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Sample records for upper limb muscle

  1. Neck muscle fatigue alters upper limb proprioception.

    PubMed

    Zabihhosseinian, Mahboobeh; Holmes, Michael W R; Murphy, Bernadette

    2015-05-01

    Limb proprioception is an awareness by the central nervous system (CNS) of the location of a limb in three-dimensional space and is essential for movement and postural control. The CNS uses the position of the head and neck when interpreting the position of the upper limb, and altered input from neck muscles may affect the sensory inputs to the CNS and consequently may impair the awareness of upper limb joint position. The purpose of this study was to determine whether fatigue of the cervical extensors muscles (CEM) using a submaximal fatigue protocol alters the ability to recreate a previously presented elbow angle with the head in a neutral position. Twelve healthy individuals participated. CEM activity was examined bilaterally using surface electromyography, and kinematics of the elbow joint was measured. The fatigue protocol included an isometric neck extension task at 70 % of maximum until failure. Joint position error increased following fatigue, demonstrating a significant main effect of time (F 2, 18?=?19.41, p???0.0001) for absolute error. No significant differences were found for variable error (F 2, 18?=?0.27, p?=?0.76) or constant error (F 2, 18?=?1.16 of time, p???0.33). This study confirms that fatigue of the CEM can reduce the accuracy of elbow joint position matching. This suggests that altered afferent input from the neck subsequent to fatigue may impair upper limb proprioception. PMID:25764200

  2. Characteristic MRI Findings of upper Limb Muscle Involvement in Myotonic Dystrophy Type 1

    PubMed Central

    Sugie, Kazuma; Sugie, Miho; Taoka, Toshio; Tonomura, Yasuyo; Kumazawa, Aya; Izumi, Tesseki; Kichikawa, Kimihiko; Ueno, Satoshi

    2015-01-01

    The objective of our study was to evaluate the relation between muscle MRI findings and upper limb weakness with grip myotonia in patients with myotonic dystrophy type 1 (DM1). Seventeen patients with DM1 were evaluated by manual muscle strength testing and muscle MRI of the upper limbs. Many DM1 patients presenting with decreased grasping power frequently showed high intensity signals in the flexor digitorum profundus (FDP) muscles on T1-weighted imaging. Patients presenting with upper limb weakness frequently also showed high intensity signals in the flexor pollicis longus, abductor pollicis longus, and extensor pollicis muscles. Disturbances of the distal muscles of the upper limbs were predominant in all DM1 patients. Some DM1 patients with a prolonged disease duration showed involvement of not only distal muscles but also proximal muscles in the upper limbs. Muscle involvement of the upper limbs on MRI strongly correlated positively with the disease duration or the numbers of CTG repeats. To our knowledge, this is the first study to provide a detailed description of the distribution and severity of affected muscles of the upper limbs on MRI in patients with DM1. We conclude that muscle MRI findings are very useful for identifying affected muscles and predicting the risk of muscle weakness in the upper limbs of DM1 patients. PMID:25919300

  3. Novel muscle activation sensors for estimating of upper limb motion intention.

    PubMed

    Han, Hyonyoung; Kim, Jung

    2009-01-01

    Measurement of muscle activation is important to understand body motion and the exertion of force. This paper presents two novel muscle activation sensors, a piezo cable muscle activation sensor (pMAS) and an optical muscle activation sensor (oMAS). The pMAS measures variations of a flexible piezo cable band that originate from diameter changes of muscle bundles. The sensors are easily attached and can be worn on clothes. The oMAS, which measures the optical density of muscle fibers, has advantages of small size, ease of use, and non-referenced individual sensing. Muscle activations of the upper limb during movements were collected to evaluate the performance of the proposed pMAS, and oMAS, respectively. Furthermore, the relation between movements and sensor signals was analyzed to estimate the upper limb movements. PMID:19964812

  4. Force irradiation effects during upper limb diagonal exercises on contralateral muscle activation.

    PubMed

    Abreu, Rosa; Lopes, Alfredo Alexandre; Sousa, Andreia S P; Pereira, Soraia; Castro, Marcelo P

    2015-04-01

    The aim of this study was to explore the force irradiation effects of upper limb isometric diagonal exercises on shoulder muscle activities. Interactions among diagonal directions, contraction intensities (moderate and maximum) and sex were assessed. Thirty healthy subjects (11 males) performed isometric unilateral diagonal exercises based on proprioceptive neuromuscular facilitation technique in an isokinetic dynamometer with their dominant upper limbs. The second diagonal for flexion and for extension were assessed while the participants performed their maximum isometric torque (MIT) and at 25% of their MIT. During the exercise the muscle activity of the medial deltoid, pectoralis major and upper trapezius in the non-dominant (non-exercised) upper limbs of the participants was recorded by surface electromyography. The highest muscle activity occurred in the upper trapezius during the diagonal for flexion (27% of maximum isometric voluntary contractions). Upper trapezius and pectoralis major were more active during the diagonal for flexion than diagonal for extension (p < 0.001), while similar values between both diagonals were observed for the medial deltoid (p > 0.05). In conclusion, we observed that force irradiation during upper limb diagonal exercises is affected by diagonal direction, contraction intensity and sex when performed by healthy participants. PMID:25592384

  5. Muscle weakness and cocontraction in upper limb hemiparesis: relationship to motor impairment and physical disability.

    PubMed

    Chae, John; Yang, Guang; Park, Byung Kyu; Labatia, Ihab

    2002-09-01

    The purpose of this article is to describe the relationship between poststroke upper limb muscle weakness and cocontraction, and clinical measures of upper limb motor impairment and physical disability. Electrormyographic (EMG) activity of the paretic and nonparetic wrist flexors and extensors of 26 chronic stroke survivors were recorded during isometric wrist flexion and extension. The root mean square (RMS) of the EMG signal was used as a measure of strength of contraction. A ratio of RMS of antagonist and agonist muscles was used as a measure of cocontraction. Upper limb motor impairment and physical disability were assessed with the Fugl-Meyer motor assessment (FMA) and the arm motor ability test (AMAT), respectively. The strength of muscle contraction was significantly stronger in the nonparetic limb (P < 0.001). The degree of cocontraction was significantly greater in the paretic limb (P < 0.001). The strength of muscle contraction in the paretic limb correlated significantly with FMA (r = 0.62 to 0.87, P < or = 0.001) and AMAT (r = 0.66 to 0.80, P < or = 0.001) scores. Similarly, the degree of cocontraction correlated significantly with FMA (r = -0. 70 to -0.64, P < or = 0.001) and AMAT (r = -0. 72 to -0.62, P < or = 0.001) scores. Muscle weakness and degree of cocontraction correlate significantly with motor impairment and physical disability in upper limb hemiplegia. This relationship may provide insights toward development of specific interventions. However, additional studies are needed to demonstrate a cause and effect relationship. PMID:12234087

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

    NASA Astrophysics Data System (ADS)

    Zu, Xiaoqi; Zhou, Qianxiang; Li, Yun

    2012-07-01

    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.

  7. Partial weight support differentially affects corticomotor excitability across muscles of the upper limb

    PubMed Central

    Runnalls, Keith D.; Anson, Greg; Wolf, Steven L.; Byblow, Winston D.

    2014-01-01

    Abstract Partial weight support may hold promise as a therapeutic adjuvant during rehabilitation after stroke by providing a permissive environment for reducing the expression of abnormal muscle synergies that cause upper limb impairment. We explored the neurophysiological effects of upper limb weight support in 13 healthy young adults by measuring motor?evoked potentials (MEPs) from transcranial magnetic stimulation (TMS) of primary motor cortex and electromyography from anterior deltoid (AD), biceps brachii (BB), extensor carpi radialis (ECR), and first dorsal interosseous (FDI). Five levels of weight support, varying from none to full, were provided to the arm using a commercial device (Saebo Mobile Arm Support). For each level of support, stimulus–response (SR) curves were derived from MEPs across a range of TMS intensities. Weight support affected background EMG activity in each of the four muscles examined (P <0.0001 for each muscle). Tonic background activity was primarily reduced in the AD. Weight support had a differential effect on the size of MEPs across muscles. After curve fitting, the SR plateau for ECR increased at the lowest support level (P =0.004). For FDI, the SR plateau increased at the highest support level (P =0.0003). These results indicate that weight support of the proximal upper limb modulates corticomotor excitability across the forearm and hand. The findings support a model of integrated control of the upper limb and may inform the use of weight support in clinical settings. PMID:25501435

  8. Partial weight support differentially affects corticomotor excitability across muscles of the upper limb.

    PubMed

    Runnalls, Keith D; Anson, Greg; Wolf, Steven L; Byblow, Winston D

    2014-12-01

    Partial weight support may hold promise as a therapeutic adjuvant during rehabilitation after stroke by providing a permissive environment for reducing the expression of abnormal muscle synergies that cause upper limb impairment. We explored the neurophysiological effects of upper limb weight support in 13 healthy young adults by measuring motor-evoked potentials (MEPs) from transcranial magnetic stimulation (TMS) of primary motor cortex and electromyography from anterior deltoid (AD), biceps brachii (BB), extensor carpi radialis (ECR), and first dorsal interosseous (FDI). Five levels of weight support, varying from none to full, were provided to the arm using a commercial device (Saebo Mobile Arm Support). For each level of support, stimulus-response (SR) curves were derived from MEPs across a range of TMS intensities. Weight support affected background EMG activity in each of the four muscles examined (P < 0.0001 for each muscle). Tonic background activity was primarily reduced in the AD. Weight support had a differential effect on the size of MEPs across muscles. After curve fitting, the SR plateau for ECR increased at the lowest support level (P = 0.004). For FDI, the SR plateau increased at the highest support level (P = 0.0003). These results indicate that weight support of the proximal upper limb modulates corticomotor excitability across the forearm and hand. The findings support a model of integrated control of the upper limb and may inform the use of weight support in clinical settings. PMID:25501435

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

    PubMed Central

    2014-01-01

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

  10. Delay in initiation and termination of muscle contraction, motor impairment, and physical disability in upper limb hemiparesis.

    PubMed

    Chae, John; Yang, Guang; Park, Byung Kyu; Labatia, Ihab

    2002-04-01

    The purpose of this study was to describe the relationship between the delay in initiation and termination of muscle contraction and clinical measures of motor impairment and physical disability in the affected upper limb of patients with hemiparesis. Electromyographic (EMG) activity of 26 long-term survivors of stroke was recorded during isometric wrist flexion and extension. Upper limb motor impairment and disability were assessed with the Fugl-Meyer motor assessment (FMA) and arm motor ability test (AMAT), respectively. Delay in initiation and termination of muscle contraction was significantly prolonged in the paretic arm. However, the delay was not significantly affected by stroke type, stroke level, side of hemiparesis, or presence of aphasia. Delay in initiation and termination of muscle contraction correlated significantly with FMA and AMAT. Abnormally delayed initiation and termination of muscle contraction may contribute to hemiparetic upper limb motor impairment and physical disability in hemiparetic patients. PMID:11932975

  11. Volitional walking via upper limb muscle-controlled stimulation of the lumbar locomotor center in man.

    PubMed

    Sasada, Syusaku; Kato, Kenji; Kadowaki, Suguru; Groiss, Stefan J; Ugawa, Yoshikazu; Komiyama, Tomoyoshi; Nishimura, Yukio

    2014-08-13

    Gait disturbance in individuals with spinal cord lesion is attributed to the interruption of descending pathways to the spinal locomotor center, whereas neural circuits below and above the lesion maintain their functional capability. An artificial neural connection (ANC), which bridges supraspinal centers and locomotor networks in the lumbar spinal cord beyond the lesion site, may restore the functional impairment. To achieve an ANC that sends descending voluntary commands to the lumbar locomotor center and bypasses the thoracic spinal cord, upper limb muscle activity was converted to magnetic stimuli delivered noninvasively over the lumbar vertebra. Healthy participants were able to initiate and terminate walking-like behavior and to control the step cycle through an ANC controlled by volitional upper limb muscle activity. The walking-like behavior stopped just after the ANC was disconnected from the participants even when the participant continued to swing arms. Furthermore, additional simultaneous peripheral electrical stimulation to the foot via the ANC enhanced this walking-like behavior. Kinematics of the induced behaviors were identical to those observed in voluntary walking. These results demonstrate that the ANC induces volitionally controlled, walking-like behavior of the legs. This paradigm may be able to compensate for the dysfunction of descending pathways by sending commands to the preserved locomotor center at the lumbar spinal cord and may enable individuals with paraplegia to regain volitionally controlled walking. PMID:25122909

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

    NASA Astrophysics Data System (ADS)

    Sharpe, Abigail N.; Jackson, Andrew

    2014-02-01

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

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

    PubMed

    Bent, Leah R; Lowrey, Catherine R

    2013-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-12-01

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

  15. Relationship of skeletal muscle metaboreceptors in the upper and lower limbs with the respiratory control in patients with heart failure.

