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1

Heteronymous reflex connections in human upper limb muscles in response to stretch of forearm muscles.  

PubMed

Torque motor produced stretch of upper limb muscles results in two distinct reflex peaks in the electromyographic activity. Whereas the short-latency reflex (SLR) response is mediated largely by the spinal monosynaptic reflex pathway, the longer-latency reflex (LLR) is suggested to involve a transcortical loop. For the SLRs, patterns of heteronymous monosynaptic Ia connections have been well-studied for a large number of muscles in the cat and in humans. For LLRs, information is available for perturbations to proximal joints, although the protocols for most of these studies did not focus on heteronymous connections. The main objective of the present study was to elicit both SLRs and LLRs in wrist flexors and extensors and to examine heteronymous connections from these muscles to elbow flexors (biceps brachii; BiBr) and extensors (triceps brachii; TriBr) and to selected distal muscles, including abductor pollicis longus (APL), first dorsal interosseous (FDI), abductor digiti minimi (ADM), and Thenars. The stretch of wrist flexors produced SLR and LLR peaks in APL, FDI, ADM, Thenars, and BiBr while simultaneously inducing inhibition of wrist extensors and TriBr. When wrist extensors were stretched, SLR and LLR peaks were observed in TriBr, whereas the primary wrist flexors, APL and BiBr, were inhibited; response patterns of FDI, ADM, and Thenars were less consistent. The main conclusions from the observed data are that: 1) as in the cat, afferents from wrist flexors and extensors make heteronymous connections with proximal and distal upper limb muscles; and 2) the strength of heteronymous connections is greater for LLRs than SLRs in the distal muscles, whereas the opposite is true for the proximal muscles. In the majority of observations, SLR and LLR excitatory peaks were observed together. However, on occasion, LLRs were observed without the SLR response in hand muscles when wrist extensors were stretched. PMID:21715666

Manning, Curtis D; Bawa, Parveen

2011-06-29

2

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

3

Muscle fatigue evaluation of astronaut upper limb based on sEMG and subjective assessment  

NASA Astrophysics Data System (ADS)

All movements are driven by muscle contraction, and it is easy to cause muscle fatigue. Evaluation of muscle fatigue is a hot topic in the area of astronaut life support training and rehabilitation. If muscle gets into fatigue condition, it may reduce work efficiency and has an impact on psychological performance. Therefore it is necessary to develop an accurate and usable method on muscle fatigue evaluation of astronaut upper limb. In this study, we developed a method based on surface electromyography (sEMG) and subjective assessment (Borg scale) to evaluate local muscle fatigue. Fifteen healthy young male subjects participated in the experiment. They performed isometric muscle contractions of the upper limb. sEMG of the biceps brachii were recorded during the entire process of isotonic muscle contraction and Borg scales of muscle fatigue were collected in certain times. sEMG were divided into several parts, and then mean energy of each parts were calculated by the one-twelfth band octave method. Equations were derived based on the relationship between the mean energy of sEMG and Borg scale. The results showed that cubic curve could describe the degree of local muscle fatigue, and could be used to evaluate and monitor local muscle fatigue during the entire process.

Zu, Xiaoqi; Zhou, Qianxiang; Li, Yun

2012-07-01

4

Influence of handle design on the surgeon's upper limb movements, muscle recruitment, and fatigue during endoscopicsuturing  

Microsoft Academic Search

  Background: Thus far, little has been done to investigate the kinematics (motion analysis) and kinetics (muscle work, muscle\\u000a fatigue, comfort) of surgeons during laparoscopic surgery. Therefore, we set out to study these ergonomic aspects of task\\u000a performance in the dominant upper limb of surgeons during endoscopic suturing. Methods: Three different handles-conventional\\u000a finger loop, rocker, and ball handle prototype-were compared in

T. A. Emam; T. G. Frank; G. B. Hanna; A. Cuschieri

2001-01-01

5

Optical muscle activation sensors for estimating upper limb force level  

Microsoft Academic Search

Muscle activation sensors are playing an important role in motion intention sensing of human-machine interaction system, such as human assisting manipulators or prosthetic devices. There are requirements of low-cost, reliability and portability for the device. This paper proposes an optical muscle activation sensor (oMAS) which measures the optical density in muscle by emitting and gathering the single wavelength light source.

Lejun Cen; Hyonyoung Han; Jung Kim

2011-01-01

6

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

Microsoft Academic Search

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

LA Harvey; J Crosbie

1999-01-01

7

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

8

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

PubMed

Aging is associated with the 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 declines of the upper limb that 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. PMID:22047782

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

2011-11-01

9

The comparable size and overlapping nature of upper limb distal and proximal muscle representations in the human motor cortex  

Microsoft Academic Search

The purpose of this study was to determine the relative size and location of proximal and distal upper limb muscle representations in the human motor cortex. Motor-evoked potentials (MEPs) evoked by transcranial magnetic stimulation were recorded in the proximal muscle anterior deltoid (AD) and in the distal muscles extensor carpi radialis (ECR) and first dorsal interosseus (1DI). The coil was

Hervé Devanne; François Cassim; Christian Ethier; Laurent Brizzi; André Thevenon; Charles Capaday

2006-01-01

10

Classification of Upper Limb Motions from Around-Shoulder Muscle Activities: Hand Biofeedback  

PubMed Central

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.

Gonzalez, Jose; Horiuchi, Yuse; Yu, Wenwei

2010-01-01

11

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

PubMed Central

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

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

2013-01-01

12

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

13

Upper limb muscle fatigue during prolonged Boccia games with underarm throwing technique.  

PubMed

This study investigated the acute fatigue pattern in neuromuscular activity after a simulated Boccia game and the effect of fatigue pattern on sport performance. Nine elite Boccia athletes were tested before, during, and after a simulated game. Maximum ball speed was captured with video, and the target hitting rate and rating of perceived exertion (RPE) score were collected and analyzed. Electromyography signals from the upper trapezius, anterior deltoid, posterior deltoid, biceps brachii, triceps brachii, and wrist extensor muscles were collected by surface electrode and were evaluated with mean power frequency (MPF). Only the upper trapezius muscle showed fatigue as demonstrated by a reduction of MPF of 8% (p = 0.027) when comparing the first and last throws in a simulated game. Subjective RPE score increased during the game (118%, p = 0.004), and sports performance in terms of maximum ball speed (-12%, p = 0.004) and target hitting rate (-25%, p = 0.004) also deteriorated. In conclusion, fatigue on the upper trapezius muscle was demonstrated in elite Boccia athletes following a prolonged Boccia game and may have affected Boccia performance. Preventative measures against upper trapezius muscle fatigue and endurance training for synergists of the upper trapezius muscle may be considered in future studies. PMID:23259234

Fong, Daniel Tik-Pui; Yam, Kit-Yee; Chu, Vikki Wing-Shan; Cheung, Roy Tsz-Hei; Chan, Kai-Ming

2012-11-01

14

Single low-threshold afferents innervating the skin of the human foot modulate ongoing muscle activity in the upper limbs.  

PubMed

We have shown for the first time that single cutaneous afferents in the foot dorsum have significant reflex coupling to motoneurons supplying muscles in the upper limb, particularly posterior deltoid and triceps brachii. These observations strengthen what we know from whole nerve stimulation, that skin on the foot and ankle can contribute to the modulation of interlimb muscles in distant innervation territories. The current work provides evidence of the mechanism behind the reflex, where one single skin afferent can evoke a reflex response, rather than a population. Nineteen of forty-one (46%) single cutaneous afferents isolated in the dorsum or plantar surface of the foot elicited a significant modulation of muscle activity in the upper limb. Identification of single afferents in this reflex indicates the strength of the connection and, ultimately, the importance of foot skin in interlimb coordination. The median response magnitude was 2.29% of background EMG, and the size of the evoked response did not significantly differ among the four mechanoreceptor classes (P > 0.1). Interestingly, although the distribution of afferents types did not differ across the foot dorsum, there was a significantly greater coupling response from receptors located on the medial aspect of the foot dorsum (P < 0.01). Furthermore, the most consistent coupling with upper limb muscles was demonstrated by type I afferents (fast and slowly adapting). This work contributes to the current literature on receptor specificity, supporting the view that individual classes of cutaneous afferents may subserve specific roles in kinesthesia, reflexes, and tactile perception. PMID:23274312

Bent, Leah R; Lowrey, Catherine R

2012-12-28

15

Upper limb prosthetic rehabilitation  

Microsoft Academic Search

This article describes principles of rehabilitation, according to the ‘international classification of functioning’ model, for people who either required upper limb amputation or have a congenital absence. It also provides a description of current clinical practice at one of the largest prosthetic service providers in the UK.The aim is to provide an overview for any health professional who may work

Sachin Watve; Greg Dodd; Ruth MacDonald; Elizabeth R. Stoppard

2011-01-01

16

The effect of added degrees of freedom and handle type on upper limb muscle activity during simulated hand tool use.  

PubMed

The human upper limb serves a number of functions ranging from coarse movements such as supporting a load when lifting overhead to the fine motor control required when painting a portrait. However, there are limited data available that address upper extremity function and performance when using hand tools in situations where the tool endpoint is not fixed but can move translationally or rotationally. The goal of this study was to examine variation in arm muscle activity when added degrees of freedom (DOF) were introduced through the use of a force application apparatus with two different handle designs (D-handle or screwdriver). Electromyography of seven forearm muscles and five muscles crossing the shoulder joint were measured to determine relative activity from a reference (0 DOF), most stable condition, to combinations of DOF ranging from 1 to 4. Substantial and statistically significant increases in muscle activity resulted from adding DOF. The screwdriver handle increased forearm muscle activity compared to the D-handle, except in the highest DOF condition. These findings have significance in the planning of work and design of tools because of the potential for increased fatigue that accompanies increased DOF at the tool endpoint. Handle type also influenced the magnitude of the muscular activity. PMID:19308817

Fischer, Steven L; Wells, Richard P; Dickerson, Clark R

2009-01-01

17

The moment arms of 23 muscle segments of the upper limb with varying elbow and forearm positions: Implications for motor control  

Microsoft Academic Search

In this study we examined moment arms of the complete muscle system of the elbow, including the wrist flexors that have their proximal attachment point on the humerus. This study was performed with the aim to identify the synergistic mover functions of the muscles as an anatomical basis for the study of motor control of the elbow. The upper limbs

G. J. C Ettema; G Styles; V Kippers

1998-01-01

18

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

19

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

2013-07-01

20

Novel muscle activation sensors for estimating of upper limb motion intention  

Microsoft Academic Search

Measurement of muscle activation is important to understand body motion and the exertion of force. This paper presents two novel muscle activation sensors, a piezo cable muscle activation sensor (pMAS) and an optical muscle activation sensor (oMAS). The pMAS measures variations of a flexible piezo cable band that originate from diameter changes of muscle bundles. The sensors are easily attached

Hyonyoung Han; Jung Kim

2009-01-01

21

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

2013-03-21

22

The effect of added degrees of freedom and handle type on upper limb muscle activity during simulated hand tool use  

Microsoft Academic Search

The human upper limb serves a number of functions ranging from coarse movements such as supporting a load when lifting overhead to the fine motor control required when painting a portrait. However, there are limited data available that address upper extremity function and performance when using hand tools in situations where the tool endpoint is not fixed but can move

Steven L. Fischer; Richard P. Wells; Clark R. Dickerson

2009-01-01

23

The corticomotor representation of upper limb muscles in writer's cramp and changes following botulinum toxin injection  

Microsoft Academic Search

Summary Transcranial magnetic stimulation was used to investigate the properties of the corticomotor pathway and to map the primary motor cortex projection to hand and forearm muscles during a sustained isometric contraction in a group of subjects with writer's cramp of varying duration. Corticomotor threshold, motor evoked potential amplitude and latency, and silent-period duration were normal on both sides in

M. L. Byrnes; G. W. Thickbroom; S. A. Wilson; P. Sacco; J. M. Shipman; R. Stell; F. L. Mastaglia

1998-01-01

24

Musculoskeletal upper limb modeling with muscle activation for flexible body simulation  

Microsoft Academic Search

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

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

2009-01-01

25

Biofeedback effectiveness to reduce upper limb muscle activity during computer work is muscle specific and time pressure dependent  

Microsoft Academic Search

Continuous electromyographic (EMG) activity level is considered a risk factor in developing muscle disorders. EMG biofeedback is known to be useful in reducing EMG activity in working muscles during computer work. The purpose was to test the following hypotheses: (1) unilateral biofeedback from trapezius (TRA) can reduce bilateral TRA activity but not extensor digitorum communis (EDC) activity; (2) biofeedback from

Pernille Vedsted; Karen Søgaard; Anne Katrine Blangsted; Pascal Madeleine; Gisela Sjøgaard

2011-01-01

26

Biofeedback effectiveness to reduce upper limb muscle activity during computer work is muscle specific and time pressure dependent.  

PubMed

Continuous electromyographic (EMG) activity level is considered a risk factor in developing muscle disorders. EMG biofeedback is known to be useful in reducing EMG activity in working muscles during computer work. The purpose was to test the following hypotheses: (1) unilateral biofeedback from trapezius (TRA) can reduce bilateral TRA activity but not extensor digitorum communis (EDC) activity; (2) biofeedback from EDC can reduce activity in EDC but not in TRA; (3) biofeedback is more effective in no time constraint than in the time constraint working condition. Eleven healthy women performed computer work during two different working conditions (time constraint/no time constraint) while receiving biofeedback. Biofeedback was given from right TRA or EDC through two modes (visual/auditory) by the use of EMG or mechanomyography as biofeedback source. During control sessions (no biofeedback), EMG activity was (mean ± SD): 2.4 ± 1.1, 2.5 ± 2.1, and 9.1 ± 3.1%max-EMGrms for right and left TRA and EDC, respectively. During biofeedback from TRA, activity was reduced in right TRA (1.7 ± 1.6%max-EMGrms) and left TRA (1.2 ± 2.0%max-EMGrms) compared to control. During biofeedback from EDC, activity in EDC was reduced (8.3 ± 3.3%max-EMGrms) compared with control. During time constraint, activity was reduced in right TRA (1.9 ± 1.3%max-EMGrms), left TRA (1.5 ± 1.5%max-EMGrms), and EDC (8.4 ± 3.2%max-EMGrms), during biofeedback compared to control. Conclusion: biofeedback reduced muscle activity in TRA by ? 30-50% and in EDC by ? 10% when given from the homologous or bilateral muscle but not from the remote muscle, and was significant in the time constraint condition; while feedback source and presentation mode showed only minor differences in the effect on reducing homologous muscle activity. This implies that biofeedback should be given from the most affected muscle in the occupational setting for targeting relief and prevention of muscle pain most effectively. PMID:20621506

Vedsted, Pernille; Søgaard, Karen; Blangsted, Anne Katrine; Madeleine, Pascal; Sjøgaard, Gisela

2011-02-01

27

The profile of patients and current practice of treatment of upper limb muscle spasticity with botulinum toxin type A: an international survey.  

PubMed

To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31 countries were studied. Most patients were over 40 years old and had a stroke. Improvement of active function was the most frequent treatment goal in the first 3 months after the onset of upper limb spasticity, but was less common than passive function in the chronic stage. Pain relief was a common goal in both the stages. As a rule, clinicians intended to assess the effectiveness of treatment with impairment level scales. Functional outcome measures seem to be rarely used in clinical practice. The use of these measures should be encouraged to assess whether the reduction in muscle tone translates into functional benefit to patients and their caregivers. PMID:20154631

Bakheit, Abdel Magid; Zakine, Benjamin; Maisonobe, Pascal; Aymard, Claire; Fhedoroff, Klemens; Hefter, Harold; Jacinto, Jorge; Jost, Wolfgang H; Molteni, Franco; Stam, Henk; Turner-Stokes, Lynne; Wissel, Jorg

2010-09-01

28

LOWER LIMB HUMAN MUSCLE ENHANCER  

Microsoft Academic Search

This paper describes the design, control, and testing of a Human Muscle Enhancer (HME) system that will augment the muscle capabilities of subjects requiring partial lower-limb weight-bearing gait support. The HME described in this paper is a pneumatically actuated quick connecting exoskeleton system that attaches to the foot and hip area of the body, thus \\

Joseph J. Misuraca; Constantinos Mavroidis

29

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

30

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

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. PMID:21689100

Diogo, R; Wood, B

2011-06-20

31

WNT pathways and upper limb anomalies.  

PubMed

The various Wnt pathways that are related to upper limb anomalies are reviewed. Abnormalities in the Wnt7a pathway (located in the dorsal ectoderm) produce several clinically relevant conditions such as the palmar duplication syndrome, nail patella syndrome, ulnar ray deficiency, limb hypoplasia, polysyndactyly and the palmar nail syndrome. Abnormalities of the Wnt3/3a pathway (located in the apical ectodermal ridge) include tetra-amelia and loss of the distal phalanges/nails. Abnormalities of the Wnt5/5a pathway (located in the apical ectodermal ridge as well as in the mesoderm) will affect chondrogenesis of the developing limb and experimental Wnt5a(-/-) limbs have terminal adactyly. Chondrogenesis and limb muscle differentiation are both affected by several Wnt pathways and these will be reviewed in details. Abnormalities in LRP 5/6 (a co-receptor for Wnts) lead to congenital bone disease and Wnt4 is specifically involved in joint development. Finally, the relationship between the Wnt pathway and SALL4 (mutations of which cause Okihiro/Duane-radial ray deficiency in humans) are discussed. PMID:20709709

Al-Qattan, M M

2010-08-13

32

Schwannoma in the Upper Limbs  

PubMed Central

Schwannomas are the commonest tumours of peripheral nerves. Despite the classical description that schwannomas are well encapsulated and can be completely enucleated during excision, a portion of them have fascicular involvement and could not be completely shelled out. A retrospective review for 8 patients was carried out over 10 years. 75% of schwannoma occurred over the distal region of upper limb (at elbow or distal to it). It occurs more in the mixed nerve instead of pure sensory or motor nerve. 50% of patients had mixed nerve involvement. Fascicular involvement was very common in schwannoma (75% of patients). Removal of the tumour with fascicles can cause functional deficit. At present, there is no method (including preoperative MRI) which can predict the occurrence of fascicular involvement; the authors therefore proposed a new system to stratify patients who may benefit from interfascicular nerve grafts. In this group of patients, the authors strongly recommend that the possibility and option of nerve graft should be discussed with patients prior to schwannoma excision, so that nerve grafting could be directly proceeded with patient consent in case there is fascicular involvement of tumour found intraoperatively.

Yuk Kwan Tang, Chris; Fung, Boris; Fok, Margaret; Zhu, Janet

2013-01-01

33

Upper limb injuries associated with rock climbing  

Microsoft Academic Search

Four cases of upper limb injuries secondary to rock-climbing or training for rock climbing are presented. All four cases had diagnosis and treatment delayed because of unawareness of the range of injuries seen in high grade rock climbing.

P Bannister; P Foster

1986-01-01

34

The Profile of Patients and Current Practice of Treatment of Upper Limb Muscle Spasticity with Botulinum Toxin Type A: An International Survey  

ERIC Educational Resources Information Center

|To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31…

Bakheit, Abdel Magid

2010-01-01

35

Upper limb position control in fibromyalgia  

PubMed Central

Background Motor problems are reported by patients with fibromyalgia (FM). However, the mechanisms leading to alterations in motor performance are not well understood. In this study, upper limb position control during sustained isometric contractions was investigated in patients with FM and in healthy controls (HCs). Methods Fifteen female FM patients and 13 HCs were asked to keep a constant upper limb position during sustained elbow flexion and shoulder abduction, respectively. Subjects received real-time visual feedback on limb position and both tasks were performed unloaded and while supporting loads (1, 2, and 3 kg). Accelerations of the dominant upper limb were recorded, with variance (SD of mean position) and power spectrum analysis used to characterize limb position control. Normalized power of the acceleration signal was extracted for three frequency bands: 1–3 Hz, 4–7 Hz, and 8–12 Hz. Results Variance increased with load in both tasks (P < 0.001) but did not differ significantly between patients and HCs (P > 0.17). Power spectrum analysis showed that the FM patients had a higher proportion of normalized power in the 1–3 Hz band, and a lower proportion of normalized power in the 8–12 Hz band compared to HCs (P < 0.05). The results were consistent for all load conditions and for both elbow flexion and shoulder abduction. Conclusion FM patients exhibit an altered neuromuscular strategy for upper limb position control compared to HCs. The predominance of low-frequency limb oscillations among FM patients may indicate a sensory deficit.

2012-01-01

36

The reliability of upper limb anthropometry in older Chinese people  

Microsoft Academic Search

OBJECTIVE: To evaluate the validity of the Durnin–Womersley equations and to derive our local predictive equations for body fat from upper limb skinfold thicknesses in older Chinese people in Hong Kong. To evaluate the validity of mid-arm circumference and corrected arm muscle area in predicting lean tissue mass in the same population. DESIGN: Comparison of fat percentages predicted by Durnin–Womersley

T Kwok; J Woo; HHL Chan; E Lau

1997-01-01

37

[Compression neuropathy of upper limbs in miners].  

PubMed

The authors analyzed prevalence of individual types of upper limb compression neuropathy in miners of coal and iron-ore mines. Medical examination covered main mining occupations exposed to suchhazards as local vibration, cooling microclimate, functional overstrain. Some types of compression neuropathies appeared to depend on duration of exposure to the hazards and on the occupation hands disease stage. PMID:16898248

Rodin, S I; Matveeva, O V

2006-01-01

38

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

ERIC Educational Resources Information Center

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

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

2011-01-01

39

Rehabilitation system with 3-D exercise machine for upper limb  

Microsoft Academic Search

Movements of the upper limbs are complicated, various and indispensable for daily activities. It therefore is important for the aged to exercise to keep their upper limb function. When something is wrong with the upper limb function because of disease or disorder, rehabilitation along with medical treatment is needed to recover function. Application of robotics and virtual reality technology makes

K. Koyanagi; F. Furusho; U. Ryu; A. Inoue

2003-01-01

40

The upper limb of Australopithecus sediba.  

PubMed

The evolution of the human upper limb involved a change in function from its use for both locomotion and prehension (as in apes) to a predominantly prehensile and manipulative role. Well-preserved forelimb remains of 1.98-million-year-old Australopithecus sediba from Malapa, South Africa, contribute to our understanding of this evolutionary transition. Whereas other aspects of their postcranial anatomy evince mosaic combinations of primitive (australopith-like) and derived (Homo-like) features, the upper limbs (excluding the hand and wrist) of the Malapa hominins are predominantly primitive and suggest the retention of substantial climbing and suspensory ability. The use of the forelimb primarily for prehension and manipulation appears to arise later, likely with the emergence of Homo erectus. PMID:23580536

Churchill, Steven E; Holliday, Trenton W; Carlson, Kristian J; Jashashvili, Tea; Macias, Marisa E; Mathews, Sandra; Sparling, Tawnee L; Schmid, Peter; de Ruiter, Darryl J; Berger, Lee R

2013-04-12

41

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

Microsoft Academic Search

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

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

1993-01-01

42

[Major upper limb trauma: Patients' outcomes. About 22 cases].  

PubMed

In front of a major upper limb trauma, do we need to make everything possible to keep the limb with the risk of facing poor functional outcomes? This study was performed to evaluate and compare long-term functional, psychological and social outcomes following major upper extremity trauma between patients treated with amputation and those who underwent limb salvage. This was a retrospective monocenter cohort study of 22 patients who sustained an upper limb injury requiring either amputation or limb salvage. The characteristics of the patient, trauma and initial take-care were studied. The outcomes of amputation and upper limb salvage were compared by using functional scores (DASH, Chen), autonomy (activities of the everyday life, work, driving, leisure activities), psychological and quality of life evaluation (NHP, EVA, Russel's score). Twenty-two patients were supported. Eleven limb salvages were performed with six secondary amputations. Sixteen patients were reviewed: five with limb salvage and 11 amputees with a mean follow-up of 12years and 5months. All patients were autonomous. There were no significant differences between both groups regarding DASH and NHP scores or to work status and driving ability. Russel's score showed that patients with salvaged upper limb were pleased to have kept it and would recommend this treatment. Although the results of upper limb macro-replantation are sometimes disappointing, the satisfaction for these patients to keep their upper limb and their body integrity seems to justify such upper limb salvage when it is technically possible. PMID:23932768

Malherbe, M; Cheval, D; Lejacques, B; Vaiss, L; Kerfant, N; Le Nen, D

2013-07-24

43

Compressive neuropathy in the upper limb  

PubMed Central

Entrampment neuropathy or compression neuropathy is a fairly common problem in the upper limb. Carpal tunnel syndrome is the commonest, followed by Cubital tunnel compression or Ulnar Neuropathy at Elbow. There are rarer entities like supinator syndrome and pronator syndrome affecting the Radial and Median nerves respectively. This article seeks to review comprehensively the pathophysiology, Anatomy and treatment of these conditions in a way that is intended for the practicing Hand Surgeon as well as postgraduates in training. It is generally a rewarding exercise to treat these conditions because they generally do well after corrective surgery. Diagnostic guidelines, treatment protocols and surgical technique has been discussed.

Thatte, Mukund R.; Mansukhani, Khushnuma A.

2011-01-01

44

Bypass Surgery for the Treatment of Upper Limb Chronic Ischaemia  

Microsoft Academic Search

ObjectivesThis study aims to evaluate the results and complications of surgical arterial revascularisation of the upper limb for treatment of chronic ischaemia using infrabrachial bypass. Results of limb salvage and follow-up with graft patency are analysed.

F. Spinelli; F. Benedetto; G. Passari; M. La Spada; G. Carella; F. Stilo; G. De Caridi; S. Lentini

2010-01-01

45

Abnormal spontaneous muscle activity in plegic limb appears to initiate distal to the upper motor neuron: a case report in a stroke patient  

PubMed Central

Objective: To study the effect of the cutaneous silent period (CSP) on spontaneous muscle activity occurring after an upper motor injury from stroke, with a goal of developing an insight into the origin of the pathological activity. Methods: A patient with an acute right centrum semiovale ischemic stroke had left hemiparesis. Fibrillation potentials and positive sharp waves were recorded in several left arm muscles. CSP silent period studies were performed in both arms. Results: The CSP inhibited the volitional activity in the unaffected right arm. In the plegic left arm, fibrillation potentials and positive sharp waves persisted during the time period during which the CSP would have been expected, based upon the right-sided studies. Conclusions: Spontaneous activity after a cerebrovascular accident was resistant to inhibition from CSP. These findings suggest that the localization of the origin of the spontaneous activity is distal to the upper motor neuron. A confirmatory study with more patients and in a variety of stroke subtypes would strengthen this conclusion.

Souayah, N; Saadeh, P; Krivitskaya, N; Sander, HW

2013-01-01

46

Sensory feedback in upper limb prosthetics.  

PubMed

One of the challenges facing prosthetic designers and engineers is to restore the missing sensory function inherit to hand amputation. Several different techniques can be employed to provide amputees with sensory feedback: sensory substitution methods where the recorded stimulus is not only transferred to the amputee, but also translated to a different modality (modality-matched feedback), which transfers the stimulus without translation and direct neural stimulation, which interacts directly with peripheral afferent nerves. This paper presents an overview of the principal works and devices employed to provide upper limb amputees with sensory feedback. The focus is on sensory substitution and modality matched feedback; the principal features, advantages and disadvantages of the different methods are presented. PMID:23278223

Antfolk, Christian; D'Alonzo, Marco; Rosén, Birgitta; Lundborg, Göran; Sebelius, Fredrik; Cipriani, Christian

2013-01-01

47

Robust Tracking of the Upper Limb for Functional Stroke Assessment  

Microsoft Academic Search

We present a robust 3-D parts-based (PB) tracking system designed to follow the upper limb of stroke survivors during desktop activities. This system fits a probabilistic model of the arm to sequences of images taken from multiple angles. The arm model defines shapes and colors of limbs and limb configurations that are more or less likely. We demonstrate that the

Sonya Allin; Nancy Baker; Emily Eckel; Deva Ramanan

2010-01-01

48

Effect of Haptic Force Feedback on Upper Limb  

Microsoft Academic Search

A methodology for studying the effect of vibrations generated by a haptic interface on upper limb is introduced. In the proposed methodology, a subject presses on a horizontally vibrating, rigid, virtual object with a cheap off-the-shelf (COTS) haptic device. When the subject feels vibrations of fixed amplitude and varying frequencies the electromyographic (EMG) activity of upper limb is recorded. The

Sunil Belur Nagaraj; Daniela Constantinescu

2009-01-01

49

Upper Limb Contralateral Physiological Characteristic Evaluation for Robot-Assisted Post Stroke Hemiplegic Rehabilitation  

Microsoft Academic Search

\\u000a An innovative robot-aided quantitative evaluation method was established in order to evaluate disability level of post hemiplegic\\u000a stroke patients. A sEMG-driven musculoskeletal model utilized the physiological characters of impaired limb and normalized\\u000a by healthy limbs’ physiological characters can be applied to calculate muscle strength and other dynamics data (such as elbow\\u000a joint torque). By comparing physiological characters of impaired upper

Lap-Nam Wong; Qun Xie; Linhong Ji

50

Multijoint upper limb torque estimation from sEMG measurements.  

PubMed

Estimation of joint torques through musculoskeletal models and measurements of muscle activations can be used for real-time control of robotic devices for rehabilitation. Many works developed models for analytic one joint motion, but less are found that develop models for functional multijoint movements. In this work we develop a methodology for tuning and optimizing Hill-based EMG-driven models oriented to the force control of robotic exoskeletons for the upper limb, selecting the more suitable parameters to be optimized. The model is tuned from experimental data obtained from healthy people. The torques estimated by that model will serve as reference for force-based control of an exoskeleton for rehabilitation. PMID:24111414

Bueno, Diana R; Montano, L

2013-07-01

51

Proposal of bioinstrumentation using shape deformation of amputated upper limb.  

PubMed

Some upper limb amputees have been annually supplied with myoelectric prostheses by social rehabilitation promotion services. However, the persons supplied with the prostheses have been limited because a supply system has not been established yet. Accordingly, we propose a new bioinstrumentation using the shape deformation of the amputated upper limbs without using the myoelectricity generated on the skin of the upper limbs. The repeatability is superior to the myoelectricity because the shape deformation is directly measured by strain gages and also the cost is much superior to the myoelectricity. PMID:24109829

Mori, Takahiko; Tanaka, Yuya; Yoshikawa, Kenichi; Katane, Daisuke; Torishima, Hiroyuki; Shimizu, Yukiyo; Hara, Yuki

2013-07-01

52

Comparison of upper limb musculoskeletal function and throwing performance in adolescent baseball players and matched controls  

Microsoft Academic Search

Objectives: To compare upper limb musculoskeletal profile and throwing speed in adolescent baseball players and matched controls. Participants: Fourteen elite early adolescent (13–16 years) baseball players and 14 age, height and weight matched control subjects. Main outcome measures: Joint range of motion, isometric muscle strength and overhead throwing speed. Results: No significant differences in shoulder or elbow joint range of

Anita S. Clements; Karen A. Ginn; Elizabeth C. Henley

2001-01-01

53

Impact of physical exposure on neck and upper limb disorders in female workers  

Microsoft Academic Search

Physical workload [muscular load of the trapezius and infraspinatus muscles using electromyography (EMG), wrist positions and movements by electrogoniometers] and neck and upper limb disorders (from, for example, a physical examination) were studied in women with repetitive industrial work (n=95) and referents (n=74). The repetitive work displayed higher ratings for wrist movements, but not for EMG. The prevalences of neck,

Gert-Åke Hansson; Istvan Balogh; Kerstina Ohlsson; Birgitta Pålsson; Lars Rylander; Staffan Skerfving

2000-01-01

54

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

55

Lung and respiratory muscle function in limb girdle muscular dystrophy.  

PubMed Central

BACKGROUND--Pulmonary involvement is frequently observed in patients with limb girdle muscular dystrophy and occurs early in the disease. The aim of this study was to establish the prevalence of pulmonary dysfunction; the type of dysfunction; and any correlation between patient age, disease duration, or limb weakness and lung or respiratory muscle dysfunction. METHODS--Twenty patients with strictly delineated limb girdle muscular dystrophy and 20 healthy controls were evaluated. Full inspiration chest radiographs were obtained. Standard lung and respiratory muscle function tests were performed and the data were statistically analysed. RESULTS--The mean age of the patients was 40.6 years, the mean disease duration was 18.9 years, and the mean average muscle score (a numerical expression of limb weakness) was 5.73 out of 10. Chest radiography showed unilateral paresis of the diaphragm in three patients. Increased residual volumes, with either increased or decreased total lung capacity, correlated inversely with disease duration. Respiratory muscle weakness was common but mild. Expiratory muscle function was more impaired than inspiratory muscle function and correlated positively with expiratory reserve volume. CONCLUSIONS--Respiratory muscle strength is commonly impaired in limb girdle muscle dystrophy. A dissociation of the limb and mild respiratory muscle involvement is observed; wheelchair restriction does not predict worsening of pulmonary function, and patient age, disease duration, or degree of limb weakness do not predict pulmonary morbidity. The diaphragm is not disproportionately affected by the dystrophic process compared with limb muscles.

Stubgen, J P; Ras, G J; Schultz, C M; Crowther, G

1994-01-01

56

A review of supernumerary and absent limbs and digits of the upper limb.  

PubMed

For years people have been enamored by anomalies of the human limbs, particularly supernumerary and absent limbs and digits. Historically, there are a number of examples of such anomalies, including royal families of ancient Chaldea, tribes from Arabia, and examples from across nineteenth century Europe. The development of the upper limbs in a growing embryo is still being elucidated with the recent advent of homeobox genes, but researchers agree that upper limbs develop between stages 12-23 through a complex embryological process. Maternal thalidomide intake during limb development is known to cause limb reduction and subsequent amelia or phocomelia. Additionally, a number of clinical reports have illustrated different limb anomaly cases, with each situation unique in phenotype and developmental abnormality. Supernumerary and absent limbs and digits are not unique to humans, and a number of animal cases have also been reported. This review of the literature illustrates the historical, anatomical, and clinical aspects of supernumerary and absent limbs and digits for the upper limb. PMID:22068244

Klaassen, Zachary; Choi, Monica; Musselman, Ruth; Eapen, Deborah; Tubbs, R Shane; Loukas, Marios

2011-11-09

57

Kinematic Analysis of Complex Therapeutic Movements of the Upper Limb  

Microsoft Academic Search

The paper presents the results of kinematic analysis of therapeutic movements of the upper limb, according to PNF method recommendations.\\u000a Real trajectories of upper limb movements were recorded using the photogrammetric method. The measuring site consisted of\\u000a a set of 8 digital cameras, two computer workstations, a set of markers, calibrating dice and light sources. On the basis\\u000a of the

R. Michnik; J. Jurkojc; Z. Rak; A. Mezyk; Z. Paszenda; W. Rycerski; J. Janota; J. Brandt

2008-01-01

58

Muscle Function Impairment Following Lower Limb Unloading in Men.  

National Technical Information Service (NTIS)

Effects of microgravity on skeletal muscle mass and function was simulated in humans. Unilateral lowerlimb unloading was conducted in six healthy men by suspending one lower limb while walking on crutches. Muscle strength (Peak Torque (PT)) was measured d...

P. A. Tesch H. E. Berg T. Haeggmark H. Ohlsen G. A. Dudley

1990-01-01

59

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

Microsoft Academic Search

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

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

2008-01-01

60

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

2011-06-09

61

How close to a pendulum is human upper limb movement during walking?  

PubMed

The aim of this work was to investigate how close to pendulum-like behaviour the periodic motion of the human upper limb (or upper extremity) is, during normal walking at a comfortable speed of locomotion. Twenty-five healthy young persons (males and females) participated in the experiment. Biomechanical testing was undertaken (mass and centre of mass of each segment of the total upper extremity). Participants were walking on a treadmill with a standardised velocity of 1.1 ms(-1) (comfortable speed for all of them). A video analysis system with Silicon software was used to measure the different angles of the arm and forearm. The theoretical period of motion and maximal angular velocity were computed for the centre of mass of the total upper limb from the measured phases of the arm swing and associated positional potential energies. Actual measured periods of motion, in comparison, represented a level of similarity to a lightly damped simple pendulum. Using this assumption, the "damping factor" was calculated from the ratio between theoretical and measured values. A vast majority of people exhibited an actual angular velocity exceeding the expected theoretical angular velocity calculated for a virtual pendulum of similar mass and length characteristics. This may be due to muscle forces that are contributing to the motion of the upper limb during walking rather than simple gravity force acting alone. The observed positional potential energy of the dominant limb was greater than that of the non-dominant limb for the vast majority of participants. PMID:15901117

Gutnik, B; Mackie, H; Hudson, G; Standen, C

2005-01-01

62

Multibody system of the upper limb including a reverse shoulder prosthesis.  

