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1

Upper and Lower Limb Muscle Activation Is Bidirectionally and Ipsilaterally Coupled  

PubMed Central

Purpose There are neural connections between the upper and lower limbs of humans that enable muscle activation in one limb pair (upper or lower) to modulate muscle activation in the other limb pair (lower or upper, respectively). The aims of this study were to extend previous findings regarding submaximal exercise to maximal effort exercise and determine if there is an ipsilateral or contralateral bias to the neural coupling during a rhythmic locomotor-like task. Methods We measured upper and lower limb muscle activity, joint kinematics, and limb forces in neurologically intact subjects (n = 16) as they performed recumbent stepping using different combinations of upper and lower limb efforts. Results We found increased muscle activation in passive lower limbs during active upper limb effort compared to passive upper limb effort. Likewise, increased muscle activation in passive upper limbs occurred during active lower limb effort compared to passive lower limb effort, suggesting a bidirectional effect. Maximal muscle activation in the active lower limbs was not different between conditions with active upper limb effort and conditions with passive upper limb movement. Similarly, maximal muscle activation in the active upper limbs was not different between conditions with active lower limb effort and conditions with passive lower limb movement. Further comparisons revealed that neural coupling was primarily from active upper limb muscles to passive ipsilateral lower limb muscles. Conclusion These findings indicate that interlimb neural coupling affects muscle recruitment during maximal effort upper and lower limb rhythmic exercise and provide insight into the architecture of the neural coupling. PMID:19657291

Huang, Helen J.; Ferris, Daniel P.

2009-01-01

2

Evaluation of upper limb muscle fatigue based on surface electromyography.  

PubMed

Fatigue is believed to be a major contributory factor to occupational injuries in machine operators. The development of accurate and usable techniques to measure operator fatigue is therefore important. In this study, we used a novel method based on surface electromyography (sEMG) of the biceps brachii and the Borg scale to evaluate local muscle fatigue in the upper limb after isometric muscle action. Thirteen young males performed isometric actions with the upper limb at different force levels. sEMG activities of the biceps brachii were recorded during the actions. Borg scales were used to evaluate the subjective sensation of local fatigue of the biceps brachii after the actions. sEMG activities were analyzed using the one-third band octave method, and an equation to determine the degree of fatigue was derived based on the relationship between the variable and the Borg scale. The results showed that the relationship could be expressed by a conic curve, and could be used to evaluate muscle fatigue during machine operation. PMID:22038006

Zhou, Qianxiang; Chen, Yuhong; Ma, Chao; Zheng, Xiaohui

2011-10-01

3

Upper limb muscle strength & endurance in chronic obstructive pulmonary disease  

PubMed Central

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

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

2013-01-01

4

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

Microsoft Academic Search

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

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

2009-01-01

5

Surface electromyography activity of upper limb muscle during wheelchair propulsion: Influence of wheelchair configuration  

Microsoft Academic Search

BackgroundBiomechanical studies have linked handrim wheelchair propulsion with a prevalence of upper limb musculoskeletal disorders. The purpose of this study was to record upper limb muscle recruitment patterns using surface electromyography during wheelchair propulsion. Recordings were made for various wheelchair configurations to understand the effect of wheelchair configuration on muscle recruitment.

N. Louis; P. Gorce

2010-01-01

6

Muscle deoxygenation of upper-limb muscles during progressive arm-cranking exercise.  

PubMed

The purpose of this study was to determine which upper-limb muscle exhibits the greatest change in muscle deoxygenation during arm-cranking exercise (ACE). We hypothesized that the biceps brachii (BB) would show the greatest change in muscle deoxygenation during progressive ACE to exhaustion relative to triceps brachii (TR), brachioradialis (BR), and anterior deltoid (AD). Healthy young men (n = 11; age = 27 +/- 1 y; mean +/- SEM) performed an incremental ACE test to exhaustion. Near-infrared spectroscopy (NIRS) was used to monitor the relative concentration changes in oxy- (O2Hb), deoxy- (HHb), and total hemoglobin (Hbtot), as well as tissue oxygenation index (TOI) in each of the 4 muscles. During submaximal arm exercise, we found that changes to NIRS-derived measurements were not different between the 4 muscles studied (p > 0.05). At maximal exercise HHb was significantly higher in the BB compared with AD (p < 0.05). Relative to the other 3 muscles, BB exhibited the greatest decrease in O2Hb and TOI (p < 0.05). Our investigation provides two new and important findings: (i) during submaximal ACE the BB, TR, BR, and AD exhibit similar changes in muscle deoxygenation and (ii) during maximal ACE the BB exhibits the greatest change in intramuscular O2 status. PMID:18347677

Lusina, Sarah-Jane C; Warburton, Darren E R; Hatfield, Nicola G; Sheel, A William

2008-04-01

7

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

PubMed Central

Background It has previously been demonstrated that an extensive upper limb neurological examination of individual muscle function, sensation in homonymous innervated territories, and nerve trunk allodynia is reliable and that the outcome reflects symptoms. Since this approach may appear complicated and time consuming, this study deals with the value of an examination limited to manual testing of only six muscles. Methods Two examiners blinded to symptom status performed manual muscle testing of six muscles in 82 upper limbs with or without pain, weakness, and/or numbness/tingling. The six muscles represent three antagonist pairs (pectoralis major/posterior deltoid, biceps/triceps, and radial flexor of wrist/short radial extensor of wrist). The inter-rater reliability of detecting muscular weaknesses and the relation of weakness to the mentioned symptoms were analysed by kappa-statistics. Results The two examiners recognized weaknesses in 48 and 55 limbs, respectively, with moderate agreement (median kappa?=?0.58). Out of these, 35 and 32 limbs, respectively, were symptomatic. There was good correlation between findings and symptoms for one examiner (kappa?=?0.61) and fair correlation for the other one (kappa?=?0.33). Both reached high sensitivity (0.92, 0.84) but less satisfactory specificity (0.70, 0.50). Weaknesses agreed upon by the two examiners correlated moderately with symptoms (kappa?=?0.57). Conclusions Weakness in one or more muscles was present in almost all symptomatic limbs but in many non-symptomatic limbs as well. Manual testing of six muscles may represent a useful screening approach to upper limb neuropathic conditions, but a confirmative diagnosis requires further assessment. PMID:24767511

2014-01-01

8

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

9

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

10

Influence of fatigue on upper limb muscle activity and performance in tennis.  

PubMed

The study examined the fatigue effect on tennis performance and upper limb muscle activity. Ten players were tested before and after a strenuous tennis exercise. Velocity and accuracy of serve and forehand drives, as well as corresponding surface electromyographic (EMG) activity of eight upper limb muscles were measured. EMG and force were also evaluated during isometric maximal voluntary contractions (IMVC). Significant decreases were observed after exercise in serve accuracy (-11.7%) and velocity (-4.5%), forehand accuracy (-25.6%) and consistency (-15.6%), as well as pectoralis major (PM) and flexor carpi radialis (FCR) IMVC strength (-13.0% and -8.2%, respectively). EMG amplitude decreased for PM and FCR in serve, forehand and IMVC, and for extensor carpi radialis in forehand. No modification was observed in EMG activation timing during strokes or in EMG frequency content during IMVC. Several hypotheses can be put forward to explain these results. First, muscle fatigue may induce a reduction in activation level of PM and forearm muscles, which could decrease performance. Second, conscious or subconscious strategies could lead to a redistribution of muscle activity to non-fatigued muscles in order to protect the organism and/or limit performance losses. Otherwise, the modifications of EMG activity could also illustrate the strategies adopted to manage the speed-accuracy trade-off in such a complex task. PMID:24239164

Rota, Samuel; Morel, Baptiste; Saboul, Damien; Rogowski, Isabelle; Hautier, Christophe

2014-02-01

11

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

PubMed Central

Background Despite growing interest in the relationship between exercise and short-term neural plasticity, the effects of exercise on motor cortical (M1) excitability are not well studied. Acute, lower-limb aerobic exercise may potentially modulate M1 excitability in working muscles, but the effects on muscles not involved in the exercise are unknown. Here we examined the excitability changes in an upper limb muscle representation following a single session of lower body aerobic exercise. Investigating the response to exercise in a non-exercised muscle may help to determine the clinical usefulness of lower-body exercise interventions for upper limb neurorehabilitation. Methods In this study, transcranial magnetic stimulation was used to assess input–output curves, short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI) and intracortical facilitation (ICF) in the extensor carpi radialis muscle in twelve healthy individuals following a single session of moderate stationary biking. Additionally, we examined whether the presence of a common polymorphism of the brain-derived neurotrophic factor (BDNF) gene would affect the response of these measures to exercise. Results We observed significant increases in ICF and decreases in SICI following exercise. No changes in LICI were detected, and no differences were observed in input–output curves following exercise, or between BDNF groups. Conclusions The current results demonstrate that the modulation of intracortical excitability following aerobic exercise is not limited to those muscles involved in the exercise, and that while exercise does not directly modulate the excitability of motor neurons, it may facilitate the induction of experience-dependent plasticity via a decrease in intracortical inhibition and increase in intracortical facilitation. These findings indicate that exercise may create favourable conditions for adaptive plasticity in M1 and may be an effective adjunct to traditional training or rehabilitation methods. PMID:25031838

2014-01-01

12

Relationships between power and strength of the upper and lower limb muscles and throwing velocity in male handball players.  

PubMed

This study aimed to investigate relationships between peak power (PP) as measured by upper limb (PPUL) and lower limb (PPLL) force-velocity tests, maximal upper limb force assessed by 1 repetition maximum bench press (1RMBP), and pullover (1RMPO) exercises, estimates of local muscle volume and 3-step running handball throwing velocity (T3-Steps). Fourteen male handball players volunteered for the investigation (age: 19.6+/-0.6 years; body mass: 86.7+/-12.9 kg; and height 1.87+/-0.07 m). Lower and upper limb force-velocity tests were performed on appropriately modified forms of a Monark cycle ergometer, with measurement of PPUL and PPLL, and the corresponding respective maximal forces (F0UL and F0LL) and velocities (V0UL and V0LL). T3-Steps was assessed using a radar Stalker ATS system. Muscle volumes of the upper and lower limbs were estimated with a standard anthropometric kit. T3-Steps was closely related to absolute PPUL and to F0UL (r=0.69, p<0.01 for both relationships). T3-Steps was also moderately related to 1RMBP and 1RMPO (r=0.56, p<0.05; r=0.55, p<0.05 respectively), and to PPLL and F0LL (r=0.56, p<0.05; r=0.62, p<0.05, respectively). When PPLL was expressed per unit of limb muscle volume, the relationship with T3-Steps disappeared. This suggests the importance of muscle volume to performance in throwing events. Force-velocity data may prove useful in regulating conditioning and rehabilitation programs for handball players. Our results also highlight the contribution of both the lower and the upper limbs to handball throwing velocity, suggesting the need for coaches to include upper and lower limb strength and power programs when improving the throwing velocity of handball players. PMID:20508448

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

2010-06-01

13

Upper limb muscle forces during a simple reach-to-grasp movement: a comparative study.  

PubMed

Muscle force knowledge during reaching is an important research field and tools development for measuring those forces is a challenging task, especially for clinical routines. The purpose of this study was, during a simple reach-to-grasp movement, to compare forces estimation from a Hill-type model and from the EMG-to-Force Processing (EFP) method. Ten healthy male volunteers were tested. Surface EMG signals were recorded from deltoid scapular, deltoid clavicular, triceps brachii, and biceps brachii. Ten repeated measures of right upper limb kinematics had been recorded. Three reaching distances were tested: 20, 30, and 40 cm. Muscle activations were calculated and forces were estimated by the two methods. Correlations and low RMS error found between the two methods indicate that EFP is a good way to estimate muscle forces for this kind of movement. This knowledge is essential in order to integrate these forces in reaching models developed nowadays in robotic, rehabilitation, and ergonomics field of research. PMID:19784682

Louis, N; Gorce, P

2009-11-01

14

Muscle dependency of corticomuscular coherence in upper and lower limb muscles and training-related alterations in ballet dancers and weightlifters.  

PubMed

It has been well documented that the 15- to 35-Hz oscillatory activity of the sensorimotor cortex shows coherence with the muscle activity during weak to moderate steady contraction. To investigate the muscle dependency of the corticomuscular coherence and its training-related alterations, we quantified the coherence between electroencephalogram (EEG) from the sensorimotor cortex and rectified electromyogram (EMG) from five upper limb (first dorsal interosseous, flexor carpi radialis, extensor carpi radialis, biceps brachii, triceps brachii) and four lower limb muscles (soleus, tibialis anterior, biceps femoris, rectus femoris), while maintaining a constant force level at 30% of maximal voluntary contraction of each muscle, in 24 untrained, 12 skill-trained (ballet dancers), and 10 strength-trained (weightlifters) individuals. Data from untrained subjects demonstrated the muscle dependency of corticomuscular coherence. The magnitude of the EEG-EMG coherence was significantly greater in the distally located lower limb muscles, such as the soleus and tibialis anterior, than in the upper or other lower limb muscles in untrained subjects (P < 0.05). These results imply that oscillatory coupling between the sensorimotor cortex and spinal motoneurons during steady contraction differs among muscles, according to the functional role of each muscle. In addition, the ballet dancers and weightlifters showed smaller EEG-EMG coherences than the untrained subjects, especially in the lower limb muscles (P < 0.05). These results indicate that oscillatory interaction between the sensorimotor cortex and spinal motoneurons can be changed by long-term specialized use of the muscles and that this neural adaptation may lead to finer control of muscle force during steady contraction. PMID:20689093

Ushiyama, Junichi; Takahashi, Yuji; Ushiba, Junichi

2010-10-01

15

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

16

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

17

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

PubMed

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

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

2014-02-01

18

Alterations in upper limb muscle synergy structure in chronic stroke survivors  

PubMed Central

Previous studies in neurologically intact subjects have shown that motor coordination can be described by task-dependent combinations of a few muscle synergies, defined here as a fixed pattern of activation across a set of muscles. Arm function in severely impaired stroke survivors is characterized by stereotypical postural and movement patterns involving the shoulder and elbow. Accordingly, we hypothesized that muscle synergy composition is altered in severely impaired stroke survivors. Using an isometric force matching protocol, we examined the spatial activation patterns of elbow and shoulder muscles in the affected arm of 10 stroke survivors (Fugl-Meyer <25/66) and in both arms of six age-matched controls. Underlying muscle synergies were identified using non-negative matrix factorization. In both groups, muscle activation patterns could be reconstructed by combinations of a few muscle synergies (typically 4). We did not find abnormal coupling of shoulder and elbow muscles within individual muscle synergies. In stroke survivors, as in controls, two of the synergies were comprised of isolated activation of the elbow flexors and extensors. However, muscle synergies involving proximal muscles exhibited consistent alterations following stroke. Unlike controls, the anterior deltoid was coactivated with medial and posterior deltoids within the shoulder abductor/extensor synergy and the shoulder adductor/flexor synergy in stroke was dominated by activation of pectoralis major, with limited anterior deltoid activation. Recruitment of the altered shoulder muscle synergies was strongly associated with abnormal task performance. Overall, our results suggest that an impaired control of the individual deltoid heads may contribute to poststroke deficits in arm function. PMID:23155178

Rymer, William Z.; Perreault, Eric J.; Yoo, Seng Bum; Beer, Randall F.

2013-01-01

19

Methodological consideration for the recruitment of upper limb muscles during two joint arm movements  

Microsoft Academic Search

We investigated muscle activation levels or patterns determined during two-joint arm movements. Twelve subjects were instructed to move their right (dominant) wrists in a horizontal plane. Surface electromyographic activities were recorded from the brachioradialis, biceps brachii, and triceps brachii. The muscle activation level was demonstrated as a function of both the elbow and shoulder torque in a 3-dimensional plot and

Tasuku Miyoshi; Yoshiyuki Takahashi; Hokyoo Lee; Masaki Yamaguchi; Takashi Komeda

2009-01-01

20

Upper limb injuries in sports  

Microsoft Academic Search

Injuries, either to the athletes, amateurs, trainees or professional players, are common in any sporting event. Injuries can be to the limbs or to the trunk; acute, chronic or repetitive, from mild to severely disabling in severity. The most commonly injured regions are knee (28%) followed by the upper limb (23%). The common upper extremity injuries are the shoulder, followed

B B Putty

2010-01-01

21

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

PubMed Central

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

Amaral, Josaria F.; Alvim, Felipe C.; Castro, Eliane A.; Doimo, Leonice A.; Silva, Marcus V.; Novo, Jose M.

2014-01-01

22

Upper limb muscle forces during a simple reach-to-grasp movement: a comparative study  

Microsoft Academic Search

Muscle force knowledge during reaching is an important research field and tools development for measuring those forces is\\u000a a challenging task, especially for clinical routines. The purpose of this study was, during a simple reach-to-grasp movement,\\u000a to compare forces estimation from a Hill-type model and from the EMG-to-Force Processing (EFP) method. Ten healthy male volunteers\\u000a were tested. Surface EMG signals

N. Louis; P. Gorce

2009-01-01

23

Movement-related cortical potentials during muscle fatigue induced by upper limb submaximal isometric contractions.  

PubMed

The aim of this study was to examine the central neurophysiological mechanisms during fatigue induced by submaximal isometric contractions. A total of 23 individuals participated in the study and were assigned to fatigue and nonfatigue groups. Handgrip force, root mean square (RMS) of surface electromyography (sEMG) signal and movement-related cortical potentials during self-paced submaximal handgrip isometric contractions were assessed for each participant. The experimental data showed significant decreases in both maximal voluntary contraction [-24.3%; F(3,?42)=19.62, P<0.001, ?p=0.48] and RMS [-30.1%; F(3,?42)=19.01, P<0.001, ?p=0.57] during maximal voluntary contractions and a significant increase [F(3,?42)=14.27, P<0.001, ?p=0.50] in the average RMS of sEMG over four blocks in the fatigue group. There was no significant difference in the readiness potential between the fatigue and the nonfatigue groups at early stages, and at late stages, significant differences were observed only at the Fp1 and FC1 sites. Motor potential amplitudes were significantly higher in the fatigue group than in the nonfatigue group irrespective of block or electrode positions. Positive waveforms were observed in the prefrontal cortex in states without muscle fatigue, whereas a negative waveform pattern was observed with muscle fatigue. Significant within-subject correlations were observed between motor potential at the C1 site and RMS of sEMG (r=-0.439, P=0.02, ?p=0.11). Neurophysiological evidence indicates that cortical activity increases in the prefrontal cortex, primary motor cortex and supplementary motor cortex with muscle fatigue. Muscle fatigue appears to have considerable effects on the components of movement-related cortical potentials during movement execution, whereas the readiness potential before movement is sensitive to cognitive demands during prolonged exercise. Our results provide additional evidence for a link between central motor command during movement execution and motor unit recruitment. PMID:25089802

Guo, Feng; Wang, Ji-Ya; Sun, Yong-Jun; Yang, A-Li; Zhang, Ri-Hui

2014-10-01

24

Understanding muscle markers: lower limbs.  

PubMed

Musculoskeletal markers are frequently used to reconstruct past lifestyles and activity patterns. Yet the reliability of muscle marker measurements has been called into question because they may be confounded by body size. In this study, an aggregate muscle marker variable was calculated using 20 insertion sites (14 femoral, 6 tibial), and I examined their effects on lower limb size (as a proxy for body size), age, and sex. Analyses were made of a sample of 77 (57 males, 20 females) Native British Columbians (3,500-1,500 years BP) and 18th century Quebec prisoners. Muscle markers were measured using two-point observer rating scales; size was measured by standard methods; and age and sex were determined through pelvic, cranial, and dental morphology. Lower limb muscle markers correlated with: age, r=0.61; lower limb size, r=0.52; and sex, r=0.49; P <0.001. Older individuals had higher muscle marker scores, as did larger individuals and males. Based on partial correlations and regression analyses, age was the best overall predictor of lower limb muscle markers. PMID:15386252

Weiss, Elizabeth

2004-11-01

25

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. PMID:21689100

Diogo, R; Wood, B

2011-01-01

26

Infantile lipofibromatosis of the upper limb.  

PubMed

The imaging features of extensive lipofibromatosis presenting in a 1-day-old female infant are reported. This lesion involved her entire right upper limb, extending from the axilla to the palm of the hand. Radiographs showed marked deformity and thinning of all the right upper-limb bones due to pressure effect of soft-tissue enlargement, especially affecting the distal humerus and proximal forearm bones. Magnetic resonance imaging showed a huge soft-tissue mass infiltrating most of the muscles of the entire upper limb, with bony erosion. The mass was largely T1-isointense, moderately T2-hyperintense and showed marked enhancement. There were intra-lesional signal changes consistent with fatty elements. A lesion debulking procedure was performed and the histology was that of lipofibromatosis. The limb was found to be non-viable after the procedure and a subsequent above-elbow amputation was performed. Although the resection margins were not clear, she had no further recurrence over a subsequent 3-year follow-up period. PMID:16096756

Teo, Harvey E L; Peh, Wilfred C G; Chan, Mei-Yoke; Walford, Norman

2005-12-01

27

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

NASA Astrophysics Data System (ADS)

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

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

2013-12-01

28

Update on embryology of the upper limb.  

PubMed

Current concepts in the steps of upper limb development and the way the limb is patterned along its 3 spatial axes are reviewed. Finally, the embryogenesis of various congenital hand anomalies is delineated with an emphasis on the pathogenetic basis for each anomaly. PMID:23684522

Al-Qattan, Mohammad M; Kozin, Scott H

2013-09-01

29

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

30

Tourniquet use in upper limb surgery  

Microsoft Academic Search

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

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

2011-01-01

31

Variability of limb muscle size in young men.  

PubMed

The purpose of this study was to determine the interindividual variability of the upper and lower limb muscle size in young men. Subjects were 655 Japanese men aged 18-39 years. They were sedentary and mildly to highly active individuals, including college athletes of various sports. Muscle thicknesses at each of the anterior and posterior portions of the upper arm, thigh, and lower leg were measured using B-mode ultrasonography. Interindividual variability of muscle thickness was evaluated by coefficients of variation (CVs). The CVs of muscle thicknesses were found to be in the order of upper arm posterior (17.7%), thigh anterior (14.8%), thigh posterior (12.6%), upper arm anterior (12.2%), lower leg anterior (9.8%), and lower leg posterior (9.4%). The CVs were significantly different between each pair of measurement sites except for those of upper arm anterior-thigh posterior and lower leg anterior-posterior. These differences remain significant even when the muscle thicknesses were normalized to the segment length. The observed differences in the size variability can be interpreted as muscle-related differences in hypertrophic responsiveness to resistance training. The muscle-dependent size variability may be related to the differences in the fiber-type composition and/or muscle usage in daily life among examined muscle groups. PMID:19533610

Wakahara, Taku; Takeshita, Kazumi; Kato, Emika; Miyatani, Masae; Tanaka, Noriko I; Kanehisa, Hiroaki; Kawakami, Yasuo; Fukunaga, Tetsuo

2010-01-01

32

The anatomy and ontogeny of the head, neck, pectoral, and upper limb muscles of Lemur catta and Propithecus coquereli (primates): discussion on the parallelism between ontogeny and phylogeny and implications for evolutionary and developmental biology.  

PubMed

Most anatomical studies of primates focus on skeletal tissues, but muscular anatomy can provide valuable information about phylogeny, functional specializations, and evolution. Herein, we present the first detailed description of the head, neck, pectoral, and upper limb muscles of the fetal lemuriforms Lemur catta (Lemuridae) and Propithecus coquereli (Indriidae). These two species belong to the suborder Strepsirrhini, which is often presumed to possess some plesiomorphic anatomical features within primates. We compare the muscular anatomy of the fetuses with that of infants and adults and discuss the evolutionary and developmental implications. The fetal anatomy reflects a phylogenetically more plesiomorphic condition in nine of the muscles we studied and a more derived condition in only two, supporting a parallel between ontogeny and phylogeny. The derived exceptions concern muscles with additional insertions in the fetus which are lost in adults of the same species, that is, flexor carpi radialis inserts on metacarpal III and levator claviculae inserts on the clavicle. Interestingly, these two muscles are involved in movements of the pectoral girdle and upper limb, which are mainly important for activities in later stages of life, such as locomotion and prey capture, rather than activities in fetal life. Accordingly, our findings suggest that some exceptions to the "ontogeny parallels phylogeny" rule are probably driven more by ontogenetic constraints than by adaptive plasticity. PMID:24757163

Diogo, Rui; Molnar, Julia L; Smith, Timothy D

2014-08-01

33

Extrinsic influences on limb muscle organisation  

Microsoft Academic Search

Skeletal muscle within the vertebrate limb originates from the somite. Much work has focussed upon the role of secreted signalling molecules of the Hedgehog, fibroblast growth factor (FGF), bone morphogenetic protein (BMP), and Wnt families plus their associated antagonists in establishing somitic cell types, yet there is no consensus on how these signals combine to influence muscle patterning. When somitic

Chris S. Blagden; Simon M. Hughes

1999-01-01

34

Upper-Limb Powered Exoskeleton Design  

Microsoft Academic Search

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

Joel C. Perry; Jacob Rosen; Stephen Burns

2007-01-01

35

Upper limb musculoskeletal disorders in healthcare personnel.  

PubMed

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

Occhionero, Vincenzo; Korpinen, Leena; Gobba, Fabriziomaria

2014-08-01

36

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

37

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

38

Effect of limb immobilization on skeletal muscle  

NASA Technical Reports Server (NTRS)

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

Booth, F. W.

1982-01-01

39

Rehabilitation of musicians with upper limb amputations.  

PubMed

Three saxophone players with upper limb amputations have been successfully rehabilitated to play their musical instruments using skin-conductivity touch control. Each attained a standard of musicianship sufficient to perform the standard repertoire of the instrument in a concert setting. The mechanical and electrical modifications to the saxophone are described, as well as the principles of operation of the skin-conductivity touch control module. The touch control module is commercially available for prosthetists who wish to fit musicians or others with upper extremity amputations who require rapid accurate control of a number of channels of powered prosthetic function. PMID:3411524

Charles, D; James, K B; Stein, R B

1988-01-01

40

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

PubMed

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

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

2012-04-01

41

[Major upper limb trauma: patients' outcomes in 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 12 years and 5 months. 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

2013-09-01

42

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

ERIC Educational Resources Information Center

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

Desmond, Deirdre M.; MacLachlan, Malcolm

2010-01-01

43

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

PubMed

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

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

2013-06-01

44

Estimation of musculotendon properties in the human upper limb.  

PubMed

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 maximum physiological lengths of the actuator. In phase I, the positions of the bones and the activation levels of the muscles are found by maximizing the isometric torque developed for each degree of freedom at each joint. In phase II, the architectural properties of each musculotendon actuator are found by matching the strength profile of the model to that measured for subjects. The method is used to estimate the architectural properties of 26 major muscle groups crossing the shoulder, elbow, and wrist. Wherever possible, the model calculations are compared against measurements obtained from anatomical studies reported in the literature. Architectural data obtained from our work should be useful to researchers interested in developing musculoskeletal models of the upper limb. PMID:12627828

Garner, Brian A; Pandy, Marcus G

2003-02-01

45

Upper limb cerebellar motor function in children with spina bifida  

PubMed Central

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

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

2011-01-01

46

Upper limb neuropathy in computer operators? A clinical case study of 21 patients  

Microsoft Academic Search

BACKGROUND: The character of upper limb disorder in computer operators remains obscure and their treatment and prevention have had limited success. Symptoms tend to be mostly perceived as relating to pathology in muscles, tendons or insertions. However, the conception of a neuropathic disorder would be supported by objective findings reflecting the common complaints of pain, subjective weakness, and numbness\\/tingling. By

Jørgen Riis Jepsen

2004-01-01

47

Critical analysis of musculoskeletal modelling complexity in multibody biomechanical models of the upper limb.  

PubMed

The inverse dynamics technique applied to musculoskeletal models, and supported by optimisation techniques, is used extensively to estimate muscle and joint reaction forces. However, the solutions of the redundant muscle force sharing problem are sensitive to the detail and modelling assumptions of the models used. This study presents four alternative biomechanical models of the upper limb with different levels of discretisation of muscles by bundles and muscle paths, and their consequences on the estimation of the muscle and joint reaction forces. The muscle force sharing problem is solved for the motions of abduction and anterior flexion, acquired using video imaging, through the minimisation of an objective function describing muscle metabolic energy consumption. While looking for the optimal solution, not only the equations of motion are satisfied but also the stability of the glenohumeral and scapulothoracic joints is preserved. The results show that a lower level of muscle discretisation provides worse estimations regarding the muscle forces. Moreover, the poor discretisation of muscles relevant to the joint in analysis limits the applicability of the biomechanical model. In this study, the biomechanical model of the upper limb describing the infraspinatus by a single bundle could not solve the complete motion of anterior flexion. Despite the small differences in the magnitude of the forces predicted by the biomechanical models with more complex muscular systems, in general, there are no significant variations in the muscular activity of equivalent muscles. PMID:24156405

Quental, Carlos; Folgado, João; Ambrósio, Jorge; Monteiro, Jacinto

2015-05-01

48

Fibre operating lengths of human lower limb muscles during walking  

PubMed Central

Muscles actuate movement by generating forces. The forces generated by muscles are highly dependent on their fibre lengths, yet it is difficult to measure the lengths over which muscle fibres operate during movement. We combined experimental measurements of joint angles and muscle activation patterns during walking with a musculoskeletal model that captures the relationships between muscle fibre lengths, joint angles and muscle activations for muscles of the lower limb. We used this musculoskeletal model to produce a simulation of muscle–tendon dynamics during walking and calculated fibre operating lengths (i.e. the length of muscle fibres relative to their optimal fibre length) for 17 lower limb muscles. Our results indicate that when musculotendon compliance is low, the muscle fibre operating length is determined predominantly by the joint angles and muscle moment arms. If musculotendon compliance is high, muscle fibre operating length is more dependent on activation level and force–length–velocity effects. We found that muscles operate on multiple limbs of the force–length curve (i.e. ascending, plateau and descending limbs) during the gait cycle, but are active within a smaller portion of their total operating range. PMID:21502124

Arnold, Edith M.; Delp, Scott L.

2011-01-01

49

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

PubMed

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

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

2013-07-01

50

Development of an Upper Limb Motorized Assistive-Rehabilitative Robot  

NASA Astrophysics Data System (ADS)

While the number of people requiring help for the activities of daily living are increasing, several studies have been shown the effectiveness of robot training for upper limb functionality recovery. The robotic system described in this paper is an active end-effector based robot which can be used for assisting and rehabilitating of human upper limb. The robot is able to take into account desire of the patient for the support that patient needs to complete the task.

Amiri, Masoud; Casolo, Federico

51

Activity patterns of leg muscles in periodic limb movement disorder  

Microsoft Academic Search

The movements of leg muscles in reference to periodic limb movement disorder (PLMD) have only been described in global terms. The sequences of contracting muscles that cause the PLMs are said to be stereotypical. There is, however, doubt about this fixed sequencing in PLMD. Our goal was to define the sequence of muscle movements in PLMs and then analyse their

A W de Weerd; R M Rijsman; A Brinkley

2004-01-01

52

Ubiquitous human upper-limb motion estimation using wearable sensors.  