    PubMed

    Scott, Adam C; Davies, L Ceri; Coats, Andrew J S; Piepoli, Massimo

    2002-01-01

    Increased activity of muscle metaboreceptors (afferents sensitive to muscle contraction that are responsible for the ventilatory responses to exercise) has been proposed in patients with chronic heart failure (CHF) to constitute a missing link between muscle metabolic abnormalities and exercise overventilation. We looked at this reflex overactivation to determine if it is systemic or limited to a single muscle region in the same human subject. This was done by comparing the metaboreflex response of ventilatory control in the lower and upper limbs in CHF patients and healthy controls. Groups of 15 stable CHF patients (63.7+/-2.7 years) and eight control subjects (69.8+/-1.8 years) performed both leg and arm metaboreflex tests. These metaboreflex tests involved two 5 min episodes of bicycle or handgrip exercise: on one occasion after the exercise the subjects recovered normally, while on the other occasion tourniquet cuffs were inflated around the exercising limb to supra-systolic pressure at the onset of recovery to obtain a regional circulatory occlusion, which isolates and maintains the stimulation of the metaboreflex after exercise. The contribution of the metaboreflex to exercise ventilation was computed as the absolute increment of peak ventilation that was maintained by regional circulatory occlusion. The metaboreceptor contribution to the ventilatory response to both leg exercise (patients, 5.3+/-1.6 litres/min; controls, 0.2+/-0.7 litres/min) and arm exercise (patients, 3.7+/-1.0 litres/min; controls, 0.02+/-0.4 litres/min) was significantly higher in CHF patients (P<0.05). A significant correlation was present between metaboreflex responses to arm and leg exercises (r=0.4, P<0.05). Metaboreflex responses during both types of exercise were inversely correlated with peak oxygen uptake (leg, r=-0.43, P<0.05; arm, r=-0.633, P=0.0009), but only the reflex during arm exercise was correlated with the .V(E) (ventilation)/.V(CO)(2) (CO(2) production) slope (r=0.576, P<0.005). Thus the metaboreflex system is systemically overactive and may potentially contribute to exercise intolerance during both lower- and upper-limb efforts in CHF. This suggests a unique mechanism responsible for overactivation of this system in the skeletal muscle of heart failure patients. PMID:11749657

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

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

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

    PubMed Central

    2015-01-01

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

  18. 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

    Diogo, R; Wood, B

    2011-01-01

    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

  19. Influence of complementing a robotic upper limb rehabilitation system with video games on the engagement of the participants: a study focusing on muscle activities.

    PubMed

    Li, Chong; Rusák, Zoltán; Horváth, Imre; Ji, Linhong

    2014-12-01

    Efficacious stroke rehabilitation depends not only on patients' medical treatment but also on their motivation and engagement during rehabilitation exercises. Although traditional rehabilitation exercises are often mundane, technology-assisted upper-limb robotic training can provide engaging and task-oriented training in a natural environment. The factors that influence engagement, however, are not fully understood. This paper therefore studies the relationship between engagement and muscle activities as well as the influencing factors of engagement. To this end, an experiment was conducted using a robotic upper limb rehabilitation system with healthy individuals in three training exercises: (a) a traditional exercise, which is typically used for training the grasping function, (b) a tracking exercise, currently used in robot-assisted stroke patient rehabilitation for fine motor movement, and (c) a video game exercise, which is a proliferating approach of robot-assisted rehabilitation enabling high-level active engagement of stroke patients. These exercises differ not only in the characteristics of the motion that they use but also in their method of triggering engagement. To measure the level of engagement, we used facial expressions, motion analysis of the arm movements, and electromyography. The results show that (a) the video game exercise could engage the participants for a longer period than the other two exercises, (b) the engagement level decreased when the participants became too familiar with the exercises, and (c) analysis of normalized root mean square in electromyographic data indicated that muscle activities were more intense when the participants are engaged. This study shows that several sub-factors on engagement, such as versatility of feedback, cognitive tasks, and competitiveness, may influence engagement more than the others. To maintain a high level of engagement, the rehabilitation system needs to be adaptive, providing different exercises to engage the participants. PMID:25221845

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

    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.

  1. The effectiveness of stretch-shortening cycling in upper-limb extensor muscles during elite cross-country skiing with the double-poling technique.

    PubMed

    Zoppirolli, Chiara; Holmberg, Hans-Christer; Pellegrini, Barbara; Quaglia, Diego; Bortolan, Lorenzo; Schena, Federico

    2013-12-01

    This investigation was designed to evaluate the effectiveness of stretch-shortening cycling (SSC(EFF)) in upper-limb extensor muscles while cross-country skiing using the double-poling technique (DP). To this end, SSC(EFF) was analyzed in relation to DP velocity and performance. Eleven elite cross-country skiers performed an incremental test to determine maximal DP velocity (V(max)). Thereafter, cycle characteristics, elbow joint kinematics and poling forces were monitored on a treadmill while skiing at two sub-maximal and racing velocity (85% of V(max)). The average EMG activities of the triceps brachii and latissimus dorsi muscles were determined during the flexion and extension sub-phases of the poling cycle (EMG(FLEX), EMG(EXT)), as well as prior to pole plant (EMG(PRE)). SSC(EFF) was defined as the ratio of aEMG(FLEX) to aEMG(EXT). EMG(PRE) and EMG(FLEX) increased with velocity for both muscles (P < 0.01), as did SSC(EFF) (from 0.9 ± 0.3 to 1.3 ± 0.5 for the triceps brachii and from 0.9 ± 0.4 to 1.5 ± 0.5 for the latissimus dorsi) and poling force (from 253 ± 33 to 290 ± 36N; P < 0.05). Furthermore, SSC(EFF) was positively correlated to Vmax, to EMG(PRE) and EMG(FLEX) (P < 0.05). The neuromuscular adaptations made at higher velocities, when more poling force must be applied to the ground, exert a major influence on the DP performance of elite cross-country skiers. PMID:24064180

  2. Comparison of muscle and joint pressure-pain thresholds in patients with complex regional pain syndrome and upper limb pain of other origin.

    PubMed

    Mainka, Tina; Bischoff, Florian S; Baron, Ralf; Krumova, Elena K; Nicolas, Volkmar; Pennekamp, Werner; Treede, Rolf-Detlef; Vollert, Jan; Westermann, Andrea; Maier, Christoph

    2014-03-01

    Pain localized in the deep tissues occurs frequently in complex regional pain syndrome (CRPS). In addition, hyperalgesia to blunt pressure over muscles is common in CRPS, but it often appears in limb pain of other origin as well. Considering that 3-phase bone scintigraphy (TPBS) reveals periarticular enhanced bone metabolism in CRPS, joint-associated hyperalgesia to blunt pressure might be a more specific finding than hyperalgesia over muscles. In 34 patients with upper limb pain (18 CRPS, 16 non-CRPS; diagnosed in accordance to the Budapest criteria) and in 18 healthy controls, pressure-pain thresholds (PPT) were assessed bilaterally over the thenar (PPTThenar), the metacarpophalangeal (PPTMCP), and the proximal interphalangeal (PPTPIP) joints using a pressure algometer (Somedic, Sweden). Beforehand, all patients had received TPBS for diagnostic purposes independently of the study. Region-of-interest (ROI) ratios (mineralization phase) for the MCP and PIP, excluding fracture sites, were correlated with the PPT. In CRPS, all ROI ratios were significantly increased and all PPT of the affected hand were decreased compared to non-CRPS (PPTThenar: 243±150kPa vs 358±197kPa, PPTMCP: 80±67kPa vs 159±93kPa, PPTPIP: 80±56kPa vs 184±110kPa; P<.01) and controls (PPTThenar: 478±106kPa, PPTMCP: 254±50kPa, PPTPIP: 275±76kPa; P<.01). A PPTThenar below 293kPa revealed 77% sensitivity but only 63% specificity, whereas a PPTPIP below 102kPa had 82% sensitivity and 94% specificity to identify CRPS. Only in CRPS were PPTMCP and PPTPIP correlated significantly inversely with the ROI ratio (MCP: r=-0.439, PIP: r=-0.447). PPTPIP shows higher specificity for CRPS type I than PPTThenar without loss of sensitivity. Therefore, measurement of joint PPT could be a noninvasive diagnostic tool reflecting increased bone metabolism assessed by TPBS as a sign of bone pathophysiology. PMID:24333949

  3. Effects of proprioceptive neuromuscular facilitation on the initiation of voluntary movement and motor evoked potentials in upper limb muscles.

    PubMed

    Shimura, Kuniyoshi; Kasai, Tatsuya

    2002-04-01

    To better understand the mechanisms behind proprioceptive neuromuscular facilitation (PNF), an important method in motor rehabilitation, we investigated the effects of assuming a PNF posture relative to a neutral posture on the initiation of voluntary movement (Experiment 1) and the excitability of the motor cortex (Experiment 2) using a wrist extension task. The initiation of voluntary wrist movement was operationalized in terms of the electromyographic reaction time (EMG-RT), and the excitability of the motor cortex in terms of motor evoked potentials (MEPs). Compared to the neutral position, we found that (1) the facilitation position changed the muscle discharge order enhancing the movement efficiency of the joint, (2) the facilitation position led to a reduction in EMG-RT, the magnitude of which depended on the proximity of the muscle to the movement joint, and (3) MEP amplitude increased and MEP latency decreased in the facilitation position as a function of the proximity of the muscle to the joint. These findings corroborate the presumed effects of PNF and provide insights into the neurophysiological mechanisms underlying the PNF method. PMID:11983436

  4. 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

    Bakheit, Abdel Magid

    2010-01-01

    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…

  5. Benign monomelic amyotrophy with proximal upper limb involvement: case report.

    PubMed

    Neves, Marco Antonio Orsini; Freitas, Marcos R G de; Mello, Mariana Pimentel de; Dumard, Carlos Henrique; Freitas, Gabriel R de; Nascimento, Osvaldo J M

    2007-06-01

    Monomelic amyotrophy (MA) is a rare condition in which neurogenic amyotrophy is restricted to an upper or lower limb. Usually sporadic, it usually has an insidious onset with a mean evolution of 2 to 4 years following first clinical manifestations, which is, in turned, followed by stabilization. We report a case of 20-years-old man who presented slowly progressive amyotrophy associated with proximal paresis of the right upper limb, which was followed by clinical stabilization 4 years later. Eletroneuromyography revealed denervation along with myofasciculations in various muscle groups of the right upper limb. We call attention to this rare location of MA, as well as describe some theories concerning its pathophysiology . PMID:17665029

  6. 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

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

    2014-08-01

    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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  8. The upper limb of Australopithecus sediba.

