA Astrophysics Data System (ADS)

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.

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

2007-03-01

292

Unilateral upper-limb loss: satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts.  

PubMed

Prosthetic use and satisfaction in wounded servicemembers and veterans with unilateral upper-limb loss has not been thoroughly explored. Through a national survey, we enrolled 47 participants from the Vietnam conflict and 50 from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) with combat-associated major unilateral upper-limb loss. Upper-limb prosthetic devices were used by 70% of the Vietnam group and 76% of the OIF/OEF group. Mechanical/body-powered upper-limb devices were favored by the Vietnam group, while a combination of myoelectric/hybrid and mechanical/body-powered devices were favored by the OIF/OEF group. Upper-limb devices were completely abandoned in 30% of the Vietnam and 22% of the OIF/OEF groups. Abandonment was more frequent for transhumeral and more proximal levels (42% of Vietnam and 40% of OIF/OEF) than more distal limb-loss levels. Upper-limb prostheses were rejected because of dissatisfaction with the device by significantly fewer (23%) members of the Vietnam group than the OIF/OEF group (45%) (p < 0.001). Most common reasons for rejection included pain, poor comfort, and lack of functionality. A significant paradigm shift has been noted in the OIF/OEF group, who use a greater number and diversity of upper-limb prostheses than the Vietnam group. PMID:20803400

McFarland, Lynne V; Hubbard Winkler, Sandra L; Heinemann, Allen W; Jones, Melissa; Esquenazi, Alberto

2010-01-01

293

Effect of hind limb muscle unloading on liver metabolism of rats.  

PubMed

In response to decreased use, skeletal muscle undergoes an adaptive reductive remodeling. There is a shift in fiber types from slow twitch to fast twitch fiber types. Associated with muscle unloading is an increased reliance on carbohydrate metabolism for energy. The hind limb suspended (HLS) rat model was used as the experimental model to determine whether skeletal muscle unloading had any impact on the liver. We used a combination of actual enzyme assays and microarray mRNA expression to address this question. The GenMAPP program was used to identify altered metabolic pathways. We found that the major changes in the liver with HLS were increases in the expression of genes involved in the generation of energy fuels for export, specifically gluconeogenesis and lipogenesis. The expression of mRNA was increased (P<0.05) for three of the four enzymes involved in the regulation of gluconeogenesis pathway (pyruvate carboxylase (PC), phosphoenolpyruvate carboxykinase (PEPCK), and glucose-6-phosphatase (G-6-Pase). Actual assay of enzymatic activity, in micromol . min(-1) . mg protein(-1) showed G-6-Pase (0.14+0.01 vs 0.17+0.01 P<0.05), fructose 1,6, bisphophosphatase (0.048+0.002 vs 0.054+0.002, P<0.07), and PEPCK (0.031+0.002 vs 0.038+0.012 (P<0.05) to be increased. We conclude that 1) atrophied muscle is not the only tissue to be affected by HLS, as there is also a response by the liver; and 2) the major changes in liver substrate metabolism induced by HLS appear to be limited to glucose and triglyceride production. The increase in glycolytic capacity in disused muscle is paralleled by an increase in glucogenic capacity by the liver. PMID:15629235

Stein, T Peter; Schluter, Margaret D; Galante, Anthony T; Soteropoulos, Patricia; Ramirez, Manuel; Bigbee, Allison; Grindeland, Richard E; Wade, Charles E

2005-01-01

294

Gene transfer establishes primacy of striated vs. smooth muscle sarcoglycan complex in limb-girdle muscular dystrophy.  

PubMed

Limb-girdle muscular dystrophy types 2E and F are characterized by skeletal muscle weakness and often cardiomyopathy and are due to mutations in the genes encoding beta- and delta-sarcoglycan. We previously demonstrated that loss of sarcoglycans in smooth muscle leads to constrictions of the microvasculature that contributes to the cardiac phenotype. It is unclear how vasculature abnormalities affect skeletal muscle. We injected recombinant beta- or delta-sarcoglycan adenoviruses into skeletal muscles of corresponding null mice. We hypothesized that the adenoviruses would not transduce vascular smooth muscle, and we would only target skeletal muscle. Indeed, sustained expression of intact sarcoglycan-sarcospan complex was noted at the sarcolemma, neuromuscular junction, myotendinous junction, and in peripheral nerve, but not in vascular smooth muscle. Gene transfer of the corresponding deleted sarcoglycan gene preserved sarcolemmal integrity, prevented pathological dystrophy and hypertrophy, and protected against exercised-induced damage. We conclude that vascular dysfunction is not a primary cause of beta- and delta-sarcoglycan-deficient muscular dystrophy. In addition, we show successful functional rescue of entire muscles after adenovirus-mediated gene delivery. Thus, virus-mediated gene transfer of sarcoglycans to skeletal muscle in combination with pharmacological prevention of cardiomyopathy constitute promising therapeutic strategies for limb-girdle muscular dystrophies. PMID:12851463

Durbeej, Madeleine; Sawatzki, Shanna M; Barresi, Rita; Schmainda, Kathleen M; Allamand, Valérie; Michele, Daniel E; Campbell, Kevin P

2003-07-22

295

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

PubMed

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

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

2012-06-01

296

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

PubMed Central

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.

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

2012-01-01

297

The Development of Upper Limb Movements: From Fetal to Post-Natal Life  

PubMed Central

Background The aim of this longitudinal study was to investigate how the kinematic organization of upper limb movements changes from fetal to post-natal life. By means of off-line kinematical techniques we compared the kinematics of hand-to-mouth and hand-to-eye movements, in the same individuals, during prenatal life and early postnatal life, as well as the kinematics of hand-to-mouth and reaching-toward-object movements in the later age periods. Methodology/Principal Findings Movements recorded at the 14th, 18th and 22nd week of gestation were compared with similar movements recorded in an ecological context at 1, 2, 3, 4, 8, and 12 months after birth. The results indicate a similar kinematic organization depending on movement type (i.e., eye, mouth) for the infants at one month and for the fetuses at 22 weeks of gestation. At two and three months such differential motor planning depending on target is lost and no statistical differences emerge. Hand to eye movements were no longer observed after the fourth month of life, therefore we compared kinematics for hand to mouth with hand to object movements. Results of these analyses revealed differences in the performance of hand to mouth and reaching to object movements in the length of the deceleration phase of the movement, depending on target. Conclusion/Significance Data are discussed in terms of how the passage from intrauterine to extra-uterine environments modifies motor planning. These results provide novel evidence of how different types of upper extremity movements, those directed towards one’s own face and those directed to external objects, develop.

Zoia, Stefania; Blason, Laura; D'Ottavio, Giuseppina; Biancotto, Marina; Bulgheroni, Maria; Castiello, Umberto

2013-01-01

298

Drinking Behavior Training for Stroke Patients Using Action Observation and Practice of Upper Limb Function  

PubMed Central

[Purpose] This study examined the effects of action observation and action practice on stroke patients’ upper limb function. [Subjects and Methods] The subjects were 33 chronic stroke patients who were randomly assigned to four groups. The action observation group (5 males, 3 females) watched a video of the task, the action practice group (5 males, 4 females) performed the action, the combined action observation-action practice group (5 males, 4 females) watched the video of the task and practiced the action, and the control group (4 males, 3 females) did not perform either action observation or action practice. The video used in the action observational physical training comprised a scene of an adult male picking up a cup, bringing it to his mouth in order to touch his mouth, and then returning the cup to its initial position. [Results] Improvements in drinking behavior functions were observed immediately after the experiment and one week later. After the intervention, the number of drinking motions had increased the most in the combination group. One week after the experiment, there were increases in the action observation, action training, and combination groups. [Conclusion] A combination of action observation and action training is the most effective treatment method, and action training is a desirable second to combined therapy.

Lee, Daehee; Roh, Hyolyun; Park, Jungseo; Lee, Sangyoung; Han, Seulki

2013-01-01

299

Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO  

NASA Astrophysics Data System (ADS)

In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named "Hybrid-PLEMO" in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

Kikuchi, T.; Jin, Y.; Fukushima, K.; Akai, H.; Furusho, J.

2009-02-01

300

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

PubMed

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

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

2013-01-01

301

Characteristics of upper limb muscular strength in male wheelchair tennis players  

PubMed Central

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.

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

2013-01-01

302

Autobiographical Memory and Psychological Distress in a Sample of Upper-Limb Amputees  

PubMed Central

Amputation is a traumatic and life-changing event that can take years to adjust to. The present study (a) examines psychological adjustment in a specific trauma-exposed sample, (b) compares the phenomenology (e.g., vividness) of amputation-related memories to more recent memories, and (c) tests whether memory phenomenology is associated with psychological distress. A total of 24 upper-limb amputees recalled two autobiographical memories–an amputation-related memory and a recent memory–and rated the phenomenological qualities of each memory, including Vividness, Coherence, Emotional Intensity, Visual Perspective, and Distancing. Participants also completed self-rated measures of psychological distress and personality. The sample was generally well adjusted; participants showed no relevant symptoms of anxiety and depression, and personality scores were similar to the general population. There were no significant differences in phenomenology between the two types of memories recalled. Even though amputation-related memories were, on average, almost 20 years older than the recent memories, they retained their intense phenomenology. Despite the intensity of the memory, none of the phenomenological dimensions were associated with psychological distress. It is worth to further define which dimensions of phenomenology characterize memories of traumatic events, and their association with individuals' psychological reactions.

Luchetti, Martina; Montebarocci, Ornella; Rossi, Nicolino; Cutti, Andrea G.; Sutin, Angelina R.