PubMed

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

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

2011-07-01

53

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

PubMed Central

Previous studies have postulated that the amount of brain reorganization following peripheral injuries may be correlated with negative symptoms or consequences. However, it is unknown whether restoring effective limb function may then be associated with further changes in the expression of this reorganization. Recently, targeted reinnervation (TR), a surgical technique that restores a direct neural connection from amputated sensorimotor nerves to new peripheral targets such as muscle, has been successfully applied to upper-limb amputees. It has been shown to be effective in restoring both peripheral motor and sensory functions via the reinnervated nerves as soon as a few months after the surgery. However, it was unclear whether TR could also restore normal cortical motor representations for control of the missing limb. To answer this question, we used high-density electroencephalography (EEG) to localize cortical activity related to cued motor tasks generated by the intact and missing limb. Using a case study of 3 upper-limb amputees, 2 of whom went through pre and post-TR experiments, we present unique quantitative evidence for the re-mapping of motor representations for the missing limb closer to their original locations following TR. This provides evidence that an effective restoration of peripheral function from TR can be linked to the return of more normal cortical expression for the missing limb. Therefore, cortical mapping may be used as a potential guide for monitoring rehabilitation following peripheral injuries. PMID:24273732

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

2013-01-01

54

Anatomy and physiology of perforator flaps of the upper limb.  

PubMed

Perforator flaps are an excellent reconstructive option for a functional upper limb reconstruction. This article explores the physiology and general principles of perforator flaps and their indications for use in reconstruction of the upper extremity. Workhorse perforator flaps of the upper extremity, such as the radial artery perforator, ulnar artery perforator, lateral arm perforator, posterior interosseous artery, first dorsal metacarpal artery perforator and perforator-based propeller flaps, are discussed in greater detail. PMID:24731605

Appleton, Sarah E; Morris, Steven F

2014-05-01

55

Respiratory and Limb Muscle Function in Lung Allograft Recipients  

Microsoft Academic Search

Lung transplantation recipients have reduced exercise capacity despite normal resting pulmonary and hemodynamic function. The limiting factor may be contractile dysfunction of skeletal muscle. To test this postulate, we measured limb and respiratory muscle function in nine clinically stable lung al- lograft recipients (six men and three women, aged 30 to 65 yr, at 5 to 102 mo after transplantation)

JOÃO G. PANTOJA; FRANCISCO H. ANDRADE; DOBRIVOJE S. STOKI; ADAANI E. FROST; WILLIAM L. ESCHENBACHER; MICHAEL B. REID

1999-01-01

56

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. PMID:21937156

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

2011-01-01

57

Short- and long-term modulation of upper limb motor-evoked potentials induced by acupuncture.  

PubMed

The aim of this study was to investigate in humans the effects of acupuncture upon upper-limb motor-evoked potentials (MEPs), elicited by transcranial magnetic stimulation of the primary motor cortex. It is known that peripheral sensory stimulation can be used to induce short- and long-term changes in motor cortex excitability. Data show that the simple insertion of the needle is an adequate somatosensory stimulus to induce a significant modulation of MEP amplitude, the sign of which (facilitation or inhibition) is specific to the investigated muscle and to the point of needle insertion. Moreover, MEP changes in upper-limb muscles are also observed following needling of lower-limb sites, revealing the presence of long-distance effects of acupuncture. Finally, the modulation in muscle excitability considerably outlasts the time period of needle application, demonstrating the induction of long-term plastic changes in the central nervous system. In addition, results have shown that the effects on muscle excitability are not restricted to the stimulation of well-coded acupoints, as described in traditional Chinese medicine, but they can also be induced by needling of nonacupoints, normally not used for therapeutic purposes. The possible neuronal mechanisms underlying the observed effects of acupuncture are discussed in relation to the available neurophysiological data regarding the interlimb reflexes and the changes in the representational cortical maps induced in humans by a prolonged somatosensory stimulation. PMID:16623849

Maioli, Claudio; Falciati, Luca; Marangon, Mattia; Perini, Sergio; Losio, Antonio

2006-04-01

58

Skeletal muscle responses to lower limb suspension in humans  

NASA Technical Reports Server (NTRS)

The morphological responses of human skeletal muscle to unweighting were assessed by analyzing multiple transaxial magnetic resonance (MR) images of both lower limbs and skeletal muscle biopsies of the unweighted lower limb before and after six weeks of unilaterial (left) lower limb suspension (ULLS). Results indicated that, as a results of 6 weeks of unweighting (by the subjects walking on crutches using only one limb), the cross sectional area (CSA) of the thigh muscle of the unweighted left limb decreased 12 percent, while the CSA of the right thigh muscle did not change. The decrease was due to a twofold greater response of the knee extensors than the knee flexors. The pre- and post-ULLS biopsies of the left vastus lateralis showed a 14 percent decrease in average fiber CSA due to unweighting. The number of capillaries surrounding the different fiber types was unchanged after ULLS. Results showed that the adaptive responses of human skeletal muscle to unweighting are qualitatively, but not quantitatively, similar to those of lower mammals and not necessarily dependent on the fiber-type composition.

Hather, Bruce M.; Adams, Gregory R.; Tesch, Per A.; Dudley, Gary A.

1992-01-01

59

Upper limb prostheses for amputations above elbow: A review  

Microsoft Academic Search

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

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

2009-01-01

60

Endoscopic thoracic sympathectomy in the treatment of upper limb hyperhidrosis.  

PubMed Central

The technique of endoscopic sympathectomy is described and its value in the treatment of upper limb hyperhidrosis is reported in an initial series of 7 patients (13 sympathectomies). It is recommended as the treatment of choice for this condition. Images Fig. 1 Fig. 2 PMID:3954316

Malone, P. S.; Cameron, A. E.; Rennie, J. A.

1986-01-01

61

Kinematic model aided inertial motion tracking of human upper limb  

E-print Network

is the ultimate goal in the field of human motion tracking. In this section, existing motion tracking systems@essex.ac.uk Abstract-- A new motion tracking framework has been devel- oped to estimate the position and orientationKinematic model aided inertial motion tracking of human upper limb Huiyu Zhou and Huosheng Hu

Hu, Huosheng

62

Development of upper limb motor function training and rehabilitation system  

Microsoft Academic Search

In this paper, we propose a novel task-oriented motor function training and assistance of upper limbs system for patients following stroke based on Virtual-Reality. In this system, a haptic device (Phantom Omni) and an inertia sensor are used to realize coordination training of two hands. We hope that this kind of training with haptic sensory and visual sensory will be

Shuxiang Guo; Zhibin Song; Changchun Ren

2009-01-01

63

VR-based active rehabilitation system for upper limbs  

Microsoft Academic Search

In this paper, VR-based novel rehabilitation system has been developed to help mild stroke patients to recover their motor function of upper limbs. The system consists of haptic device (PHANTOM Omni), an advanced inertial sensor (MTx) and a computer. Our intention is to facilitate patientspsila cortical plasticity according to observing virtual object correlated with self-generated intended action. Subject engages in

Shuxiang Guo; Zhibin Song

2008-01-01

64

A comparison of energy consumption in upper limb during swing through gait with axillary and elbow crutches in normal subjects  

Microsoft Academic Search

The swing-through gait using Functional Electrical Stimulation (FES) with crutches has a problem that patientsupper limbs have to support their body against gravity during the body-swing phase. So we compared the energy consumption in upper limb muscles during the swing-through gait using axillary and elbow crutches to consider the selection of a suitable crutch for the swing-through gait by FES.

Chida S; Shimada Y; Matsunaga T; Sato M; Hatakeyama K; Misawa A; Sakuraba T; Aizawa T; Iwami T; Miyawaki K; Iizuka K

65

Prediction of Gene Network Models in Limb Muscle Precursors  

PubMed Central

The ventrolateral dermomyotome gives rise to all muscles of the limbs through the delamination and migration of cells into the limb buds. These cells proliferate and form myoblasts, withdraw from the cell cycle and become terminally differentiated. The myogenic lineage colonizes pre-patterned regions to form muscle anlagen as muscle fibers are assembled. The regulatory mechanisms that control the later steps of this myogenic program are not well understood. The homeodomain transcription factor Pitx2 is expressed in the muscle lineage from the migration of precursors to adult muscle. Ablation of Pitx2 results in distortion, rather than loss, of limb muscle anlagen, suggesting that its function becomes critical during the colonization of, and/or fiber assembly in, the anlagen. Gene expression arrays were used to identify changes in gene expression in flow-sorted migratory muscle precursors, labeled by Lbx1EGFP, which resulted from the loss of Pitx2. Target genes of Pitx2 were clustered using the “David Bioinformatics Functional Annotation Tool” to bin genes according to enrichment of gene ontology keywords. This provided a way to both narrow the target genes and identify potential gene families regulated by Pitx2. Representative target genes in the most enriched bins were analyzed for the presence and evolutionary conservation of Pitx2 consensus binding sequence, TAATCY, on the ?20kb, intronic, and coding regions of the genes. Fifteen Pitx2 target genes were selected based on the above analysis and were identified as having functions involving cytoskeleton organization, tissue specification, and transcription factors. Data from these studies suggest that Pitx2 acts to regulate cell motility and expression of muscle specific genes in the muscle precursors during forelimb muscle development. This work provides a framework to develop the gene network leading to skeletal muscle development, growth and regeneration. PMID:22917675

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

2012-01-01

66

Histological characteristics of the deep fascia of the upper limb.  

PubMed

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

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

2006-01-01

67

Disorders of Upper Limb Movements in Ataxia-Telangiectasia  

PubMed Central

Ataxia-telangiectasia is known for cerebellar degeneration, but clinical descriptions of abnormal tone, posture, and movements suggest involvement of the network between cerebellum and basal ganglia. We quantitatively assessed the nature of upper-limb movement disorders in ataxia-telangiectasia. We used a three-axis accelerometer to assess the natural history and severity of abnormal upper-limb movements in 80 ataxia-telangiectasia and 19 healthy subjects. Recordings were made during goal-directed movements of upper limb (kinetic task), while arms were outstretched (postural task), and at rest. Almost all ataxia-telangiectasia subjects (79/80) had abnormal involuntary movements, such as rhythmic oscillations (tremor), slow drifts (dystonia or athetosis), and isolated rapid movements (dystonic jerks or myoclonus). All patients with involuntary movements had both kinetic and postural tremor, while 48 (61%) also had resting tremor. The tremor was present in transient episodes lasting several seconds during two-minute recording sessions of all three conditions. Percent time during which episodic tremor was present was greater for postural and kinetic tasks compared to rest. Resting tremor had higher frequency but smaller amplitude than postural and kinetic tremor. Rapid non-rhythmic movements were minimal during rest, but were triggered during sustained arm postures and goal directed arm movements suggesting they are best considered a form of dystonic jerks or action myoclonus. Advancing age did not correlate with the severity of involuntary limb movements. Abnormal upper-limb movements in ataxia-telangiectasia feature classic cerebellar impairment, but also suggest involvement of the network between the cerebellum and basal ganglia. PMID:23826191

Shaikh, Aasef G.; Zee, David S.; Mandir, Allen S.; Lederman, Howard M.; Crawford, Thomas O.

2013-01-01

68

The effect of limb crossing and limb congruency on multisensory integration in peripersonal space for the upper and lower extremities.  

PubMed

The present study investigated how multisensory integration in peripersonal space is modulated by limb posture (i.e. whether the limbs are crossed or uncrossed) and limb congruency (i.e. whether the observed body part matches the actual position of one's limb). This was done separately for the upper limbs (Experiment 1) and the lower limbs (Experiment 2). The crossmodal congruency task was used to measure peripersonal space integration for the hands and the feet. It was found that the peripersonal space representation for the hands but not for the feet is dynamically updated based on both limb posture and limb congruency. Together these findings show how dynamic cues from vision, proprioception, and touch are integrated in peripersonal limb space and highlight fundamental differences in the way in which peripersonal space is represented for the upper and lower extremity. PMID:23579198

van Elk, Michiel; Forget, Joachim; Blanke, Olaf

2013-06-01

69

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

2004-01-01

70

Combined mirror visual and auditory feedback therapy for upper limb phantom pain: a case report  

Microsoft Academic Search

INTRODUCTION: Phantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain. CASE PRESENTATION: We present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated

Delia G Wilcher; Ivan Chernev; Kun Yan

2011-01-01

71

Implications of lower- and upper-limb training procedures in patients with chronic airway obstruction.  

PubMed

In assessing the effectiveness of lower-limb and upper-limb nonspecific physical training, we have considered 3 objectives in this study: (1) determination of clinical and functional actual state in patients with chronic airway obstruction (CAO), before and after training; (2) determination of the tests, level of work, and duration of the session training as well as how to increase the training load throughout the training program; and (3) the "particular" upper-limb exercise training in patients with CAO. Many personal factors such as psychologic (personality, degree of patient motivation), alcohol and smoking habits, physical activity, malnutrition, as well as routine tests, at rest and maximal exercise, including the control of metabolic acidosis (lactate) and arterial blood gases (or at least of SaO2), should be considered. Exercise training has the potential to improve exercise tolerance in those who develop metabolic acidosis. The pattern of lactates during exercise represents a good criterion on the selection of patient's training. Two ergospirometric strategies, at high intensity exercise, established from the anaerobic threshold (AT) are described: (a) the above AT 45 min constant exercise (high work rate), at 60% of the difference between AT and maximum VO2 or 80% of the maximal tolerated power (MTP), and (b) the "45 min square-wave endurance exercise test" (SWEET), simulating an interval training session, established from the MTP and the AT. To the SWEET's base (% MTP from AT or aerobic training), a peak of 60 s at MTP (anaerobic training) is added every 5 min. While those 2 protocols, after 6 to 8 weeks of training, lactate and ventilation were lower for identical work rate. In addition, endurance (time in "a" and total physical work in "b") increased up to 60%. Further, maximal exercise ventilation and maximum VO2 increased after SWEET training. Roughly every 7 training sessions, a 10% to 15% reduction in heart rate (HR), during the training program, allows the patient to increase the work rate of the sessions. Evaluation of training the upper limb in patients with CAO requires measurements of MTP and maximum VO2. With the upper limb (wheelchair ergometer), Wmax, maximum VO2, and HR represent 30%, 65%, and 95%, respectively, of the lower limb (ergometer). Further, some expiratory and inspiratory accessory muscles show electromyographic fatigue at the MTP upper-limb level. This may contribute to the rationale for training respiratory muscles.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1576850

Gimenez, M; Predine, E; Marchand, M; Servera, E; Ponz, J L; Polu, J M

1992-05-01

72

A novel robot neurorehabilitation for upper limb motion.  

PubMed

Our goal is to apply robotics and automation technology to assist, quantify, enhance, and verify neuro-rehabilitation. In this paper a novel robot neuro-rehabilitation for upper limb, with many merits, is developed. Mechanism and control of the robot are introduced in detail. By a clinical trial involving 30 stroke patients with three months at Rehabilitation Center of China, some results are obtained 1) robot-aided therapy does not have adverse effects, 2) patients can accept the procedure, 3) the therapy may reduce muscular tension, and 4) manipulation of the impaired upper limb may influence brain recovery. Some new ideas are also presented to make rehabilitation therapy more effectively. These ideas will be helpful to further quicken the development of the robot neuro-rehabilitation. PMID:17281378

Xiu-Feng, Zhang; Lin-Hong, Ji; Li-Yun, Guo

2005-01-01

73

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

74

Upper limb asymmetries in the utilization of proprioceptive feedback  

Microsoft Academic Search

Despite the importance of proprioception during upper limb movement, the extent to which arm\\/hemisphere asymmetries exist\\u000a in the utilization of proprioceptive feedback remains unclear. In the present study, movement accuracy and arm dynamics were\\u000a examined in 20 right-handed adults during a proprioceptive matching task that required subjects to actively match remembered\\u000a target positions of the elbow with the contralateral arm.

Daniel J. Goble; Colleen A. Lewis; Susan H. Brown

2006-01-01

75

Immediate tissue transplantation in upper limb trauma: spare parts reconstruction.  

PubMed

The management of mutilated upper extremity wounds offers challenges for all hand surgeons. Loss of composite tissues usually requires grafts or flaps to gain coverage and restore function. Nonsalvagable digits or amputated parts are a source of spare tissues that can be used for reconstruction of the hand or limb. Immediate tissue transplantation is a resourceful technique for hand surgeons to limit donor morbidity while making the most out of a terrible injury to the hand or upper extremity. This article reviews the various methods by which immediate tissue transplantation can be employed in hand trauma. PMID:24996461

Lin, Chih Hung; Webb, Kelli; Neumeister, Michael W

2014-07-01

76

Comparing the efficacy of botulinum toxin with tizanidine in upper limb post stroke spasticity  

PubMed Central

Background This study evaluated the efficacy of focal intramuscular injection of botulinum (BoNT) toxin type A in comparison with oral tizanidine (TZD) in treatment of post-stroke upper limb spasticity. Methods This was a double-blinded randomized clinical trial that recruited 68 patients with post-stroke upper limb spasticity. Thirty-four patients received BoNT (Dysport®) injections in affected muscles of upper limb at the baseline and week 12. Thirty-four patients were treated with tizanidine (Sirdalude) by gradual increase in dosage of 2mg/week to reach maximum 24mg at week 12. Modified Ashworth Scale (MAS) and Action Research Arm Test (ARAT) were evaluated at the baseline, week 12 and week 24 for all the participants. Results The mean score of MAS reduced from 3.32 and 3.13 at baseline to 1.79 and 1.56 at week 24 on elbow and wrist joints, respectively (P < 0.01). However, there were only reductions from 2.79 and 2.77 to 2.32 and 2.31 (P < 0.001) in TZD group. ARAT increased from 1.79 to 10.97 (P < 0.001) in BoNT group. ARAT increased from 11.08 to 11.35 in TZD group (P = 0.026). Conclusion BoNT injection was safe and effective in reducing post-stroke upper extremity spasticity in comparison with TZD. PMID:24250901

Yazdchi, Mohammad; Ghasemi, Zahra; Moshayedi, Hanieh; Rikhtegar, Reza; Mostafayi, Somayeh; Mikailee, Hale

2013-01-01

77

Shaping muscle bioarchitecture for the fin to limb transition  

PubMed Central

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

Cole, Nicholas J.; Currie, Peter

2012-01-01

78

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

PubMed Central

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

Rathinam, Bertha A. D.

2013-01-01

79

Upper limb stroke rehabilitation: the effectiveness of Stimulation Assistance through Iterative Learning (SAIL).  

PubMed

A novel system has been developed which combines robotic therapy with electrical stimulation (ES) for upper limb stroke rehabilitation. This technology, termed SAIL: Stimulation Assistance through Iterative Learning, employs advanced model-based iterative learning control (ILC) algorithms to precisely assist participant's completion of 3D tracking tasks with their impaired arm. Data is reported from a preliminary study with unimpaired participants, and also from a single hemiparetic stroke participant with reduced upper limb function who has used the system in a clinical trial. All participants completed tasks which involved moving their (impaired) arm to follow an image of a slowing moving sphere along a trajectory. The participants' arm was supported by a robot and ES was applied to the triceps brachii and anterior deltoid muscles. During each task, the same tracking trajectory was repeated 6 times and ILC was used to compute the stimulation signals to be applied on the next iteration. Unimpaired participants took part in a single, one hour training session and the stroke participant undertook 18, 1 hour treatment sessions composed of tracking tasks varying in length, orientation and speed. The results reported describe changes in tracking ability and demonstrate feasibility of the SAIL system for upper limb rehabilitation. PMID:22275698

Meadmore, Katie L; Cai, Zhonglun; Tong, Daisy; Hughes, Ann-Marie; Freeman, Chris T; Rogers, Eric; Burridge, Jane H

2011-01-01

80

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

PubMed Central

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

2014-01-01

81

Activity patterns of leg muscles in periodic limb movement disorder.  

PubMed

The movements of leg muscles in reference to periodic limb movement disorder (PLMD) have only been described in global terms. The sequences of contracting muscles that cause the PLMs are said to be stereotypical. There is, however, doubt about this fixed sequencing in PLMD. Our goal was to define the sequence of muscle movements in PLMs and then analyse their patterns. We recorded with surface EMG all movements of the muscles said to be involved in PLMs (extensor digitorum brevis, EDB; tibialis anterior, TA; biceps femoris, BF; tensor fasciae latae; TFL) as well as the quadriceps (Q) and soleus (S) muscles in 12 patients with restless legs syndrome combined with PLMD. Accompanying polysomnography provided the sleep parameters. In total, 469 movements were analysed. In only 12% was there the appearance of the classic movement (EDB-TA-BF-TFL) or its direct variants. The most frequent sequences were characterised by contraction of only the TA, TA-EDB only, or TA-EDB followed by all other combinations (32%). The pattern EDB only, EDB-TA, or EDB-TA followed by contraction of one or more other muscles, was seen in 18%. All other combinations appeared in much smaller numbers or only once. Eight patients had specific patterns. Three consistently started with the same muscle. One patient always contracted all six muscles. Six patients never contracted more than three muscles. The number of muscles contracted correlated positively with the appearance of arousal from sleep. The interval between onset of contractions within the PLMs varied randomly in a range of 0-1 s. Within PLMs many variations of muscle movements were documented. Patterns were recognisable, individually determined, and related to arousal from sleep. PMID:14742617

de Weerd, A W; Rijsman, R M; Brinkley, A

2004-02-01

82

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

E-print Network

. Abstract With the advent of myoelectric prosthetics in the 1960s, amputees could use nerves in the residual limb to control their prostheses. However, upper-limb prosthetics still lack the feedback necessary

Mountziaris, T. J.

83

Pain in traumatic upper limb amputees in Sierra Leone.  

PubMed

Data on 40 upper limb amputees (11 bilateral) with regard to stump pain, phantom sensation and phantom pain is presented. All the patients lost their limbs as a result of violent injuries intended to terrorise the population and were assessed 10-48 months after the injury. All amputees reported stump pain in the month prior to interview and ten of the 11 bilateral amputees had bilateral pain. Phantom sensation was common (92.5%), but phantom pain was only present in 32.5% of amputees. Problems in translation and explanation may have influenced the low incidence of phantom pain and high incidence of stump pain. In the bilateral amputees phantom sensation, phantom pain and telescoping all showed bilateral concordance, whereas stump pain and neuromas did not show concordance. About half the subjects (56%) had lost their limb at the time of injury (primary) while the remainder had an injury, then a subsequent amputation in hospital (secondary). There was no association between the incidence of phantom pain and amputation irrespective of being primary or secondary. PMID:12237209

Lacoux, Philippe A; Crombie, Iain K; Macrae, William A

2002-09-01

84

A survey on robotic devices for upper limb rehabilitation  

PubMed Central

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

2014-01-01

85

Global optimization method for combined spherical-cylindrical wrapping in musculoskeletal upper limb modelling.  

PubMed

In musculoskeletal modelling, many muscles cannot be represented as straight lines from origin to insertion because the bony and musculotendinous morphology of neighboring structures causes them to wrap. The majority of these passive structures can be adequately described as simple geometric shapes such as spheres and cylinders. Techniques for describing smooth muscle paths around multiple obstacles have been developed for modelling use. Until now obstacle-set methods have combined the path of single structures. This does not analytically define the shortest smooth path around multiple objects. When a sphere is included in a multiple-object wrapping algorithm, muscle paths around that sphere are restricted to a bundle of planes containing the sphere center. This assumed restriction can compromise the iterative process for finding the true shortest muscle path that satisfies all restrictions of a smooth path. This can cause model instability. The new method involves the determination of the shortest smooth muscle path in a spherical and cylindrical wrapping algorithm. A typical example is musculoskeletal modelling of the upper limb, where the muscle fibers have to wrap over this combination of obstacles. PMID:18606476

Audenaert, A; Audenaert, E

2008-10-01

86

Segmental Resection and Replantation Have a Role for Selected Advanced Sarcomas in the Upper Limb  

Microsoft Academic Search

Although limb salvage surgery for primary sarcoma of the upper limb is a standard procedure, it often is technically challenging.\\u000a We asked whether segmental resection and replantation would provide (1) local control and long-term survival and (2) useful\\u000a limb function in patients who had advanced primary malignant and aggressive tumors of the upper limbs. We retrospectively\\u000a reviewed six patients treated

Soo Bong Hahn; Yun Rak Choi; Ho Jung Kang; Kyoo Ho Shin

2009-01-01

87

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. PMID:21261965

2011-01-01

88

Wireless wearable controller for upper-limb neuroprosthesis.  

PubMed

The objective of this project was to develop a wireless, wearable joint angle transducer to enable proportional control of an upper-limb neuroprosthesis by wrist position. Implanted neuroprostheses use functional electrical stimulation to provide hand grasp to individuals with tetraplegia. Wrist position is advantageous for control because it augments the tenodesis grasp and can be implemented bilaterally. Recently developed, fully implantable multichannel stimulators are battery-powered and use wireless telemetry to control stimulator outputs. An external wrist controller was designed for command signal acquisition for people with cervical-level spinal cord injury to control this implantable stimulator. The wearable controller, which uses gigantic magnetoresistive sensing techniques to measure wrist position, is worn on the forearm. A small dime-sized magnet is fixed to the back of the hand. Results indicate that the device is a feasible control method for an upper-limb neuroprosthesis and could be reduced to a small "wristwatch" size for cosmesis and easy donning. PMID:19533538

Wheeler, Christa A; Peckham, P Hunter

2009-01-01

89

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. PMID:16504144

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

2006-01-01

90

Tendinous muscular insertions onto the deep fascia of the upper limb. First part: anatomical study.  

PubMed

We examined 30 upper limbs in order to study the tendinous muscular insertions into the deep fascia and to verify whether they have a specific anatomical arrangement and to measure their resilience to traction. We have found that the fascia receives many tendinous muscular insertions, which are always present and exhibit a constant anatomical structure. In particular, the pectoralis major fascia always continues with the brachial fascia in two distinct ways: the fascia overlying the clavicular part of pectoralis major had an expansion towards the anterior brachial fascia, whereas the fascia covering its costal part extended into the medial brachial fascia and the medial intermuscular septum. The lacertus fibrosus was also composed by two groups of fibres: the main group was oriented downwards and medially, the second group longitudinally. The palmaris longus opened out into a fan-shape in the palm of the hand and sent some tendinous expansions to the flexor retinaculum and fascia overlying the thenar eminence muscles. In the posterior region of the arm, the fascia of the latissimus dorsi sent a fibrous lamina to the triceps brachial fascia. The triceps tendon inserted partially into the antebrachial fascia, while the extensor carpi ulnaris sent a tendinous expansion to the fascia of the hypothenar eminence. It is hypothesized that the tendinous muscular insertions maintain the fascia at a basal tension and create myofascial continuity between the different muscles actuating flexion and extension of the upper limb, stretching the fascia in different ways according to the different motor directions. PMID:17574470

Stecco, C; Gagey, O; Macchi, V; Porzionato, A; De Caro, R; Aldegheri, R; Delmas, V

2007-03-01

91

Muscle phenotypic variability in limb girdle muscular dystrophy 2 G.  

PubMed

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

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

2013-06-01

92

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. PMID:24130621

2013-01-01

93

Sex determination using upper limb bones in Korean populations  

PubMed Central

The purpose of this research is to establish metric standards for the determination of sex from the upper limb bones of Korean. We took a set of eleven measurements on each of 175 right sides of adult skeletons chosen at Korean sample. Classification accuracy dropped only one or two individuals when only vertical head diameter of humerus is used. Variables in relation with maximal length were less accurate than head diameter of humerus. Two variables were selected by the stepwise procedure: maximal length of humerus, vertical head diameter of humerus. The combined accuracy was 87%. This study of modern Korean skeletons underscores the need for population-specific techniques, not only for medicolegal investigations, but also for the study of population affinities and factors affecting bone configurations.

Lee, Je-Hun; Kim, Yi-Suk; Lee, U-Young; Park, Dae-Kyoon; Jeong, Young-Gil; Lee, Nam Seob; Han, Seung Yun; Kim, Kyung-Yong

2014-01-01

94

Motorised mobility scooters; upper limb fractures in elderly novice users  

PubMed Central

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

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

2014-01-01

95

Comparison between Flail Arm Syndrome and Upper Limb Onset Amyotrophic Lateral Sclerosis: Clinical Features and Electromyographic Findings  

PubMed Central

Flail arm syndrome (FAS), an atypical presentation of amyotrophic lateral sclerosis (ALS), is characterized by progressive, predominantly proximal, weakness of upper limbs, without involvement of the lower limb, bulbar, or respiratory muscles. When encountering a patient who presents with this symptomatic profile, possible diagnoses include upper limb onset ALS (UL-ALS), and FAS. The lack of information regarding FAS may make differential diagnosis between FAS and UL-ALS difficult in clinical settings. The aim of this study was to compare clinical and electromyographic findings from patients diagnosed with FAS with those from patients diagnosed with UL-ALS. To accomplish this, 18 patients with FAS and 56 patients with UL-ALS were examined. Significant differences were observed between the 2 groups pertaining to the rate of fasciculation, patterns of predominantly affected muscles, and the Medical Research Council scale of the weakest muscle. The presence of upper motor neuron signs and lower motor neuron involvement evidenced through electromyography showed no significant between-group differences. PMID:25258573

Yoon, Byung-Nam; Choi, Seong Hye; Rha, Joung-Ho; Kang, Sa-Yoon; Lee, Kwang-Woo

2014-01-01

96

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

PubMed

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

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

2011-02-01

97

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

PubMed Central

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

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

2014-01-01

98

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

Microsoft Academic Search

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

Isabelle Rogowski; Gaële Ducher; Olivier Brosseau; Christophe Hautier

2008-01-01

99

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

Microsoft Academic Search

In this paper we propose a new rehabilitation training support system for upper limbs. The proposed system enables therapists to quantitatively evaluate the therapeutic effect of upper limb motor function during training, to easily change the load of resistance of training and to easily develop a new training program suitable for the subjects. For this purpose we develop control algorithms

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

2007-01-01

100

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

101

Movement analysis of upper limb during resistance training using general purpose robot arm "PA10"  

NASA Astrophysics Data System (ADS)

In this paper we perform movement analysis of an upper limb during resistance training. We selected sanding training, which is one type of resistance training for upper limbs widely performed in occupational therapy. Our final aims in the future are to quantitatively evaluate the therapeutic effect of upper limb motor function during training and to develop a new rehabilitation training support system. For these purposes, first of all we perform movement analysis using a conventional training tool. By measuring upper limb motion during the sanding training we perform feature abstraction. Next we perform movement analysis using the simulated sanding training system. This system is constructed using the general purpose robot arm "PA10". This system enables us to measure the force/torque exerted by subjects and to easily change the load of resistance. The control algorithm is based on impedance control. We found these features of the upper limb motion during the sanding training.

Morita, Yoshifumi; Yamamoto, Takashi; Suzuki, Takahiro; Hirose, Akinori; Ukai, Hiroyuki; Matsui, Nobuyuki

2005-12-01

102

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

103

Outcomes with respect to disabilities of the upper limb after hand allograft transplantation: a systematic review.  