    PubMed

    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

    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

  9. Upper limb kinematics after cervical spinal cord injury: a review.

    PubMed

    Mateo, Sébastien; Roby-Brami, Agnès; Reilly, Karen T; Rossetti, Yves; Collet, Christian; Rode, Gilles

    2015-01-01

    Although a number of upper limb kinematic studies have been conducted, no review actually addresses the key-features of open-chain upper limb movements after cervical spinal cord injury (SCI). The aim of this literature review is to provide a clear understanding of motor control and kinematic changes during open-chain upper limb reaching, reach-to-grasp, overhead movements, and fast elbow flexion movements after tetraplegia. Using data from MEDLINE between 1966 and December 2014, we examined temporal and spatial kinematic measures and when available electromyographic recordings. We included fifteen control case and three series case studies with a total of 164 SCI participants and 131 healthy control participants. SCI participants efficiently performed a broad range of tasks with their upper limb and movements were planned and executed with strong kinematic invariants like movement endpoint accuracy and minimal cost. Our review revealed that elbow extension without triceps brachii relies on increased scapulothoracic and glenohumeral movements providing a dynamic coupling between shoulder and elbow. Furthermore, contrary to normal grasping patterns where grasping is prepared during the transport phase, reaching and grasping are performed successively after SCI. The prolonged transport phase ensures correct hand placement while the grasping relies on wrist extension eliciting either whole hand or lateral grip. One of the main kinematic characteristics observed after tetraplegia is motor slowing attested by increased movement time. This could be caused by (i) decreased strength, (ii) triceps brachii paralysis which disrupts normal agonist-antagonist co-contractions, (iii) accuracy preservation at movement endpoint, and/or (iv) grasping relying on tenodesis. Another feature is a reduction of maximal superior reaching during overhead movements which could be caused by i) strength deficit in agonist muscles like pectoralis major, ii) strength deficit in proximal synergic muscles responsible for scapulothoracic and glenohumeral joint stability, iii) strength deficit in distal synergic muscles preventing the maintenance of elbow extension by shoulder elbow dynamic coupling, iv) shoulder joint ankyloses, and/or v) shoulder pain. Further studies on open chain movements are needed to identify the contribution of each of these factors in order to tailor upper limb rehabilitation programs for SCI individuals. PMID:25637224

  10. Balneotherapy in Treatment of Spastic Upper Limb after Stroke

    PubMed Central

    Erceg-Rukavina, Tatjana; Stefanovski, Mihajlo

    2015-01-01

    Introduction: After stroke, spasticity is often the main problem that prevents functional recovery. Pain occurs in up to 70% of patients during the first year post-stroke. Materials and methods: A total of 70 patients (30 female and 45 male) mean age (65.67) participated in prospective, controlled study. Inclusion criteria: ischaemic stroke, developed spasticity of upper limb, post-stroke interval <6 months. Exclusion criteria: contraindications for balneotherapy and inability to follow commands. Experimental group (Ex) (n=35) was treated with sulphurous baths (31°-33°C) and controlled group (Co) with taped water baths, during 21 days. All patients were additionally treated with kinesitherapy and cryotherapy. The outcome was evaluated using Modified Ashworth scale for spasticity and VAS scale for pain. The significance value was sat at p<0.05. Goal: To find out the effects of balneotherapy with sulphurous bath on spasticity and pain in affected upper limb. Results: Reduction in tone of affected upper limb muscles was significant in Ex group (p<0.05). Pain decreased significantly in Ex-group (p<0.01). Conclusion: Our results show that balneotherapy with sulphurous water reduces spasticity and pain significantly and can help in treatment of post-stroke patients. PMID:25870474

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

    ERIC Educational Resources Information Center

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    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…

  12. Upper Limb Ischemia: Clinical Experiences of Acute and Chronic Upper Limb Ischemia in a Single Center

    PubMed Central

    Bae, Miju; Chung, Sung Woon; Lee, Chung Won; Choi, Jinseok; Song, Seunghwan; Kim, Sang-pil

    2015-01-01

    Background Upper limb ischemia is less common than lower limb ischemia, and relatively few cases have been reported. This paper reviews the epidemiology, etiology, and clinical characteristics of upper limb ischemia and analyzes the factors affecting functional sequelae after treatment. Methods The records of 35 patients with acute and chronic upper limb ischemia who underwent treatment from January 2007 to December 2012 were retrospectively reviewed. Results The median age was 55.03 years, and the number of male patients was 24 (68.6%). The most common etiology was embolism of cardiac origin, followed by thrombosis with secondary trauma, and the brachial artery was the most common location for a lesion causing obstruction. Computed tomography angiography was the first-line diagnostic tool in our center. Twenty-eight operations were performed, and conservative therapy was implemented in seven cases. Five deaths (14.3%) occurred during follow-up. Twenty patients (57.1%) complained of functional sequelae after treatment. Functional sequelae were found to be more likely in patients with a longer duration of symptoms (odds ratio, 1.251; p=0.046) and higher lactate dehydrogenase (LDH) levels (odds ratio, 1.001; p=0.031). Conclusion An increased duration of symptoms and higher initial serum LDH levels were associated with the more frequent occurrence of functional sequelae. The prognosis of upper limb ischemia is associated with prompt and proper treatment and can also be predicted by initial serum LDH levels. PMID:26290835

  13. [Major upper limb trauma: patients' outcomes in 22 cases].

    PubMed

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

    2013-09-01

    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

  14. Unusual Cause of Swelling in the Upper Limb: Kimura Disease

    PubMed Central

    Chokkappan, Kabilan; Al-Riyami, Abeer M.; Krishnan, Vijay; Min, Victor L. K.

    2015-01-01

    Kimura disease is a rare chronic inflammatory disease of unknown etiology. The disease typically presents in young Asian males with single or multiple slowly progressing painless subcutaneous lumps in the head and neck region; regional lymphadenopathy is commonly accompanied. The disease is associated with peripheral blood eosinophilia and elevated serum immunoglobulin E levels. This gives an important clinical clue to the diagnosis and implies a possible immune-mediated pathophysiology. Although the disease commonly affects the head and neck region, it may also affect the extremities, axilla, groin, and abdomen. Upper limb involvement in Kimura’s disease is rare and few cases have been reported in the literature. We describe the case of a man who presented with a history of progressive upper limb swelling. He was diagnosed with Kimura’s disease based on concordant clinical, laboratory, radiological, and histopathological grounds. Although rare in the upper limb, the possibility of Kimura’s disease has to be considered in young males presenting with painless swelling in the medial epitrochlear region with compatible imaging appearance, particularly if associated with lymph node enlargement and increased blood eosinophils. Characteristic imaging findings of Kimura’s disease of the upper limb include specific location along the neuro-lymphovascular structures, the absence of necrosis or calcification, mutliple flow voids representing vascular structures, a varying amount of edema of subcutaneous fat plane overlying the lesion; displacement of adjacent muscles; and neurovascular structures without signs of direct invasion. Clinicians should be aware of this distinct entity in order to avoid misdiagnosis and to tailor appropriate management. PMID:26421119

  15. The Ipsilesional Upper Limb Can Be Affected following Stroke

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2011-01-01

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

  17. Music related upper limb pain in schoolchildren.

    PubMed Central

    Fry, H J; Rowley, G L

    1989-01-01

    Two British secondary schools (one a specialist music school) were surveyed to assess the prevalence of upper limb pain among specialist music students compared with students in a regular school setting. Female students tended to report pain more often than male students, but for both significantly higher prevalence was found in the music school. Pain in the regular school was most often attributed to writing, whereas in the music school it was associated with the playing of all instruments, but most particularly with cello, clarinet, and flute. Music students reported long hours of practice, but it appeared that the intensity of practice may be more important as a determinant of pain than the total hours spent practising. The results of the study are in substantial agreement with those previously published from Australia and North America. On the balance of probabilities the pain is due to overuse syndrome, which is very common in musicians and well known in writers. PMID:2619360

  18. Music related upper limb pain in schoolchildren.

    PubMed

    Fry, H J; Rowley, G L

    1989-12-01

    Two British secondary schools (one a specialist music school) were surveyed to assess the prevalence of upper limb pain among specialist music students compared with students in a regular school setting. Female students tended to report pain more often than male students, but for both significantly higher prevalence was found in the music school. Pain in the regular school was most often attributed to writing, whereas in the music school it was associated with the playing of all instruments, but most particularly with cello, clarinet, and flute. Music students reported long hours of practice, but it appeared that the intensity of practice may be more important as a determinant of pain than the total hours spent practising. The results of the study are in substantial agreement with those previously published from Australia and North America. On the balance of probabilities the pain is due to overuse syndrome, which is very common in musicians and well known in writers. PMID:2619360

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

    NASA Technical Reports Server (NTRS)

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

    1984-01-01

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

  20. Facts about Upper and Lower Limb Reduction Defects

    MedlinePLUS

    ... Facts about Upper and Lower Limb Reduction Defects Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ... Blood Disorders & Disabilities Information For... Media Policy Makers Language: English Español (Spanish) File Formats Help: How do I ...

  1. Upper limb functional electrical stimulation devices and their man-machine interfaces.

    PubMed

    Venugopalan, L; Taylor, P N; Cobb, J E; Swain, I D

    2015-11-01

    Functional Electrical Stimulation (FES) is a technique that uses electricity to activate the nerves of a muscle that is paralysed due to hemiplegia, multiple sclerosis, Parkinson's disease or spinal cord injury (SCI). FES has been widely used to restore upper limb functions in people with hemiplegia and C5-C7 tetraplegia and has improved their ability to perform their activities of daily living (ADL). At the time of writing, a detailed literature review of the existing upper limb FES devices and their man-machine interfaces (MMI) showed that only the NESS H200 was commercially available. However, the rigid arm splint doesn't fit everyone and prevents the use of a tenodesis grip. Hence, a robust and versatile upper limb FES device that can be used by a wider group of people is required. PMID:26508077

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

    NASA Astrophysics Data System (ADS)

    Veer, Karan

    2015-04-01

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

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

    NASA Astrophysics Data System (ADS)

    Wu, Tzong-Ming; Chen, Dar-Zen

    2012-06-01

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

  4. Muscle phenotype remains unaltered after limb autotomy and unloading.

    PubMed

    Griffis, B; Moffett, S B; Cooper, R L

    2001-01-01

    Loss of chelipeds in crustaceans results in severe atrophy of the major muscle responsible for lifting the limb, the anterior levator. We decided to test if this loss of mechanical load altered muscle phenotype as measured by SDS-PAGE analysis of levator total protein and actomyosin fractions. Levator muscles of adult crayfish, Procambarus clarkii, with either functional regenerate limbs or lack of limb buds (papilla stage) were compared with those from normal contralateral limbs and those from pristine animals. We find that there is no difference in protein profiles among the three conditions. However, the total protein profile for the dually excited levator muscle is unique compared to those of fast or slow muscles of the abdomen (L and SEL, respectively), which receive only phasic or tonic excitatory innervation. The levator myosin heavy chain profile is similar to that of slow phenotype muscles such as the SEL and opener. We conclude that load does not influence levator phenotype. This is likely due either to the intact innervation and continued activation of the levator during atrophy or to the maintenance of passive tension on the muscle. J. Exp. Zool. 289:10-22, 2001. PMID:11169489

  5. Skeletal muscle responses to lower limb suspension in humans

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

    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.

  6. Upper limb malformations in DiGeorge syndrome

    SciTech Connect

    Cormier-Daire, V.; Iserin, L.; Sidi, D.