2014-01-01

303

Hydrostatic Isolated Limb Perfusion with Adeno-associated Virus Vectors Enhances Correction of Skeletal Muscle in Pompe Disease  

PubMed Central

Glycogen storage disease type II (GSD-II; Pompe disease; MIM 232300) stems from the inherited deficiency of acid-?-glucosidase (GAA; acid maltase; EC 3.2.1.20), which primarily involves cardiac and skeletal muscles. We hypothesized that hydrostatic isolated limb perfusion (ILP) administration of an adeno-associated virus (AAV) vector containing a muscle specific promoter could achieve relatively higher transgene expression in the hindlimb muscles of GAA-knockout (GAA-KO) mice, in comparison with intravenous (IV) administration. ILP adminstration of AAV2/8 vectors encoding alkaline phosphatase or human GAA transduced skeletal muscles of the hindlimb widely, despite the relatively low number of vector particles administered (1×1011), and IV administration of an equivalent vector dose failed to transduce skeletal muscle detectably. Similarly, ILP administration of fewer vector particles of the AAV2/9 vector encoding human GAA (3×1010) transduced skeletal muscles of the hindlimb widely and significantly reduced glycogen content to, in comparison with IV administration. The only advantage for IV administration was moderately high level transduction of cardiac muscle, which demonstrated compellingly that ILP administration sequestered vector particles within the perfused limb. Reduction of glycogen storage in the extensor digitorum longus demonstrated the potential advantage of ILP-mediated delivery of AAV vectors in Pompe disease, because type II myofibers are resistant to enzyme replacement therapy. Thus, ILP will enhance AAV transduction of multiple skeletal muscles while reducing the required dosages in terms of vector particle numbers.

Sun, Baodong; Li, Songtao; Bird, Andrew; Koeberl, Dwight D.

2010-01-01

304

Eccentric exercise affects the upper limbs more than the lower limbs in position sense and reaction angle  

Microsoft Academic Search

In this study, we investigated the effect of eccentric exercise on position sense and reaction angle of the elbow and knee flexors. Twelve males underwent two eccentric exercise sessions involving a randomized crossover design. In the first session participants used their elbow flexors and in the other session their knee flexors. Muscle damage indices, position sense, and joint reaction angle

Vassilis Paschalis; Michalis G. Nikolaidis; Anastasios A. Theodorou; Giannis Giakas; Athanasios Z. Jamurtas; Yiannis Koutedakis

2010-01-01

305

Upper limb neuropathy such as carpal tunnel syndrome as an initial manifestation of ATTR Val30Met familial amyloid polyneuropathy.  

PubMed

We report here two patients with amyloidogenic transthyretin (ATTR) Val30Met familial amyloid polyneuropathy (FAP) who developed numbness in both hands and were diagnosed as having bilateral carpal tunnel syndrome (CTS). In both patients systemic TTR amyloidosis consisting of polyneuropathy affecting both upper and lower limbs and/or autonomic dysfunction gradually appeared after surgery for CTS. Although CTS associated with TTR amyloidosis has been known as an initial symptom in some patients with ATTR non-Val30Met FAP and those with senile systemic amyloidosis, this is the first report of ATTR Val30Met FAP patients starting with upper limb neuropathy including CTS-like symptoms. It is also notable that both patients had no genealogical relationship with two Japanese endemic foci of this disease. PMID:20132088

Tojo, Kana; Tsuchiya-Suzuki, Ayako; Sekijima, Yoshiki; Morita, Hiroshi; Sumita, Naoko; Ikeda, Shu-Ichi

2010-03-01

306

Home-Based Telerehabilitation Shows Improved Upper Limb Function in Adults with Chronic Stroke: A Pilot Study  

PubMed Central

Objective This pilot study investigates the use of telerehabilitation to improve upper limb performance in chronic stages of stroke recovery. Design Intervention study with pre/post/one month follow-up tests. Methods Seven adults with chronic stroke participated in the study. Tests consisted of lab-based clinical and kinematic assessments. Participants completed the Upper Limb Training and Assessment (ULTrA) program at home. Training was 5 days/week, 60 min/day for 6 weeks with intermittent supervision of participants. Results Participants showed improvements in the training program tasks as well as clinical and kinematic assessments. Results also suggest there may be auxiliary benefits in cognitive function. Conclusions A home-based telerehabilitation program is a viable approach to provide rehabilitation in chronic stages of stroke.

Langan, Jeanne; DeLave, Kelsey; Phillips, Lauren; Pangilinan, Percival; Brown, Susan H.

2014-01-01

307

Effectiveness of botulinum toxin A for upper and lower limb spasticity in children with cerebral palsy: a summary of evidence  

Microsoft Academic Search

Botulinum toxin type A (BoNT-A) therapy has gained wide acceptance in the management of spasticity in cerebral palsy (CP).\\u000a Clinical experience from numerous case reports and series, retrospective and prospective open label cohort studies, and randomized\\u000a controlled trials (RCT) has grown over the past 10 years. Several independent systematic reviews on the role of BoNT-A for\\u000a upper and lower limb spasticity

Marissa Barlaan Lukban; Raymond L. Rosales; Dirk Dressler

2009-01-01

308

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

Microsoft Academic Search

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

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

2009-01-01

309

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

Microsoft Academic Search

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

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

2009-01-01

310

Validation of Aura Microwave Limb Sounder O3 and CO observations in the upper troposphere and lower stratosphere  

Microsoft Academic Search

Global satellite observations of ozone and carbon monoxide from the Microwave Limb Sounder (MLS) on the EOS Aura spacecraft are discussed with emphasis on those observations in the 215-100 hPa region (the upper troposphere and lower stratosphere). The precision, resolution and accuracy of the data produced by the MLS ``version 2.2'' processing algorithms are discussed and quantified. O3 accuracy is

N. J. Livesey; M. J. Filipiak; L. Froidevaux; W. G. Read; A. Lambert; M. L. Santee; J. H. Jiang; H. C. Pumphrey; J. W. Waters; R. E. Cofield; D. T. Cuddy; W. H. Daffer; B. J. Drouin; R. A. Fuller; R. F. Jarnot; Y. B. Jiang; B. W. Knosp; Q. B. Li; V. S. Perun; M. J. Schwartz; W. V. Snyder; P. C. Stek; R. P. Thurstans; P. A. Wagner; M. Avery; E. V. Browell; J.-P. Cammas; L. E. Christensen; G. S. Diskin; R.-S. Gao; H.-J. Jost; M. Loewenstein; J. D. Lopez; P. Nedelec; G. B. Osterman; G. W. Sachse; C. R. Webster

2008-01-01

311

Measuring the motor output of the pontomedullary reticular formation in the monkey: do stimulus-triggered averaging and stimulus trains produce comparable results in the upper limbs?  

PubMed Central

The pontomedullary reticular formation (PMRF) of the monkey produces motor outputs to both upper limbs. EMG effects evoked from stimulus-triggered averaging (StimulusTA) were compared with effects from stimulus trains to determine whether both stimulation methods produced comparable results. Flexor and extensor muscles of scapulothoracic, shoulder, elbow, and wrist joints were studied bilaterally in two male M. fascicularis monkeys trained to perform a bilateral reaching task. The frequency of facilitation versus suppression responses evoked in the muscles was compared between methods. Stimulus trains were more efficient (94% of PMRF sites) in producing responses than StimulusTA (55%), and stimulus trains evoked responses from more muscles per site than from StimulusTA. Facilitation (72%) was more common from stimulus trains than StimulusTA (39%). In the overall results, a bilateral reciprocal activation pattern of ipsilateral flexor and contralateral extensor facilitation was evident for StimulusTA and stimulus trains. When the comparison was restricted to cases where both methods produced a response in a given muscle from the same site, agreement was very high, at 80%. For the remaining 20%, discrepancies were accounted for mainly by facilitation from stimulus trains when StimulusTA produced suppression, which was in agreement with the under-representation of suppression in the stimulus train data as a whole. To the extent that the stimulus train method may favor transmission through polysynaptic pathways, these results suggest that polysynaptic pathways from the PMRF more often produce facilitation in muscles that would typically demonstrate suppression with StimulusTA.

Herbert, Wendy J.; Davidson, Adam G.

2010-01-01

312

The Impact of Recovery of Visuo-Spatial Neglect on Motor Recovery of the Upper Paretic Limb after Stroke  

PubMed Central

The aim of the current study was to investigate the longitudinal relationship between improvements of synergism and strength of the upper paretic limb and severity of visuo-spatial neglect during the first 52 weeks post-stroke. The longitudinal association between severity of VSN and motor impairment using Fugl Meyer motor score and Motricity Index of the arm was measured in an intensive repeated measurement design including 18 measurement sessions for each subject. Neglect was assessed using the letter cancellation test applied in a prospective cohort of 101 ischemic, first-ever, hemispheric stroke patients. All time-dependent measures were taken weekly, starting within 14 days post-stroke. From week 10 to 20 biweekly measurements are obtained. The longitudinal relationship of (bi)weekly time on improvement of motor functions and severity of neglect was investigated using random coefficient analysis and trend analyses. Fifty-one of the 101 stroke patients showed neglect at stroke onset. Less improvement of synergism and strength of the upper paretic limb was associated with more severe neglect. This association was most pronounced in the first 10 weeks post-stroke. The seemingly suppressive effect of neglect on upper-limb motor recovery appears to take place mainly during spontaneous neurological recovery of first 10 weeks post-stroke. This finding suggests that damage to large-scale white matter tracts of especially the perceptual-attention networks suppress recovery of other networks at distance in the brain suggesting a common underlying mechanism.