PubMed

The aim of this work is to compare disabilities of the upper limb before and after hand allograft transplantation (HAT), and to describe the side effects of immunosuppressive (IS) agents given to recipients of hand allografts. Clinical cases of HAT published between 1999 and 2011 in English, French, or German were reviewed systematically, with emphasis on comparing disabilities of the arm, shoulder and hand (DASH) scores before and after transplantation. Duration of ischemia, extent of amputation, and time since amputation were evaluated for their effect on intrinsic musculature function. Infectious, metabolic, and oncological complications because of IS therapy were recorded. Twenty-eight patients were reported in 56 clinical manuscripts. Among these patients, disabilities of the upper limb dropped by a mean of 27.6 (±19.04) points on the DASH score after HAT (P?=?0.005). Lower DASH scores (P?=?0.036) were recorded after secondary surgery on hand allografts. The presence of intrinsic muscle function was observed in 57% of the recipients. Duration of ischemia, extent of transplantation, and time since amputation were not associated statistically with the return of intrinsic musculature function. Three grafts were lost to follow-up because of noncompliance with immunosuppression, rejection, and arterial thrombosis, respectively. Fifty-two complications caused by IS agents were reported, and they were successfully managed medically or surgically. HAT recipients showed notable functional gains, but most complications resulted from the IS protocols. PMID:22332605

Landin, Luis; Bonastre, Jorge; Casado-Sanchez, Cesar; Diez, Jesus; Ninkovic, Marina; Lanzetta, Marco; del Bene, Massimo; Schneeberger, Stefan; Hautz, Theresa; Lovic, Aleksandar; Leyva, Francisco; García-de-Lorenzo, Abelardo; Casado-Perez, Cesar

2012-04-01

104

Morphological characteristics of changes in limb skeletal muscle tissue during experimental postischemic recirculation  

Microsoft Academic Search

In a previous communication the writers gave data on changes in skeletal muscles in the ischemic period of acute arterial occlusion of the limbs, and the microscopic picture and functional morphology of the ischemic skeletal muscles 2 h after restoration of the blood flow to the limbs were stugied. Early postischemic recirculation is undoubtedly the most reliable test of viability

V. S. Savel'ev; G. A. Chekareva; O. D. Mishnev; O. A. Bogdanov

1985-01-01

105

The validity and reliability of surface EMG to assess the neuromuscular response of the abdominal muscles to rapid limb movement  

Microsoft Academic Search

The transversus abdominus muscle (TrA) has been demonstrated to be active prior to rapid movements of the upper and lower limbs. This activity is termed feed forward motivation. The lack of feed-forward activation for TrA has been demonstrated in subjects with low back pain. The measures used for investigation of TrA function have been fine-wire needle EMG. This limits the

P. Marshall; B. Murphy

2003-01-01

106

Neural interfaces for control of upper limb prostheses: the state of the art and future possibilities.  

PubMed

Current treatment of upper limb amputation restores some degree of functional ability, but this ability falls far below the standard set by the natural arm. Although acceptance rates can be high when patients are highly motivated and receive proper training and care, current prostheses often fail to meet the daily needs of amputees and frequently are abandoned. Recent advancements in science and technology have led to promising methods of accessing neural information for communication or control. Researchers have explored invasive and noninvasive methods of connecting with muscles, nerves, or the brain to provide increased functionality for patients experiencing disease or injury, including amputation. These techniques offer hope of more natural and intuitive prosthesis control, and therefore increased quality of life for amputees. In this review, we discuss the current state of the art of neural interfaces, particularly those that may find application within the prosthetics field. PMID:21257135

Schultz, Aimee E; Kuiken, Todd A

2011-01-01

107

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. PMID:20808486

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

2009-01-01

108

Development of risk filter and risk assessment worksheets for HSE guidance—‘Upper Limb Disorders in the Workplace’ 2002  

Microsoft Academic Search

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

Rod J Graves; David Riley; Clare Lawton; Len Morris

2004-01-01

109

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

PubMed Central

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

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

2014-01-01

110

Endoscopic transthoracic sympathectomy for idiopathic upper limb hyperhidrosis.  

PubMed

A 5-year experience of 51 endoscopic transthoracic dorsal sympathectomies for idiopathic palmar hyperhidrosis in 26 patients is presented. Fifty-two percent complained of excessive sweating over their hands, 28% of axillary sweating and 20% over both areas, with a mean duration of 10 years. The second, third and fourth thoracic ganglia and their interconnecting fibres on the affected side were ablated using diathermy cautery. Over a mean follow up time of 26 months, this procedure was successful in curing or improving intractable sweating in 92%. However, axillary sweating was less well controlled than in the palms with 20% of patients describing residual wetness in the axilla. Compensatory sweating (75%) and gustatory sweating (48%) were the commonest side effects; despite this, most patients were satisfied with the functional and cosmetic outcome. Other complications included a temporary Horner's syndrome in one patient, a pneumothorax in the immediate post-operative period in another and a unilateral non-infective reactionary pleural effusion in a third. Two patients developed recurrence of palmar hyperhidrosis within 6 months of surgery. One has been successfully treated by re-operation on the affected side. All patients complained of mild to moderate interscapular chest pain which was easily controlled by non-steroidal anti-inflammatory agents, and resolved within 7-10 days post-operatively. The technique of endoscope transthoracic sympathectomy is effective, relatively simple to perform and usually requires only an overnight stay. It is recommended as the surgical treatment of choice for upper limb hyperhidrosis unresponsive to conservative measures. PMID:1422103

Masters, A; Rennie, J A

1992-10-01

111

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. PMID:23576267

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

112

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. PMID:19672605

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

2011-01-01

113

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

Microsoft Academic Search

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

Yuqin Shi; Fuming Gu

114

Habitual throwing and swimming correspond with upper limb diaphyseal strength and shape in modern human athletes  

Microsoft Academic Search

Variation in upper limb long bone cross- sectional properties may reflect a phenotypically plastic response to habitual loading patterns. Structural differ- ences between limb bones have often been used to infer past behavior from hominin remains; however, few stud- ies have examined direct relationships between behav- ioral differences and bone structure in humans. To help address this, cross-sectional images (50%

Colin N. Shaw; Jay T. Stock

2009-01-01

115

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

116

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

117

Anatomical study of myofascial continuity in the anterior region of the upper limb.  

PubMed

Fifteen unembalmed cadavers were dissected in order to study the "anatomical continuity" between the various muscles involved in the movement of flexion of the upper limb. This study demonstrated the existence of specific myofascial expansions, with a nearly constant pattern, which originate from the flexor muscles and extend to the overlying fascia. The clavicular part of the pectoralis major sends a myofascial expansion, with a mean length of 3.6cm, to the anterior region of the brachial fascia, and the costal part sends one to the medial region of the brachial fascia (mean length: 6.8cm). The biceps brachii presents two expansions: the lacertus fibrosus, oriented medially, with a mean height of 4.7cm and a base of 1.9cm, and a second, less evident, longitudinal expansion (mean length: 4.5cm, mean width: 0.7cm). Lastly, the palmaris longus sends an expansion to the fascia overlying the thenar muscles (mean length: 1.6cm, mean width: 0.5cm). During flexion, as these muscles contract, the anterior portion of the brachial and antebrachial fascia is subject to tension. As the fascia is rich in proprioceptive nerve endings, it is hypothesized that this tension activates a specific pattern of receptors, contributing to perception of motor direction. If the muscular fascia is in a non-physiological state, these mechanisms are altered, and the proprioceptors in the fascia may be incorrectly activated, thus giving rise to many types of extra-articular pain. PMID:19118793

Stecco, Antonio; Macchi, Veronica; Stecco, Carla; Porzionato, Andrea; Ann Day, Julie; Delmas, Vincent; De Caro, Raffaele

2009-01-01

118

Upper Limb Static-Stretching Protocol Decreases Maximal Concentric Jump Performance  

PubMed Central

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

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

2014-01-01

119

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

PubMed

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

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

2014-01-01

120

Cancer cachexia decreases specific force and accelerates fatigue in limb muscle  

SciTech Connect

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

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

2013-06-07

121

Cardiac autonomic responses during upper versus lower limb resistance exercise in healthy elderly men  

PubMed Central

Objective To investigate the cardiac autonomic responses during upper versus lower limb discontinuous resistance exercise (RE) at different loads in healthy older men. Method Ten volunteers (65±1.2 years) underwent the one-repetition maximum (1RM) test to determine the maximum load for the bench press and the leg press. Discontinuous RE was initiated at a load of 10%1RM with subsequent increases of 10% until 30%1RM, followed by increases of 5%1RM until exhaustion. Heart rate (HR) and R-R interval were recorded at rest and for 4 minutes at each load applied. Heart rate variability (HRV) was analyzed in 5-min segments at rest and at each load in the most stable 2-min signal. Results Parasympathetic indices decreased significantly in both exercises from 30%1RM compared to rest (rMSSD: 20±2 to 11±3 and 29±5 to 12±2 ms; SD1: 15±2 to 8±1 and 23±4 to 7±1 ms, for upper and lower limb exercise respectively) and HR increased (69±4 to 90±4 bpm for upper and 66±2 to 89±1 bpm for lower). RMSM increased for upper limb exercise, but decreased for lower limb exercise (28±3 to 45±9 and 34±5 to 14±3 ms, respectively). In the frequency domain, the sympathetic (LF) and sympathovagal balance (LF/HF) indices were higher and the parasympathetic index (HF) was lower for upper limb exercise than for lower limb exercise from 35% of 1RM. Conclusions Cardiac autonomic change occurred from 30% of 1RM regardless of RE limb. However, there was more pronounced sympathetic increase and vagal decrease for upper limb exercise than for lower limb exercise. These results provide a basis for more effective prescription of RE to promote health in this population. PMID:24675908

Machado-Vidotti, Heloisa G.; Mendes, Renata G.; Simoes, Rodrigo P.; Castello-Simoes, Viviane; Catai, Aparecida M.; Borghi-Silva, Audrey

2014-01-01

122

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

PubMed

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

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

2011-01-01

123

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. PMID:17066503

Rha, Dong-wook

2006-01-01

124

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. PMID:15610395

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

2004-01-01

125

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

126

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

127

Muscle Is a Target for Preservation in a Rat Limb Replantation Model  

PubMed Central

Background: Ischemia exceeding 6 hours makes clinical limb replantation difficult and places the patient at risk of functional deficit or limb loss. We investigated the preservation of muscle function and morphology with solutions in rat hindlimb in vivo and in vitro. Methods: Quadriceps femoris muscles from luciferase transgenic rats were preserved for 24 hours at 4°C in extracellular-type trehalose containing Kyoto (ETK), University of Wisconsin (UW), or lactated Ringer’s (LR) solution (control). Muscle luminescence was measured with a bioimaging system. Amputated limbs of Lewis rats preserved with ETK, UW, or LR for 6 or 24 hours at 4°C were transplanted orthotopically. At week 8, terminal latency and amplitude were measured in the tibialis anterior muscle. The muscles were also analyzed histologically. Results: Isolated muscles preserved in ETK or UW had significantly higher luminescence than did muscles immersed in LR (P < 0.05). In the 6-hour-preserved limb transplantation model, although the 3 groups had almost the same terminal latency, electrical amplitude was significantly lower in the LR group. Histologically, muscles preserved with LR showed the most atrophic changes. In the 24-hour-preserved model, the survival rate of the LR group was 37.5% in contrast to 80% in the ETK and UW groups. Electrical signals were not detected in the LR group owing to severe muscle atrophy and fibrosis. The ETK and UW groups showed good muscle function electrophysiologically. Conclusions: Preservation solutions can protect muscle function and morphology in ischemia–reperfusion limbs and improve recipient survival rates after transplantation of long-term-preserved limbs.

Iijima, Yuki; Teratani, Takumi; Hoshino, Yuichi; Kobayashi, Eiji

2013-01-01

128

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

Microsoft Academic Search

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

Jessie Van Swearingen; Cynthia Lance-Jones

1995-01-01

129

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

E-print Network

are redundant, such as exoskeleton system. In this paper, we put both the upper-level PID admittance controlPID Admittance Control for an Upper Limb Exoskeleton Wen Yu, Jacob Rosen, Xiaoou Li Abstract-- The unique exoskeleton system (EXO-UL7) in UCSC is controlled in two levels. The lower-level uses standard

Rosen, Jacob

130

Magnetic resonance imaging of skeletal muscle involvement in limb restricted vasculitis  

PubMed Central

Objective: To describe the MRI findings in the legs of three patients with limb restricted vasculitides (two PAN, one isolated vasculitis of the skeletal muscle) with histologically established muscle involvement. Methods: MRI was carried out on calf muscles and T2 weighted images, unenhanced T1 weighted images, and STIR sequences were obtained. Results: Muscle damage resulted in oedema-like changes on MRI characterised by hyperintense signals in T2 weighted and slow tau inversion recovery (STIR) sequences and normal unenhanced T1 weighted sequences of one or several leg muscles. Conclusions: MRI should be considered a useful complementary examination that might facilitate the recognition of limb restricted vasculitides, and possibly indicate the site for muscle biopsy. It could also be useful in monitoring the course of the disease. Future studies should also evaluate MRI for systemic PAN or other systemic vasculitides with muscle involvement. PMID:12429545

Gallien, S; Mahr, A; Rety, F; Kambouchner, M; Lhote, F; Cohen, P; Guillevin, L

2002-01-01

131

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. PMID:22987639

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

2012-01-01

132

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

PubMed Central

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

Cortes, Camilo; Ardanza, Aitor; Molina-Rueda, F.; Cuesta-Gomez, A.; Ruiz, Oscar E.

2014-01-01

133

Upper limb posture estimation in robotic and virtual reality-based rehabilitation.  

PubMed

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

Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F; Cuesta-Gómez, A; Unzueta, Luis; Epelde, Gorka; Ruiz, Oscar E; De Mauro, Alessandro; Florez, Julian

2014-01-01

134

Increased lower limb muscle activity induced by wearing MBT shoes: physiological benefits and potential concerns  

Microsoft Academic Search

Wearing rocker bottom shoes such as Masai Barefoot Technology (Masai Marketing & Trading AG, Winterthur, Switzerland) during quiet standing and comfortable walking results in greater lower limb muscle activity in comparison with conventional (flat-bottomed) shoes. This contribution will review current literature in the area of rocker bottom shoes by summarizing the acute and chronic effects associated with increased muscle activity.

Nicola A. Maffiuletti

2012-01-01

135

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. PMID:23236504

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

2012-01-01

136

The influence of dopaminergic striatal innervation on upper limb locomotor synergies.  

PubMed

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. PMID:23236504

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

2012-01-01

137

A Systematic Review of Bilateral Upper Limb Training Devices for Poststroke Rehabilitation  

PubMed Central

Introduction. In stroke rehabilitation, bilateral upper limb training is gaining ground. As a result, a growing number of mechanical and robotic bilateral upper limb training devices have been proposed. Objective. To provide an overview and qualitative evaluation of the clinical applicability of bilateral upper limb training devices. Methods. Potentially relevant literature was searched in the PubMed, Web of Science, and Google Scholar databases from 1990 onwards. Devices were categorized as mechanical or robotic (according to the PubMed MeSH term of robotics). Results. In total, 6 mechanical and 14 robotic bilateral upper limb training devices were evaluated in terms of mechanical and electromechanical characteristics, supported movement patterns, targeted part and active involvement of the upper limb, training protocols, outcomes of clinical trials, and commercial availability. Conclusion. Initial clinical results are not yet of such caliber that the devices in question and the concepts on which they are based are firmly established. However, the clinical outcomes do not rule out the possibility that the concept of bilateral training and the accompanied devices may provide a useful extension of currently available forms of therapy. To actually demonstrate their (surplus) value, more research with adequate experimental, dose-matched designs, and sufficient statistical power are required. PMID:23251833

van Delden, A. (Lex) E. Q.; Peper, C. (Lieke) E.; Kwakkel, Gert; Beek, Peter J.

2012-01-01

138

Rhesus monkey is a new model of secondary lymphedema in the upper limb  

PubMed Central

Objective: This study is to establish the rhesus monkey model of lymphedema in the upper limbs, and assess the suitability of this model. Methods: An animal model of lymphedema was established by the combined irradiation and surgical techniques in the upper limbs of these rhesus monkeys. Physical examination, high-resolution MR lymphangiography, bioelectrical impedance analysis (BIA), and immunohistochemical staining were performed to determine the severity of the edema in the upper limbs of the animal model. Results: Our results from physical examination indicated that the rhesus monkey model present with typical appearance and features of lymphedema. MR lymphangiography further demonstrated pathologically modified lymphatic vessels in our rhesus monkey model. BIA revealed increased water content in the upper limb in these rhesus monkeys, which was in line with the pathology of lymphedema. Immunohistochemical staining showed the curvature of the lymphatic vessels in the rhesus monkey model, typical pathological changes in lymphedema. Conclusion: Rhesus monkey lymphedema model provides a more consistent background to elucidate the pathophysiology of the disease. This new model would help to increase our understanding of acquired upper limb lymphedema, and promote the development of new treatments for this intractable disorder. PMID:25337207

Wu, Guojun; Xu, Hao; Zhou, Wenhong; Yuan, Xianshun; Yang, Zhe; Yang, Qing; Ding, Feng; Meng, Zhigang; Liang, Weili; Geng, Chong; Gao, Ling; Tian, Xingsong

2014-01-01

139

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

140

Limb congestion enhances the synchronization of sympathetic outflow with muscle contraction  

NASA Technical Reports Server (NTRS)

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

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

2000-01-01

141

Combined mirror visual and auditory feedback therapy for upper limb phantom pain: a case report  

PubMed Central

Introduction Phantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain. Case presentation We present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated with mirror visual feedback combined with auditory feedback with improved pain relief. Conclusion This case may suggest that auditory feedback might enhance the effectiveness of mirror visual feedback and serve as a valuable addition to the complex multi-sensory processing of body perception in patients who are amputees. PMID:21272334

2011-01-01

142

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

PubMed Central

Functional loss of limb control in individuals with spinal cord injury or stroke can be caused by interruption of corticospinal pathways, although the neural circuits located above and below the lesion remain functional. An artificial neural connection that bridges the lost pathway and connects cortical to spinal circuits has potential to ameliorate the functional loss. We investigated the effects of introducing novel artificial neural connections in a paretic monkey that had a unilateral spinal cord lesion at the C2 level. The first application bridged the impaired spinal lesion. This allowed the monkey to drive the spinal stimulation through volitionally controlled power of high-gamma activity in either the premotor or motor cortex, and thereby to acquire a force-matching target. The second application created an artificial recurrent connection from a paretic agonist muscle to a spinal site, allowing muscle-controlled spinal stimulation to boost on-going activity in the muscle. These results suggest that artificial neural connections can compensate for interrupted descending pathways and promote volitional control of upper limb movement after damage of descending pathways such as spinal cord injury or stroke. PMID:23596396

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

2013-01-01

143

Muscle MRI findings in limb girdle muscular dystrophy type 2L.  

PubMed

Limb girdle muscular dystrophy type 2L (LGMD2L) is an adult-onset slowly progressive muscular dystrophy associated with recessive mutations in the ANO5 gene. We analysed the muscle MRI pattern in a cohort of 25 LGMD2L patients in order to understand the extent and progression of muscle pathology in LGM2L and assess if muscle MRI might help in the diagnostic work-up of these patients. Our results showed a homogeneous pattern of muscle pathology on muscle MRI, with a predominant involvement of the posterior compartment muscles in both the thighs and calves. The muscles of the anterior compartments in the leg together with the sartorius and gracilis muscles were best preserved, which partially overlaps with patterns observed for other recessive LGMDs. Muscle MRI therefore does not appear to be as useful in the diagnostic work up of LGMD2L as for other neuromuscular diseases, such as Bethlem myopathy or myofibrillar myopathy. PMID:22980763

Sarkozy, Anna; Deschauer, Marcus; Carlier, Robert-Yves; Schrank, Bertold; Seeger, Jürgen; Walter, Maggie C; Schoser, Benedikt; Reilich, Peter; Leturq, France; Radunovic, Aleksandar; Behin, Anthony; Laforet, Pascal; Eymard, Bruno; Schreiber, Herbert; Hicks, Debbie; Vaidya, Sujit S; Gläser, Dieter; Carlier, Pierre G; Bushby, Kate; Lochmüller, Hanns; Straub, Volker

2012-10-01

144

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

145

Differences in myosin composition between human oro-facial, masticatory and limb muscles: enzyme-, immunohisto-and biochemical studies  

Microsoft Academic Search

Immunohistochemistry was used to determine the myosin composition of defined fibre types of three embryologically different adult muscles, the oro-facial, masseter and limb muscles. In addition, the myosin composition in whole muscle specimens was analysed with biochemical methods. Both similarities and differences between muscles in the content of myosin heavy chains and myosin light chains were found. Nevertheless, each muscle

P. Stål; P.-O. Eriksson; S. Schiaffino; G. S. Butler-Browne; L.-E. Thornell

1994-01-01

146

Assessment of neuromuscular activation of the upper limbs in children with spastic hemiparetic cerebral palsy during a dynamical task.  

PubMed

This study compared the intensity, co-activity and frequency content of the electromyography (EMG) signals recorded bilaterally from six muscles of the upper limbs in children with spastic hemiparetic cerebral palsy (SHCP) and typically developing (TD) children during a bilateral movement. It was found that children with SHCP executed the bimanual circular movement with higher intensities of mean neuromuscular activity in both arms compared to TD children. Furthermore, the movement was performed with longer phases of concentric and eccentric activity in children with SHCP, indicating more co-activation, especially in the more impaired arm. The EMG signals yielded a higher mean power frequency in all the muscles of the more impaired arm and the wrist and elbow flexors of the less impaired arm, which was interpreted as a relatively higher contribution of type II muscle fibres compared to TD children. These observations suggest that in children with SHCP bimanual coordination requires higher neuromuscular activation in the muscles of both arms. Furthermore, SHCP also seems to involve structural changes to the muscle properties, which differ between arms. PMID:19666231

Feltham, Max G; Ledebt, Annick; Deconinck, Frederik J A; Savelsbergh, Geert J P

2010-06-01

147

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

PubMed Central

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

Ache, Jan M.

2012-01-01

148

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

149

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. PMID:24175124

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

2013-01-01

150

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

PubMed Central

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

2014-01-01

151

Unilateral lower limb injury: Its long-term effects on quadriceps, hamstring, and plantarflexor muscle strength  

Microsoft Academic Search

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 activities. The relation between the size of decrement and limb dominance, type of injury, and time since injury was also considered.Design: Isometric and\\/or dynamic

Heather M. Holder-Powell; Olga M. Rutherford

1999-01-01

152

Development of a new exoskeleton for upper limb rehabilitation  

Microsoft Academic Search

This paper deals with the development of a novel exoskeleton for the robotic rehabilitation of upper extremities. The system is based on modular custom-designed actuation groups implementing high reduction ratios and redundant position measurement for securing patient safety, and joint torque sensing for guaranteeing system performance and providing application flexibility. Experimental results of the special component prototypes are reported which

Rocco Vertechy; Antonio Frisoli; Andrea Dettori; Massimiliano Solazzi; Massimo Bergamasco

2009-01-01

153

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

154

The effect of textured surfaces on postural stability and lower limb muscle activity.  

PubMed

Textured insoles may enhance sensory input on the plantar surfaces of the feet, thereby influencing neuromuscular function. The aim of this study was to investigate whether textured surfaces alter postural stability and lower limb muscle activity during quiet bipedal standing balance with eyes open. Anterior-posterior (AP) and mediolateral (ML) sway variables and the intensity of electromyographic (EMG) activity in eight dominant lower limb muscles were collected synchronously over 30s in 24 young adults under three randomised conditions: control surface (C), texture 1 (T1) and texture 2 (T2). Repeated measures ANOVA showed that the textured surfaces did not significantly affect AP or ML postural sway in comparison to the control condition (p>0.05). Neither did the textured surfaces significantly alter EMG activity in the lower limbs (p>0.05). Under the specific conditions of this study, texture did not affect either postural sway or lower limb muscle activity in static bipedal standing. The results of this study point to three areas of further work including the effect of textured surfaces on postural stability and lower limb muscle activity: (i) in young healthy adults under more vigorous dynamic balance tests, (ii) post-fatigue, and (iii) in older adults presenting age-related deterioration. PMID:18565764

Hatton, Anna Lucy; Dixon, John; Martin, Denis; Rome, Keith

2009-10-01

155

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

PubMed Central

Peripheral nerve entrapment occurs at specific anatomic locations. Familiarity with the anatomy and the magnetic resonance imaging (MRI) features of nerve entrapment syndromes is important for accurate diagnosis and early treatment of entrapment neuropathies. The purpose of this paper is to illustrate the normal anatomy of peripheral nerves in the upper and lower limbs and to review the MRI features of common disorders affecting the peripheral nerves, both compressive/entrapment and noncompressive, involving the suprascapular nerve, the axillary nerve, the radial nerve, the ulnar nerve, and the median verve in the upper limb and the sciatic nerve, the common peroneal nerve, the tibial nerve, and the interdigital nerves in the lower limb. PMID:23125929

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

2012-01-01

156

Normative data for modified Box and Blocks test measuring upper-limb function via motion capture.  

PubMed

Motion analysis is an important tool for examining upper-limb function. Based on previous work demonstrating a modified Box and Blocks (BB) test with motion capture to assess prosthetic performance, we collected data in 16 nondisabled participants to establish normative kinematics for this test. Four motions of the modified BB test were analyzed to establish kinematic data for upper-limb and trunk motion. The test was repeated for right and left arms in standing and seated positions. Data were compared using a nonparametric Friedman test. No differences were found between right- and left-hand performance other than for task completion time. Small but significant differences were found for standing and seated performance, with slightly greater ranges in standing for axial trunk rotation, medial-lateral sternum displacement, and anterior-posterior hand displacement. The kinematic trajectories, however, were very consistent. The consistency in our nondisabled data suggests that normative kinematic trajectories can be defined for this task. This motion capture procedure may add to the understanding of movement in upper-limb impairment and may be useful for measuring the effect of interventions to improve upper-limb function. PMID:25356979

Hebert, Jacqueline S; Lewicke, Justin; Williams, Thomas R; Vette, Albert H

2014-01-01

157

Exoskeleton robots for upper-limb rehabilitation: State of the art and future prospects  

Microsoft Academic Search

Current health services are struggling to provide optimal rehabilitation therapy to victims of stroke. This has motivated researchers to explore the use of robotic devices to provide rehabilitation therapy for strokepatients. This paper reviews the recent progress of upper limb exoskeleton robots for rehabilitation treatment of patients with neuromuscular disorders. Firstly, a brief introduction to rehabilitation robots will be given

Ho Shing Lo; Sheng Quan Xie

158

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

159

Force control of an upper limb exoskeleton for virtual reality using impedance control  

Microsoft Academic Search

This paper presents the development of an upper limb exoskeleton for displaying force generated by virtual environment. The device allows the user to sense the profile of virtual object through joints at wrist, elbow and shoulder. The Impedance controller with model feed forward is used to compensate the weight of the device and adjust the closed loop system to perform

Chaiyaporn Silawatchananai; Manukid Parnichkun

2011-01-01

160

The principles of management of congenital anomalies of the upper limb  

PubMed Central

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

Watson, S.

2000-01-01

161

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

PubMed Central

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

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

2014-01-01

162

Neural PID Control of Robot Manipulators with Application to an Upper Limb Exoskeleton  

E-print Network

in a PID controller reduces the bandwidth of the closed-loop system. In order to remove steady-state error1 Neural PID Control of Robot Manipulators with Application to an Upper Limb Exoskeleton Wen Yu to uncertainties in robot control, PID control needs a big integral gain, or a neural compensator is added

Rosen, Jacob

163

Flap Decisions and Options in Soft Tissue Coverage of the Upper Limb  

PubMed Central

Soft tissue deficiency in the upper limb is a common presentation following trauma, burns infection and tumour removal. Soft tissue coverage of the upper limb is a challenging problem for reconstructive surgeons to manage. The ultimate choice of soft tissue coverage will depend on the size and site of the wound, complexity of the injury, status of surrounding tissue, exposure of the vital structures and health status of the patient. There are several local cutaneous flaps that provide adequate soft tissue coverage for small sized defects of the hand, forearm and arm. When these flaps are limited in their mobility regional flaps and free flaps can be utilised. Free tissue transfer provides vascularised soft tissue coverage in addition to the transfer of bone, nerve and tendons. Careful consideration of free flap choice, meticulous intraoperative dissection and elevation accompanied by post-operative physiotherapy are required for successful outcomes for the patient. Several free flaps are available for reconstruction in the upper limb including the groin flap, anterolateral flap, radial forearm flap, lateral arm flap and scapular flap. In this review we will provide local, regional and free flap choice options for upper limb reconstruction, highlighting the benefits and challenges of different approaches. PMID:25408782

Griffin, Michelle; Hindocha, Sandip; Malahias, Marco; Saleh, Mohamed; Juma, Ali

2014-01-01

164

The biological and behavioral basis of upper limb asymmetries in sensorimotor performance  

Microsoft Academic Search

Asymmetries in upper limb performance are a fundamental aspect of human behavior. This phenomenon, commonly known as handedness, has inspired a great deal of research over the course of the past century garnering interest across a multitude of scientific domains. In the present paper, a thorough review of this literature is provided focusing on the current state of knowledge regarding

Daniel J. Goble; Susan H. Brown

2008-01-01

165

Prevalence of upper limb musculo skeletal disorders among brass metal workers in West Bengal, India.  

PubMed

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, 50 male brass metal workers (Experimental Group) and 50 male office workers (Comparison Group) were selected. For the symptom survey, a questionnaire on discomfort symptoms was performed. Repetitiveness of work and Hand Grip Strength of both the groups were measured. It was revealed that upper limb MSD was a major problem among brass metal workers, primarily involving the hand, wrist, fingers and shoulder. Among the workers reporting subjective discomfort, most of them felt pain, followed by tingling and numbness in their hands. Many complained of swelling, warmth and tenderness in their wrists. Their activities were highly repetitive and the handgrip strength of these workers was significantly less than that of the comparison group. Based on these findings, it appears that high repetitiveness, prolonged work activity (10.5 h of work per day with 8.4 h spent on hammering) and decreased handgrip strength may be causative factors in the occurrence of upper limb MSD among brass metal workers in West Bengal, India. PMID:17485885

Gangopadhyay, Somnath; Ghosh, Tirthankar; DAS, Tamal; Ghoshal, Goutam; DAS, Bani Brata

2007-04-01

166

The Effect of Sound Stimuli on Neurologic Rehabilitation of Upper and Lower Limbs: A Meta Analysis  

Microsoft Academic Search

The purpose of this study was to analyze the existing quantitative research evaluating the effect of sound stimuli on neurologic rehabilitation of upper and lower limbs. Seventeen studies were used in two separate analyses. The first one evaluated the effects of sound stimuli on within-subjects groups. Data were recorded before and during music intervention. The second analysis evaluated the effects

Paula Chandra

2005-01-01

167

A virtual tabletop workspace for the assessment of upper limb function in Traumatic Brain Injury (TBI)  

Microsoft Academic Search

Traditional methods of movement assessment in clinical rehab are often labor intensive and provide a limited number of outcome variables for tracking recovery. Entry level virtual reality (VR) systems afford new possibilities for systematic assessment and treatment. This paper describes the development of a virtual tabletop environment for the assessment of upper limb function in Traumatic Brain Injury (TBI). The

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

2007-01-01

168

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. PMID:12598671

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

2003-01-01

169

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

170

Development of a potential system for upper limb rehabilitation training based on virtual reality  

Microsoft Academic Search

This paper proposed a novel rehabilitation system for rehabilitation training of the upper limbs for patients whose brain injured such as stroke. We also proposed some strategies of rehabilitation using this system based on Virtual Reality. In this paper, Virtual Reality (VR) was adapted in this system in which the water simulation provided fundamental environment for rehabilitation training and we

Zhibin Song; Shuxiang Guo; Mohd Yazid

2011-01-01

171

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

Microsoft Academic Search

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

MASSIMO BOVENZI; ANTONELLA ZADINI; ANDREA FRANZINELLI; FLAVIO BORGOGNI

1991-01-01

172

Influence of upper- and lower-limb exercise training on cardiovascular function and walking distances in patients with intermittent claudication  

Microsoft Academic Search

Purpose: The effects of upper-limb (arm cranking) and lower-limb (leg cranking) exercise training on walking distances in patients with intermittent claudication was assessed. Methods: Sixty-seven patients (33 to 82 years old) with moderate to severe intermittent claudication were recruited, and the maximum power generated during incremental upper- and lower-limb ergometry tests was determined, as were pain-free and maximum walking distances

Richard D Walker; Shah Nawaz; Claire H Wilkinson; John M Saxton; A. Graham Pockley; Richard F. M Wood

2000-01-01

173

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

PubMed Central

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

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

2014-01-01

174

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

PubMed Central

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

2013-01-01

175

The closer muscle is a second target for the stretcher inhibitor motoneuron of the crayfish's thoracic limbs  

Microsoft Academic Search

The stretcher inhibitor motoneuron of each thoracic limb of a crayfish (Pacifastacus leniusculus) was consistently found to innervate parts of the closer muscle, in addition to the stretcher muscle; it is thus not a specific inhibitor as previously thought. The common inhibitory motoneuron also innervates parts of both muscles. Some individual closer muscle fibers are inhibited more strongly by one

T. J. Wiens

1993-01-01

176

Combined effects of botulinum toxin injection and hind limb unloading on bone and muscle.  