    1995-03-13

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

  7. SHUEE on the evaluation of upper limb in cerebral palsy

    PubMed Central

    Tedesco, Ana Paula; Nicolini-Panisson, Renata D'Agostini; de Jesus, Aline

    2015-01-01

    OBJECTIVE: To demonstrate the use of the tool for evaluation of spastic upper limb SHUEE (Shriners Hospital Upper Extremity Evaluation) in the evaluation of upper limb in cerebral palsy (CP) and its ability to detect changes after surgical treatment of identified deformities. METHODS: 19 patients with spastic hemiplegic CP had their upper limb evaluated by SHUEE. Five patients underwent surgical treatment of deformities detected and performed the test at one year postoperatively. RESULTS: The mean age was 9.02 years old; 18 patients were classified as level I GMFCS and one patient as level II. At baseline, the mean spontaneous functional analysis was 59.01; dynamic positional analysis was 58.05 and grasp-and-release function, was 91.21. In the postoperative period the scores were, respectively, 65.73, 69.62 and 100, showing an improvement of 3.5% in the spontaneous functional analysis and of 44.8% in dynamic positional analysis. CONCLUSIONS: SHUEE is a tool for evaluation of spastic upper limb in cerebral palsy that helps in the specific diagnosis of deformities, indication of treatment and objective detection of results after surgical treatment. Level of Evidence IV, Case Series. PMID:26327806

  8. The artery blood supply variant of the upper limb

    PubMed Central

    MASLARSKI, IVAN

    2015-01-01

    Variations of arterial patterns in the upper limb have represented the most common subject of vascular anatomy. Different types of artery branching pattern of the upper limb are very important for orthopedists in angiographic and microvascular surgical practice. The brachial artery (BA) is the most important vessel in the normal vascular anatomy of the upper limb. The classical pattern of the palmar hand region distribution shows the superficial palmar arch. Normally this arch is formed by the superficial branch of the ulnar artery and completed on the lateral side by one of these arteries: the superficial palmar branch of the radial artery, the princeps pollicis artery, the superficial palmar branch of the radial artery or the median artery. After the routine dissection of the right upper limb of an adult male cadaver, we found a very rare variant of the superficial arch artery – a division in a higher level brachial artery. We found this division at 10.4 cm from the beginning of the brachial artery. This superficial brachial artery became a radial artery and was not involved in the formation of the palm arch. In the forearm region, the artery variant was present with the median artery and the ulnar artery, which form the superficial palm arch.

  9. Muscle exercise in limb girdle muscular dystrophies: pitfall and advantages.

    PubMed

    Siciliano, Gabriele; Simoncini, Costanza; Giannotti, Stefano; Zampa, Virna; Angelini, Corrado; Ricci, Giulia

    2015-05-01

    Different genetic mutations underlying distinct pathogenic mechanisms have been identified as cause of muscle fibers degeneration and strength loss in limb girdle muscular dystrophies (LGMD). As a consequence, exercise tolerance is affected in patients with LGMD, either as a direct consequence of the loss of muscle fibers or secondary to the sedentary lifestyle due to the motor impairment. It has been debated for many years whether or not muscle exercise is beneficial or harmful for patients with myopathic disorders. In fact, muscular exercise would be considered in helping to hinder the loss of muscle tissue and strength. On the other hand, muscle structural defects in LGMD can result in instability of the sarcolemma, making it more likely to induce muscle damage as a consequence of intense muscle contraction, such as that performed during eccentric training. Several reports have suggested that supervised aerobic exercise training is safe and may be considered effective in improving oxidative capacity and muscle function in patients with LGMD, such as LGMD2I, LGMD2L, LGMD2A. More or less comfortable investigation methods applied to assess muscle function and structure can be useful to detect the beneficial effects of supervised training in LGMD. However, it is important to note that the available trials assessing muscle exercise in patients with LGMD have often involved a small number of patients, with a wide clinical heterogeneity and a different experimental design. Based on these considerations, resistance training can be considered part of the rehabilitation program for patients with a limb-girdle type of muscular dystrophy, but it should be strictly supervised to assess its effects and prevent possible development of muscle damage. PMID:26155063

  10. Mitochondrial Regulation of the Muscle Microenvironment in Critical Limb Ischemia

    PubMed Central

    Ryan, Terence E.; Schmidt, Cameron A.; Green, Tom D.; Brown, David A.; Neufer, P. Darrell; McClung, Joseph M.

    2015-01-01

    Critical limb ischemia (CLI) is the most severe clinical presentation of peripheral arterial disease and manifests as chronic limb pain at rest and/or tissue necrosis. Current clinical interventions are largely ineffective and therapeutic angiogenesis based trials have shown little efficacy, highlighting the dire need for new ideas and novel therapeutic approaches. Despite a decade of research related to skeletal muscle as a determinant of morbidity and mortality outcomes in CLI, very little progress has been made toward an effective therapy aimed directly at the muscle myopathies of this disease. Within the muscle cell, mitochondria are well positioned to modulate the ischemic cellular response, as they are the principal sites of cellular energy production and the major regulators of cellular redox charge and cell death. In this mini review, we update the crucial importance of skeletal muscle to CLI pathology and examine the evolving influence of muscle and endothelial cell mitochondria in the complex ischemic microenvironment. Finally, we discuss the novelty of muscle mitochondria as a therapeutic target for ischemic pathology in the context of the complex co-morbidities often associated with CLI. PMID:26635622

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. Limb muscles are androgen targets in an acrobatic tropical bird.

    PubMed

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

    2010-03-01

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

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

    PubMed

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

    2015-04-01

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

  14. Reliability of the Melbourne assessment of unilateral upper limb function.

    PubMed

    Randall, M; Carlin, J B; Chondros, P; Reddihough, D

    2001-11-01

    This study examines the reliability of the Melbourne Assessment of Unilateral Upper Limb Function: a quantitative test of quality of movement in children with neurological impairment. The assessment was administered to 20 children aged from 5 to 16 years (mean age 9 years 10 months, SD 2 years 10 months) who had various types and degrees of cerebral palsy (CP). The performances of the 20 children during assessment were videotaped for subsequent scoring by 15 occupational therapists. Scores were analyzed for internal consistency of test items, inter- and intrarater reliability of scorings of the same videotapes, and test-retest reliability using repeat videotaping. Results revealed very high internal consistency of test items (alpha=0.96), moderate to high agreement both within and between raters for all test items (intraclass correlations of at least 0.7) apart from item 16 (hand to mouth and down), and high interrater reliability (0.95) and intrarater reliability (0.97) for total test scores. Test-retest results revealed moderate to high intrarater reliability for item totals (mean of 0.83 and 0.79) for each rater and high reliability for test totals (0.98 and 0.97). These findings indicate that the Melbourne Assessment of Unilateral Upper Limb Function is a reliable tool for measuring the quality of unilateral upper-limb movement in children with CP. PMID:11730151

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

    PubMed

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

    2007-01-01

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

  16. Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy

    PubMed Central

    Diogo, Rui; Esteve-Altava, Borja; Smith, Christopher; Boughner, Julia C.; Rasskin-Gutman, Diego

    2015-01-01

    How do the various anatomical parts (modules) of the animal body evolve into very different integrated forms (integration) yet still function properly without decreasing the individual’s survival? This long-standing question remains unanswered for multiple reasons, including lack of consensus about conceptual definitions and approaches, as well as a reasonable bias toward the study of hard tissues over soft tissues. A major difficulty concerns the non-trivial technical hurdles of addressing this problem, specifically the lack of quantitative tools to quantify and compare variation across multiple disparate anatomical parts and tissue types. In this paper we apply for the first time a powerful new quantitative tool, Anatomical Network Analysis (AnNA), to examine and compare in detail the musculoskeletal modularity and integration of normal and abnormal human upper and lower limbs. In contrast to other morphological methods, the strength of AnNA is that it allows efficient and direct empirical comparisons among body parts with even vastly different architectures (e.g. upper and lower limbs) and diverse or complex tissue composition (e.g. bones, cartilages and muscles), by quantifying the spatial organization of these parts—their topological patterns relative to each other—using tools borrowed from network theory. Our results reveal similarities between the skeletal networks of the normal newborn/adult upper limb vs. lower limb, with exception to the shoulder vs. pelvis. However, when muscles are included, the overall musculoskeletal network organization of the upper limb is strikingly different from that of the lower limb, particularly that of the more proximal structures of each limb. Importantly, the obtained data provide further evidence to be added to the vast amount of paleontological, gross anatomical, developmental, molecular and embryological data recently obtained that contradicts the long-standing dogma that the upper and lower limbs are serial homologues. In addition, the AnNA of the limbs of a trisomy 18 human fetus strongly supports Pere Alberch's ill-named "logic of monsters" hypothesis, and contradicts the commonly accepted idea that birth defects often lead to lower integration (i.e. more parcellation) of anatomical structures. PMID:26452269

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

    PubMed Central

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

    2009-01-01

    Neural coupling of proximal and distal upper limb segments may have functional implications in the recovery of hemiparesis after stroke. The goal of the present study was to investigate whether the stretch reflex response magnitude of spastic finger flexor muscles poststroke is influenced by sensory input from the shoulder and the elbow and whether reflex coupling of muscles throughout the upper limb is altered in spastic stroke survivors. Through imposed extension of the metacarpophalangeal (MCP) joints, stretch of the relaxed finger flexors of the four fingers was imposed in 10 relaxed stroke subjects under different conditions of proximal sensory input, namely static arm posture (3 different shoulder/elbow postures) and electrical stimulation (surface stimulation of biceps brachii or triceps brachii, or none). Fast (300°/s) imposed stretch elicited stretch reflex flexion torque at the MCP joints and reflex electromyographic (EMG) activity in flexor digitorum superficialis. Both measures were greatest in an arm posture of 90° of elbow flexion and neutral shoulder position. Biceps stimulation resulted in greater MCP stretch reflex flexion torque. Fast imposed stretch also elicited reflex EMG activity in nonstretched heteronymous upper limb muscles, both proximal and distal. These results suggest that in the spastic hemiparetic upper limb poststroke, sensorimotor coupling of proximal and distal upper limb segments is involved in both the increased stretch reflex response of the finger flexors and an increased reflex coupling of heteronymous muscles. Both phenomena may be mediated through changes poststroke in the spinal reflex circuits and/or in the descending influence of supraspinal pathways. PMID:19571191

  18. Orthotic aided training of the paretic upper limb in chronic stroke: results of a phase 1 trial.

    PubMed

    Farrell, John F; Hoffman, Henry B; Snyder, Janet L; Giuliani, Carol A; Bohannon, Richard W

    2007-01-01

    This was a phase 1 investigation of an upper limb training program using the SaeboFlex dynamic orthosis to improve upper limb motor status. Thirteen individuals with chronic hemiparesis from stroke (age 26-71 years) participated. After being fitted with a SaeboFlex orthosis, each participant was engaged in 5 days of training (6 hours per day) that consisted of repetitive, task oriented activities with the SaeboFlex, exercises, and functional electrical stimulation. Individuals demonstrated improvements in movement at the shoulder and elbow. Wrist extension also improved, but wrist flexion and finger movement did not. Two more global measures of upper limb status improved. Muscle tone decreased. All participants remained pain free. This investigation demonstrates that a program using the orthosis was accompanied by many desirable changes and no untoward consequences. PMID:17656834

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

    PubMed

    Audenaert, A; Audenaert, E

    2008-10-01

    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

  20. A solitary fibrous tumor of the upper limb.

    PubMed

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

    2015-02-01

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

  1. A body-powered functional upper limb orthosis.

    PubMed

    Rahman, T; Sample, W; Seliktar, R; Alexander, M; Scavina, M

    2000-01-01

    This paper describes the development and preliminary testing of a functional upper-limb orthosis for people that have limited strength in their arms. This is symptomatic of conditions such as muscular dystrophy (MD), spinal muscular atrophy (SMA), and partial spinal cord injury. The exoskeletal orthosis is wheelchair mounted, has two links and four degrees of freedom. It uses linear elastic elements to balance out the effects of gravity in three dimensions. Preliminary results on testing with ten subjects will be presented. PMID:11321003

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

    PubMed Central

    2011-01-01

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

  3. The Upper Atmosphere Research Satellite microwave limb sounder instrument

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

  4. A survey on robotic devices for upper limb rehabilitation

    PubMed Central

    2014-01-01

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

  5. Lesion Characteristics of Individuals With Upper Limb Spasticity After Stroke.

    PubMed

    Cheung, Daniel K; Climans, Seth A; Black, Sandra E; Gao, Fuqiang; Szilagyi, Gregory M; Mochizuki, George

    2016-01-01

    This study explores the relationship between lesion location and volume and upper limb spasticity after stroke. Ninety-seven stroke patients (51 with spasticity) were included in the analysis (age = 67.5 ± 13.3 years, 57 males). Lesions were traced from computed tomography and magnetic resonance images and coregistered to a symmetrical brain template. Lesion overlays from the nonspastic group were subtracted from the spastic group to determine the regions of the brain more commonly lesioned in spastic patients. Similar analysis was performed across groups of participants whose upper limb (elbow or wrist) Modified Ashworth Scale (MAS) score ranged from 1 (mild) to 4 (severe). Following subtraction analysis and Fisher's exact test, the putamen was identified as the area most frequently lesioned in individuals with spasticity. More severe spasticity was associated with a higher lesion volume. This study establishes the neuroanatomical correlates of poststroke spasticity and describes the relationship between lesion characteristics and the severity of spasticity using mixed brain imaging modalities, including computed tomography imaging, which is more readily available to clinicians. Understanding the association between lesion location and volume with the development and severity of spasticity is an important first step toward predicting the development of spasticity after stroke. Such information could inform the implementation of intervention strategies during the recovery process to minimize the extent of impairment. PMID:25995383

  6. Protein synthesis rates in atrophied gastrocnemius muscles after limb immobilization

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

  7. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy.