Nijboer, Tanja C. W.; Kollen, Boudewijn J.; Kwakkel, Gert

2014-01-01

313

Cross-cultural adaptation, reliability and validity of the Spanish version of the upper limb functional index  

PubMed Central

Background The Upper Limb Functional Index (ULFI) is an internationally widely used outcome measure with robust, valid psychometric properties. The purpose of study is to develop and validate a ULFI Spanish-version (ULFI-Sp). Methods A two stage observational study was conducted. The ULFI was cross-culturally adapted to Spanish through double forward and backward translations, the psychometric properties were then validated. Participants (n?=?126) with various upper limb conditions of >12 weeks duration completed the ULFI-Sp, QuickDASH and the Euroqol Health Questionnaire 5 Dimensions (EQ-5D-3 L). The full sample determined internal consistency, concurrent criterion validity, construct validity and factor structure; a subgroup (n?=?35) determined reliability at seven days. Results The ULFI-Sp demonstrated high internal consistency (??=?0.94) and reliability (r?=?0.93). Factor structure was one-dimensional and supported construct validity. Criterion validity with the EQ-5D-3 L was fair and inversely correlated (r?=??0.59). The QuickDASH data was unavailable for analysis due to excessive missing responses. Conclusions The ULFI-Sp is a valid upper limb outcome measure with similar psychometric properties to the English language version.

2013-01-01

314

[Repetitive movements of the upper limbs: results of exposure evaluation and clinical investigation in refinishing ceramic ornaments].  

PubMed

An evaluation was made of the degree of exposure to risk and the frequency of disorders attributable to biomechanical overload of the upper limb in workers performing finishing operation on ceramic vases and cups in a ceramics factory. The risks were first evaluated against a checklist, then subsequently an assessment was made of the tasks found to feature the highest risks, using an ergonomic analysis method, which identified activities associated with a large number of actions per minute (> 50). The 22 female workers performing the tasks in question underwent a risk-targeted physical examination which included an electroneurographic test using surface electrodes. The clinical test detected an extremely high frequency of carpal tunnel syndrome cases, in addition to other upper limb disorders. In particular, nine female workers (41%) were found to be suffering from carpal tunnel syndrome, and five (22%) from other pathologies of the upper limbs (4 scapulo-humeral periarthritis, 1 epicondylitis). As a result of the findings arising out of this study, immediate preventive measures were adopted; moreover, it has become evident that further epidemiological studies on larger sample populations are needed. PMID:9148115

Arfaioli, C; Tartaglia, R; Lombardi, A; Ianniello, G; Camporeale, P

1996-01-01

315

Bradykinesia-Akinesia Incoordination Test: Validating an Online Keyboard Test of Upper Limb Function  

PubMed Central

Background The Bradykinesia Akinesia Incoordination (BRAIN) test is a computer keyboard-tapping task that was developed for use in assessing the effect of symptomatic treatment on motor function in Parkinson's disease (PD). An online version has now been designed for use in a wider clinical context and the research setting. Methods Validation of the online BRAIN test was undertaken in 58 patients with Parkinson's disease (PD) and 93 age-matched, non-neurological controls. Kinesia scores (KS30, number of key taps in 30 seconds), akinesia times (AT30, mean dwell time on each key in milliseconds), incoordination scores (IS30, variance of travelling time between key presses) and dysmetria scores (DS30, accuracy of key presses) were compared between groups. These parameters were correlated against total motor scores and sub-scores from the Unified Parkinson's Disease Rating Scale (UPDRS). Results Mean KS30, AT30 and IS30 were significantly different between PD patients and controls (p?0.0001). Sensitivity for 85% specificity was 50% for KS30, 40% for AT30 and 29% for IS30. KS30, AT30 and IS30 correlated significantly with UPDRS total motor scores (r?=??0.53, r?=?0.27 and r?=?0.28 respectively) and motor UPDRS sub-scores. The reliability of KS30, AT30 and DS30 was good on repeated testing. Conclusions The BRAIN test is a reliable, convenient test of upper limb motor function that can be used routinely in the outpatient clinic, at home and in clinical trials. In addition, it can be used as an objective longitudinal measurement of emerging motor dysfunction for the prediction of PD in at-risk cohorts.

Noyce, Alastair J.; Nagy, Anna; Acharya, Shami; Hadavi, Shahrzad; Bestwick, Jonathan P.; Fearnley, Julian; Lees, Andrew J.; Giovannoni, Gavin

2014-01-01

316

Optimising case definitions of upper limb disorder for aetiological research and prevention - a review  

PubMed Central

Background Experts disagree about the optimal classification of upper limb disorders (ULDs). To explore whether differences in associations with occupational risk factors offer a basis for choosing between case definitions in aetiological research and surveillance, we analysed previously published research. Methods Eligible reports (those with estimates of relative risk (RR) for >1 case definition relative to identical exposures were identified from systematic reviews of ULD and occupation and by hand-searching five peer-review journals published between January 1990 and June 2010. We abstracted details by anatomical site of the case and exposure definitions employed and paired estimates of RR, for alternative case definitions with identical occupational exposures. Pairs of case definitions were typically nested, a stricter definition being a subset of a simpler version. Differences in RR between paired definitions were expressed as the ratio of RRs, using that for the simpler definition as the denominator. Results We found 21 reports, yielding 320 pairs of RRs (82, 75 and 163 respectively at the shoulder, elbow, and distal arm). Ratios of RRs were frequently ?1 (46%), the median ratio overall and by anatomical site being close to unity. In only 2% of comparisons did ratios reach ?4. Conclusion Complex ULD case definitions (e.g. involving physical signs, more specific symptom patterns, and investigations) yield similar associations with occupational risk factors to those using simpler definitions. Thus, in population-based aetiological research and surveillance, simple case definitions should normally suffice. Data on risk factors can justifiably be pooled in meta-analyses, despite differences in case definition.

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

2012-01-01

317

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

PubMed Central

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.

2014-01-01

318

The role of ventral and preventral organs as attachment sites for segmental limb muscles in Onychophora  

PubMed Central

Background The so-called ventral organs are amongst the most enigmatic structures in Onychophora (velvet worms). They were described as segmental, ectodermal thickenings in the onychophoran embryo, but the same term has also been applied to mid-ventral, cuticular structures in adults, although the relationship between the embryonic and adult ventral organs is controversial. In the embryo, these structures have been regarded as anlagen of segmental ganglia, but recent studies suggest that they are not associated with neural development. Hence, their function remains obscure. Moreover, their relationship to the anteriorly located preventral organs, described from several onychophoran species, is also unclear. To clarify these issues, we studied the anatomy and development of the ventral and preventral organs in several species of Onychophora. Results Our anatomical data, based on histology, and light, confocal and scanning electron microscopy in five species of Peripatidae and three species of Peripatopsidae, revealed that the ventral and preventral organs are present in all species studied. These structures are covered externally with cuticle that forms an internal, longitudinal, apodeme-like ridge. Moreover, phalloidin-rhodamine labelling for f-actin revealed that the anterior and posterior limb depressor muscles in each trunk and the slime papilla segment attach to the preventral and ventral organs, respectively. During embryonic development, the ventral and preventral organs arise as large segmental, paired ectodermal thickenings that decrease in size and are subdivided into the smaller, anterior anlagen of the preventral organs and the larger, posterior anlagen of the ventral organs, both of which persist as paired, medially-fused structures in adults. Our expression data of the genes Delta and Notch from embryos of Euperipatoides rowelli revealed that these genes are expressed in two, paired domains in each body segment, corresponding in number, position and size with the anlagen of the ventral and preventral organs. Conclusions Our findings suggest that the ventral and preventral organs are a common feature of onychophorans that serve as attachment sites for segmental limb depressor muscles. The origin of these structures can be traced back in the embryo as latero-ventral segmental, ectodermal thickenings, previously suggested to be associated with the development of the nervous system.

2013-01-01

319

High-density surface EMG maps from upper-arm and forearm muscles  

PubMed Central

Background sEMG signal has been widely used in different applications in kinesiology and rehabilitation as well as in the control of human-machine interfaces. In general, the signals are recorded with bipolar electrodes located in different muscles. However, such configuration may disregard some aspects of the spatial distribution of the potentials like location of innervation zones and the manifestation of inhomogineties in the control of the muscular fibers. On the other hand, the spatial distribution of motor unit action potentials has recently been assessed with activation maps obtained from High Density EMG signals (HD-EMG), these lasts recorded with arrays of closely spaced electrodes. The main objective of this work is to analyze patterns in the activation maps, associating them with four movement directions at the elbow joint and with different strengths of those tasks. Although the activation pattern can be assessed with bipolar electrodes, HD-EMG maps could enable the extraction of features that depend on the spatial distribution of the potentials and on the load-sharing between muscles, in order to have a better differentiation between tasks and effort levels. Methods An experimental protocol consisting of isometric contractions at three levels of effort during flexion, extension, supination and pronation at the elbow joint was designed and HD-EMG signals were recorded with 2D electrode arrays on different upper-limb muscles. Techniques for the identification and interpolation of artifacts are explained, as well as a method for the segmentation of the activation areas. In addition, variables related to the intensity and spatial distribution of the maps were obtained, as well as variables associated to signal power of traditional single bipolar recordings. Finally, statistical tests were applied in order to assess differences between information extracted from single bipolar signals or from HD-EMG maps and to analyze differences due to type of task and effort level. Results Significant differences were observed between EMG signal power obtained from single bipolar configuration and HD-EMG and better results regarding the identification of tasks and effort levels were obtained with the latter. Additionally, average maps for a population of 12 subjects were obtained and differences in the co-activation pattern of muscles were found not only from variables related to the intensity of the maps but also to their spatial distribution. Conclusions Intensity and spatial distribution of HD-EMG maps could be useful in applications where the identification of movement intention and its strength is needed, for example in robotic-aided therapies or for devices like powered- prostheses or orthoses. Finally, additional data transformations or other features are necessary in order to improve the performance of tasks identification.