PubMed

The reverse shoulder replacement, recommended for the treatment of several shoulder pathologies such as cuff tear arthropathy and fractures in elderly people, changes the biomechanics of the shoulder when compared to the normal anatomy. Although several musculoskeletal models of the upper limb have been presented to study the shoulder joint, only a few of them focus on the biomechanics of the reverse shoulder. This work presents a biomechanical model of the upper limb, including a reverse shoulder prosthesis, to evaluate the impact of the variation of the joint geometry and position on the biomechanical function of the shoulder. The biomechanical model of the reverse shoulder is based on a musculoskeletal model of the upper limb, which is modified to account for the properties of the DELTA® reverse prosthesis. Considering two biomechanical models, which simulate the anatomical and reverse shoulder joints, the changes in muscle lengths, muscle moment arms, and muscle and joint reaction forces are evaluated. The muscle force sharing problem is solved for motions of unloaded abduction in the coronal plane and unloaded anterior flexion in the sagittal plane, acquired using video-imaging, through the minimization of an objective function related to muscle metabolic energy consumption. After the replacement of the shoulder joint, significant changes in the length of the pectoralis major, latissimus dorsi, deltoid, teres major, teres minor, coracobrachialis, and biceps brachii muscles are observed for a reference position considered for the upper limb. The shortening of the teres major and teres minor is the most critical since they become unable to produce active force in this position. Substantial changes of muscle moment arms are also observed, which are consistent with the literature. As expected, there is a significant increase of the deltoid moment arms and more fibers are able to elevate the arm. The solutions to the muscle force sharing problem support the biomechanical advantages attributed to the reverse shoulder design and show an increase in activity from the deltoid, teres minor, and coracobrachialis muscles. The glenohumeral joint reaction forces estimated for the reverse shoulder are up to 15% lower than those in the normal shoulder anatomy. The data presented here complements previous publications, which, all together, allow researchers to build a biomechanical model of the upper limb including a reverse shoulder prosthesis. PMID:24008920

Quental, C; Folgado, J; Ambrósio, J; Monteiro, J

2013-11-01

63

Upper limb malformations in DiGeorge syndrome  

SciTech Connect

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

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

1995-03-13

64

Upper limb cumulative trauma disorders for the orthopaedic surgeon.  

PubMed

Work-related musculoskeletal disorders (WRMSDs) of the upper limb have become a serious concern in many countries and have been steadily progressing for several decades. The cause of WRMSDs is assumed to be the direct consequence of repetitiveness, extreme postures, and intensive efforts in a problematic psychosocial environment. Therapy should therefore associate the occupational physician and the regulatory bodies. It may be necessary to modify the individual workstation and to reorganize the company. Such upper limb pathologies may be surgically treated but the results are often delayed and poorer when compared to the general population. PMID:23347753

Houvet, P; Obert, L

2013-01-21

65

Is electrostimulation preferable to surgery for upper limb ataxia?  

PubMed

Ataxic syndromes of the upper limbs are observed in various situations but are usually a result of lesions involving the efferent pathways of the cerebellum, the superior cerebellar peduncles and midbrain. The commonest causes are multiple sclerosis, brain injury and focal neoplastic or vascular lesions. Cerebellar tremor, which usually comprises a postural and intentional component, is the commonest clinical form. In this review, we assess the value of the various surgical techniques in the treatment of this particular form of ataxia of the upper limbs. PMID:9007403

Nguyen, J P; Fève, A; Keravel, Y

1996-12-01

66

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

67

The effect of an exercise ball on trunk muscle responses to rapid limb movement.  

PubMed

The use of exercise balls as an aid to facilitate improvements in posture in patients with trunk weakness is widely advocated. However, mechanisms underlying any effect on postural mechanisms have received little attention. This study compared the increases in trunk EMG activity in response to limb movement when seated on an exercise ball or on a chair in 16 healthy, moderately active subjects. At the sound of an auditory cue, the subjects carried out either hip flexion or arm flexion (unilateral or bilateral), as fast as possible, whilst sitting on an exercise ball or a standard chair. The amplitude of EMG activity was recorded from selected trunk muscles (erector spinae, external obliques, internal obliques and rectus abdominis) and either an upper limb muscle (deltoid) or a lower limb muscle (rectus femoris). There were minimal differences in amplitudes of EMG activity in any of the trunk muscles between the conditions (ball or chair) following the upper limb movements. These results suggest that there is no benefit in simple arm flexion movements whilst seated on the exercise ball in comparison to a chair. The onset and amplitude of the rectus abdominis (RA) and external obliques (EO) were significantly different between conditions in the hip flexion protocol. However, they do suggest significant benefit in decreasing RA and EO muscle activity onsets and increasing amplitude in the hip flexion condition. These results may have implications for rehabilitation of those with trunk muscle deficits such as stroke. PMID:22050973

Weaver, H; Vichas, D; Strutton, P H; Sorinola, I

2011-11-01

68

Upper-Limb Movement Training in Children Following Injection of Botulinum Toxin A Multiple Sclerosis  

Microsoft Academic Search

\\u000a Botulinum Neurotoxin A (BoNT-A) is a useful medication for the reduction of spasticity and dystonia in the upper limb of children\\u000a with cerebral palsy (CP). The method of toxin delivery, dose, and muscle selection criteria are established. Children who\\u000a are being treated require appropriate assessment at the impairment and activity levels of functioning. Once injected, children\\u000a require specific therapy delivered

Brian Hoare; Remo N. Russo

69

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

2012-05-29

70

SEMG feature extraction methods for pattern recognition of upper limbs  

Microsoft Academic Search

In this paper, a new feature of surface electromyo- graphy (sEMG) by using discrete wavelet transform (DWT) is proposed for motion recognition of upper limbs, and this method can be eventually used for rehabilitation robot control. Seven traditional features of sEMG are also extracted for comparative study, they are integral of absolute value (IAV), difference absolute mean value (DAMV), zero

Feng Zhang; Pengfeng Li; Zeng-Guang Hou; Yixiong Chen; Fei Xu; Jin Hu; Qingling Li; Min Tan

2011-01-01

71

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

72

Computer simulations of neural mechanisms explaining upper and lower limb excitatory neural coupling  

PubMed Central

Background When humans perform rhythmic upper and lower limb locomotor-like movements, there is an excitatory effect of upper limb exertion on lower limb muscle recruitment. To investigate potential neural mechanisms for this behavioral observation, we developed computer simulations modeling interlimb neural pathways among central pattern generators. We hypothesized that enhancement of muscle recruitment from interlimb spinal mechanisms was not sufficient to explain muscle enhancement levels observed in experimental data. Methods We used Matsuoka oscillators for the central pattern generators (CPG) and determined parameters that enhanced amplitudes of rhythmic steady state bursts. Potential mechanisms for output enhancement were excitatory and inhibitory sensory feedback gains, excitatory and inhibitory interlimb coupling gains, and coupling geometry. We first simulated the simplest case, a single CPG, and then expanded the model to have two CPGs and lastly four CPGs. In the two and four CPG models, the lower limb CPGs did not receive supraspinal input such that the only mechanisms available for enhancing output were interlimb coupling gains and sensory feedback gains. Results In a two-CPG model with inhibitory sensory feedback gains, only excitatory gains of ipsilateral flexor-extensor/extensor-flexor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 26%. In a two-CPG model with excitatory sensory feedback gains, excitatory gains of contralateral flexor-flexor/extensor-extensor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 100%. However, within a given excitatory sensory feedback gain, enhancement due to excitatory interlimb gains could only reach levels up to 20%. Interconnecting four CPGs to have ipsilateral flexor-extensor/extensor-flexor coupling, contralateral flexor-flexor/extensor-extensor coupling, and bilateral flexor-extensor/extensor-flexor coupling could enhance motor output up to 32%. Enhancement observed in experimental data exceeded 32%. Enhancement within this symmetrical four-CPG neural architecture was more sensitive to relatively small interlimb coupling gains. Excitatory sensory feedback gains could produce greater output amplitudes, but larger gains were required for entrainment compared to inhibitory sensory feedback gains. Conclusions Based on these simulations, symmetrical interlimb coupling can account for much, but not all of the excitatory neural coupling between upper and lower limbs during rhythmic locomotor-like movements.

2010-01-01

73

Descriptions of the upper limb skeleton of Homo floresiensis.  

PubMed

Several bones of the upper extremity were recovered during excavations of Late Pleistocene deposits at Liang Bua, Flores, and these have been attributed to Homo floresiensis. At present, these upper limb remains have been assigned to six different individuals - LB1, LB2, LB3, LB4, LB5, and LB6. Several of these bones are complete or nearly so, but some are quite fragmentary. All skeletal remains recovered from Liang Bua were extremely fragile, but have now been stabilized and hardened in the laboratory in Jakarta. They are now curated in museum-quality containers at the National Research and Development Centre for Archaeology in Jakarta, Indonesia. These skeletal remains are described and illustrated photographically. The upper limb presents a unique mosaic of derived (human-like) and primitive morphologies, the combination of which is never found in either healthy or pathological modern humans. PMID:19056103

Larson, S G; Jungers, W L; Tocheri, M W; Orr, C M; Morwood, M J; Sutikna, T; Awe, Rokhus Due; Djubiantono, T

2008-12-04

74

Stable, conditional, and muscle-fiber-specific expression of electroporated transgenes in chick limb muscle cells.  

PubMed

Limb muscle formation is spread out over time and, consequently, muscle cells are not easy to target at any particular stages. We aimed to design a technique to study gene function in the different steps of limb muscle formation. We have associated transposon-mediated gene transfer and a tetracycline-dependent activation method with forelimb somite electroporation. In addition, we have established a new vector combining a differentiated-muscle-cell-specific promoter and the transposon system, which allows stable gene expression in limb differentiated muscle cells and not in muscle progenitors. Using these methods, we observed that conditional Fgf4 expression in muscle cells at the onset of fetal muscle differentiation and specific Fgf4 expression in differentiated muscle cells alter muscle fiber formation in chick limbs. Limb somite electroporation with these set of vectors allowing stable, conditional, and differentiated-muscle-specific expression of transgenes opens new perspectives for investigating gene function at various steps of limb muscle formation. PMID:21509896

Wang, Hui; Bonnet, Aline; Delfini, Marie Claire; Kawakami, Koichi; Takahashi, Yoshiko; Duprez, Delphine

2010-12-02

75

Left and right hand recognition in upper limb amputees.  

PubMed

Previous research suggests a close similarity in brain activity between mental simulation of a movement and its real counterpart. To explore this similarity, we aimed to assess whether imagery is affected by the loss of a limb or of its motor skills. We examined the performance of 16 adult, upper limb amputees (and age-matched controls) in a left/right hand judgement task that implicitly requires motor imagery. The experimental group included subjects who had suffered the amputation of the dominant or the non-dominant limb. Although responding well above chance, amputees as a group were slower and less accurate than controls. Nevertheless, their response pattern was similar to that of controls, namely slower response times and more errors for stimuli depicting hands in unnatural orientations, i.e. postures difficult to reach with a real movement. Interestingly, for all stimuli, amputees' performance was strongly affected by the side of limb loss: subjects who underwent amputation of their preferred limb made more errors and required greater latencies to respond as compared with amputees of the non-dominant limb. In a further analysis we observed that the habit of wearing an aesthetic prosthesis significantly interfered with the ability to judge the corresponding hand. Our data lead to three main conclusions: (i) loss of a single limb per se does not prevent motor imagery but it significantly enhances its difficulty; (ii) these subjects apparently perform the hand recognition task using a strategy in which they initially mentally simulate movements of their dominant limb; (iii) wearing a prosthesis, devoid of any motor function, seems to interfere with motor imagery, consistent with the view that only 'tools' can be incorporated in a dynamic body schema. PMID:14607796

Nico, Daniele; Daprati, Elena; Rigal, François; Parsons, Lawrence; Sirigu, Angela

2003-11-07

76

Muscle activation during low-intensity muscle contractions with varying levels of external limb compression  

Microsoft Academic Search

The purpose was to investigate muscle activation during low- intensity muscle contractions with various levels of external limb compression to reduce muscle perfusion\\/outflow. A series of unilateral elbow flexion muscle contractions (30 repetitive contractions followed by 3 sets x 15 contractions) was per- formed at 20% of 1RM with varying levels of external compres- sion (0 (without compression), 98, 121,

Tomohiro Yasuda; William F. Brechue; Taku Fujita; Yoshiaki Sato; Takashi Abe

2008-01-01

77

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

78

Development of rehabilitation system for the upper limbs in a NEDO project  

Microsoft Academic Search

Movements of the upper limbs are complicated, various and indispensable for daily activities. It therefore is important for the aged to exercise to keep their upper limb function. When something is wrong with the upper limb function because of disease or disorder, rehabilitation along with medical treatment is needed to recover function. Application of robotics and virtual reality technology makes

Ken'ichi Koyanagi; Junji Furusho; Ushio Ryu; Akio Inoue

2003-01-01

79

Paradoxical embolus: an unusual indication for upper limb amputation.  

PubMed Central

Paradoxical emboli occur when venous embolic material passes into the arterial circulation (via a right-to-left cardiac shunt). The association of paradoxical emboli and arterial ischaemia has been described previously, especially with respect to cerebral infarcts. We describe a case in which double paradoxical emboli following a long haul flight, resulted in emergency amputation of an upper limb. Amputation resulting from a paradoxical embolus has not previously been described. Images Figure 1

Patel, S. K.; Tomlinson, M.; Anjum, A.; Quarmby, J.

2001-01-01

80

Wound closure and decompression in upper limb replantation.  

PubMed

Limb replantations and revascularizations with a significant muscle bulk may be dangerous and even have life-threatening complications. This is intimately related to the period of muscle anoxia which may lead to postischemia (crush) syndrome with its associated pathological conditions. Once blood circulation is reestablished, every step must be taken to maintain optimal blood flow and to avoid secondary ischemia within the revascularized part, due to increased pressure within muscle compartments as a consequence of traumatic and postanoxic edema formation (compartment syndrome). Therefore, wound closure and primary decompression require particular attention and experience. Methods to achieve optimal primary decompression and wound closure are described. Special emphasis is put on the importance of radical skeletal shortening, initial fasciotomies, primary excision of damaged musculature and effective skin release using the mesh graft principle. PMID:1695515

Meyer, V E

1990-01-01

81

Objective measurement of upper limb activity and mobility during everyday behavior using ambulatory accelerometry: The upper limb activity monitor  

Microsoft Academic Search

Ambulatory accelerometry is a technique that allows objective measurement of aspects of everyday human behavior. The aim of\\u000a our research has been to develop, validate, and apply this technique, which recently resulted in an upper limb activity monitor\\u000a (ULAM). The ULAM consists of body-mounted acceleration sensors connected to a waist-worn data recorder and allows valid and\\u000a objective assessment of activity

FABIËNNE C. SCHASFOORT; Wim L. J. Martens; Henk J. Stam

2006-01-01

82

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

PubMed Central

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.

Stinear, James W; Byblow, Winston D

2002-01-01

83

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

PubMed

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

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

2010-01-01

84

Comprehensive care for the child with upper extremity limb deficiency.  

PubMed

Children with limb deficiencies/amputations are best managed by a multidisciplinary team comprised of physicians specializing in their care, prosthetists, and therapists. For a successful functional outcome, the rehabilitation team will need to consider the goals of the child and parents as they select appropriate components that will aid and not overwhelm the child. The prosthesis will need to accommodate growth and development and withstand the rigors of use during play. The child will benefit from a team approach to introduce, train, and problem-solve the process of prosthetic restoration. We examine strategies for decision making for children with upper extremity limb deletions that will allow appropriate component selection to ensure the prosthesis will be accepted and improve function for the child. PMID:21791813

Kelly, Brian M; Davis, Alicia J; Justice, Denise; Miller, Quaintance L; Nelson, Virginia S

2009-01-01

85

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

86

Postoperative education concerning the use of the upper limb, and exercise and treatment of the upper limb: cross-sectional survey of 105 breast cancer patients  

Microsoft Academic Search

In this retrospective survey we investigated the recall of breast cancer patients ( n=105) 6 months after the operation concerning postoperative instructions on exercises for shoulder mobility, and instructions for oedema prevention and treatment, upper limb strength training and the use of the upper limb in daily activities. Patients also described the content in their own words and ranked the instructors

Anne Kärki; Riitta Simonen; Esko Mälkiä; James Selfe

2004-01-01

87

Skeletal muscle vascular responses in human limbs to isometric handgrip  

Microsoft Academic Search

Studies of whole limb blood flow have shown that static handgrip elicits a vasodilatation in the resting forearm and vasoconstriction in the resting leg. We asked if these responses occur in the skeletal muscle vascular bed, and if so, what is the relative contribution of local metabolic versus other mechanisms to these vascular responses. Blood flow recordings were made simultaneously

Tage N. Jacobsen; Jim Hansen; Henrik V. Nielsen; Gordon Wildschiødtz; Eli Kassis; Bjørn Larsen; Ole Amtorp

1994-01-01

88

Scaling Body Support in Mammals: Limb Posture and Muscle Mechanics  

Microsoft Academic Search

The scaling of bone and muscle geometry in mammals suggests that peak stresses (ratio of force to cross-sectional area) acting in these two support elements increase with increasing body size. Observations of stresses acting in the limb bones of different sized mammals during strenuous activity, however, indicate that peak bone stress is independent of size (maintaining a safety factor of

Andrew A. Biewener

1989-01-01

89

Single centre experience of the upper limb replantation and revascularisation.  

PubMed

Replantation is defined as reattachment of the amputated limb using the neurovascular and musculoskeletal structures in order to obtain the recovery of the limb. Fortunately, injuries causing limb amputation are rare. Adequate treatment within the optimal time scale can provide successful rehabilitation of the shape and function of the replanted part. We report the experience of our Clinical Centre (regional replantation centre) in the replantation of five forearms/hands and revascularisation of six hands between 1997 and 2001. The most frequent site of injury was the distal part of the forearm, while the major cause of injuries was a wood processing machine. The surgical procedures were performed under general anaesthesia within 2-6 hours after injury. Vascular anastomoses, nerve repair and muscle repair were performed following the external bone fixation. All patients were given anticoagulation treatment postoperatively. Thrombosis in the anastomotic site developed as an early complication in two patients who underwent thrombectomy; one of these patients developed gangrene and underwent amputation. Late postoperative results were good in 10 patients. One patient developed acral epidermolysis. Postoperative results after revascularisation were good in all patients. PMID:15962813

Visnjic, Milan M; Kovacevic, Predrag T; Paunkovic, Ljiljana M; Milenkovic, Sasa S

2004-01-01

90

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

Microsoft Academic Search

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

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

2006-01-01

91

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

92

Evolution of upper limb function in children with congenital hemiplegia.  

PubMed

Hand function deficits in hemiplegic children are a major cause of disability, but there is a lack of appropriate instruments for evaluating the evolution of this deficit over time and for verifying the efficacy of its treatment. We evaluated changes in upper limb function in relation to age and the course of individual rehabilitation treatment in 20 children (13 males and 7 females) who were first seen within the first four years of life and subsequently followed until a mean age of 13 years and four months (range, 11-17 years) in accordance with a diagnostic/rehabilitation program initiated in our division in 1989. All of the children were treated by us; those whose paretic upper limb functioned well were not treated in any specific or directed manner. The protocol involved a qualitative evaluation of the spontaneous use of the paretic hand and a quantitative evaluation of grip. Analysis of the results revealed an age-related global improvement over time, occurring within the first five years of life and more pronounced in terms of grip than spontaneous use. This finding makes our protocol more specific than those currently used because it more reliably establishes the real capacity to use the paretic hand in different situations of everyday life. The most important changes concerned the children with more impaired functional capacity, whereas the children who presented with good functional skill retained this capacity over time, thus confirming the initial decision not to treat them. PMID:11917974

Pagliano, E; Andreucci, E; Bono, R; Semorile, C; Brollo, L; Fedrizzi, E

2001-10-01

93

Shaping muscle bioarchitecture for the fin to limb transition.  

PubMed

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

Cole, Nicholas J; Currie, Peter

2012-05-01

94

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

95

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

PubMed Central

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

Fleming, Neil; Donne, Bernard; Fletcher, David

2012-01-01

96

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

PubMed Central

Background Few research in multiple sclerosis (MS) has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle strength and functional capacity in MS patients with evident paresis. Methods A case series was applied, with provision of a training program (3×/week, 30 minutes/session), supplementary on the customary maintaining care, by employing a gravity-supporting exoskeleton apparatus (Armeo Spring). Ten high-level disability MS patients (Expanded Disability Status Scale 7.0-8.5) actively performed task-oriented movements in a virtual real-life-like learning environment with the affected upper limb. Tests were administered before and after training, and at 2-month follow-up. Muscle strength was determined through the Motricity Index and Jamar hand-held dynamometer. Functional capacity was assessed using the TEMPA, Action Research Arm Test (ARAT) and 9-Hole Peg Test (9HPT). Results Muscle strength did not change significantly. Significant gains were particularly found in functional capacity tests. After training completion, TEMPA scores improved (p = 0.02), while a trend towards significance was found for the 9HPT (p = 0.05). At follow-up, the TEMPA as well as ARAT showed greater improvement relative to baseline than after the 8-week intervention period (p = 0.01, p = 0.02 respectively). Conclusions The results of present pilot study suggest that upper limb functionality of high-level disability MS patients can be positively influenced by means of a technology-enhanced physical rehabilitation program.

2011-01-01

97

Diagnostic accuracy of the neurological upper limb examination II: Relation to symptoms of patterns of findings  

PubMed Central

Background In a sample of patients in clinical occupational medicine we have demonstrated that an upper limb neurological examination can reliably identify patterns of findings suggesting upper limb focal neuropathies. This further study aimed at approaching the diagnostic accuracy of the examination. Methods 82 limbs were semi-quantitatively assessed by two blinded examiners (strength in 14 individual muscles, sensibility in 7 homonymous territories, and mechanosensitivity at 10 locations along nerves). Based on the topography of nerves and their muscular and sensory innervation we defined 10 neurological patterns each suggesting a localized nerve affliction. Information on complaints (pain, weakness and/or numbness/tingling) collected by others served as a reference for comparison. The relation between the presence of pattern(s) and complaints was assessed by ?-statistics. Sensitivity, specificity, and positive/negative predictive values were calculated, and pre-test odds were compared to post-test probability. Results The two examiners identified pattern(s) suggesting focal neuropathy in 34/36 out of 38 symptomatic limbs, respectively (? = 0.70/0.75), with agreement in 28 limbs. Out of 44 non-symptomatic limbs the examiners agreed on absence of any pattern in 38 limbs. With concordance between the examiners with regard to the presence or absence of any pattern, the sensitivity, specificity, positive and negative predictive values were 0.73, 0.86, 0.93 and 0.90, respectively. While the pre-test odds for a limb to be symptomatic amounted to 0.46 the post-test probability was 0.81. For each examiner the post-test probability was 0.87 and 0.88, respectively. Conclusion The improved diagnostic confidence is an indication of one aspect of construct validity of the physical examination. For determination of clinical feasibility of the examination further studies are required, most importantly 1) studies of validity by means of comparison with additional references and 2) studies of the potential benefit that can be attained from its use.

Jepsen, J?rgen R; Laursen, Lise H; Hagert, Carl-Goran; Kreiner, Svend; Larsen, Anders I

2006-01-01

98

Trial Study of a Power Presentation Method for Upper-Limb Orthoses  

Microsoft Academic Search

\\u000a We are developing an upper-limb movement mechanism which is driven by push and pull forces in order to realize human-friendly\\u000a orthoses. In this paper, we propose a new device which can move the upper limbs without a rotatory center, and describe its\\u000a feasibility. From the results, it was found that our method can move the upper limbs to some extent.

Chikamune Wada; Futoshi Wada; Hirotaka Iwata; Naoki Chidiwa; Akio Tsutsumi; Kenji Hachisuka

99

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

Microsoft Academic Search

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

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

100

Disuse osteoporosis of the upper limb: assessment of thirty patients  

PubMed Central

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

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

2013-01-01

101

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

102

Botulinum toxin treatment in upper limb spasticity: treatment consistency.  

PubMed

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 of spasticity and attainment of pre-determined goals at 3, 6 and 12 months post each treatment. Mean age at treatment onset was 6y 4mo (SD: 4y 10mo), median F/U, 2.5 years (4 months-6 8/12 years). Number of injection sessions was 1-10; few had more than 6 sessions. In 106 (69.28%) children, more than one anatomic regions of the limb were injected. Most (56.2%), had at least two injection sessions; median time interval between the sessions was 9 months (IQR: 4-35 months, similar for unilateral and bilateral cerebral palsy, p = 0.874). Children >4 years old at the first treatment had longer intervals between sessions (25.8%) compared to younger ones (p = 0.010). The mixed effects models demonstrated that botulinum toxin dosage was stable over subsequent visits (p = 0.144) and that intermediate intervals for subsequent visits were similar to the first one (p = 0.279). PMID:21862370

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

2011-09-08

103

[Injuries to the upper limbs in competitive wrestlers].  

PubMed

Great variety of tackling and defence in wrestling in standing position and on the floor cannot be compared to other kind of sports. High demand to motoric characteristics and tournament specific movability is required. However wrestling in Germany belongs to a fringe sport there is an increase of professionality. This leads to a sufficient and high-demanded supervision. Aim of this retrospective study was to evaluate sport injuries using a questionnaire and to figure out a correlation between kind and frequency of sport injuries of different body regions. 163 questionnaires out of 200 had been evaluated. In the region of the upper limb injuries had been found in 23%. The injury rate was higher in the athletes wrestling in the 2nd league. Wrestling is a technically and tactically ambitious sport. Injuries should be evaluated very careful to minimize the risk changing tactics and training methods. PMID:18543163

Michael, J W-P; Müller, L; Schikora, N; Eysel, P; König, D P

2008-06-01

104

Robotic assessment of upper limb motor function after stroke.  

PubMed

Traditional assessment of a stroke subject's motor ability, carried out by a therapist who observes and rates the subject's motor behavior using ordinal measurements scales, is subjective, time consuming and lacks sensitivity. Rehabilitation robots, which have been the subject of intense inquiry over the last decade, are equipped with sensors that are used to develop objective measures of motor behaviors in a semiautomated way during therapy. This article reviews the current contributions of robot-assisted motor assessment of the upper limb. It summarizes the various measures related to movement performance, the models of motor recovery in stroke subjects and the relationship of robotic measures to standard clinical measures. It analyses the possibilities offered by current robotic assessment techniques and the aspects to address to make robotic assessment a mainstream motor assessment method. PMID:23080041

Balasubramanian, Sivakumar; Colombo, Roberto; Sterpi, Irma; Sanguineti, Vittorio; Burdet, Etienne

2012-11-01

105

Self-reported use of the upper limbs related to clinical tests in persons with multiple sclerosis.  

PubMed

Abstract Purpose: This study investigated the relationship between self-reported use of the upper limbs and clinical tests in persons with multiple sclerosis (pwMS). Methods: This cross-sectional study involved 25?pwMS with upper limb dysfunction. The Motor Activity Log (MAL) was bilaterally applied to investigate the self-reported use of both upper limbs. Clinical tests on function level were the Motricity Index (MI) and the Brunnström-Fugl-Meyer (BFM). On activity level, the Action Research Arm test (ARAt) was conducted. To identify the relationship between the self-reported use and the clinical tests, Spearman correlation coefficients were calculated. Subgroups of dominant and non-dominant arms were differentiated, and compared with the Wilcoxon Signed rank test. Results: The highest correlations were found between the MAL and function level tests: MI (r?=?0.83, p?upper limbs was highly associated with measures on function level. The association with activity level was, however, less pronounced. Magnitudes of relationships were influenced by hand dominance. Implications for Rehabilitation Self-reported use of the upper limbs in persons with MS, measured by the MAL, is highly associated with muscle strength and movement control. The ARAt (activity level of the ICF) is less associated with self-reported use compared to outcome measures at function level. The ARAt seems to be less sensitive to mild arm dysfunction. This study indicates that it is feasible and clinically relevant to apply the MAL as a self-reported outcome measure of upper limb use in MS. PMID:23627537

Lamers, Ilse; Timmermans, Annick A A; Kerkhofs, Lore; Severijns, Deborah; Van Wijmeersch, Bart; Feys, Peter

2013-04-29

106

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

Microsoft Academic Search

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

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

2010-01-01

107

Phantom movements and pain An fMRI study in upper limb amputees  

Microsoft Academic Search

Summary Using functional MRI, we investigated 14 upper limb amputees and seven healthy controls during the execution of hand and lip movements and imagined movements of the phantom limb or left hand. Only patients with phantom limb pain showed a shift of the lip representation into the deafferented primary motor and somatosensory hand areas during lip movements. Displacement of the

Martin Lotze; Herta Flor; Wolfgang Grodd; Wolfgang Larbig; Niels Birbaumer

2001-01-01

108

Effect of sensory feedback from the proximal upper limb on voluntary isometric finger flexion and extension in hemiparetic stroke subjects.  

PubMed

This study investigated the potential influence of proximal sensory feedback on voluntary distal motor activity in the paretic upper limb of hemiparetic stroke survivors and the potential effect of voluntary distal motor activity on proximal muscle activity. Ten stroke subjects and 10 neurologically intact control subjects performed maximum voluntary isometric flexion and extension, respectively, at the metacarpophalangeal (MCP) joints of the fingers in two static arm postures and under three conditions of electrical stimulation of the arm. The tasks were quantified in terms of maximum MCP torque [MCP flexion (MCP(flex)) or MCP extension (MCP(ext))] and activity of targeted (flexor digitorum superficialis or extensor digitorum communis) and nontargeted upper limb muscles. From a previous study on the MCP stretch reflex poststroke, we expected stroke subjects to exhibit a modulation of voluntary MCP torque production by arm posture and electrical stimulation and increased nontargeted muscle activity. Posture 1 (flexed elbow, neutral shoulder) led to greater MCP(flex) in stroke subjects than posture 2 (extended elbow, flexed shoulder). Electrical stimulation did not influence MCP(flex) or MCP(ext) in either subject group. In stroke subjects, posture 1 led to greater nontargeted upper limb flexor activity during MCP(flex) and to greater elbow flexor and extensor activity during MCP(ext). Stroke subjects exhibited greater elbow flexor activity during MCP(flex) and greater elbow flexor and extensor activity during MCP(ext) than control subjects. The results suggest that static arm posture can modulate voluntary distal motor activity and accompanying muscle activity in the paretic upper limb poststroke. PMID:21832028

Hoffmann, Gilles; Schmit, Brian D; Kahn, Jennifer H; Kamper, Derek G

2011-08-10

109

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

110

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

111

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

PubMed Central

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.

Gupta, Ravi; Lahan, Vivekananda; Goel, Deepak

2013-01-01

112

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

113

Prevalence of Upper Limb Musculo Skeletal Disorders among Brass Metal Workers in West Bengal, India  

Microsoft Academic Search

Brass metal work is one of the oldest cottage industries in West Bengal, India. Workers performing rigorous hand intensive jobs are likely to suffer from MSD affecting the upper limbs. The present investigation was intended to establish the prevalence of upper limb MSD among the brass metal workers and to identify the causative factors behind its development. In this study,

Somnath GANGOPADHYAY; Tirthankar GHOSH; Tamal DAS; Goutam GHOSHAL; Bani Brata DAS

2007-01-01

114

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

Microsoft Academic Search

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

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

2004-01-01

115

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

Microsoft Academic Search

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

Andrew J McHardy; Henry P Pollard

2005-01-01

116

An upper limb robot model of children limb for cerebral palsy neurorehabilitation.  

PubMed

Robot therapy has emerged in the last few decades as a tool to help patients with neurological injuries relearn motor tasks and improve their quality of life. The main goal of this study was to develop a simple model of the human arm for children affected with cerebral palsy (CP). The Simulink based model presented here shows a comparison for children with and without disabilities (ages 6-15) with normal and reduced range of motion in the upper limb. The model incorporates kinematic and dynamic considerations required for activities of daily living. The simulation was conducted using Matlab/Simulink and will eventually be integrated with a robotic counterpart to develop a physical robot that will provide assistance in activities of daily life (ADLs) to children with CP while also aiming to improve motor recovery. PMID:23366294

Pathak, Yagna; Johnson, Michelle

2012-01-01

117

Kinematic and electromyographic study of the nociceptive withdrawal reflex in the upper limbs during rest and movement.  

PubMed

This study set out to evaluate nociceptive withdrawal reflex (NWR) excitability and the corresponding mechanical response in the upper limbs during rest and movement. We used a three-dimensional motion analysis system and a surface EMG system to record, in 10 healthy subjects, the NWR in eight upper limb muscles and the corresponding mechanical response in two experimental conditions: rest and movement (reaching for, picking up, and moving a cylinder). The NWR was elicited through stimulation of the index finger with trains of pulses delivered at multiples of the pain threshold (PT). We correlated movement types (reach-to-grasp, grasp-and-lift), movement phases (acceleration, deceleration), and muscle activity types (shortening, lengthening, isometric) with the presence/absence of the NWR (reflex-muscle pattern), with NWR size values, and with the mechanical responses. At rest, when the stimulus was delivered at 4x PT, the NWR was present, in all muscles, in >90% of trials, and the mechanical response consisted of wrist adduction, elbow flexion, and shoulder anteflexion. At this stimulus intensity, during movement, the reflex-muscle pattern, reflex size, and mechanical responses were closely modulated by movement type and phase and by muscle activity type. We did not find, during movement, significant correlations with the level of EMG background activity. Our findings suggest that a complex functional adaptation of the spinal cord plays a role in modulating the NWR in the transition from rest to movement and during voluntary arm movement freely performed in three-dimensional space. Study of the upper limb NWR may provide a window onto the spinal neural control mechanisms operating during movement. PMID:16571758

Serrao, Mariano; Pierelli, Francesco; Don, Romildo; Ranavolo, Alberto; Cacchio, Angelo; Currà, Antonio; Sandrini, Giorgio; Frascarelli, Massimo; Santilli, Valter

2006-03-29

118

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

119

Botulinum toxin assessment, intervention and follow-up for paediatric upper limb hypertonicity: international consensus statement.  

PubMed

The primary objective of this paper was to evaluate the published evidence of efficacy and safety of botulinum neurotoxin (BoNT) injections in paediatric upper limb hypertonia (PULH). Secondary objectives included the provision of clinical context, based on evidence and expert opinion, in the areas of assessment, child and muscle selection, dosing, and adjunctive treatment. A multidisciplinary panel of authors systematically reviewed, abstracted, and classified relevant literature. Recommendations were based on the American Academy of Neurology (AAN) evidence classification. Following a literature search, 186 potential articles were screened for inclusion, and 15 of these met the criteria and were reviewed. Grade A evidence was found to support the use of BoNT to reach individualized therapeutic goals for PULH. There is grade B evidence (probably effective) for tone reduction following BoNT injections and grade U evidence (inconclusive) for improvement in upper limb (UL) activity and function. BoNT injections were generally found to be safe and well tolerated with the most common side effect identified as a transient decrease in grip strength. PMID:20633178

Fehlings, D; Novak, I; Berweck, S; Hoare, B; Stott, N S; Russo, R N

2010-08-01

120

Posture-movement responses to stance perturbations and upper limb fatigue during a repetitive pointing task.  

PubMed

Localized muscle fatigue and postural perturbation have separately been shown to alter whole-body movement but little is known about how humans respond when subjected to both factors combined. Here we sought to quantify the kinematics of postural control and repetitive upper limb movement during standing surface perturbations and in the presence of fatigue. Subjects stood on a motion-based platform and repetitively reached between two shoulder-height targets until noticeably fatigued (rating of perceived exertion=8/10). Every minute, subjects experienced a posterior and an anterior platform translation while reaching to the distal target. Outcomes were compared prior to and with fatigue (first vs. final minute data). When fatigued, regardless of the perturbation condition, subjects decreased their shoulder abduction and increased contralateral trunk flexion, a strategy that may relieve the load on the fatiguing upper limb musculature. During perturbations, kinematic adaptations emerged across the trunk and arm to preserve task performance. In contrast to our expectation, the kinematic response to the perturbations did not alter in the presence of fatigue. Kinematic adaptations in response to the perturbation predominantly occurred in the direction of the reach whereas fatigue adaptations occurred orthogonal to the reach. These findings suggest that during repetitive reaching, fatigue and postural perturbation compensations organize so as to minimize interaction with each other and preserve the global task characteristics of endpoint motion. PMID:24054899

Fuller, Jason R; Fung, Joyce; Côté, Julie N

2013-08-11

121

Upper Limb Portable Motion Analysis System Based on Inertial Technology for Neurorehabilitation Purposes  

PubMed Central

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

Perez, Rodrigo; Costa, Ursula; Torrent, Marc; Solana, Javier; Opisso, Eloy; Caceres, Cesar; Tormos, Josep M.; Medina, Josep; Gomez, Enrique J.