    PubMed

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

    2014-01-01

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

  8. Relation between systemic inflammatory markers, peripheral muscle mass, and strength in limb muscles in stable COPD patients

    PubMed Central

    Ferrari, Renata; Caram, Laura MO; Faganello, Marcia M; Sanchez, Fernanda F; Tanni, Suzana E; Godoy, Irma

    2015-01-01

    The aim of this study was to investigate the association between systemic inflammatory mediators and peripheral muscle mass and strength in COPD patients. Fifty-five patients (69% male; age: 64±9 years) with mild/very severe COPD (defined as forced expiratory volume in the first second [FEV1] =54%±23%) were evaluated. We evaluated serum concentrations of IL-8, CRP, and TNF-?. Peripheral muscle mass was evaluated by computerized tomography (CT); midthigh cross-sectional muscle area (MTCSA) and midarm cross-sectional muscle area (MACSA) were obtained. Quadriceps, triceps, and biceps strength were assessed through the determination of the one-repetition maximum. The multiple regression results, adjusted for age, sex, and FEV1%, showed positive significant association between MTCSA and leg extension (0.35 [0.16, 0.55]; P=0.001), between MACSA and triceps pulley (0.45 [0.31, 0.58]; P=0.001), and between MACSA and biceps curl (0.34 [0.22, 0.47]; P=0.001). Plasma TNF-? was negatively associated with leg extension (?3.09 [?5.99, ?0.18]; P=0.04) and triceps pulley (?1.31 [?2.35, ?0.28]; P=0.01), while plasma CRP presented negative association with biceps curl (?0.06 [?0.11, ?0.01]; P=0.02). Our results showed negative association between peripheral muscle mass (evaluated by CT) and muscle strength and that systemic inflammation has a negative influence in the strength of specific groups of muscles in individuals with stable COPD. This is the first study showing association between systemic inflammatory markers and strength in upper limb muscles. PMID:26345641

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2014-09-01

    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

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

    NASA Technical Reports Server (NTRS)

    Gustincic, J. J. (inventor)

    1981-01-01

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

  12. Sex determination using upper limb bones in Korean populations

    PubMed Central

    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

    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. PMID:25276479

  13. Specifications of an electromyogram-driven neuromuscular stimulator for upper limb functional recovery.

    PubMed

    Muraoka, Yoshihiro; Tanabe, Shigeo; Yamaguchi, Tomofumi; Takeda, Kotaro

    2013-01-01

    An electromyogram (EMG)-driven neuromuscular stimulator for upper limb functional recovery (Muraoka et al., 1998) can stimulate target muscles in proportion to the amount of voluntary EMG of the identical target muscles. Furthermore, it can facilitate the contraction of paralyzed muscles by electrical stimulation at subthreshold intensity level. Although it has been suggested that to use the stimulator for as long a time as possible might be needed for more effective treatment, the utilization time was limited by the size of the stimulator, which involved a laptop personal computer. To use in daily life, the device was improved to be a smaller size of 95×65×40 mm (including batteries) which was equivalent to a mobile phone (in 2002). The stimulator was called the Integrated Volitional-control Electrical Stimulator (IVES). IVES has already been manufactured and its use has spread in Japan since 2008. Nowadays, therapy using IVES is an effective therapy to improve the motor function of the upper limb in post-stroke patients with hemiparesis. However, the signal processing and internal structure of IVES has not yet been reported. In this study the device specification of IVES is described, especially its electrical circuits and signal processing that detect voluntary EMG and stimulate from the same electrodes. IVES uses two DIACs for detecting voluntary EMG from stimulating electrodes. The DIACs switch passively between the stimulation circuit and the EMG amplifier circuit. Furthermore, the signal processing of the time-shifted difference of the 2-cycle EMG signal following identical stimulation pulses eliminates stimulation artifacts and evoked potentials, and extracts voluntary EMG. PMID:24109678

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

    PubMed Central

    Heitmann, Stewart; Ferns, Norm; Breakspear, Michael

    2012-01-01

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

  15. Early prediction of long-term upper limb spasticity after stroke

    PubMed Central

    Danielsson, Anna; Alt Murphy, Margit; Persson, Hanna C.; Sunnerhagen, Katharina Stibrant

    2015-01-01

    Objective: To identify predictors and the optimal time point for the early prediction of the presence and severity of spasticity in the upper limb 12 months poststroke. Methods: In total, 117 patients in the Gothenburg area who had experienced a stroke for the first time and with documented arm paresis day 3 poststroke were consecutively included. Assessments were made at admission and at 3 and 10 days, 4 weeks, and 12 months poststroke. Upper limb spasticity in elbow flexion/extension and wrist flexion/extension was assessed with the modified Ashworth Scale (MAS). Any spasticity was regarded as MAS ?1, and severe spasticity was regarded as MAS ?2 in any of the muscles. Sensorimotor function, sensation, pain, and joint range of motion in the upper limb were assessed with the Fugl-Meyer assessment scale, and, together with demographic and diagnostic information, were included in both univariate and multivariate logistic regression analysis models. Seventy-six patients were included in the logistic regression analysis. Results: Sensorimotor function was the most important predictor both for any and severe spasticity 12 months poststroke. In addition, spasticity 4 weeks poststroke was a significant predictor for severe spasticity. The best prediction model for any spasticity was observed 10 days poststroke (85% sensitivity, 90% specificity). The best prediction model for severe spasticity was observed 4 weeks poststroke (91% sensitivity, 92% specificity). Conclusions: Reduced sensorimotor function was the most important predictor both for any and severe spasticity, and spasticity could be predicted with high sensitivity and specificity 10 days poststroke. PMID:26276377

  16. Differential diagnosis of a rare case of upper limb pain: Paget-Schroetter syndrome in a doner kebab chef

    PubMed Central

    Aytekin, Ebru; Dogan, Yasemin Pekin; Okur, Sibel Caglar; Burnaz, Ozer; Caglar, Nil Sayiner

    2015-01-01

    [Purpose] Paget-Schroetter syndrome (PSS) is an uncommon deep vein thrombosis of the axillary and subclavian veins which may occur spontaneously, but is usually caused by excessive upper limb activity. PSS is clinically similar to other upper limb musculoskeletal disorders and soft tissue infections, and this may lead to delay in correct diagnosis in its early stages. The aim of our case report is to discuss this rare condition with reference to the available literature. [Subjects and Methods] Here we report the case of a doner kebab chef who complained of swelling and pain in his right arm around the biceps muscle. The initial diagnosis was biceps tendon rupture, for which the patient underwent magnetic resonance imaging (MRI) of the right arm and shoulder. Since the MRI revealed no pathological findings, right upper limb venous Doppler ultrasound analysis was performed. Subacute thrombosis materials were detected in the subclavian, axillary, and brachial veins. [Results] With rapid anticoagulant therapy, the patient’s symptoms quickly improved. [Conclusion] Early diagnosis and treatment of PSS is critical for preventing potentially fatal complications such as pulmonary embolism. Prophylaxis is important for preventing recurrent thrombosis and for avoiding the development of post-thrombotic syndrome. PSS should be considered a possible cause of painful swelling of the upper limbs, especially in young, active patients who use their arms excessively. PMID:26644704

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

    PubMed

    Pathak, Yagna; Johnson, Michelle

    2012-01-01

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

  18. REV I EW Open Access Upper limb kinematics after cervical spinal cord

    E-print Network

    REV I EW Open Access Upper limb kinematics after cervical spinal cord injury: a review Sébastien actually addresses the key­features of open­chain upper limb movements after cervical spinal cord injury, Reaching, Reach­to­grasp, Kinematic Cervical spinal cord injury (SCI) leads to extensive sensorimotor

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

    NASA Astrophysics Data System (ADS)

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

    2005-12-01

    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.

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed Central

    Williams, Ian; Constandinou, Timothy G.

    2014-01-01

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

  2. Upper limb malformations in chromosome 22q11 deletions

    SciTech Connect

    Shalev, S.A.; Dar, H.; Barel, H.; Borochowitz, Z.

    1996-03-29

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

  3. Active upper limb prosthesis based on natural movement trajectories.

    PubMed

    Ramírez-García, Alfredo; Leija, Lorenzo; Muñoz, Roberto

    2010-03-01

    The motion of the current prostheses is sequential and does not allow natural movements. In this work, complex natural motion patterns from a healthy upper limb were characterized in order to be emulated for a trans-humeral prosthesis with three degrees of freedom at the elbow. Firstly, it was necessary to define the prosthesis workspace, which means to establish a relationship using an artificial neural network (ANN), between the arm-forearm (3-D) angles allowed by the prosthesis, and its actuators length. The 3-D angles were measured between the forearm and each axis of the reference system attached at the elbow. Secondly, five activities of daily living (ADLs) were analyzed by means of the elbow flexion (EF), the forearm prono-supination (FPS) and the 3-D angles, from healthy subjects, by using a video-based motion analysis system. The 3-D angles were fed to the prosthesis model (ANN) in order to analyze which ADLs could be emulated by the prosthesis. As a result, a prosthesis kinematics approximation was obtained. In conclusion, in spite of the innovative mechanical configuration of the actuators, it was possible to carry out only three of the five ADLs considered. Future work will include improvement of the mechanical configuration of the prosthesis to have greater range of motion. PMID:20196688

  4. Temporal alignment of electrocorticographic recordings for upper limb movement

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    2013-06-07

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

  6. Muscle fatigue, nNOS and muscle fiber atrophy in limb girdle muscular dystrophy.

    PubMed

    Angelini, Corrado; Tasca, Elisabetta; Nascimbeni, Anna Chiara; Fanin, Marina

    2014-12-01

    Muscle fatigability and atrophy are frequent clinical signs in limb girdle muscular dystrophy (LGMD), but their pathogenetic mechanisms are still poorly understood. We review a series of different factors that may be connected in causing fatigue and atrophy, particularly considering the role of neuronal nitric oxide synthase (nNOS) and additional factors such as gender in different forms of LGMD (both recessive and dominant) underlying different pathogenetic mechanisms. In sarcoglycanopathies, the sarcolemmal nNOS reactivity varied from absent to reduced, depending on the residual level of sarcoglycan complex: in cases with complete sarcoglycan complex deficiency (mostly in beta-sarcoglycanopathy), the sarcolemmal nNOS reaction was absent and it was always associated with early severe clinical phenotype and cardiomyopathy. Calpainopathy, dysferlinopathy, and caveolinopathy present gradual onset of fatigability and had normal sarcolemmal nNOS reactivity. Notably, as compared with caveolinopathy and sarcoglycanopathies, calpainopathy and dysferlinopathy showed a higher degree of muscle fiber atrophy. Males with calpainopathy and dysferlinopathy showed significantly higher fiber atrophy than control males, whereas female patients have similar values than female controls, suggesting a gender difference in muscle fiber atrophy with a relative protection in females. In female patients, the smaller initial muscle fiber size associated to endocrine factors and less physical effort might attenuate gender-specific muscle loss and atrophy. PMID:25873780