PubMed

Bone receives mechanical stimulation from two primary sources, muscle contractions and external gravitational loading; but the relative contribution of each source to skeletal health is not fully understood. Understanding the most effective loading for maintaining bone health has important clinical implications for prescribing physical activity for the treatment or prevention of osteoporosis. Therefore, we investigated the relative effects of muscle paralysis and reduced gravitational loading on changes in muscle mass, bone mineral density, and microarchitecture. Adult female C57Bl/6J mice (n = 10/group) underwent one of the following: unilateral botulinum toxin (BTX) injection of the hind limb, hind limb unloading (HLU), both unilateral BTX injection and HLU, or no intervention. BTX and HLU each led to significant muscle and bone loss. The effect of BTX was diminished when combined with HLU, though generally the leg that received the combined intervention (HLU+BTX) had the most detrimental changes in bone and muscle. We found an indirect effect of BTX affecting the uninjected (contralateral) leg that led to significant decreases in bone mineral density and deficits in muscle mass and bone architecture relative to the untreated controls; the magnitude of this indirect BTX effect was comparable to the direct effect of BTX treatment and HLU. Thus, while it was difficult to definitively conclude whether muscle force or external gravitational loading contributes more to bone maintenance, it appears that BTX-induced muscle paralysis is more detrimental to muscle and bone than HLU. PMID:24240478

Ellman, Rachel; Grasso, Daniel J; van Vliet, Miranda; Brooks, Daniel J; Spatz, Jordan M; Conlon, Christine; Bouxsein, Mary L

2014-03-01

177

Lower Limb Muscles SEMG Activity during High-Heeled Latin Dancing  

Microsoft Academic Search

\\u000a aim of this study is to provide information about surface electromyography (SEMG) activity pattern in lower limb muscles during\\u000a Latin dancing with different heel height shoes. SEMG signals from tibialis anterior, medial and lateral sides of gastrocnemius,\\u000a soleus and biceps femoris of ten professional female dancers were recorded. All the muscles average EMG (aEMG) values except\\u000a biceps femoris were significantly

Y. D. Gu; J. S. Li; G. Q. Ruan; Y. C. Wang; M. J. Lake; X. J. Ren

178

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

NASA Technical Reports Server (NTRS)

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

Kuzmina, G. I.

1980-01-01

179

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. PMID:22558231

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

2012-01-01

180

Real-time upper limb motion estimation from surface electromyography and joint angular velocities using an artificial neural network for human-machine cooperation.  

PubMed

A current challenge with human-machine cooperation systems is to estimate human motions to facilitate natural cooperation and safety of the human. It is a logical approach to estimate the motions from their sources (skeletal muscles); thus, we employed surface electromyography (SEMG) to estimate body motions. In this paper, we investigated a cooperative manipulation control by an upper limb motion estimation method using SEMG and joint angular velocities. The SEMG signals from five upper limb muscles and angular velocities of the limb joints were used to approximate the flexion-extension of the limb in the 2-D sagittal plane. The experimental results showed that the proposed estimation method provides acceptable performance of the motion estimation [normalized root mean square error (NRMSE) <0.15, correlation coefficient (CC) >0.9] under the noncontact condition. From the analysis of the results, we found the necessity of the angular velocity input and estimation error feedback due to physical contact. Our results suggest that the estimation method can be useful for a natural human-machine cooperation control. PMID:21558060

Kwon, Suncheol; Kim, Jung

2011-07-01

181

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

2013-03-01

182

A method for positioning electrodes during surface EMG recordings in lower limb muscles  

Microsoft Academic Search

Purpose: The aim of this work is to provide information about the degree of inter-subject uniformity of location of innervation zone (IZ) in 13 superficial muscles of the lower limb. The availability of such information will allow researchers to standardize and optimize their electrode positioning procedure and to obtain accurate and repeatable estimates of surface electromyography (sEMG) signal amplitude, spectral

A. Rainoldi; G. Melchiorri; I. Caruso

2004-01-01

183

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

PubMed Central

Artificial limbs allow amputees to manipulate objects, but the loss of a limb severs the sensory link between a subject and objects they touch. A novel surgical technique we term targeted reinnervation (TR) allows severed cutaneous nerves to reinnervate skin on a different portion of the body. This technique provides a physiologically appropriate portal to the sensory pathways of the missing limb through the reinnervated skin. This study quantified the ability of three amputee subjects who had undergone TR surgery on the chest (two subjects) and upper arm (one subject) to discriminate changes in graded force on their reinnervated skin over a range of 1–4 N using a stochastic staircase approach. These values were compared to those from sites on their intact contralateral skin and index fingers, and from the chests and index fingers of a control population (n = 10). Weber’s ratio (WR) was used to examine the subjects’ abilities to discriminate between a baseline force and subsequent forces of different magnitudes. WRs of 0.22, 0.25, and 0.12 were measured on the reinnervated skin of the three TR subjects, whereas WRs of 0.25,0.23, and 0.12 were measured on their contralateral skin. TR subjects did not have substantially different WRs on their reinnervated versus their contralateral normal side and did not appear to exhibit a trend towards impaired sensation. No significant difference was found between the WR of the chest and index finger of the control subjects, which ranged between 0.09 and 0.21. WR of reinnervated skin for TR subjects were within the 95% confidence interval of the control group. These data suggest that subjects with targeted reinnervation have unimpaired ability to discriminate gradations in force. PMID:19775983

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

2011-01-01

184

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

PubMed

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

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

2013-12-01

185

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

NASA Technical Reports Server (NTRS)

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

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

1987-01-01

186

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

187

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

2013-07-01

188

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

2008-03-01

189

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

NASA Astrophysics Data System (ADS)

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

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

2007-12-01

190

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

PubMed

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

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

2009-05-01

191

Intrauterine Upper Limb Ischemia: An Unusual Presentation of Fetal Thrombophilia--A Case Report and Review of the Literature  

PubMed Central

Upper limb ischemia presenting in neonatal period is extremely rare. Moreover, presenting newborn with evidence of intrauterine upper limb vascular occlusion is even rarer. It needs prompt intervention to restore perfusion and avoid morbidity. We present a newborn with right upper limb brachial artery thrombosis causing ischemia that was noted at birth and appeared later to be homozygous for factor V Leiden and glycoprotein IIIa with no other identifiable risk factors. In this report, we present the case, its successful medical management, proper counseling, and review of the literature. We recommend investigating the neonates and their parents for thrombophilia mutations when they present with unusual vascular occlusion site as newborns. PMID:24223318

Abdelrazeq, Samer; Alkhateeb, Abdullatif; Saleh, Hani; Alhasan, Haitham; Khammash, Hatem

2013-01-01

192

Upper limb musculoskeletal abnormalities in type 2 diabetic patients in low socioeconomic strata in Pakistan  

PubMed Central

Background Musculoskeletal manifestations of diabetes in the upper limb are well recognized. No data has been available in this regard from Pakistan. Our aim was to find out the frequency of upper limb musculoskeletal abnormalities in diabetic patients. Methods This was an observational study in which type 2 diabetes patients attending our diabetic clinic were enrolled along with age and gender matched controls. Data was analyzed on SPSS 16. Results In total, 210 Type 2 diabetics (male 34.3%, female 65.7%) and 203 controls (male 35%, female 65%) were recruited. The mean age was 50.7± 10.2 years in diabetic group as compared to 49.5±10.6 years in the control group. The frequencies of hand region abnormalities were significantly higher in the diabetic subjects as compared to the controls (20.4%, p-value <0.001). Limited joint mobility (9.5% vs 2.5%), carpal tunnel syndrome (9% vs 2%), trigger finger (3.8% vs 0.5%), and dupuytren’s contracture (1% vs 0%) were found more frequent as compared to controls (all p-values <0.05). In the shoulder region of diabetic subjects, adhesive capsulitis and tendonitis was found in 10.9% and 9.5% respectively as compared to 2.5% and 2% in control group [p- value <0.001]. A weak but positive relationship was observed between age and duration of diabetes with these upper limb abnormalities. However, no correlation was found between the frequencies of these abnormalities with control of diabetes. Conclusion A higher frequency of upper limb musculoskeletal abnormalities was observed in Type 2 diabetic patients as compared to control group. PMID:23327429

2013-01-01

193

Unilateral Variations in Upper Limb Arterial System: A Case Report with Literature Review  

PubMed Central

In a female cadaver unilateral variations were found in upper limb arterial system - as (1) high-up origin of ulnar artery at arm, (2) persistent prominent arteria nervii mediana or median artery, (3) common interosseous artery branching out of brachial artery. Literature review revealed these coexistent anomalies as the consequence of aberrant finalization of the path chosen by axis arterial network in embryonic life. PMID:24596751

Roy, Tanushree; Roy, Hironmoy; Ghosal (Sen), Tanwi; Begum, Shabana

2014-01-01

194

Relations between upper limb soft tissue disorders and repetitive movements at work.  

PubMed

To make a preliminary assessment of whether upper limb soft tissue disorders might be associated with activities at work, we have conducted a case-control study of subjects attending orthopedic clinics in three cities. All subjects between the ages of 16 and 65 years, in whom defined soft tissue conditions of the upper limb were diagnosed by the participating orthopedic surgeons, were invited to take part. Controls were subjects attending the same clinics within the same age range whose clinical diagnosis did not include disease of the upper limb, cervical or thoracic spine. Information concerning repetitive movements of the upper limbs at work was elicited by questionnaire. Five hundred eighty cases and 996 controls were studied, representing 96% and 93%, respectively, of those invited to participate. The diagnoses of the cases included soft tissue conditions affecting the shoulder, elbow, forearm, wrist, thumb, hand, and fingers. The diagnoses of the controls included traumatic, degenerative, and inflammatory conditions, mostly of the legs and lower back. Women predominated among the cases (70%) and men among the controls (56%). Of 221 female cases with injury to the wrist and forearm, 32 were cleaner/domestics (14.5%) compared to 35 to 439 controls (8%), a difference statistically significant at the 2 1/2% level. Other jobs significantly overrepresented (5% level) among female cases with injuries at various anatomical sites included hairdressers, secretary/temps, assembly line workers, and machine operators (type unspecified). Among male cases, electricians were significantly overrepresented (5% level). Jobs for which there was a suggestion (p < 0.1) of overrepresentation among cases included butchers and teacher/lecturers (both males only) and the combined job groups (chosen a priori for analysis) of keyboard operators, machine operators, and music teachers (all three jobs, females only). PMID:7900737

English, C J; Maclaren, W M; Court-Brown, C; Hughes, S P; Porter, R W; Wallace, W A; Graves, R J; Pethick, A J; Soutar, C A

1995-01-01

195

Patterns in Adult and Subadult Upper Limb Asymmetry from North American Archaic and Mississippian Populations  

Microsoft Academic Search

Bone morphology is heavily influenced by mechanical loading during an individual’s lifetime. This can be used to infer behavioral variability among individuals, sexes, ages, and populations based primarily on the division of labor. This study compares osteometric dimensions and cross-sectional geometries from the adult and subadult upper limbs of three North American Archaic populations known to be hunter-gatherers: Windover, Indian

Geoffrey P. Thomas

2011-01-01

196

Robotic techniques for upper limb evaluation and rehabilitation of stroke patients  

Microsoft Academic Search

This paper presents two robot devices for use in the rehabilitation of upper limb movements and reports the quantitative parameters obtained to characterize the rate of improvement, thus allowing a precise monitoring of patient's recovery. A one degree of freedom (DoF) wrist manipulator and a two-DoF elbow-shoulder manipulator were designed using an admittance control strategy; if the patient could not

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

2005-01-01

197

Development of the MACARM - a novel cable robot for upper limb neurorehabilitation  

Microsoft Academic Search

This paper describes the design and operation of the multi-axis cartesian-based arm rehabilitation machine (MACARM), a new cable (wire) robot for upper limb rehabilitation. The prototype configuration is comprised of an array of 8 motors mounted at the corners of a cubic support frame that provides, via cables, 6 degree of freedom (DOF) control of a centrally located end-effector. A

David Mayhew; Benjamin Bachrach; W. Zev Rymer; Randall F. Beer

2005-01-01

198

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

PubMed Central

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

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

2014-01-01

199

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

2013-01-01

200

Assessment of movement quality in robot- assisted upper limb rehabilitation after stroke: a review.  

PubMed

: Studies of stroke patients undergoing robot-assisted rehabilitation have revealed various kinematic parameters describing movement quality of the upper limb. However, due to the different level of stroke impairment and different assessment criteria and interventions, the evaluation of the effectiveness of rehabilitation program is undermined. This paper presents a systematic review of kinematic assessments of movement quality of the upper limb and identifies the suitable parameters describing impairments in stroke patients. A total of 41 different clinical and pilot studies on different phases of stroke recovery utilizing kinematic parameters are evaluated. Kinematic parameters describing movement accuracy are mostly reported for chronic patients with statistically significant outcomes and correlate strongly with clinical assessments. Meanwhile, parameters describing feed-forward sensorimotor control are the most frequently reported in studies on sub-acute patients with significant outcomes albeit without correlation to any clinical assessments. However, lack of measures in coordinated movement and proximal component of upper limb enunciate the difficulties to distinguish the exploitation of joint redundancies exhibited by stroke patients in completing the movement. A further study on overall measures of coordinated movement is recommended. PMID:25217124

Nordin, Nurdiana; Xie, Sheng Quan; Wünsche, Burkhard

2014-01-01

201

Classification of lymphoscintigraphy and relevance to surgical indication for lymphaticovenous anastomosis in upper limb lymphedema.  

PubMed

Upper limb lymphedema that develops after breast cancer surgery causes physical discomfort and psychological distress, and it can require both conservative and surgical treatment. Lymphaticovenous anastomosis has been reported to be an effective treatment; however the disease severity criteria that define indications for this treatment remain unclear. Here, we examined lymphoscintigraphic findings in 78 patients with secondary upper limb lymphedema and classified them into 5 major types (Type I-V) and 3 subtypes (Subtype E, L, and 0). Results revealed that this classification is related to the clinical stage scale of the International Society of Lymphology. Based on intraoperative examination findings in 20 of the 78 patients, lymphatic pressure is likely to be further elevated in Type II-V cases which are characterized by the presence of dermal back flow. Therefore, lymphaticovenous anastomosis should be considered as a treatment option for lymphedema in Type II-V cases. Furthermore, there are only limited lymph vessel sites usable for lymphaticovenous anastomosis in more severe lymphedema types [Types IV and Type V (which is characterized by dermal backflow only in the hand)]. The findings in Type IV-V cases suggest that therapeutic strategies for severe upper limb lymphedema need further consideration. PMID:22458117

Mikami, T; Hosono, M; Yabuki, Y; Yamamoto, Y; Yasumura, K; Sawada, H; Shizukuishi, K; Maegawa, J

2011-12-01

202

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

Microsoft Academic Search

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

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

2010-01-01

203

Necrotising soft-tissue infections of the upper limb: risk factors for amputation and death.  

PubMed

Necrotising soft-tissue infections (NSTIs) of the upper limb are uncommon, but potentially life-threatening. We used a national database to investigate the risk factors for amputation of the limb and death. We extracted data from the Japanese Diagnosis Procedure Combination database on 116 patients (79 men and 37 women) who had a NSTI of the upper extremity between 2007 and 2010. The overall in-hospital mortality was 15.5%. Univariate analysis of in-hospital mortality showed that the significant variables were age (p = 0.015), liver dysfunction (p = 0.005), renal dysfunction (P < 0.001), altered consciousness (p = 0.049), and sepsis (p = 0.021). Logistic regression analysis showed that the factors associated with death in hospital were age over 70 years (Odds Ratio (OR) 6.6; 95% confidence interval (CI) 1.5 to 28.2; p = 0.011) and renal dysfunction (OR 15.4; 95% CI 3.8 to 62.8; p < 0.001). Univariate analysis of limb amputation showed that the significant variables were diabetes (p = 0.017) mellitus and sepsis (p = 0.001). Multivariable logistic regression analysis showed that the factors related to limb amputation were sepsis (OR 1.8; 95% CI 1.5 to 24.0; p = 0.013) and diabetes mellitus (OR 1.6; 95% CI 1.1 to 21.1; p = 0.038). For NSTIs of the upper extremity, advanced age and renal dysfunction are both associated with a higher rate of in-hospital mortality. Sepsis and diabetes mellitus are both associated with a higher rate of amputation. Cite this article: Bone Joint J 2014;96-B:1530-4. PMID:25371469

Uehara, K; Yasunaga, H; Morizaki, Y; Horiguchi, H; Fushimi, K; Tanaka, S

2014-11-01

204

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

PubMed

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

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

2014-02-15

205

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

Microsoft Academic Search

BACKGROUND: It has been shown that intense training can significantly improve post-stroke upper-limb functionality. However, opportunities for stroke survivors to practice rehabilitation exercises can be limited because of the finite availability of therapists and equipment. This paper presents a haptic-enabled exercise platform intended to assist therapists and moderate-level stroke survivors perform upper-limb reaching motion therapy. This work extends on existing

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

2008-01-01

206

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

Microsoft Academic Search

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

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

2010-01-01

207

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

Microsoft Academic Search

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

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

2008-01-01

208

Development of a hybrid strength training technique for paretic lower-limb muscles  

Microsoft Academic Search

A hybrid resistance exercise technique for strength training of patients with lower-limb paresis was developed. It consists of electrical stimulation-induced contractions (ESIC) superimposed on voluntary contractions to increase recruitment of motor units and the functional load capability of paretic quadriceps and hamstring muscle groups. The feasibility of this hybrid exercise technique was demonstrated in 10 able-bodied subjects during submaximal isometric

T. L. Bennett; R. M. Glaser; T. W. J. Janssen; W. P. Couch; C. J. Herr; J. W. Almeyda; S. H. Petrofsky; P. Akuthota

1996-01-01

209

Muscle metabolism changes with training in the nonamputated limb after vascular amputation: Interest of phosphorus 31 NMR spectroscopy  

Microsoft Academic Search

Objective: To determine by 31P nuclear magnetic resonance (NMR) spectroscopy the efficacy of training in improving aerobic metabolism of calf muscle in nonamputated limb after recent vascular amputation; to assess the possible associated microcirculatory changes; and to evaluate the need for noninvasive monitoring techniques during training in the nonamputated limb after recent vascular amputation.Design: Prospective study, before and after training.

Veronique Dulieu; Jean-Marie Casillas; Jean-Françis Maillefert; Paul Walker; Yves Cottin; Jean-Pierre Didier; François Brunotte

1997-01-01

210

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

211

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

PubMed

This study aimed to investigate the efficacy of lower limb compression as a recovery strategy following exercise-induced muscle damage (EIMD). Seventeen female volunteers completed 10 x 10 plyometric drop jumps from a 0.6-m box to induce muscle damage. 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 12 h immediately following damaging exercise. Passive recovery group participants had no intervention. Indirect indices of muscle damage (muscle soreness, creatine kinase activity, knee extensor concentric strength, and vertical jump performance) were assessed prior to and 1, 24, 48, 72, and 96 h following plyometric exercise. Plyometric exercise had a significant effect (p < or = 0.05) on all indices of muscle damage. The compression treatment reduced decrements in countermovement jump performance (passive recovery 88.1 +/- 2.8% vs. treatment 95.2 +/- 2.9% of pre-exercise), squat jump performance (82.3 +/- 1.9% vs. 94.5 +/- 2%), and knee extensor strength loss (81.6 +/- 3% vs. 93 +/- 3.2%), and reduced muscle soreness (4.0 +/- 0.23 vs. 2.4 +/- 0.24), but had no significant effect on creatine kinase activity. The results indicate that compression clothing is an effective recovery strategy following exercise-induced muscle damage. PMID:20376479

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

2010-08-01

212

Reciprocal axo-axonal synapses between the common inhibitor and excitor motoneurons in crustacean limb muscles.  

PubMed

Nerve terminals of the common inhibitor motoneuron in a crab (Eriphia spiniforns) limb closer muscle and in a crayfish (Procambarus clarkii) limb accessory flexor muscle make neuromuscular synapses with the muscle membrane (postsynaptic inhibition) as well as axo-axonal synapses with the terminals of the excitatory axon (presynaptic inhibition). That transmission is from the inhibitor to the excitor terminals at these axo-axonal synapses is indicated by the occurrence on the inhibitor membrane of presynaptic dense bars denoting sites of transmitter release. Axo-axonal synapses with the opposite polarity, in which transmission is from an excitatory onto an inhibitory terminal, were occasionally seen either adjacent to or separate from the inhibitory axo-axonal synapse. Nerve terminals of the specific inhibitor in the crayfish opener muscle were seen to make numerous axo-axonal output synapses upon excitatory nerve terminals but excitor nerve terminals were not seen to make output synapses onto inhibitor terminals. Thus reciprocal axo-axonal synapses appear to be a feature of the common inhibitor but not of the specific inhibitor. The excitor-to-inhibitor component of these reciprocal synapses may serve to limit transmitter output in the common inhibitor axon by activating glutamateB receptors which facilitate efflux of K+ and hyperpolarization of the membrane. PMID:8478645

Pearce, J; Govind, C K

1993-04-01

213

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. PMID:20021677

2009-01-01

214

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. PMID:23666198

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

2013-01-01

215

Effect of a robotic rehabilitation device on upper limb function in a sub-acute cervical spinal cord injury population  

Microsoft Academic Search

Robotic rehabilitation devices have been suggested as a tool to increase the amount of rehabilitation delivered after a neurological injury. Clinical robotic rehabilitation studies of the upper extremity have generally focused on stroke survivors. We present the results of a multi-center pilot study where an upper- limb robotic rehabilitation device (Armeo Spring®, Hocoma AG) was incorporated into the rehabilitation program

Jose Zariffa; Naaz Kapadia; John L. K. Kramer; Philippa Taylor; Milad Alizadeh-Meghrazi; Vera Zivanovic; Rhonda Willms; Andrea Townson; Armin Curt; Milos R. Popovic; John D. Steeves

2011-01-01

216

Upper limb amputees can be induced to experience a rubber hand as their own  

PubMed Central

We describe how upper limb amputees can be made to experience a rubber hand as part of their own body. This was accomplished by applying synchronous touches to the stump, which was out of view, and to the index finger of a rubber hand, placed in full view (26 cm medial to the stump). This elicited an illusion of sensing touch on the artificial hand, rather than on the stump and a feeling of ownership of the rubber hand developed. This effect was supported by quantitative subjective reports in the form of questionnaires, behavioural data in the form of misreaching in a pointing task when asked to localize the position of the touch, and physiological evidence obtained by skin conductance responses when threatening the hand prosthesis. Our findings outline a simple method for transferring tactile sensations from the stump to a prosthetic limb by tricking the brain, thereby making an important contribution to the field of neuroprosthetics where a major goal is to develop artificial limbs that feel like a real parts of the body. PMID:19074189

Rosen, Birgitta; Stockselius, Anita; Ragno, Christina; Kohler, Peter; Lundborg, Goran

2008-01-01

217

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

218

Virtual reality environments to enhance upper limb functional recovery in patients with hemiparesis.  

PubMed

Impairments in reaching and grasping have been well-documented in patients with post-stroke hemiparesis. Patients have deficits in spatial and temporal coordination and may use excessive trunk displacement to assist arm transport during performance of upper limb tasks. Studies of therapeutic effectiveness have shown that repetitive task-specific practice may improve motor function outcomes. Movement retraining may be optimized when done in virtual reality (VR) environments. Environments created with VR technology can incorporate elements essential to maximize motor learning, such as repetitive and varied task practice, performance feedback and motivation. Haptic technology can also be incorporated into VR environments to enhance the user's sense of presence and to make motor tasks more ecologically relevant to the participant. As a first step in the validation of the use of VR environments for rehabilitation, it is necessary to demonstrate that movements made in virtual environments are similar to those made in equivalent physical environments. This has been verified in a series of studies comparing pointing and reaching/grasping movements in physical and virtual environments. Because of the attributes of VR, rehabilitation of the upper limb using VR environments may lead to better rehabilitation outcomes than conventional approaches. PMID:19592789

Levin, Mindy F; Knaut, Luiz Alberto Manfre; Magdalon, Eliane C; Subramanian, Sandeep

2009-01-01

219

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

PubMed Central

Background Hand-arm vibration syndrome (HAVS) is a well-known disease among workers using hand-held vibrating tools. These patients experience major symptoms from their upper limbs. However, there are few studies on disability in this patient group. In this study we wanted to describe the disability of HAVS patients. Methods All HAVS patients diagnosed at Haukeland University Hospital in Bergen, Norway in a five-year period were invited. The disabilities of the arm, shoulder and hand (DASH) questionnaire was sent by mail. Clinical data were extracted from their hospital journals. Descriptive statistics and regression analyses were performed. Results Thirty-eight patients were recruited. Mean DASH score was 41.2, while the mean of a normal population is 10. Ability to perform tasks related to work and everyday life was affected in these patients. We found a significant association between the DASH score, hand grip strength and tendinitis, also after adjustment for age and smoking in pack-years. Conclusion HAVS patients demonstrate a high level of upper limb disability as assessed by the DASH score. Ability to perform tasks related to work and everyday life was affected. We found a significant association between the DASH score, hand grip strength and tendinitis. This should be focused upon in future research. PMID:24517340

2014-01-01

220

A novel system for automatic classification of upper limb motor function after stroke: An exploratory study.  

PubMed

In the early post-stroke phase, when clinicians attempt to evaluate interventions and accurately measure motor performance, reliable tools are needed. Therefore, the development of a system capable of independent, repeated and automatic assessment of motor function is of increased importance. This manuscript explores the potential of a newly designed device for automatic assessment of motor impairment after stroke. A portable motion capture system was developed to acquire three-dimensional kinematics data of upper limb movements. These were then computed through an automatic decision tree classifier, with features inferred from the Functional Ability Score (FAS) of the Wolf Motor Function Test (WMFT). Five stroke patients were tested on both sides across five selected tasks. The system was compared against a trained clinician, operating simultaneously and blinded. Regarding performance time, the mean difference (system vs clinician) was 0.17s (sd=0.14s). For FAS evaluation, there was agreement in 4 out of 5 patients in the two tasks evaluated. The prototype tested was able to automatically classify upper limb movement, according to a widely used functional motor scale (WMFT) in a relevant clinical setting. These results represent an important step towards a system capable of precise and independent motor evaluation after stroke. The portability and low-cost design will contribute for its usability in ambulatory clinical settings and research trials. PMID:25280582

Tedim Cruz, Vítor; Bento, Virgílio Ferro; Ribeiro, David Dieteren; Araújo, Isabel; Branco, Catarina Aguiar; Coutinho, Paula

2014-12-01

221

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

PubMed

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

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

2014-06-01

222

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

2013-07-15

223

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

224

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

PubMed Central

Background Studies involving chronic creatine supplementation in elite soccer players are scarce. Therefore, the aim of this study was to examine the effects of creatine monohydrate supplementation on lower-limb muscle power in Brazilian elite soccer players (n?=?14 males) during pre-season training. Findings This was a randomized, double-blind, placebo-controlled parallel-group study. Brazilian professional elite soccer players participated in this study. During the pre-season (7 weeks), all the subjects underwent a standardized physical and specific soccer training. Prior to and after either creatine monohydrate or placebo supplementation, the lower-limb muscle power was measured by countermovement jump performance. The Jumping performance was compared between groups at baseline (p?=?0.99). After the intervention, jumping performance was lower in the placebo group (percent change?=?- 0.7%; ES?=?- 0.3) than in the creatine group (percent change?=?+ 2.4%; ES?=?+ 0.1), but it did not reach statistical significance (p?=?0.23 for time x group interaction). Fisher’s exact test revealed that the proportion of subjects that experienced a reduction in jumping performance was significantly greater in the placebo group than in the creatine group (5 and 1, respectively; p?=?0.05) after the training. The magnitude-based inferences demonstrated that placebo resulted in a possible negative effect (50%) in jumping performance, whereas creatine supplementation led to a very likely trivial effect (96%) in jumping performance in the creatine group. Conclusions Creatine monohydrate supplementation prevented the decrement in lower-limb muscle power in elite soccer players during a pre-season progressive training. PMID:24991195

2014-01-01

225

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

2011-10-01

226

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

227

[Intrauterine upper limb ischemia due to a heterozygous mutation (677C>T) of the methylene-tetrahydrofolatereductase gene].  

PubMed

Limb ischemia rarely occurs in utero. The diagnosis can be made by clinical observation at birth or a few hours later. Color duplex ultrasound is the first imaging test used to confirm the diagnosis. The etiology appears to be complex and multifactorial. We report 2 cases of intrauterine limb ischemia involving the upper limb in 2 newborns. Both children were heterozygous for the 5,10-methylenetetrahydrofolate reductase 677C>T gene variant. The first patient was born by caesarean section at 34 weeks of gestation. At delivery, the infant presented with pallor in his right upper limb and weak radial arterial pulsation. Doppler ultrasound and computed tomography angiography demonstrated a totally occlusive thrombus within the right brachial artery. The newborn underwent systemic thrombolysis with good recovery. The second patient was born via cesarean section at 37 weeks of gestation. At delivery, the infant presented with a motionless, cold, and gangrenous right upper limb. The demarcation line was just below the right elbow. Doppler ultrasound revealed a complete occlusion of the right subclavian artery. After failure of antithrombotic therapy, the limb was amputated with no further complication. We discuss the epidemiology, etiology, and clinical features of this rare pathology. PMID:24332183

Hakim, A; Ben Hamad, A; Regaieg, R; Gargouri, A

2014-02-01

228

Upper limb motor rehabilitation impacts white matter microstructure in multiple sclerosis.  