2010-01-01

122

Bioelectrical Impedance for Detecting Upper Limb Lymphedema in Nonlaboratory Settings  

PubMed Central

Abstract Background Single-frequency bioelectrical impedance has been used in clinical and research settings to measure extracellular fluid in arms. Its ease of use and low risk of user error suggests this measurement method may have advantages for use in nonlaboratory (community-based) environments when compared to other measurement methods. The purpose of this study was to evaluate the feasibility of using single-frequency bioelectrical impedance to detect upper limb lymphedema in nonlaboratory settings. Methods and Results Using a standardized protocol, impedance ratios among healthy normal women, breast cancer survivors with lymphedema, and breast cancer survivors without lymphedema were compared with participants seated in an upright position conducive for use outside laboratory settings (community-based environments). Ratios of healthy normal controls and breast cancer survivor groups without lymphedema were very similar, with almost complete overlap in confidence intervals. However, those values were markedly different from the values assessed in the survivor group with lymphedema (p < 0.001). Conclusions These findings suggest impedance ratios determined by single-frequency bioelectrical impedance can be used as markers for lymphedema in nonlaboratory settings when a standardized protocol is used.

Dietrich, Mary S.; Deng, Jie; Bonner, Candace M.; Kidd, Nancy

2009-01-01

123

Upper limb malformations in chromosome 22q11 deletions  

SciTech Connect

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

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

1996-03-29

124

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

125

Differences in capillary supply between human oro-facial, masticatory and limb muscles  

Microsoft Academic Search

In this report we show that immunostaining of the capillary basement membrane with an antibody directed against laminin is a useful alternative in detecting the capillaries in human muscle. Using this method, the capillary supply of three embryologically, morphologically and functionally different muscle groups, oro-facial, masticatory and limb muscles, were analysed. Significant differences in capillarization between muscles and muscle groups

P. Stål; P.-O. Eriksson; L.-E. Thornell

1996-01-01

126

Effect of Acute Exercise on Upper-Limb Volume in Breast Cancer Survivors: A Pilot Study  

PubMed Central

ABSTRACT Purpose: Strenuous upper-extremity activity and/or exercise have traditionally been prescribed for breast cancer survivors with or at risk of developing lymphedema. The purpose of this study was to assess the effect of an acute bout of exercise on upper-limb volume and symptoms in breast cancer survivors, with the intent to provide pilot data to guide a subsequent larger study. Methods: Twenty-three women who regularly participated in dragon-boat racing took part in the study. A single exercise bout was performed at a moderate intensity (rating of perceived exertion: 13–14) for 20 continuous minutes on an arm ergometer. The difference between affected and unaffected limb volume was assessed pre- and post-exercise via measurements of limb circumference at five time points. Results: Although limb volume increased following exercise in both limbs, the difference between the limbs remained stable at each measurement point. Only one participant was found to have an increase in arm-volume difference of >100 ml post intervention, and only four participants reported symptoms of tension and/or heaviness in the affected limb. Conclusion: The results suggest that limb volume in breast cancer survivors increases after an acute bout of upper-limb exercise but that, for the majority of women, the response is not different between affected and unaffected limbs. Future research using a larger sample and more sensitive measurement methods are recommended.

Campbell, Kristin L.; Courneya, Kerry S.; Mackey, John R.

2009-01-01

127

Upper limbs dysmetria caused by cervical spinal cord injury: a case report  

PubMed Central

Background Upper limbs dysmetria caused by spinal cord injury is very rare. We will discuss the associated mechanism in our articles. Case presentation A 51-year-old male had sudden onset of weakness, dysmetria over bilateral upper limbs and ataxia after he fell accidentally. Brain magnetic resonance imaging (MRI) revealed no specific findings. C-spine MRI revealed C1 myelopathy and C4-6 spinal cord compression by bulged disc. The symptoms subsided after surgical intervention. Conclusion Sudden onset of upper limbs dysmetria is a sign of dysfunction in cerebellum and its associated pathway. However, lesion in spinal cord can also cause cerebellar signs such as dysmetria.

Lin, Hsun-Chang; Chen, Chun-Hung; Khor, Gim-Thean; Huang, Poyin

2009-01-01

128

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

129

Upper limb dynamic responses to impulsive forces for selected assembly workers.  

PubMed

This study evaluated the upper limb, dynamic, mechanical response parameters for 14 male assembly workers recruited from selected jobs based on power tool use. It was hypothesized that the type of power tool operation would affect stiffness, effective mass, and damping of the upper extremity; and workers with symptoms and positive physical examination findings would have different mechanical responses than asymptomatic workers without physical examination findings. Participants included operators who regularly used torque reaction power hand tools, such as nutrunners and screwdrivers, and nontorque reaction power hand tools, such as riveters. The mechanical parameters of the upper limb were characterized from the loading response of an apparatus having known dynamic properties while worker grasps an oscillating handle in free vibration. In addition, all workers underwent a physical examination, magnetic resonance imaging, and completed a symptom survey. Workers were categorized as controls or cases based on reported forearm symptoms and physical exam findings. A total of seven workers were categorized as cases and had less average mechanical stiffness (46%, p > 0.01), damping (74%, p > 0.01), and effective mass (59%, p > 0.05) than the seven workers categorized as controls. Magnetic resonance imaging (MRI) findings suggestive of muscle edema were observed for two workers classified as cases and who regularly used torque reaction power tools. No MRI enhancement was observed in the seven subjects who did not regularly use torque reaction power tools. The ergonomic consequences of less stiffness, effective mass, and damping in symptomatic workers may include reduced capacity to react against rapidly building torque reaction forces encountered when operating power hand tools. PMID:16361220

Sesto, Mary E; Radwin, Robert G; Block, Walter F; Best, Thomas M

2006-02-01

130

A Compliant exoskeleton for multi-planar upper limb physiotherapy and training  

Microsoft Academic Search

In general, treatment of full or partial loss of fu nction in the upper limb due to injury relies on extremely labour intensive physiotherapy procedures. Although mechanical assistive device exist for li mbs this is rare for the upper body. In this paper we p resent a seven degree of motion prototype upper arm training\\/physiotherapy (exoskeleton) system. The t otal

N. G. TSAGARAKIS; DARWIN G. CALDWELL

131

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

132

Optimized Gaussian mixture models for upper limb motion classification  

Microsoft Academic Search

This work introduces the use of Gaussian mixture models (GMM) for discriminating multiple classes of limb motions using continuous myoelectric signals (MES). The purpose of this work is to investigate an optimum configuration of a GMM-based limb motion classification scheme. For this effort, a complete experimental evaluation of the Gaussian mixture motion model is conducted on a 12-subject database. The

Y. Huang; K. B. Englehart; B. Hudgins; A. D. C. Chan

2004-01-01

133

Upper limb motor function in young adults with spina bifida and hydrocephalus  

PubMed Central

Objective The objective of the study was to measure upper limb motor function in young adults with spina bifida meningomyelocele (SBM) and typically developing age peers. Method Participants were 26 young adults with SBM, with a Verbal or Performance IQ score of at least 70 on the Wechsler scales, and 27 age- and gender-matched controls. Four upper limb motor function tasks were performed under four different visual and cognitive challenge conditions. Motor independence was assessed by questionnaire. Results Fewer SBM than control participants obtained perfect posture and rebound scores. The SBM group performed less accurately and was more disrupted by cognitive challenge than controls on limb dysmetria tasks. The SBM group was slower than controls on the diadochokinesis task. Adaptive motor independence was related to one upper limb motor task, arm posture, and upper rather than lower spinal lesions were associated with less motor independence. Conclusions Young adults with SBM have significant limitations in upper limb function and are more disrupted by some challenges while performing upper limb motor tasks. Within the group of young adults with SBM, upper spinal lesions compromise motor independence more than lower spinal lesions.

Salman, M. S.; Jewell, D.; Hetherington, R.; Spiegler, B. J.; MacGregor, D. L.; Drake, J. M.; Humphreys, R. P.; Gentili, F.

2011-01-01

134

Mechanosensitivity of the median nerve and mechanically produced motor responses during Upper Limb Neurodynamic Test 1  

Microsoft Academic Search

ObjectivesIn spite of the widespread use and recognised importance of the Upper Limb Neurodynamic Test 1 (ULNT1) in clinical practice, controversy remains about the neurophysiological basis for sensory and motor responses to the test. The aims of this study were to determine the effects of two limb positions (neutral and ULNT1) on mechanosensitivity of the median nerve, and to investigate

Shapour Jaberzadeh; Sheila Scutter; Homer Nazeran

2005-01-01

135

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

136

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

PubMed Central

Background Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. Objective To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing. Discussion An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury.

McHardy, Andrew J; Pollard, Henry P

2005-01-01

137

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

138

Upper-limb function in Australian children with traumatic brain injury: A controlled, prospective study  

Microsoft Academic Search

Wallen MA, Mackay S, Duff SM, McCartney LC, O'Flaherty SJ. Upper-limb function in Australian children with traumatic brain injury: a controlled, prospective study. Arch Phys Med Rehabil 2001;82:642-9. Objective: To describe upper-limb function in children with mild and severe traumatic brain injury (TBI), by using both quantitative and qualitative measures. Design: Controlled, prospective cohort study with assessment points initially, at

Margaret A Wallen; Suzanne Mackay; Sharon M Duff; Lynn C McCartney; Stephen J O'Flaherty

2001-01-01

139

Impact of early applied upper limb stimulation: The EXPLICIT-stroke programme design  

Microsoft Academic Search

BACKGROUND: Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke) aims to explore the underlying mechanisms of post stroke upper limb

Gert Kwakkel; Carel GM Meskers; Erwin E van Wegen; Guus J Lankhorst; Alexander CH Geurts; Annet A van Kuijk; Eline Lindeman; Anne Visser-Meily; Erwin de Vlugt; J Hans Arendzen

2008-01-01

140

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

Microsoft Academic Search

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

H Kumahara; H Tanaka; Y Schutz

2004-01-01

141

Upper and lower motor neuron lesions in the upper extremity muscles of tetraplegics  

Microsoft Academic Search

Paralysed upper extremity muscles of 24 tetraplegie patients were examined to determine whether their lower motor neuron was intact. Primary emphasis was placed on the forearm finger flexor muscles (Flexor Digitorum Superficialis and Flexor Digitorum Profundus) and finger extensor muscles (Extensor Digitorum Communis and Extensor Indicis). It was found that the vast majority of these muscles in C4, C5 and

P H Peckham; J T Mortimer; E B Marsolais

1976-01-01

142

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

143

Reconstruction of the hand and upper limb with free flaps based on musculocutaneous perforators.  

PubMed

Since the advent of perforator flaps, a wide variety of applications have been documented. This study focuses on free flaps based on musculocutaneous perforators, because they have not been well-described in the literature of upper-limb reconstruction. They can be trimmed to be thin and pliable, and may provide large flaps with multiple components on the same pedicle to facilitate three-dimensional inset of flaps. Microvascular free flaps based on musculocutaneous perforators were performed in 36 cases for reconstruction of the thumb and thenar web, palm, dorsum of the hand, wrist, and forearm. They included the anterolateral thigh perforator flap (27 cases), thoracodorsal perforator flap (5 cases), and deep inferior epigastric perforator flap (4 cases). In 2 other cases not included in this series, the thoracodorsal perforator flap could not be elevated due to anatomical variations. There was no failure in this series, but complications included: 1) hematoma in 2 cases, and 2) infection in 2 cases with flap rim necrosis which was treated by a local rotation flap and skin graft. The thin flaps facilitated secondary reconstructive procedures, and only minor effort was required for the debulking procedure of the flaps. On average, these patients required 2.3 occasions of secondary procedures for further reconstruction following coverage with a perforator flap. The perforator flaps provide medium-thickness flaps for coverage of large defects in the upper limb with improved aesthetics and function. With careful dissection of the musculocutaneous perforators and primary thinning of the flaps, the use of a perforator flap is quite safe. Preservation of the muscles leads to better preservation of donor-site functions. Less requirement of secondary debulking procedures is a great advantage. However, caution should be taken in the presence of wound infection. PMID:15274182

Chen, Hung-Chi; Tang, Yueh-Bih; Mardini, Samir; Tsai, Bo-Wen

2004-01-01

144

Estimation of Musculotendon Properties in the Human Upper Limb  

Microsoft Academic Search

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

Brian A. Garner; Marcus G. Pandy

2003-01-01

145

Botulinum Toxin Type A Injection for Management of Upper Limb Spasticity in Children with Cerebral Palsy: a Literature Review  

PubMed Central

The aim of this article was to present a review of the research literature on the outcome of botulinum toxin type A (BTX-A) injection for management of upper limb spasticity in children with cerebral palsy (CP). We searched the electronic databases of MEDLINE, CINAHL and PUBMED for all published studies with full-length English text available. For each study, the quality of the methods and the strength of evidence were assessed by 2 independent reviewers based on the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) guidelines. Four studies of level I, 8 studies of level IV and 4 studies of level V were identified. Due to the limited number of studies with high quality evidence and inconsistent results among studies, we were unable to support or refute the usefulness of BTX-A injection for management of upper limb spasticity in children with CP. Moreover, we identified several variables that may affect the outcome of injection, such as timing of age, dosage, dilution volumes, localization techniques of target muscles and participant characteristics. In summary, we have presented a review the literature and a discussion of the considerable uncertainty and variation associated with the clinical use of BTX-A injection for management of upper limb spasticity in children with CP.

Rha, Dong-wook

2006-01-01

146

Upper limb assessment in tetraplegia: clinical, functional and kinematic correlations.  

PubMed

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 velocity, movement time, percent time-to-maximal velocity, index of curvature, number of peaks, and joint range of motion) were correlated to clinical (Standard Neurological Classification of Spinal Cord Injury-American Spinal Injury Association) and functional [Functional Independence Measure (FIM) and Spinal Cord Independence Measure II (SCIM II)] evaluation scores. Twenty control participants were also selected to obtain normal reference parameters. There was a positive correlation between total motor index and FIM (r=0.6089; P=0.0044) and SCIM II (r=0.5229; P=0.018). Both functional scores showed positive correlation with each other (r=0.8283; P<0.0001). A correlation was also observed between the right and left motor indices, the motor FIM, and the SCIM II in most of the reach-to-grasp kinematic variables studied (hand peak velocity, movement time, index of curvature, and number of peaks). In contrast, for the joint range of motion (shoulder, elbow, and wrist), only the wrist in the horizontal plane showed correlation with clinical variables. This study shows that muscle strength assessed by the American Spinal Injury Association motor index influences the reach-to-grasp kinematic variables of patients with tetraplegia. However, the functional assessments did not present the same influence. PMID:20805758

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

2011-03-01

147

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

PubMed Central

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.

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

2006-01-01

148

Frequency response of vestibular reflexes in neck, back, and lower limb muscles.  

PubMed

Vestibular pathways form short-latency disynaptic connections with neck motoneurons, whereas they form longer-latency disynaptic and polysynaptic connections with lower limb motoneurons. We quantified frequency responses of vestibular reflexes in neck, back, and lower limb muscles to explain between-muscle differences. Two hypotheses were evaluated: 1) that muscle-specific motor-unit properties influence the bandwidth of vestibular reflexes; and 2) that frequency responses of vestibular reflexes differ between neck, back, and lower limb muscles because of neural filtering. Subjects were exposed to electrical vestibular stimuli over bandwidths of 0-25 and 0-75 Hz while recording activity in sternocleidomastoid, splenius capitis, erector spinae, soleus, and medial gastrocnemius muscles. Coherence between stimulus and muscle activity revealed markedly larger vestibular reflex bandwidths in neck muscles (0-70 Hz) than back (0-15 Hz) or lower limb muscles (0-20 Hz). In addition, vestibular reflexes in back and lower limb muscles undergo low-pass filtering compared with neck-muscle responses, which span a broader dynamic range. These results suggest that the wider bandwidth of head-neck biomechanics requires a vestibular influence on neck-muscle activation across a larger dynamic range than lower limb muscles. A computational model of vestibular afferents and a motoneuron pool indicates that motor-unit properties are not primary contributors to the bandwidth filtering of vestibular reflexes in different muscles. Instead, our experimental findings suggest that pathway-dependent neural filtering, not captured in our model, contributes to these muscle-specific responses. Furthermore, gain-phase discontinuities in the neck-muscle vestibular reflexes provide evidence of destructive interaction between different reflex components, likely via indirect vestibular-motor pathways. PMID:23904494

Forbes, Patrick A; Dakin, Christopher J; Vardy, Alistair N; Happee, Riender; Siegmund, Gunter P; Schouten, Alfred C; Blouin, Jean-Sébastien

2013-07-31

149

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

2012-12-16

150

The Influence of Dopaminergic Striatal Innervation on Upper Limb Locomotor Synergies  

PubMed Central

To determine the role of striatal dopaminergic innervation on upper limb synergies during walking, we measured arm kinematics in 13 subjects with Parkinson disease. Patients were recruited according to several inclusion criteria to represent the best possible in vivo model of dopaminergic denervation. Of relevance, we included only subjects with normal spatio-temporal parameters of the stride and gait speed to avoid an impairment of upper limbs locomotor synergies as a consequence of gait impairment per se. Dopaminergic innervation of the striatum was measured by FP-CIT and SPECT. All patients showed a reduction of gait-associated arms movement. No linear correlation was found between arm ROM reduction and contralateral dopaminergic putaminal innervation loss. Still, a partition analysis revealed a 80% chance of reduced arm ROM when putaminal dopamine content loss was >47%. A significant correlation was described between the asymmetry indices of the swinging of the two arms and dopaminergic striatal innervation. When arm ROM was reduced, we found a positive correlation between upper-lower limb phase shift modulation (at different gait velocities) and striatal dopaminergic innervation. These findings are preliminary evidence that dopaminergic striatal tone plays a modulatory role in upper-limb locomotor synergies and upper-lower limb coupling while walking at different velocities.

Isaias, Ioannis U.; Volkmann, Jens; Marzegan, Alberto; Marotta, Giorgio; Cavallari, Paolo; Pezzoli, Gianni

2012-01-01

151

Venous pressures in the isolated upper limb during saline injection  

Microsoft Academic Search

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

Barry A. Finegan; M. David Bukht

1984-01-01

152

Advances in upper limb stroke rehabilitation: a technology push  

Microsoft Academic Search

Strokes affect thousands of people worldwide leaving sufferers with severe disabilities affecting their daily activities.\\u000a In recent years, new rehabilitation techniques have emerged such as constraint-induced therapy, biofeedback therapy and robot-aided\\u000a therapy. In particular, robotic techniques allow precise recording of movements and application of forces to the affected\\u000a limb, making it a valuable tool for motor rehabilitation. In addition, robot-aided

Rui C. V. LoureiroWilliam; William S. Harwin; Kiyoshi Nagai; Michelle Johnson

153

Exercise intensity and muscle hypertrophy in blood flow-restricted limbs and non-restricted muscles: a brief review.  

PubMed

Although evidence for high-intensity resistance training-induced muscle hypertrophy has accumulated over the last several decades, the basic concept of the training can be traced back to ancient Greece: Milo of Croton lifted a bull-calf daily until it was fully grown, which would be known today as progressive overload. Now, in the 21st century, different types of training are being tested and studied, such as low-intensity exercise combined with arterial as well as venous blood flow restriction (BFR) to/from the working muscles. Because BFR training requires the use of a cuff that is placed at the proximal ends of the arms and/or legs, the BFR is only applicable to limb muscles. Consequently, most previous BFR training studies have focused on the physiological adaptations of BFR limb muscles. Muscle adaptations in non-BFR muscles of the hip and trunk are lesser known. Recent studies that have reported both limb and trunk muscle adaptations following BFR exercise training suggest that low-intensity (20-30% of 1RM) resistance training combined with BFR elicits muscle hypertrophy in both BFR limb and non-BFR muscles. However, the combination of leg muscle BFR with walk training elicits muscle hypertrophy only in the BFR leg muscles. In contrast to resistance exercise with BFR, the exercise intensity may be too low during BFR walk training to cause muscle hypertrophy in the non-BFR gluteus maximus and other trunk muscles. Other mechanisms including hypoxia, local and systemic growth factors and muscle cell swelling may also potentially affect the hypertrophic response of non-BFR muscles to BFR resistance exercise. PMID:22681600

Abe, Takashi; Loenneke, Jeremy P; Fahs, Christopher A; Rossow, Lindy M; Thiebaud, Robert S; Bemben, Michael G

2012-04-10

154

Effects of 8-week in-season upper and lower limb heavy resistance training on the peak power, throwing velocity, and sprint performance of elite male handball players.  

PubMed

The aims of this study were to test the potential of in-season heavy upper and lower limb strength training to enhance peak power output (Wpeak), vertical jump, and handball related field performance in elite male handball players who were apparently already well trained, and to assess any adverse effects on sprint velocity. Twenty-four competitors were divided randomly between a heavy resistance (HR) group (age 20 ± 0.7 years) and a control group (C; age 20 ± 0.1 years). Resistance training sessions were performed twice a week for 8 weeks. Performance was assessed before and after conditioning. Peak power (W(peak)) was determined by cycle ergometer; vertical squat jump (SJ) and countermovement jump (CMJ); video analyses assessed velocities during the first step (V(1S)), the first 5 m (V(5m)), and between 25 and 30 m (V(peak)) of a 30-m sprint. Upper limb bench press and pull-over exercises and lower limb back half squats were performed to 1-repetition maximum (1RM). Upper limb, leg, and thigh muscle volumes and mean thigh cross-sectional area (CSA) were assessed by anthropometry. W(peak) (W) for both limbs (p < 0.001), vertical jump height (p < 0.01 for both SJ and CMJ), 1RM (p < 0.001 for both upper and lower limbs) and sprint velocities (p < 0.01 for V(1S) and V(5m); p < 0.001 for V(peak)) improved in the HR group. Upper body, leg, and thigh muscle volumes and thigh CSA also increased significantly after strength training. We conclude that in-season biweekly heavy back half-squat, pull-over, and bench-press exercises can be commended to elite male handball players as improving many measures of handball-related performance without adverse effects upon speed of movement. PMID:21869628

Hermassi, Souhail; Chelly, Mohamed Souhaiel; Tabka, Zouhair; Shephard, Roy J; Chamari, Karim

2011-09-01

155

Constraint-Induced Movement Therapy (CIT) for Restoration of Upper-limb Function. II: Hemipareses Application  

Microsoft Academic Search

\\u000a Constraint-induced movement therapy (CIT) is a highly specialized form of rehabilitation for those with upper-limb paresis.\\u000a The intervention uses a combination of motor training elements and psychological concepts to facilitate increased use of the\\u000a affected limb as well as improved movement quality and control. Importantly, CIT is designed to achieve real-world improvements\\u000a through behavioral measures that facilitate the incorporation of

Annette Sterr; Katherine Herron; Jennifer Sanders

156

Design of a 7DOF upper-limb power-assist exoskeleton robot with moving shoulder joint mechanism  

Microsoft Academic Search

Various tasks are performed by upper-limbs in activities in daily living. Therefore, it is important to assist human upper-limb motions for physically weak persons such as elderly, injured, or disabled persons in order to live an independent life. To assist daily life motions of the physically weak persons, many kinds of upper-limb power-assist robots have been developed. Although the position

Kazuo Kiguchi; Kenryu Kado; Yoshiaki Hayashi

2011-01-01

157

The contribution of upper limb and total body movement to adolescents’ energy expenditure whilst playing Nintendo Wii  

Microsoft Academic Search

Little research documents the contribution of upper limb and total body movement to energy expenditure (EE) during active\\u000a video gaming. To address this, EE, heart rate (HR), and, upper limb and total body movement were assessed in 11- to 17-year-old\\u000a adolescents whilst playing three active (Nintendo Wii) and one sedentary (XBOX 360) video games. Non-dominant upper limb activity,\\u000a EE and

Lee E. F. Graves; Nicola D. Ridgers; Gareth Stratton

2008-01-01

158

Motor capacities of upper limbs in tetraplegics: a new scale for the assessment of the results of functional surgery on upper limbs  

Microsoft Academic Search

Study design: Metrological investigation.Objectives: To study the validity and the reliability of a Motor Capacities Scale (MCS) specifically designed for tetraplegics who undergo a functional surgery of upper limbs.Setting: Bouffard-Vercelli Centre, Cerbere, France.Methods: From diverse sources (observation of patients, review of literature, discussions with occupational therapists and physicians), we compiled a list of 300 activities relating to daily living tasks.

C Fattal

2004-01-01

159

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

PubMed Central

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

Jepsen, Jorgen R; Thomsen, Gert

2008-01-01

160

On Fitts's and Hooke's laws: simple harmonic movement in upper-limb cyclical aiming.  

PubMed

Can discrete, single-shot movements and continuous, cyclical movements be reduced to a single concept? In the classical, computational approach to human motor behaviour, cyclical aimed movement has generally been considered to derive from discrete primitives through a concatenation mechanism. Much importance, accordingly, has been attached to discrete-movement paradigms and to techniques allowing the segmentation of continuous data. An alternative approach, suggested by the nonlinear dynamical systems theory, views discreteness as a limiting case of cyclicity. Although attempts have been made recently to account for discrete movements in dynamical terms, cyclical paradigms have been favoured. The concatenation interpretation of cyclical aimed movement is criticized on the ground that it implies a complete waste of mechanical energy once in every half-cycle. Some kinematic data from a one-dimensional reciprocal (i.e., cyclical) aiming experiment are reported, suggesting that human subjects do save muscular efforts from one movement to the next in upper-limb cyclical aiming. The experiment demonstrated convergence on simple harmonic motion as aiming tolerance was increased, an outcome interpreted with reference to Hooke's law, in terms of the muscles' capability of storing potential, elastic energy across movement reversals. Not only is the concatenation concept problematic for understanding cyclical aimed movements, but the very reality of discrete movements is questionable too. It is pointed out that discrete motor acts of real life are composed of complete cycles, rather than half-cycles. PMID:8475763

Guiard, Y

1993-03-01

161

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

162

[Upper limb pain and limited mobility in the patients after stroke].  

PubMed

Pain in the paretic upper limb is a common complaint in the post-stroke patients. It usually affects shoulder joint and, less frequently, wrist and hand. Pain is usually accompanied by limited mobility of the shoulder and sometimes by swelling of the hand and wrist. The aetiology of these complaints remains unclear. The objective of the study was to evaluate the incidence of pain, limited mobility, swelling and other signs that appear in the paretic limb within the first year after stroke. Forty-five stroke patients treated in the Department of Neurology in 2000 who answered the questionnaire concerning type, localization and intensity of the complaints from paretic upper limb were included. Twenty-six patients (58%) had a painful shoulder, wrist or hand. These complaints concerned women more frequently than men (71% vs. 46%, consecutively), younger patients aged below 55, and those who initially had more severe paresis. Symptoms and signs appeared within first month after stroke in majority of patients, and 70% of patients considered these symptoms very disturbing, significantly deteriorating the dexterity of the paretic limb. Thirty five percent of patients complained of limited mobility in the shoulder joint, 18% had incomplete mobility of fingers in the paretic limb. Twenty two percent of patients had swollen wrist and hand, and 24% had a discoloration and trophic changes of the skin in the paretic hand. Cold intolerance by means of freezing sensation in the affected limb was experienced by 58% of patients. Three patients had complaints both in shoulder and hand, with accompanied swelling, trophic changes and vasomotor disturbances in the hand, what fulfilled criteria for the diagnosis of shoulder-hand syndrome. The results of the study show that upper limb pain and limited mobility are common complications of the stroke. Usually underestimated by family doctors these symptoms and signs cause a significant discomfort for the patients and delay the recovery of the paretic limb. PMID:16813269

Zyluk, Andrzej; Zyluk, Beata

2006-01-01

163

Changes in muscle contractile characteristics and jump height following 24 days of unilateral lower limb suspension  

Microsoft Academic Search

We measured changes in maximal voluntary and electrically evoked torque and rate of torque development because of limb unloading.\\u000a We investigated whether these changes during single joint isometric muscle contractions were related to changes in jump performance\\u000a involving dynamic muscle contractions and several joints. Six healthy male subjects (21 ± 1 years) underwent 3 weeks of unilateral\\u000a lower limb suspension (ULLS) of the right

Astrid M. HorstmanC; C. J. de Ruiter; N. T. L. van Duijnhoven; M. T. E. Hopman; A. de Haan

2012-01-01

164

Unilateral Lower Limb Injury: Its Long-Term Effects on Quadriceps, Hamstring, and Plantarflexor Muscle Strength  

Microsoft Academic Search

Holder-Powell HM, Rutherford OM. Unilat- eral lower limb injury: its long-term effects on quadriceps, hamstring, and plantarflexor muscle strength. Arch Phys Med Rehabil 1999;80:717-720. Objective: To ascertain if long-term deficits in quadriceps, hamstring, and plantarflexor muscle strength remain after unilateral lower-limb musculoskeletal injury and to quantify whether improvements in performance continue once a subject concludes rehabilitation and returns to everyday

Heather M. Holder-Powell; Olga M. Rutherford

165

Short-term recovery of limb muscle strength after acute stroke  

Microsoft Academic Search

Andrews AW, Bohannon RW. Short-term recovery of limb muscle strength after acute stroke. Arch Phys Med Rehabil 2003;84:125-30. Objectives: To document, by using norm-referenced strength measures, the recovery of limb muscle strength of patients undergoing stroke rehabilitation and to examine the relation between comorbidities and the recovery of strength after stroke. Design: Retrospective analysis of data from a consecutive convenience

A. Williams Andrews; Richard W. Bohannon

2003-01-01

166

The effect of endurance exercise on muscle force generating capacity of the lower limbs  

Microsoft Academic Search

The purpose of this study was to investigate the recovery of muscle force generating capacity (FGC) of the lower limbs following a session of cycle exercise (CE). Fourteen male cyclists (mean ± SD age 25± 4 yrs and V?O2max 65.8 ± 5 ml.kg?1min?1) performed tests assessing lower limb muscle FGC at rest (pre-test). as well as 6 and 24 hrs

David J. Bentley; Shi Zhou; Allan J. Davie

1998-01-01

167

Mechanisms underlying the sparing of masticatory versus limb muscle function in an experimental critical illness model.  

PubMed

Acute quadriplegic myopathy (AQM) is a common debilitating acquired disorder in critically ill intensive care unit (ICU) patients that is characterized by tetraplegia/generalized weakness of limb and trunk muscles. Masticatory muscles, on the other hand, are typically spared or less affected, yet the mechanisms underlying this striking muscle-specific difference remain unknown. This study aims to evaluate physiological parameters and the gene expression profiles of masticatory and limb muscles exposed to factors suggested to trigger AQM, such as mechanical ventilation, immobilization, neuromuscular blocking agents, corticosteroids (CS), and sepsis for 5 days by using a unique porcine model mimicking the ICU conditions. Single muscle fiber cross-sectional area and force-generating capacity, i.e., maximum force normalized to fiber cross-sectional area (specific force), revealed maintained masseter single muscle fiber cross-sectional area and specific-force after 5 days' exposure to all triggering factors. This is in sharp contrast to observations in limb and trunk muscles, showing a dramatic decline in specific force in response to 5 days' exposure to the triggering factors. Significant differences in gene expression were observed between craniofacial and limb muscles, indicating a highly complex and muscle-specific response involving transcription and growth factors, heat shock proteins, matrix metalloproteinase inhibitor, oxidative stress responsive elements, and sarcomeric proteins underlying the relative sparing of cranial vs. spinal nerve innervated muscles during exposure to the ICU intervention. PMID:22010006

Aare, Sudhakar; Ochala, Julien; Norman, Holly S; Radell, Peter; Eriksson, Lars I; Göransson, Hanna; Chen, Yi-Wen; Hoffman, Eric P; Larsson, Lars

2011-10-18

168

Effect of side dominance on myoelectric manifestations of muscle fatigue in the human upper trapezius muscle  

Microsoft Academic Search

The purpose of this study was to investigate whether differences in the peripheral and control properties of the neuromuscular system due to long-term preferential use, related to side dominance, affect postural muscles, such as the upper trapezius. Therefore, fatigability properties of the upper trapezius muscles of the dominant and non-dominant side were assessed. Surface EMG signals were detected from the

Dario Farina; Laura A. C. Kallenberg; Roberto Merletti; Hermie J. Hermens

2003-01-01

169

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

170

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

171

A transcranial magnetic stimulation study of the ipsilateral silent period in lower limb muscles  

Microsoft Academic Search

The lower limb ipsilateral silent periods (ISP) were determined with transcranial magnetic stimulation in 30 normal subjects using a round coil. The mean duration and transcallosal conduction time were comparable to values obtained from upper limb recordings. No age-related correlation was found for either parameter, corroborating previous imaging and pathological studies of interhemispheric pathways. Our results highlight the feasibilty of

Y. L. Lo; S. Fook-Chong

2004-01-01

172

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

Microsoft Academic Search

This paper describes new total stratospheric inorganic bromine (Bry) abundance estimates inferred from the first global observations of upper stratospheric BrO, made by the EOS Microwave Limb Sounder on the Aura satellite. Our ‘best estimate’ of total upper stratospheric bromine loading (based on JPL-2002 kinetics with the addition of a BrONO2 + O reaction) is 18.6 ± 5.5 pptv, for

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

2006-01-01

173

Investigation of human mirror-image for bilateral movement training of upper limb rehabilitation  

Microsoft Academic Search

Bilateral movement training for the upper extremity rehabilitation is attracting a lot of attention. In this paper, we investigated the relationship between left and right of the human body system(human mirror-image) using robotic force field for planning effective bimanual movement training of upper limb rehabilitation. We use two robot manipulators and force\\/torque sensors to realize the force field, and we

YoungWoo Kim; C. Nagai; Goro Obinata

2010-01-01

174

Analysis of earth limb viewing from the Upper Atmospheric Research Satellite  

Microsoft Academic Search

The Upper Atmospheric Research Satellite (UARS) is a multi-instrumented satellite which will examine the earth's upper atmosphere. One of the instruments onboard UARS is a Cryogenic Limb Array Etalon Spectrometer (CLAES) developed at the Lockheed Research Laboratory to measure atmospheric infrared emissions. This paper addresses the Sun-Orbit-CLAES viewing geometry during the two year mission. Orbit averages and monthly averages are

Donald L. Hitzl; Jack B. Kumer; Frank Zele

1991-01-01

175

Motor Control Testing of Upper Limb Function After Botulinum Toxin Injection: A Case Study  

Microsoft Academic Search

Hurvitz EA, Conti GE, Flansburg EL, Brown SH. Motor control testing of upper limb function after botuli- num toxin injection: a case study. Arch Phys Med Rehabil 2000;81:1408-15. Objective: To evaluate changes in upper extremity function in a hemiparetic patient after treatment with botulinum toxin (BTX) using motor-control testing (MCT) techniques. Design: Interventional with longitudinal study, open label. Setting: A

Edward A. Hurvitz; Gerry E. Conti; Erin L. Flansburg; Susan H. Brown

2000-01-01

176

Motor control testing of upper limb function after botulinum toxin injection: A case study  

Microsoft Academic Search

Hurvitz EA, Conti GE, Flansburg EL, Brown SH. Motor control testing of upper limb function after botulinum toxin injection: a case study. Arch Phys Med Rehabil 2000;81:1408-15. Objective: To evaluate changes in upper extremity function in a hemiparetic patient after treatment with botulinum toxin (BTX) using motor-control testing (MCT) techniques. Design: Interventional with longitudinal study, open label. Setting: A children's

Edward A. Hurvitz; Gerry E. Conti; Erin L. Flansburg; Susan H. Brown

2000-01-01

177

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…

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

2011-01-01

178

Upper limb splints and the right to drive—who decides?  

Microsoft Academic Search

Management of upper limb pathology frequently requires the wearing of a splint for a period of time. Our Occupational Therapy Department fits approximately 2000 thermoplastic splints per year. A significant number of these patients drive. In a bid to try and elucidate who is thought to have and who actually has responsibility for deciding which splints are safe to drive

J. W Hobman

2004-01-01

179

Apparent G syndrome presenting as neck and upper limb dystonia and severe gastroesophageal reflux.  