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

    PubMed Central

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

    2009-01-01

    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

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

    PubMed Central

    Payne, RC; Veenman, P; Wilson, AM

    2005-01-01

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

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

    PubMed Central

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

    2004-01-01

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

  10. Neuromuscular Activity of Upper and Lower Limbs during two Backstroke Swimming Start Variants.

    PubMed

    De Jesus, Karla; De Jesus, Kelly; Medeiros, Alexandre I A; Gonçalves, Pedro; Figueiredo, Pedro; Fernandes, Ricardo J; Vilas-Boas, João Paulo

    2015-09-01

    A proficient start is decisive in sprint competitive swimming events and requires swimmers' to exert maximal forces in a short period to complete the task successfully. The aim of this study was to compare the electromyographic (EMG) activity in-between the backstroke start with feet positioned parallel and partially emerged performed with the hands on the highest horizontal and on the vertical handgrip at hands-off, take-off, flight and entry start phases. EMG comparisons between starting variants were supported by upper and lower limb joint angles at starting position and 15 m start time data. Following a four-week start training to familiarize participants with each start variant, 10 male competitive backstroke swimmers performed randomly six 15 m maximal trials, being three of each start variant. Surface EMG of Biceps Brachii, Triceps Brachii, Rectus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior was recorded and processed using the time integral EMG (iEMG). Eight video cameras (four surface and four underwater) were used to determine backstroke start phases and joint angles at starting position. EMG, joint angles and temporal parameters have not evidenced changes due to the different handgrips. Nevertheless, clear differences were observed in both variants for upper and lower limb muscles activity among starting phases (e.g. Biceps Brachii at take-off vs. flight phase, 15.17% ± 2.76% and 22.38% ± 4.25%; 14.24% ± 7.11% and 25.90% ± 8.65%, for variant with hands horizontal and vertically positioned, respectively). It was concluded that different handgrips did not affect EMG, kinematics and temporal profile in backstroke start. Despite coaches might plan similar strength training for both start variants, further attention should be given on the selection of proper exercises to maximize the contribution of relevant muscles at different starting phases. Key pointsAn effective swim start component (from the starting signal until the swimmers' vertex reaches the 15 m mark) is decisive in short distance events.In 2008, FINA approved the Omega OSB11 starting block (Swiss Timing Ltd., Switzerland) with two horizontal and one vertical backstroke start handgrip and currently swimmers can adopt different starting variants.The start performance is related to the exertion of maximal force in the shortest time, as other high-velocity movements; thus, the study of the current variants in-between them from a neuromuscular standpoint is indispensable for training support.The use of different handgrips did not affect upper and lower limb electromyographic activity; angular kinematics and overall 15 m backstroke start profile.Independent of the start variant selected, the role played by each upper and lower limb muscles at different starting phases should be considered in specific resistance training program to optimize backstroke start performance. PMID:26336346

  11. Neuromuscular Activity of Upper and Lower Limbs during two Backstroke Swimming Start Variants

    PubMed Central

    De Jesus, Karla; De Jesus, Kelly; Medeiros, Alexandre I. A.; Gonçalves, Pedro; Figueiredo, Pedro; Fernandes, Ricardo J.; Vilas-Boas, João Paulo

    2015-01-01

    A proficient start is decisive in sprint competitive swimming events and requires swimmers’ to exert maximal forces in a short period to complete the task successfully. The aim of this study was to compare the electromyographic (EMG) activity in-between the backstroke start with feet positioned parallel and partially emerged performed with the hands on the highest horizontal and on the vertical handgrip at hands-off, take-off, flight and entry start phases. EMG comparisons between starting variants were supported by upper and lower limb joint angles at starting position and 15 m start time data. Following a four-week start training to familiarize participants with each start variant, 10 male competitive backstroke swimmers performed randomly six 15 m maximal trials, being three of each start variant. Surface EMG of Biceps Brachii, Triceps Brachii, Rectus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior was recorded and processed using the time integral EMG (iEMG). Eight video cameras (four surface and four underwater) were used to determine backstroke start phases and joint angles at starting position. EMG, joint angles and temporal parameters have not evidenced changes due to the different handgrips. Nevertheless, clear differences were observed in both variants for upper and lower limb muscles activity among starting phases (e.g. Biceps Brachii at take-off vs. flight phase, 15.17% ± 2.76% and 22.38% ± 4.25%; 14.24% ± 7.11% and 25.90% ± 8.65%, for variant with hands horizontal and vertically positioned, respectively). It was concluded that different handgrips did not affect EMG, kinematics and temporal profile in backstroke start. Despite coaches might plan similar strength training for both start variants, further attention should be given on the selection of proper exercises to maximize the contribution of relevant muscles at different starting phases. Key points An effective swim start component (from the starting signal until the swimmers’ vertex reaches the 15 m mark) is decisive in short distance events. In 2008, FINA approved the Omega OSB11 starting block (Swiss Timing Ltd., Switzerland) with two horizontal and one vertical backstroke start handgrip and currently swimmers can adopt different starting variants. The start performance is related to the exertion of maximal force in the shortest time, as other high-velocity movements; thus, the study of the current variants in-between them from a neuromuscular standpoint is indispensable for training support. The use of different handgrips did not affect upper and lower limb electromyographic activity; angular kinematics and overall 15 m backstroke start profile. Independent of the start variant selected, the role played by each upper and lower limb muscles at different starting phases should be considered in specific resistance training program to optimize backstroke start performance. PMID:26336346

  12. First Neuromuscular Contact Correlates with Onset of Primary Myogenesis in Rat and Mouse Limb Muscles

    PubMed Central

    Duxson, Marilyn J.; Deries, Marianne

    2015-01-01

    Skeletal muscle development has been the focus of intensive study for many decades. Recent advances in genetic manipulation of the mouse have increased our understanding of the cell signalling involved in the development of muscle progenitors which give rise to adult skeletal muscles and their stem cell populations. However, the influence of a vital tissue type – the peripheral nerve—has largely been ignored since its earliest descriptions. Here we carefully describe the timing in which myogenic progenitors expressing Pax3 and Pax7 (the earliest markers of myogenic cells) enter the limb buds of rat and mouse embryos, as well as the spatiotemporal relationship between these progenitors and the ingrowing peripheral nerve. We show that progenitors expressing Pax3 enter the limb bud one full day ahead of the first neurites and that Pax7-expressing progenitors (associated with secondary myogenesis in the limb) are first seen in the limb bud at the time of nerve entry and in close proximity to the nerve. The initial entry of the nerve also coincides with the first expression of myosin heavy chain showing that the first contact between nerves and myogenic cells correlates with the onset of myogenic differentiation. Furthermore, as the nerve grows into the limb, Pax3 expression is progressively replaced by Pax7 expression in myogenic progenitors. These findings indicate that the ingrowing nerve enters the limb presumptive muscle masses earlier than what was generally described and raises the possibility that nerve may influence the differentiation of muscle progenitors in rodent limbs. PMID:26207754

  13. Acupuncture in the Treatment of Upper-Limb Lymphedema

    PubMed Central

    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

    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

  14. A systematic review of prognostic factors for distal upper limb pain

    PubMed Central

    Whibley, Daniel; Martin, Kathryn R; Lovell, Karina; Jones, Gareth T

    2015-01-01

    Background: Musculoskeletal pain in the distal upper limb is relatively common, can be a cause of disability, presents a high cost to society and is clinically important. Previous reviews of prognostic factors have focused on pain in the proximal upper limb, whole upper extremity or isolated regions of the distal upper limb. Aim: To identify factors that predict outcome of distal upper limb pain. Study design: Systematic review Method: Eight bibliographic databases were searched from inception to March 2014. Eligible articles included adults with pain anywhere in the distal upper limb at baseline from randomised controlled trials with a waiting list, expectant policy or usual care group, or observational studies where no treatment or usual care was provided. Data describing the association between a putative prognostic factor and pain or functional outcome at follow-up were required. Quality was assessed using the Quality in Prognostic Studies tool. Results: Seven articles reporting on six studies were identified. Heterogeneity of study populations and outcome measures prevented a meta-analysis so a narrative synthesis of results was undertaken. Three factors (being female, a longer duration of the complaint at initial presentation and having musculoskeletal pain in multiple locations) were significantly associated with poor pain outcome in more than one study. Being female was the only factor significantly associated with poor functional outcome in more than one study. Conclusions: A range of sociodemographic, pain-related, occupational and psychosocial prognostic factors for distal upper limb pain outcomes were investigated in studies included in the review. However, due to the lack of commonality of factors investigated and lack of consistency of results across studies, there is limited evidence for predictors of distal upper limb pain outcomes. Further research is required to identify prognostic factors of distal upper limb pain, particularly modifiable factors that may influence management. PMID:26526466

  15. WITHDRAWAL REFLEXES IN THE UPPER LIMB ADAPT TO ARM POSTURE AND STIMULUS LOCATION

    E-print Network

    Perreault, Eric J.

    WITHDRAWAL REFLEXES IN THE UPPER LIMB ADAPT TO ARM POSTURE AND STIMULUS LOCATION CARRIE L. PETERSON, USA Accepted 31 July 2013 ABSTRACT: Introduction: Withdrawal reflexes in the leg adapt in a context-appropriate manner to remove the limb from noxious stimuli, but the extent to which withdrawal reflexes adapt

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

    PubMed Central

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

    2011-01-01

    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

  17. Upper Limb Position Sensing: A Machine Vision Dianna Han1, 2

    E-print Network

    Wang, Yuan-Fang

    algorithm running on a PC. This algorithm will produce a trigger signal whenever the arm posture conforms an approach to sensing upper limb posture for a stroke rehabilitation system that does not require any devices

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2004-01-01

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

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

    PubMed

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

    2014-01-01

    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

  1. Limb congestion enhances the synchronization of sympathetic outflow with muscle contraction

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

    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.