2012-01-01

320

Effect of joystick stiffness, movement speed and movement direction on joystick and upper limb kinematics when using hydraulic-actuation joystick controls in heavy vehicles.  

PubMed

Despite the widespread use of hydraulic-actuation joysticks in mobile North American construction, mining and forestry vehicles, the biomechanical effects that joysticks have on their human operators has not been studied extensively. Using nine unskilled joystick operators and a laboratory mock-up with a commonly used North American heavy off-road equipment hydraulic-actuation joystick and operator seat, the purpose of this work was to quantify and compare the effects of three hydraulic-actuation joystick stiffnesses and two movement speeds on upper limb and joystick kinematics as one of the initial steps towards the development of a hydraulic-actuation joystick design protocol. In addition to providing a detailed description of the kinematics of a constrained occupational task, coupled with the corresponding effects of the task on operator upper limb kinematics, results from principal component analysis and ANOVA procedures revealed a number of differences in joystick and upper limb angle ranges and movement curve shapes resulting from the various joystick stiffness-speed combinations tested. For the most part, these joystick motion alterations were caused by small, insignificant changes in one or more upper limb joint angles. The two exceptions occurred for forward movements of the joystick; the fast speed - light stiffness condition movement pattern shape change was caused primarily by an alteration of the elbow flexion-extension movement pattern. Similarly, the fast speed - normal stiffness condition movement curve shape perturbation - was caused principally by a combination of significant movement curve shape alterations to elbow flexion-extension, external-internal shoulder rotation and flexion-extension of the shoulder. The finding that joystick stiffness and speed alterations affect joystick and upper limb kinematics minimally indicates that the joystick design approach of modelling the joystick and operator upper limb as a closed linkage system should be pursued. This approach would allow one to simulate the upper limb and joystick kinematics that result from virtual changes to upper limb and joystick lengths. PMID:17457745

Oliver, M; Tingley, M; Rogers, R; Rickards, J; Biden, E

2007-06-01

321

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

Microsoft Academic Search

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

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

2002-01-01

322

System for Multifunctional Control of Upper Limb Prosthesis via EMG Signal Identification.  

National Technical Information Service (NTIS)

The patent application discloses a system for controlling the operation of an electrically powered prosthetic appliance which replaces an amputee's missing limb. The method employed consists of conducting electromyographic (EMG) signals from the stump of ...

Barrington

1978-01-01

323

Virtual reality for the rehabilitation of the upper limb motor function after stroke: a prospective controlled trial  

PubMed Central

Background Recent evidence has demonstrated the efficacy of Virtual Reality (VR) for stroke rehabilitation nonetheless its benefits and limitations in large population of patients have not yet been studied. Objectives To evaluate the effectiveness of non-immersive VR treatment for the restoration of the upper limb motor function and its impact on the activities of daily living capacities in post-stroke patients. Methods A pragmatic clinical trial was conducted among post-stroke patients admitted to our rehabilitation hospital. We enrolled 376 subjects who had a motor arm subscore on the Italian version of the National Institutes of Health Stroke Scale (It-NIHSS) between 1 and 3 and without severe neuropsychological impairments interfering with recovery. Patients were allocated to two treatments groups, receiving combined VR and upper limb conventional (ULC) therapy or ULC therapy alone. The treatment programs consisted of 2 hours of daily therapy, delivered 5 days per week, for 4 weeks. The outcome measures were the Fugl-Meyer Upper Extremity (F-M UE) and Functional Independence Measure (FIM) scales. Results Both treatments significantly improved F-M UE and FIM scores, but the improvement obtained with VR rehabilitation was significantly greater than that achieved with ULC therapy alone. The estimated effect size of the minimal difference between groups in F-M UE and FIM scores was 2.5 ± 0.5 (P < 0.001) pts and 3.2 ± 1.2 (P = 0.007) pts, respectively. Conclusions VR rehabilitation in post-stroke patients seems more effective than conventional interventions in restoring upper limb motor impairments and motor related functional abilities. Trial registration Italian Ministry of Health IRCCS Research Programme 2590412

2013-01-01

324

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

PubMed Central

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.

2011-01-01

325

Analysis of Changes in Muscle Length of Lower Limbs during High-heeled Walking Based on the Musculoskeletal Model  

Microsoft Academic Search

In this paper, we analyzed changes in muscle length of lower limbs during high-heel walking based on the musculoskeletal model. Twenty young healthy women participated in this study. For each subject, the 3D motion analysis was performed for four different cases; walking with flat shoe, 3 cm high-heel, 6 cm high-heel, and 9 cm high-heel. Then the musculoskeletal model, with

Jongsang Son; Hueseok Choi; Youngho Kim

2008-01-01

326

[Muscle anomalies of the upper extremity as an atavistic cause of peripheral nerve disorder].  

PubMed

We report on 2 patients with anomalous muscles of the upper extremity causing symptoms of peripheral nerve entrapment. Our first case clinically showed a lesion of the R. dorsalis manus of nervus ulnaris produced by an accessory muscle belly at the dorsum of the hand to be identified as an extensor indicis brevis muscle. The second case presented a carpal-tunnel-syndrome, tunnel into the palm. Phylogenetically and ontogenetically these muscles are classified as atavistic. We demonstrate the homologies of the upper extremity of fishes, amphibians, reptiles, lower mammals and man, which show an upward migration of the muscle masses from the hand to the forearm. By that means the upper extremity gains additionally to the power of the reptiles paw the functionality and free motility of the human hand. PMID:8396294

Kraus, E; Schön, R; Boller, O; Nabavi, A

1993-01-01

327

Cardiorespiratory Responses to Varied Exercise Distributions between Upper and Lower Body Muscle Groups.  

National Technical Information Service (NTIS)

The present study examined the influence that distributing exercise between upper (arm crank exercise) and lower (cycle exercise) body muscle groups had upon cardiorespiratory responses to constant power output (PO) exercise. Six male volunteers completed...

M. M. Toner M. N. Sawka L. Levine K. B. Pandolf

1982-01-01

328

Three-dimensional upper limb movement characteristics in children with hemiplegic cerebral palsy and typically developing children.  

PubMed

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 tasks (forwards, upwards, and sideways), two reach-to-grasp tasks (with objects requiring different hand orientations), and three gross motor tasks. Spatiotemporal (movement duration, trajectory straightness, maximum velocity, and timing of maximum velocity), as well as kinematic parameters (discrete angles and waveforms of the trunk, scapula, shoulder, elbow and wrist), were compared between 20 children with HCP (age 10.9 ± 2.9 years) and 20 individually age-matched TDC (age 10.9 ± 3.0 years). Kinematic calculations followed the recommendations from the International Society of Biomechanics. Results showed that children with HCP had longer movement durations, less straight hand trajectories, and lower maximum velocities compared to the TDC. Timing of maximum velocity did not differ between both groups. The movement pathology in children with HCP was highlighted by increased trunk movements and reduced shoulder elevation during reaching and reach-to-grasp. We also measured an increased anterior tilting and protraction of the scapula in children with HCP, although differences were not significant for all tasks. Finally, compared to the TDC, children with HCP used less elbow extension and supination and more wrist flexion to execute all tasks. This study reported distinct 3D upper limb movement characteristics in children with HCP and age-matched TDC, establishing the discriminative ability of the measurement procedure. From a clinical perspective, combining spatiotemporal and kinematic parameters may facilitate the identification of the pathological movement patterns seen in children with HCP and thereby add to a well-targeted upper limb treatment planning. PMID:21862283

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

2011-01-01

329

Diagnosing soft tissue rheumatic disorders of the upper limb in epidemiological studies of vibration-exposed populations  

Microsoft Academic Search

Objectives  To investigate approaches adopted to diagnose soft tissue rheumatic disorders of the upper limb (ULDs) in vibration-exposed\\u000a populations and in other settings, and to compare their methodological qualities.\\u000a \\u000a \\u000a \\u000a Methods  Systematic searches were made of the Medline, Embase, and CINAHL electronic bibliographic databases, and of various supplementary\\u000a sources (textbooks, reviews, conference and workshop proceedings, personal files). For vibration-exposed populations, qualifying\\u000a papers were

Keith T. Palmer

2008-01-01

330

Spatio-temporal evaluation of neck muscle activation during postural perturbations in healthy subjects  

Microsoft Academic Search

The purpose of this study was to examine the spatio-temporal activation of the sternocleidomastoid (SCM) and cervical extensor (CE) muscles with respect to the deltoid muscle onset during rapid voluntary upper limb movement in healthy volunteers. The repeatability and reliability of the spatio-temporal aspects of the myoelectric signals were also examined. Ten subjects performed bilateral and unilateral rapid upper limb

D. Falla; A. Rainoldi; R. Merletti; G. Jull

2004-01-01

331

The Design and Control of a Low-Power, Upper-Limb Prosthesis  

Microsoft Academic Search

Control moment gyroscopes (CMGs) offer a unique approach to address power consumption issues that currently limit the design of prosthetic limbs. CMGs generate large output torques while requiring less power than conventional actuators. This advance is possible because CMGs conserve angular momentum without increasing the kinetic energy of the system, providing high-agility, low-power movements. We have designed a novel, three

A. M. Jarc; A. B. Kimes; M. E. Pearson; M. A. Peck

2006-01-01

332

Case of complex craniofacial anomalies, bilateral nasal proboscides, palatal pituitary, upper limbs reduction, and amnion rupture sequence: disorganization phenotype?  