PubMed

We have studied a 3-month-old boy with severe gastroesophageal reflux, feeding difficulties, neck and upper limb dystonia, abnormal ears, normal genitalia, and anatomically apparently normal larynx and trachea. Initially diagnosed as suffering from Sandifer "syndrome," he was treated with a gastrostomy and Nissen fundoplication. However, his characteristic facial appearance subsequently led to the diagnosis of G syndrome. PMID:3425612

Williams, C A; Frias, J L

1987-10-01

180

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

Microsoft Academic Search

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

Peter W Buckle; J Jason Devereux

2002-01-01

181

Motor imagery EEG-based online control system for upper artificial limb  

Microsoft Academic Search

For the characters of EEG signal due to motor imagery, six motor imagery tasks are planned and the methods of common spatial pattern (CSP) feature extraction and probabilistic neural network (PNN) classification of EEG signal are studied. And an online control system for upper limb prosthesis based on motor imagery EEG is realized, which consists of the brain computer interface

Aiqin Sun; Binghui Fan; Chaochuan Jia

2011-01-01

182

Multifunctional control of artificial upper limbs based on parameter identification of myoelectric signals  

Microsoft Academic Search

The paper describes a system for controlling an artificial upper extremity prosthesis for above elbow amputees in several degrees of freedom. The system employs microprocessor hardware and is based on time series identification of the voluntary myoelectric signals involved and on subsequent limb-function discrimination via the above parameters. The system requires only 1 to 2 electrode sites and satisfies the

D. Graupe; W. J. Monlux

1975-01-01

183

Transposed brachial-basilic arteriovenous fistulas versus prosthetic upper limb grafts: A meta-analysis  

Microsoft Academic Search

BackgroundControversy exists regarding the best type of arteriovenous (AV) fistula to be formed in secondary and tertiary access procedures when primary fistulas have failed. This meta-analysis aimed to compare transposed brachial-basilic AV fistulas (BBAVFs) with upper limb AV prosthetic grafts.

M. K. Lazarides; G. S. Georgiadis; C. P. Papasideris; G. Trellopoulos; V. D. Tzilalis

2008-01-01

184

Dielectric elastomers as actuators for upper limb prosthetics: Challenges and opportunities  

Microsoft Academic Search

Recent research has indicated that consumers of upper limb prostheses desire lighter-weight, anthropomorphic devices. The potential of dielectric elastomer (DE) actuators to better meet the design priorities of prosthesis users is explored. Current challenges are critically reviewed with respect to (1) durability, (2) precision control, (3) energy consumption, and (4) anthropomorphic implementation. The key points arising from the literature review

Elaine Biddiss; Tom Chau

2008-01-01

185

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

186

Effect of maturational status and training on upper limb pulse wave velocity  

Microsoft Academic Search

Cardiovascular adaptations to training may include changes in arterial distensibility, although studies involving sick and healthy individuals have yielded contradictory results. Moreover, despite the fact that endurance training frequently begins in childhood, its influence on arterial distensibility is less well characterised in children. This study was therefore to compare the upper limb pulse wave velocity (PWVUL) in highly trained prepubertal

Agnès Vinet; Stéphane Nottin; Lionel Beck; Antonia Pérez-Martin; Michel Dauzat; Philippe Obert

2005-01-01

187

Neurological status in paediatric upper limb injuries in the emergency department - current practice  

PubMed Central

Background In upper limb injuries it is important to assess associated neurological injury. The aim of this study was to assess the initial (Emergency Department (ED)) documentation of neurological status in paediatric patients presenting with upper limb injuries. Findings Case notes of paediatric patients admitted to the orthopaedic ward with upper limb injuries were retrospectively collected over a three month period. Initial ED documentation was recorded and case notes examined for any neurological deficit on admission. Of the 121 patients, 107 (88.4%) of case notes had some form of neurological documentation. The remaining case notes (n?=?14, 11.6%) had no mention of neurological examination. There were 10 (8.2%) patients with pre-operative neurological deficits identified; none of these had been previously identified by the ED. Conclusion There are failings of neurological documentation on the part of ED staff. It is likely that these reflect a knowledge deficit in the examination of the injured upper limb in paediatric patients.

2012-01-01

188

Pain tolerance in upper limb disorders: findings from a community survey  

PubMed Central

Aims: To test the hypothesis that non-specific upper limb pain arises from altered pain perception with reduced tolerance of sensory stimuli. Methods: Subjects undergoing clinical examination as part of a community based survey of upper limb disorders were invited to return for an assessment of pain tolerance. A standardised algorithm was used to classify the 94 participants according to whether they had specific upper limb disorders (n = 22), non-specific arm pain (n = 15), or no arm pain (n = 57). Pain tolerance was assessed at three anatomical sites in each arm in response to electrocutaneous stimulation with alternating currents up to a maximum of 10 mA at three frequencies (5, 250, and 2000 Hz). A proportional odds model was used to compare pain tolerance thresholds according to sex, age, and diagnosis. Results: Women were less tolerant of pain than men (OR 0.13) and tolerance also declined with age (OR for one year increase in age 0.97). After allowance for sex and age, there was no indication that pain tolerance was lower in subjects with non-specific arm pain than in those with specific upper limb disorders or those who had no arm pain. Conclusions: The study hypothesis was not supported. However, before the hypothesis is dismissed, it should be tested further in patients with more severe and disabling arm pain.

Mitchell, S; Reading, I; Walker-Bone, K; Palmer, K; Cooper, C; Coggon, D

2003-01-01

189

Thoracoscopic Sympathectomy for Upper Limb Hyperhidrosis: Looking for the Right Operation  

Microsoft Academic Search

Background. Thoracoscopic sympathectomy is the most effective treatment for upper limb hyperhidrosis. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory sweating. Anticipating that a technique that respects the sympathetic chain and divides only the rami communicantes may lead to fewer side effects, we assessed the technique described by R. Wittmoser,

Dominique Gossot; Luis Toledo; Sylvie Fritsch; Michel Célérier

1997-01-01

190

Upper Limb Peripheral Motor Deficits due to Extracranial Vertebral Artery Dissection  

Microsoft Academic Search

We describe 2 patients with extracranial vertebral artery dissection presenting with left cervical pain and peripheral motor deficits in the left upper limb. Potential mechanisms of peripheral nervous system involvement in dissection of the extracranial vertebral artery include compression of the spinal nerves by an enlarged vertebral artery or ischemia of the anterior horn of the spinal cord or the

T. Dubard; J. Pouchot; C. Lamy; D. Hier; L. R. Caplan; J. L. Mas

1994-01-01

191

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

192

Comparing unilateral and bilateral upper limb training: The ULTRA-stroke program design  

Microsoft Academic Search

BACKGROUND: About 80% of all stroke survivors have an upper limb paresis immediately after stroke, only about a third of whom (30 to 40%) regain some dexterity within six months following conventional treatment programs. Of late, however, two recently developed interventions - constraint-induced movement therapy (CIMT) and bilateral arm training with rhythmic auditory cueing (BATRAC) - have shown promising results

Jaap Harlaar; Andreas Daffertshofer; Nienke I Zijp; Kirsten Nienhuys; Peter Koppe; Gert Kwakkel; Peter J Beek

2009-01-01

193

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

194

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

Microsoft Academic Search

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

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

2006-01-01

195

Autonomous and nonautonomous roles of Hedgehog signaling in regulating limb muscle formation  

PubMed Central

Muscle progenitor cells migrate from the lateral somites into the developing vertebrate limb, where they undergo patterning and differentiation in response to local signals. Sonic hedgehog (Shh) is a secreted molecule made in the posterior limb bud that affects patterning and development of multiple tissues, including skeletal muscles. However, the cell-autonomous and non-cell-autonomous functions of Shh during limb muscle formation have remained unclear. We found that Shh affects the pattern of limb musculature non-cell-autonomously, acting through adjacent nonmuscle mesenchyme. However, Shh plays a cell-autonomous role in maintaining cell survival in the dermomyotome and initiating early activation of the myogenic program in the ventral limb. At later stages, Shh promotes slow muscle differentiation cell-autonomously. In addition, Shh signaling is required cell-autonomously to regulate directional muscle cell migration in the distal limb. We identify neuroepithelial cell transforming gene 1 (Net1) as a downstream target and effector of Shh signaling in that context.

Hu, Jimmy Kuang-Hsien; McGlinn, Edwina; Harfe, Brian D.; Kardon, Gabrielle; Tabin, Clifford J.

2012-01-01

196

The use of cooled saline during bone drilling to reduce the incidence of upper-limb palsy after cervical laminoplasty.  

PubMed

Object No previous hypothesis has attempted to fully account for the occurrence of upper-limb palsy (ULP) after cervical laminoplasty. The authors propose that friction-generated heat from a high-speed drill may cause thermal injury to the nerve roots close to the drilled bone, which may then lead to ULP. The authors investigated the effect of cooling the saline used for irrigation during the drilling on the incidence of upper-limb (C-5) palsy following cervical laminoplasty. Methods The irrigation saline for drilling was used at room temperature (RT, average temperature of 25.6°C) in operations of 79 patients (the RT group) and cooled to an average of 12.1°C in operations of 80 patients (the low-temperature [LT] group). The authors used a hand-held dynamometer to precisely assess muscle strength presurgery and 2 weeks postsurgery. Results There was a 7.6% and 1.9% decrease in the strength of the deltoid muscle, a 10.1% and 4.4% decrease in the strength of the biceps brachii, a 1.3% and 0.6% decrease in the strength of the triceps brachii, and a 7.6% and 3.1% decrease in grip strength in the RT and LT groups, respectively. Multivariate analysis revealed that a significant predictor for decreased deltoid muscle strength was the use of irrigation saline at RT. Conclusions Using cooled irrigation saline during bone drilling significantly decreased the incidence of ULP and can thus be recommended as a simple method for the prevention of ULP. PMID:23952322

Takenaka, Shota; Hosono, Noboru; Mukai, Yoshihiro; Miwa, Toshitada; Fuji, Takeshi

2013-08-16

197

[Pit falls in the emergency walk in clinic: upper limb].  

PubMed

Trauma to the upper extremity presents difficulties in diagnosis because of the complexity of the anatomy and of the structures involved. These injuries are common, representing more that 45% of all injuries coming to a walk-in emergency center. Commonly missed or misdiagnosed injuries are listed below with clinical examples. Posterior dislocation of the shoulder or perilunar dislocations of the carpus are still commonly missed today in spite of ample information in all medically oriented media. This series of articles is tended to warn emergency room practitioners of the these traps for the unwary. PMID:21250422

Abrassart, Sophie; Hoffmeyer, Pierre

2010-12-22

198

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

199

Conditioning effects of sural nerve stimulation on short and long latency motor evoked potentials in lower limb muscles  

Microsoft Academic Search

The effects of conditioning sural nerve stimulation on motor evoked potentials (MEPs) in relaxed muscles of the lower limb were examined in 11 healthy adults. The study tested the hypothesis that cutaneous afferent stimulation, in the absence of muscle afferent input, facilitates the short latency MEPs evoked in lower limb muscles following transcranial magnetic stimulation of motor cortex. Non-painful (3.6

D. L. Wolfe; K. C. Hayes

1995-01-01

200

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

201

Reconstruction of blast injuries of the hand and upper limb.  

PubMed

Over recent years, hand surgeons in the Middle East and Arabic region have particularly had to deal with an increasing number of war blast injuries to the upper extremity, in the acute, subacute and chronic phases. Many have been referred from War Zone countries such as Iraq and, more recently, Syria, where the resources to treat such complex injuries are scarce. The present article is a comprehensive review of the basic principles of management of blast injuries based on the available literature merged with the authors' personal experience of these injuries. The state of the art in treatment of blast injuries to the hand, from ammunition physics and wound ballistics to radiological investigation and, ultimately, the principles of surgical management are discussed. PMID:23357578

Bakhach, Joseph; Abu-Sitta, Ghassan; Dibo, Saad

2013-01-25

202

Upper Limb Biomechanics During the Volleyball Serve and Spike  

PubMed Central

Background: The shoulder is the third-most commonly injured body part in volleyball, with the majority of shoulder problems resulting from chronic overuse. Hypothesis: Significant kinetic differences exist among specific types of volleyball serves and spikes. Study Design: Controlled laboratory study. Methods: Fourteen healthy female collegiate volleyball players performed 5 successful trials of 4 skills: 2 directional spikes, an off-speed roll shot, and the float serve. Volunteers who were competent in jump serves (n, 5) performed 5 trials of that skill. A 240-Hz 3-dimensional automatic digitizing system captured each trial. Multivariate analysis of variance and post hoc paired t tests were used to compare kinetic parameters for the shoulder and elbow across all the skills (except the jump serve). A similar statistical analysis was performed for upper extremity kinematics. Results: Forces, torques, and angular velocities at the shoulder and elbow were lowest for the roll shot and second-lowest for the float serve. No differences were detected between the cross-body and straight-ahead spikes. Although there was an insufficient number of participants to statistically analyze the jump serve, the data for it appear similar to those of the cross-body and straight-ahead spikes. Shoulder abduction at the instant of ball contact was approximately 130° for all skills, which is substantially greater than that previously reported for female athletes performing tennis serves or baseball pitches. Conclusion: Because shoulder kinetics were greatest during spiking, the volleyball player with symptoms of shoulder overuse may wish to reduce the number of repetitions performed during practice. Limiting the number of jump serves may also reduce the athlete’s risk of overuse-related shoulder dysfunction. Clinical Relevance: Volleyball-specific overhead skills, such as the spike and serve, produce considerable upper extremity force and torque, which may contribute to the risk of shoulder injury.

Reeser, Jonathan C.; Fleisig, Glenn S.; Bolt, Becky; Ruan, Mianfang

2010-01-01

203

Biomedical research on the International Space Station postural and manipulation problems of the human upper limb in weightlessness  

NASA Astrophysics Data System (ADS)

Accumulated evidence, based on information gathered on space flight missions and ground based models involving both humans and animals, clearly suggests that exposure to states of microgravity conditions for varying duration induces certain physiological changes; they involve cardiovascular deconditioning, balance disorders, bone weakening, muscle hypertrophy, disturbed sleep patterns and depressed immune responses. The effects of the microgravity on the astronauts' movement and attitude have been studied during different space missions, increasing the knowledge of the human physiology in weightlessness. The purpose of the research addressed in the present paper is to understand and to assess the performances of the upper limb, especially during grasp. Objects of the research are the physiological changes related to the long-term duration spaceflight environment. Specifically, the changes concerning the upper limb are investigated, with particular regard to the performances of the hand in zero-g environments. This research presents also effects on the Earth, improving the studies on a number of pathological states, on the health care and the rehabilitation. In this perspective, a set of experiments are proposed, aimed at the evaluation of the effects of the zero-g environments on neurophysiology of grasping movements, fatigue assessment, precision grip. .

Neri, Gianluca; Zolesi, Valfredo

2000-01-01

204

Congenital terminal transverse deformity of upper limb: clinical and radiological findings in a sporadic care.  

PubMed

Congenital transverse limb anomalies are rare, which affect upper and/or lower limbs and may accompany several syndromic malformations. We present a sporadic male subject with congenital, unilateral transverse arrest of the left hand. The affected arm was observed to be short with reduced zeugopod and truncated palm. Fingers were represented by five bead-like nubbins. Roentgenographic examination revealed short radius and ulna with hypoplastic distal heads, absent carpals/metacarpals, and a hypoplastic bony island in each nubbin. Consanguinity was denied, and the subject had no symptoms in the orofacial, neurological and skeletal systems. Detailed clinical data with literature survey is presented. PMID:23458049

Malik, Sajid; Afzal, Muhammad

2013-03-01

205

The Muscle Machine and Upper Body Strength.  

ERIC Educational Resources Information Center

This article describes successful efforts by physical education teachers at Elberton Elementary School (GA) to construct an affordable pull-up board that could be used to help improve students' arm and upper body strength. An explanation is given of how to use the machine, and the benefits to students are briefly discussed. (IAH)

English, Agnes

1989-01-01

206

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

207

Isometric training of young rats — Effects upon hind limb muscles  

Microsoft Academic Search

The soleus, reetus femoris, and gastrocnemius muscles of young rats trained isometrically for 4 weeks were studied by light and electron microscopy.—The percentage of fast-twitch oxidative muscle fibers decreased at the cost of the fast-twitch glycolytic fibers in the rectus femoris muscle. The percentages of the slow-twitch oxidative fibers did not change significantly in any of the muscles studied. The

Werner Mtiller; W. Vogell

1975-01-01

208

Clear cell sarcoma of the upper thoracic back muscle.  

PubMed

Clear cell sarcoma (CCS), also called malignant melanoma of soft parts, is a rare malignant soft tissue tumor and is often associated with tendons or aponeuroses. Most of CCS involve extremities, especially lower extremities, but a tumor occurring in the trunk is rare. We report an extremely rare case of CCS originated in the upper thoracic back muscle. To our knowledge, this case is the second report of CCS of the back muscle. PMID:19274123

Kim, Dae-Hyun; Choi, Ki-Hwan; Cho, Young-Dae

2009-02-28

209

Motor patterns of distal hind limb muscles in walking turtles: Implications for models of limb bone loading.  

PubMed

Previous studies of limb bone loading in walking turtles indicate that the ground reaction force exerts a flexor moment at the ankle during stance, requiring extensor muscle activity to maintain joint equilibrium. Of four proposed ankle extensors in turtles, two (gastrocnemius medialis, pronator profundus) originate on the tibia and fibula, respectively, while the other two (flexor digitorum longus, gastrocnemius lateralis) originate from the distal femur, crossing the flexor aspect of the knee and potentially eliciting compensatory forces from antagonist knee extensor muscles that could contribute to femoral stress. Published bone stress models assume all four proposed ankle extensors are active during stance in turtles. However, if only the ankle extensors that cross the knee were active then femoral stresses might be higher than predicted by published models, whereas if only extensors that do not cross the knee were active then femoral stresses might be lower than predicted. We analyzed synchronized footfall and electromyographic activity patterns in slider turtles (Trachemys scripta) and found that all four proposed ankle extensors were active during at least part of stance phase in most individuals, corroborating bone stress models. However, activation patterns were complex, with multiple bursts in many ankle extensors that frequently persisted into swing phase. In addition, two hypothesized ankle flexors (tibialis anterior, extensor digitorum communis) were frequently active during stance. This might increase the joint moment that ankle extensors must counter, elevating the forces they transfer across the knee joint and, thereby, raising femoral stress. Recognition of these activity patterns may help reconcile differences between evaluations of loads on turtle limbs based on force platform versus in vivo strain studies. Moreover, while some variation in motor patterns for the distal hind limbs of turtles may reflect functional compartmentalization of muscles, it may also indicate flexibility in the control of their limb movements. PMID:20967829

Schoenfuss, Heiko L; Roos, John D; Rivera, Angela R V; Blob, Richard W

2010-12-01

210

THE EFFECT OF DOUBLE VERSUS SINGLE OSCILLATING EXERCISE DEVICES ON TRUNK AND LIMB MUSCLE ACTIVATION  

PubMed Central

Purpose/Background: Proper strengthening of the core and upper extremities is important for muscular health, performance, and rehabilitation. Exercise devices have been developed that attempt to disrupt the center of gravity in order to activate the trunk stabilizing muscles. The objective of this study was to analyze the trunk and shoulder girdle muscle activation with double and single oscillating exercise devices (DOD and SOD respectively) in various planes. Methods: Twelve male subjects performed three interventions using both devices under randomized conditions: single-handed vertical orientation of DOD and SOD to produce 1) medio-lateral oscillation in the frontal plane 2) dorso-ventral oscillation in the sagittal plane and 3) single-handed horizontal orientation for superior and inferior oscillation in the transverse plane. Electromyographic (EMG) activity during the interventions of the anterior deltoid, triceps brachii, biceps brachii, forearm flexors as well as lower abdominal and back stabilizer muscles was collected, and were normalized to maximal voluntary contractions. A two way repeated measures ANOVA (2x3) was conducted to assess the influence of the devices and movement planes on muscle activation. Results: The DOD provided 35.9%, 40.8%, and 52.3% greater anterior deltoid, transverse abdominus (TA)/internal oblique (IO) and lumbo-sacral erector spinae (LSES) activation than did the SOD respectively. Effect size calculations revealed that these differences were of moderate to large magnitude (0.86, 0.48, and 0.61 respectively). There were no significant differences in muscular activation achieved between devices for the triceps brachii, biceps brachii and forearm flexor muscles. Exercise in the transverse plane resulted in 30.5%, 29.5%, and 19.5% greater activation than the sagittal and 21.8%, 17.2%, and 26.3% greater activation than the frontal plane for the anterior deltoid, TA/IO and LSES respectively. Conclusions: A DOD demonstrated greater muscular activity for trunk and shoulder muscle activation but does not provide an advantage for limb activation. Overall, oscillating the devices in the transverse plane provided greater muscular activation of the anterior deltoid, TA/IO and LSES than use of the devices during frontal or sagittal plane movements. Level of evidence: 2c: Outcomes research.

Arora, Shruti; Button, Duane C.; Basset, Fabien A.

2013-01-01

211

Inter-individual variability in the upper-lower limb breaststroke coordination.  

PubMed

The aim of the present study was to examine inter-individual variability in upper-lower limb breaststroke coordination. First, inter-individual variability was compared between recreational and comparative swimmers. Second, as recreational swimmers revealed more variable inter-limb coordination than competitive swimmers, inter-individual variability was assessed among recreational swimmers to identify coordination profiles. The elbow-knee continuous relative phase (CRP) was used to analyze upper-lower limbs coupling during a breaststroke cycle. Twenty-four recreational and twenty-four competitive swimmers swam 25 m at 80% of their maximal speed. Underwater and aerial side views were mixed and genlocked. Angular position, velocity and CRP were calculated for the knee and elbow joints by digitizing body markers from the side view. The kinematics of three cycles were filtered, averaged and normalized in terms of percentage of total cycle duration. The topography of the mean CRP curve of the recreational swimmers resembled a 'W-shape', whereas an 'inverse U-shape' was seen in the competitive swimmers. However, higher inter-individual variability was observed among the recreational swimmers than among the competitive swimmers (38.1° vs. 19.4°; p<.05), suggesting that several profiles of inter-limb coordination may exist in recreational swimmers. Coordination profiling showed that three clusters could classify the recreational swimmers. PMID:21439666

Seifert, L; Leblanc, H; Herault, R; Komar, J; Button, C; Chollet, D

2011-03-24

212

Kinematic improvement following Botulinum Toxin-A injection in upper limb spasticity due to stroke  

PubMed Central

Background and Purpose Focal spasticity is a significant motor disorder following stroke. Botulinum Toxin Type-A (BoNT-A) is a useful treatment for it. We evaluated kinematic modifications induced by spasticity, and whether or not there is an improvement following injection of BoNT-A. Methods Eight stroke patients with upper limb spasticity, showing a flexor pattern, were evaluated using kinematics before and after focal treatment with BoNT-A. A group of sex and age-matched normal volunteers acted as a control group. Results Repeated-measure ANOVA showed that stroke patients performed slower in comparison to the control group. Following treatment with BoNT-A there was a significant improvement in kinematics in stroke patients while in the control group performance remained unchanged. Conclusions Focal treatment of spasticity with Botulinum Toxin Type-A leads to an adaptive change in the upper limb of spastic stroke patients.

Fridman, Esteban A.; Crespo, Marcos; Arguello, Santiago Gomez; Degue, Lorena; Villarreal, Mirta; Bohlhalter, Stephan; Wheaton, Lewis; Hallett, Mark

2011-01-01

213

[Biomechanical overload of the upper limbs and energy expenditure in bricklayers activity].  

PubMed

The work explains the method we used for biomechanical overload risk assessment of upper limbs in construction industry, to make boarding with perforated bricks (preparation of mortar and building materials, construction, plastering) and shows the preliminary results obtained. The activity was observed and analysed through simulations of building site; all tasks were filmed with digital cameras; after we applied OCRA check-list to obtain values of biomechanical overload for upper limbs. We found an high risk of biomechanical overload, due to awkward postures and use of strength, for shoulders, elbows and, in particular, for wrists. This data helped us to understand why we found an high prevalence of wrist-WMSD (such as Carpal Tunnel Syndrome) in bricklayers evaluated in health surveillance. PMID:23405584

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

214

Risk of upper limb complaints due to computer use in older persons: a randomized study  

PubMed Central

Background We studied whether the twelve-month use of a standard computer would induce complaints of upper limb pain or functional limitations in older novice computer users. Methods Participants between 64 and 76 of age were randomly assigned to an Intervention group (n = 62), whose members received a personal computer and fast Internet access at their homes, or a No Intervention control group (n = 61), whose members refrained from computer use during the twelve month study period. Results Difference scores between baseline and twelve months assessments on both complaint (SFS) and functional health scales (SF-36) did not differ between groups (all p > .05). Conclusion Prolonged, self-paced use of a standard computer interface does not put older persons at a risk of upper limb complaints or reduce functional health in older adults.

van Boxtel, Martin PJ; Slegers, Karin; Jolles, Jelle; Ruijgrok, Joop M

2007-01-01

215

Electrodiagnosis support system for localizing neural injury in an upper limb.  

PubMed

Needle electromyography (EMG) is used for the diagnosis of a neural injury in patients with a cervical/lumbar radiculopathy, plexopathy, peripheral neuropathy, or myopathy. Needle EMG is a particularly invasive test and thus it is important to minimize the pain during inspections. In this paper, we introduce the Electrodiagnosis Support System (ESS), which is a clinical decision support system specialized for neural injury diagnosis in the upper limb. ESS can guide users through the diagnosis process and assist them in making the optimal decision for minimizing unnecessary inspections and as an educational tool for medical trainees. ESS provides a graphical user interface that visualizes the neural structure of the upper limb, through which users input the results of needle EMG tests and retrieve diagnosis results. We validated the accuracy of the system using the diagnosis records of 133 real patients. PMID:20442155

Shin, Hanjun; Kim, Ki Hoon; Song, Chihwan; Lee, Injoon; Lee, Kyubum; Kang, Jaewoo; Kang, Yoon Kyoo

216

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

NASA Astrophysics Data System (ADS)

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

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

2008-04-01

217

Position-matching in the upper limb: professional ballet dancers perform with outstanding accuracy  

Microsoft Academic Search

Objectives: To investigate the accuracy in position-matching in the upper limb in two groups of subjects who were physically fit and movement aware.Design: A mixed-group design was used. Objective measurement of the accuracy in position-matching at the shoulder and elbow in both dominant and nondominant arms consisted of photographic record of the position-matching test, with goniometric measurement.Settings: Physiotherapy department at

Jill RE Ramsay; M Jane Riddoch

2001-01-01

218

Do work-related physical factors predict neck and upper limb symptoms in office workers?  

Microsoft Academic Search

Objectives: The objective of this study was to examine the influence of physical exposure at work on neck and upper limb symptoms in office workers. Methods: Data were used from a prospective cohort study with a follow-up period of 3 years. Independent variables were physical exposure at work, observed and self-reported. Outcome measures were neck–shoulder symptoms and elbow–wrist–hand symptoms. Data were

S. G. van den Heuvel; A. J. van der Beek; B. M. Blatter; P. M. Bongers

2006-01-01

219

Upper Limb Deep Vein Thrombosis: A Literature Review to Streamline the Protocol for Management  

Microsoft Academic Search

Objective: The objective of this article is to provide up-to-date information about aetiology, pathogenesis, diagnostic modalities and treatment of upper limb deep vein thrombosis (ULDVT). Methods: Generic terms including ULDVT, axillary-subclavian DVT, and complications of central venous catheters were searched on electronic database. We analysed original studies, review articles and evaluation studies published over the last 25 years. Results: Forty-seven

Muhammad S. Sajid; Naeem Ahmed; Mittal Desai; Daryll Baker; George Hamilton

2007-01-01

220

Magnetic transcranial stimulation in healthy humans: influence on the behavior of upper limb motor units  

Microsoft Academic Search

Aim of the study was to analyze the characteristics of motor action potentials recruitment during magnetic trans-cranial stimulation (TCS) of the brain. Coaxial needle recordings from hand and upper limb musculature, as well as surface electrodes were employed in 20 healthy controls during magnetic TCS with regular and figure-of-8 coil in different experimental protocols including: (a) simple reaction time paradigm

P. M. Rossini; M. D. Caramia; C. Iani; M. T. Desiato; G. Sciarretta; G. Bernardi

1995-01-01

221

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

Microsoft Academic Search

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

Konstantinos Dermitzakis; Alejandro Hernandez Arieta; Rolf Pfeifer

2011-01-01

222

Upper-limb fatigue-related joint power shifts in experienced wheelchair users and nonwheelchair users  

Microsoft Academic Search

This paper evaluates power transfer or shifting across upper-limb segments, resulting from fatigue-inducing wheelchair propulsion. Nineteen manual wheelchair users (WCUs) and ten nonwheelchair users (NUs) participated in this study. Subjects propelled an instrumented wheelchair ergo- meter at a workload corresponding to 75% of the peak oxygen uptake attained during a maximal-graded exercise tolerance test. Subjects were required to propel the

Mary M. Rodgers; Kevin J. McQuade; Elizabeth K. Rasch; Randall E. Keyser; Margaret A. Finley

2003-01-01

223

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

224

Ultrasound-guided posterior approach to brachial plexus for the treatment of upper phantom limb syndrome.  

PubMed

The purpose of the case is to report the clinical value of the ultrasound-guided posterior approach to the brachial plexus in the treatment of phantom limb syndrome after an upper extremity amputation. The author experienced ultrasound guidance as sole technique to localize the brachial plexus for the purpose of placing a catheter for continuous infusion of a local anesthetic in a patient where standard landmark-based nerve stimulation for placement of a continuous perineural block was not possible. PMID:21623340

Tognù, A; Borghi, B; Gullotta, S; White, P F

2011-05-30

225

Upper-Limb Posture Definition During Grasping with Task and Environment Constraints  

Microsoft Academic Search

\\u000a The purpose of this study is to propose a new tool to define the posture of a complete upper-limb model during grasping taking\\u000a into account task and environment constraints. The developed model is based on a neural network architecture mixing both supervised\\u000a and reinforcement learning. The task constraints are materialized by target points to be reached by the fingertips on

Nasser Rezzoug; Philippe Gorce

2005-01-01

226

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

227

Neural decoding of unilateral upper limb movements using single trial MEG signals.  

PubMed

A brain machine interface (BMI) provides the possibility of controlling such external devices as prosthetic arms for patients with severe motor dysfunction using their own brain signals. However, there have been few studies investigating the decoding accuracy for multiclasses of useful unilateral upper limb movements using non-invasive measurements. We investigated the decoding accuracy for classifying three types of unilateral upper limb movements using single-trial magnetoencephalography (MEG) signals. Neuromagnetic activities were recorded in 9 healthy subjects performing 3 types of right upper limb movements: hand grasping, pinching, and elbow flexion. A support vector machine was used to classify the single-trial MEG signals. The movement types were predicted with an average accuracy of 66 ± 10% (chance level: 33.3%) using neuromagnetic activity during a 400-ms interval (-200 ms to 200 ms from movement onsets). To explore the time-dependency of the decoding accuracy, we also examined the time course of decoding accuracy in 50-ms sliding windows from -500 ms to 500 ms. Decoding accuracies significantly increased and peaked once before (50.1 ± 4.9%) and twice after (58.5 ± 7.5% and 64.4 ± 7.6%) movement onsets in all subjects. Significant variability in the decoding features in the first peak was evident in the channels over the parietal area and in the second and third peaks in the channels over the sensorimotor area. Our results indicate that the three types of unilateral upper limb movement can be inferred with high accuracy by detecting differences in movement-related brain activity in the parietal and sensorimotor areas. PMID:22683716

Sugata, Hisato; Goto, Tetsu; Hirata, Masayuki; Yanagisawa, Takufumi; Shayne, Morris; Matsushita, Kojiro; Yoshimine, Toshiki; Yorifuji, Shiro

2012-06-08

228

Constraint-induced movement therapy for recovery of upper-limb function following traumatic brain injury  

Microsoft Academic Search

A volunteer sample of 22 participants with chronic traumatic brain injury (TBI) (onset >1 year) and relative hemi- plegia that revealed moderate disability in the more-affected upper limb (UL) participated. Constraint-induced (CI) move- ment therapy (CI therapy) was employed for a 2-week period; treatments included massed practice, shaping of the more- affected UL, behavioral contracts, and other behavioral tech- niques

Sharon E. Shaw; David M. Morris; Gitendra Uswatte; Staci McKay; Jay M. Meythaler; Edward Taub

2005-01-01

229

Quantitative evaluation of upper-limb motor control in robot-aided rehabilitation  

Microsoft Academic Search

This paper is focused on the multimodal analysis of patient performance, carried out by means of robotic technology and wearable\\u000a sensors, and aims at providing quantitative measure of biomechanical and motion planning features of arm motor control following\\u000a rehabilitation. Upper-limb robotic therapy was administered to 24 community-dwelling persons with chronic stroke. Performance\\u000a indices on patient motor performance were computed from

Loredana Zollo; Luca Rossini; Marco Bravi; Giovanni Magrone; Silvia Sterzi; Eugenio Guglielmelli

230

Cross-bridge kinetics of fast and slow fibres of cat jaw and limb muscles: correlations with myosin subunit composition  

Microsoft Academic Search

Mechanical properties of the jaw-closing muscles of the cat are poorly understood. These muscles are known to differ in myosin\\u000a and fibre type compositions from limb muscles. This work aims to correlate mechanical properties of single fibres in cat jaw\\u000a and limb muscles with their myosin subunit compositions. The stiffness minimum frequency, fmin, which reflects isometric cross-bridge kinetics, was measured

Joseph F. Y. Hoh; Zhao-Bo Li; Han Qin; Michael K. H. Hsu; Gunther H. Rossmanith

2007-01-01

231

Upper-limb tremor suppression with a 7DOF exoskeleton power-assist robot.  

PubMed

A tremor which is one of the involuntary motions is somewhat rhythmic motion that may occur in various body parts. Although there are several kinds of the tremor, an essential tremor is the most common tremor disorder of the arm. The essential tremor is a disorder of unknown cause, and it is common in the elderly. The essential tremor interferes with a patient's daily living activity, because it may occur during a voluntary motion. If a patient of an essential tremor uses an EMG-based controlled power-assist robot, the robot might misunderstand the user's motion intention because of the effect of the essential tremor. In that case, upper-limb power-assist robots must carry out tremor suppression as well as power-assist, since a person performs various precise tasks with certain tools by the upper-limb in daily living. Therefore, it is important to suppress the tremor at the hand and grasped tool. However, in the case of the tremor suppression control method which suppressed the vibrations of the hand and the tip of the tool, vibration of other part such as elbow might occur. In this paper, the tremor suppression control method for upper-limb power-assist robot is proposed. In the proposed method, the vibration of the elbow is suppressed in addition to the hand and the tip of the tool. The validity of the proposed method was verified by the experiments. PMID:24111275

Kiguchi, Kazuo; Hayashi, Yoshiaki

2013-07-01

232

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

233

'Hybrid-PLEMO', rehabilitation system for upper limbs with active / passive force feedback mode.  

PubMed

Several rehabilitation robots for upper limbs have been proposed so far, and clinical effectiveness was reported in several studies for the aged people or patients with stroke. However most of them have only 2-DOF for its active motion. It is important for designing a rehabilitation system which trains in the 3-DOF space because the upper limbs of humans works in 3-DOF space even expect for the wrist. We developed the quasi 3-DOF rehabilitation system which has 2-DOF force-feedback function in working plane but its working plane can be adjusted the inclination. And we named it Hybrid-PLEMO for it can be switched between active type and passive type. Hybrid-PLEMO is a compact, low-cost rehabilitation system for upper limbs with high safety by using ER brakes or ER actuators. Additionally, in Hybrid-PLEMO, we take direct-drive linkage mechanism by adding sub links. In this paper, we describe the mechanism and haptic control of Hybrid-PLEMO. PMID:19163078

Kikuchi, Takehito; Jin, Ying; Fukushima, Kazuki; Akai, Hiroki; Furusho, Junji

2008-01-01

234

Fatigue alters in vivo function within and between limb muscles during locomotion  

PubMed Central

Muscle fatigue, a reduction in force as a consequence of exercise, is an important factor for any animal that moves, and can result from both peripheral and/or central mechanisms. Although much is known about whole-limb force generation and activation patterns in fatigued muscles under sustained isometric contractions, little is known about the in vivo dynamics of limb muscle function in relation to whole-body fatigue. Here we show that limb kinematics and contractile function in the lateral (LG) and medial (MG) gastrocnemius of helmeted guineafowl (Numida meleagris) are significantly altered following fatiguing exercise at 2?m?s?1 on an inclined treadmill. The two most significant findings were that the variation in muscle force generation, measured directly from the muscles' tendons, increased significantly with fatigue, and fascicle shortening in the proximal MG, but not the distal MG, decreased significantly with fatigue. We suggest that the former is a potential mechanism for decreased stability associated with fatigue. The region-specific alteration of fascicle behaviour within the MG as a result of fatigue suggests a complex response to fatigue that probably depends on muscle–aponeurosis and tendon architecture not previously explored. These findings highlight the importance of studying the integrative in vivo dynamics of muscle function in response to fatigue.

Higham, Timothy E.; Biewener, Andrew A.