  2. Prediction of prognosis of ALS: Importance of active denervation findings of the cervical-upper limb area and trunk area

    PubMed Central

    Sato, Yoko; Nakatani, Eiji; Watanabe, Yasuhiro; Fukushima, Masanori; Nakashima, Kenji; Kannagi, Mari; Kanatani, Yasuhiro; Mizushima, Hiroshi

    2015-01-01

    Summary Amyotrophic lateral sclerosis (ALS) is a motor neuron disease characterized by serious muscle atrophy and weakness. The purpose of this study was to find prognostic factors in patients with mild ALS using application forms for the Specified Disease Treatment Research Program in Japan. We classified ALS as mild, moderate and severe. The subjects consisted of 363 patients with mild ALS who underwent needle electromyography at registration and were followed for more than one year. Time to progression to severe ALS and time to deterioration of activities of daily living such as speech dysfunction, upper limb dysfunction, and walking disability were used as outcomes. Cox proportional hazards model analysis was performed to identify prognostic factors. Of the patients with initially mild ALS, 38.3% (139/363) had progressed severe ALS at the last follow-up. In multivariate analysis of time to progression to severe ALS, bulbar onset (hazard ratio [95% confidence interval]: 1.68 [1.13–2.49], p = 0.010), tongue atrophy (1.69 [1.14–2.51], p = 0.009), dyspnea (1.57 [1.02–2.41], p = 0.042) and active denervation findings (ADFs) of the cervical-upper limb area (1.81 [1.25–2.63], p = 0.002) emerged as prognostic factors. Furthermore ADFs in the trunk area were prognostic factors for upper limb dysfunction and walking disability (1.72 [1.05–2.81], p = 0.031, and 1.97 [1.09–3.59], p = 0.026). In conclusion ADFs of the cervical-upper limb area and trunk area were prognostic factors in ALS patients. PMID:26668778

  3. Ultrasound assessment on selected peripheral nerve pathologies. Part I: Entrapment neuropathies of the upper limb – excluding carpal tunnel syndrome

    PubMed Central

    Sudo?-Szopi?ska, Iwona

    2012-01-01

    Ultrasound (US) is one of the methods for imaging entrapment neuropathies, post-traumatic changes to nerves, nerve tumors and postoperative complications to nerves. This type of examination is becoming more and more popular, not only for economic reasons, but also due to its value in making accurate diagnosis. It provides a very precise assessment of peripheral nerve trunk pathology – both in terms of morphology and localization. During examination there are several options available to the specialist: the making of a dynamic assessment, observation of pain radiation through the application of precise palpation and the comparison of resultant images with the contra lateral limb. Entrapment neuropathies of the upper limb are discussed in this study, with the omission of median nerve neuropathy at the level of the carpal canal, as extensive literature on this subject exists. The following pathologies are presented: pronator teres muscle syndrome, anterior interosseus nerve neuropathy, ulnar nerve groove syndrome and cubital tunnel syndrome, Guyon's canal syndrome, radial nerve neuropathy, posterior interosseous nerve neuropathy, Wartenberg's disease, suprascapular nerve neuropathy and thoracic outlet syndrome. Peripheral nerve examination technique has been presented in previous articles presenting information about peripheral nerve anatomy [Journal of Ultrasonography 2012; 12 (49): 120–163 – Normal and sonographic anatomy of selected peripheral nerves. Part I: Sonohistology and general principles of examination, following the example of the median nerve; Part II: Peripheral nerves of the upper limb; Part III: Peripheral nerves of the lower limb]. In this article potential compression sites of particular nerves are discussed, taking into account pathomechanisms of damage, including predisposing anatomical variants (accessory muscles). The parameters of ultrasound assessment have been established – echogenicity and echostructure, thickness (edema and related increase in the cross sectional area of the nerve trunk), vascularization and the reciprocal relationship with adjacent tissue. PMID:26674101

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

    PubMed

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

    2014-02-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

    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

  8. Functional anatomy and muscle moment arms of the thoracic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris)

    PubMed Central

    Williams, S B; Wilson, A M; Daynes, J; Peckham, K; Payne, R C

    2008-01-01

    We provide quantitative muscle–tendon architecture and geometry data for the racing greyhound thoracic limb. Muscle mass, belly length, fascicle lengths, pennation angles and moment arms were measured, as were tendon masses and lengths. Maximum isometric force and maximum power were estimated for muscles, and maximum stress and strain were estimated for tendons. Results are compared with other fast quadrupedal runners, and to previously published data in mixed-breed dogs. The implications of the functional adaptations of the greyhound thoracic limb for sprinting performance are discussed. The thoracic limb was found to benefit from a similar proportion of locomotor muscle mass to the pelvic limb, suggesting that it may be used to some extent in propulsion, or alternatively that stabilisation is very important in this animal. Extrinsic muscles, especially latissimus dorsi and pectoralis profundus, were predicted to be powerful and important for generating net positive work during accelerations. Proximal biarticular muscles show specialisation toward preventing collapse of the shoulder and elbow joints to enable strut-like limb function, or some form of dynamic control. Distal muscles did not appear specialised for elastic energy storage, a functional difference to pelvic limb muscles, and the equivalents in horse thoracic limbs. The greyhound thoracic limb appears to possess substantial differences from both that of more ‘sub-maximal specialist’ quadrupeds, and from the greyhound pelvic limb. PMID:19034998

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

    PubMed Central

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

    2009-01-01

    Background and Purpose To present a systematic review of studies that investigates the effects of robot-assisted therapy on motor and functional recovery in patients with stroke. Summary of Review A database of articles published up to October 2006 was compiled using the following MEDLINE key words: cerebral vascular accident, cerebral vascular disorders, stroke, paresis, hemiplegia, upper extremity, arm and robot. References listed in relevant publications were also screened. Studies that satisfied the following selection criteria were included: (1) patients were diagnosed with cerebral vascular accident; (2) effects of robot-assisted therapy for the upper limb were investigated; (3) the outcome was measured in terms of motor and/or functional recovery of the upper paretic limb; (4) The study was a randomised clinical trial (RCT). For each outcome measure, the estimated effect size (ES) and the summary effect size (SES) expressed in standard deviation units (SDU) were calculated for motor recovery and functional ability (ADL) using fixed and random effect models. Ten studies, involving 218 patients, were included in the synthesis. Their methodological quality ranged from 4 to 8 on a (maximum) 10 point scale. Meta-analysis showed a non-significant heterogeneous SES in terms of upper limb motor recovery. Sensitivity analysis of studies involving only shoulder-elbow robotics subsequently demonstrated a significant homogeneous SES for motor recovery of the upper paretic limb. No significant SES was observed for functional ability (ADL). Conclusion As a result of marked heterogeneity in studies between distal and proximal arm robotics, no overall significant effect in favour of robot-assisted therapy was found in the present meta-analysis. However, subsequent sensitivity analysis showed a significant improvement in upper limb motor function after stroke for upper arm robotics. No significant improvement was found in ADL function. However, the administered ADL scales in the reviewed studies fail to adequately reflect recovery of the paretic upper limb and valid instruments that measure outcome of dexterity of the paretic arm and hand are mostly absent in selected studies. Future research on the effects of robot-assisted therapy should therefore distinguish between upper and lower robotics arm training and concentrate on kinematical analysis to differentiate between genuine upper limb motor recovery and functional recovery due to compensation strategies by proximal control of the trunk and upper limb. PMID:17876068

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

    PubMed Central

    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

    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

  11. Effective Management of Upper Limb Parkinsonian Tremor by IncobotulinumtoxinA Injections Using Sensor-based Biomechanical Patterns

    PubMed Central

    Rahimi, Fariborz; Samotus, Olivia; Lee, Jack; Jog, Mandar

    2015-01-01

    Background Focal treatment of Parkinson’s disease tremor by botulinum toxin type A incobotulinumtoxinA (BoNT-A) injections has been inadequately investigated and at best provides modest relief with significant muscle weakness. Complexity of multi-joint tremulous movements results in non-individualized dosing regimens. This 38-week open-label study used kinematic technology to guide muscle selection and improve efficacy of incobotulinumtoxinA (BoNT-A) injections for Parkinson’s disease tremor. Methods Participants (n=28) attended study visits at weeks 0, 6, 16, 22, 32, and 38, and were injected with BoNT-A at weeks 0, 16, and 32. During each visit, clinical tremor scales, the Unified Parkinson’s Disease Rating Scale (UPDRS) and the Fahn–Tolosa–Marin (FTM), and kinematic assessments were conducted. Participants performed rest and postural scripted tasks with motion sensors placed over the wrist, elbow, and shoulder joints where tremor was quantified by angular root mean square (RMS) amplitude in multiple degrees of freedom at each joint. Injection parameters were determined using the clinician’s interpretation of which muscles would contribute to the upper limb tremor biomechanics analyzed kinematically. Results Kinematic measures of tremor amplitude allowed detailed segmentation of tremor into directional components at each arm joint permitting a statistically significant decrease in mean UPDRS item 20 (rest tremor) at week 16 (p=0.006) and at week 32 (p=0.014), and in FTM tremor severity scores at week 6 (p=0.024). Ten participants perceived mild muscle weakness following the third treatment, which did not interfere with performing activities of daily living. Discussion Kinematics is a simple method for standardizing assessments and treatment of upper limb Parkinson’s disease tremor, thereby personalizing tremor therapy and optimizing the effect of BoNT-A injections for Parkinson’s disease tremor. PMID:26566459

  12. An upper limb mathematical model of an oil palm harvester

    NASA Astrophysics Data System (ADS)

    Tumit, N. P.; Rambely, A. S.; BMT, Shamsul; Shahriman A., B.; Ng Y., G.; Deros, B. M.; Zailina, H.; Goh, Y. M.; Arumugam, Manohar; Ismail, I. A.; Abdul Hafiz A., R.

    2014-09-01

    The main purpose of this article is to develop a mathematical model of human body during harvesting via Kane's method. In this paper, a 2-D closed-kinematic biomechanical model that represents a harvesting movement is developed. The model of six segments consisted of upper right arm, right forearm, harvesting equipment, left forearm, upper left arm, and upper part of trunk. Finally, the inverse dynamic equations are represented in matrix form.

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

    PubMed

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

    2010-06-01

    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

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

    PubMed Central

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

    2003-01-01

    The vestibular system was activated by galvanic electrical stimulation in 19 normal subjects. With the head turned to one side so that the stimulating anode was on the posterior mastoid process, stimulation caused standing subjects to sway backwards in the sagittal plane. Electromyography showed bilateral activation of erector spinae, gluteus maximus, biceps femoris, soleus and intrinsic foot (toe flexor) muscles. When head direction or electrode polarity was reversed so that the anode was anterior, all those muscles became less active and the subjects swayed forwards. With the head facing forward, stimulation caused sideways sway in the coronal plane, towards the anode, with excitation of the erector spinae on the anode side and reduced activity on the cathode side. The limb muscles were activated on the side opposite the anode and showed complex responses on the anode side. Responses were detectable in the erectores spinae muscles in sitting subjects. No responses in limb muscles were detected in the sitting posture. Subject responses in erector spinae recorded at L3/L4 had latencies from 59 to 110 ms, using a 2 mA stimulus. Latencies in lower limb muscles were longer. The results suggest a role for the vestibular system and descending brain stem motor pathways to the erectores spinae muscles in the control of postural orientation of the back when sitting and standing. The conduction velocity in the motor pathway was estimated to be 13 ± 10 m s?1 (mean ± s.d., n = 12 subjects). PMID:12527747

  15. Salutary Effects of Cepharanthine against Skeletal Muscle and Kidney Injuries following Limb Ischemia/Reperfusion

    PubMed Central

    Kao, Ming-Chang; Chung, Chih-Yang; Chang, Ya-Ying; Lin, Chih-Kung; Sheu, Joen-Rong; Huang, Chun-Jen

    2015-01-01

    Limb ischemia/reperfusion (I/R) causes oxidation and inflammation and subsequently induces muscle and kidney injuries. Cepharanthine, a natural plant alkaloid, possesses anti-inflammatory and antioxidative properties. We elucidated the salutary effects of cepharanthine against muscle and kidney injuries following limb I/R. Adult male rats were randomized to receive I/R or I/R plus cepharanthine. I/R was achieved by applying tourniquet high around each thigh for 3 hours followed by reperfusion for 24 hours. Cepharanthine (10?mg/kg, intraperitoneal) was injected immediately before reperfusion. After euthanization, degrees of tissue injury, inflammation, and oxidation were examined. Our data revealed that the I/R group had significant increases in injury biomarker concentrations of muscle (creatine kinase and lactate dehydrogenase) and kidney (creatinine, neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1). Histological assays revealed moderate muscle and kidney injury characteristics in the I/R group. The I/R group also had significant increases in concentrations of inflammatory molecules (interleukin-6, macrophage inflammatory protein-2, and prostaglandin E2) and reactive nitrogen species (nitric oxide) as well as lipid peroxidation (malondialdehyde). Of note, these effects of limb I/R could be mitigated by cepharanthine. These data confirmed that cepharanthine attenuated muscle and kidney injuries induced by limb I/R. The mechanisms may involve its anti-inflammatory and antioxidative capacities. PMID:26587045

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

    PubMed Central

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

    2015-01-01

    [Purpose] The aim of the present study was to perform a systematic review of the literature on the scales and methods most often used for the evaluation of upper limb function in individuals with cerebral palsy. [Materials and Methods] Searches were conducted in the Medline, PEDro, Lilacs, Scielo, and PubMed databases. The following inclusion criteria were used for the selection of articles: randomized controlled study, evaluation of upper limb function in individuals with cerebral palsy, and publication between 2006 and 2014. The methodological quality of the articles was evaluated using the PEDro evidence scale. [Results] Five articles met the inclusion criteria and achieved 6 points or higher on the PEDro scale of methodological quality. [Conclusion] The studies analyzed used different evaluation scales, but no consensus has been reached thus far on which scale is the most appropriate. Thus, further studies are needed to establish an adequate method for the evaluation of upper limb function in individuals with cerebral palsy. PMID:26157275

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    2014-01-01

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

  20. Upper limb musculoskeletal complaints among technicians working in a diagnostic tuberculosis laboratory: two case reports.