PubMed

We report a case of a dizygotic twin with complex abnormalities of head, body, and limbs. The anomalies include the following: lateral and midline cleft upper lip, ectopic palatal pituitary, natal teeth, bilateral nasal proboscides with an absent nose, left microphthalmia with conjunctival-lined cyst, right ocular dysgenesis, bilateral retinal dysplasia, platybasia with skull asymmetry, hydrocephalus secondary to aqueductal atresia, brain hemispheric asymmetry with a parietal-occipital cortical flap, agenesis of posterior corpus callosum, absence of the olfactory nerves and left anterior cerebral artery, leptomeningeal and intraventricular heterotopias, right radial longitudinal terminal meromelia with constriction rings of fingers, partial syndactyly of the third and fourth left fingers, dorsiflexed great toes and pes equinovarus bilaterally, and multiple skin tags with a sacral appendage. Additionally, this twin's placental disc and extraplacental membranes were devoid of amnion. We regard these anomalies as a possible expression of the human homologue of the disorganization phenotype or another gene mutation. Nevertheless, an abnormality of blastogenesis with early damage to organizing tissues of the frontonasal region and limbs, or a vascular disruption, cannot be excluded. Early amnion rupture sequence (possible extraamniotic pregnancy with amniotic bands, limb reduction defects with Streeter bands, and multiple skin tags tapering into amniotic bands) was also present in this case, and may have acted as a contributing factor. PMID:11178637

Stanek, J; de Courten-Myers, G; Spaulding, A G; Strub, W; Hopkin, R J

2001-01-01

333

Influence of tonic neck reflexes on the upper limb stretch reflex in man  

Microsoft Academic Search

This study was designed to test the influence of tonic neck reflexes (TNR) on the elbow extensor muscles. Surface electromyography (EMG) of triceps brachii (TB), anconeus (ANC) and biceps brachii (BB) muscles were recorded simultaneously with elbow acceleration. Stretch reflex responses from the elbow extensors were analysed in seven healthy subjects for three head positions, two positions of the eyes

A. Le Pellec; B. Maton

1996-01-01

334

[Study on relationship between teeth clenching in intercuspal position and isometric movement of upper limbs].  

PubMed

To investigate the relationship between teeth clenching in intercuspal position and isometric shoulder adduction movement in 12 normal subjects, the muscle strength and electromyogram (EMG) of the seven muscles concerned were measured by using Cybex 6000 Extremity Testing and Rehabilitation System and surface EMG analyzing system. Normalized peak torque (n-PT) and normalized average torque (n-AT) were analyzed to find muscle strength. Normalized integrated EMG (n-iEMG) was analyzed to find muscle activity. The results were as follows: 1. For n-AT, the value in 100%MVC significantly increased by 5.4% as compared with that in the rest position (RP). 2. There was a significant positive correlation between biting force of intercuspal position (ICP), 20%MVC, 50%MVC and 100%MVC and muscle strength of n-PT and n-AT. 3. For n-iEMG, the value of latissimus dorsi, teres major, triceps brachii and forearm extensor muscles in 100%MVC significantly increased by 8.4%, 13.0%, 9.3% and 18.9% respectively as compared with that in RP. 4. There was a significant positive correlation between biting force of intercuspal position (ICP), 20%MVC, 50%MVC and 100%MVC and muscle activity of pectralis major, latissimus dorsi, teres major, biceps brachii, triceps brachii, forearm extensor and forearm flexor muscles. PMID:7665962

Ueno, T

1995-06-01

335

Toll-Like Receptors in Ischaemia and Its Potential Role in the Pathophysiology of Muscle Damage in Critical Limb Ischaemia  

PubMed Central

Toll-like receptors (TLRs) are key receptors of the innate immune system which are expressed on immune and nonimmune cells. They are activated by both pathogen-associated molecular patterns and endogenous ligands. Activation of TLRs culminates in the release of proinflammatory cytokines, chemokines, and apoptosis. Ischaemia and ischaemia/reperfusion (I/R) injury are associated with significant inflammation and tissue damage. There is emerging evidence to suggest that TLRs are involved in mediating ischaemia-induced damage in several organs. Critical limb ischaemia (CLI) is the most severe form of peripheral arterial disease (PAD) and is associated with skeletal muscle damage and tissue loss; however its pathophysiology is poorly understood. This paper will underline the evidence implicating TLRs in the pathophysiology of cerebral, renal, hepatic, myocardial, and skeletal muscle ischaemia and I/R injury and discuss preliminary data that alludes to the potential role of TLRs in the pathophysiology of skeletal muscle damage in CLI.

Patel, Hemanshu; Shaw, Sidney G.; Shi-Wen, Xu; Abraham, David; Baker, Daryll M.; Tsui, Janice C. S.

2012-01-01

336

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

PubMed Central

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

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

2014-01-01

337

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

Microsoft Academic Search

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

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

1995-01-01

338

Is typing speed proportional to the severity of pain in keyboard workers with work-related upper limb disorder  

PubMed Central

Objectives To investigate if typing speed is proportional to the severity of pain in keyboard workers with work-related upper limb disorder (WRULD). Design Standardized functional typing test with participants scoring pain before and after typing; calculation of typing speed. Participants Fifty-nine patients and six controls. Setting Tertiary hospital centre for hand and upper limb pain. Main outcome measures Pain (VAS 0–10) and calculation of typing speed as words per minute. Results Three subgroups of patients were found based on their typing speed: fast, slow and intermediate. Two-tailed student T-test with P level at 0.05 was used for evaluation. The typing speeds were significantly different between all three patient groups (P < 0.05). The typing speed was significantly faster in the fastest patient group than in the control group (P = 0.04) and the slow and middle groups (P = < 0.0001). The pain before typing was highest in the ‘slow’ group, in both hands but this difference was not statistically significant. Conclusion Typing speed is not proportional to the severity of pain in keyboard workers with WRULD. Patients with statistically significant slower or faster typing speeds do not have statistically different levels of pain.

Povlsen, Bo

2012-01-01

339

Lingual Muscle Activity Across Sleep-Wake States in Rats with Surgically Altered Upper Airway  

PubMed Central

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.

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

2014-01-01

340

Function and Bulk of Respiratory and Limb Muscles in Patients with Cystic Fibrosis  

Microsoft Academic Search

Inspiratory muscle weakness due to lung hyperinflation and muscle wasting may occur in cystic fibrosis. We therefore measured dia- phragm function and bulk in 18 stable patients with cystic fibrosis and 15 matched control subjects; the abdominal and quadriceps muscles were studied for comparison. We assessed diaphragm mass, abdominal muscle thickness, twitch transdiaphragmatic and gastric pressures, quadriceps cross-section and isokinetic

Christophe Pinet; Marie Cassart; Pietro Scillia; Michel Lamotte; Christiane Knoop; Georges Casimir; Christian Melot; Marc Estenne

2003-01-01

341

Toward electrocorticographic control of a dexterous upper limb prosthesis: building brain-machine interfaces.  

PubMed

One of the most exciting and compelling areas of research and development is building brain machine interfaces (BMIs) for controlling prosthetic limbs. Prosthetic limb technology is advancing rapidly, and the modular prosthetic limb (MPL) of the Johns Hopkins University/ Applied Physics Laboratory (JHU/APL) permits actuation with 17 degrees of freedom in 26 articulating joints. There are many signals from the brain that can be leveraged, including the spiking rates of neurons in the cortex, electrocorticographic (ECoG) signals from the surface of the cortex, and electroencephalographic (EEG) signals from the scalp. Unlike microelectrodes that record spikes, ECoG does not penetrate the cortex and has a higher spatial specificity, signal-to-noise ratio, and bandwidth than EEG signals. We have implemented an ECoG-based system for controlling the MPL in the Johns Hopkins Hospital Epilepsy Monitoring Unit, where patients are implanted with ECoG electrode grids for clinical seizure mapping and asked to perform various recorded finger or grasp movements. We have shown that low-frequency local motor potentials (LMPs) and ECoG power in the high gamma frequency (70,150 Hz) range correlate well with grasping parameters, and they stand out as good candidate features for closed-loop control of the MPL. PMID:22344950

Fifer, Matthew S; Acharya, Soumyadipta; Benz, Heather L; Mollazadeh, Mohsen; Crone, Nathan E; Thakor, Nitish V

2012-01-01

342

Limb segment vibration modulates spinal reflex excitability and muscle mRNA expression after spinal cord injury  

PubMed Central

Objective We investigated the effect of various doses of vertical oscillation (vibration) on soleus H-reflex amplitude and post-activation depression in individuals with and without SCI. We also explored the acute effect of short-term limb vibration on skeletal muscle mRNA expression of genes associated with spinal plasticity. Methods Six healthy adults and five chronic complete SCI subjects received vibratory stimulation of their tibia over three different gravitational accelerations (0.3g, 0.6g, and 1.2g) at a fixed frequency (30 Hz). Soleus H-reflexes were measured before, during, and after vibration. Two additional chronic complete SCI subjects had soleus muscle biopsies 3 h following a single bout of vibration. Results H-reflex amplitude was depressed over 83% in both groups during vibration. This vibratory-induced inhibition lasted over 2 min in the control group, but not in the SCI group. Post-activation depression was modulated during the long-lasting vibratory inhibition. A single bout of mechanical oscillation altered mRNA expression from selected genes associated with synaptic plasticity. Conclusions Vibration of the lower leg inhibits the H-reflex amplitude, influences post-activation depression, and alters skeletal muscle mRNA expression of genes associated with synaptic plasticity. Significance Limb segment vibration may offer a long term method to reduce spinal reflex excitability after SCI.

Chang, Shuo-Hsiu; Tseng, Shih-Chiao; McHenry, Colleen L.; Littmann, Andrew E.; Suneja, Manish; Shields, Richard K.

2012-01-01

343

Neck proprioceptors contribute to the modulation of muscle sympathetic nerve activity to the lower limbs of humans.  