2008-01-01

235

Vestibular actions on back and lower limb muscles during postural tasks in man  

PubMed Central

The vestibular system was activated by galvanic electrical stimulation in 19 normal subjects. With the head turned to one side so that the stimulating anode was on the posterior mastoid process, stimulation caused standing subjects to sway backwards in the sagittal plane. Electromyography showed bilateral activation of erector spinae, gluteus maximus, biceps femoris, soleus and intrinsic foot (toe flexor) muscles. When head direction or electrode polarity was reversed so that the anode was anterior, all those muscles became less active and the subjects swayed forwards. With the head facing forward, stimulation caused sideways sway in the coronal plane, towards the anode, with excitation of the erector spinae on the anode side and reduced activity on the cathode side. The limb muscles were activated on the side opposite the anode and showed complex responses on the anode side. Responses were detectable in the erectores spinae muscles in sitting subjects. No responses in limb muscles were detected in the sitting posture. Subject responses in erector spinae recorded at L3/L4 had latencies from 59 to 110 ms, using a 2 mA stimulus. Latencies in lower limb muscles were longer. The results suggest a role for the vestibular system and descending brain stem motor pathways to the erectores spinae muscles in the control of postural orientation of the back when sitting and standing. The conduction velocity in the motor pathway was estimated to be 13 ± 10 m s?1 (mean ± s.d., n = 12 subjects).

Ali, Alima S; Rowen, Katherine A; Iles, J F

2003-01-01

236

The mechanical function of linked muscles in the guinea fowl hind limb  

PubMed Central

Although mechanical linkages between the proximal and distal limb are present in a range of species, their functional significance is unknown. We have investigated the mechanical function of the flexor cruris lateralis pars pelvica (FCLP), flexor cruris lateralis pars accessoria (FCLA) and gastrocnemius intermedia (GI), a system of linked muscles spanning proximal and distal limb segments in the guinea fowl (Numida meleagris) hind limb. The FCLP, which is in the anatomical position of a hamstring muscle, is the primary component of the linkage. It is connected to the distal femur via the FCLA, the tarsometatarsus via the tendon of insertion of the GI and the common Achilles tendon, and the tibiotarsus via a distal tendon of insertion. The FCLP may, therefore, potentially exert moments at the hip, knee and ankle joints depending on the joint angles and the relative states of activation in the three muscles. Evidence presented here suggests that the GI and FCLA act as actively controlled links that alter distal action of the FCLP. The FCLP and GI are coactive in the late swing and early stance phases of the stride, forming a triarticular complex, and likely act together to resist and control ankle flexion immediately after foot-down in addition to providing hip extension and knee flexion moments. The FCLP and FCLA are coactive from mid-through to late stance, acting together as a uniarticular hip extensor. Available evidence suggests that this role of the FCLP and FCLA is of increased importance in inclined running and accelerations. This linkage between a proximal muscle and alternate distal connections allows for functional flexibility, both in terms of the site at which the muscle exerts force and the nature of the muscle's mechanical function. The interactions generated between the proximal and distal limb by linkages of this type suggest that less emphasis should be placed on the distinct functional roles of specific anatomical classes of muscle within proximal and distal limb segments.

Ellerby, David J.; Marsh, Richard L.

2010-01-01

237

Pax3 modulates expression of the c-Met receptor during limb muscle development.  

PubMed Central

Pax3 is a transcription factor whose expression has been used as a marker of myogenic precursor cells arising in the lateral somite destined to migrate to and populate the limb musculature. Accruing evidence indicates that the embryologic origins of axial and appendicular muscles are distinct, and limb muscle abnormalities in both mice and humans harboring Pax3 mutations support this distinction. The mechanisms by which Pax3 affects limb muscle development are unknown. The tyrosine kinase receptor for hepatocyte growth factor/scatter factor encoded by the c-met protooncogene is also expressed in limb muscle progenitors and, like Pax-3, is required in the mouse for limb muscle development. Here, we show that c-met expression is markedly reduced in the lateral dermomyotome of Splotch embryos lacking Pax3. We show that Pax3 can stimulate c-met expression in cultured cells, and we identify a potential Pax3 binding site in the human c-MET promoter that may contribute to direct transcriptional regulation. In addition, we have found that several cell lines derived from patients with rhabdomyosarcomas caused by a t(2;13) chromosomal translocation activating PAX3 express c-MET, whereas those rhabdomyosarcoma cell lines examined without the translocation do not. These results are consistent with a model in which Pax3 modulates c-met expression in the lateral dermomyotome, a function that is required for the appropriate migration of these myogenic precursors to the limb where the ligand for c-met (hepatocyte growth factor/scatter factor) is expressed at high levels. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5

Epstein, J A; Shapiro, D N; Cheng, J; Lam, P Y; Maas, R L

1996-01-01

238

Impact of early applied upper limb stimulation: The EXPLICIT-stroke programme design  

PubMed Central

Background Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke) aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT) and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS) in patients with respectively a favourable or poor probability for recovery of dexterity. Methods/design 180 participants suffering from an acute, first-ever ischemic stroke will be recruited. Functional prognosis at the end of the first week post stroke is used to stratify patient into a poor prognosis group for upper limb recovery (N = 120, A2 project) and a group with a favourable prognosis (N = 60, A1 project). Both groups will be randomized to an experimental arm receiving respectively modified CIMT (favourable prognosis) or EMG-NMS (poor prognosis) for 3 weeks or to a control arm receiving usual care. Primary outcome variable will be the Action Research Arm Test (ARAT), assessed at 1,2,3,4,5, 8, 12 and 26 weeks post stroke. To study the impact of modified CIMT or EMG-NMS on stroke recovery mechanisms i.e. neuroplasticity, compensatory movements and upper limb neuromechanics, 60 patients randomly selected from projects A1 and A2 will undergo TMS, kinematical and haptic robotic measurements within a repeated measurement design. Additionally, 30 patients from the A1 project will undergo fMRI at baseline, 5 and 26 weeks post stroke. Conclusion EXPLICIT stroke is a 5 year translational research programme which main aim is to investigate the effects of early applied intensive intervention for regaining dexterity and to explore the underlying mechanisms that are involved in regaining upper limb function after stroke. EXPLICIT-stroke will provide an answer to the key question whether therapy induced improvements are due to either a reduction of basic motor impairment by neural repair i.e. restitution of function and/or the use of behavioural compensation strategies i.e. substitution of function. EXPLICIT is registered at the Netherlands Trial Register (NTR, ., TC 1424)

Kwakkel, Gert; Meskers, Carel GM; van Wegen, Erwin E; Lankhorst, Guus J; Geurts, Alexander CH; van Kuijk, Annet A; Lindeman, Eline; Visser-Meily, Anne; de Vlugt, Erwin; Arendzen, J Hans

2008-01-01

239

Effect of pathological changes in computer generated action potentials in lower limb muscles of children with cerebral palsy  

Microsoft Academic Search

Lower limb muscles of children with cerebral palsy undergo progressive pathological changes. Type-I fiber abundance and Type-II fiber deficiency are found to be common in these muscles. Both fiber types also suffer from atrophy. This paper investigates the effects of simulated physiological changes that occur in muscles of subjects with cerebral palsy using computer generated muscle action potentials (CGAPs). The

Abdoul A. Simpore; Mohammad A. Ahad

2012-01-01

240

Myogenic and neurogenic regulation of myosin gene expression in cat jaw-closing muscles regenerating in fast and slow limb muscle beds  

Microsoft Academic Search

Summary Immunocytochemical techniques were used to study changes in myosin gene expression during the regeneration of the cat posterior temporalis muscle transplanted into the bed of either the fast extensor digitorum longus (EDL) or the slow soleus muscle. Strips of the posterior temporalis, a homogeneously superfast muscle, were treated with Marcaine and then transplanted into limb muscle beds which had

J. F. Y. Hoy; S. Hughes

1988-01-01

241

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

PubMed

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

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

2009-10-13

242

Regulation of Motility of Myogenic Cells in Filling Limb Muscle Anlagen by Pitx2  

PubMed Central

Cells of the ventrolateral dermomyotome delaminate and migrate into the limb buds where they give rise to all muscles of the limbs. The migratory cells proliferate and form myoblasts, which withdraw from the cell cycle to become terminally differentiated myocytes. 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 specifically 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. Microarrays were used to identify changes in gene expression in flow-sorted migratory muscle precursors, labeled by Lbx1EGFP/+, which resulted from the loss of Pitx2. Very few genes showed changes in expression. Many small-fold, yet significant, changes were observed in genes encoding cytoskeletal and adhesion proteins which play a role in cell motility. Myogenic cells from genetically-tagged mice were cultured and subjected to live cell-tracking analysis using time-lapse imaging. Myogenic cells lacking Pitx2 were smaller, more symmetrical, and had more actin bundling. They also migrated about half of the total distance and velocity. Decreased motility may prevent myogenic cells from filling pre-patterned regions of the limb bud in a timely manner. Altered shape may prevent proper assembly of higher-order fibers within anlagen. Pitx2 therefore appears to regulate muscle anlagen development by appropriately balancing expression of cytoskeletal and adhesion molecules.

Campbell, Adam L.; Shih, Hung-Ping; Xu, Jun; Gross, Michael K.; Kioussi, Chrissa

2012-01-01

243

Lower limb compression garment improves recovery from exercise-induced muscle damage in young, active females  

Microsoft Academic Search

This study aimed to investigate the efficacy of lower limb compression as a recovery strategy following exercise-induced muscle\\u000a damage (EIMD). Seventeen female volunteers completed 10 × 10 plyometric drop jumps from a 0.6-m box to induce muscle damage.\\u000a Participants were randomly allocated to a passive recovery (n = 9) or a compression treatment (n = 8) group. Treatment group volunteers wore full leg compression stockings for

John R. Jakeman; Chris Byrne; Roger G. Eston

2010-01-01

244

Risk-taking, coordination and upper limb fractures in children: a population based case-control study  

Microsoft Academic Search

The aim of this population based case-control study was to examine the association between risk-taking behaviour, motor coordination and upper limb fractures in children aged 9–16 years. A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. The number for different types of upper limb fractures was 91 for hand, 190 for wrist and forearm

Deqiong Ma; Ruth Morley; Graeme Jones

2004-01-01

245

Limb, Respiratory and Masticatory Muscle Compartmentalization: Developmental and Hormonal Considerations  

PubMed Central

Neuromuscular compartments are subvolumes of muscle that have unique biomechanical actions and can be activated singly or in groups to perform the necessary task. Beside unique biomechanical actions, other evidence that supports the neuromuscular compartmentalization of muscles includes segmental reflexes that preferentially excite motoneurons from the same compartment, proportions of motor unit types that differ among compartments and a central partitioning of motoneurons that innervate each compartment. The current knowledge regarding neuromuscular compartments in representative muscles involved in locomotion, respiration and mastication is presented to compare and contrast these different motor systems. Developmental features of neuromuscular compartment formation in these three motor systems are reviewed to identify when these compartments are formed, their innervation patterns and the process of refinement to achieve the adult phenotype. Finally, the role of androgen modulation of neuromuscular compartment maturation in representative muscles of these motor systems is reviewed and the impact of testosterone on specific myosin heavy chain fiber types is discussed based on recent data. In summary, neuromuscular compartments are pre-patterned output elements in muscle that undergo refinement of compartment boundaries and muscle fiber phenotype during maturation. Further studies are needed to understand how these output elements are selectively controlled during locomotion, respiration and mastication.

Widmer, C. G.; Morris-Wiman, J.

2011-01-01

246

Upper-limb kinematics and coordination of short grip and classic drives in field hockey.  

PubMed

The aim of this study was to compare the upper-limb kinematics and coordination of the short grip and classic drives in field hockey. Ten elite female players participated in the experiment. The VICON system was used to record the displacement of markers placed on the stick and the players' joints during five short grip and five classic drives. Kinematic and coordination parameters were analyzed. The ball's velocity was recorded by a radar device that also served as the drive target. Kinematic differences were noted between the two drive conditions, with shorter duration and smaller overall amplitude in the short grip drive, explained by the shorter lever arm and the specific context in which it is used. No differences were noted for upper-limb coordination. In both types of stick holding, an interlimb dissociation was noted on the left side, whereas the right interlimb coordination was in phase. Moreover, the time lag increased in the disto-proximal direction, suggesting wrist uncocking before impact and the initiation of descent motion by the left shoulder. Mediolateral analysis confirmed these results: coordination of left-right limbs converged at the wrist but dissociated with more proximal joints (elbows and shoulders). PMID:18843151

Bretigny, Perrine; Seifert, Ludovic; Leory, David; Chollet, Didier

2008-08-01

247

Classification of upper limb motions in stroke using high density surface EMG.  

PubMed

Myoelectric pattern recognition techniques have been developed to infer user's intention of performing different functional movements, which can be used to provide volitional control of assisted devices for people with disabilities. The pattern recognition based myoelectric control systems have rarely been designed for stroke survivors. Aiming at developing such a system for stroke rehabilitation, this study assessed the myoelectric control information remained in the affected limb of stroke survivors using high density surface electromyogram (EMG) recording and pattern recognition techniques. The experimental results from 3 stroke subjects indicate that high accuracies (92.42% ± 5.51%) can be achieved in classification of 20 different intended movements of the affected limb. This study confirms that substantial motor control command can be extracted from paretic muscles of stroke survivors, potentially facilitating their rehabilitation. PMID:22255061

Zhang, Xu; Zhou, Ping

2011-01-01

248

[Possibilities of radionuclide study of lower-limb muscles perfusion in diagnosis of chronic arterial insufficiency].  

PubMed

The authors have hereby proposed a method to diagnose lower-limb muscular ischaemia by means of scintigraphy, used in 35 patients suffering from atherosclerosis obliterans with stage IIB and III A chronic arterial insufficiency of limbs. To do so, administration of the radioactive agent "Myoview" (??m)Tc-tetrophosmine) manufactured by the "Nycomed" Company into a patient's peripheral vein was followed by assessing its accumulation in lower-limb muscles at rest and after standard physical load. Alterations in the parameters studied relative to the norm made it possible to judge on the presence of lower-limb circulatory impairments. The method proved highly efficient, thus making it possible to use it for both therapeutic decision-making and probably in future for dynamic control after the treatment performed. Minimally invasive nature and simplicity in use of the methodology open wide possibilities for its use. PMID:21389945

Karalkin, A V; Kuznetsov, M R; Tepliakov, S A; Tugdumov, B V; Rumiantseva, E I

2010-01-01

249

Sirenomelia: four further cases with discussion of associated upper limb defects.  

PubMed

Sirenomelia, also known as the 'mermaid malformation/syndrome', is a rare, serious congenital anomaly characterized by variable degrees of fusion of the lower limbs and associated severe malformations of the lower vertebral and genitourinary systems. In this report, we describe a series of African patients with sirenomelia. We present the clinical and radiological features of four black South African patients and illustrate some of the rarer associated abnormalities, which include asymmetrical upper limb defects, not confined to the radial ray. The clinical phenotypic overlap between caudal dysgenesis, VACTERL association and sirenomelia in our patients is highlighted, lending support to the theory that these entities may be different manifestations of a single pathogenic process. PMID:22660421

Moosa, Shahida; Lambie, Lindsay Ann; Krause, Amanda

2012-07-01

250

Validation of water vapor retrieval from SCIAMACHY limb measurements in the upper troposphere and lower stratosphere  

NASA Astrophysics Data System (ADS)

Water vapor is retrieved from scattered solar radiation measured with the SCanning Imaging Absorption spectroMeter for Atmospheric CHartograpY (SCIAMACHY). We use data from limb observation geometry in the near infrared spectral range around 1400nm. The water vapor retrieval covers an altitude range of about 12 to 23 km with a vertical resolution between about 2 and 6 km. Multiple scattering must be considered and due to a high amount of water vapor in the troposphere the retrieval is challenging. SCIAMACHY reaches global coverage at the equator within 6 days and measures continuously since 2002. The retrieval from the SCIAMACHY limb mode offer a fairly dense horizontal sampling, good vertical resolution, and a long time series in the upper troposphere and lower stratosphere (UTLS). Here, the retrieved water vapor is compared to several other satellite instruments e.g. ACE-FTS, MIPAS, MLS and in situ measurements.

Weigel, Katja; Rozanov, Alexei; Weber, Mark; Bovensmann, Heinrich; Stiller, Gabriele; Burrows, John P.

251

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

PubMed

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

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

2013-06-01

252

Functional trade-offs in the limb muscles of dogs selected for running vs. fighting.  

PubMed

The physical demands of rapid and economical running differ from those of physical fighting such that functional trade-offs may prevent simultaneous evolution of optimal performance in both behaviours. Here we test three hypotheses of functional trade-off by measuring determinants of limb musculoskeletal function in two breeds of domestic dogs that have undergone intense artificial selection for running (Greyhound) or fighting performance (Pit Bull). We found that Greyhounds differ from Pit Bulls in having relatively less muscle mass distally in their limbs, weaker muscles in their forelimbs than their hindlimbs, and a much greater capacity for elastic storage in the in-series tendons of the extensor muscles of their ankle joints. These observations are consistent with the hypothesis that specialization for rapid or economical running can limit fighting performance and vice versa. We suggest that functional trade-offs that prevent simultaneous evolution of optimal performance in both locomotor and fighting abilities are widespread taxonomically. PMID:14635871

Pasi, B M; Carrier, D R

2003-03-01

253

The relationship of phantom limb pain to other phantom limb phenomena in upper extremity amputees 1 This work was supported by the Deutsche Forschungsgemeinschaft (Research Group `Clinical Psychophysiology of Pain', Bi 195\\/24). 1  

Microsoft Academic Search

In thirty-two unilateral upper extremity amputees with and without phantom limb pain, various phantom limb phenomena were investigated. In general, the incidence of non-painful phantom limb sensations was higher in patients with phantom limb pain than in pain-free amputees. Kinesthetic and kinetic phantom limb sensations were reported more frequently than exteroceptive cutaneous sensations. There was a significant positive correlation between

Pedro Montoya; Wolfgang Larbig; Norbert Grulke; Herta Flor; Edward Taub; Niels Birbaumer

1997-01-01

254

Development of a 3-D Rehabilitation System for Upper Limbs Using ER Actuators in a Nedo Project  

NASA Astrophysics Data System (ADS)

New training methods and exercises for upper limbs rehabilitation are made possible by application of robotics and virtual reality technology. The technologies can also make quantitative evaluations and enhance the qualitative effect of training. We have joined a project managed by NEDO (New Energy and Industrial Technology Development Organization as a semi-governmental organization under the Ministry of Economy, Trade and Industry of Japan) 5-year Project, "Rehabilitation System for the Upper Limbs and Lower Limbs", and developed a 3-DOF exercise machine for upper limbs (EMUL) using ER actuators. In this paper, we also present the development of software for motion exercise trainings and some results of clinical evaluation. Moreover, it is discussed how ER actuators ensure the mechanical safety.

Furusho, Junji; Koyanagi, Ken'ichi; Nakanishi, Kazuhiko; Ryu, Ushio; Takenaka, Shigekazu; Inoue, Akio; Domen, Kazuhisa; Miyakoshi, Koichi

255

The influence of motor cortical stimulus intensity on the relaxation rate of human lower limb muscles.  

PubMed

Transcranial magnetic stimulation (TMS) allows an in vivo assessment of the rate of muscle relaxation during a voluntary contraction. It is unknown if this method can be applied to lower limb muscles, and the effect of stimulus intensity on relaxation rate has not been investigated in any muscle group. The present study sought to address these unknowns. A secondary aim was to test the sensitivity of the method to a change in muscle length by comparing the relaxation rate of the plantar flexor muscles with the gastrocnemius at short and long lengths. Seven subjects performed 21 maximal voluntary isometric contractions (MVCs) of the dorsiflexors (DF) and plantar flexors with a knee angle of either 90° or 180° (PF90 and PF180, respectively). TMS intensity ranged from 40 to 100% stimulator output in intervals of 10%. Relaxation rates increased with stimulus intensity but were equivalent to maximal output at 50 (DF and PF90) or 60% (PF180). MVC torque was greater, and the rate of relaxation was faster for PF180 compared to PF90. The main findings are that TMS can be used to measure relaxation rates of lower limb muscles, and these rates are robust provided the stimulus intensity is above a critical threshold. The dependency of plantar flexor relaxation rate on the length of the fast-twitch gastrocnemius fibers reinforces published temperature and fatigue data which show that the method is sensitive to the contractile properties of the muscle fibers which are actively contributing to torque production. PMID:23681296

McNeil, Chris J; Bredius, Marlous S; Molenaar, Joery P; Gandevia, Simon C

2013-05-17

256

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

2012-02-28

257

A modified QuickDASH-9 provides a valid outcome instrument for upper limb function  

PubMed Central

Background The 30-item Disabilities Arm Shoulder and Hand (DASH) questionnaire was introduced to facilitate assessment of upper limb functional limitations. To improve practicality and eliminate item redundancy a modified instrument was needed. The 11-item QuickDASH was developed to fulfil these requirements and translated into several languages. However, prospective investigations of psychometric and practical characteristics are limited. No published study investigated readability or used concurrent validation with a standardized upper limb criterion measure. The validity of the QuickDASH has been questioned as the results for factor structure are conflicting, and the English-language version has not yet had factor structure reported. A shortened 9-item version, the QuickDASH-9, that addresses these issues is proposed. Methods This two-stage observational study assessed the psychometric and practical characteristics of the QuickDASH and the extracted QuickDASH-9. The Upper Limb Functional Index (ULFI) was the criterion standard in both stages. Stage 1, calibration, reanalyzed extracted QuickDASH and QuickDASH-9 responses from a previous prospective study, by the authors, of the 30-item DASH (n = 137). Stage 2, prospective validation, investigated the QuickDASH through repeated measures in consecutive upper limb musculoskeletal participants' consulting for physical therapy in Australia (n = 67). The QuickDASH and extracted QuickDASH-9 data from both stages was analyzed and compared for psychometric properties, practical characteristics and factor structure. Results The proposed QuickDASH-9 had a unidimensional structure, high reliability (ICC 2:1, r = 0.92), internal consistency (alpha = 0.93) and responsiveness (ES = 1.05). It correlated highly with both the DASH (r = 0.97), QuickDASH (r = 0.99) and ULFI criterion (r = 0.85). QuickDASH-9 missing responses reduced to 3.5% from 26% in the QuickDASH. Completion and scoring time was 134 ± 56 seconds and required a computational aid. The QuickDASH demonstrated a bidimensional structure making it invalid. The QuickDASH-9 summary performance was measured on the 'Measurement of Outcome Measures' at 88% and on the 'Bot' clinimetric scale at 75%. Conclusions The proposed QuickDASH-9 had a unidimensional structure and similar psychometric precision to the full-length DASH with improved practicality and completion time. The QuickDASH was invalid as its bidimensional structure made a single summated score inappropriate. The QuickDASH-9 offers a future direction for ongoing use of the QuickDASH concept.

2009-01-01

258

Analysis of elbow-joints misalignment in upper-limb exoskeleton.  

PubMed

This paper presents advantages of introducing elbow-joints misalignments in an exoskeleton for upper limb rehabilitation. Typical exoskeletons are characterized by axes of the device as much as possible aligned to the rotational axes of human articulations. This approach leads to advantages in terms of movements and torques decoupling, but can lead to limitations nearby the elbow singular configuration. A proper elbow axes misalignment between the exoskeleton and the human can improve the quality of collaborative rehabilitation therapies, in which a correct torque transmission from human articulations to mechanical joints of the device is required to react to torques generated by the patient. PMID:22275597

Malosio, Matteo; Pedrocchi, Nicola; Vicentini, Federico; Tosatti, Lorenzo Molinari

2011-01-01

259

Severe upper limb injuries in four passengers of a 'People Carrier'; the contribution of design faults.  

PubMed

Four passengers of a 'People Carrier' in a single vehicle motor accident sustained severe left upper limb trauma, when the vehicle rolled onto the near side. These injuries were directly attributable to the large glass interface between patient and road. The glass windows shattered on contact, providing no protection and in effect created a secondary injury mechanism. We advocate both the use of laminated side windows and mandatory testing of 'roll-over' characteristics for these 'People Carriers' to reduce the incidence of such injuries. PMID:7649628

Teanby, D N; Perks, A G; Watson, S B; Thorlby, A

1995-05-01

260

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

261

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

Microsoft Academic Search

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

Mohammad Pourmahabadian; Kamal Azam

262

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

263

NO2 in the lower stratosphere and upper troposphere region retrieved from SCIAMACHY limb measurements  

NASA Astrophysics Data System (ADS)

As significant amounts of nitrogen dioxide in the atmosphere are from anthropogenic sources, the investigation of this species is of special interest. Nature also has its own significant sources (e.g. lightning events). The investigations can be done using the SCIAMACHY instrument launched on board the European Environment Satellite (ENVISAT-1) in March 2002. SCIA-MACHY measures the scattered and reflected spectral radiance in nadir and limb geometry and the spectral radiance transmitted through the atmosphere in solar/lunar occultation geometry in the spectral region 240 -2380 nm. Our main focus is the lower stratosphere/ upper troposphere (UT/LS) region. An improvement of the NO2 limb retrieval sensitivity at these altitudes is of great importance for the investigation of increased NO2 amounts due to e.g. aircraft emissions, lightning events, meteorological bombs. Higher vertical resolution in limb viewing geometry makes it a better choice than nadir viewing geometry, despite the lower horizontal resolution. Concentrating on the UTLS region we will discuss among others averaged NO2 profiles over the North Atlantic and comparisons with model results over the same area. We will also present comparisons with NO2 amounts derived from in situ measurements performed by the airborne instrument CARIBIC.

Bauer, Ralf; Rozanov, Alexei; Bovensmann, Heinrich; Hoor, Peter; Jöckel, Patrick; Brenninkmeijer, Carl; Burrows, John P.

264

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

PubMed Central

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

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

2009-01-01

265

Relationships between Lower Limb Muscle Strength and Locomotor Capacity in Children and Adolescents with Cerebral Palsy Who Walk Independently  

ERIC Educational Resources Information Center

This study aimed to quantify relationships between lower limb muscle strength and locomotor capacity for children and adolescents with cerebral palsy (CP) to identify key muscle groups for strength training. Fifty 6- to 16-year-olds with CP (Gross Motor Function Classification System level I or II) participated. Isometric muscle strength of hip…

Ferland, Chantale; Lepage, Celine; Moffet, Helene; Maltais, Desiree B.

2012-01-01

266

Relationships between range of motion, Lo, and passive force in five strap-like muscles of the feline hind limb  

Microsoft Academic Search

The relationships between range of motion, optimal length for force production (lo), and passive force provide useful insights into the struc- ture and function of muscles but are unknown for most individual muscles. We measured these values and examined their relationships in five strap-like muscles of the cat hind limb: caudofemoralis, semitendinosus, sartorius ante- rior, tenuissimus, and biceps femoris anterior.

Ian E. Brown; Tiina L. Liinamaa; Gerald E. Loeb

1996-01-01

267

Relationships between Lower Limb Muscle Strength and Locomotor Capacity in Children and Adolescents with Cerebral Palsy Who Walk Independently  

ERIC Educational Resources Information Center

|This study aimed to quantify relationships between lower limb muscle strength and locomotor capacity for children and adolescents with cerebral palsy (CP) to identify key muscle groups for strength training. Fifty 6- to 16-year-olds with CP (Gross Motor Function Classification System level I or II) participated. Isometric muscle strength of hip…

Ferland, Chantale; Lepage, Celine; Moffet, Helene; Maltais, Desiree B.

2012-01-01

268

Muscle moment arms of the gibbon hind limb: implications for hylobatid locomotion  

PubMed Central

Muscles facilitate skeletal movement via the production of a torque or moment about a joint. The magnitude of the moment produced depends on both the force of muscular contraction and the size of the moment arm used to rotate the joint. Hence, larger muscle moment arms generate larger joint torques and forces at the point of application. The moment arms of a number of gibbon hind limb muscles were measured on four cadaveric specimens (one Hylobates lar, one H. moloch and two H. syndactylus). The tendon travel technique was used, utilizing an electro-goniometer and a linear voltage displacement transducer. The data were analysed using a technique based on a differentiated cubic spline and normalized to remove the effect of body size. The data demonstrated a functional differentiation between voluminous muscles with short fascicles having small muscle moment arms and muscles with longer fascicles and comparatively smaller physiological cross-sectional area having longer muscle moment arms. The functional implications of these particular configurations were simulated using a simple geometric fascicle strain model that predicts that the rectus femoris and gastrocnemius muscles are more likely to act primarily at their distal joints (knee and ankle, respectively) because they have short fascicles. The data also show that the main hip and knee extensors maintain a very small moment arm throughout the range of joint angles seen in the locomotion of gibbons, which (coupled to voluminous, short-fascicled muscles) might help facilitate rapid joint rotation during powerful movements.

Channon, Anthony J; Crompton, Robin H; Gunther, Michael M; Vereecke, Evie E

2010-01-01

269

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

2012-05-30

270

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

PubMed

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. PMID:23673294

Roberts, B M; Frye, G S; Ahn, B; Ferreira, L F; Judge, A R

2013-05-11

271

Fusimotor reflexes influencing secondary muscle spindle afferents from flexor and extensor muscles in the hind limb of the cat.  

PubMed

The purpose of this study was to investigate secondary muscle spindle afferents from the triceps-plantaris (GS) and posterior biceps and semitendinosus (PBSt) muscles with respect to their fusimotor reflex control from different types of peripheral nerves and receptors. The activity of single secondary muscle spindle afferents was recorded from dissected and cut dorsal root filaments in alpha-chloralose anaesthetized cats. Both single spindle afferents and sets of simultaneously recorded units (2-3) were investigated. The modulation and mean rate of firing of the afferent response to sinusoidal stretching of the GS and PBSts muscle were determined. Control measurements were performed in the absence of any reflex stimulation, while test measurements were made during reflex stimulation. The reflex stimuli consisted of manually performed movements of the contralateral hind limb, muscle stretches, ligament tractions and electrical stimulations of cutaneous afferents. Altogether 21 secondary spindle afferents were investigated and 20 different reflex stimuli were employed. The general responsiveness (i.e. number of significant reflex effects/number of control-test series) was 52.4%, but a considerable variation between different stimuli was found, with the highest (89.9%) for contralateral whole limb extension and the lowest (25.0%) for stretch of the contralateral GS muscle. The size of the response to a given stimulus varied considerably between different afferents, and, in the same afferent, different reflex stimuli produced effects of varying size. Most responses were characterized by an increase in mean rate of discharge combined with a decrease in modulation, indicative of static fusimotor drive (Cussons et al., 1977). Since the secondary muscle spindle afferents are part of a positive feedback loop, projecting back to both static and dynamic fusimotor neurones (Appelberg Et al., 1892 a, 1983 b; Appelberg et al., 1986), it is suggested that the activity in the loop may work like an amplified which, during some circumstances, enhance the effect of other reflex inputs to the system (Johansson et al., 1991 b). PMID:1840304

Wadell, I; Johansson, H; Sjölander, P; Sojka, P; Djupsjöbacka, M; Niechaj, A

1991-01-01

272

Links between nurses' organisational work environment and upper limb musculoskeletal symptoms: independently of effort-reward imbalance! The ORSOSA study.  

PubMed

The role of psychosocial factors in the development of upper limb musculoskeletal disorders has now been clearly demonstrated. However, only a few studies have analysed the association between the organisational work environment and musculoskeletal disorders in health care workers. The main goal of this study was to test the hypothesis that some specific organisational constraints may be related to upper limb musculoskeletal symptoms experienced by registered nurses, independently of the effort/reward imbalance model and major confounding factors. In 2006, 2194 female registered nurses in 7 French teaching hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded to valid self-report questionnaires (ERI [effort-reward imbalance], Nordic-style questionnaire). The organisational work environment was assessed by the self-rated Nursing Work Index-Extended Organisation scale. Multilevel models were used for analyses. We found that 2 organisational health care constraints: low level of shared values about work between members in the unit and lack of support from the administration were significantly associated with upper limb symptoms, independently of ERI perceptions. This study identified and quantified specific health care organisational factors that have an impact on nurses' upper limb symptoms, sometimes independently of ERI perception. A prospective study is needed to clarify the causal role of psychosocial and organisational work factors in upper limb injury in nurses. Organisational approaches may be more effective in improving health at work and may also have a longer-lasting impact than individual approaches. PMID:21570771

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

2011-05-13

273

The relationship of force output characteristics during a sit-to-stand movement with lower limb muscle mass and knee joint extension in the elderly  

Microsoft Academic Search

This study examined the reliability of ground reaction force (GRF) parameters during sit-to-stand (STS) movements and the relationships between the GRF parameters and lower limb muscle mass and knee extension muscle strength. Fifty elderly females performed an STS movement twice from a chair adjusted to their knee height and the GRF, lower limb muscle mass and isometric knee extension muscle

Takayoshi Yamada; Shinichi Demura

2010-01-01

274

Dynamics of goat distal hind limb muscle-tendon function in response to locomotor grade  

PubMed Central

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

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

2009-01-01

275

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; Giminiani, R; Tihanyi, József

2013-03-01

276

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

Microsoft Academic Search

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

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

2009-01-01

277

The incidence of associated fractures of the upper limb in fractures of the radial head  

PubMed Central

Radial head fractures are common injuries. In American publications, one-third of the patients with these fractures have been shown to have associated injuries. The aim of this retrospective study is to describe the epidemiology of radial head fractures and associated fractures of the ipsilateral upper extremity in a European population. This study describes the epidemiology of radial head and associated fractures of the upper extremity in a Dutch population by a retrospective radiographic review of all patients with a radial head fracture between 1 January 2006 and 1 July 2007. A total of 147 radial head fractures were diagnosed in 145 patients. The incidence in the general population was 2.5 per 10.000 per year. The average age was 45.9 (SD 17.3) years and male–female ratio was 2:3. The mean age of males was significantly lower (37.1, SD 14.2 years) than of women (53.9, SD 16.4 years). Associated fracture of the upper extremity was found in 10.2%. Coronoid fractures were most common (4.1%). Associated upper limb fractures in patients with a radial head fracture are common in the European population. It is of clinical importance to suspect associated lesions and to perform a thorough physical examination and additional radiological examination on demand.

Kaas, Laurens; van Riet, Roger P.; Vroemen, Jos P. A. M.

2008-01-01

278

Liebenberg syndrome is caused by a deletion upstream to the PITX1 gene resulting in transformation of the upper limbs to reflect lower limb characteristics.  

PubMed

Liebenberg syndrome (MIM 186550) is a very rare autosomal dominant condition characterized by three main features: dysplasia of all of the bony components of the elbow joint, abnormalities in the shape of carpal bones, and brachydactyly. In this paper, we report a Saudi Arabian family with Liebenberg syndrome. Comparative genomic hybridization (CGH) revealed a 275-kb deletion within the cytogenetic band 5q31.1 which contains the H2AFY gene and 190,428bp of its downstream region. The deleted region is upstream to the PITX1 gene. The radiological features in the upper limbs of all affected members of the family were almost identical to the phenotype in the mouse model with ectopic expression of Pitx1 in the forelimbs. We therefore re-define the phenotype of Liebenberg syndrome as a transformation of the upper limbs to reflect lower limb characteristics and speculate that the area of deletion contains a regulatory sequence that suppresses the expression of PITX1 in the upper limb buds. PMID:23587911

Al-Qattan, Mohammad M; Al-Thunayan, Abdullah; Alabdulkareem, Ibrahim; Al Balwi, Mohammed

2013-04-12

279

Roles of proximal-to-distal sequential organization of the upper limb segments in striking the keys by expert pianists.  