PubMed

Upper limb impairments can occur in patients with multiple sclerosis, affecting daily living activities; however there is at present no definite agreement on the best rehabilitation treatment strategy to pursue. Moreover, motor training has been shown to induce changes in white matter architecture in healthy subjects. This study aimed at evaluating the motor behavioral and white matter microstructural changes following a 2-month upper limb motor rehabilitation treatment based on task-oriented exercises in patients with multiple sclerosis. Thirty patients (18 females and 12 males; age=43.3 ± 8.7 years) in a stable phase of the disease presenting with mild or moderate upper limb sensorimotor deficits were randomized into two groups of 15 patients each. Both groups underwent twenty 1-hour treatment sessions, three times a week. The "treatment group" received an active motor rehabilitation treatment, based on voluntary exercises including task-oriented exercises, while the "control group" underwent passive mobilization of the shoulder, elbow, wrist and fingers. Before and after the rehabilitation protocols, motor performance was evaluated in all patients with standard tests. Additionally, finger motor performance accuracy was assessed by an engineered glove. In the same sessions, every patient underwent diffusion tensor imaging to obtain parametric maps of fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. The mean value of each parameter was separately calculated within regions of interest including the fiber bundles connecting brain areas involved in voluntary movement control: the corpus callosum, the corticospinal tracts and the superior longitudinal fasciculi. The two rehabilitation protocols induced similar effects on unimanual motor performance, but the bimanual coordination task revealed that the residual coordination abilities were maintained in the treated patients while they significantly worsened in the control group (p=0.002). Further, in the treatment group white matter integrity in the corpus callosum and corticospinal tracts was preserved while a microstructural integrity worsening was found in the control group (fractional anisotropy of the corpus callosum and corticospinal tracts: p=0.033 and p=0.022; radial diffusivity of the corpus callosum and corticospinal tracts: p=0.004 and p=0.008). Conversely, a significant increase of radial diffusivity was observed in the superior longitudinal fasciculi in both groups (p=0.02), indicating lack of treatment effects on this structure, showing damage progression likely due to a demyelination process. All these findings indicate the importance of administering, when possible, a rehabilitation treatment consisting of voluntary movements. We also demonstrated that the beneficial effects of a rehabilitation treatment are task-dependent and selective in their target; this becomes crucial towards the implementation of tailored rehabilitative approaches. PMID:24370819

Bonzano, Laura; Tacchino, Andrea; Brichetto, Giampaolo; Roccatagliata, Luca; Dessypris, Adriano; Feraco, Paola; Lopes De Carvalho, Maria L; Battaglia, Mario A; Mancardi, Giovanni L; Bove, Marco

2014-04-15

229

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

230

Dielectric elastomers as actuators for upper limb prosthetics: challenges and opportunities.  

PubMed

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 are illustrated with empirical examples of the strain performance and durability of one of the most popular DEs, VHB 4910. Practical application of DE actuators in powered upper extremity prosthetics is at present impeded by poor durability and susceptibility to air-borne contaminants, unreliable control owing to viscoelasticity, hysteresis, stress relaxation and creep mechanisms, high voltage requirements, and insufficient stress and strain performance within the confines of anthropomorphic size, weight, and function. Our review suggests that the implementation of DE actuators in powered upper extremity prosthetics is not feasible at present but worthy of reevaluation as the materials advance. PMID:17632030

Biddiss, Elaine; Chau, Tom

2008-05-01

231

Botulinum Toxin Treatment on Upper Limb Function in School Age Children With Bilateral Spastic Cerebral Palsy: One Year Follow-up  

PubMed Central

Objective To prospectively investigate the long-term effects of botulinum toxin treatment on the upper limb function and performance of school age children with spastic bilateral cerebral palsy, who have limitations in performing activities of daily living and school activities, due to spasticity of the upper extremities. Methods Botulinum type A toxin (BoNT-A) was injected into 24 spastic upper limbs of 15 children. We used a Modified Ashworth Scale and a Modified Tardieu Scale for the evaluation of upper limb spasticity, and Quality of Upper Extremity Skills Test (QUEST), Canadian Occupational Performance Measure (COPM), and Test of Visual-Motor Skills-Revised (TVMS-R) for the evaluation of upper limb function and performance. Results Upper limb spasticity continuously decreased until the end of the one-year follow-up. Upper limb function on QUEST and COPM showed the best performance at 3 months and deteriorated slightly, but still showed a significantly better performance at 9 and 12 months than at pre-injection. In more functional nine subjects who could perform TVMS-R, the performance enhancement effects remained constant after 12 months, suggesting that the reduced spasticity led to the learning effect acquired by the repeated use of the affected upper limb. Conclusion For school age children with bilateral spastic cerebral palsy whose upper limb functions are important, BoNT-A injections seem to be of help in the performance of school activities and activities of daily living. PMID:23869330

Lee, Kyu Bum; Lee, Yu Ryun; Choi, You Nam; Park, Chul Woo; Park, Sang Duck; Jung, Dong Hwa; Lee, Chul Sang

2013-01-01

232

"Studying the cutaneous microcirculatory response during upper-limb exercise in healthy, older, sedentary people".  

PubMed

This study investigated changes incurred in cutaneous skin blood flux (SKBF) in the superficial veins of the lower limb by upper limb exercise training in the form of arm-cranking in 14 healthy participants over the age of 50 years. Changes in cutaneous microvascular function of the lower leg were assessed using laser Doppler Flowmetry (LDF) during a 30-minute exercise session undertaken over 4-exercise periods. Both SKBF and Time to reach Peak Perfusion (Tmax) were improved significantly during the 2nd (e.g. 121 (± 107.2) vs 280 (± 269.1) and 171 (± 34.4) vs. 247 (± 38.3) respectively) when compared to the first exercise period, while values approaching initial levels in the following stages. The results indicate that the thermoregulatory and vasodilation mechanisms observed during exercise in middle-aged and older healthy people are different to the one appearing in younger age groups, suggesting a more extensive effect of the age-related structural changes than it was previously thought. PMID:22240367

Klonizakis, Markos

2012-01-01

233

Scattering particles in nightside limb observations of Venus’ upper atmosphere by Venus Express VIRTIS  

NASA Astrophysics Data System (ADS)

Nightside infrared limb spectra of the Venus upper atmosphere, obtained by Venus Express VIRTIS, show strong scattering of thermal radiation. This scattering of upward-going radiation into the line-of-sight is dominant below 82.5 km even at a wavelength of 5 ?m, which is indicative of relatively large particles. We show that 1 ?m-sized sulfuric acid particles (also known as mode 2 particles) provide a good fit to the VIRTIS limb data at high altitudes. We retrieve vertical profiles of the mode 2 number density between 75 and 90 km at two latitude ranges: 20-30°N and 47-50°N. Between 20 and 30°N, scattering by mode 2 particles is the main source of radiance for altitudes between 80 and 85 km. Above altitudes of 85 km smaller particles can also be used to fit the spectra. Between 47 and 50°N mode 2 number densities are generally lower than between 20 and 30°N and the profiles show more variability. This is consistent with the 47-50° latitude region being at the boundary between the low latitudes and high latitudes, with the latter showing lower cloud tops and higher ultraviolet brightness (Titov, D.V., Taylor, F.W., Svedhem, H., Ignatiev, N.I., Markiewicz, W.J., Piccioni, G., Drossart, P. [2008]. Nature 456, 620-623).

de Kok, R.; Irwin, P. G. J.; Tsang, C. C. C.; Piccioni, G.; Drossart, P.

2011-01-01

234

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

PubMed Central

Background Electroencephalography (EEG) combined with independent component analysis enables functional neuroimaging in dynamic environments including during human locomotion. This type of functional neuroimaging could be a powerful tool for neurological rehabilitation. It could enable clinicians to monitor changes in motor control related cortical dynamics associated with a therapeutic intervention, and it could facilitate noninvasive electrocortical control of devices for assisting limb movement to stimulate activity dependent plasticity. Understanding the relationship between electrocortical dynamics and muscle activity will be helpful for incorporating EEG-based functional neuroimaging into clinical practice. The goal of this study was to use independent component analysis of high-density EEG to test whether we could relate electrocortical dynamics to lower limb muscle activation in a constrained motor task. A secondary goal was to assess the trial-by-trial consistency of the electrocortical dynamics by decoding the type of muscle action. Methods We recorded 264-channel EEG while 8 neurologically intact subjects performed isometric and isotonic, knee and ankle exercises at two different effort levels. Adaptive mixture independent component analysis (AMICA) parsed EEG into models of underlying source signals. We generated spectrograms for all electrocortical source signals and used a naïve Bayesian classifier to decode exercise type from trial-by-trial time-frequency data. Results AMICA captured different electrocortical source distributions for ankle and knee tasks. The fit of single-trial EEG to these models distinguished knee from ankle tasks with 80% accuracy. Electrocortical spectral modulations in the supplementary motor area were significantly different for isometric and isotonic tasks (p?limb motor tasks. Using a broad distribution of electrocortical signals may improve classification of human lower limb movements from single-trial EEG. PMID:22682644

2012-01-01

235

Bimanual Haptic-desktop platform for upper-limb post-stroke rehabilitation:Practical trials  

Microsoft Academic Search

This paper presents three haptic-based virtual applications for the\\u000d\\u000a\\u0009undergoing rehabilitation of upper-limb post stroke patients. The\\u000d\\u000a\\u0009three exercises are developed for their use on the multi-modal interface\\u000d\\u000a\\u0009so-called Bimanual Haptic Desktop System (BHDS), which integrates\\u000d\\u000a\\u0009the haptic functionalities and Video Display Terminal (VDT) within\\u000d\\u000a\\u0009the work-plane of a desk. Firstly, two basic exercises, tracking\\u000d\\u000a\\u0009task and lifting task, are

Siqiao Li; Antonio Frisoli; Carlo Alberto Avizzano; Emanuele Ruffaldi; Luis I. Lugo-Villeda; Massimo Bergamasco

2009-01-01

236

A fuzzy clustering neural network architecture for multifunction upper-limb prosthesis.  

PubMed

Accurate and computationally efficient means of classifying surface myoelectric signals has been the subject of considerable research effort in recent years. The aim of this paper is to classify myoelectric signals using new fuzzy clustering neural network (NN) architectures to control multifunction prostheses. This paper presents a comparative study of the classification accuracy of myoelectric signals using multilayered perceptron NN using back-propagation, conic section function NN, and new fuzzy clustering NNs (FCNNs). The myoelectric signals considered are used in classifying six upper-limb movements: elbow flexion, elbow extension, wrist pronation and wrist supination, grasp, and resting. The results suggest that FCNN can generalize better than other NN algorithms and help the user learn better and faster. This method has the potential of being very efficient in real-time applications. PMID:14619995

Karlik, Bekir; Tokhi, M Osman; Alci, Musa

2003-11-01

237

Stable fixation of osteoporotic fractures and nonunions in the upper limb - life before the "locking plate".  

PubMed

I have had a wonderful opportunity over the past 30 years to surgically reconstruct many complex fractures and non- unions in the upper limb in the elderly patient with underlying osteoporosis and prior to the development of the "locked plate". This article will present a number of specific techniques using standard LC-DCP and screw in a variety of applications to provide stable internal fixation. These include the use of long plates; creating a "waved plate" initially described by Blatter and Weber; double plating; 3.5 mm intramedullary plate combined with a larger plate on the cortex; custom and machi- ned blade plates as well as enhancement of screw fixation with bone cement and/ or Norian SRS cement. PMID:21040646

Jupiter, J B; Wyss, H

2010-10-01

238

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

NASA Astrophysics Data System (ADS)

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

Burkholder, Kristin C.; Lozier, M. Susan

2014-06-01

239

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

240

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. PMID:22443334

2012-01-01

241

Relationship between Lower Limb Muscle Structure and Function in Cerebral Palsy  

PubMed Central

[Purpose] The purpose of the study was to provide information for intervention by comparing lower limb muscle thickness, gross motor function and functional level of activity daily living between cerebral palsy (CP) and mental retardation (MR). [Subjects] Sixty subjects participated: 38 CP and 9 MR subjects and 13 normally developing infants. [Methods] Ultrasonography and a manual muscle tester were used for measuring the thickness and strength of knee extensor and ankle plantar flexor muscles. The Gross Motor Function Measure (GMFM) and Wee Functional Independence Measure (WeeFIM) were used to evaluate level of gross motor and independence level. [Results] Knee extensor thicknesses of CP and MR subjects were thinner than those of normally developing infants. Strengths of knee extensor and ankle plantar flexor showed differences being strongest in normally developing infants, followed by MR, and CP. Subjects in the examination of GMFM, there were no significant differences between CP and MR. A decline in social cognition of MR subjects was found in the examination of WeeFIM. [Conclusion] CP and MR subjects had smaller muscle thicknesses and strengths than those of normally developing infants, and lower gross motor function and functional independent level. PMID:24567677

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

2014-01-01

242

One-leg standing performance and muscle activity: are there limb differences?  

PubMed

The purpose of this study was to compare static balance performance and muscle activity during one-leg standing on the dominant and nondominant leg under various sensory conditions with increased levels of task difficulty. Thirty healthy young adults (age: 23 ± 2 years) performed one-leg standing tests for 30 s under three sensory conditions (ie, eyes open/firm ground; eyes open/ foam ground [elastic pad on top of the balance plate]; eyes closed/firm ground). Center of pressure displacements and activity of four lower leg muscles (ie, m. tibialis anterior [TA], m. soleus [SOL], m. gastrocnemius medialis [GAS], m. peroneus longus [PER]) were analyzed. An increase in sensory task difficulty resulted in deteriorated balance performance (P < .001, effect size [ES] = .57-2.54) and increased muscle activity (P < .001, ES = .50-1.11) for all but two muscles (ie, GAS, PER). However, regardless of the sensory condition, one-leg standing on the dominant as compared with the nondominant limb did not produce statistically significant differences in various balance (P > .05, ES = .06-.22) and electromyographic (P > .05, ES = .03-.13) measures. This indicates that the dominant and the nondominant leg can be used interchangeably during static one-leg balance testing in healthy young adults. PMID:24610423

Muehlbauer, Thomas; Mettler, Claude; Roth, Ralf; Granacher, Urs

2014-06-01

243

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

244

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

PubMed Central

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

Ferronato, Priscilla A. M.; Domellof, Erik; Ronnqvist, Louise

2014-01-01

245

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

PubMed

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. PMID:22681653

Frisoli, Antonio; Procopio, Caterina; Chisari, Carmelo; Creatini, Ilaria; Bonfiglio, Luca; Bergamasco, Massimo; Rossi, Bruno; Carboncini, Maria Chiara

2012-01-01

246

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

PubMed

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

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

2014-07-01

247

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

Microsoft Academic Search

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

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

2011-01-01

248

Course review: the 4th bob huffstadt upper and lower limb flap dissection course.  

PubMed

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

Dunne, Jonathan A

2014-12-01

249

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. PMID:15649978

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

2005-01-01

250

The effectiveness of occupational therapy and physiotherapy in multiple sclerosis patients with ataxia of the upper limb and trunk  

Microsoft Academic Search

Objective: The aim of the study was to evaluate the effectiveness of therapy intervention in reducing impairment and disability due to upper limb and trunk ataxia in chronic multiple sclerosis (MS).Design: The change in performance scores of two patient groups - an inpatient group who received two weeks' therapy intervention and an outpatient 'control' group awaiting a similar admission -

L. Jones; Y. Lewis; J. Harrison; CM Wiles

1996-01-01

251

Development of a Physics-Based Target Shooting Game to Train Amputee Users of Multijoint Upper Limb Prostheses  

Microsoft Academic Search

For upper limb amputees, learning the control of myoelectric prostheses is difficult and challenging. Introduction of newer prostheses with multiple degrees of freedom controlled by various neural commands will make such training even more difficult. To produce smooth and human-like movements, the user must learn to produce multiple neural commands with precise amplitude and timing. To aid in training of

Rahman Davoodi; Gerald E. Loeb

2012-01-01

252

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

253

Upper Limb Neurodynamic Test 2Median Nerve Bias: An Investigation of Examiner Reliability, End-Range Shoulder Abduction, and Symptom Response in Asymptomatic Subjects  

Microsoft Academic Search

Background and purpose: The Upper Limb Tension Test (ULTT) has been established as a physical therapy examination tool to assist in assessment of the cervical nerve roots and peripheral nerves as possible components contributing to upper limb symptoms in patients. Research has focused on the use of the ULTT in assessment of asymptomatic individuals, and on the ULTT2-Radial Nerve Bias,

Rebecca Reisch; Kimberly Williams

2001-01-01

254

Coherence between the sympathetic drives to relaxed and contracting muscles of different limbs of human subjects.  

PubMed Central

1. This study was undertaken to quantify the simultaneous sympathetic drives to muscles in the two legs of human subjects, and to elucidate the extent to which a common drive determines sympathetic outflow to different limbs at rest, during apnoea and during voluntary contractions. 2. Sympathetic efferent activity was recorded simultaneously from fascicles of both peroneal nerves, innervating the pretibial flexor muscles. At rest the similarity was quantified for a sample of records by manual measurement of equivalent bursts in the two recordings, and for all records by cross-correlation and power spectral analysis of the two recordings. During contractions, only the latter method was used. 3. At rest the correlation coefficient for the relationship between the burst amplitudes for the two recordings was 0.72 (S.D. 0.1). For the same sequences, the computed coherence between the two recordings was 85.6% (S.D. 6.7%) at the cardiac period. There was a statistically significant linear relationship between these two measures of similarity, and this was stronger when data from sequences recorded during apnoea were included in the analysis. At rest the mean difference in coherence between consecutive sequences with no intervening manoeuvre (apnoea, contraction, change in recording site) was 4.2% (S.D. 4.3%). In only two of forty-nine such instances was the difference in coherence > 10%. 4. Apnoea at end-expiration increased the amplitude and frequency of sympathetic bursts and increased the similarity between the two recordings. The correlation coefficients increased from a mean of 0.72 at rest to 0.89 during apnoea. Coherence increased from a mean of 82.1% at rest to 91.9% during apnoea. 5. On the right side, graded voluntary contractions were performed at 5, 10, 20 or 30% maximal force using the muscle innervated by the fascicle from which the recording was made. The coherence between the recordings made from the right and left legs decreased by > 10% at each contraction level. Pooling the data for all contractions, there was a significant decrease in power at the cardiac frequency in the sympathetic recording from the contracting leg. Contraction of a synergist or antagonist at 10% maximum produced negligible changes in coherence. 6. It is concluded that, at rest, homologous muscles of the lower limbs are subject to a common drive and that, during apnoea, this common drive can dominate the sympathetic outflow to the virtual exclusion of regional drives. During voluntary activity, the importance of this common drive is lessened, presumably because of regionally specific changes involving the contracting muscle.(ABSTRACT TRUNCATED AT 400 WORDS) Images Fig. 8 PMID:1484355

Wallin, B G; Burke, D; Gandevia, S C

1992-01-01

255

Coherence between the sympathetic drives to relaxed and contracting muscles of different limbs of human subjects.  

PubMed

1. This study was undertaken to quantify the simultaneous sympathetic drives to muscles in the two legs of human subjects, and to elucidate the extent to which a common drive determines sympathetic outflow to different limbs at rest, during apnoea and during voluntary contractions. 2. Sympathetic efferent activity was recorded simultaneously from fascicles of both peroneal nerves, innervating the pretibial flexor muscles. At rest the similarity was quantified for a sample of records by manual measurement of equivalent bursts in the two recordings, and for all records by cross-correlation and power spectral analysis of the two recordings. During contractions, only the latter method was used. 3. At rest the correlation coefficient for the relationship between the burst amplitudes for the two recordings was 0.72 (S.D. 0.1). For the same sequences, the computed coherence between the two recordings was 85.6% (S.D. 6.7%) at the cardiac period. There was a statistically significant linear relationship between these two measures of similarity, and this was stronger when data from sequences recorded during apnoea were included in the analysis. At rest the mean difference in coherence between consecutive sequences with no intervening manoeuvre (apnoea, contraction, change in recording site) was 4.2% (S.D. 4.3%). In only two of forty-nine such instances was the difference in coherence > 10%. 4. Apnoea at end-expiration increased the amplitude and frequency of sympathetic bursts and increased the similarity between the two recordings. The correlation coefficients increased from a mean of 0.72 at rest to 0.89 during apnoea. Coherence increased from a mean of 82.1% at rest to 91.9% during apnoea. 5. On the right side, graded voluntary contractions were performed at 5, 10, 20 or 30% maximal force using the muscle innervated by the fascicle from which the recording was made. The coherence between the recordings made from the right and left legs decreased by > 10% at each contraction level. Pooling the data for all contractions, there was a significant decrease in power at the cardiac frequency in the sympathetic recording from the contracting leg. Contraction of a synergist or antagonist at 10% maximum produced negligible changes in coherence. 6. It is concluded that, at rest, homologous muscles of the lower limbs are subject to a common drive and that, during apnoea, this common drive can dominate the sympathetic outflow to the virtual exclusion of regional drives. During voluntary activity, the importance of this common drive is lessened, presumably because of regionally specific changes involving the contracting muscle.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1484355

Wallin, B G; Burke, D; Gandevia, S C

1992-09-01

256

Condensation of Plasmid DNA Enhances Mitochondrial Association in Skeletal Muscle Following Hydrodynamic Limb Vein Injection  

PubMed Central

Mitochondrial gene therapy and diagnosis have the potential to provide substantial medical benefits. However, the utility of this approach has not yet been realized because the technology available for mitochondrial gene delivery continues to be a bottleneck. We previously reported on mitochondrial gene delivery in skeletal muscle using hydrodynamic limb vein (HLV) injection. HLV injection, a useful method for nuclear transgene expression, involves the rapid injection of a large volume of naked plasmid DNA (pDNA). Moreover, the use of a condensed form of pDNA enhances the nuclear transgene expression by the HLV injection. The purpose of this study was to compare naked pDNA and condensed pDNA for mitochondrial association in skeletal muscle, when used in conjunction with HLV injection. PCR analysis showed that the use of condensed pDNA rather than naked pDNA resulted in a more effective mitochondrial association with pDNA, suggesting that the physicochemical state of pDNA plays a key role. Moreover, no mitochondrial toxicities in skeletal muscle following the HLV injection of condensed pDNA were confirmed, as evidenced by cytochrome c oxidase activity and mitochondrial membrane potential. These findings have the potential to contribute to the development for in vivo mitochondrial gene delivery system. PMID:25195732

Yasuzaki, Yukari; Yamada, Yuma; Fukuda, Yutaka; Harashima, Hideyoshi

2014-01-01

257

The effects of limb elevation and increased intramuscular pressure on nerve and muscle function in the human leg  

Microsoft Academic Search

In this study we investigated the effects of increased intramuscular pressure (IMP) on nerve and muscle function in the leg\\u000a and foot. In study A, muscle pressure was increased by inducing venous stasis in both legs, placed in plaster casts, of eight\\u000a healthy subjects having a mean age of 29?years. The results from elevated and non-elevated limbs were compared. In

Per Wiger; Qiuxia Zhang; Jorma Styf

2000-01-01

258

Bihemispheric repetitive transcranial magnetic stimulation combined with intensive occupational therapy for upper limb hemiparesis after stroke: a preliminary study.  

PubMed

We investigated the safety, feasibility, and efficacy of the combination of bihemispheric repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis in poststroke patients. The study participants were eight poststroke patients with upper limb hemiparesis (age at intervention: 62.8±4.9 years, time after stroke: 84.3±87.2 months, mean±SD). During 15 days of hospitalization, each patient received 10 sessions of 40-min bihemispheric rTMS and 240-min intensive OT (120-min one-to-one training and 120-min self-training). One session of bihemispheric rTMS comprised the application of both 1 and 10 Hz rTMS (2000 stimuli for each hemisphere). The Fugl-Meyer Assessment, Wolf Motor Function Test, and the Modified Ashworth Scale were administered on the day of admission and at discharge. All patients completed the treatment without any adverse effects. Motor function of the affected upper limb improved significantly, on the basis of changes in Fugl-Meyer Assessment and Wolf Motor Function Test (P<0.05, each). A significant decrease in the Modified Ashworth Scale score was noted in the elbow, wrist, and finger flexors of the affected upper limb (P<0.05, each). The combination of bihemispheric rTMS and intensive OT was safe and feasible therapy for poststroke hemiparetic patients, and improved motor function of the hemiparetic upper limb in poststroke patients. The findings provide a new avenue for the treatment of patients with poststroke hemiparesis. PMID:23797616

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

2013-12-01

259

Efficacy of lower limb compression and combined treatment of manual massage and lower limb compression on symptoms of exercise-induced muscle damage in women.  

PubMed

Strategies to manage the symptoms of exercise-induced muscle damage (EIMD) are widespread, though are often based on anecdotal evidence. The aim of this study was to determine the efficacy of a combination of manual massage and compressive clothing and compressive clothing individually as recovery strategies after muscle damage. Thirty-two female volunteers completed 100 plyometric drop jumps and were randomly assigned to a passive recovery (n = 17), combined treatment (n = 7), or compression treatment group (n = 8). Indices of muscle damage (perceived soreness, creatine kinase activity, isokinetic muscle strength, squat jump, and countermovement jump performance) were assessed immediately before and after 1, 24, 48, 72, and 96 hours of plyometric exercise. The compression treatment group wore compressive tights for 12 hours after damage and the combined treatment group received a 30-minute massage immediately after damaging exercise and wore compression stockings for the following 11.5 hours. Plyometric exercise had a significant effect on all indices of muscle damage (p < 0.05). The treatments significantly reduced decrements in isokinetic muscle strength, squat jump performance, and countermovement jump performance and reduced the level of perceived soreness in comparison with the passive recovery group (p < 0.05). The addition of sports massage to compression after muscle damage did not improve performance recovery, with recovery trends being similar in both treatment groups. The treatment combination of massage and compression significantly moderated perceived soreness at 48 and 72 hours after plyometric exercise (p < 0.05) in comparison with the passive recovery or compression alone treatment. The results indicate that the use of lower limb compression and a combined treatment of manual massage with lower limb compression are effective recovery strategies following EIMD. Minimal performance differences between treatments were observed, although the combination treatment may be beneficial in controlling perceived soreness. PMID:20940646

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

2010-11-01

260

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

Microsoft Academic Search

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

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

2006-01-01

261

The Southampton examination schedule for the diagnosis of musculoskeletal disorders of the upper limb  

PubMed Central

OBJECTIVES—Following a consensus statement from a multidisciplinary UK workshop, a structured examination schedule was developed for the diagnosis and classification of musculoskeletal disorders of the upper limb. The aim of this study was to test the repeatability and the validity of the newly developed schedule in a hospital setting.?METHOD—43 consecutive referrals to a soft tissue rheumatism clinic (group 1) and 45 subjects with one of a list of specific upper limb disorders (including shoulder capsulitis, rotator cuff tendinitis, lateral epicondylitis and tenosynovitis) (group 2), were recruited from hospital rheumatology and orthopaedic outpatient clinics. All 88 subjects were examined by a research nurse (blinded to diagnosis), and everyone from group 1 was independently examined by a rheumatologist. Between observer agreement was assessed among subjects from group 1 by calculating Cohen's ? for dichotomous physical signs, and mean differences with limits of agreement for measured ranges of joint movement. To assess the validity of the examination, a pre-defined algorithm was applied to the nurse's examination findings in patients from both groups, and the sensitivity and specificity of the derived diagnoses were determined in comparison with the clinic's independent diagnosis as the reference standard.?RESULTS—The between observer repeatability of physical signs varied from good to excellent, with ? coefficients of 0.66 to 1.00 for most categorical observations, and mean absolute differences of 1.4°-11.9° for measurements of shoulder movement. The sensitivity of the schedule in comparison with the reference standard varied between diagnoses from 58%-100%, while the specificities ranged from 84%-100%. The nurse and the clinic physician generally agreed in their diagnoses, but in the presence of shoulder capsulitis the nurse usually also diagnosed shoulder tendinitis, whereas the clinic physician did not.?CONCLUSION—The new examination protocol is repeatable and gives acceptable diagnostic accuracy in a hospital setting. Examination can feasibly be delegated to a trained nurse, and the protocol has the benefit of face and construct validity as well as consensus backing. Its performance in the community, where disease is less clear cut, merits separate evaluation, and further refinement is needed to discriminate between discrete pathologies at the shoulder.?? PMID:10627419

Palmer, K.; Walker-Bone, K.; Linaker, C.; Reading, I.; Kellingray, S.; Coggon, D.; Cooper, C.

2000-01-01

262

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

PubMed Central

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

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

2012-01-01

263

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

PubMed Central

Background The aim of this longitudinal study was to investigate how the kinematic organization of upper limb movements changes from fetal to post-natal life. By means of off-line kinematical techniques we compared the kinematics of hand-to-mouth and hand-to-eye movements, in the same individuals, during prenatal life and early postnatal life, as well as the kinematics of hand-to-mouth and reaching-toward-object movements in the later age periods. Methodology/Principal Findings Movements recorded at the 14th, 18th and 22nd week of gestation were compared with similar movements recorded in an ecological context at 1, 2, 3, 4, 8, and 12 months after birth. The results indicate a similar kinematic organization depending on movement type (i.e., eye, mouth) for the infants at one month and for the fetuses at 22 weeks of gestation. At two and three months such differential motor planning depending on target is lost and no statistical differences emerge. Hand to eye movements were no longer observed after the fourth month of life, therefore we compared kinematics for hand to mouth with hand to object movements. Results of these analyses revealed differences in the performance of hand to mouth and reaching to object movements in the length of the deceleration phase of the movement, depending on target. Conclusion/Significance Data are discussed in terms of how the passage from intrauterine to extra-uterine environments modifies motor planning. These results provide novel evidence of how different types of upper extremity movements, those directed towards one’s own face and those directed to external objects, develop. PMID:24324642

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

2013-01-01

264

Anatomy of the deep fascia of the upper limb. Second part: study of innervation.  

PubMed

Analysis of specimens taken from different areas of the deep fascia in 20 upper limbs was made in order to establish which kind of nerve fibres and endings are present in the deep muscular fascia. The flexor retinaculum and the lacertus fibrosus were also evaluated because they are anatomically hardly separable from the deep muscular fascia, although they have different functions. In particular, specimens were taken at the level of: (a) the expansion of pectoralis major onto the bicipital fascia, (b) the middle third of the brachial fascia, (c) the lacertus fibrosus, (d) the middle third of the antebrachial fascia, (e) the flexor retinaculum. This study demonstrated an abundant innervation of the fascia consisting in both free nerve endings and encapsulated receptors, in particular, Ruffini and Pacini corpuscles. However, differences in innervation were verified: the flexor retinaculum was resulted the more innervated element whilst lacertus fibrosus and the pectoralis major expansion the less innervated. These results suggest that the retinaculum has more a perceptive function whereas the tendinous expansions onto the fascia have mostly a mechanical role in the transmission of tension. The hypothesis that the fascia plays an important role in proprioception, especially dynamic proprioception, is therefore advanced. In fact, the fascia is a membrane that extends throughout the whole body and numerous muscular expansions maintain it in a basal tension. During a muscular contraction these expansions could also transmit the effect of the stretch to a specific area of the fascia, stimulating the proprioceptors in that area. PMID:17574469

Stecco, C; Gagey, O; Belloni, A; Pozzuoli, A; Porzionato, A; Macchi, V; Aldegheri, R; De Caro, R; Delmas, V

2007-03-01

265

Characteristics of upper limb muscular strength in male wheelchair tennis players  

PubMed Central

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

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

2013-01-01

266

Customized device for pediatric upper limb rehabilitation in obstetric brachial palsy.  

PubMed

A 12-yr-old child, with a history of gestational Erb-Duchenne palsy and, later, musculoskeletal injuries in the left arm caused by a car accident, inspired the design of a customized exoskeleton-like device. Such piece, intended for rehabilitation, has one degree of freedom because the exercise routine involves elbow flexion-extension, which was indicated for the damaged muscular group. The device has two functioning modes, passive and assisted, in which the patient can trigger the movement by a biceps contraction, thus promoting the active role of the user in the rehabilitation process. The results were evaluated in terms of qualitative measures of the biceps and the triceps performed by the medical staff and by a questionnaire related to functional activities of the upper limb. A significant improvement in the arm movement and elbow angle was observed after 3 mos of assisted therapy, complementary to conventional exercises. In conclusion, a simple and low-cost device was designed and tested to complement the rehabilitation process of a pediatric patient with physical impairment. PMID:24561320

López, Natalia M; de Diego, Nicolás; Hernández, Rafael; Pérez, Elisa; Ensinck, Gustavo; Valentinuzzi, Max E

2014-03-01

267

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

268

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

269

Outcome of the upper limb in cervical spinal cord injury: Profiles of recovery and insights for clinical studies.  