PubMed

Several different strategies have now been used to demonstrate that the vestibular system can modulate muscle sympathetic nerve activity (MSNA) in humans and thereby contribute to the regulation of blood pressure during changes in posture. However, it remains to be determined how the brain differentiates between head-only movements that do not require changes in vasomotor tone in the lower limbs from body movements that do require vasomotor changes. We tested the hypothesis that neck movements modulate MSNA in the lower limbs of humans. MSNA was recorded in 10 supine young adult subjects, at rest, during sinusoidal stretching of neck muscles (100 cycles, 35° peak to peak at 0.37 ± 0.02 Hz) and during a ramp-and-hold (17.5° for 54 ± 9 s) static neck muscle stretch, while their heads were held fixed in space. Cross-correlation analysis revealed cyclical modulation of MSNA during sinusoidal neck muscle stretch (modulation index 45.4 ± 5.3 %), which was significantly less than the cardiac modulation of MSNA at rest (78.7 ± 4.2 %). Interestingly, cardiac modulation decreased significantly during sinusoidal neck displacement (63.0 ± 9.3 %). By contrast, there was no significant difference in MSNA activity during static ramp-and-hold displacements of the neck to the right or left compared with that with the head and neck aligned. These data suggest that dynamic, but not static, neck movements can modulate MSNA, presumably via projections of muscle spindle afferents to the vestibular nuclei, and may thus contribute to the regulation of blood pressure during orthostatic challenges. PMID:24691758

Bolton, P S; Hammam, E; Macefield, V G

2014-07-01

344

Kinematic Analysis of the Upper Limb Motor Strategies in Stroke Patients as a Tool towards Advanced Neurorehabilitation Strategies: A Preliminary Study  

PubMed Central

Advanced rehabilitation strategies of the upper limb in stroke patients focus on the recovery of the most important daily activities. In this study we analyzed quantitatively and qualitatively the motor strategies employed by stroke patients when reaching and drinking from a glass. We enrolled 6 hemiparetic poststroke patients and 6 healthy subjects. Motion analysis of the task proposed (reaching for the glass, bringing it to the mouth, and putting it back on the table) with the affected limb was performed. Clinical assessment using the Fugl-Meyer Assessment for Upper Extremity was also included. During the reaching for the glass the patients showed a reduced arm elongation and trunk axial rotation due to motor deficit. For this reason, as observed, they carried out compensatory strategies which included trunk forward displacement and head movements. These preliminary data should be considered to address rehabilitation treatment. Moreover, the kinematic analysis protocol developed might represent an outcome measure of upper limb rehabilitation processes.

Simbolotti, Chiara

2014-01-01

345

Immediate effect of visual attention on corticospinal excitability in the upper trapezius muscle.  

PubMed

This study investigated the immediate effect of visual attention on corticospinal excitability in the upper trapezius muscle. 10 healthy males gazed at a horizontal bar. A warning tone, indicating that a line would be slightly displaced 7,400 msec. later, was delivered in the high-attention-demand condition. A different warning tone, indicating the line would not be displaced, was delivered in the low-attention-demand condition. Participants verbally declared the direction of line displacement in the high-attention-demand condition, or stated that the warning tone meant that the line would not be displaced in the low-attention-demand condition. The amplitude of the motor-evoked potential in the upper trapezius muscle increased 7,000 msec. after the warning tone in the high-attention-demand condition. Apparently, visual attention immediately increases corticospinal excitability in the upper trapezius muscle. PMID:24422350

Hiraoka, Koichi; Mori, Nobuhiko; Horino, Hiroshi

2013-08-01

346

Optimising speed and energy expenditure in accurate visually directed upper limb movements.  

PubMed

Traditional models of speed-accuracy relations and limb control are steady-state models that fail to consider the learning history and strategic approach of the performer. Work from this laboratory indicates that a performer adjusts his/her behaviour from trial-to-trial to optimise not only the speed and accuracy of performance, but also energy expenditure. Because some errors have greater temporal and energy costs than others, most performers execute movements that are prepared such that potential errors are of minimal expense. The trajectories and subsequent endpoint distributions of rapid aiming movements depend on advance knowledge about the availability of afferent information for online control, as well as the costs associated with undershooting or overshooting the target position with the initial impulse. With practice, a performer is able to reduce the trial-to-trial variability associated with goal-directed movement through more consistent movement planning processes and more rapid online control. Part of the optimisation process is related to the development of an internal model of performance against which early afferent feedback can be evaluated. This framework for examining speed, accuracy and energy expenditure in goal-directed reaching can be used to help understand the breakdown of efficient limb control due to fatigue, ageing and pathology. PMID:19401895

Elliott, Digby; Hansen, Steve; Grierson, Lawrence E M

2009-04-01

347

Analysis of upper limb motions in tennis swings toward rehabilitation training  

Microsoft Academic Search

A new method for the rehabilitation by playing virtual tennis is proposed. As the first step, we investigate whether the tennis swings are applicable for the range of joint motion exercise and the muscle strengthening exercise in this paper. For the evaluation of the range of joint motion exercise, we measure the motion range of the shoulder joints in various

T. Wadat; N. Yoshii; Y. Yamaji; S. Tanaka; K. Tsukamoto

2002-01-01

348

Impact of movement training on upper limb motor strategies in persons with shoulder impingement syndrome  

Microsoft Academic Search

BACKGROUND: Movement deficits, such as changes in the magnitude of scapulohumeral and scapulathoracic muscle activations or perturbations in the kinematics of the glenohumeral, sternoclavicular and scapulothoracic joints, have been observed in people with shoulder impingement syndrome. Movement training has been suggested as a mean to contribute to the improvement of the motor performance in persons with musculoskeletal impairments. However, the

Jean-Sébastien Roy; Hélène Moffet; Bradford J McFadyen; Richard Lirette

2009-01-01

349

SEMG analysis of astronaut upper arm during isotonic muscle actions with normal standing posture  

Microsoft Academic Search

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

Zhou Qianxiang; Ma Chao; Zheng Xiaohui

2010-01-01

350

Delayed-onset muscle soreness and motor performance of the upper extremity  

Microsoft Academic Search

.   The purpose of this study was to examine the effects of delayed-onset muscle soreness after a strength-training session on\\u000a the motor performance of the upper extremities, including the reaction time, speed of movement, tapping speed and coordination.\\u000a In addition, muscle strength, electromyographic (EMG) activity, creatine kinase (CK) and soreness responses were measured.\\u000a The study was a randomised cross-over intervention

Kari Kauranen; Pertti Siira; Heikki Vanharanta

2001-01-01

351

Indocyanine Green (ICG) Lymphography Is Superior to Lymphoscintigraphy for Diagnostic Imaging of Early Lymphedema of the Upper Limbs  

PubMed Central

Background Secondary lymphedema causes swelling in limbs due to lymph retention following lymph node dissection in cancer therapy. Initiation of treatment soon after appearance of edema is very important, but there is no method for early diagnosis of lymphedema. In this study, we compared the utility of four diagnostic imaging methods: magnetic resonance imaging (MRI), computed tomography (CT), lymphoscintigraphy, and Indocyanine Green (ICG) lymphography. Patients and Methods Between April 2010 and November 2011, we examined 21 female patients (42 arms) with unilateral mild upper limb lymphedema using the four methods. The mean age of the patients was 60.4 years old (35–81 years old). Biopsies of skin and collecting lymphatic vessels were performed in 7 patients who underwent lymphaticovenous anastomosis. Results The specificity was 1 for all four methods. The sensitivity was 1 in ICG lymphography and MRI, 0.62 in lymphoscintigraphy, and 0.33 in CT. These results show that MRI and ICG lymphography are superior to lymphoscintigraphy or CT for diagnosis of lymphedema. In some cases, biopsy findings suggested abnormalities in skin and lymphatic vessels for which lymphoscintigraphy showed no abnormal findings. ICG lymphography showed a dermal backflow pattern in these cases. Conclusions Our findings suggest the importance of dual diagnosis by examination of the lymphatic system using ICG lymphography and evaluation of edema in subcutaneous fat tissue using MRI.

Araki, Jun; Kikuchi, Kazuki; Narushima, Mitsunaga; Yamamoto, Takumi; Iida, Takuya; Yoshimatsu, Hidehiko; Murai, Noriyuki; Mitsui, Kito; Okitsu, Taro; Koshima, Isao

2012-01-01

352

A new calibration methodology for thorax and upper limbs motion capture in children using magneto and inertial sensors.  

PubMed

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

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

2014-01-01

353

Validity and reliability of the modified sphygmomanometer test to assess strength of the lower limbs and trunk muscles after stroke.  

PubMed

Objectives: To investigate the criterion-related validity, test-retest and inter-rater reliabilities of the modified sphygmomanometer test (MST) for assessment of the strength of the trunk and lower limb muscles in subjects with chronic stroke, and to verify whether the number of trials affected the results. Patients and methods: Fifty-nine subjects with stroke (mean age 57.80 years; standard deviation 13.79 years) were included in the study. Maximum isometric strength was assessed with a hand-held dynamometer and the MST. To investigate whether the number of trials affected the results, one-way analysis of variance was applied. For the criterion-related validity, test-retest and inter-rater reliabilities of the MST, Pearson correlation coefficients, coefficients of determination, and intra-class correlation coefficient (ICC) were calculated. Results: Different numbers of trials provided similar values for all assessed muscles (0.003???F???0.08; 0.92???p???1.00) with adequate validity (0.79???r???0.90; p???0.001), test-retest (0.57???ICC???0.98; p???0.001), and inter-rater reliabilities (0.53???ICC???0.97; p???0.001), except for the inter-rater reliability of the non-paretic ankle plantar flexors. The values obtained with the MST were good predictors of those obtained with the hand-held dynamometer (0.57???r2???0.79). Conclusion: In general, the MST showed adequate criterion-related validity, test-retest and inter-rater reliabilities for the assessment of strength of the lower limb and trunk muscles in subjects with chronic stroke. For the majority of the assessed muscles, only one trial, after familiarization, provided adequate strength values. PMID:24849895

Souza, Lucas Araújo; Martins, Júlia Caetano; Teixeira-Salmela, Luci Fuscaldi; Lara, Eliza Maria; Moura, Juliana Braga; Aguiar, Larissa Tavares; de Morais Faria, Christina Danielli Coelho

2014-06-25

354

A decision-theoretic approach in the design of an adaptive upper-limb stroke rehabilitation robot.  