PubMed

Roles played by the proximal-to-distal sequencing (PDS) of the multi-joint limb in a relatively slow target-aiming task by the arm were investigated using keystroke motion on the piano. Kinematic recordings were made while experts (N=7) and novices (N=7) of piano players performed an octave keystroke at four linearly-scaled loudness levels with a short tone production (staccato) technique. The temporal relationship of the peak angular velocity at the shoulder, elbow and wrist joints showed a clear PDS organization for the experts, but not for the novices. The result thus confirmed that the PDS occurred in a slow and skilled multi-joint movement. The summation effect of segmental speed in terms of increment of the peak segmental angular velocity was equal for both groups. Similarly, no group difference was found for the total kinetic energy produced by the upper limb during keystroke. The role of the PDS in piano keystroke thus cannot be explained by the exploitation of speed-summation effect and mechanical efficiency. Compared to the novices, the experts had a longer period and a greater magnitude of deceleration at the shoulder and elbow joints while their adjacent distal joints were accelerating. These results indicated that greater inertial forces had been generated to descend the forearm as well as the hand for the experts. A dominant role of the PDS in pianists can therefore be to effectively exploit motion-dependent interaction torques at the forearm and hand, and thereby reducing muscle-dependent torques to make the keystroke more physiologically efficient. PMID:17574744

Furuya, Shinichi; Kinoshita, Hiroshi

2007-06-02

280

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

Microsoft Academic Search

This investigation compared the amplitude and the timing of the muscle activity of the lower limb, as well as the three-dimensional\\u000a kinematics of the hip, knee and ankle joints, of male and female elite soccer players performing an unanticipated cutting\\u000a manoeuvre. These data were recorded for 15 female and 15 male participants for five successful cutting manoeuvres. For this\\u000a manoeuvre

Mélanie L. Beaulieu; Mario Lamontagne; Lanyi Xu

2009-01-01

281

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

NASA Astrophysics Data System (ADS)

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

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

2013-02-01

282

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

2012-04-21

283

Muscle MRI findings in patients with limb girdle muscular dystrophy with calpain 3 deficiency (LGMD2A) and early contractures  

Microsoft Academic Search

Limb girdle muscular dystrophy 2A is a common variant secondary to mutations in the calpain 3 gene. A proportion of patients has early and severe contractures, which can cause diagnostic difficulties with other conditions. We report clinical and muscle magnetic resonance imaging findings in seven limb girdle muscular dystrophy 2A patients (four sporadic and three familial) who had prominent and

Eugenio Mercuri; Kate Bushby; Enzo Ricci; Daniel Birchall; Marika Pane; Maria Kinali; Joanna Allsop; Vincenzo Nigro; Amets Sáenz; Annachiara Nascimbeni; Luigi Fulizio; Corrado Angelini; Francesco Muntoni

2005-01-01

284

Relation among the Gross Motor Function, Manual Performance and Upper Limb Functional Measures in Children with Spastic Cerebral Palsy  

PubMed Central

Purpose The objective of this study was to describe hand function in relation with gross motor function and subtype of spastic cerebral palsy and to investigate the relationships among gross motor function, bimanual performance, unimanual capacity and upper limb functional measures in children with spastic cerebral palsy (CP). Materials and Methods We collected upper extremity data of 140 children with spastic CP. The Gross Motor Functional Classification System (GMFCS) was used to assess gross motor function, Manual Ability Classification System (MACS) for bimanual performance, and Modified House Functional Classification (MHC) for the best capacity of each hand. Upper limb functions were evaluated by using the Upper Limb Physician's Rating Scale and Upper Extremity Rating Scale. Results There was a good correlation between GMFCS and MACS in children with bilateral CP, but the correlation was not strong in children with unilateral CP. No significant difference between GMFCS and MACS was found in children with bilateral CP, but children with unilateral CP scored higher on GMFCS than on MACS. A strong correlation was observed between MACS and MHC in children with bilateral CP, but not in children with unilateral CP. The upper limb functional measures in each hand were highly related with MACS and MHC in bilateral CP, but not in unilateral CP. Conclusion Gross motor function, bimanual performance and the best capacity of each hand are closely related with each other in children with bilateral CP, but not in children with unilateral CP.

Park, Eun Sook; Rha, Dong Wook; Park, Jin Hee; Park, Doug Ho

2013-01-01

285

Development of risk filter and risk assessment worksheets for HSE guidance--'Upper Limb Disorders in the Workplace' 2002.  

PubMed

Upper limb disorders (ULDs) in the workplace represent a significant cause of ill health in Great Britain. As part of the Health and Safety Commission's strategy for the prevention of musculoskeletal disorders (MSDs), the well known guidance document on ULDs--"Work-related Upper Limb Disorders: a Guide to Prevention" (HSG60), (HMSO, London.), has been extensively revised. This revision (Upper limb disorders in the workplace. HSG60 (rev), HSE Books, Sudbury.) includes the development of new risk assessment tools that can be used by employers to identify ULD risk factors in work activities and more importantly to take action to reduce or eliminate ULD risks. The risk assessment tools form part of a seven stage management approach that underpins the new guidance. This paper outlines the development of the risk assessment tools contained in the revised guidance. PMID:15246886

Graves, Rod J; Way, Kïrsten; Riley, David; Lawton, Clare; Morris, Len

2004-09-01

286

The contribution of upper limb and total body movement to adolescents' energy expenditure whilst playing Nintendo Wii.  

PubMed

Little research documents the contribution of upper limb and total body movement to energy expenditure (EE) during active video gaming. To address this, EE, heart rate (HR), and, upper limb and total body movement were assessed in 11- to 17-year-old adolescents whilst playing three active (Nintendo Wii) and one sedentary (XBOX 360) video games. Non-dominant upper limb activity, EE and HR were significantly greater during Wii Sports boxing [mean 267.2 (SD 115.8) J kg(-1) min(-1); 136.7 (24.5) beats min(-1)] than tennis or bowling (P < or = 0.044). For all active games hip activity best predicted EE (R (2) > or = 0.53), with two-measure models of HR and single-site activity data, and multi-site activity data, similarly explaining the variance in EE (R (2) > or = 0.64). The physiological cost of upper-body orientated active video games increased when movement of both upper limbs was encouraged. Improvements in EE explanatory power provide support for multi-site activity monitoring during unique, non-ambulatory activities. PMID:18607619

Graves, Lee E F; Ridgers, Nicola D; Stratton, Gareth

2008-07-08

287

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

288

Water vapor in the upper troposphere and lower stratosphere from SCIAMACHY limb measurements, 2002 - 2011  

NASA Astrophysics Data System (ADS)

The SCanning Imaging Absorption spectroMeter for Atmospheric CHartographY (SCIAMACHY) on Envisat started to operate in 2002 and the measurements are ongoing. SCIAMACHY measures the scattered sunlight using different observation geometries. The limb viewing geometry allows to retrieve water vapor at about 12 to 23 km altitude from the near infrared spectral range (1353-1410 nm). These data cover the upper troposphere and lower stratosphere (UTLS) a region of special interest for a variety of dynamical and chemical processes. Here we present a validation of the latest data version of water vapor from SCIAMACHY measurements by comparisons with other satellite data and frost point hygrometer data. The time series from 2002 to 2011 are presented and their variability during the last decade is investigated.

Weigel, K.; Rozanov, A.; Azam, F.; Eichmann, K.-U.; Weber, M.; Bovensmann, H.; Stiller, G. P.; Burrows, J. P.

2012-04-01

289

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

2013-03-07

290

Perceived discomfort functions based on joint moment for various joint motion directions of the upper limb.  

PubMed

The aim of the present study was to formulate the relationship between the perceived discomfort and the joint moment ratio for twelve joint motion directions of the upper limb by considering the between-subject variability, and to investigate the effect of joint motion direction. Three approximation models (i.e., linear, exponential, and logistic function models) were compared in terms of the accuracy of predicting the perceived discomfort, and the logistic function was selected because its average error was lowest. The concept of L-R fuzzy number was used to consider the individual variability of perceived discomfort, and a simplified distribution of perceived discomfort was represented. Cluster analysis showed that the twelve discomfort functions formed two clusters: one for elbow flexion and a second for the remaining joint motions. The data show that elbow flexion is more sensitive than other joint motions to increases in the joint moment ratio. PMID:23684117

Chihara, Takanori; Izumi, Taiki; Seo, Akihiko

2013-05-17

291

[Biomechanical risk for the upper limbs: experience at a factory of feeding electric cables].  

PubMed

Cumulative trauma disorders are found more and more frequently in working environments. Our examination concerns a factory of feeding electric cables, whose workers were subjected to a sanitary checking in 2001, 2002, 2003. The valuation of the risk due to a biomechanical overload of the upper limbs, carried out according to the OCRA method, pointed out, with reference to the specific task of pressing, a middle-high grade of exposure, while the clinical-instrumental results showed symptoms and objective signs of suffering on the median nerve of the wrist with regard to a significant percentage of workers. The following interventions on the production cycle and on the exposure times obtained a reduction of the risk with a subsequent decrease of the noticed troubles. PMID:14979129

Spigno, F; Insalaco, R; Piccinini, M; Bonsignore, A D

292

Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke  

PubMed Central

This study, conducted in a group of nine chronic patients with right-side hemiparesis after stroke, investigated the effects of a robotic-assisted rehabilitation training with an upper limb robotic exoskeleton for the restoration of motor function in spatial reaching movements. The robotic assisted rehabilitation training was administered for a period of 6?weeks including reaching and spatial antigravity movements. To assess the carry-over of the observed improvements in movement during training into improved function, a kinesiologic assessment of the effects of the training was performed by means of motion and dynamic electromyographic analysis of reaching movements performed before and after training. The same kinesiologic measurements were performed in a healthy control group of seven volunteers, to determine a benchmark for the experimental observations in the patients’ group. Moreover degree of functional impairment at the enrolment and discharge was measured by clinical evaluation with upper limb Fugl-Meyer Assessment scale (FMA, 0–66 points), Modified Ashworth scale (MA, 0–60 pts) and active ranges of motion. The robot aided training induced, independently by time of stroke, statistical significant improvements of kinesiologic (movement time, smoothness of motion) and clinical (4.6?±?4.2 increase in FMA, 3.2?±?2.1 decrease in MA) parameters, as a result of the increased active ranges of motion and improved co-contraction index for shoulder extension/flexion. Kinesiologic parameters correlated significantly with clinical assessment values, and their changes after the training were affected by the direction of motion (inward vs. outward movement) and position of target to be reached (ipsilateral, central and contralateral peripersonal space). These changes can be explained as a result of the motor recovery induced by the robotic training, in terms of regained ability to execute single joint movements and of improved interjoint coordination of elbow and shoulder joints.

2012-01-01

293

Power hand tool kinetics associated with upper limb injuries in an automobile assembly plant.  

PubMed

This study investigated the relationship between pneumatic nutrunner handle reactions, workstation characteristics, and prevalence of upper limb injuries in an automobile assembly plant. Tool properties (geometry, inertial properties, and motor characteristics), fastener properties, orientation relative to the fastener, and the position of the tool operator (horizontal and vertical distances) were measured for 69 workstations using 15 different pneumatic nutrunners. Handle reaction response was predicted using a deterministic mechanical model of the human operator and tool that was previously developed in our laboratory, specific to the measured tool, workstation, and job factors. Handle force was a function of target torque, tool geometry and inertial properties, motor speed, work orientation, and joint hardness. The study found that tool target torque was not well correlated with predicted handle reaction force (r=0.495) or displacement (r=0.285). The individual tool, tool shape, and threaded fastener joint hardness all affected predicted forces and displacements (p<0.05). The average peak handle force and displacement for right-angle tools were twice as great as pistol grip tools. Soft-threaded fastener joints had the greatest average handle forces and displacements. Upper limb injury cases were identified using plant OSHA 200 log and personnel records. Predicted handle forces for jobs where injuries were reported were significantly greater than those jobs free of injuries (p<0.05), whereas target torque and predicted handle displacement did not show statistically significant differences. The study concluded that quantification of handle reaction force, rather than target torque alone, is necessary for identifying stressful power hand tool operations and for controlling exposure to forces in manufacturing jobs involving power nutrunners. Therefore, a combination of tool, work station, and task requirements should be considered. PMID:17474028

Ku, Chia-Hua; Radwin, Robert G; Karsh, Ben-Tzion

2007-06-01

294

[Working tasks with upper limbs repetitive movements: analysis of different methods for risk assessment].  

PubMed

A review of different methods for the risk assessment of upper limbs repetitive movements is carried out mainly referring to a recent ISO standard (ISO 11228-3). This standard establishes ergonomic recommendations for tasks involving manual handling of low loads at high frequency (repetitive work). It is a "voluntary" standard and provides information for all professionals involved in occupational prevention as well as in job and product design. It refers to a four-step approach, involving both risk assessment and risk reduction (hazard identification, risk estimation, risk evaluation and risk reduction). General reference is made to a general model reported in a Consensus Document published by the IEA Technical Committee "Musculoskeletal Disorders", with the endorsement of ICOH. Apart from risk identification, the standard addresses and suggests several methods for a simple risk estimation (i.e. Plibel, Osha Checklist, Upper Limb Expert Tool, Qec, Checklist Ocra). If the risk estimation results in the 'yellow' or 'red' zone, or if the job is composed by two or more repetitive tasks, a more detailed risk assessment is recommended. For a detailed risk assessment, the OCRA method is suggested as "preferred"; however, other methods (STRAIN INDEX; HAL-TLV-ACGIH) can also be used. The applicative limits of the methods mentioned above, considering the purposes of the standard, are shortly discussed together with their recent scientific updates and applicative perspectives. The standard, with the suggested risk assessment procedures and methods, represents a useful tool for all OSH operators involved in the application of European and National legislation regarding the prevention of UL WMSDs. PMID:19288787

Occhipinti, E

295

The reliability of upper limb kinematics in children with hemiplegic cerebral palsy.  

PubMed

This study describes the reliability of a protocol for upper limb three-dimensional movement analysis (UL-3DMA) in children with hemiplegic cerebral palsy (HCP). The UL-3DMA is based on the ISB-recommendations, and contains a set of functional and clinically relevant tasks. Tasks were selected to reflect the characteristic movement deficits seen in children with HCP. The protocol consists of three reach tasks (forwards, upwards, sideways); two reach-to-grasp tasks (with objects requiring different hand orientations); and three gross motor tasks. Within and between session reliability was tested in a group of 12 children with HCP, aged 6-15 years. Reliability of movement duration/speed and joint angles at endpoint was assessed with the intraclass correlation coefficient; similarity of the waveforms with the coefficient of multiple correlation. Measurement errors were calculated for all parameters. Results indicated good within and between session reliability for movement duration/speed. Trunk, scapula, shoulder, elbow and wrist angles at endpoint generally showed moderately high to very high reliability. High levels of reliability were also found for scapula, shoulder and elbow waveforms and lower levels for the wrist and trunk. Within and between session measurement errors were below 5° and 7°, respectively, for most kinematic parameters. Joint angles in the transverse plane, as well as wrist flexion generally showed higher between session errors (7-10°). This study indicates that the proposed protocol is a reliable tool to quantify upper limb movements in children with HCP, providing a sound base for its clinical application. Further research is needed to establish the discriminative ability of the UL-3DMA. PMID:21334208

Jaspers, Ellen; Feys, Hilde; Bruyninckx, Herman; Cutti, Andrea; Harlaar, Jaap; Molenaers, Guy; Desloovere, Kaat

2011-02-18

296

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

ERIC Educational Resources Information Center

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

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

2012-01-01

297

Limb salvage of lower-extremity wounds using free gracilis muscle reconstruction.  

PubMed

An extensive series reviewing the benefits and drawbacks of use of the gracilis muscle in lower-extremity trauma has not previously been collected. In this series of 50 patients, the use of microvascular free transfer of the gracilis muscle for lower-extremity salvage in acute traumatic wounds and posttraumatic chronic wounds is reviewed. In addition, the wound size, injury patterns, problems, and results unique to the use of the gracilis as a donor muscle for lower-extremity reconstruction are identified. In a 7-year period from 1991 to 1998, 50 patients underwent lower-extremity reconstruction using microvascular free gracilis transfer at the University of Maryland Shock Trauma Center, Johns Hopkins Hospital, and Johns Hopkins Bayview Medical Center. There were 22 patients who underwent reconstruction for coverage of acute lower-extremity traumatic soft-tissue defects associated with open fractures. The majority of patients were victims of high-energy injuries with 91 percent involving motor vehicle or motorcycle accidents, gunshot wounds, or pedestrians struck by vehicles. Ninety-one percent of the injuries were Gustilo type IIIb tibial fractures and 9 percent were Gustilo type IIIc. The mean soft-tissue defect size was 92.2 cm2. Successful limb salvage was achieved in 95 percent of patients. Twenty-eight patients with previous Gustilo type IIIb tibia-fibula fractures presented with posttraumatic chronic wounds characterized by osteomyelitis or deep soft-tissue infection. Successful free-tissue transfer was accomplished in 26 of 28 patients (93 percent). All but one of the patients in this group who underwent successful limb salvage (26 of 27, or 96 percent) are now free of infection. Use of the gracilis muscle as a free-tissue transfer has been shown to be a reliable and predictable tool in lower-extremity reconstruction, with a flap success and limb salvage rate comparable to those in other large studies. PMID:11129178

Redett, R J; Robertson, B C; Chang, B; Girotto, J; Vaughan, T

2000-12-01

298

Reliability of bloodflux measurements from the upper trapezius muscle during muscle contractions  

Microsoft Academic Search

The aim of this study was to assess the blood flux responses to isometric contractions and recovery. We also wanted to assess\\u000a the variations in Laser Doppler blood fluxes (LDF) within the upper trapezius muscles, the concordance between the left and\\u000a right sides and the reliability of blood-flux measurements between contractions and over measurement days. Ten subjects, mean\\u000a age 25 years

Cecilie Røe; Elin Damsgård; Stein Knardahl

2008-01-01

299

The recombinant limb as a model for the study of limb patterning, and its application to muscle development  

Microsoft Academic Search

The recombinant limb is a model system that has proved fruitful for analyzing epithelial-mesenchymal interactions and understanding\\u000a the functional properties of the components of the limb bud. Here we present an overview of some of the insights obtained\\u000a through the use of this technique. Among these are the understanding that fore or hind limb identity is inherent to the limb

Marian Fernandez-Teran; M. Elisa Piedra; Maria A. Ros; John F. Fallon

1999-01-01

300

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

301

Bradykinesia akinesia inco-ordination test (BRAIN TEST): an objective computerised assessment of upper limb motor function  

Microsoft Academic Search

OBJECTIVESA simple and rapid computerised keyboard test, based on the alternating finger tapping test, has been developed to quantify upper limb motor function. The test generates several variables: (1) kinesia score: the number of keystrokes in 60 seconds; (2) akinesia time: cumulative time that keys are depressed; (3) dysmetria score: a weighted index calculated using the number of incorrectly hit

G Giovannoni; J van Schalkwyk; V U Fritz; A J Lees

1999-01-01

302

What Affects Return to Work for Graduates of a Pain Management Program with Chronic Upper Limb Pain?  

Microsoft Academic Search

Chronic upper limb pain often causes work loss, and return to work after pain management is disappointingly low. This study aimed to identify patient characteristics and beliefs contributing to return to work or nonreturn. A total of 103 (66%) ex-patients with CULP, who had completed a pain management program, agreed to telephone interview. Participants were predominantly female and in middle

Jacqueline H. Adams; Amanda C de C Williams

2003-01-01

303

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

304

Retrieval of water vapor in the upper troposphere\\/lower stratosphere from MIPAS\\/Envisat limb emission spectra  

Microsoft Academic Search

Global Measurements of water vapor in the upper troposphere and lower stratosphere (UT\\/LS) are required to assess its influence on the radiation budget of the Earth and for its use as a suitable tracer for the study of troposphere-stratosphere exchange processes (STE). MIPAS (Michelson Interferometer for Passive Atmospheric Sounding) is a Fourier transform spectrometer measuring limb emission spectra. The field

Mathias Milz; Thomas von Clarmann; Gabriele P. Stiller; Herbert Fischer

1999-01-01

305

Effects of botulinum toxin type A on upper limb function in children with cerebral palsy: a systematic review  

Microsoft Academic Search

Objective: To evaluate whether botulinum toxin type A injections improve upper limb function in children with cerebral palsy.Methods: An extensive search was carried out in PUBMED, CINAHL, PICARTA, EMBASE, PEDRO and the Cochrane Controlled Trials Register. Controlled and uncontrolled studies were included and evaluated on the basis of a best evidence synthesis.Results: Twelve out of 645 identified studies were included:

Alexander Reeuwijk; Petra EM van Schie; Jules G Becher; Gert Kwakkel

2006-01-01

306

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

307

An investigation of somatosensory profiles in work related upper limb disorders: a case-control observational study protocol  

Microsoft Academic Search

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

Niamh Moloney; Toby Hall; Catherine Doody

2010-01-01

308

Quantification of force abnormalities during passive and active-assisted upper-limb reaching movements in post-stroke hemiparesis  

Microsoft Academic Search

The authors evaluated a method for measuring abnormal upper-limb motor performance in post-stroke hemiparetic subjects. A servomechanism (MIME) moved the forearm in simple planar trajectories, directly controlling hand position and forearm orientation. Design specifications are presented, along with system performance data during an initial test of 13 stroke subjects with a wide range of impairment levels. Performance of subjects was

Peter S. Lum; Charles G. Burgar; Deborah E. Kenney; H. F. Machiel Van der Loos

1999-01-01

309

The distribution of occupations in two populations with upper limb pain.  

PubMed

Occupations of two geographically distinct populations of patients with upper limb pain were examined. Relative risks for being in an occupation were calculated for subjects with epicondylitis, carpal tunnel syndrome, and pain syndromes in one population and nonspecific occupational overuse syndrome (OOS) in the other. Population A subjects (806 female, 154 male Auckland clinic referrals) with epicondylitis and carpal tunnel syndrome had higher rates of manual occupations compared with the Auckland employed population, consistent with previous research. Both Population A and Population B subjects (1,188 female, 499 male national notifications to the Department of Labour) with pain syndrome or nonspecific OOS had increased rates of clerical occupations. Relative risks ranged from 2.24 (95% CI 1.69,2.97) to 3.92 (3.50 ,4.40). Word processor operators, data-entry operators, and mail sorters were overrepresented in both populations. An unexplained association between nonspecific upper arm pain and being in some clerical occupations requires further research. PMID:11513070

Dryson, E W; Walls, C B

310

The effectiveness of a work style intervention and a lifestyle physical activity intervention on the recovery from neck and upper limb symptoms in computer workers  

Microsoft Academic Search

This study assessed the effectiveness of a single intervention targeting work style and a combined intervention targeting work style and physical activity on the recovery from neck and upper limb symptoms. Computer workers with frequent or long-term neck and upper limb symptoms were randomised into the work style group (WS, n=152), work style and physical activity group (WSPA, n=156), or

Claire M. Bernaards; Geertje A. M. Ariëns; Dirk L. Knol; Vincent H. Hildebrandt

2007-01-01

311

Histological abnormalities of muscle from limb, thorax and diaphragm in chronic heart failure.  

PubMed

The aim of the study was to compare histological findings in limb and respiratory muscles from control subjects and patients with heart failure of two different aetiologies. Biopsies of the quadriceps femoris, strap, diaphragm and pectoralis major muscles were taken from each group. The control subjects all had normal left ventricular function, and comprised seven undergoing surgical ablation of electrical pathways and 10 undergoing coronary artery surgery. The heart failure group had severely impaired left ventricular function, and were undergoing cardiac transplantation in all except one case. Ten patients with idiopathic dilated cardiomyopathy and seven with heart failure of ischaemic origin were studied. Conventional histochemical techniques and specific anti-myosin immunofluorescent stains were used. There were no consistent differences in fibre type prevalence or diameter between the groups. There were no important histological abnormalities in the two control groups. There were minor/major changes in four of seven patients with ischaemic heart failure but no major abnormality, whilst in the dilated cardiomyopathy group there were five of 10 patients with minor/major changes and three of 10 with major abnormalities (P < 0.001 vs controls). A variety of changes were seen in both groups of heart failure subjects. These were more marked in the dilated cardiomyopathy than ischaemic group, and suggest the presence of fibre type regeneration and/or transformation. Amongst the findings were tubular aggregates, internalization of nuclei, bizzare staining of myosin and staining of neonatal myosin (seven of 14) and the presence of cores (five of 14). Such changes were more prominent in the diaphragm than in the other muscles. In conclusion, histological abnormalities are present in the limb and respiratory muscles from subjects with heart failure. The changes are most marked in subjects with idiopathic dilated cardiomyopathy, suggesting that there may be a generalized cardiac and skeletal myopathy in these subjects. The presence of histological abnormalities in the respiratory muscles may contribute to the pathogenesis of dyspnoea in heart failure. PMID:8869866

Lindsay, D C; Lovegrove, C A; Dunn, M J; Bennett, J G; Pepper, J R; Yacoub, M H; Poole-Wilson, P A

1996-08-01

312

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

313

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning.  

PubMed

The aim of the study was to investigate the uniformity of the muscle motor point location for lower limb muscles in healthy subjects. Fifty-three subjects of both genders (age range: 18-50 years) were recruited. The muscle motor points were identified for the following ten muscles of the lower limb (dominant side): vastus medialis, rectus femoris, and vastus lateralis of the quadriceps femoris, biceps femoris, semitendinosus, and semimembranosus of the hamstring muscles, tibialis anterior, peroneus longus, lateral and medial gastrocnemius. The muscle motor point was identified by scanning the skin surface with a stimulation pen electrode and corresponded to the location of the skin area above the muscle in which an electrical pulse evoked a muscle twitch with the least injected current. For each investigated muscle, 0.15 ms square pulses were delivered through the pen electrode at low current amplitude (<10 mA) and frequency (2 Hz). 16 motor points were identified in the 10 investigated muscles of almost all subjects: 3 motor points for the vastus lateralis, 2 motor points for rectus femoris, vastus medialis, biceps femoris, and tibialis anterior, 1 motor point for the remaining muscles. An important inter-individual variability was observed for the position of the following 4 out of 16 motor points: vastus lateralis (proximal), biceps femoris (short head), semimembranosus, and medial gastrocnemius. Possible implications for electrical stimulation procedures and electrode positioning different from those commonly applied for thigh and leg muscles are discussed. PMID:21796408

Botter, Alberto; Oprandi, Gianmosè; Lanfranco, Fabio; Allasia, Stefano; Maffiuletti, Nicola A; Minetto, Marco Alessandro

2011-07-28

314

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

315

Intrauterine Upper Limb Ischemia Associated with Fetal Thrombophilia: A Case Report and Review of the Literature  

Microsoft Academic Search

Neonatal extremity gangrene is rare, even rarer are those born with evidence of intrauterine vascular occlusion. Intrauterine limb ischemia has been attributed to several etiological factors which include thromboembolic disease occluding the arteries of the affected limb or compression of the limb during intrauterine life. In this report, we present a case of brachioradial arterial thrombosis associated with mild homocysteinemia

Wadah M. Khriesat; Hala S. Al-Rimawi; Isam M. Lataifeh; Suleimman Al-Sweedan; Eyad Baqain

2010-01-01

316

Toward Electrocorticographic Control of a Dexterous Upper Limb Prosthesis: Building Brain-Machine Interfaces  

Microsoft Academic Search

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

Matthew Fifer; Soumyadipta Acharya; Heather Benz; Mohsen Mollazadeh; Nathan Crone; Nitish Thakor

2012-01-01

317

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

PubMed

Moles have modified thoracic limbs with hypertrophied pectoral girdle muscles that allow them to apply remarkably high lateral out-forces during the power stroke when burrowing. To further understand the high force capabilities of mole forelimbs, architectural properties of the thoracic limb muscles were quantified in the Eastern mole (Scalopus aquaticus). Architectural properties measured included muscle mass, moment arm, belly length, fascicle length, and pennation angle, and these were used to provide estimates of maximum isometric force, joint torque, and power. Measurements of muscle moment arms and limb lever lengths were additionally used to analyze the out-force contributions of the major pectoral girdle muscles. Most muscles have relatively long fascicles and little-to-no pennation. The humeral abductor/rotators as a functional group are massive and are capable of relatively high force, power, and joint torque. Of this group, the bipennate m. teres major is the most massive and has the capacity to produce the highest force and joint torque to abduct and axially rotate the humerus. In general, the distal limb muscles are relatively small, but have the capacity for high force and mechanical work by fascicle shortening. The muscle architectural properties of the elbow extensors (e.g., m. triceps brachii) and carpal flexors (e.g., m. palmaris longus) are consistent with the function of these muscles to augment lateral out-force application. The humeral abductor/rotators m. latissimus dorsi, m. teres major, m. pectoralis, and m. subscapularis are calculated to contribute 13.9 N to out-force during the power stroke, and this force is applied in a 'frontal' plane causing abduction of the humerus about the sternoclavicular joint. Moles have several specializations of their digging apparatus that greatly enhance the application of out-force, and these morphological features suggest convergence on limb form and burrowing function between New and Old World moles. J. Morphol. 274:1277-1287, 2013. © 2013 Wiley Periodicals, Inc. PMID:23907929

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

2013-08-02

318

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

PubMed Central

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 of nerve palpation and ULNTs. ULNTs were interpreted based on symptom reproduction and structural differentiation. To put the reliability of these tests in perspective, a comparison with the reliability of clinical tests for nerve function was made. Methods Two experienced clinicians examined 31 patients with unilateral arm and/or neck pain. The examination included clinical tests for nerve function (sensory testing, reflexes and manual muscle testing (MMT)) and mechanosensitivity (ULNTs and palpation of the median, radial and ulnar nerve). Kappa statistics were calculated to evaluate intertester reliability. A meta-analysis determined an overall kappa for the domains with multiple kappa values (MMT, ULNT, palpation). We then compared the difference in reliability between the tests of mechanosensitivity and nerve function using a one-sample t-test. Results We observed moderate to substantial reliability for the tests for afferent/efferent nerve function (sensory testing: kappa = 0.53; MMT: kappa = 0.68; no kappa was calculated for reflexes due to a lack of variation). Tests to investigate mechanosensitivity demonstrated moderate reliability (ULNT: kappa = 0.45; palpation: kappa = 0.59). When compared statistically, there was no difference in reliability for tests for nerve function and mechanosensitivity (p = 0.06). Conclusion This study demonstrates that clinical tests which evaluate increased nerve mechanosensitivity and afferent/efferent nerve function have comparable moderate to substantial reliability. To further investigate the clinometric properties of these tests, more studies are needed to evaluate their validity.

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

2009-01-01

319

Primary Cutaneous Diffuse Large B-Cell Lymphoma of the Upper Limb: A Fascinating Entity  

PubMed Central

Primary cutaneous lymphomas are defined as lymphoid neoplasms that present themselves clinically on the skin and do not have extra-cutaneous disease, when the diagnosis is made or even after 6 months of the diagnosis. Primary cutaneous lymphomas of B-cells are less frequent than lymphomas of T-cells. Primary B-cell lymphomas have a better prognosis than secondary B-cell lymphomas. Primary B-cell cutaneous lymphomas are classified into five types according to the World Health Organization and European Organization for Research and Treatment of Cancer classification. The primary diffuse large B-cell cutaneous lymphoma – leg type corresponds to approximately 5-10% of the B-cell cutaneous lymphomas. It is predominantly seen in elderly people and has a female preponderance. Skin lesions can be single, multiple, and even grouped. A 5-year survival rate ranges from 36 to 100% of the cases. The expression of Bcl-2, presence of multiple lesions, and involvement of both the upper limbs lead to a worse prognosis. Very few cases have been described in the literature.

Gopal, Manoj Madakshira; Malik, Ajay

2013-01-01

320

Primary cutaneous diffuse large B-cell lymphoma of the upper limb: a fascinating entity.  

PubMed

Primary cutaneous lymphomas are defined as lymphoid neoplasms that present themselves clinically on the skin and do not have extra-cutaneous disease, when the diagnosis is made or even after 6 months of the diagnosis. Primary cutaneous lymphomas of B-cells are less frequent than lymphomas of T-cells. Primary B-cell lymphomas have a better prognosis than secondary B-cell lymphomas. Primary B-cell cutaneous lymphomas are classified into five types according to the World Health Organization and European Organization for Research and Treatment of Cancer classification. The primary diffuse large B-cell cutaneous lymphoma - leg type corresponds to approximately 5-10% of the B-cell cutaneous lymphomas. It is predominantly seen in elderly people and has a female preponderance. Skin lesions can be single, multiple, and even grouped. A 5-year survival rate ranges from 36 to 100% of the cases. The expression of Bcl-2, presence of multiple lesions, and involvement of both the upper limbs lead to a worse prognosis. Very few cases have been described in the literature. PMID:24082181

Gopal, Manoj Madakshira; Malik, Ajay

2013-09-01

321

Vital endowments: Sir Charles Bell and the history of some congenital abnormalities of the upper limb.  

PubMed

Born in Edinburgh in 1774 Sir Charles Bell, as a young man, studied anatomy and surgery in his hometown. There followed a distinguished career that culminated in his becoming the first professor of Anatomy and Surgery at the College of Surgeons in London. Renowned as a brilliant neuroanatomist he was invited, on the advice of His Grace the Archbishop of Canterbury and the Bishop of London, to contribute one of eight volumes of a work on the Power Wisdom and Goodness of God as manifested in the Creation - known as the Bridgewater Treatises. 'The Hand its Mechanism and Vital Endowments as Evincing Design' was published in 1833 and it is an account of his considering the hand as a machine that has been engineered to exacting standards to interact with the environment in which we live. In it he expressed a deep understanding of the similarity of the structure of the upper limbs of the higher orders of animals. The similarity of the paddle of a turtle and a human hand with acrosymbrachydactyly is unmistakable. This congenital abnormality, given the eponymous title of Apert's syndrome, is one of a number of congenital abnormalities that have parallels in the animal kingdom. Others who have had similar syndromes named after them include Poland, Marfan, Streeter and a number of others. The life and times of these men and their contributions to medicine will be presented in this paper. PMID:22507417

Thurston, Alan

2011-05-10

322

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

323

Two-dimensional myoelectric control of a robotic arm for upper limb amputees  

NASA Astrophysics Data System (ADS)

Rehabilitation engineering and medicine have become integral and significant parts of health care services, particularly and unfortunately in the last three or four decades, because of wars, terrorism and large number of car accidents. Amputees show a high rate of rejection to wear prosthetic devices, often because of lack of an adequate period of adaptation. A robotic arm may appear as a good preliminary stage. To test the hypothesis, myoelectric signals from two upper limb amputees and from four normal volunteers were fed, via adequate electronic conditioning and using MATLAB, to an industrial robotic arm. Proportional strength control was used for two degrees of freedom (x-y plane) by means of eight signal features of control (four traditional statistics plus energy, integral of the absolute value, Willison's amplitude, waveform length and envelope) for comparison purposes, and selecting the best of them as final reference. Patients easily accepted the system and learned in short time how to operate it. Results were encouraging so that valuable training, before prosthesis is implanted, appears as good feedback; besides, these patients can be hired as specialized operators in semi-automatized industry.

López Celani, Natalia M.; Soria, Carlos M.; Orosco, Eugenio C.; di Sciascio, Fernando A.; Valentinuzzi, Max E.

2007-11-01

324

Audit of upper limb fracture management in an accident and emergency department.  

PubMed

The objective of this study was to audit the initial management of patients with upper limb fractures, and to determine whether the accident and emergency (A&E) management of fractures is improved by using guidelines for treatment and referral. This was achieved by comparing the standard of treatment, as determined by fracture clinic doctors, before and after the introduction of fracture treatment guidelines in the A&E department of a London teaching hospital. A total of 326 patients seen in the department and referred to the fracture clinic over two 2-month periods were included in the audit. The first audit revealed some error in 69/215 (32.1%) referrals and 51/215 (23.7%) of these were potentially liable to increased morbidity. After introducing the guidelines the total errors fell to 14/111 (12.6%) patients referred, of which only eight patients (7.2%) were at risk of increased morbidity. This represents an overall improvement of 19.5% [95% confidence interval (CI) 12.3 to 29.7%] and a 16.5% (95% CI 9.1 to 23.9%) reduction in the potentially more significant errors. Hence, the use of audit and implementation of simple guidelines for fracture management in an A&E department improves the standard of treatment. PMID:7921563

Jenkins, D P; Cooke, M W; Glucksman, E E

1994-06-01

325

Treatment of upper limb nerve war injuries associated with vascular trauma.  

PubMed

During a 4-year period, in the Departments of Plastic Surgery and Vascular Surgery at the Clinical Hospital Centre in Zagreb, 151 upper limb nerve injuries caused by war weapons were treated using microsurgical procedures, and 119 patients have been assessed. Among them, 44 patients with 58 nerve injuries had associated arterial injuries. It is of great importance that peripheral nerve as well as vessel injuries should be considered in all extremity war wounds. Every effort should be made to perform immediate revascularization of a damaged artery, as this is the best guarantee for long-term arterial patency. Reconstruction with autologous vein has been the method of choice for arterial war injuries. Injured peripheral nerves, at the time of vascular repair, were marked and left for secondary reconstruction. Primary repair of such injuries was contraindicated because it was impossible to determine the exact proximal and distal extent of injury. Functional results were obtained in only 44.8 per cent of cases with concomitant nerve and arterial war injuries, an outcome that could be explained by insufficient vascularization at the site of nerve repair (using both mechanisms of graft revascularization), as well as proximal levels of injury and extent of nerve damage, which resulted in long nerve defects. PMID:9509088

Stanec, S; Tonkovi?, I; Stanec, Z; Tonkovi?, D; Dzepina, I

1997-09-01

326

Postural tremor and control of the upper limb in air pistol shooters.  