PubMed

Background Improved appreciation of recovery profiles of sensory and motor function as well as complex motor functions (prehension) after cervical spinal cord injury (SCI) will be essential to inform clinical studies to consider primary and secondary outcome measures for interventions and the optimization of dosing and timing of therapies in acute and chronic SCI. Objectives (1) To define the sensory, motor, and prehension recovery profiles of the upper limb and hand in acute cervical SCI and (2) to confirm the impact of AIS severity and conversion on upper limb sensorimotor recovery. Methods An observational longitudinal cohort study consisting of serial testing of 53 patients with acute cervical SCI was conducted. International Standards of Neurological Classification of Spinal Cord Injury, Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), Capabilities of Upper Extremity (CUE-Q) Questionnaire, and Spinal Cord Independence Measure III (SCIM-III) were administered at 0-10 days, 1, 3, 6, and 12 months. Analysis Change over time was plotted using mean and standard deviation of the total and subgroups of the sample. Results Individuals with traumatic tetraplegia show distinct patterns of recovery. Factors that distinguish homogeneous subgroups of the sample are: severity of injury (level of injury, completeness) at baseline and conversion from a complete to an incomplete injury. Conclusions In cervical SCI, clinical recovery can be assessed using standardized measures that distinguish levels of activity and impairment. Specific recovery profiles of the upper limb over the 1-year timecourse provide new insights and opportunity for combined analysis of recovery profiles for different clinical assessment tools of upper limb function which are meaningful to inform the design of study protocols. PMID:25229734

Kalsi-Ryan, Sukhvinder; Beaton, Dorcas; Curt, Armin; Popovic, Milos R; Verrier, Mary C; Fehlings, Michael G

2014-09-01

270

The Effects of Abdominal Hollowing in Lower-limb PNF Pattern Training on the Activation of Contralateral Muscles  

PubMed Central

[Purpose] The purpose of this study was to determine the effects of abdominal hollowing during lower-limb proprioceptive neuromuscular facilitation (PNF) training on the activation of contralateral muscles. [Subjects] Twenty male college students without symptoms or signs of muscular or nervous disease participated in this experiment after signing a consent form. [Methods] All the subjects were measured with electromyography (EMG) in a muscle activation test before and after abdominal hollowing. In the PNF program, the lower-limb pattern of PNF training, was maintained for 5 seconds, followed by a 2-minute break. This was repeated three times. The resting time between sets was 30 minutes. Surface EMG (Keypoint, Medtronic Inc., USA) was used for the measurements, and the highest value of three measurements was used in the analysis. [Result] The results revealed a significant change in the muscular activation of the opposite-side lower limbs. The muscular activations of the vastus lateralis, tibialis anterior, semitendinosus and gastrocnemius were increased significantly after the abdominal hollowing. [Conclusion] The findings suggest that abdominal hollowing in PNF pattern training can be effective at promoting muscular activation of the contralateral muscles. To promote muscular activation of the opposite side in lower-limb PNF pattern training, abdominal hollowing should be considered to improve the effect of PNF pattern training. PMID:24259788

Yoo, Byungho; Park, Hankyu; Heo, Kwangjin; Lee, Joongsook; Lee, Jaeseok; Oh, Taeyoung; Han, Dongwook

2013-01-01

271

Investigation of Risk Factors of Work-Related Upper-Limb Musculoskeletal Disorders in a Pharmaceutical Industry or Research Article  

NASA Astrophysics Data System (ADS)

This study was performed among workers of an Iranian pharmaceutical industry with the aiming to determine WRMDs prevalence and exposure assessment of WRMDs risks. In this cross-sectional study, 84 female and male workers randomly selected from five packing operations. Modified Nordic Musculoskeletal Questionnaire (NMQ) was applied to study the prevalence of WRMDs and Rapid Upper Limb Assessment (RULA) method was used for the evaluation of the exposure to risk factors associated with work-related upper limb disorders. Results showed a significant association exists between neck, lower arm and A scores group with those obtained by self-reported pain (p<0.01). Similar RULA grand scores of 3 and 4 and action level of 2 were found for workers in five packing operations. Also, the results of this study revealed that RULA method is a fairly suitable tool for the evaluation of WRMDs among packing workers in pharmaceutical industry.

Pourmahabadian, Mohammad; Akhavan, Mehdi; Azam, Kamal

272

Delivering evidence-based upper limb rehabilitation for children with cerebral palsy: barriers and enablers identified by three pediatric teams.  

PubMed

ABSTRACT This study aimed to identify barriers and enablers experienced by occupational therapists to delivering evidence-based upper limb intervention for children with unilateral cerebral palsy. Semistructured interviews informed by the Theoretical Domains Framework were conducted with nine occupational therapists from three teams to ascertain barriers and enablers to implementing five evidence criteria. A key barrier was lack of knowledge of current evidence for upper limb therapies for children with unilateral cerebral palsy. Therapists were confident in delivering goal-directed bimanual occupational therapy, but less knowledgeable and skilled, and hence confident in providing constraint therapy. Strategies to increase dose of therapy were identified as greater use of home programs and group-based interventions; however, therapists indicated the need for further education and skill development in these areas. In order to increase the uptake of research evidence into practice, findings from this study will be used to inform context-specific, individually targeted implementation strategies. PMID:24303800

Sakzewski, Leanne; Ziviani, Jenny; Boyd, Roslyn N

2014-11-01

273

Reliability of the Southampton examination schedule for the diagnosis of upper limb disorders in the general population  

PubMed Central

Objective: To investigate the reliability of this schedule in the general population. Methods: Ninety seven adults of working age reporting recent neck or upper limb symptoms were invited to attend for clinical examination consisting of inspection and palpation of the upper limbs, measurement of active and passive ranges of motion, and clinical provocation tests. A doctor and a trained research nurse examined each patient separately, in random order and blinded to each other's findings. Results: Between observer repeatability of the schedule was generally good, with a median ? coefficient of 0.66 (range 0.21 to 0.93) for each of the specific diagnoses considered. Conclusion: As expected, the repeatability of tests is poorer in the general population than in the hospital clinic, but the Southampton examination schedule is sufficiently reproducible for epidemiological research in the general population. PMID:12429544

Walker-Bone, K; Byng, P; Linaker, C; Reading, I; Coggon, D; Palmer, K; Cooper, C

2002-01-01

274

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

PubMed Central

Objective This pilot study investigates the use of telerehabilitation to improve upper limb performance in chronic stages of stroke recovery. Design Intervention study with pre/post/one month follow-up tests. Methods Seven adults with chronic stroke participated in the study. Tests consisted of lab-based clinical and kinematic assessments. Participants completed the Upper Limb Training and Assessment (ULTrA) program at home. Training was 5 days/week, 60 min/day for 6 weeks with intermittent supervision of participants. Results Participants showed improvements in the training program tasks as well as clinical and kinematic assessments. Results also suggest there may be auxiliary benefits in cognitive function. Conclusions A home-based telerehabilitation program is a viable approach to provide rehabilitation in chronic stages of stroke. PMID:23319181

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

2014-01-01

275

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

PubMed

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

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

2014-12-01

276

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

277

Relationship between the modifications of bilateral deficit in upper and lower limbs by resistance training in humans  

Microsoft Academic Search

Maximal voluntary strength of simultaneous bilateral exertion is known to be small compared to the sum of the unilateral\\u000a exertions. This phenomenon is called bilateral deficit and the purpose of this study was to investigate whether it operates\\u000a in both upper and lower limbs. A group of 7 female and 32 male students were divided into 4 training groups and

Yuko Taniguchi

1998-01-01

278

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

Microsoft Academic Search

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

Marissa Barlaan Lukban; Raymond L. Rosales; Dirk Dressler

2009-01-01

279

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

Microsoft Academic Search

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

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

2009-01-01

280

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

Microsoft Academic Search

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

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

2009-01-01

281

Virtual rehabilitation of upper-limb function in traumatic brain injury: A mixed-approach evaluation of the Elements system  

Microsoft Academic Search

The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for rehabilitation of upper-limb function in patients with traumatic brain injury (TBI). A mixed-approach design was used. Performance was evaluated at three time points using a within-group design: Preintervention 1 and 2, conducted 4 weeks apart, and Postintervention. Subjective ratings were provided after

Peter H. Wilson; Nick Mumford; Jonathan Duckworth; Patrick Thomas; David Shum; Gavin Williams

2011-01-01

282

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

283

Correlation between the lengths of the upper limb and cubital tunnel: potential use in patients with proximal ulnar nerve entrapment  

Microsoft Academic Search

Introduction  We hypothesized that a correlation may exist between the length of the upper limb and the length of the cubital tunnel, which\\u000a transmits the ulnar nerve from the arm to the forearm. If true, this association might aid in predicting individuals at greater\\u000a risk of developing ulnar nerve compression at this site.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  A total of 46 cadaveric upper

R. Shane Tubbs; Marios Loukas; Nihal Apaydin; Tiffany D. Cossey; Bulent Yalçin; Mohammadali M. Shoja; Aaron A. Cohen-Gadol

2010-01-01

284

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

PubMed Central

The aim of the current study was to investigate the longitudinal relationship between improvements of synergism and strength of the upper paretic limb and severity of visuo-spatial neglect during the first 52 weeks post-stroke. The longitudinal association between severity of VSN and motor impairment using Fugl Meyer motor score and Motricity Index of the arm was measured in an intensive repeated measurement design including 18 measurement sessions for each subject. Neglect was assessed using the letter cancellation test applied in a prospective cohort of 101 ischemic, first-ever, hemispheric stroke patients. All time-dependent measures were taken weekly, starting within 14 days post-stroke. From week 10 to 20 biweekly measurements are obtained. The longitudinal relationship of (bi)weekly time on improvement of motor functions and severity of neglect was investigated using random coefficient analysis and trend analyses. Fifty-one of the 101 stroke patients showed neglect at stroke onset. Less improvement of synergism and strength of the upper paretic limb was associated with more severe neglect. This association was most pronounced in the first 10 weeks post-stroke. The seemingly suppressive effect of neglect on upper-limb motor recovery appears to take place mainly during spontaneous neurological recovery of first 10 weeks post-stroke. This finding suggests that damage to large-scale white matter tracts of especially the perceptual-attention networks suppress recovery of other networks at distance in the brain suggesting a common underlying mechanism. PMID:24950224

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

2014-01-01

285

The clavicular part of the pectoralis major: a true entity of the upper limb on anatomical, phylogenetic, ontogenetic, functional and clinical bases. Case report and review of the literature.  

PubMed

The pectoralis major consists of three parts: clavicular, sternocostal and abdominal. The first is usually separated from the deltoid by a deltopectoral triangular space, and often from the sternocostal part by another triangular space. The clavicular part is a new acquisition in Anthropoids, to optimize stabilization of the upper limb to the thorax thus permitting an increased limb mobility in Primates. It is synergetic with the deltoid in arm flexion and even more in adduction. This action is important in Humans, as the coracobrachialis becomes smaller in Mammals. Among non human Primates, those having cranially displaced shoulder joint show a significant clavicular origin of the pectoralis major. The clavicular origin might be necessary in flexion of the forelimb, when the humeral insertion of the muscle is on the same transverse plane as, or cranial to, the sternal manubrium. As to the blood and nerve supply, occurrence in Humans of a neuro-vascular pedicle for the clavicular part, shared with the deltoid, indicates a relatively morpho-functional independence of this part from the rest of the muscle. Under this regard, the width of the lateral pectoral nerve, which supplies the clavicular part of the muscle, may be related to a greater functional ability. Many manoeuvres for plastic and reconstructive surgery are performed by isolating the clavicular part of the pectoralis major. Indeed, this part may be considered as a true, self-standing anatomical entity. In fact, it has morphological individuality, peculiar bony attachments and functional autonomy, so that it is simply adjacent to the sternocostal part. Moreover, according to phylogenesis, this topographic relation develops secondarily, in parallel with the development of the clavicle. Therefore, it may be regarded not only as a simple part of an extrinsic muscle of the thorax, but also as an intrinsic muscle of the upper limb. PMID:25345076

Barberini, Fabrizio

2014-01-01

286

Respiratory-related activity of upper airway muscles in anesthetized rabbit.  

PubMed

The electromyographic activity of the glossal, suprahyoid, infrahyoid, and pharyngeal muscles was examined during spontaneous respiration in rabbits anesthetized with ketamine hydrochloride. This activity was then correlated with phases of the respiratory cycle. Our findings indicate that the overwhelming majority of the muscles comprising these groups show activity that increased during inspiration and returns to the background level during expiration and the end-expiratory pause. The exceptions are the inferior pharyngeal constrictor muscle, which demonstrates increased activity during expiration and the end-expiratory pause, and the stylohyoid major and digastric muscles, whose activity was not modulated with respiration. In general, the results obtained under ketamine anesthesia are in agreement with the studies on a more limited number of muscles in humans during sleep or in animal studies utilizing light anesthesia. Furthermore, the use of ketamine avoids the central suppressant effects produced by barbituate anesthesia. It has been argued that the upper airway muscles are rhythmically active during respiration to maintain the patency of the upper airway. Both the number of muscles that are rhythmically active and their strict correlation with specific phases of the respiratory cycle suggest that the forces exerted on the upper airway are complex and that peak tension is generated during inspiration. Further studies are required to evaluate the effects of ketamine anesthesia on these upper airway muscles before this rabbit model can be utilized to examine respiratory disorders of the upper airway. PMID:6662774

Rothstein, R J; Narce, S L; deBerry-Borowiecki, B; Blanks, R H

1983-12-01

287

Electromyographic responses of erector spinae and lower limb's muscles to dynamic postural perturbations in patients with adolescent idiopathic scoliosis.  

PubMed

The aim of this study was to evaluate electromyographic (EMG) responses of erector spinae (ES) and lower limbs' muscles to dynamic forward postural perturbation (FPP) and backward postural perturbation (BPP) in patients with adolescent idiopathic scoliosis (AIS) and in a healthy control group. Ten right thoracic AIS patients (Cobb=21.6±4.4°) and 10 control adolescents were studied. Using bipolar surface electrodes, EMG activities of ES muscle at T10 (EST10) and L3 (ESL3) levels, biceps femoris (BF), gastrocnemius lateralis (G) and rectus femoris (RF) muscles in the right and the left sides during FPP and BPP were evaluated. Muscle responses were measured over a 1s time window after the onset of perturbation. In FPP test, the EMG responses of right EST10, ESL3 and BF muscles in the scoliosis group were respectively about 1.40 (p=0.035), 1.43 (p=0.07) and 1.45 (p=0.01) times greater than those in control group. Also, in BPP test, at right ESL3 muscle of the scoliosis group the EMG activity was 1.64 times higher than that in the control group (p=0.01). The scoliosis group during FPP displayed asymmetrical muscle responses in EST10 and BF muscles. This asymmetrical muscle activity in response to FPP is hypothesized to be a possible compensatory strategy rather than an inherent characteristic of scoliosis. PMID:25008019

Farahpour, Nader; Ghasemi, Safoura; Allard, Paul; Saba, Mohammad Sadegh

2014-10-01

288

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

PubMed

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

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

2014-12-01

289

Test-retest reliability of robotic assessment measures for the evaluation of upper limb recovery.  

PubMed

Rehabilitation robots have built-in technology and sensors that allow accurate measurement of movement kinematics and kinetics, which can be used to derive measures related to upper limb performance and highlight changes in motor behavior due to rehabilitation. This study aimed to assess the test-retest reliability of some robot-measured parameters by analyzing their intra-session and inter-session (day-by-day) variability. The study was carried out in two groups: 31 patients after stroke and 15 healthy subjects. Both groups practiced two different motor tasks consisting of point-to-point reaching movements in the shape of two geometrical figures that were selected for the assessment of global and directional (eight directions of the workspace) test-retest reliability. The reliability of six parameters measuring movement velocity, accuracy, efficiency and smoothness was assessed intra-session and inter-session by the ICC, SEM, and CV. Healthy subjects exhibited very high ICC values ( > 0.85) and low SEM for all parameters. Patients had high ICC values and low SEM but their global reliability was generally lower compared to healthy subjects. In addition, their inter-session reliability showed very high ICC values ( > 0.91) and low SEM for all parameters. Direction analysis showed that in some parameters the reliability was generally high but not homogeneous in all directions. In addition, some directions showed systematic error. This study demonstrates that robot-measured parameters are reliable and can be considered ideal candidates for use in combination with impairment and functional clinical scales to evaluate motor improvement during robot-assisted neurorehabilitation. PMID:24760936

Colombo, Roberto; Cusmano, Ivana; Sterpi, Irma; Mazzone, Alessandra; Delconte, Carmen; Pisano, Fabrizio

2014-09-01

290

Scaling and kinematics optimisation of the scapula and thorax in upper limb musculoskeletal models  

PubMed Central

Accurate representation of individual scapula kinematics and subject geometries is vital in musculoskeletal models applied to upper limb pathology and performance. In applying individual kinematics to a model?s cadaveric geometry, model constraints are commonly prescriptive. These rely on thorax scaling to effectively define the scapula?s path but do not consider the area underneath the scapula in scaling, and assume a fixed conoid ligament length. These constraints may not allow continuous solutions or close agreement with directly measured kinematics. A novel method is presented to scale the thorax based on palpated scapula landmarks. The scapula and clavicle kinematics are optimised with the constraint that the scapula medial border does not penetrate the thorax. Conoid ligament length is not used as a constraint. This method is simulated in the UK National Shoulder Model and compared to four other methods, including the standard technique, during three pull-up techniques (n=11). These are high-performance activities covering a large range of motion. Model solutions without substantial jumps in the joint kinematics data were improved from 23% of trials with the standard method, to 100% of trials with the new method. Agreement with measured kinematics was significantly improved (more than 10° closer at p<0.001) when compared to standard methods. The removal of the conoid ligament constraint and the novel thorax scaling correction factor were shown to be key. Separation of the medial border of the scapula from the thorax was large, although this may be physiologically correct due to the high loads and high arm elevation angles. PMID:25011621

Prinold, Joe A.I.; Bull, Anthony M.J.

2014-01-01

291

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

PubMed Central

Background The Bradykinesia Akinesia Incoordination (BRAIN) test is a computer keyboard-tapping task that was developed for use in assessing the effect of symptomatic treatment on motor function in Parkinson's disease (PD). An online version has now been designed for use in a wider clinical context and the research setting. Methods Validation of the online BRAIN test was undertaken in 58 patients with Parkinson's disease (PD) and 93 age-matched, non-neurological controls. Kinesia scores (KS30, number of key taps in 30 seconds), akinesia times (AT30, mean dwell time on each key in milliseconds), incoordination scores (IS30, variance of travelling time between key presses) and dysmetria scores (DS30, accuracy of key presses) were compared between groups. These parameters were correlated against total motor scores and sub-scores from the Unified Parkinson's Disease Rating Scale (UPDRS). Results Mean KS30, AT30 and IS30 were significantly different between PD patients and controls (p?0.0001). Sensitivity for 85% specificity was 50% for KS30, 40% for AT30 and 29% for IS30. KS30, AT30 and IS30 correlated significantly with UPDRS total motor scores (r?=??0.53, r?=?0.27 and r?=?0.28 respectively) and motor UPDRS sub-scores. The reliability of KS30, AT30 and DS30 was good on repeated testing. Conclusions The BRAIN test is a reliable, convenient test of upper limb motor function that can be used routinely in the outpatient clinic, at home and in clinical trials. In addition, it can be used as an objective longitudinal measurement of emerging motor dysfunction for the prediction of PD in at-risk cohorts. PMID:24781810

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

2014-01-01

292

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

PubMed Central

Background The so-called ventral organs are amongst the most enigmatic structures in Onychophora (velvet worms). They were described as segmental, ectodermal thickenings in the onychophoran embryo, but the same term has also been applied to mid-ventral, cuticular structures in adults, although the relationship between the embryonic and adult ventral organs is controversial. In the embryo, these structures have been regarded as anlagen of segmental ganglia, but recent studies suggest that they are not associated with neural development. Hence, their function remains obscure. Moreover, their relationship to the anteriorly located preventral organs, described from several onychophoran species, is also unclear. To clarify these issues, we studied the anatomy and development of the ventral and preventral organs in several species of Onychophora. Results Our anatomical data, based on histology, and light, confocal and scanning electron microscopy in five species of Peripatidae and three species of Peripatopsidae, revealed that the ventral and preventral organs are present in all species studied. These structures are covered externally with cuticle that forms an internal, longitudinal, apodeme-like ridge. Moreover, phalloidin-rhodamine labelling for f-actin revealed that the anterior and posterior limb depressor muscles in each trunk and the slime papilla segment attach to the preventral and ventral organs, respectively. During embryonic development, the ventral and preventral organs arise as large segmental, paired ectodermal thickenings that decrease in size and are subdivided into the smaller, anterior anlagen of the preventral organs and the larger, posterior anlagen of the ventral organs, both of which persist as paired, medially-fused structures in adults. Our expression data of the genes Delta and Notch from embryos of Euperipatoides rowelli revealed that these genes are expressed in two, paired domains in each body segment, corresponding in number, position and size with the anlagen of the ventral and preventral organs. Conclusions Our findings suggest that the ventral and preventral organs are a common feature of onychophorans that serve as attachment sites for segmental limb depressor muscles. The origin of these structures can be traced back in the embryo as latero-ventral segmental, ectodermal thickenings, previously suggested to be associated with the development of the nervous system. PMID:24308783

2013-01-01

293

Functional Outcomes of Intramuscular Botulinum Toxin Type A and Occupational Therapy in the Upper Limbs of Children With Cerebral Palsy: A Randomized Controlled Trial  

Microsoft Academic Search

Wallen M, O’Flaherty SJ, Waugh MC. Functional outcomes of intramuscular botulinum toxin type A and occupational therapy in the upper limbs of children with cerebral palsy: a randomized controlled trial.

Margaret Wallen; Stephen J. O’Flaherty; Mary-Clare A. Waugh

2007-01-01

294

Kinematic MRI study of upper-airway biomechanics using electrical muscle stimulation  

NASA Astrophysics Data System (ADS)

We have developed a new and powerful method to study the movement and function of upper airway muscles. Our method is to use direct electrical stimulation of individual upper airway muscles, while performing state of the art high resolution magnetic resonance imaging (MRI). We have adapted a paralyzed isolated UA cat model so that positive or negative static pressure in the UA can be controlled at specific levels while electrical muscle stimulation is applied during MRI. With these techniques we can assess the effect of muscle stimulation on airway cross-sectional area compliance and soft tissue motion. We are reporting the preliminary results and MRI techniques which have enabled us to examine changes in airway dimensions which result form electrical stimulation of specific upper airway dilator muscles. The results of this study will be relevant to the development of new clinical treatments for obstructive sleep apnea by providing new information as to exactly how upper airway muscles function to dilate the upper airway and the strength of stimulation required to prevent the airway obstruction when overall muscle tone may not be sufficient to maintain regular breathing.

Brennick, Michael J.; Margulies, Susan S.; Ford, John C.; Gefter, Warren B.; Pack, Allan I.

1997-05-01

295

Estimating upper extremity tendon slack lengths  

Microsoft Academic Search

Tendon slack lengths are used in a dynamic muscle and limb model to animate the upper extremity based on user supplied activation levels. This paper provides tendon slack length estimates for actuators crossing the elbow and inserting on the radius or ulna. These values were not previously available as a complete see for the upper extremity. Muscle parameters used in

Brian R. von Konsky

1995-01-01

296

749. Effective Plasmid DNA Dose Range and Promoters for Gene Expression in Muscle Following Hydrodynamic Limb Vein Delivery of pDNA into Rodents and Primates  

Microsoft Academic Search

Plasmid DNA (pDNA) is efficiently delivered to limb muscles of rodents and large animals by hydrodynamic limb vein (HLV) injection, a facile procedure that uses a tourniquet or blood pressure cuff placed distal to the injected vein to delimit the target tissue. In rhesus monkeys of various weights and ages we detected much higher reporter gene expression when the pDNA

Christine I. Wooddell; Julia O. Hegge; Guofeng Zhang; Patricia Kleinpeter; Magdolna G. Sebestyén; Mark A. Noble; Loretta V. Pfannes; Hans Herweijer; Serge Braun; Thierry Huss; Jon A. Wolff

2006-01-01

297

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

298

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. PMID:21679457

2011-01-01

299

Effect of Ankle-foot Orthosis on Lower Limb Muscle Activities and Static Balance of Stroke Patients Authors' Names  

PubMed Central

[Purpose] This study examined the effects of an ankle-foot orthosis worn during balance training on lower limb muscle activity and static balance of chronic stroke patients. [Subjects] The subjects were twenty-five inpatients receiving physical therapy for chronic stroke. [Methods] The chronic stroke patients were divided into two groups: thirteen patients were assigned to the ankle-foot orthosis group, while the remaining twelve patients wore only their shoes. Each group performed balance training for 20 minutes, twice per day, 5 days per week, for 6 weeks. The lower limb muscle activities of the paralyzed side tibialis anterior, medial gastrocnemius, and the stability index were measured before and after the 6-week intervention. [Results] Comparison of the groups indicated a significant difference in the muscle activity of the paralyzed side tibialis anterior and the stability index of the eyes-open standing position. After the intervention, the ankle-foot orthosis group evidenced a significant difference in the muscle activities of the paralyzed side tibialis anterior and paralyzed side medial gastrocnemius as well as the stability index of the eyes-open standing position, eyes-closed standing position, eyes-open standing position on a sponge, and eyes-closed standing position on a sponge. The group that only wore their shoes showed significant differences in the stability indexes of eyes-open standing and eyes-open standing on a sponge. [Conclusion] Using the ankle-foot orthosis was effective during the initial training of lower limb muscle activities and the static balance training of chronic stroke patients. However, it was not effective for a variety of dynamic situations. PMID:24648626

Lee, Youngmin; Her, Jin Gang; Choi, Youngeun; Kim, Heesoo

2014-01-01

300

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

301

Re-emergence of hand-muscle representations in human motor cortex after hand allograft  

Microsoft Academic Search

The human primary motor cortex (M1) undergoes considerable reorganization in response to traumatic upper limb amputation. The representations of the preserved arm muscles expand, invading portions of M1 previously dedicated to the hand, suggesting that former hand neurons are reassigned to the control of remaining proximal upper limb muscles. Hand allograft offers a unique opportunity to study the reversibility of

Claudia D. Vargas; Antoine Aballéa; Érika C. Rodrigues; Karen T. Reilly; Catherine Mercier; Palmina Petruzzo; Jean M. Dubernard; Angela Sirigu

2009-01-01

302

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

303

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

Microsoft Academic Search

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

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

1995-01-01

304

Limb girdle muscular dystrophy type 2G with myopathic-neurogenic motor unit potentials and a novel muscle image pattern  

PubMed Central

Background Limb girdle muscular dystrophy type 2G (LGMD2G) is a subtype of autosomal recessive muscular dystrophy caused by mutations in the telethonin gene. There are few LGMD2G patients worldwide reported, and this is the first description associated with early tibialis anterior sparing on muscle image and myopathic-neurogenic motor unit potentials. Case presentation Here we report a 31 years old caucasian male patient with progressive gait disturbance, and severe lower limb proximal weakness since the age of 20 years, associated with subtle facial muscle weakness. Computed tomography demonstrated soleus, medial gastrocnemius, and diffuse thigh muscles involvement with tibialis anterior sparing. Electromyography disclosed both neurogenic and myopathic motor unit potentials. Muscle biopsy demonstrated large groups of atrophic and hypertrophic fibers, frequent fibers with intracytoplasmic rimmed vacuoles full of autophagic membrane and sarcoplasmic debris, and a total deficiency of telethonin. Molecular investigation identified the common homozygous c.157C?>?T in the TCAP gene. Conclusion This report expands the phenotypic variability of telethoninopathy/ LGMD2G, including: 1) mixed neurogenic and myopathic motor unit potentials, 2) facial weakness, and 3) tibialis anterior sparing. Appropriate diagnosis in these cases is important for genetic counseling and prognosis. PMID:25298746

2014-01-01

305

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

PubMed Central

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

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

2014-01-01

306

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

PubMed Central

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

Rogowski, Isabelle; Creveaux, Thomas; Cheze, Laurence; Mace, Pierre; Dumas, Raphael

2014-01-01

307

Can sit-to-stand lower limb muscle power predict fall status?  

PubMed

Sit-to-stand (STS) movements are essential for daily activities. Failure to perform STS movements efficiently and smoothly may lead to falls. In this study, we developed a forceplate to analyze vertical ground reaction force (VGRF), STS duration and generated muscle power to investigate which parameters were fall status predictors. A total of 105 participants were included in this study and were grouped into those (1) aged between 20 and 30 years (Young), (2) aged above 65 years without a history of falling (Non-fallers) and (3) aged above 65 with a history of falling in the past 12 months (Fallers). The results indicated a significantly higher maximal lower limb muscle power (MP) for the Young (9.05 ± 3.66 W/kg), followed by Non-fallers (5.50 ± 2.02W/kg) and Fallers (3.66 ± 1.45 W/kg) as well as higher modified falls efficacy scale (MFES) scores for the Young (Young: 9.88 ± 0.10; Non-fallers: 6.27 ± 1.40; Fallers: 4.83 ± 0.89) and shorter times for the five times sit-to-stand test (FSTST) for the young (Young: 6.09 ± 2.20 s; Non-fallers: 15.65 ± 3.30s; Fallers: 19.82 ± 4.46 s). There was a significant difference between the Young group and the Non-fallers in the maximal vertical ground reaction force (VGRF) (138.79 ± 24.20 N/BW in Young, 117.51 ± 8.57 N/BW in old Non-fallers, p < 0.01), and there was a significant difference between the Non-fallers and the Fallers in the duration of the STS movement (2.74 ± 0.87 s for the Non-fallers, 4.27 ± 2.56 s for the Fallers, p < 0.01). The regression analysis results further indicated that only MP and the STS stabilization phase could differentiate individuals who had past fall events. Therefore, the equipment we developed could potentially be useful in the assessment and monitoring of balance and the risk of falling in older people. PMID:24974126

Cheng, Yuan-Yang; Wei, Shun-Hwa; Chen, Po-Yin; Tsai, Mei-Wun; Cheng, I-Chung; Liu, Ding-Hao; Kao, Chung-Lan

2014-07-01

308

Ozone vertical profiles in the upper troposphere and stratosphere from the OMPS limb sensor  

NASA Astrophysics Data System (ADS)

Scheduled for launch in October 2011, the NPOESS Preparatory Project (NPP) mission includes the Ozone Mapping and Profiler Suite (OMPS) which is composed of two Nadir looking sensors and an Earth-limb viewing sensor. This paper is concerned with the OMPS limb sensor, the primary product of which is an ozone vertical profile with a 1.5 km vertical resolution, a vertical range of cloud top to 60 km and an along-track spacing of 125 km. Secondary products include stratospheric aerosol vertical distribution, cloud top height and NO2 vertical profiles. The paper describes the OMPS mission (sensor specifications, orbital characteristics, timeline), reviews the heritage in space-based ozone measurements, illustrates the limb sensor expected performance (accuracy and precision), describes the planned product validation effort (comparison with ground and space instruments) and defines the data release procedure (content, format and release schedule).