PubMed

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 partially observable Markov decision process (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. The performance of the system was evaluated through various simulations and by comparing the decisions made by the system with those of a human therapist for a single patient. In general, the simulations showed promising results and the therapist thought the system decisions were believable. PMID:22275621

Huq, Rajibul; Kan, Patricia; Goetschalckx, Robby; Hébert, Debbie; Hoey, Jesse; Mihailidis, Alex

2011-01-01

355

Determining specificity of motor imagery training for upper limb improvement in chronic stroke patients: a training protocol and pilot results.  

PubMed

Motor imagery (MI) refers to the mental rehearsal of a movement without actual motor output. MI training has positive effects on upper limb recovery after stroke.However, until now it is unclear whether this effect is specific to the trained task or a more general motors kill improvement. This study was set up to advance our insights into the efficacy of MI training and the specificity of its effects. We investigated whether MI training affected the trained hand exclusively, or both hands. Four stroke participants received a 15-min MI training four times a week for 3 weeks. Hand function was measured before and after the training using three measurement of increasing complexity. Hand function improved after MI training, thus confirming the earlier studies. Second, we found specific effects of the MI training for two of the three measurements. These results suggest that MI specificity is dependent on the complexity of the hand function task. PMID:20505516

Craje, Celine; van der Graaf, Chantal; Lem, Frits C; Geurts, Alexander C H; Steenbergen, Bert

2010-12-01

356

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

NASA Astrophysics Data System (ADS)

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 steel plate fixation group, minimal cortical bone under the steel plate and opposite side to the steel plate was also harvested for observation. Main outcome measurements were taken such as osteocyte morphology, Harversian canal histological observation under light microscope; radiographic observation of fracture healing, and computed tomography quantitative scanning of cortical bone. As a conclusion, SMC has a lesser stress-shielding effect to fixed bone than steel plate. Finally, the mechanism of the lesser stress-shielding effect of SMC is discussed.

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

2009-08-01

357

Muscle weights and succinic dehydrogenase distribution in the hind limb musculature of two rodents (Thryonomys gregorianus and Pedetes capensis) with different locomotory habits.  

PubMed

The hind limb muscles of the spring hare (Pedetes capensis) were found to be relatively heavier than the hind limb muscles of the cane rat (Thryonomys gregorianus). The distribution of succine dehydrogenase activity was investigated in four of these muscles (m. gluteus superficialis, m.semimembranosus, m. biceps femoris and m.rectus femoris) from both animals. It was found that the spring hare had a higher proportion of low-activity fibres in all four muscles than the cane rat. All muscle fibre types were also smaller in diameter in the spring hare than the cane rat. These results are discussed in relation to the different locomotry habits of the two animals. PMID:685649

Stickland, N C

1978-01-01

358

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

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.

Kreissl, S.; Uber, A.

2008-01-01

359

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

PubMed

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

Basteris, Angelo; Nijenhuis, Sharon M; Stienen, Arno Ha; Buurke, Jaap H; Prange, Gerdienke B; Amirabdollahian, Farshid

2014-01-01

360

A randomized trial of upper limb botulimun toxin versus placebo injection, combined with physiotherapy, in children with hemiplegia.  

PubMed

The main goal of this study was to investigate the efficacy of Botulinum Toxin A (BoNT-A), combined with an individualized intensive physiotherapy/orthoses treatment, in improving upper limb activity and competence in daily activity in children with hemiplegia, and to compare its effectiveness with that of non-pharmacological instruments. It was a Randomized Clinical Trial of 27 children with spastic hemiplegic cerebral palsy, outpatients of two high speciality Centres for child rehabilitation. Each child was assigned by simple randomization to experimental group (BoNT-A) or control group (placebo). Assisting Hand Assessment (AHA) was chosen as primary outcome measure; other measures were selected according to ICF dimensions. Participants were assessed at baseline (T0), at T1, T2, T3 (1-3-6 months after injection, respectively). Every patient was given a specific physiotherapeutic treatment, consisting of individualized goal directed exercises, task oriented activities, daily stretching manoeuvres, functional and/or static orthoses. BoNT-A group showed a significant increase of AHA raw scores at T2, compared to control group (T2-T0: p=.025) and functional goals achievement (GAS) was also slightly better in the same group (p=.033). Other measures indicated some improvement in both groups, without significant intergroup differences. Children with intermediate severity of hand function at House scale for upper limb impairment seem to have a better benefit from BoNT-A protocol. BoNT-A was effective in improving manipulation in the activity domain, in association with individualized goal-directed physiotherapy and orthoses; the combined treatment is recommended. The study brings more evidence for the efficacy of a combined treatment botulinum toxin injection-physiotherapy-orthoses, and it gives some suggestions for candidate selection and individualized treatment. PMID:24995688

Ferrari, Adriano; Maoret, Anna Rosa; Muzzini, Simonetta; Alboresi, Silvia; Lombardi, Francesco; Sgandurra, Giuseppina; Paolicelli, Paola Bruna; Sicola, Elisa; Cioni, Giovanni

2014-10-01

361

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

PubMed Central

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.

2014-01-01

362

An investigation of somatosensory profiles in work related upper limb disorders: a case-control observational study protocol  

PubMed Central

Background Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP), remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain. Methods/Design Three groups of participants will be investigated: Groups 1 and 2 will be office workers with either NSAP or cervical radiculopathy and Group 3 will be a control group of non office workers without upper limb pain. Participants will undergo a clinical assessment, pain questionnaires (LANSS, Short Form McGill, DASH and TSK) and quantitative sensory testing comprising thermal detection and pain thresholds, vibration thresholds and pressure pain thresholds. Discussion The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying neurophysiology in NSAP and may influence future classification and intervention studies relating to this condition.

2010-01-01

363

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

PubMed Central

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.

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

2014-01-01

364

Diagnosing soft tissue rheumatic disorders of the upper limb in epidemiological studies of vibration-exposed populations  

PubMed Central

Objectives To investigate approaches adopted to diagnose soft tissue rheumatic disorders of the upper limb (ULDs) in vibration-exposed populations and in other settings, and to compare their methodological qualities. Methods Systematic searches were made of the Medline, Embase, and CINAHL electronic bibliographic databases, and of various supplementary sources (textbooks, reviews, conference and workshop proceedings, personal files). For vibration-exposed populations, qualifying papers were scored in terms of the provenance of their measuring instruments (adequacy of documentation, standardisation, reliability, criterion-related and content validity). Similar criteria were applied to general proposals for whole diagnostic schemes, and evidence was collated on the test-retest reliability of symptom histories and clinical signs. Results In total, 23 relevant reports were identified concerning vibration-exposed populations - 21 involving symptoms and 9 involving examination/diagnosis. Most of the instruments employed scored poorly in terms of methodological quality. The search also identified, from the wider literature, more than a dozen schemes directed at classifying ULDs, and 18 studies of test-retest reliability of symptoms and physical signs in the upper limb. Findings support the use of the standardised Nordic questionnaire for symptom inquiry and suggest that a range of physical signs can be elicited with reasonable between-observer agreement. Four classification schemes rated well in terms of content validity. One of these had excellent documentation, and one had been tested for repeatability, agreement with an external reference standard, and utility in distinguishing groups that differed in disability, prognosis and associated risk factors. Conclusions Hitherto, most studies of ULDs in vibration-exposed populations have used custom-specified diagnostic methods, poorly documented, and non-stringent in terms of standardisation and supporting evidence of reliability and/or validity. The broader literature contains several question sets and procedures that improve upon this, and offer scope in vibration-exposed populations to diagnose ULDs more systematically.

Palmer, Keith T

2013-01-01

365

The Neurochip BCI: towards a neural prosthesis for upper limb function.  

PubMed

The Neurochip BCI is an autonomously operating interface between an implanted computer chip and recording and stimulating electrodes in the nervous system. By converting neural activity recorded in one brain area into electrical stimuli delivered to another site, the Neurochip BCI could form the basis for a simple, direct neural prosthetic. In tests with normal, unrestrained monkeys, the Neurochip continuously recorded activity of single neurons in primary motor cortex for several weeks at a time. Cortical activity was correlated with simultaneously-recorded electromyogram (EMG) activity from arm muscles during free behavior. In separate experiments with anesthetized monkeys, we found that microstimulation of the cervical spinal cord evoked movements of the arm and hand, often involving multiple muscles synergies. These observations suggest that spinal microstimulation controlled by cortical neurons could help compensate for damaged corticospinal projections. PMID:16792290

Jackson, Andrew; Moritz, Chet T; Mavoori, Jaideep; Lucas, Timothy H; Fetz, Eberhard E

2006-06-01

366

Electrodiagnostic techniques in the evaluation of nerve compressions and injuries in the upper limb.  

PubMed

Nerve conduction studies and the needle examination of muscles (EMG) are valuable aids in the evaluation of acute and chronic focal neuropathies. A careful clinical examination, however, remains the best way to assess patients with these disorders. In an acute and apparently complete nerve lesion, the main drawbacks of electrophysiologic testing are that a full evaluation cannot usually be done before 10 days after the injury, and the differentiation between axonotmesis and neurotmesis cannot be made. PMID:3793766

Stewart, J D

1986-11-01

367

Inter-tester reliability and precision of manual muscle testing and hand-held dynamometry in lower limb muscles of children with spina bifida.  