PubMed

A postural tremor appears whenever someone attempts to maintain a steady position against gravity. We examined the postural tremor that occurred while air pistol shooters were taking aim so as to compare the coordinative control of the shooters and to identify the features critical to successful shooting. Ten elite and ten pre-elite athletes participated in pistol shooting at 10 m, and the postural tremors in the pistol and upper limb were recorded with lightweight accelerometers. Exploratory analysis showed that the elite shooters had smaller tremor amplitudes than the pre-elite shooters in the pistol and distal arm segments. Compared with the pre-elite shooters, the elite shooters had a smaller tremor amplitude in the lateral direction relative to that in the vertical direction, together with weaker tremor coupling in the lateral direction and stronger vertical coupling of the pistol-hand complex. The resulting shot performance was inversely related to the amplitude of the tremor and to the 8-12 Hz spectral peak of the lateral tremor in the pistol-hand complex. We conclude that the postural tremors of air pistol shooters are associated with the skill of the shooters, and that the elite shooters could optimize the control of the pistol-hand complex, which strongly determined success in shooting. PMID:18979336

Tang, Wen-Tzu; Zhang, Wen-Yu; Huang, Chien-Chun; Young, Ming-Shing; Hwang, Ing-Shiou

2008-12-01

327

Calpain 3 is important for muscle regeneration: Evidence from patients with limb girdle muscular dystrophies  

PubMed Central

Background Limb girdle muscular dystrophy (LGMD) type 2A is caused by mutations in the CAPN3 gene and complete lack of functional calpain 3 leads to the most severe muscle wasting. Calpain 3 is suggested to be involved in maturation of contractile elements after muscle degeneration. The aim of this study was to investigate how mutations in the four functional domains of calpain 3 affect muscle regeneration. Methods We studied muscle regeneration in 22 patients with LGMD2A with calpain 3 deficiency, in five patients with LGMD2I, with a secondary reduction in calpain 3, and in five patients with Becker muscular dystrophy (BMD) with normal calpain 3 levels. Regeneration was assessed by using the developmental markers neonatal myosin heavy chain (nMHC), vimentin, MyoD and myogenin and counting internally nucleated fibers. Results We found that the recent regeneration as determined by the number of nMHC/vimentin-positive fibers was greatly diminished in severely affected LGMD2A patients compared to similarly affected patients with LGMD2I and BMD. Whorled fibers, a sign of aberrant regeneration, was highly elevated in patients with a complete lack of calpain 3 compared to patients with residual calpain 3. Regeneration is not affected by location of the mutation in the CAPN3 gene. Conclusions Our findings suggest that calpain 3 is needed for the regenerative process probably during sarcomere remodeling as the complete lack of functional calpain 3 leads to the most severe phenotypes.

2012-01-01

328

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

Microsoft Academic Search

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

Alison K. McConnell; Michelle Lomax

2006-01-01

329

Systemic delivery of AAV8 in utero results in gene expression in diaphragm and limb muscle: Treatment implications for muscle disorders  

PubMed Central

One of the major challenges in the treatment of primary muscle disorders, which often affect many muscle groups, is achieving efficient, widespread transgene expression in muscle. In utero gene transfer can potentially address this problem by accomplishing gene delivery when the tissue mass is small and the immune system is immature. Previous studies with systemic in utero adeno-associated viral (AAV) vector serotype 1 gene delivery to embryonic day 16 (E-16) pups resulted in high levels of transduction in diaphragm and intercostal muscles, but no detectable transgene expression in limb muscles. Recently newer AAV serotypes such as AAV8 have demonstrated widespread and high transgene expression in skeletal muscles and diaphragm by systemic delivery in adult and neonatal mice. We tested AAV8 vector gene delivery by intraperitoneal administration in E-16 mice in utero. Using an AAV8 vector carrying a lacZ reporter gene, we observed high level transduction of diaphragm and intercostal muscles and more moderate transduction of multiple limb muscles and heart. Our current studies demonstrate the potential of AAV8 to achieve widespread muscle transduction in utero and suggest its therapeutic potential for primary muscle disorders.

Koppanati, Bhanu Munil; Li, Juan; Xiao, Xiao; Clemens, Paula R.

2009-01-01

330

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

331

Effects of corticosteroids in the development of limb muscle weakness in a porcine intensive care unit model.  

PubMed

Severe muscle wasting is a debilitating condition in critically ill intensive care unit (ICU) patients, characterized by general muscle weakness and dysfunction, resulting in a prolonged mobilization, delayed weaning from the ventilator, and a decreased quality of life post-ICU. The mechanisms underlying limb muscle weakness in ICU patients are complex and involve the impact of primary disease, but also factors common to critically ill ICU patients such as sepsis, mechanical ventilation (MV), immobilization, and systemic administration of corticosteroids (CS). These factors may have additive negative effects on skeletal muscle structure and function, but their respective role alone remain unknown. The primary aim of this study was to examine how CS administration potentiates ventilator and immobilization-related limb muscle dysfunction at the gene level. Comparing biceps femoris gene expression in pigs exposed to MV and CS for 5 days with only MV pigs for the same duration of time showed a distinct deregulation of 186 genes according to microarray. Surprisingly, the decreased force-generation capacity at the single muscle fiber reported in response to the addition of CS administration in mechanically ventilated and immobilized pigs was not associated with an additional upregulation of proteolytic pathways. On the other hand, an altered expression of genes regulating kinase activity, cell cycle, transcription, channel regulation, oxidative stress response, cytoskeletal, sarcomeric, and heat shock protein, as well as protein synthesis at the translational level, appears to play an additive deleterious role for the limb muscle weakness in immobilized ICU patients. PMID:23429211

Aare, Sudhakar; Radell, Peter; Eriksson, Lars I; Akkad, Hazem; Chen, Yi-Wen; Hoffman, Eric P; Larsson, Lars

2013-02-19

332

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

NASA Astrophysics Data System (ADS)

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

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

2011-11-01

333

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

PubMed Central

The purpose of this study was to assess the influence of the work history of the inspiratory muscles upon the fatigue characteristics of the plantar flexors (PF). We hypothesized that under conditions where the inspiratory muscle metaboreflex has been elicited, PF fatigue would be hastened due to peripheral vasoconstriction. Eight volunteers undertook seven test conditions, two of which followed 4 week of inspiratory muscle training (IMT). The inspiratory metaboreflex was induced by inspiring against a calibrated flow resistor. We measured torque and EMG during isometric PF exercise at 85% of maximal voluntary contraction (MVC) torque. Supramaximal twitches were superimposed upon MVC efforts at 1 min intervals (MVCTI); twitch interpolation assessed the level of central activation. PF was terminated (Tlim) when MVCTI was <50% of baseline MVC. PF Tlim was significantly shorter than control (9.93 ± 1.95 min) in the presence of a leg cuff inflated to 140 mmHg (4.89 ± 1.78 min; P = 0.006), as well as when PF was preceded immediately by fatiguing inspiratory muscle work (6.28 ± 2.24 min; P = 0.009). Resting the inspiratory muscles for 30 min restored the PF Tlim to control. After 4 weeks, IMT, inspiratory muscle work at the same absolute intensity did not influence PF Tlim, but Tlim was significantly shorter at the same relative intensity. The data are the first to provide evidence that the inspiratory muscle metaboreflex accelerates the rate of calf fatigue during PF, and that IMT attenuates this effect.

McConnell, Alison K; Lomax, Michelle

2006-01-01

334

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

Microsoft Academic Search

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

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

2001-01-01

335

The Prevalence of and Risk Factors for Neck Pain and Upper Limb Pain among Secondary School Teachers in Hong Kong  

Microsoft Academic Search

Objective: To investigate the prevalence and occupational risk factors of neck and upper limb disorders among secondary school teachers.\\u000a Methods: One hundred secondary schools in Hong Kong were randomly chosen. Every full-time teacher received a questionnaire and a letter\\u000a describing the purpose of the study. Questionnaires were collected 1 to 3 weeks later. Results: Among 3,100 secondary school teachers, the

Thomas T. W. Chiu; Peggo K. W. Lam

2007-01-01

336

Organization of the upper limb movement for piano key-depression differs between expert pianists and novice players  

Microsoft Academic Search

The present study investigated the expert-novice difference in the organization of upper-limb movement for the key-depression\\u000a on the piano. Kinematic and electromyographic recordings were made while experts (N = 7) and novices (N = 7) of classical-piano players performed a right hand octave keystroke to produce four different sound dynamics. The joint\\u000a torque generated at the key-bottom moment (key-force torque) was also estimated. At

Shinichi Furuya; Hiroshi Kinoshita

2008-01-01

337

Cold induced vasodilatation and cardiovascular responses in humans during cold water immersion of various upper limb areas  

Microsoft Academic Search

To study the physiological responses induced by immersing in cold water various areas of the upper limb, 20 subjects immersed\\u000a either the index finger (T1), hand (T2) or forearm and hand (T3) for 30?min in 5°C water followed by a 15-min recovery period.\\u000a Skin temperature of the index finger, skin blood flow (Qsk) measured by laser Doppler flowmetry, as well

Isabelle Sendowski; Gustave Savourey; Yves Besnard; Jacques Bittel

1997-01-01

338

Amyotrophic lateral sclerosis presenting as upper limb weakness in a 35 year old female: a case report.  

PubMed

Chiropractors regularly assess and provide treatment for a variety of neuromuscular complaints. Many of these respond well to conservative care however some represent conditions that must be referred for further evaluation. This article chronicles the management of a patient who presented with upper limb weakness and was subsequently diagnosed with amyotrophic lateral sclerosis (ALS). Chiropractors should be informed of the nature and presentation of this disease to facilitate early diagnosis and treatment. PMID:21886282

Sigurdson, Leif A

2011-09-01

339

Children with surgically corrected hand deformities and upper limb deficiencies: self-concept and psychological well-being  

Microsoft Academic Search

We studied self-concept and psychological well-being in children with hand deformities and upper limb deficiencies. Ninety-two children, 53 boys, 39 girls, aged 9–11 years were included. The children were divided into two subgroups – one with milder (less visible) deformities and one with severe (more complex and visible) finger–hand–arm deformities. Of the 92 children, 79 had received reconstructive surgery, and

G.-B. Andersson; C. Gillberg; E. Fernell; M. Johansson; A. Nachemson

2011-01-01

340

Skeletal muscle pump versus respiratory muscle pump: modulation of venous return from the locomotor limb in humans  

PubMed Central

The vast majority of quantitative data examining the effects of breathing on venous return have been derived from anaesthetized or reduced animal preparations, making an extrapolation to an upright exercising human problematic due to the lack of a hydrostatic column and an absence of muscular contraction. Thus, this study is the first to quantitatively examine the effects of different breathing mechanics on venous return from the locomotor limbs both at rest and during calf contraction exercise in the semirecumbent human. When subjects inspired using predominantly their ribcage/accessory inspiratory muscles at rest (change in gastric pressure (?PGA) = < 2 cmH2O, change in oesophageal pressure (?PES) =??6 cmH2O; inspiratory time/total breath time (TI/TTOT) = 0.5), a slight facilitation of femoral venous return was observed during inspiration (65% of all flow occurred during inspiration), with a slight reduction in femoral venous return during the ensuing expiratory phase of the breath. However, when subjects inspired using a predominantly diaphragmatic breath at rest (?PGA= > 5 cmH2O, ?PES=??6 cmH2O; TI/TTOT= 0.5), femoral venous return was markedly impeded (net retrograde flow of 11%) and significantly lower than that observed during ribcage breathing conditions (P < 0.01). During the ensuing expiratory phase of a diaphragmatic breath, there was a large resurgence of femoral venous blood flow. The pattern of modulation during ribcage and diaphragmatic breathing persisted during both mild (peak calf force = 7 kg) and moderate (peak calf force = 11 kg) levels of calf contraction. Despite the significant within-breath modulation of femoral venous return by breathing, net blood flow in the steady state was not altered by the breathing pattern followed by the subjects. Though popliteal blood flow appeared to be modulated by respiration at rest, this pattern was absent during mild calf contraction where popliteal outflow was phasic with the concentric phase of calf contraction. We conclude that respiratory muscle pressure production is the predominant factor modulating venous return from the locomotor limb both at rest and during calf contraction even when the veins of the lower limb are distended due to the presence of a physiologic hydrostatic column.

Miller, Jordan D; Pegelow, David F; Jacques, Anthony J; Dempsey, Jerome A

2005-01-01

341

[Neck and upper limb disorders caused by combined exposures to ergonomic risk factors and hand-transmitted vibration].  

PubMed

A review of neck and upper limb disorders caused by combined exposures to hand-transmitted vibration and ergonomic risk factors (repetitiveness, force, posture) suggested the following conclusions: (1) hand-transmitted vibration has a dominant role in the etiopathogenesis of Raynaud's phenomenon and various forms of peripheral neuropathy with sensory impairment (digital, multifocal) in users of vibrating tools; (2) vibration of low frequency and high amplitude from percussive tools concur, together with adverse ergonomic factors, to produce degenerative changes in the bones and joints of the upper limbs, mainly in the wrist and elbow; (3) there is strong epidemiological and experimental evidence that combined exposures to hand-transmitted vibration and physical load are associated with an excess risk of carpal tunned syndrome; (4) there is limited evidence for an association between Dupuytren's contracture and vibration exposure owing to the small number of currently available epidemiological studies; (5) there is insufficient evidence for a contribution of hand-transmitted vibration to the development of chronic pain and clinical syndromes in the neck and upper limb, while excessive physical load and ergonomic stress have a primary role in the etiopathogenesis of these disorders. PMID:19288788

Bovenzi, M; Mauro, M; Ronchese, F; Larese Filon, F

342

Participant perceptions of use of CyWee Z as adjunct to rehabilitation of upper-limb function following stroke.  

PubMed

This article reports on the perceptions of 14 adults with chronic stroke who participated in a pilot study to determine the utility, acceptability, and potential efficacy of using an adapted CyWee Z handheld game controller to play a variety of computer games aimed at improving upper-limb function. Four qualitative in-depth interviews and two focus groups explored participant perceptions. Data were thematically analyzed with the general inductive approach. Participants enjoyed playing the computer games with the technology. The perceived benefits included improved upper-limb function, concentration, and balance; however, six participants reported shoulder and/or arm pain or discomfort, which presented while they were engaged in play but appeared to ease during rest. Participants suggested changes to the games and provided opinions on the use of computer games in rehabilitation. Using an adapted CyWee Z controller and computer games in upper-limb rehabilitation for people with chronic stroke is an acceptable and potentially beneficial adjunct to rehabilitation. The development of shoulder pain was a negative side effect for some participants and requires further investigation. PMID:22773264

Hale, Leigh A; Satherley, Jessica A; McMillan, Nicole J; Milosavljevic, Stephan; Hijmans, Juha M; King, Marcus J

2012-01-01

343

Unilateral lower limb muscle fatigue induces bilateral effects on undisturbed stance and muscle EMG activities.  

PubMed

The study investigated the effects of an unilateral ankle muscle fatigue onto independent postural control parameters including the trajectories of the estimated resultant CoP (CoPres) and his components: the centre of gravity (CG) and CoP-CG trajectories. Nine healthy men realized series of 10 toe-lift immediately followed by 10 knee flexions until exhaustion with one (Ex) leg. Maximal isometric voluntary contractions, postural sway measures of each leg, and muscular activities of the ankle muscles were recorded before and immediately after the fatiguing exercise. As expected, the latter induced a decrease in maximal voluntary peak force associated with a greater variability of the relative contribution of each leg on the CoPres, enhanced all postural parameters of the non-exercised leg. A significant decreased of the tibialis anterior EMG activity for the Ex leg and an increased one for the NoEx leg. Finally, following unilateral fatigue, the body sway destabilisation seemed to occur only along the medio-lateral (ML) axis. The enhanced and greater variability of the variance along ML axis might be explained by the recourse at the loading-unloading strategy choice and suggests a central attempt to compensate for pain sensation. PMID:19879160

Berger, L L; Regueme, S C; Forestier, N

2009-10-29

344

Electrophysiological characterization of upper portion of descending limb of long-looped nephron.  

PubMed

The upper portion of the descending limb of long-looped nephron (LDLu) of the hamster is characterized by high water and ion permeabilities. Although the paracellular route is considered to be the major pathway representing cation permselectivity of this segment, ion transport mechanisms through the transcellular pathway are unknown. To study this issue; we applied cable analysis and conventional microelectrode technique to the hamster LDLu perfused in vitro. The transmural voltage (VT) was not different from zero, and transmural resistance (RT) was very low, 18.3 +/- 2.0 omega.cm2 (n = 12). The basolateral membrane voltage was -80 +/- 2 mV (n = 55), and fractional apical membrane resistance was 0.92 +/- 0.23 (n = 5). Ouabain (0.1 mM) in the bath decreased basolateral membrane voltage (VB) by 23 +/- 3 mV (n = 6, P less than 0.001). Increase in K+ concentration in bath and in lumen from 5 to 50 mM decreased VB by 39 +/- 2 (n = 7, P less than 0.01) and apical membrane voltage (VA) by 10 +/- 1 mV (n = 7, P less than 0.001), respectively. Addition of 2 mM Ba2+ to bath and to lumen decreased VB by -47 +/- 2 (n = 11, P less than 0.001) and decreased VA by 8 +/- 1 mV, respectively. Reduction of HCO3- in bath from 25 to 2.5 mM decreased VB by 4 +/- 1 mV (n = 7, P less than 0.005). Reduction of bath Cl- did not cause any rapid deflection of VB. No appreciable Na+ conductance was detected in the apical membrane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1848045

Yoshitomi, K; Imai, M

1991-03-01

345

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

PubMed

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

Sen, A; Richardson, Stanley

2007-12-01

346

The role of limb torque, muscle action and proprioception during closed kinetic chain rehabilitation of the lower extremity.  

PubMed

This paper defines the differences between open and closed kinetic chain exercise and explains the role of limb torque, muscle action, and proprioception during rehabilitation of the lower extremity. Closed kinetic chain rehabilitation is shown to decrease shear forces, increase proprioception, and increase muscle group coordination through examples of progressive exercises. The authors conclude that closed kinetic chain rehabilitation is an economical, efficient, and effective means of rehabilitation, with the ultimate goal of enhancing proprioception, thus gaining lower extremity joint stability. PMID:16558197

Bunton, E E; Pitney, W A; Cappaert, T A; Kane, A W

1993-01-01

347

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

348

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

PubMed

The purpose of this study was to assess the influence of the work history of the inspiratory muscles upon the fatigue characteristics of the plantar flexors (PF). We hypothesized that under conditions where the inspiratory muscle metaboreflex has been elicited, PF fatigue would be hastened due to peripheral vasoconstriction. Eight volunteers undertook seven test conditions, two of which followed 4 week of inspiratory muscle training (IMT). The inspiratory metaboreflex was induced by inspiring against a calibrated flow resistor. We measured torque and EMG during isometric PF exercise at 85% of maximal voluntary contraction (MVC) torque. Supramaximal twitches were superimposed upon MVC efforts at 1 min intervals (MVC(TI)); twitch interpolation assessed the level of central activation. PF was terminated (T(lim)) when MVC(TI) was <50% of baseline MVC. PF T(lim) was significantly shorter than control (9.93 +/- 1.95 min) in the presence of a leg cuff inflated to 140 mmHg (4.89 +/- 1.78 min; P = 0.006), as well as when PF was preceded immediately by fatiguing inspiratory muscle work (6.28 +/- 2.24 min; P = 0.009). Resting the inspiratory muscles for 30 min restored the PF T(lim) to control. After 4 weeks, IMT, inspiratory muscle work at the same absolute intensity did not influence PF T(lim), but T(lim) was significantly shorter at the same relative intensity. The data are the first to provide evidence that the inspiratory muscle metaboreflex accelerates the rate of calf fatigue during PF, and that IMT attenuates this effect. PMID:16973699

McConnell, Alison K; Lomax, Michelle

2006-09-14

349

Nicolas Andry Award. Increased tissue pressure and its effects on muscle oxygenation in level and elevated human limbs.  

PubMed

Increased tissue pressure is an important cause of local circulatory compromise. In both rabbit and human model systems known external pressures were applied to otherwise normal limbs. Side-by-side comparison of the wick and the infusion techniques revealed that both methods of pressure measurement yielded essentially identical results when tissue pressure was elevated. Measured tissue pressure significantly exceeded the external pressure applied to the limb. Using a mass spectrometer-Teflon membrane catheter system, we monitored muscle PO2 and PCO2 at different applied pressures. Muscle PO2 decreased progressively with increasing tissue pressure but did not approach zero until tissue pressure exceeded local arterial pressure. Comparison of results with level and elevated limbs indicated that elevation of an extremity dramatically lowered its tolerance for increased tissue pressure. Although they may be clinically useful modalities, these are conditions in which compression and elevation have a significant potential for compromising local circulation. PMID:535242

Matsen, F A; Krugmire, R B; King, R V

1979-10-01

350

Non-LTE CO limb emission at 4.7 ? m in the upper atmosphere of Venus, Mars and Earth: Observations and modeling  

Microsoft Academic Search

We report here on CO limb observations in Mars, Venus and Earth and their model simulations. A comparative study of the CO emission, including the most recent spacecraft observations of the three planets’ atmospheres, has been performed. Strong daytime emissions near 4.7?m have been recently observed in the limb of the upper atmosphere of the three terrestrial planets by the

G. Gilli; M. A. López-Valverde; B. Funke; M. López-Puertas; P. Drossart; G. Piccioni; V. Formisano

2011-01-01

351

Histology of the bone-tendon interfaces of limb muscles in lizards.  

PubMed

Lizards exhibit continual bone growth at the epiphysis, and their limb muscles are distributed differently from those of mammals because of differences in weight bearing. We therefore characterized the bone-tendon (B-T) interface (also termed the enthesis) in lizards. Using the forelimbs of five monitor lizards and three iguanas, we performed histological investigations on 57 B-T interfaces. Most reptilian tendons were very short and were often composed of wavy fiber bundles. Fibrocartilage (FC)-mediated direct insertion was observed at all epiphyses, whereas periosteum-mediated indirect insertions, including fleshy attachments, were often located on the flat surfaces of the pectoral girdles and at the diaphyses of the limb bones. The reptilian B-T interface was characterized by variability in the morphology of the FC-mediated insertions, especially by morphologies intermediate between those of FC- and periosteum-mediated interfaces; i.e., 1) various degrees of absence of the clear FC zonation seen in mammals, including the tidemark; 2) involvement of the periosteum in the FC; 3) the presence of various types of FC cells in the tendon near the interface, to reinforce the tendon against compression or shear stress; and 4) both FC and hyaline cartilage (lateral articular cartilage) receiving the tendon at the epiphysis. Overall, variations in the connective tissue, especially the FC tissue, were very evident in the reptilian B-T interface. The specific structures of the interfaces probably represent adaptations to the continuous growth and loose joint structures of lizards. PMID:12201047

Suzuki, Daisuke; Murakami, Gen; Minoura, Nachio

2002-07-01

352

Foot center of pressure manipulation and gait therapy influence lower limb muscle activation in patients with osteoarthritis of the knee  

Microsoft Academic Search

BackgroundFoot center of pressure (COP) manipulation has been associated with improved gait patterns. The purpose of this study was to determine lower limb muscle activation changes in knee osteoarthritis patients, both immediately after COP manipulation and when COP manipulation was combined with continuous gait therapy (AposTherapy).

Yulia Goryachev; Eytan M. Debbi; Amir Haim; Nimrod Rozen; Alon Wolf

2011-01-01

353

Upper-Limb Joint Power and Its Distribution in Spinal Cord Injured Wheelchair Users: Steady-State Self-Selected Speed Versus Maximal Acceleration Trials  

Microsoft Academic Search

Price R, Ashwell ZR, Chang MW, Boninger ML, Koontz AM, Sisto SA. Upper-limb joint power and its distribution in spinal cord injured wheelchair users: steady-state self-selected speed versus maximal acceleration trials.

Robert Price; Zachary R. Ashwell; Michael W. Chang; Michael L. Boninger; Alicia M. Koontz; Sue Ann Sisto

2007-01-01

354

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

Microsoft Academic Search

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

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

2003-01-01

355

The Influence of Wheelchair Propulsion Technique on Upper Extremity Muscle Demand: A Simulation Study  

PubMed Central

Background The majority of manual wheelchair users will experience upper extremity injuries or pain, in part due to the high force requirements, repetitive motion and extreme joint postures associated with wheelchair propulsion. Recent studies have identified cadence, contact angle and peak force as important factors for reducing upper extremity demand during propulsion. However, studies often make comparisons between populations (e.g., able-bodied vs. paraplegic) or do not investigate specific measures of upper extremity demand. The purpose of this study was to use a musculoskeletal model and forward dynamics simulations of wheelchair propulsion to investigate how altering cadence, peak force and contact angle influence individual muscle demand. Methods Forward dynamics simulations of wheelchair propulsion were generated to emulate group-averaged experimental data during four conditions: 1) self-selected propulsion technique, and while 2) minimizing cadence, 3) maximizing contact angle and 4) minimizing peak force using biofeedback. Simulations were used to determine individual muscle mechanical power and stress as measures of muscle demand. Results Minimizing peak force and cadence had the lowest muscle power requirements. However, minimizing peak force increased cadence and recovery power, while minimizing cadence increased average muscle stress. Maximizing contact angle increased muscle stress and had the highest muscle power requirements. Interpretation Minimizing cadence appears to have the most potential for reducing muscle demand and fatigue, which could decrease upper extremity injuries and pain. However, altering any of these variables to extreme values appears to be less effective; instead small to moderate changes may better reduce overall muscle demand.

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

2012-01-01

356

Adult onset asymmetric upper limb tremor misdiagnosed as Parkinson's disease: A clinical and electrophysiological study  

PubMed Central

Summary Approximately 10% of subjects thought clinically to have early Parkinson’s disease (PD) have normal dopaminergic functional imaging (SWEDDs – Scans Without Evidence of Dopaminergic Deficit). SWEDDs are a heterogeneous group. Here we aimed to delineate clinical and electrophysiological characteristics of a distinct subgroup of SWEDDs patients from PD and to clarify the underlying pathophysiology of this subgroup as a form of parkinsonism or dystonia. Therefore we compared clinical details of 25 patients referred with a diagnosis of tremor-dominant PD but with normal DaT SPECT scans (SWEDDs) with 12 tremor-dominant PD patients with abnormal DaT SPECT scans. We performed tremor analysis using accelerometry in the following patients with 1) SWEDDs, 2) PD, 3) primary segmental dystonia with dystonic limb tremor and 4) essential tremor (ET). We used transcranial magnetic stimulation with a facilitatory paired associative stimulation (PAS) paradigm to test if sensorimotor plasticity in SWEDDs resembled the pattern seen in PD, dystonia or ET. Although PD and SWEDDs patients shared several clinical features, the lack of true bradykinesia, occurrence of dystonia, and position- and task-specificity of tremor favoured a diagnosis of SWEDDs, whereas re-emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs as well as presence of nonmotor symptoms made PD more likely. Basic tremor parameters overlapped between SWEDDs, PD, segmental dystonia and ET. However, a combination of re-emergent tremor and highest tremor amplitude in the resting condition was characteristic of PD tremor, while SWEDDs, dystonia and ET subjects had the highest tremor amplitude during action. Both SWEDDs and segmental dystonia patients exhibited an exaggerated pattern of sensorimotor plasticity in response to the PAS paradigm, with spread of excitation to an adjacent hand muscle. In contrast, PD patients showed no response to PAS, and the response of ET patients was no different from controls. Taken together, these results may help differentiate these SWEDDs patients from PD and support our hypothesis that adult-onset dystonia is the underlying diagnosis in this sub-group of patients with SWEDDs.

Schwingenschuh, Petra; Ruge, Diane; Edwards, Mark J; Terranova, Carmen; Katschnig, Petra; Carrillo, Fatima; Silveira-Moriyama, Laura; Schneider, Susanne A; Kagi, Georg; Dickson, John; Lees, Andrew J; Quinn, Niall; Mir, Pablo; Rothwell, John C; Bhatia, Kailash P

2010-01-01

357

Coupling between "hand" primary sensorimotor cortex and lower limb muscles after ulnar nerve surgical transfer in paraplegia.  

PubMed

Previous neuroimaging evidence revealed an "invasion" of "hand" over "lower limb" primary sensorimotor cortex in paraplegic subjects, with the exception of a rare patient who received a surgical motor reinnervation of hip-thigh muscles by the ulnar nerve. Here, the authors show that a functional reorganization of cortico-muscular and cortico-cortical oscillatory coupling was related to the recovery of the rare patient, as a paradigmatic case of long-term plasticity in human sensorimotor cortex after motor reinnervation of paraplegic muscles. This conclusion was based on electroencephalographic and electromyographic data collected while the patient and normal control subjects performed isometric muscle contraction of the left hand or lower limb. Cortico-muscular and cortico-cortical coupling was estimated by electroencephalographic-electromyographic coherence and directed transfer function of a multivariate autoregressive model. PMID:14979799

Babiloni, C; Vecchio, F; Babiloni, F; Brunelli, G A; Carducci, F; Cincotti, F; Pizzella, V; Romani, G L; Tecchio, F T; Rossini, P M

2004-02-01

358

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

359

Gravitoinertial force level affects the appreciation of limb position during muscle vibration.  

PubMed

Illusory motion and displacement of the restrained forearm can be elicited by vibrating the biceps brachii or triceps brachii muscle. We measured the influence of gravitoinertial force level on these perceptual responses to vibration during parabolic flight maneuvers where normal (1G) and high force (1.8G) background levels alternated with microgravity (0G). Subjects indicated the apparent forearm position of the vibrated arm with the other forearm and also made verbal reports. Biceps brachii vibration induced illusory extension of the forearm and triceps brachii, illusory flexion; these apparent motions and displacements were highly G force-dependent being enhanced at 1.8G and diminished at 0G relative to normal 1G force level. These alterations are discussed in terms of vestibulo-spinal and propriospinal influences on alpha-gamma motoneuronal control of muscle tone and the varying requirements for postural load support in different force backgrounds. Their implications for the control and appreciation of limb movements during exposure to different G force levels are also described. PMID:1450908

Lackner, J R; DiZio, P

1992-10-01

360

A New Technique of Upper Eyelid Blepharoplasty Using the Orbicularis Muscle Flap  

Microsoft Academic Search

Background  Blepharoplasty of the upper eyelids is one of the most commonly performed procedures in aesthetic plastic surgery. The orbicularis\\u000a muscle flap technique provides good results for patients with atonic skin and an atonic orbicularis muscle when there is excessive\\u000a fullness in the lateral aspect of the upper lid. This flap also can be used to contain a prominent lacrimal gland

Manfredi Greco; Tiziana Vitagliano; Maria Antonia Fiorillo; Antonio Greto Ciriaco

361

Standardising surface electromyogram recordings for assessment of activity and fatigue in the human upper trapezius muscle  

Microsoft Academic Search

.   The objectives of this work were to determine optimal surface electromyogram (EMG) electrode locations, and inter-electrode\\u000a distance (IED), when assessing activity and fatigue in the human upper trapezius muscle. Surface EMG signals were recorded\\u000a from the upper trapezius muscle of 11 healthy male subjects using a linear array of 16 surface electrodes. Five arm positions\\u000a were investigated (arms at the side

Dario Farina; Pascal Madeleine; Thomas Graven-Nielsen; Roberto Merletti; Lars Arendt-Nielsen

2002-01-01

362

Progression of diabetic retinopathy correlated with muscle perfusion disturbances of the lower limbs, with clinically important diagnostic recommendations  

PubMed Central

Introduction The objective of this study was to investigate the relationship between microvascular and macrovascular disturbances in patients with type 2 diabetes, as shown by results of ophthalmological examination and by vascular and perfusion examinations of the lower limbs. Material and methods A total of 85 patients with type 2 diabetes and an additional cardiovascular risk factor were enrolled in the study. All patients underwent complex ophthalmological examination, including fundus colour photography and fluorescein angiography, and were divided into two groups: group I with signs of diabetic non-proliferative retinopathy (NPDR), and group II with signs of diabetic proliferative retinopathy (P/PDR). After collection of the general medical history and analysis of medical data, patients underwent vascular and muscle perfusion examination of the lower limbs. Results In the P/PDR group, disturbances of lower-limb perfusion were more frequent than in the NPDR group. Analysis of the blood flow and results of lower-limb muscle perfusion for the two groups showed a significant relationship with the severity of microvascular complications observed in examination of the fundus. Conclusions Ophthalmological assessment of the progression of diabetic retinopathy in patients with type 2 diabetes is a reliable indicator of the changes in peripheral vessel systems and perfusion defects in the lower limbs.

Tryniszewski, Wieslaw; Gadzicki, Mariusz; Maziarz, Zbigniew; Kusmierczyk, Jaroslaw; Gos, Roman; Rysz, Jacek; Banach, Maciej

2010-01-01

363

A novel mission concept for upper air water vapour observations: active limb sounding with a constellation of retroreflectors  

NASA Astrophysics Data System (ADS)

The topic for the Alpbach summer school 2010 was "Missions for Understanding Climate Change''. Early career scientists and engineers from many countries formed working groups to devise new space missions to tackle this challenging subject. Following the summer school, one mission concept was chosen for further development at a subsequent workshop in Obergurgl, which is described in this paper. At the core of the mission chosen for further study was a novel active limb-sounding instrument, used as part of a multi-instrument measurement approach to observing upper air water vapour. The concept combines a LiDAR in nadir-viewing mode with a LiDAR in limb sounding by occultation geometry, designed to operate as a multiple discrete wavelength, very long path system for intergrated path differential absorption measurements. This is achieved using a monostatic transmitter-receiver spacecraft flown in formation with multiple spaceborne retroreflectors. Looking through the limb of the atmosphere, this system will sample the upper troposphere-lower stratosphere and above at high vertical resolution, with a long integration path allowing detection of the low concentrations of water vapour at this height. A secondary payload of a medium resolution multispectral radiometer allows wide-swath cloud and aerosol imaging. Active limb sounding has not yet been attempted in space, and this novel concept presents significant challenges, including the performance of the lasers in space, the tracking and locking procedure between the main spacecraft and the retroreflectors, and the design of the telescopes to achieve a high enough signal-to-noise ratio for the high precision measurements. These issues are addressed in this preliminary feasibility study, which shows promising results.

Clifford, D.; Hoffmann, A.; Weitnauer, C.; Topham, R.; Romano, P.; Lohrey, S.; Kox, S.; Krings, T.; Krejci, D.; Kern, K.; Huesing, J.; Esen, B.; Deconinck, F.; Carton, J. G.; Aulinas, J.

2011-12-01

364

Upper and Lower Extremity Muscle Fatigue After a Baseball Pitching Performance  

Microsoft Academic Search

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

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

2005-01-01

365

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

Microsoft Academic Search

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

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

2009-01-01

366

An electromyographic study of strength and upper extremity muscle activity in simulated meat cutting tasks  

Microsoft Academic Search

Meat cutting has long been associated with a high incidence rate of upper extremity musculoskeletal disorders. This study examined upper extremity muscle activities and force exertion capabilities to identify postures which have potential for causing overexertion injuries. Fifteen subjects exerted force against a handle in postures similar to those observed in the meatpacking industry. Exertion level, direction of exertion, handle

Katharyn A. Grant; Daniel J. Habes

1997-01-01

367

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

PubMed Central

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 reports on a novel, user-friendly methodology that allows for the assessment of both signal magnitude and timing variability in upper limb movement trajectories during functional task performance. In order to demonstrate the technique, we report on a study in which the variability in timing and signal magnitude of data collected during the performance of two functional tasks is compared between a group of subjects with stroke and a group of individually matched control subjects. Methods We employ dynamic time warping for curve registration to quantify two aspects of movement variability: 1) variability of the timing of the accelerometer signals' characteristics and 2) variability of the signals' magnitude. Six stroke patients and six matched controls performed several trials of a unilateral ('drinking') and a bilateral ('moving a plate') functional task on two different days, approximately 1 month apart. Group differences for the two variability metrics were investigated on both days. Results For 'drinking from a glass' significant group differences were obtained on both days for the timing variability of the acceleration signals' characteristics (p = 0.002 and p = 0.008 for test and retest, respectively); all stroke patients showed increased signal timing variability as compared to their corresponding control subject. 'Moving a plate' provided less distinct group differences. Conclusion This initial application establishes that movement variability metrics, as determined by our methodology, appear different in stroke patients as compared to matched controls during unilateral task performance ('drinking'). Use of a user-friendly, inexpensive accelerometer makes this methodology feasible for routine clinical evaluations. We are encouraged to perform larger studies to further investigate the metrics' usefulness when quantifying levels of impairment.

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

2009-01-01

368

Upper limb joint kinetics during manual wheelchair propulsion in patients with different levels of spinal cord injury.  