Fleig, Albert; Rault, Didier F.

2011-11-01

309

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. PMID:19705481

Margeta, Marta; Connolly, Anne M.; Winder, Thomas L.; Pestronk, Alan; Moore, Steven A.

2010-01-01

310

A comparison between double-injection axillary brachial plexus block and midhumeral block for emergency upper limb surgery.  

PubMed

In this prospective and randomized study, we compared a double-injection axillary (median and radial nerves) block with a midhumeral block in 90 patients undergoing emergency upper limb surgery. Time to perform the block, success rate, and patient tolerance were evaluated. The time to perform the block was 5 min longer in the midhumeral group. The success rate was similar in both groups (80% and 91% in groups axillary and midhumeral respectively), except for the musculocutaneous nerve. Patient tolerance was better in the axillary group. Double-injection axillary brachial plexus block is superior to midhumeral block for emergency hand surgery. PMID:16717337

Fuzier, Régis; Fourcade, Olivier; Pianezza, Antoine; Gilbert, Marie-Luce; Bounes, Vincent; Olivier, Michel

2006-06-01

311

[Musculo-skeletal disorders of the upper limb in the "new tables of professional diseases in industry and agriculture"].  

PubMed

The author, after an analysis of the statistical data on work-related diseases reported to the INAIL and listed on the Annual Report 2007, examines the main highlights of the "new tables of professional diseases in industry and agriculture" published in the Ministerial Decree of July 21st, 2008 (GU n.169, 21-7-2008), also relating to the introduction of musculo-skeletal disorders of the upper limb due to bio-mechanical strain into the list of professional diseases to which the legal presumption of origin is applicable. PMID:19288789

Clemente, M

2008-01-01

312

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

313

TNSRE-2011-00211.R1 1 Abstract--Upper limb robotic rehabilitation devices can collect  

E-print Network

injury (SCI) population. A retrospective analysis was conducted on data collected from subjects using XXX, 2011. This study was supported by the Rick Hansen Institute (grant #2009-34) and the NCCR Neural stages of recovery after injury. Therapists therefore help to support and move the limbs during

Popovic, Milos R.

314

Development and Testing of a Low-Cost Diagnostic Tool for Upper Limb Dysfunction  

E-print Network

Limb (UL) dysfunction (due to muscular dystrophy and stroke) ­ the diagnostic aspect of which not only between different patients in patient populations (due to demographic or age-related differences dexterity, speed, coordination, range of motion, strength and endurance, using subjective or semi

Krovi, Venkat

315

Limb segment vibration modulates spinal reflex excitability and muscle mRNA expression after spinal cord injury  

PubMed Central

Objective We investigated the effect of various doses of vertical oscillation (vibration) on soleus H-reflex amplitude and post-activation depression in individuals with and without SCI. We also explored the acute effect of short-term limb vibration on skeletal muscle mRNA expression of genes associated with spinal plasticity. Methods Six healthy adults and five chronic complete SCI subjects received vibratory stimulation of their tibia over three different gravitational accelerations (0.3g, 0.6g, and 1.2g) at a fixed frequency (30 Hz). Soleus H-reflexes were measured before, during, and after vibration. Two additional chronic complete SCI subjects had soleus muscle biopsies 3 h following a single bout of vibration. Results H-reflex amplitude was depressed over 83% in both groups during vibration. This vibratory-induced inhibition lasted over 2 min in the control group, but not in the SCI group. Post-activation depression was modulated during the long-lasting vibratory inhibition. A single bout of mechanical oscillation altered mRNA expression from selected genes associated with synaptic plasticity. Conclusions Vibration of the lower leg inhibits the H-reflex amplitude, influences post-activation depression, and alters skeletal muscle mRNA expression of genes associated with synaptic plasticity. Significance Limb segment vibration may offer a long term method to reduce spinal reflex excitability after SCI. PMID:21963319

Chang, Shuo-Hsiu; Tseng, Shih-Chiao; McHenry, Colleen L.; Littmann, Andrew E.; Suneja, Manish; Shields, Richard K.

2012-01-01

316

Towards a movement quantification system capable of automatic evaluation of upper limb motor function after neurological injury.  

PubMed

The paper proposes an integrated system to automatically assess motor function after neurological injury. A portable motion capture system was developed in order to obtain all the relevant three dimensional kinematics of the upper limb movement. These kinematics were analyzed by means of a decision tree classifier which features where inferred from the Functional Ability Score (FAS) of the Wolf Motor Function Test (WMFT). In addition, the system is able to correctly quantify the performance time of each selected task of the WMFT. In terms of the FAS the system and the clinician show coherent results for 3 out of 5 patients in the first task tested and 4 out of 5 for the second task tested. Regarding performance time, the mean error between the system and the clinician was of 0.216 s for the 25 trials performed (5 patients, 5 tasks each). These results represent an important proof of concept towards a system capable of precisely evaluate upper limb motor function after neurological injury. PMID:22255572

Bento, Virgílio F; Cruz, Vitor T; Ribeiro, David D; Cunha, João P S

2011-01-01

317

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

PubMed

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

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

2014-12-01

318

Hind limb suspension and long-chain omega-3 PUFA increase mRNA endocannabinoid system levels in skeletal muscle.  

PubMed

Muscle disuse has numerous physiological consequences that end up with significant catabolic metabolism and ultimately tissue atrophy. What is not known is how muscle atrophy affects the endocannabinoid (EC) system. Arachidonic acid (AA) is the substrate for anandamide (AEA) and 2-arachidonylgycerol (2-AG), which act as agonists for cannabinoid receptors CB1 and CB2 found in muscle. Diets with n-3 polyunsaturated fatty acids (PUFA) have been shown to reduce tissue levels of AA, AEA and 2-AG. Therefore, we hypothesized that hind limb suspension (HS)-induced muscle atrophy and intake of n-3 PUFA will change mRNA levels of the EC system. Mice were randomized and assigned to a moderate n-3 PUFA [11.7 g/kg eicosapentaenoic acid (EPA)+docosahexaenoic acid (DHA)], high n-3 PUFA (17.6 g/kg EPA+DHA) or control diets for 12 days and then subjected to HS or continued weight bearing (WB) for 14 days. HS resulted in body weight, epididymal fat pad and quadriceps muscle loss compared to WB. Compared to WB, HS had greater mRNA levels of AEA and 2-AG synthesis enzymes and CB2 in the atrophied quadriceps muscle. The high n-3 PUFA diet resulted in greater mRNA levels of EC synthesis enzymes, and CB1 and CB2. The higher mRNA levels for EC with HS and dietary n-3 PUFA suggest that muscle disuse and diet induce changes in the EC system to sensitize muscle in response to metabolic and physiological consequences of atrophy. PMID:22051448

Hutchins-Wiese, Heather L; Li, Yong; Hannon, Kevin; Watkins, Bruce A

2012-08-01

319

Neck proprioceptors contribute to the modulation of muscle sympathetic nerve activity to the lower limbs of humans.  

PubMed

Several different strategies have now been used to demonstrate that the vestibular system can modulate muscle sympathetic nerve activity (MSNA) in humans and thereby contribute to the regulation of blood pressure during changes in posture. However, it remains to be determined how the brain differentiates between head-only movements that do not require changes in vasomotor tone in the lower limbs from body movements that do require vasomotor changes. We tested the hypothesis that neck movements modulate MSNA in the lower limbs of humans. MSNA was recorded in 10 supine young adult subjects, at rest, during sinusoidal stretching of neck muscles (100 cycles, 35° peak to peak at 0.37 ± 0.02 Hz) and during a ramp-and-hold (17.5° for 54 ± 9 s) static neck muscle stretch, while their heads were held fixed in space. Cross-correlation analysis revealed cyclical modulation of MSNA during sinusoidal neck muscle stretch (modulation index 45.4 ± 5.3 %), which was significantly less than the cardiac modulation of MSNA at rest (78.7 ± 4.2 %). Interestingly, cardiac modulation decreased significantly during sinusoidal neck displacement (63.0 ± 9.3 %). By contrast, there was no significant difference in MSNA activity during static ramp-and-hold displacements of the neck to the right or left compared with that with the head and neck aligned. These data suggest that dynamic, but not static, neck movements can modulate MSNA, presumably via projections of muscle spindle afferents to the vestibular nuclei, and may thus contribute to the regulation of blood pressure during orthostatic challenges. PMID:24691758

Bolton, P S; Hammam, E; Macefield, V G

2014-07-01

320

Influence of visual and proprioceptive afferences on upper limb ataxia in patients with multiple sclerosis.  

PubMed

Our objective was to investigate how cooling of the arm and vision influence pointing movements in healthy subjects and patients with cerebellar limb ataxia due to clinically proven multiple sclerosis. An infrared video motion analysis system was used to record the unrestricted, horizontal pointing movements toward a target under three different conditions involving a moving, stationary, or imaginary target; a visual, or acoustic trigger; and vision or memory guidance. All three tasks were performed before and after cooling the arm in ice water. Patients had more hypermetric and slower pointing movements than controls under all tested conditions. Patients also had significantly larger three-dimensional finger sway paths during the postural phase and larger movement angles of the wrist joint. Memory-guided movements were the most hypermetric recorded in both groups. Cooling of the limb had no effect on amplitude or peak velocity of the pointing movement in either group under all tested conditions, but significantly reduced the three-dimensional finger sway path during the postural phase in patients with limb ataxia. Cooling-induced reduction of the finger sway was largest in those patients with the largest finger sway before cooling. In conclusion, the cooling-induced reduction of the proprioceptive afferent inflow, most probably of group I spindle afferents, reduces postural tremor of patients with cerebellar dysfunction. PMID:10223413

Quintern, J; Immisch, I; Albrecht, H; Pöllmann, W; Glasauer, S; Straube, A

1999-02-01

321

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. PMID:23226218

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

2012-01-01

322

Coordination of murine limb muscle, skeleton and connective tissue development by Lmx1b  

Microsoft Academic Search

The underlying genetic defects of a congenital disease Nail-Patella Syndrome are loss-of-function mutations in the LMX1B gene. Lmx1b encodes a LIM-homeodomain transcription factor that is expressed specifically in the dorsal limb bud mesenchyme. Gain- and loss-of-function experiments suggest that Lmx1b is both necessary and sufficient to specify dorsal limb patterning. However, how Lmx1b coordinates patterning of the dorsal tissues in

Ying Li

2009-01-01

323

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

Microsoft Academic Search

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

Naoto Igarashi; Kenji Suzuki; Hiroaki Kawamoto; Yoshiyuki Sankai

2010-01-01

324

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

PubMed Central

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

Kreissl, S.; Uber, A.

2008-01-01

325

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

NASA Astrophysics Data System (ADS)

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

Komada, Satoshi; Murakami, Yosuke; Hirai, Junji

326

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

PubMed Central

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

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

2014-01-01

327

The anatomical arrangement of muscle and tendon enhances limb versatility and locomotor performance  

PubMed Central

The arrangement of muscles and tendons has been studied in detail by anatomists, surgeons and biomechanists for over a century, and the energetics and mechanics of muscle contraction for almost as long. Investigation of how muscles function during locomotion and the relative length change in muscle fibres and the associated elastic tendon has, however, been more challenging. In recent years, novel in vivo measurement methods such as ultrasound and sonomicrometry have contributed to our understanding of the dynamics of the muscle tendon unit during locomotion. Here, we examine both published and new data to explore how muscles are arranged to deliver the wide repertoire of locomotor function and the trade-offs between performance and economy that result. PMID:21502125

Wilson, Alan; Lichtwark, Glen

2011-01-01

328

Thoracoscopic sympathectomy for palmar hyperhidrosis and Raynaud's phenomenon of the upper limb and excessive facial blushing: a five year experience  

PubMed Central

Primary hyperhidrosis of the palms, face, and axillae has a strong negative impact on social and professional life. A retrospective analysis of 40 laparoscopic transaxillary thoracic sympathectomies performed in a district general hospital over a five year period was undertaken in order to determine the effectiveness of this procedure. A postal questionnaire was sent to all patients to assess the benefit from the operation; postoperative pain and time off work were collated. Immediate failure was noted in three patients, of whom two later underwent successful reoperation. Recurrence was noted in three patients (8%). Though immediate complications were minimal, the major long term postoperative morbidity was compensatory hyperhidrosis on the back, chest, and thigh (77%) along with gustatory sweating over the face (22%). Thoracoscopic sympathectomy is a safe, effective, and minimally invasive surgical treatment for hyperhidrosis, Raynaud's phenomenon of the upper limb, and excessive facial blushing; however, the chance of long term compensatory hyperhidrosis is high. PMID:12496327

Rajesh, Y; Pratap, C; Woodyer, A

2002-01-01

329

Effector-independent brain activity during motor imagery of the upper and lower limbs: An fMRI study.  

PubMed

We utilized functional magnetic resonance imaging (fMRI) to evaluate the common brain region of motor imagery for the right and left upper and lower limbs. The subjects were instructed to repeatedly imagined extension and flexion of the right or left hands/ankles. Brain regions, which included the supplemental motor area (SMA), premotor cortex and parietal cortex, were activated during motor imagery. Conjunction analysis revealed that the left SMA and inferior frontal gyrus (IFG)/ventral premotor cortex (vPM) were commonly activated with motor imagery of the right hand, left hand, right foot, and left foot. This result suggests that these brain regions are activated during motor imagery in an effector independent manner. PMID:25150928

Mizuguchi, Nobuaki; Nakata, Hiroki; Kanosue, Kazuyuki

2014-10-01

330

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. PMID:17909839

Palmer, Keith T

2013-01-01

331

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

PubMed

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

Basteris, Angelo; Nijenhuis, Sharon M; Stienen, Arno H A; Buurke, Jaap H; Prange, Gerdienke B; Amirabdollahian, Farshid

2014-01-01

332

A randomized trial of upper limb botulimun toxin versus placebo injection, combined with physiotherapy, in children with hemiplegia.  

PubMed

The main goal of this study was to investigate the efficacy of Botulinum Toxin A (BoNT-A), combined with an individualized intensive physiotherapy/orthoses treatment, in improving upper limb activity and competence in daily activity in children with hemiplegia, and to compare its effectiveness with that of non-pharmacological instruments. It was a Randomized Clinical Trial of 27 children with spastic hemiplegic cerebral palsy, outpatients of two high speciality Centres for child rehabilitation. Each child was assigned by simple randomization to experimental group (BoNT-A) or control group (placebo). Assisting Hand Assessment (AHA) was chosen as primary outcome measure; other measures were selected according to ICF dimensions. Participants were assessed at baseline (T0), at T1, T2, T3 (1-3-6 months after injection, respectively). Every patient was given a specific physiotherapeutic treatment, consisting of individualized goal directed exercises, task oriented activities, daily stretching manoeuvres, functional and/or static orthoses. BoNT-A group showed a significant increase of AHA raw scores at T2, compared to control group (T2-T0: p=.025) and functional goals achievement (GAS) was also slightly better in the same group (p=.033). Other measures indicated some improvement in both groups, without significant intergroup differences. Children with intermediate severity of hand function at House scale for upper limb impairment seem to have a better benefit from BoNT-A protocol. BoNT-A was effective in improving manipulation in the activity domain, in association with individualized goal-directed physiotherapy and orthoses; the combined treatment is recommended. The study brings more evidence for the efficacy of a combined treatment botulinum toxin injection-physiotherapy-orthoses, and it gives some suggestions for candidate selection and individualized treatment. PMID:24995688

Ferrari, Adriano; Maoret, Anna Rosa; Muzzini, Simonetta; Alboresi, Silvia; Lombardi, Francesco; Sgandurra, Giuseppina; Paolicelli, Paola Bruna; Sicola, Elisa; Cioni, Giovanni

2014-10-01

333

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

2013-03-01

334

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

PubMed Central

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

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

2014-01-01

335

Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury  

Microsoft Academic Search

Purpose: To evaluate the lower motor neuron (LMN) integrity of upper extremity muscles of persons with high tetraplegia (C1-C4) in order to determine muscles available for stimulation. Methods: Fourteen subjects (23 arms) were evaluated for LMN integrity. Muscles that elicited a functional response (grade 3 or better) to surface electrical stimulation were considered to have intact LMN and good candidates

M-J Mulcahey; BT Smith; RR Betz

1999-01-01

336

Effect of Intensive Functional Electrical Stimulation Therapy on Upper-Limb Motor Recovery after Stroke  

E-print Network

�lectrique fonctionnelle (FES) pouvait redonner la fonction volontaire du bras et de la main chez les patients qui avaient bras ainsi qu'une combinaison de se�ances de FES pre�programme�es et de mouvements assiste�s. Me maximale des muscles de la portion supe�rieure du bras n'ait pas montre� d'ame�lioration notable, la

Popovic, Milos R.

337

Age- and Sex-Related Differences in Force-Velocity Characteristics of Upper and Lower Limbs of Competitive Adolescent Swimmers  

PubMed Central

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

2012-01-01

338

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

E-print Network

limb, the contralateral limb has already acquired the best technique or strategy to learn that motor task and thus, there is a transfer of learning across the two limbs. Second, the transfer of learning across two limbs can be explained using...) and across trials (trial to trial variability) (Christou et al. 2007). These differences in motor performance may contribute to learning differences between the ipsilateral limbs. Clinically, it may enable the development of new training techniques...

Kaur, Navneet

2010-07-14

339

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

340

A Kinematic Model of the Upper Limb Based on the Visible Human Project (VHP) Image Dataset  

Microsoft Academic Search

A kinematic model of the arm was developed using high-resolution medical images obtained from the National Library of Medicine's Visible Human Project (VHP) dataset. The model includes seven joints and uses thirteen degrees of freedom to describe the relative movements of seven upper-extremity bones: the clavicle, scapula, humerus, ulna, radius, carpal bones, and hand. Two holonomic constraints were used to

BRIAN A. GARNER; MARCUS G. PANDY

1999-01-01

341

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

PubMed

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

Pecking, A P

1995-09-01

342

Can lower limb muscles be retrained to decrease the risk of ACL injury?  

Microsoft Academic Search

Rupture of the anterior cruciate ligament (ACL) of the knee joint frequently occurs in sports that require the athlete to land or change direction suddenly. The structural integrity of this ligament during such maneuvers is heavily dependent upon coordinated quadriceps and hamstring muscle activation. Therefore, strategies used to recruit these muscles have a pivotal role in equipping the knee to

Elizabeth Jane Cowling

2004-01-01

343

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

PubMed Central

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

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

2014-01-01

344

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

PubMed

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

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

2014-01-01

345

Electromyography of selected lower-limb muscles fatigued by exercise at the intensity of soccer match-play.  

PubMed

Surface electromyography has been useful in comparing muscular activity among different sports movements and it is a valuable technique for evaluating muscle activation, co-ordination and fatigue. Since these important variables have not been investigated during the full game in soccer, the present study aimed to investigate the activity of major muscles of the lower extremity during a soccer-simulation fatiguing protocol. Ten amateur soccer players (age 21.40+/-3.13 years; height 1.77+/-0.06 m; mass 74.55+/-8.5 kg) were tested. The exercise protocol, performed on a programmable motorised treadmill, consisted of the different intensities observed during soccer match-play (walking, jogging, running, sprinting). Electromyographic activity was recorded from the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) and gastrocnemius (GC) muscles before exercise, at half-time and immediately after the 90-min exercise protocol. The EMG data were analysed using custom-written software to compute the root mean square (RMS) value over ten gait cycles. With regard to RF, BF and TA, a significant main effect (P< 0.05) was found for condition (pre-game, half-time and post-game), speed (6, 12, 15 and 21 km h(-1)) (P<0.05) and interaction between condition and speed (P< 0.05). For GC, a significant effect was not found for condition or interaction between condition and speed, but a significant main effect (P< 0.001) was found for speed, with the RMS value increasing continually with increasing speed from 6 to 2 1km h(-1). The results indicated that after a simulation of the exercise intensity of soccer-play the EMG activity in major lower-limb muscles was less than before. This decrease indicated that prolonged intermittent exercise had an effect on muscle activity even when work-rate was sustained. PMID:16146698

Rahnama, Nader; Lees, Adrian; Reilly, Thomas

2006-06-01

346

Upper trapezius muscle activation patterns in neck-shoulder pain patients and healthy controls.  

PubMed

This study aimed at investigating whether patients with neck-shoulder complaints from different aetiologies (work-related musculo-skeletal disorders, WMSD; whiplash associated disorders, WAD) show comparable muscle activation patterns, characterised by higher activation and lower relaxation levels of the trapezius muscles compared to healthy controls. Twenty healthy controls, 21 WMSD and 20 WAD patients with non-acute neck-shoulder pain were recruited for this cross-sectional study. Surface electromyography (sEMG) recordings were performed at the upper trapezius muscles during reference contractions, standardised computer tasks (typing and unilateral stress task), and rest measurements. sEMG was continuously recorded during these measurements. Outcome measures were root mean square (RMS) to study muscle activity, and relative rest time (RRT) to study muscle relaxation. Statistical analysis comprised the bootstrap technique and Kruskall-Wallis tests. Results showed no clear evidence for abnormal muscle activation patterns in WMSD and WAD patients compared to healthy controls. However, a tendency was observed for higher RMS levels during the reference contractions and computer tasks in both patient groups compared to healthy controls, and lower RRT levels at the non-dominant side during stress. Both patient groups also showed larger variability in RMS and RRT values. This variability has more often been reported in literature and may suggest the existence of subgroups of pain patients with corresponding different muscle activation patterns not related to aetiology. Future research may focus on identifying these subgroups of patients with neck-shoulder pain. PMID:16845552

Voerman, G E; Vollenbroek-Hutten, M M R; Hermens, H J

2007-12-01

347

Comparative Study of Motor Performance of Deaf and Hard of Hearing Students in Reaction Time, Visual-Motor Control and Upper Limb Speed and Dexterity Abilities  

ERIC Educational Resources Information Center

Using the Bruininks-Oseretsky Test the motor performance of 34 deaf--hard-of-hearing pupils, 6-14 year, was evaluated in reaction time, visual-motor control and upper limb speed and dexterity. The two-way ANOVA variance analysis for two independent variables, group, age, and the Post Hoc (Scheffe test) for multiple comparisons were used. The…

Gkouvatzi, Anastasia N.; Mantis, Konstantinos; Kambas, Antonis

2010-01-01

348

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

NASA Technical Reports Server (NTRS)

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

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

2004-01-01

349

Fiber size and myosin phenotypes of selected rhesus lower limb muscles after a 14-day spaceflight  

NASA Technical Reports Server (NTRS)

Muscle biopsies were taken from the rhesus (Macaca mulatta) soleus (Sol, a slow ankle extensor), medial gastrocnemius (MG, a fast ankle extensor), tibialis anterior (TA, a fast ankle flexor), and vastus lateralis (VL, a fast knee extensor) muscles in vivarium controls (n=5) before and after either a 14-day spaceflight (Bion 11, n=2) or a 14-day ground-based flight simulation (n=3). Myosin heavy chain (MHC) composition (gel electrophoresis), fiber type distribution (immunohistochemistry), and fiber size were determined. Although there were no significant changes, each muscle showed trends towards adaptation.

Roy, R. R.; Zhong, H.; Bodine, S. C.; Pierotti, D. J.; Talmadge, R. J.; Barkhoudarian, G.; Kim, J.; Fanton, J. W.; Kozlovskaya, I. B.; Edgerton, V. R.

2000-01-01

350

Determination of upper arm muscle and fat areas using electrical impedance measurements.  

PubMed

An electrical impedance technique is described which enables the cross-sectional areas of fat and muscle in the upper arm to be recorded. By making comparisons with measurements obtained using the x-ray technique of computerised tomography (CT) scanning it is shown that fat can be determined to a mean accuracy of 2.3 cm2 and muscle to a mean accuracy of 1.5 mm2. These results are more accurate than a parallel set of measurements made using the traditional anthropometric technique. PMID:3359744

Brown, B H; Karatzas, T; Nakielny, R; Clarke, R G

1988-02-01

351

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

PubMed Central

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

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

2013-01-01

352

Lower limb muscle strength and physical activity in healthy individuals approaching retirement  

Microsoft Academic Search

The purpose of this study was to examine knee extensor\\/flexor muscle strength and physical activity in healthy males and females approaching retirement. Peak torques of the knee extensor and knee flexor muscle groups were measured bilaterally in 95 individuals (mean age 59.4 years) using an isokinetic dynamometer. Isokinetic concentric contractions were performed at angular velocities of 1.05 and 3.14 rad · s. Physical

E. C. Bryant; M. E. Trew; A. M. Bruce; L. Cheek

2007-01-01

353

Location specificity of plantar cutaneous reflexes involving lower limb muscles in humans  

Microsoft Academic Search

It is known that cutaneous reflexes in human hand muscles show strong location-specificity dependent on the digit stimulated. We hypothesized that in lower leg muscles the cutaneous reflex following tactile sensation of the plantar surface of the foot is also organized in a location-specific manner. The purpose of the present study was to test this hypothesis. Middle latency reflexes (?70–110 ms,

Tsuyoshi Nakajima; Masanori Sakamoto; Toshiki Tazoe; Takashi Endoh; Tomoyoshi Komiyama

2006-01-01

354

Isometric Contraction of an Upper Extremity and Its Effects on the Contralateral Lower Extremity  

PubMed Central

[Purpose] The aim of this study was to examine effects of the isometric contraction of an upper limb in a supine position on the muscle activity of a healthy adult in the contralateral lower limb. [Subjects] The subjects were 40 healthy adults (35 males and 5 females). [Methods] The muscle activity of the rectus femoris (RF), biceps femoris, anterior tibialis, and medial gastrocnemius (MG) of the contralateral lower limb was measured using electromyography while the subjects flexed, extended, abducted, and adducted the shoulder joint of an upper limb. [Results] The muscle activity of the RF of the contralateral lower limb was significantly high when the subject flexed the shoulder joint of an upper limb, and the muscle activity of the MG of the contralateral lower limb was significantly high when the subject adducted the shoulder joint of an upper limb. [Conclusion] The isometric contraction that results from flexion and adduction of the shoulder joint of an upper limb in a supine position is considered to selectively affect the RF and MG activity of the contralateral lower limb.

Lee, Daehee; Park, Jungseo; Lee, Sangyong

2014-01-01

355

A palmar pressure sensor for measurement of upper limb weight bearing by the hands during transfers by paraplegics.  

PubMed

Paraplegic patients have to effect transfer from one seat to another by using their upper limbs. In this process the hands bear almost the entire weight of the body in at least some phases of the transfer. It is desirable to train patients, especially those who are elderly and otherwise weak, to distribute their weight so as to avoid large forces being sustained on any one hand for an extended period. It is also desirable to evaluate the effectiveness of assistive devices like lower limb FES in sharing the load on the hand. This study presents a simple and versatile method of measuring palmar hand force during transfers by paraplegic patients. It is important that this force sensor should not interfere with the grasping and stabilizing properties of the hands and should permit normal transferring. The force sensor comprises an air-filled pouch or pillow that can be placed on any surface. This pneumatic sensor feels like upholstery padding on the surface on which it is placed. The sensor integrates the total pressure applied to the surface of the pouch, thereby obtaining the total force exerted by the palm/hand. The fabrication of the sensor is described, as well as the associated measurement circuit. The static calibration shows that the sensor is linear up to 350?N and the dynamic calibration shows that it has a bandwidth of 13?Hz. The sensor was fabricated using an inflated inelastic airbag attached to a pressure transducer. An automatic offset correction circuit in the preamplifier module ensures that any offset due to initial pressure or sensor drift is removed and the output is zero under no load condition. The key to this sensor arrangement is the ease of fitting it into the intended location without disturbing the existing arrangement for the subject's activities of daily living (ADL). PMID:23964668

Kunju, Nissan; Ojha, Rajdeep; Devasahayam, Suresh R

2013-10-01

356

Time-dependence between upper arm muscles activity during rapid movements: observation of the proportional effects predicted by the kinematic theory.  

PubMed

Rapid human movements can be assimilated to the output of a neuromuscular system with an impulse response modeled by a Delta-Lognormal equation. In such a model, the main assumption concerns the cumulative time delays of the response as it propagates toward the effector following a command. To verify the validity of this assumption, delays between bursts in electromyographic (EMG) signals of agonist and antagonist muscles activated during a rapid hand movement were investigated. Delays were measured between the surface EMG signals of six muscles of the upper limb during single rapid handwriting strokes. From EMG envelopes, regressions were obtained between the timing of the burst of activity produced by each monitored muscle. High correlation coefficients were obtained supporting the proportionality of the cumulative time delays, the basic hypothesis of the Delta-Lognormal model. A paradigm governing the sequence of muscle activities in a rapid movement could, in the long run, be useful for applications dealing with the analysis and synthesis of human movements. PMID:23219167

Plamondon, Réjean; Djioua, Moussa; Mathieu, Pierre A

2013-10-01

357

Built for rowing: frog muscle is tuned to limb morphology to power swimming  

PubMed Central

Rowing is demanding, in part, because drag on the oars increases as the square of their speed. Hence, as muscles shorten faster, their force capacity falls, whereas drag rises. How do frogs resolve this dilemma to swim rapidly? We predicted that shortening velocity cannot exceed a terminal velocity where muscle and fluid torques balance. This terminal velocity, which is below Vmax, depends on gear ratio (GR = outlever/inlever) and webbed foot area. Perhaps such properties of swimmers are ‘tuned’, enabling shortening speeds of approximately 0.3Vmax for maximal power. Predictions were tested using a ‘musculo-robotic’ Xenopus laevis foot driven either by a living in vitro or computational in silico plantaris longus muscle. Experiments verified predictions. Our principle finding is that GR ranges from 11.5 to 20 near the predicted optimum for rowing (GR ? 11). However, gearing influences muscle power more strongly than foot area. No single morphology is optimal for producing muscle power. Rather, the ‘optimal’ GR decreases with foot size, implying that rowing ability need not compromise jumping (and vice versa). Thus, despite our neglect of additional forces (e.g. added mass), our model predicts pairings of physiological and morphological properties to confer effective rowing. Beyond frogs, the model may apply across a range of size and complexity from aquatic insects to human-powered rowing. PMID:23676897

Richards, Christopher T.; Clemente, Christofer J.

2013-01-01

358

Osteopoikilosis associated with fibromyalgia and active myofascial trigger point in upper trapezius muscles.  