PubMed

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 therapists and a student physical therapist. Inter-tester reliability [ICC(2,1)] for HHD varied from 0.76 to 0.83, indicating excellent reliability for the three muscle groups. Inter-tester reliability for MMT was 0.75 for the hip abductor muscle group, indicating good reliability, and 0.37 to 0.40 for the remaining muscle groups. The minimum detectable change was 15N for HHD and 1 scale unit of a 0 to 5 MMT scale. The results suggest a situation-specific solution to the question of which method to use. To detect small strength changes over time in children with spina bifida, MMT should be used when the child has insufficient strength to move the limb against gravity; otherwise, HHD should be used. PMID:19197758

Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

2009-01-01

368

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

PubMed

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

Pecking, A P

1995-09-01

369

WORK RELATED MUSCULOSKELETAL DISORDERS OF THE UPPER LIMBS AMONG STEEL INDUSTRY POPULATIONS  

Microsoft Academic Search

For high occurrences of upper extremity disorders in working populations and in order to compare the occurrence of musculoskeletal alterations due to ergonomic risk factors such as highly force exertion, repetition, awkward posture between exposed and non-exposed groups, the research was carried out in Tabarestan steel industry. All 526 male workers (316 as exposed group : 132 aged 20-35 years,

S. A. Moussavi-Najarkola; A. Khavanin

370

Long-term results after total and subtotal macroamputations of the upper limb  

Microsoft Academic Search

Using our personal series of 65 patients operated on between 1982 and 1993 (upper arm: n = 18, proximal and middle forearm: n = 32, distal forearm and wrist level: n = 15) and the results of an extensive literature review the following criteria were evaluated: (1) survival rate, (2) possible individual motor and sensory functions of the extremity, (3)

Robert Hierner; Alfred C. Berger

2005-01-01

371

A Kinematic Model of the Upper Limb Based on the Visible Human Project (VHP) Image Dataset  

Microsoft Academic Search

A kinematic model of the arm was developed using high-resolution medical images obtained from the National Library of Medicine's Visible Human Project (VHP) dataset. The model includes seven joints and uses thirteen degrees of freedom to describe the relative movements of seven upper-extremity bones: the clavicle, scapula, humerus, ulna, radius, carpal bones, and hand. Two holonomic constraints were used to

BRIAN A. GARNER; MARCUS G. PANDY

1999-01-01

372

Pretranslational markers of contractile protein expression in human skeletal muscle: effect of limb unloading plus resistance exercise.  

PubMed

Previously, it has been shown that the human ground-based model consisting of unilateral limb suspension (ULLS) induces atrophy and reduced strength of the affected quadriceps muscle group. Resistance exercise (RE) involving concentric-eccentric actions, in the face of ULLS, is effective in ameliorating these deficits. The goal of the present study was to determine whether alterations in contractile protein gene expression, e.g., myosin heavy chain and actin, as studied at the pretranslational level, provide molecular markers concerning the deficits that occur in muscle mass/volume during ULLS, as well as its maintenance in response to ULLS plus RE. Muscle biopsies were obtained from the vastus lateralis muscle of 31 middle-aged men and women before and after 5 wk of ULLS, ULLS plus RE, or RE only. The RE paradigm consisted of 12 sessions of 4 sets of 7 concentric-eccentric knee extensions. Our findings show that there were net deficits in total RNA, total mRNA, and actin and myosin heavy chain mRNA levels of expression after ULLS (P < 0.05), whereas these alterations were blunted in the two groups receiving RE. Additional observations involving IGF-I and its associated receptor and binding proteins suggest that RE postures the skeletal muscle for signaling processes that favor a greater anabolic state relative to that observed in the ULLS group. Collectively, these findings suggest that molecular markers of contractile protein gene expression serve as useful subcellular indicators for ascertaining the underlying mechanisms regulating alterations in muscle mass in human subjects in response to altered loading states. PMID:15298986

Haddad, F; Baldwin, K M; Tesch, P A

2005-01-01

373

Optimization of Muscle Activity for Task-Level Goals Predicts Complex Changes in Limb Forces across Biomechanical Contexts  

PubMed Central

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 an unrestrained balance task in cats, we demonstrate that achieving task-level constraints center of mass forces and moments while minimizing control effort predicts detailed patterns of muscle activity and ground reaction forces in an anatomically-realistic musculoskeletal model. Whereas optimization is typically used to resolve redundancy at a single level of the motor hierarchy, we simultaneously resolved redundancy across both muscles and limbs and directly compared predictions to experimental measures across multiple perturbation directions that elicit different intra- and interlimb coordination patterns. Further, although some candidate task-level variables and cost functions generated indistinguishable predictions in a single biomechanical context, we identified a common optimization framework that could predict up to 48 experimental conditions per animal (n?=?3) across both perturbation directions and different biomechanical contexts created by altering animals' postural configuration. Predictions were further improved by imposing experimentally-derived muscle synergy constraints, suggesting additional task variables or costs that may be relevant to the neural control of balance. These results suggested that reduced-dimension neural control mechanisms such as muscle synergies can achieve similar kinetics to the optimal solution, but with increased control effort (?2×) compared to individual muscle control. Our results are consistent with the idea that hierarchical, task-level neural control mechanisms previously associated with voluntary tasks may also be used in automatic brainstem-mediated pathways for balance.

McKay, J. Lucas; Ting, Lena H.

2012-01-01

374

The anatomical arrangement of muscle and tendon enhances limb versatility and locomotor performance  

PubMed Central

The arrangement of muscles and tendons has been studied in detail by anatomists, surgeons and biomechanists for over a century, and the energetics and mechanics of muscle contraction for almost as long. Investigation of how muscles function during locomotion and the relative length change in muscle fibres and the associated elastic tendon has, however, been more challenging. In recent years, novel in vivo measurement methods such as ultrasound and sonomicrometry have contributed to our understanding of the dynamics of the muscle tendon unit during locomotion. Here, we examine both published and new data to explore how muscles are arranged to deliver the wide repertoire of locomotor function and the trade-offs between performance and economy that result.

Wilson, Alan; Lichtwark, Glen

2011-01-01

375

Upper limb discomfort profile due to intermittent isometric pronation torque at different postural combinations of the shoulder-arm system.  

PubMed

Twenty-seven right-handed male university students participated in this study, which comprised a full factorial model consisting of three forearm rotation angles (60% prone and supine and neutral range of motion), three elbow angles (45 degrees , 90 degrees and 135 degrees ), three upper arm angles (45 degrees flexion/extension and neutral), one exertion frequency (15 per min) and one level of pronation torque (20% maximum voluntary contraction (MVC) relative to MVC at each articulation). Discomfort rating after the end of each 5 min treatment was recorded on a visual analogue scale. Results of a repeated measures analysis of covariance on discomfort score, with torque endurance time as covariate, indicated that none of the factors was significant including torque endurance time (p = 0.153). An initial data collection phase preceded the main experiment in order to ensure that participants exerted exactly 20% MVC of the particular articulation. In this phase MVC pronation torque was measured at each articulation. The data revealed a significant forearm rotation angle effect (p = 0.001) and participant effect (p = 0.001). Of the two-way interactions, elbow*participant (p = 0.004), forearm*participant (p = 0.001) and upper arm*participant (p = 0.005) were the significant factors. Electromyographic activity of the pronator teres and biceps brachii muscles revealed no significant change in muscle activity in most of the articulations. Industrial jobs involving deviated upper arm postures are typical in industry but have a strong association with injury. Data from this study will enable better understanding of the effects of deviated upper arm postures on musculoskeletal disorders and can also be used to identify and control high-risk tasks in industry. PMID:19296327

Mukhopadhyay, Prabir; O'Sullivan, Leonard W; Gallwey, Timothy J

2009-05-01

376

First results of the limb imaging of 630.0 nm airglow using FORMOSAT-2/Imager of Sprites and Upper Atmospheric Lightnings  

NASA Astrophysics Data System (ADS)

This is the first report of the most comprehensive 630.0 nm airglow limb images taken using Imager of Sprites and Upper Atmospheric Lightnings (ISUAL) onboard FORMOSAT-2. The limb scans reveal two distinct airglow layers: the upper one corresponds to the thermospheric O(1D) emission and the lower one corresponds to the OH (9-3) emissions. Sequences of such observations are combined to generate altitude-latitude maps of the emissions, which reveal intensity enhancements of both the layers at certain locations where they often appear to be linked/joined vertically. A detailed analysis of the location and occurrence of the enhancements in the entire observations, together with simulations of the emissions suiting the ISUAL limb geometry are carried out to understand the causes and related processes.

Rajesh, P. K.; Liu, J. Y.; Chiang, C. Y.; Chen, A. B.; Chen, W. S.; Su, H. T.; Hsu, R. R.; Lin, C. H.; Hsu, M.-L.; Yee, J. H.; Nee, J. B.

2009-10-01

377

Dermal skin substitutes for upper limb reconstruction: current status, indications, and contraindications.  

PubMed

Dermal skin substitutes are a group of biologically engineered materials composed of collagen and glycosaminoglycans and are devoid of cellular structures. These biodegradable materials act as an artificial dermis to promote neovascularization and neodermis formation. Their applications in soft tissue reconstructions are rapidly expanding. In this article, the indications, advantages, and limitations of dermal skin substitutes for reconstruction of soft tissue defects of the upper extremity are reviewed. PMID:24731613

Rehim, Shady A; Singhal, Maneesh; Chung, Kevin C

2014-05-01

378

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

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…

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

2010-01-01

379