PubMed

The purpose of this study was to compare the forces and moments of the whole upper limb, analyzing forces and moments at the shoulder, elbow and wrist joints simultaneously during manual wheelchair propulsion of persons with different levels of spinal cord injury (SCI) on a treadmill. Fifty-one people participated in this study and were grouped by their level of SCI: C6 tetraplegia (G1), C7 tetraplegia (G2), high paraplegia (G3), and low paraplegia (G4). An inverse dynamic model was defined to compute net joint forces and moments from segment kinematics, the forces acting on the pushrim, and subject anthropometrics. Right side, upper limb kinematic data were collected with four camcorders (Kinescan-IBV). Kinetic data were recorded by replacing the wheels with SmartWheels (Three Rivers Holdings, LLC). All participants propelled the wheelchair at 3km/h for 1min. The most noteworthy findings in both our tetraplegic groups in relation to paraplegic groups were increased superior joint forces in the shoulder (G1 and G2 vs G3 p<0.001; G1 and G2 vs G4 p<0.01), elbow (G1 vs G3 p<0.001; G1 vs G4 p<0.05) and wrist (G1 vs G4 p<0.001), an increased adduction moment in the shoulder (G1 vs G3 p<0.001; G1 vs G4 p<0.01; G2 vs G3 and G4 p<0.05) and the constancy of the moments of force of the wrist the fact that they reached their lowest values in the tetraplegic groups. This pattern may increase the risk of developing upper limb overuse injuries in tetraplegic subjects. PMID:20541760

Gil-Agudo, Angel; Del Ama-Espinosa, Antonio; Pérez-Rizo, Enrique; Pérez-Nombela, Soraya; Pablo Rodríguez-Rodríguez, Luis

2010-06-11

369

Combined medical, surgical and endovascular treatment of a giant cell arteritis case manifesting as upper limbs acute ischemia  

PubMed Central

We report a case of giant cell arteritis manifesting as upper limbs ischemia due to a complete occlusion of the left subclavian artery and a high grade stenosis of the right subclavian artery. We decided to use a combined medical, surgical and endovascular treatment followed by long term treatment with methotrexate. After 4 years the patient had no signs or symptoms of relapse. In our personal experience long term treatment with Methotrexate demonstrated a certain efficacy in avoiding relapse of the inflammatory phase and in maintaining stability of results in this kind of disease.

de Franciscis, Stefano; Roscitano, Giuseppe; Serra, Raffaele; Buffone, Gianluca; Cotroneo, Attilio; de Franciscis, Andrea; Mastrangelo, Diego; Spinelli, Francesco

2011-01-01

370

Brain network involved in visual processing of movement stimuli used in upper limb robotic training: an fMRI study  

PubMed Central

Background The potential of robot-mediated therapy and virtual reality in neurorehabilitation is becoming of increasing importance. However, there is limited information, using neuroimaging, on the neural networks involved in training with these technologies. This study was intended to detect the brain network involved in the visual processing of movement during robotic training. The main aim was to investigate the existence of a common cerebral network able to assimilate biological (human upper limb) and non-biological (abstract object) movements, hence testing the suitability of the visual non-biological feedback provided by the InMotion2 Robot. Methods A visual functional Magnetic Resonance Imaging (fMRI) task was administered to 22 healthy subjects. The task required observation and retrieval of motor gestures and of the visual feedback used in robotic training. Functional activations of both biological and non-biological movements were examined to identify areas activated in both conditions, along with differential activity in upper limb vs. abstract object trials. Control of response was also tested by administering trials with congruent and incongruent reaching movements. Results The observation of upper limb and abstract object movements elicited similar patterns of activations according to a caudo-rostral pathway for the visual processing of movements (including specific areas of the occipital, temporal, parietal, and frontal lobes). Similarly, overlapping activations were found for the subsequent retrieval of the observed movement. Furthermore, activations of frontal cortical areas were associated with congruent trials more than with the incongruent ones. Conclusions This study identified the neural pathway associated with visual processing of movement stimuli used in upper limb robot-mediated training and investigated the brain’s ability to assimilate abstract object movements with human motor gestures. In both conditions, activations were elicited in cerebral areas involved in visual perception, sensory integration, recognition of movement, re-mapping on the somatosensory and motor cortex, storage in memory, and response control. Results from the congruent vs. incongruent trials revealed greater activity for the former condition than the latter in a network including cingulate cortex, right inferior and middle frontal gyrus that are involved in the go-signal and in decision control. Results on healthy subjects would suggest the appropriateness of an abstract visual feedback provided during motor training. The task contributes to highlight the potential of fMRI in improving the understanding of visual motor processes and may also be useful in detecting brain reorganisation during training.

2012-01-01

371

Upper-Lip Augmentation by Graft of Preseptal Orbicularis Oculi Muscle Through Blepharoplasty  

Microsoft Academic Search

Background  Upper-lip augmentation is used to enhance a thin upper lip or correct lip deficiencies or senile hypotrophy. We describe an\\u000a easy, effective, and reproducible technique.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We use two preseptal orbicularis oculi muscle grafts that provide a reliable option for soft-tissue upper-lip augmentation,\\u000a with improved vertical lip height and lateral lip projection and reappearance of the Cupid’s bow. Muscle grafts are

Mauro Tarallo; Cristiano Monarca; Maria Ida Rizzo; Nicolò Scuderi

2010-01-01

372

An investigation of the potential of the high-resolution dynamics limb sounder for upper tropospheric and lower stratospheric ozone and water vapour measurements: a minimum performance scenario  

Microsoft Academic Search

A challenge for the next generation of satellite instruments is to observe the upper troposphere and lower stratosphere. Amongst the many species of significance, ozone and water vapour in the upper troposphere present particular problems due to steep gradients in mixing ratio at the tropopause. The High Resolution Dynamics Limb Sounder (HIRDLS), due to fly on EOS-CHEM in 2003, will

J. J. Remedios; J. C. Gille; J. J. Barnett

2001-01-01

373

Phantom pain and phantom sensations in upper limb amputees: an epidemiological study  

Microsoft Academic Search

Phantom pain in subjects with an amputated limb is a well-known problem. However, estimates of the prevalence of phantom pain differ considerably in the literature. Various factors associated with phantom pain have been described including pain before the amputation, gender, dominance, and time elapsed since the amputation. The purposes of this study were to determine prevalence and factors associated with

Carolien M. Kooijman; Pieter U. Dijkstra; Jan H. B. Geertzen; Albert Elzinga; Cees P. van der Schans

2000-01-01

374

A Gaussian mixture model based classification scheme for myoelectric control of powered upper limb prostheses  

Microsoft Academic Search

This paper introduces and evaluates the use of Gaussian mixture models (GMMs) for multiple limb motion classification using continuous myoelectric signals. The focus of this work is to optimize the configuration of this classification scheme. To that end, a complete experimental evaluation of this system is conducted on a 12 subject database. The experiments examine the GMMs algorithmic issues including

Yonghong Huang; Kevin B. Englehart; Bernard Hudgins; Adrian D. C. Chan

2005-01-01

375

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

376

Effect of muscle fatigue on the sense of limb position and movement.  

PubMed

We have recently shown that in an unsupported forearm-matching task blindfolded human subjects are able to achieve an accuracy of 2-3 degrees . If one arm was exercised to produce significant fatigue and the matching task was repeated, it led subjects to make position-matching errors. Here that result is confirmed using fatigue from a simple weight-lifting exercise. A 30% drop in maximum voluntary force after the exercise was accompanied by a significant matching error of 1.7 degrees in the direction of extension when the reference arm had been fatigued, and 1.9 degrees in the direction of flexion when the indicator arm had been fatigued. We also tested the effect of fatigue on a simple movement tracking task where the reference forearm was moved into extension at a range of speeds from 10 to 50 degrees s(-1). Fatigue was found not to significantly reduce the movement-tracking accuracy. In a second experiment, movement tracking was measured while one arm was vibrated. When it was the reference arm, the subject perceived the movement to be significantly faster (3.7 degrees s(-1)) than it actually was. When it was the indicator, it was perceived to be slower (4.6 degrees s(-1)). The data supports the view that muscle spindles are responsible for the sense of movement, and that this sense is not prone to the disturbance from fatigue. By contrast, the sense of position can be disturbed by muscle fatigue. It is postulated, that the sense of effort experienced by holding the arm against the force of gravity is able to provide information about the position in space of the limb and that the increased effort from fatigue produces positional errors. PMID:16328298

Allen, T J; Proske, U

2005-11-17

377

Multi-Class SVM Classification of Surface EMG Signal for Upper Limb Function  

Microsoft Academic Search

Electromyography (EMG) signal is electrical manifestation of neuromuscular activation, that provides access to physiological processes which cause the muscle to generate force and produce movement and allow us to interact with the world. In this paper, an identification of six degree of freedom for evaluating and recording physiologic properties of muscles of the forearm at rest and while contracting is

Navleen Singh Rekhi; Ajat Shatru Arora; S. Singh; D. Singh

2009-01-01

378

Construction of efficacious gait and upper limb functional interventions based on brain plasticity evidence and model-based measures for stroke patients.  

PubMed

For neurorehabilitation to advance from art to science, it must become evidence-based. Historically, there has been a dearth of evidence from which to construct rehabilitation interventions that are properly framed, accurately targeted, and credibly measured. In many instances, evidence of treatment response has not been sufficiently robust to demonstrate a change in function that is clinically, statistically, and economically important. Research evidence of activity-dependent central nervous system (CNS) plasticity and the requisite motor learning principles can be used to construct an efficacious motor recovery intervention. Brain plasticity after stroke refers to the regeneration of brain neuronal structures and/or reorganization of the function of neurons. Not only can CNS structure and function change in response to injury, but also, the changes may be modified by "activity". For gait training or upper limb functional training for stroke survivors, the "activity" is motor behavior, including coordination and strengthening exercise and functional training that comprise motor learning. Critical principles of motor learning required for CNS activity-dependent plasticity include: close-to-normal movements, muscle activation driving practice of movement; focused attention, repetition of desired movements, and training specificity. The ultimate goal of rehabilitation is to restore function so that a satisfying quality of life can be experienced. Accurate measurement of dysfunction and its underlying impairments are critical to the development of accurately targeted interventions that are sufficiently robust to produce gains, not only in function, but also in quality of life. The Classification of Functioning, Disability, and Health Model (ICF) model of disablement, put forth by the World Health Organization, can provide not only some guidance in measurement level selection, but also can serve as a guide to incorporate function and quality of life enhancement as the ultimate goals of rehabilitation interventions. Based on the evidence and principles of activity-dependent plasticity and motor learning, we developed gait training and upper limb functional training protocols. Guided by the ICF model, we selected and developed measures with characteristics rendering them most likely to capture change in the targeted aspects of intervention, as well as measures having membership not only in the impairment, but also in the functional or life role participation levels contained in the ICF model. We measured response to innovative gait training using a knee flexion coordination measure, coefficient of coordination consistency (ACC) of relative hip/knee (H/K) movement across multiple steps (H/K ACC), and milestones of participation in life role activities. We measured response to upper limb functional training according to measures designed to quantify functional gains in response to treatment targeted at wrist/hand or shoulder elbow training (Arm Motor Ability Test for wrist/hand (AMAT W/H) or shoulder/elbow (AMAT S/E)). We found that there was a statistically significant advantage for adding FES-IM gait training to an otherwise comparable and comprehensive gait training, according to the following measures: H/K ACC, the measure of consistently executed hip/knee coordination during walking; a specific measure of isolated joint knee flexion coordination; and a measure of multiple coordinated gait components. Further, enhanced gains in gait component coordination were robust enough to result in achievement of milestones in participation in life role activities. In the upper limb functional training study, we found that robotics + motor learning (ROB ML; shoulder/elbow robotics practice plus motor learning) produced a statistically significant gain in AMAT S/E; whereas functional electrical stimulation + motor learning (FES ML) did not. We found that FES ML (wrist/hand FES plus motor learning) produced a statistically significant gain in AMAT W/H; whereas ROB ML did not. These results together, support the phenome

Daly, Janis J; Ruff, Robert L

2007-12-20

379

A delayed diagnosis that altered the professional orientation of an athlete with upper limb chronic arterial embolization  

PubMed Central

Summary Background Vascular disorders of the upper extremity in young and physically active patients present a complex and challenging problem for the treating physician. Initial presentation may often be subtle and the consequences of misdiagnosis, delayed diagnosis or mistreatment can be severe. Case Report In this report, we discuss a case of a young woman with chronic upper limb ischemia due to an arterial thoracic outlet syndrome in whom even though symptoms persisted over a number of years during which she frequently sought medical consultation, remained undiagnosed until finally presenting with limb-threatening ischemia. Furthermore, due to this delay, the patient was forced to withdraw from her professional carrier in athletics. Conclusions A thoughtful and through approach combining the history, physical findings, and use of appropriate diagnostic aids will provide the physician and patient with the greatest opportunity for a satisfactory outcome. Furthermore, a delay in definitive treatment may not only cause health deterioration, but may also incur social, economic and occupational consequences.

Ioannou, Christos V.; Kafetzakis, Alexandros; Kounnos, Christos; Koukoumtzis, Dimitris; Tavlas, Emmanuel; Kostas, Theodoros

2012-01-01

380

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

PubMed

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

Lavatelli, Ivan; Schaub, Karlheinz; Caragnano, Gabriele

2012-01-01

381

Differences in exercise limb blood flow and muscle deoxygenation with age: contributions to O 2 uptake kinetics  

Microsoft Academic Search

The adjustments of pulmonary oxygen uptake $$ \\\\left( {\\\\mathop {{V}}\\\\limits^{ \\\\cdot } {\\\\text{O}}_{{2\\\\,{\\\\text{p}}}} } \\\\right), $$ limb blood flow (LBF) and muscle deoxygenation (?HHb) were examined during transitions to moderate-intensity, knee-extension\\u000a exercise in seven older (OA; 71 ± 7 year) and seven young (YA; 26 ± 3 year) men. YA and OA performed repeated step transitions\\u000a from an active baseline (3 W; 100 g) to a similar relative

Gregory R. duManoir; Darren S. DeLorey; John M. Kowalchuk; Donald H. Paterson

2010-01-01

382

Enhanced Generation of Reactive Oxygen Species in the Limb Skeletal Muscles From a Murine Infarct Model of Heart Failure  

Microsoft Academic Search

Background—The generation of reactive oxygen species (ROS) is enhanced in the failing myocardium. We hypothesized that ROS were also increased in the limb skeletal muscles in heart failure. Methods and Results—Myocardial infarction (MI) was created in mice by ligating the left coronary artery. After 4 weeks, the left ventricle was dilated and contractility was diminished by echocardiography. Left ventricular end-diastolic

Hiroyuki Tsutsui; Tomomi Ide; Shunji Hayashidani; Nobuhiro Suematsu; Tetsuya Shiomi; Jing Wen; Kei-ichiro Nakamura; Kazuhiro Ichikawa; Hideo Utsumi; Akira Takeshita

383

Basement Membrane Remodeling in Skeletal Muscles of Patients with Limb Ischemia Involves Regulation of Matrix Metalloproteinases and Tissue Inhibitor of Matrix Metalloproteinases  

Microsoft Academic Search

Background\\/Aim: Because the pericapillary basement membrane in skeletal muscles of patients with chronic critical limb ischemia (CLI) is thickened, we determined the expression patterns of genes involved in collagen metabolism, using samples from 9 CLI patients, 4 patients with acute limb ischemia and 4 healthy controls. Methods: Gene array analysis, quantitative RT-PCR and semiquantitative grading of immunohistochemical reactivity were performed

Oliver Baum; Murielle Ganster; Iris Baumgartner; Kay Nieselt; Valentin Djonov

2007-01-01

384

Body Structures and Physical Complaints in Upper Limb Reduction Deficiency: A 24-Year Follow-Up Study  

PubMed Central

Objective To describe upper body structures associated with upper limb reduction deficiency and the development of these structures over time, to examine the presence of physical complaints in this population, and to compare body structures and complaints between groups based on prosthesis use. Design Prospective cohort study with a follow-up period of 24 years, with matched able-bodied controls. Subjects Twenty-eight patients with unilateral below-elbow reduction deficiency fitted with myoelectric prostheses, aged 8–18 years at inclusion. Method Measurements of upper arm, trunk and spine were performed and study-specific questionnaires were answered at baseline and follow-up; the Brief Pain Inventory and the Quick Disability of Arm, Shoulder, and Hand questionnaires were answered at follow-up. Results Both at baseline and follow-up, within-subjects differences in structures of the arm and trunk were shown in patients but not in controls. Spinal deviations, although small, were greater in patients compared to controls. Self-reported disability was higher in patients compared to controls. Differences in back pain and effect of prostheses use could not be shown. Conclusions Patients with unilateral below-elbow reduction deficiency have consistent differences in upper body structures. Deviations of the spine, probably of functional origin, do not progress to clinically relevant scoliosis.

Postema, Sietke G.; van der Sluis, Corry K.; Waldenlov, Kristina; Norling Hermansson, Liselotte M.

2012-01-01

385

Effects of Qigong Exercise on Upper Limb Lymphedema and Blood Flow in Survivors of Breast Cancer: A Pilot Study.  

PubMed

Hypothesis. Qigong exercise is a popular method for relieving the side effects of conventional cancer treatments in survivors of breast cancer, yet its effects are not empirically assessed. This study aimed to investigate the effects of qigong exercise on upper limb lymphedema, arterial resistance, and blood flow velocity in survivors with breast cancer and mastectomy. STUDY DESIGN: This study was conducted as a prospective clinical trial. METHODS: Eleven survivors of breast cancer with qigong experience (mean age = 58.3 ± 10.1 years) were assigned to the experimental group and 12 survivors of breast cancer without qigong experience (mean age = 53.8 ± 4.2 years) were assigned to the control group. They all had breast cancer-related lymphedema. All procedures were completed within one session. After baseline measurements were taken, the experimental group performed 18 Forms Tai Chi Internal Qigong for approximately 6 minutes while the control group rested for similar duration in a sitting position. Both groups were then reassessed. All participants were measured on their affected upper limb circumference (by using tape measures), peripheral arterial resistance, and blood flow velocities (using a Doppler ultrasound machine). RESULTS: The between-group differences were not significant for all outcome measures at baseline (P > .05). The circumferences of the affected upper arm, elbow, forearm and wrist decreased after qigong exercise (P < .05). However, no significant difference was found in the circumference measures between the 2 groups posttest (P > .0125). In terms of vascular outcomes, the resistance index decreased and the maximum systolic arterial blood flow velocity (SV) and minimum diastolic arterial blood flow velocity (DV) increased significantly after qigong exercise (P < .05). The between-group difference was close to significant for SV (P = .018) and was significant for DV (P < .001) posttest. CONCLUSION: Qigong exercise could reduce conventional cancer therapy side effects such as upper limb lymphedema and poor circulatory status in survivors of breast cancer. However, such effects may be temporary, and further studies must be conducted to explore longer term effects. PMID:23749481

Fong, Shirley S M; Ng, Shamay S M; Luk, W S; Chung, Joanne W Y; Ho, Jacqueline S C; Ying, Michael; Ma, Ada W W

2013-06-01

386

Tomographic Limb-Sounding of the Upper Troposphere and Lower Stratosphere  

NASA Astrophysics Data System (ADS)

The UTLS region is characterised by large vertical and horizontal gradients in trace gases such as O3 and H2O. Limb-sounding naturally provides products with high vertical resolution, but is sometimes criticised for its lack of horizontal resolution. Traditionally, limb-sounding retrievals assume the atmosphere to be spherically-symmetric so, at best, the retrieved profiles represent line-of-sight averages over horizontal structure in the true field. For 1-2 km thick layers, this averaging distance is ~200-300 km, which compares unfavourably with the horizontal resolution of nadir-sounding and does not satisfy contemporary requirements for UTLS research (eg stratosphere-troposphere exchange) or numerical weather prediction. The MASTER (Millimetre-wave Acquisitions for Stratosphere-Troposphere Exchange Research) instrument concept, developed by ESA, is designed to specifically address this limitation by viewing along-track and at a limb-scan spacing small enough for the horizontal structure wihin each tangent-layer to be over-sampled and each air-mass to be viewed from many different directions. A tomographic approach to obtain improved horizontal resolution is then feasible, provided that radiative transfer can be modelled accurately and efficiently in 2-D and that multiple limb-scans can be employed simultaneously to retrieve 2-D fields. In order to examine this approach, a state-of-the-art 2-D radiative transfer model and retrieval model have been developed and used in realistic simulation experiments for MASTER. This paper outlines the methodology and presents preliminary results for water vapour, ozone and other trace gases.

Reburn, W. J.; Jay, V. L.; Siddans, R.; Kerridge, B. J.

2003-04-01

387

A homeo-paired domain-binding motif directs Myf5 expression in progenitor cells of limb muscle.  

PubMed

Recruitment of multipotent mesodermal cells to the myogenic lineage is mediated by the transcription factor Myf5, the first of the myogenic regulatory factors to be expressed in most sites of myogenesis in the mouse embryo. Among numerous elements controlling the spatiotemporal pattern of Myf5 expression, the -58/-56 kb distal Myf5 enhancer directs expression in myogenic progenitor cells in limbs and in somites. Here, we show by site-directed mutagenesis within this enhancer that a predicted homeobox adjacent to a putative paired domain-binding site is required for the activity in muscle precursor cells in limbs and strongly contributes to expression in somites. By contrast, predicted binding sites for Tcf/Lef, Mef3 and Smad transcription factors play no apparent role for the expression in limbs but might participate in the control in somites. A 30mer oligonucleotide sequence containing and surrounding the homeo and paired domain-binding motifs directs faithful expression in myogenic cells in limbs and also enhances myotomal expression in somites. Pax3 and Meox2 transcription factors can bind to these consensus sites in vitro and therefore constitute potential regulators. However, genetic evidence in the Meox2-deficient mouse mutant argues against a role for Meox2 in the regulation of Myf5 expression. The data presented here demonstrate that a composite homeo and paired domain-binding motif within the -58/-56 enhancer is required and sufficient for activation of the Myf5 gene in muscle progenitor cells in the limb. Although Pax3 constitutes a potential cognate transcription factor for the enhancer, it fails to transactivate the site in transfection experiments. PMID:17301086

Buchberger, Astrid; Freitag, Diana; Arnold, Hans-Henning

2007-02-14

388

Metabolic and Structural Changes in Lower-Limb Skeletal Muscle Following Neuromuscular Electrical Stimulation: A Systematic Review  

PubMed Central

Background Transcutaneous neuromuscular electrical stimulation (NMES) can be applied as a complementary intervention to regular exercise training programs. A distinction can be made between high-frequency (HF) NMES and low-frequency (LF) NMES. In order to increase understanding of the mechanisms of functional improvements following NMES, the purpose of this study was to systematically review changes in enzyme activity, muscle fiber type composition and muscle fiber size in human lower-limb skeletal muscles following only NMES. Methods Trials were collected up to march 2012 and were identified by searching the Medline/PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL and The Physical Therapy Evidence Database (PEDro) databases and reference lists. 18 trials were reviewed in detail: 8 trials studied changes in enzyme activities, 7 trials studied changes in muscle fiber type composition and 14 trials studied changes in muscle fiber size following NMES. Results The methodological quality generally was poor, and the heterogeneity in study design, study population, NMES features and outcome parameters prohibited the use of meta-analysis. Most of the LF-NMES studies reported significant increases in oxidative enzyme activity, while the results concerning changes in muscle fiber composition and muscle size were conflicting. HF-NMES significantly increased muscle size in 50% of the studies. Conclusion NMES seems to be a training modality resulting in changes in oxidative enzyme activity, skeletal muscle fiber type and skeletal muscle fiber size. However, considering the small sample sizes, the variance in study populations, the non-randomized controlled study designs, the variance in primary outcomes, and the large heterogeneity in NMES protocols, it is difficult to draw definitive conclusions about the effects of stimulation frequencies on muscular changes.

Sillen, Maurice J. H.; Franssen, Frits M. E.; Gosker, Harry R.; Wouters, Emiel F. M.; Spruit, Martijn A.

2013-01-01

389

Contraction-based variations in upper limb EMG-force models under isometric conditions.  

PubMed

In this work, a previously developed model, which maps joint kinematic data and estimated muscle activation levels to net elbow joint torque, is trained with 4 groups of datasets in order to improve force estimation accuracy and gain insight into muscle behaviour. The training datasets are defined such that surface electromyogram (EMG) and force data are grouped within individual trials, across trials, within force levels and across force levels, and model performance is assessed. Average evaluation error ranged between 5% and 15%, with the lowest error observed for models trained with datasets grouped within separate force levels. Model error is further reduced when training datasets are grouped across data collection trials. Therefore, more accurate estimation of elbow joint behaviour can be accomplished by taking into account the functional requirements of muscle, and allowing for separate models to be developed accordingly. PMID:19963545

Mountjoy, Katherine; Morin, Evelyn; Hashtrudi-Zaad, Keyvan

2009-01-01

390

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

391

CARDIAC PATHOLOGY EXCEEDS SKELETAL MUSCLE PATHOLOGY IN TWO CASES OF LIMB-GIRDLE MUSCULAR DYSTROPHY TYPE 2I  

PubMed Central

Limb-girdle muscular dystrophy type 2I (LGMD-2I) is caused by mutations in fukutin-related protein gene (FKRP) that lead to abnormal glycosylation of ?-dystroglycan in skeletal muscle. Heart involvement in LGMD-2I is common, but little is known about underlying cardiac pathology. Here, we describe two patients with LGMD-2I (homozygous FKRP mutation c.826C>A, p.Leu276Ile) who developed severe congestive heart failure requiring cardiac transplantation. The dystrophic pathology and impairment of ?-dystroglycan glycosylation were severe in the heart but mild in the skeletal muscle, underscoring the lack of correlation between cardiac and skeletal muscle involvement in some LGMD-2I patients.

Margeta, Marta; Connolly, Anne M.; Winder, Thomas L.; Pestronk, Alan; Moore, Steven A.

2010-01-01

392

Electrical activity and relative length changes of dog limb muscles as a function of speed and gait.  

PubMed

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 of energy within a stride: a 'pendulum-like' mechanism during a walk, and a 'spring-like' mechanism during a run. In the stance phase of the walking dog, we found that the supraspinatus, long head of the triceps brachii, biceps brachii, vastus lateralis, and gastrocnemius underwent only minor length changes during a relatively long portion of their activity, Thus, a major part of their activity during the walk seems consistent with a role in stabilization of the joints as the dog 'pole-vaulted' over its limbs (and thereby conserved energy). In the stance phase of trotting and/or galloping dogs, we found that the supraspinatus, lateral head of the triceps, vastus lateralis, and gastrocnemius were active while being stretched prior to shortening (as would be required for elastic storage of energy), and that this type of activity increased with increasing speed. We also found muscular activity in the select limb flexors that was consistent with storage of kinetic energy at the end of the swing phase and recovery during the propulsive stroke. This activity pattern was apparent in the latissimus dorsi during a walk and trot, and in the biceps femoris during a trot and gallop. We conclude that, during locomotion, a significant fraction of the electrical activity of a number of limbs muscles occurs while they undergo little or no length change or are being stretched prior to shortening and that these types of activities occur in a manner that would enable the operation of pendulum-like and spring-like mechanisms for conserving energy within a stride. Therefore these forms of muscular activity, in addition to the more familiar activity associated with muscle shortening, should be considered to be important during locomotion. PMID:7310312

Goslow, G E; Seeherman, H J; Taylor, C R; McCutchin, M N; Heglund, N C

1981-10-01

393

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

394

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

395

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

396

An investigation of the reliability of Rapid Upper Limb Assessment (RULA) as a method of assessment of children's computing posture.  

PubMed

Rapid Upper Limb Assessment (RULA) is a quick observation method of posture analysis. RULA has been used to assess children's computer-related posture, but the reliability of RULA on a paediatric population has not been established. The purpose of this study was to investigate the inter-rater and intra-rater reliability of the use of RULA with children. Video recordings of 24 school children were independently viewed by six trained raters who assessed their postures using RULA, on two separate occasions. RULA demonstrated higher intra-rater reliability than inter-rater reliability although both were moderate to good. RULA was more reliable when used for assessing the older children (8-12 years) than with the younger children (4-7 years). RULA may prove useful as part of an ergonomic assessment, but its level of reliability warrants caution for its sole use when assessing children, and in particular, younger children. PMID:22018838

Dockrell, Sara; O'Grady, Eleanor; Bennett, Kathleen; Mullarkey, Clare; Mc Connell, Rachel; Ruddy, Rachel; Twomey, Seamus; Flannery, Colleen

2011-10-20

397

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

398

Current evaluation of hydraulics to replace the cable force transmission system for body-powered upper-limb prostheses.  

PubMed

Present body-powered upper-limb prostheses use a cable control system employing World War II aircraft technology to transmit force from the body to the prosthesis for operation. The cable and associated hardware are located outside the prosthesis. Because individuals with arm amputations want prostheses that are natural looking with a smooth, soft outer surface, a design and development project was undertaken to replace the cable system with hydraulics located inside the prosthesis. Three different hydraulic transmission systems were built for evaluation, and other possibilities were explored. Results indicate that a hydraulic force transmission system remains an unmet challenge as a practical replacement for the cable system. The author was unable to develop a hydraulic system that meets the necessary dynamic requirements and is acceptable in size and appearance. PMID:10149042

LeBlanc, M

1990-01-01

399

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

PubMed

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

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

2012-07-27

400

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

401

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

402

Degeneration of the Injured Cervical Cord Is Associated with Remote Changes in Corticospinal Tract Integrity and Upper Limb Impairment  

PubMed Central

Background Traumatic spinal cord injury (SCI) leads to disruption of axons and macroscopic tissue loss. Using diffusion tensor imaging (DTI), we assessed degeneration of the corticospinal tract (CST) in the cervical cord above a traumatic lesion and explored its relationship with cervical atrophy, remote axonal changes within the cranial CST and upper limb function. Methods Nine cervical injured volunteers with bilateral motor and sensory impairment and ten controls were studied. DTI of the cervical cord and brain provided measurements of fractional anisotropy (FA), while anatomical MRI assessed cross-sectional spinal cord area (i.e. cord atrophy). Spinal and central regions of interest (ROI) included the bilateral CST in the cervical cord and brain. Regression analysis identified correlations between spinal FA and cranial FA in the CST and disability. Results In individuals with SCI, FA was significantly lower in both CSTs throughout the cervical cord and brain when compared with controls (p?0.05). Reduced FA of the cervical cord in patients with SCI was associated with smaller cord area (p?=?0.002) and a lower FA of the cranial CST at the internal capsule level (p?=?0.001). Lower FA in the cervical CST also correlated with impaired upper limb function, independent of cord area (p?=?0.03). Conclusion Axonal degeneration of the CST in the atrophic cervical cord, proximal to the site of injury, parallels cranial CST degeneration and is associated with disability. This DTI protocol can be used in longitudinal assessment of microstructural changes immediately following injury and may be utilised to predict progression and monitor interventions aimed at promoting spinal cord repair.

Nagy, Zoltan; Hutton, Chloe; Weiskopf, Nikolaus; Friston, Karl; Wheeler-Kingshott, Claudia A.; Thompson, Alan J.

2012-01-01

403

Exploring the bases for a mixed reality stroke rehabilitation system, Part II: Design of Interactive Feedback for upper limb rehabilitation  

PubMed Central

Background Few existing interactive rehabilitation systems can effectively communicate multiple aspects of movement performance simultaneously, in a manner that appropriately adapts across various training scenarios. In order to address the need for such systems within stroke rehabilitation training, a unified approach for designing interactive systems for upper limb rehabilitation of stroke survivors has been developed and applied for the implementation of an Adaptive Mixed Reality Rehabilitation (AMRR) System. Results The AMRR system provides computational evaluation and multimedia feedback for the upper limb rehabilitation of stroke survivors. A participant's movements are tracked by motion capture technology and evaluated by computational means. The resulting data are used to generate interactive media-based feedback that communicates to the participant detailed, intuitive evaluations of his performance. This article describes how the AMRR system's interactive feedback is designed to address specific movement challenges faced by stroke survivors. Multimedia examples are provided to illustrate each feedback component. Supportive data are provided for three participants of varying impairment levels to demonstrate the system's ability to train both targeted and integrated aspects of movement. Conclusions The AMRR system supports training of multiple movement aspects together or in isolation, within adaptable sequences, through cohesive feedback that is based on formalized compositional design principles. From preliminary analysis of the data, we infer that the system's ability to train multiple foci together or in isolation in adaptable sequences, utilizing appropriately designed feedback, can lead to functional improvement. The evaluation and feedback frameworks established within the AMRR system will be applied to the development of a novel home-based system to provide an engaging yet low-cost extension of training for longer periods of time.

2011-01-01

404

DEVELOPMENT OF THE NEUROMUSCULAR JUNCTION: II. Cytological and Cytochemical Studies on the Neuromuscular Junction of Dedifferentiating Muscle in the Regenerating Limb of the Newt Triturus  

Microsoft Academic Search

Following amputation of the limb of the newt, Triturus viridescens, muscle fibers dedifferenti- ate giving rise to mesenchymal cells . The earliest changes detected in neuromuscular junc- tions of dedifferentiating muscle fibers are the appearance of a few vacuoles and decrease in density of the terminal axoplasm . Later, synaptic vesicles become tightly clustered in the axon termination, and their

THOMAS L. LENTZ

1970-01-01

405

Age- and sex-related differences in force-velocity characteristics of upper and lower limbs of competitive adolescent swimmers.  

PubMed

While there is a direct relationship between maximal anaerobic power (Pmax) and swimming performance, the relationship between upper and lower limbs with regard to Pmax and force-velocity (F-v) characteristics is not clear. The aim of the present study was to examine the effect of age and sex on the ratios of mechanical characteristics between upper and lower extremities of adolescent swimmers. Seventeen girls (aged 14.7±1.8 yr) (mean±standard deviation) and 28 boys (14.6±1.4 yr), all members of competitive swimming clubs, performed a F-v test for both legs and arms. In legs, boys had higher values of Pmax (t43=2.4, p<0.05), Pmax expressed in relative to body mass values (rPmax, t43=3.4, p<0.01) and v0 (t43=4.3, p<0.001), while no differences were found for F0 (t43=1.0, p=0.31) and v0/F0 (t43=0.55, p=0.59). In arms, boys had higher values of Pmax (t43=3.2, p<0.01), rPmax (t43=3.9, p<0.001) and v0 (t43=3.4, p<0.01), while no differences were found for F0 (t43=1.9, p=0.06) and v0/F0 (t43=0.16, p=0.87). However, no sex difference was found with regard to the ratios of Pmax (t43=1.9, p=0.06), F0 (t43=1.2, p=0.23) and v0 (t43=1.3, p=0.20) between upper and lower extremities. There was direct relationship between age and Pmax of legs (r=0.64, p<0.01 in girls; r=0.43, p<0.05 in boys) and arms (r=0.56, p<0.05; r=0.57, p<0.01 respectively), while there was not any significant association between age and the ratios of mechanical characteristics of upper and lower limbs. These findings emphasize the need for separate evaluation of arms' and legs' force-velocity characteristics on a regular basis and the consideration of these measures in training design. PMID:23487511

Nikolaidis, Pantelis Theo

2012-05-30

406

ROBOT-MEDIATED UPPER LIMB PHYSIOTHERAPY FOR PATIENTS WITH SPASTIC HEMIPARESIS: A PRELIMINARY STUDY  

Microsoft Academic Search

- diated physiotherapy for patients with spastic hemiparesis. Design: Controlled, randomized, preliminary study. Patients and methods: thirty patients with hemiparesis as a consequence of upper motor neurone lesion were divided randomly into 2 groups: robotic and control. Subjects from both groups received 30 minutes of Bobath therapy sessions on 20 consecutive work days. members of the robotic group received an

Gabor Fazekas; Monika Horvath; Tibor Troznai; Andras Toth

407

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

Microsoft Academic Search

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

Stephen A. Wallace; David I. Anderson; Michael Trujillo

2005-01-01

408

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

ERIC Educational Resources Information Center

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

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

2005-01-01

409

Robotics, assistive technology, and occupational therapy management to improve upper limb function in pediatric neuromuscular diseases.  

PubMed

This article presents an overview of occupational therapy assessments and treatment options for individuals with neuromuscular disabilities, with a particular focus on children with neuromuscular disorders. The discussion includes descriptions of standard treatments, commercial adaptive equipment, and homemade adaptive solutions. The state of the art in therapeutic and assistive robots and orthoses for the upper and lower extremity is also provided. PMID:22938883

Rahman, Tariq; Basante, Joseph; Alexander, Michael

2012-08-01

410

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

ERIC Educational Resources Information Center

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

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

2005-01-01

411

Constraint-Induced Movement Therapy for Restoration of Upper-Limb Function: Introduction  

Microsoft Academic Search

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