PubMed

Osteopoikilosis is a sclerosing bone dysplasia, characterized by multiple oval spots of radiodensities within the trabecular bone. It occurs equally common among men and women. Prevalence is estimated to be as high as 1:50,000. Most reported cases have been found incidentally on roentgenograms taken for other purposes. We present a 58-year-old woman with OPK associated with fibromyalgia and active myofascial trigger point in upper trapezius muscles. PMID:22142715

Uludag, Murat; Kaparov, Asylbek; Sari, Hidayet; Ornek, Nurettin Irem; Gün, Kerem; Suzen, Sibel; Akarirmak, Ulku

2011-01-01

359

Upper limb international spasticity study: rationale and protocol for a large, international, multicentre prospective cohort study investigating management and goal attainment following treatment with botulinum toxin A in real-life clinical practice  

PubMed Central

Objectives This article provides an overview of the Upper Limb International Spasticity (ULIS) programme, which aims to develop a common core dataset for evaluation of real-life practice and outcomes in the treatment of upper-limb spasticity with botulinum toxin A (BoNT-A). Here we present the study protocol for ULIS-II, a large, international cohort study, to describe the rationale and steps to ensure the validity of goal attainment scaling (GAS) as the primary outcome measure. Methods and analysis design An international, multicentre, observational, prospective, before-and-after study, conducted at 84 centres in 22 countries across three continents. Participants 468 adults presenting with poststroke upper limb spasticity in whom a decision had already been made to inject BoNT-A (5–12 consecutive participants recruited per centre). Interventions Physicians were free to choose targeted muscles, BoNT-A preparation, injected doses/technique and timing of follow-up in accordance with their usual practice and the goals for treatment. Primary outcome measure: GAS. Secondary outcomes: Measurements of spasticity, standardised outcome measures and global benefits. Steps to ensure validity included: (1) targeted training of all investigators in the use of GAS; (2) within-study validation of goal statements and (3) establishment of an electronic case report form with an in-built tracking facility for separation of baseline/follow-up data. Analysis Efficacy population: all participants who had (1) BoNT-A injection and (2) subsequent assessment of GAS. Primary efficacy variable: percentage (95% CI) achievement of the primary goal from GAS following one BoNT-A injection cycle. Ethics and dissemination This non-interventional study is conducted in compliance with guidelines for good pharmacoepidemiology practices. Appropriate ethical approvals were obtained according to local regulations. ULIS-II will provide important information regarding treatment and outcomes from BoNT-A in real-life upper limb spasticity management. The results will be published separately. Registration ClinicalTrials.gov identifier: NCT01020500. PMID:23512837

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

2013-01-01

360

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

PubMed Central

Background Rehabilitation for children with hemiplegic cerebral palsy (HCP) aimed to improve function of the impaired upper limb (UL) uses a wide range of intervention programs. A new rehabilitative approach, called Action-Observation Therapy, based on the recent discovery of mirror neurons, has been used in adult stroke but not in children. The purpose of the present study is to design a randomised controlled trial (RCT) for evaluating the efficacy of Action-Observation Therapy in improving UL activity in children with HCP. Methods/Design The trial is designed according to CONSORT Statement. It is a randomised, evaluator-blinded, match-pair group trial. Children with HCP will be randomised within pairs to either experimental or control group. The experimental group will perform an Action-Observation Therapy, called UP-CAT (Upper Limb-Children Action-Observation Training) in which they will watch video sequences showing goal-directed actions, chosen according to children UL functional level, combined with motor training with their hemiplegic UL. The control group will perform the same tailored actions after watching computer games. A careful revision of psychometric properties of UL outcome measures for children with hemiplegia was performed. Assisting Hand Assessment was chosen as primary measure and, based on its calculation power, a sample size of 12 matched pairs was established. Moreover, Melbourne and ABILHAND-Kids were included as secondary measures. The time line of assessments will be T0 (in the week preceding the onset of the treatment), T1 and T2 (in the week after the end of the treatment and 8 weeks later, respectively). A further assessment will be performed at T3 (24 weeks after T1), to evaluate the retention of effects. In a subgroup of children enrolled in both groups functional Magnetic Resonance Imaging, exploring the mirror system and sensory-motor function, will be performed at T0, T1 and T2. Discussion The paper aims to describe the methodology of a RCT for evaluating the efficacy of Action-Observation Therapy in improving UL activity in children with hemiplegia. This study will be the first to test this new type of treatment in childhood. The paper presents the theoretical background, study hypotheses, outcome measures and trial methodology. Trial Registration NCT01016496 PMID:21711525

2011-01-01

361

Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis  

PubMed Central

Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine). From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral), with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with heparin in continuous intravenous infusion and subsequent anticoagulant therapy allowed the gradual disappearance of the symptoms with the reappearance of peripheral pulses. Conclusion Angiography showed regression of vasospasm and the resumption of flow in distal vessels. The patient had regained sensitivity and motility in the upper limbs and bilaterally radial and ulnar were present. PMID:21878097

2011-01-01

362

A kinematic study of the upper-limb motion of wheelchair basketball shooting in tetraplegic adults.  

PubMed

Kinematic aspects of the reduced shooting ability of tetraplegic (TP) wheelchair basketball players were investigated and compared with those of able-bodied (AB) basketball players. TP showed significantly smaller values for the vertical component of ball release velocity (4.26 (degree/s) versus 5.45 (degree/s)) and maximum wrist flexion angular velocity (878.4 (degree/s) versus 1445.9 degrees) than AB. Moreover, for a specific shoulder horizontal adduction motion, a larger range of shoulder abduction motion and larger displacements of the right shoulder were observed in TP. The reduced ball velocity of TP subjects with lesions at the C7 to C8 levels depended on an insufficient wrist flexion angular velocity, where dysfunction of available musculature may be a causal determinant. Further, the specific motions observed in TP subjects most likely maximize the function of available musculature, thereby partially compensating for the dysfunction of the wrist flexor muscles and contributing to resultant ball release velocity. PMID:11926328

Nunome, Hiroyuki; Doyo, Wataru; Sakurai, Shinji; Ikegmai, Yasuo; Yabe, Kyonosuke

2002-01-01

363

Comparison of Lower Limb Muscle Activity during Eccentric and Concentric Exercises in Runners with Achilles Tendinopathy  

PubMed Central

[Purpose] This study aimed to identify changes in muscle activation by comparing muscle activities of the affected side (AS) and non-affected side (NAS) during eccentric and concentric exercises in runners with unilateral Achilles tendinopathy. [Subjects] The study included 18 participants consisting of men and women with chronic Achilles tendinopathy in a single leg who had more than 1?year of running experience. [Methods] All subjects performed concentric and eccentric exercise with the Achilles tendon moving from full plantar flexion to full dorsiflexion for 8 seconds, and electromyography data was obtained. [Results] All muscles examined showed a significant increase in %maximal voluntary contraction (MVC) with concentric exercise compared with eccentric exercise. Compared with the NAS, the AS showed significant increases in %MVC of the rectus femoris, tibialis anterior, and lateral gastrocnemius. All interaction effects of exercise methods and injuries showed statistically significant changes. [Conclusion] Runners with Achilles tendinopathy show increases in medial gastrocnemius activity when performing eccentric exercise. PMID:25276014

Yu, Jaeho

2014-01-01

364

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

PubMed

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

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

2014-01-01

365

Report of an unusual combination of arterial, venous and neural variations in a cadaveric upper limb  

PubMed Central

In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery. Multiple variations in typical axillary artery branches were present including existence of inferior pectoral artery. Cephalic vein was absent. A variety of interventions, from relative simple as central venous catheter placement to most complicated as brachial plexus injury repair demand thorough knowledge of area’s regional anatomy. Familiarity with anatomic variations allows more precise and careful interventions. Research on these variations is valuable for anatomists and embryologists but also for clinicians because it may provide useful information for non - typical cases but also helps in raising a high level of suspicion. PMID:24495850

2014-01-01

366

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

E-print Network

functional assessment of patients with reduced motor and/or cognitive abilities [1]. In particular, neuro-prostheses to replace motor function after disease or injury has been a major research area in rehabilitation Engineering, Tokyo Institute of Technology, Tokyo 152-8550 JAPAN muscles [10], [11]. In these works

367

Is motor knowledge part and parcel of the concepts of manipulable artifacts? Clues from a case of upper limb aplasia.  

PubMed

The sensory-motor theory of conceptual representations assumes that motor knowledge of how an artifact is manipulated is constitutive of its conceptual representation. Accordingly, if we assume that the richer the conceptual representation of an object is, the easier that object is identified, manipulable artifacts that are associated with motor knowledge should be identified more accurately and/or faster than manipulable artifacts that are not (everything else being equal). In this study, we tested this prediction by investigating the identification of manipulable artifacts in an individual, DC, who was totally deprived of hand motor experience due to upper limb aplasia. This condition prevents him from interacting with most manipulable artifacts, for which he thus has no motor knowledge at all. However, he had motor knowledge for some of them, which he routinely uses with his feet. We contrasted DC's performance in a timed picture naming task for manipulable artifacts for which he had motor knowledge versus those for which he had no motor knowledge. No detectable advantage on DC's naming performance was found for artifacts for which he had motor knowledge compared to those for which he did not. This finding suggests that motor knowledge is not part of the concepts of manipulable artifacts. PMID:24365637

Vannuscorps, Gilles; Andres, Michael; Pillon, Agnesa

2014-02-01

368

Treatment with 4-aminopyridine improves upper limb tremor of a patient with multiple sclerosis: a video case report.  

PubMed

The reversible potassium channel blocker 4-aminopyridine is effective in the treatment of numerous cerebellar dysfunctions, such as episodic ataxia type 2 and downbeat nystagmus syndrome. In 2011, its sustained release form, dalfampridine, was admitted in Europe for the treatment of walking difficulties in patients with multiple sclerosis (MS). Here we report the case of a 44-year old patient with a progressive MS whose upper limb tremor was markedly reduced under treatment with 4-aminopyridine, as documented in a Tremor Activities of Daily Living questionnaire and in the 9-Hole Peg test. Hand accelerations decreased in the left hand from 10.9 m/sec(2) to 2.2 m/sec(2) and in the right hand from 4.2 m/sec(2) to 0.9 m/sec(2). This case report indicates for the first time that 4-aminopyridine might be effective in the symptomatic treatment of tremor entities in patients with MS. The finding calls for further prospective studies to determine the usefulness of 4-aminopyridine or its sustained-release form dalfampridine in treating patients with tremor and MS. PMID:23069878

Schniepp, Roman; Jakl, Veronika; Wuehr, Max; Havla, Joachim; Kümpfel, Tanja; Dieterich, Marianne; Strupp, Michael; Jahn, Klaus

2013-04-01

369

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

PubMed

The aim of this paper was to explore how an upper limb exoskeleton can be programmed to impose specific joint coordination patterns during rehabilitation. Based on rationale which emphasizes the importance of the quality of movement coordination in the motor relearning process, a robot controller was developed with the aim of reproducing the individual corrections imposed by a physical therapist on a hemiparetic patient during pointing movements. The approach exploits a description of the joint synergies using principal component analysis (PCA) on joint velocities. This mathematical tool is used both to characterize the patient's movements, with or without the assistance of a physical therapist, and to program the exoskeleton during active-assisted exercises. An original feature of this controller is that the hand trajectory is not imposed on the patient: only the coordination law is modified. Experiments with hemiparetic patients using this new active-assisted mode were conducted. Obtained results demonstrate that the desired inter-joint coordination was successfully enforced, without significantly modifying the trajectory of the end point. PMID:22481836

Crocher, Vincent; Sahbani, Anis; Robertson, Johanna; Roby-Brami, Agnès; Morel, Guillaume

2012-05-01

370

Feature extraction using extrema sampling of discrete derivatives for spike sorting in implantable upper-limb neural prostheses.  

PubMed

Next generation neural interfaces for upper-limb (and other) prostheses aim to develop implantable interfaces for one or more nerves, each interface having many neural signal channels that work reliably in the stump without harming the nerves. To achieve real-time multi-channel processing it is important to integrate spike sorting on-chip to overcome limitations in transmission bandwidth. This requires computationally efficient algorithms for feature extraction and clustering suitable for low-power hardware implementation. This paper describes a new feature extraction method for real-time spike sorting based on extrema analysis (namely positive peaks and negative peaks) of spike shapes and their discrete derivatives at different frequency bands. Employing simulation across different datasets, the accuracy and computational complexity of the proposed method are assessed and compared with other methods. The average classification accuracy of the proposed method in conjunction with online sorting (O-Sort) is 91.6%, outperforming all the other methods tested with the O-Sort clustering algorithm. The proposed method offers a better tradeoff between classification error and computational complexity, making it a particularly strong choice for on-chip spike sorting. PMID:24760942

Zamani, Majid; Demosthenous, Andreas

2014-07-01

371

Deficits of Movement Accuracy and Proprioceptive Sense in the Ipsi-lesional Upper Limb of Patients with Hemiparetic Stroke.  

PubMed

[Purpose] Previous studies have reported on motor deficits in the ipsilateral upper limbs (UL) of a damaged brain hemisphere in motor tasks. However, little is known about sensory deficits on the ipsilateral side. Therefore, we investigated whether both motor and sensory function of the ipsilateral UL are affected in patients with stroke. [Subjects and Methods] Fifty patients with unilateral stroke and 40 age- and sex- matched normal subjects participated in this study. Subjects were evaluated on performance of a tracking task for motor function, and by the joint reposition test for integrity of proprioceptive sense in the ipsilateral UL. [Result] The comparison of the stroke group and the control group showed significant differences in performance of the tracking task and the joint reposition test. The accuracy index for the tracking task showed significant correlation with the error score for the joint reposition test in the stroke group. [Conclusion] These results suggest that the ipsilateral UL of stroke patients has impairment in sensory function which is related to proprioceptive sense, along with motor deficits. Therefore, we think that the difficulty stroke patients experience with motor tasks for the ipsilateral UL is induced by diminished integrity of sensorimotor function due to both sensory and motor deficits. PMID:24259803

Son, Sung Min; Kwon, Yong Hyun; Lee, Na Kyung; Nam, Seok Hyun; Kim, Kyoung

2013-05-01

372

Individual differences in the biomechanical effect of loudness and tempo on upper-limb movements during repetitive piano keystrokes.  

PubMed

The present study addressed the effect of loudness and tempo on kinematics and muscular activities of the upper extremity during repetitive piano keystrokes. Eighteen pianists with professional music education struck two keys simultaneously and repetitively with a combination of four loudness levels and four tempi. The results demonstrated a significant interaction effect of loudness and tempo on peak angular velocity for the shoulder, elbow, wrist and finger joints, mean muscular activity for the corresponding flexors and extensors, and their co-activation level. The interaction effect indicated greater increases with tempo when eliciting louder tones for all joints and muscles except for the elbow velocity showing a greater decrease with tempo. Multiple-regression analysis and K-means clustering further revealed that 18 pianists were categorized into three clusters with different interaction effects on joint kinematics. These clusters were characterized by either an elbow-velocity decrease and a finger-velocity increase, a finger-velocity decrease with increases in shoulder and wrist velocities, or a large elbow-velocity decrease with a shoulder-velocity increase when increasing both loudness and tempo. Furthermore, the muscular load considerably differed across the clusters. These findings provide information to determine muscles with the greatest potential risk of playing-related disorders based on movement characteristics of individual pianists. PMID:21816497

Furuya, Shinichi; Aoki, Tomoko; Nakahara, Hidehiro; Kinoshita, Hiroshi

2012-02-01

373

Ultrasonic characterization of the upper trapezius muscle in patients with chronic neck pain.  

PubMed

Myofascial trigger points (MTrPs) are palpable, tender nodules in taut bands of skeletal muscle that are painful on compression. MTrPs are characteristic findings in myofascial pain syndrome (MPS). The role of MTrPs in the pathophysiology of MPS is unknown. Localization, diagnosis, and clinical outcome measures of painful MTrPs can be improved by objectively characterizing and quantitatively measuring their properties. The goal of this study was to evaluate whether ultrasound imaging and elastography can differentiate symptomatic (active) MTrPs from normal muscle. Patients with chronic (>3 months) neck pain with spontaneously painful, palpable (i.e., active) MTrPs and healthy volunteers without spontaneous pain (having palpably normal muscle tissue) were recruited for this study. The upper trapezius muscles in all subjects were imaged, and the echotexture was analyzed using entropy filtering of B-mode images. Vibration elastography was performed by vibrating the muscle externally at 100 Hz. Color Doppler variance imaging was used to quantify the regions of color deficit exhibiting low vibration amplitude. The imaging measures were compared against the clinical findings of a standardized physical exam. We found that sites with active MTrPs (n = 14) have significantly lower entropy (p < 0.05) and significantly larger nonvibrating regions (p < 0.05) during vibration elastography compared with normal, uninvolved muscle (n = 15). A combination of both entropy analysis and vibration elastography yielded 69% sensitivity and 81% specificity in discriminating active MTrPs from normal muscle. These results suggest that active MTrPs have more homogeneous texture and heterogeneous stiffness when compared with normal, unaffected muscle. Our methods enabled us to improve the imaging contrast between suspected MTrPs and surrounding muscle. Our results indicate that in subjects with chronic neck pain and active MTrPs, the abnormalities are not confined to discrete isolated nodules but instead affect the milieu of the muscle surrounding palpable MTrPs. With further refinement, ultrasound imaging can be a promising objective method for characterizing soft tissue abnormalities associated with active MTrPs and elucidating the role of MTrPs in the pathophysiology of MPS. PMID:23493615

Turo, Diego; Otto, Paul; Shah, Jay P; Heimur, Juliana; Gebreab, Tadesse; Zaazhoa, Maryam; Armstrong, Katherine; Gerber, Lynn H; Sikdar, Siddhartha

2013-04-01

374

Muscle activation in young men during a lower limb aquatic resistance exercise with different devices.  

PubMed

Little research has been reported on the effects of using different devices with resistance exercises in a water environment. This study compared muscular activation of lower extremity and core muscles during leg adduction performed at maximum velocity with drag and floating devices of different sizes. A total of 24 young men (mean age 23.20 ± 1.18 years) performed 3 repetitions of leg adduction at maximum velocity using 4 different devices (ie, large/small and drag/floating). The maximum amplitude of the electromyographic root mean square of the adductor longus, rectus abdominis, external oblique on the dominant side, external oblique on the nondominant side, and erector lumbar spinae were recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Unexpectedly, no significant (P > 0.05) differences were found in the neuromuscular responses among the different devices used; the average activation of agonist muscle adequate for neuromuscular conditioning was 40.95% of MVIC. In addition, external oblique activation is greater on the contralateral side to stabilize the body (average, 151.74%; P < 0.05). Therefore, if maximum muscle activation is required, the kind of device is not relevant. Thus, the choice should be based on economic factors. PMID:24875975

Borreani, Sebastien; Colado, Juan Carlos; Furio, Josep; Martin, Fernando; Tella, Víctor

2014-05-01

375

A single muscle moves a crustacean limb joint rhythmically by acting against a spring containing resilin  

PubMed Central

Background The beating or fanning movements of three pairs of maxilliped flagella in crabs and crayfish modify exhalent gill currents while drawing water over chemoreceptors on the head. They play an integral part both in signalling by distributing urine odours, and in active chemosensation. Results The rhythmical maxilliped movements start with maxilliped 3 followed after a delay of 15 to 20 ms in shore crabs by maxilliped 2 and then maxilliped 1, at a frequency of 18 to 20 Hz in crabs and 10 to 13 Hz in signal crayfish. The contraction of a single abductor muscle controls the power stroke (abduction) of each flagellum, which is accompanied by flaring of feather-like setae which increase its surface area. No muscle can bring about the return stroke (adduction). Release of an isolated flagellum from an imposed abduction is followed by a rapid recoil to its resting adducted position. The relationship between the extent of abduction and the angular velocity of the return stroke indicates the operation of a spring. Blue fluorescence under UV light, and its dependence on the pH of the bathing medium, indicates that resilin is present at the joint between an exopodite and flagellum, at the annuli of a flagellum and at the base of the setae. Conclusion Resilin is progressively bent as a flagellum is abducted and resumes its natural shape when the joint recoils. Other distortions of the exopodites may also contribute to this spring-like action. The joint is therefore controlled by a single abductor muscle operating against a spring in which the elastic properties of resilin play a key role. PMID:19480647

Burrows, Malcolm

2009-01-01

376

Telescope - Optical System Performance Analysis For The Cryogenic Limb Array Etalon Spectrometer (CLAES) On The Upper Atmospheric Research Satellite  

NASA Astrophysics Data System (ADS)

This paper presents a first-order performance analysis of the telescope - optical system for the Cryogenic Limb Array Etalon Spectrometer (CLAES), one of several experiments intended for flight on the Upper Atmospheric Research Satellite (UARS). The experiment is based around a solid Fabry-Perot spectrometer which provides spectral resolution of 0.25 cm-1 for atmospheric emission spectroscopy over the 3.5- to 12-?m infrared wavelength range. A solid hydrogen cryostat sized for a two-year in-orbit lifetime provides cooling for the detector array, spectrometer, and telescope optics. The experiment involves the passive measurement of earth-limb radiance over a 10- to 60-km tangent altitude range. The instrument is required to provide near diffraction-limited performance over this 50 km or 1-deg field-of-view, and over the full wavelength range. The optical system must also provide a high degree of off-axis rejection and stray-light control, primarily to suppress intense emission from the earth surface which resides at -0.2 deg off-axis for the 10-km lowest altitude of observation. The optical system consists of a Gregorian telescope and refractive re-imager arranged in the common "z" configuration with folded baffles and no obscuration. The 6-in. telescope primary mirror produces an intermediate focus where the astigmatic image spread is oriented along the horizontal limb direction. This allows for precise location of the field stop and very sharp cutoff of the field below -0.175 deg. The astigmatism and other geometric aberrations are corrected by the secondary mirror which produces an excellent image of the primary, allowing for location of a diffraction control or Lyot stop. The re-imaging lens corrects for field curvature associated with the telescope and produces a flat field at the detector focal plane. Image quality is at the diffraction limit from 3.5 to 10 ?m, with a point spread less than 10 percent of the airy disc diameter for example at 5 ?m. The airy disc itself is less than 10 percent of a detector vertical dimension at this wavelength. Some chromatic correction remains to be incorporated between 10 and 12?m, where the point spread exceeds the diffraction limit by about 20 percent. The off-axis scattering performance of the telescope is discussed in terms of the mirror scatter coefficient and point source rejection ratio. A mirror bidirectional reflectance distribution function (BRDF) of 1 x 10-4 at 1 deg with a 1/02 roll-off between 1 and 0.2 deg is realizable based on recent measurements. This results in an off-axis radiance term generally small in comparison with the system-limiting noise equivalent radiance (NER = 10-12 W/cm2/sr at 10 ?m.) As the observational altitude increases the off-axis term becomes less and less significant.

Roche, A. E.; Forney, P. B.; Morrow, H. E.; Anapol, M.

1984-01-01

377

Repeat injection of botulinum toxin A is safe and effective for upper limb movement and function in children with cerebral palsy  

Microsoft Academic Search

The efficacy of repeated botulinum toxin A (BTX-A) injections in two and three dose regimes, together with occupational therapy, on upper limb movement and function, was studied using an evaluator blinded, randomized, controlled two-group trial. Forty-two children (31 males, 11 females; range 2–8y, mean 4y [SD 1y 7mo]) with hemiplegic cerebral palsy (Gross Motor Function Classification System Level I) longitudinally

Kevin Lowe; Iona Novak; Anne Cusick

2007-01-01

378

Low-dose\\/high-concentration localized botulinum toxin A improves upper limb movement and function in children with hemiplegic cerebral palsy  

Microsoft Academic Search

The objective was to determine the effects of low-dose, high-concentration, dual localized botulinum toxin A (BTX-A) injections on upper limb movement quality and function. Study design was an evaluator-blinded, randomized, controlled trial. Forty-two children (31 males, 11 females; range 2–8y, mean 4y [SD 1.6]) with hemiplegic cerebral palsy (Gross Motor Function Classification System level I) participated. All received occupational therapy.

Kevin Lowe; Iona Novak; Anne Cusick

2006-01-01

379

Bilateral Priming Before Wii-based Movement Therapy Enhances Upper Limb Rehabilitation and Its Retention After Stroke: A Case-Controlled Study.  

PubMed

Background. Motor deficits after a stroke are thought to be compounded by the development of asymmetric interhemispheric inhibition. Bilateral priming was developed to rebalance this asymmetry and thus improve therapy efficacy. Objective. This study investigated the effect of bilateral priming before Wii-based Movement Therapy to improve rehabilitation after stroke. Methods. Ten patients who had suffered a stroke (age, 23-77 years; 3-123 months after stroke) underwent a 14-day program of Wii-based Movement Therapy for upper limb rehabilitation. Formal Wii-based Movement Therapy sessions were immediately preceded by 15 minutes of bilateral priming, whereby active flexion-extension of the less affected wrist drove mirror-symmetric passive movements of the more affected wrist through a custom device. Functional movement was assessed at weeks 0 (before therapy), 3 (after therapy), and 28 (follow-up) using the Wolf Motor Function Test (WMFT), upper limb Fugl-Meyer Assessment (FMA), upper limb range of motion, and Motor Activity Log (MAL). Case-matched controls were patients who had suffered a stroke who received Wii-based Movement Therapy but not bilateral priming. Results. Upper limb functional ability improved for both groups on all measures tested. Posttherapy improvement on the FMA for primed patients was twice that of the unprimed patients (37.3% vs 14.6%, respectively) and was significantly better maintained at 28 weeks (P = .02). Improvements on the WMFT and MAL were similar for both groups, but the pattern of change in range of motion was strikingly different. Conclusions. Bilateral priming before Wii-based Movement Therapy led to a greater magnitude and retention of improvement compared to control, especially measured with the FMA. These data suggest that bilateral priming can enhance the efficacy of Wii-based Movement Therapy, particularly for patients with low motor function after a stroke. PMID:24627333

Shiner, Christine T; Byblow, Winston D; McNulty, Penelope A

2014-11-01

380

Constraint-induced movement therapy for the upper paretic limb in acute or sub-acute stroke: a systematic review.  

PubMed

Constraint-induced movement therapy is a commonly used intervention to improve upper limb function after stroke. However, the effectiveness of constraint-induced movement therapy and its optimal dosage during acute or sub-acute stroke is still under debate. To examine the literature on the effects of constraint-induced movement therapy in acute or sub-acute stroke. A literature search was performed to identify randomized, controlled trials; studies with the same outcome measure were pooled by calculating the mean difference. Separate quantitative analyses for high-intensity and low-intensity constraint-induced movement therapy were applied when possible. Five randomized, controlled trials were included, comprising 106 participants. The meta-analysis demonstrated significant mean differences in favor of constraint-induced movement therapy for the Fugl-Meyer arm, the Action Research Arm Test, the Motor Activity Log, Quality of Movement and the Grooved Pegboard Test. Nonsignificant mean difference in favor of constraint-induced movement therapy were found for the Motor Activity Log, Amount of Use. Separate analyses for high-intensity and low-intensity constraint-induced movement therapy resulted in significant favorable mean differences for low-intensity constraint-induced movement therapy for all outcome measures, in contrast to high-intensity constraint-induced movement therapy. This meta-analysis demonstrates a trend toward positive effects of high-intensity and low-intensity constraint-induced movement therapy in acute or sub-acute stroke, but also suggests that low-intensity constraint-induced movement therapy may be more beneficial during this period than high-intensity constraint-induced movement therapy. However, these results were based on a small number of studies. Therefore, more trials are needed applying different doses of therapy early after stroke and a better understanding is needed about the different time windows in which underlying mechanisms of recovery operate. PMID:21951408

Nijland, Rinske; Kwakkel, Gert; Bakers, Japie; van Wegen, Erwin

2011-10-01

381

Automatic real-time monitoring and assessment of tremor parameters in the upper limb from orientation data  

PubMed Central

Upper limb tremor is the most prevalent movement disorder and, unfortunately, it is not effectively managed in a large proportion of the patients. Neuroprostheses that stimulate the sensorimotor pathways are one of the most promising alternatives although they are still under development. To enrich the interpretation of data recorded during long-term tremor monitoring and to increase the intelligence of tremor suppression neuroprostheses we need to be aware of the context. Context awareness is a major challenge for neuroprostheses and would allow these devices to react more quickly and appropriately to the changing demands of the user and/or task. Traditionally kinematic features are used to extract context information, with most recently the use of joint angles as highly potential features. In this paper we present two algorithms that enable the robust extraction of joint angle and related features to enable long-term continuous monitoring of tremor with context awareness. First, we describe a novel relative sensor placement identification technique based on orientation data. We focus on relative rather than absolute sensor location, because in many medical applications magnetic and inertial measurement units (MIMU) are used in a chain stretching over adjacent segments, or are always placed on a fixed set of locations. Subsequently we demonstrate how tremor parameters can be extracted from orientation data using an adaptive estimation algorithm. Relative sensor location was detected with an accuracy of 94.12% for the 4 MIMU configuration, and 100% for the 3 MIMU configurations. Kinematic tracking error values with an average deviation of 8% demonstrate our ability to estimate tremor from orientation data. The methods presented in this study constitute an important step toward more user-friendly and context-aware neuroprostheses for tremor suppression and monitoring. PMID:25120424

Lambrecht, Stefan; Gallego, Juan A.; Rocon, Eduardo; Pons, Jose L.

2014-01-01

382

Unraveling the interaction between pathological upper limb synergies and compensatory trunk movements during reach-to-grasp after stroke: a cross-sectional study.  

PubMed

The aim of the present study was to identify how pathological limb synergies between shoulder and elbow movements interact with compensatory trunk movements during a functional movement with the paretic upper limb after stroke. 3D kinematic joint and trunk angles were measured during a reach-to-grasp movement in 46 patients with stroke and 12 healthy individuals. We used principal component analyses (PCA) to identify components representing linear relations between the degrees of freedom of the upper limb and trunk across patients with stroke and healthy participants. Using multivariate logistic regression analysis, we investigated whether component scores were related to the presence or absence of basic limb synergies as indicated by the arm section of the Fugl-Meyer motor assessment (FMA). Four and three principal components were extracted in patients with stroke and healthy individuals, respectively. Visual inspection revealed that the contribution of joint and trunk angles to each component differed substantially between groups. The presence of the flexion synergy (Shoulder Abduction and Elbow Flexion) was reflected by component 1, whereas the compensatory role of trunk movements for lack of shoulder and elbow movements was reflected by components 2 and 3 respectively. The presence or absence of basic limb synergies as determined by means of the FMA was significantly related to components 2 (p = 0.014) and 3 (p = 0.003) in patients with stroke. These significant relations indicate that PCA is a useful tool to identify clinically meaningful interactions between compensatory trunk movements and pathological synergies in the elbow and shoulder during reach-to-grasp after stroke. PMID:22791198

van Kordelaar, Joost; van Wegen, Erwin E H; Kwakkel, Gert

2012-09-01

383

The effect of three levels of foot orthotic wedging on the surface electromyographic activity of selected lower limb muscles during gait  

Microsoft Academic Search

Background. Some types of foot orthoses have been researched for their effect on lower limb electromyographic muscle activity during walking. However, foot orthoses with high levels of medial rearfoot wedging (‘inverted’ foot orthoses) have not been investigated.Methods. In a cross-sectional study, asymptomatic participants with a pronated foot type (n=15) were each issued with a pair of 0°, 15° and 30°

George S. Murley; Adam R. Bird

2006-01-01

384

Whole-body vibration effects on the muscle activity of upper and lower body muscles during the baseball swing in recreational baseball hitters  

Microsoft Academic Search

The purpose of this study was to evaluate the effects of whole-body vibration (WBV) on the muscle recruitment of selected upper and lower body muscles during the baseball swing. Participants were recreationally trained males (n = 16, 22 ± 2 years, 181.4 ± 7.4 cm, 84.7 ± 9.0 kg), with previous baseball experience. Subjects participated in three randomized sessions on separate days, consisting of three sets of five swings off

Gabriel F. “Cisco” Reyes; D. Clark Dickin; Nolan J. K. Crusat; Dennis G. Dolny

2011-01-01

385

A novel intronic single nucleotide polymorphism in the myosin heavy polypeptide 4 gene is responsible for the mini-muscle phenotype characterized by major reduction in hind-limb muscle mass in mice.  

PubMed

Replicated artificial selection for high levels of voluntary wheel running in an outbred strain of mice favored an autosomal recessive allele whose primary phenotypic effect is a 50% reduction in hind-limb muscle mass. Within the High Runner (HR) lines of mice, the numerous pleiotropic effects (e.g., larger hearts, reduced total body mass and fat mass, longer hind-limb bones) of this hypothesized adaptive allele include functional charact