    PubMed

    Wong, Joyce Y P; Chin, David; Fung, Henry; Li, Ann; Wong, Marcus M S; Kwok, Henry K H

    2014-01-01

    Upper limb musculoskeletal complaints are common among certain health professionals. We report two cases, both involving technicians working in a diagnostic tuberculosis laboratory in Hong Kong. A work process evaluation suggest that the need to repeatedly open and close small bottles, as well as to work for prolonged periods of time in confined areas, could be related to the workers' clinical presentation. The cases are also compatible with the diagnosis of repetitive strain injury (RSI) of the upper limb, but this term is not commonly used nowadays because of various definitional issues. A review of the various diagnostic issues in RSI is presented. PMID:24346264

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

    E-print Network

    Kaur, Navneet

    2010-07-14

    , 8 women; 22.1 or - 2.1 years) performed 80 trials of goal directed isometric contractions that involved accurately matching a target force of 25% MVC in 200 ms, either with the upper limb or the lower limb followed by the other limb. After...

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

    PubMed

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

    1997-08-01

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

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

    PubMed Central

    Siriphorn, Akkradate; Chamonchant, Dannaovarat

    2015-01-01

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

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

    PubMed

    Siriphorn, Akkradate; Chamonchant, Dannaovarat

    2015-01-01

    [Purpose] The potential health benefits of the Nintendo Wii balance board exercise have been widely investigated. However, no study has been conducted to examine the benefits of Wii exercise for overweight young adults. The aim of this study was to investigate the effect of exercise performed on a Nintendo Wii balance board on the balance and lower limb muscle strength in overweight young adults. [Subjects and Methods] Within-subject repeated measures analysis was used. Sixteen young adults (aged 21.87±1.13?years, body mass index 24.15 ± 0.50?kg/m(2)) were recruited. All subjects performed an exercise program on a Wii balance board for 8 weeks (30?min/session, twice a week for 8 weeks). A NeuroCom Balance Master and a hand-held dynamometer were used to measure balance performance and lower limb muscle strength. [Results] According to the comparison of pre- and post-intervention measurements, the Wii balance board exercise program significantly improved the limit of stability parameters. There was also a significant increase in strength of four lower-limb muscle groups: the hip flexor, knee flexor, ankle dorsiflexor and ankle plantarflexor. [Conclusion] These findings suggest that a Wii balance board exercise program can be used to improve the balance and lower limb muscle strength of overweight young adults. PMID:25642034

  5. Physical performance and skeletal muscle characteristics after 2-week hind-limb unweighting.

    PubMed

    Nemirovskaya, T; Shenkman, B; Nasledov, G; Arutyunyan, R

    1997-07-01

    It is well-known that 2 weeks of hind-limb suspension or space flight induce the sufficient decrease of the physical performance and simultaneously changes of muscle contractile properties and fiber size. However, the data on enzyme activities changes at present are contradictory. Numerous authors have pointed to the increase, reduction of its activity as well as its stability after experiments of the similar design. In previous studies it was shown that beta-GPA (beta-guanidino-propionic acid) administration increased the oxidative enzyme activities in the skeletal muscles and improved their contractile properties in hind-limb suspended rats. The aim of our study is to clear out what determines changes of the physical performance after 2 weeks of hind-limb suspension and beta-GPA administration. PMID:11540679

  6. Phantom hand and wrist movements in upper limb amputees are slow but naturally controlled movements.

    PubMed

    De Graaf, J B; Jarrassé, N; Nicol, C; Touillet, A; Coyle, T; Maynard, L; Martinet, N; Paysant, J

    2016-01-15

    After limb amputation, patients often wake up with a vivid perception of the presence of the missing limb, called "phantom limb". Phantom limbs have mostly been studied with respect to pain sensation. But patients can experience many other phantom sensations, including voluntary movements. The goal of the present study was to quantify phantom movement kinematics and relate these to intact limb kinematics and to the time elapsed since amputation. Six upper arm and two forearm amputees with various delays since amputation (6months to 32years) performed phantom finger, hand and wrist movements at self-chosen comfortable velocities. The kinematics of the phantom movements was indirectly obtained via the intact limb that synchronously mimicked the phantom limb movements, using a Cyberglove® for measuring finger movements and an inertial measurement unit for wrist movements. Results show that the execution of phantom movements is perceived as "natural" but effortful. The types of phantom movements that can be performed are variable between the patients but they could all perform thumb flexion/extension and global hand opening/closure. Finger extension movements appeared to be 24% faster than finger flexion movements. Neither the number of types of phantom movements that can be executed nor the kinematic characteristics were related to the elapsed time since amputation, highlighting the persistence of post-amputation neural adaptation. We hypothesize that the perceived slowness of phantom movements is related to altered proprioceptive feedback that cannot be recalibrated by lack of visual feedback during phantom movement execution. PMID:26556065

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

    NASA Technical Reports Server (NTRS)

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

    1996-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  9. Effects of stretching and disuse on amino acids in muscles of rat hind limbs

    NASA Technical Reports Server (NTRS)

    Jaspers, Stephen R.; Henriksen, Erik J.; Satarug, Soisungwan; Tischler, Marc E.

    1989-01-01

    The effects of disuse and passive stretch on the concentrations of amino acids and ammonia in the unloaded soleus muscle was investigated in hindquarter-suspended (for six days by casting one foot in dorsiflexion) tail-casted rats. For a comparison with the condition of unloading, amino acids and ammonia were also measured in shortened extensor digitorum longus in the same casted limb and in denervated leg muscles. The results obtained suggest that passive stretch diminishes some of the characteristic alterations of amino acid concentrations due to unloading. This effect of stretch is considered to be due to the maintenance of muscle tension.

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

    NASA Technical Reports Server (NTRS)

    Hu, Hua; Liu, W. Timothy

    1998-01-01

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

  11. The 6 Minute Walk Test and Performance of Upper Limb in Ambulant Duchenne Muscular Dystrophy Boys

    PubMed Central

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Fanelli, Lavinia; De Sanctis, Roberto; D’Amico, Adele; Messina, Sonia; Battini, Roberta; Bianco, Flaviana; Scutifero, Marianna; Petillo, Roberta; Frosini, Silvia; Scalise, Roberta; Vita, Gian Luca; Bruno, Claudio; Pedemonte, Marina; Mongini, Tiziana; Pegoraro, Elena; Brustia, Francesca; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Busato, Fabio; Bonfiglio, Serena; Rolle, Enrica; Colia, Giulia; Bonetti, Annamaria; Palermo, Concetta; Graziano, Alessandra; D’Angelo, Grazia; Pini, Antonella; Corlatti, Alice; Gorni, Ksenija; Baranello, Giovanni; Antonaci, Laura; Bertini, Enrico; Politano, Luisa; Mercuri, Eugenio

    2014-01-01

    The Performance of Upper Limb (PUL) test was specifically developed for the assessment of upper limbs in Duchenne muscular dystrophy (DMD). The first published data have shown that early signs of involvement can also be found in ambulant DMD boys. The aim of this longitudinal Italian multicentric study was to evaluate the correlation between the 6 Minute Walk Test (6MWT) and the PUL in ambulant DMD boys. Both 6MWT and PUL were administered to 164 ambulant DMD boys of age between 5.0 and 16.17 years (mean 8.82). The 6 minute walk distance (6MWD) ranged between 118 and 557 (mean: 376.38, SD: 90.59). The PUL total scores ranged between 52 and 74 (mean: 70.74, SD: 4.66). The correlation between the two measures was 0.499. The scores on the PUL largely reflect the overall impairment observed on the 6MWT but the correlation was not linear. The use of the PUL appeared to be less relevant in the very strong patients with 6MWD above 400 meters, who, with few exceptions had near full scores. In patients with lower 6MWD the severity of upper limb involvement was more variable and could not always be predicted by the 6MWD value or by the use of steroids. Our results confirm that upper limb involvement can already be found in DMD boys even in the ambulant phase. PMID:25642376

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

    PubMed

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

    2013-07-01

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

  13. Predictive classification of self-paced upper-limb analytical movements with EEG.

    PubMed

    Ibáñez, Jaime; Serrano, J I; Del Castillo, M D; Minguez, J; Pons, J L

    2015-11-01

    The extent to which the electroencephalographic activity allows the characterization of movements with the upper limb is an open question. This paper describes the design and validation of a classifier of upper-limb analytical movements based on electroencephalographic activity extracted from intervals preceding self-initiated movement tasks. Features selected for the classification are subject specific and associated with the movement tasks. Further tests are performed to reject the hypothesis that other information different from the task-related cortical activity is being used by the classifiers. Six healthy subjects were measured performing self-initiated upper-limb analytical movements. A Bayesian classifier was used to classify among seven different kinds of movements. Features considered covered the alpha and beta bands. A genetic algorithm was used to optimally select a subset of features for the classification. An average accuracy of 62.9 ± 7.5 % was reached, which was above the baseline level observed with the proposed methodology (30.2 ± 4.3 %). The study shows how the electroencephalography carries information about the type of analytical movement performed with the upper limb and how it can be decoded before the movement begins. In neurorehabilitation environments, this information could be used for monitoring and assisting purposes. PMID:25980505

  14. [Failure of upper limb macro-implantations: surgery and outcome. 11 cases].

    PubMed

    Houzé de l'Aulnoit, S; Schoofs, M; Leps, P; Auvray, G

    2001-04-01

    The failure of macro-implantation of the upper limb must not be considered as the end of a therapeutic method, but instead as a step in the functional rehabilitation of the upper limb. From a group of 24 patients that have been operated with a macro-implantation of the upper limb, we have seen 11 patients for who the reimplantation had failed. We have studied the surgical procedure of those failures, the mid-term evolution (prosthesis and operations), and a long-term evolution with the functional future of those patients. A surgical procedure with latissimus dorsi flap was necessary in six cases, in one hand to maintain a sufficient length of the stump for prosthesis and the other hand to preserve the articulation of the elbow. Nine patients on 11 were able to be "apparated" by a myoelectric prosthesis for the amputation below the elbow (seven cases), by prosthesis for the amputation above the elbow (two cases). On a long period of time (average time 51 months) only four patients had a permanent use of their prosthesis (myoelectric type). For us, the functional rehabilitation of the upper limb need two important elements: first a good quality of the stump with a sufficient length, and second an important motivation from the patient to live with his "new hand". PMID:11340941

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

    PubMed Central

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

    2014-01-01

    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

  16. Estimation of sex from the upper limb measurements of Sudanese adults.

    PubMed

    Ahmed, Altayeb Abdalla

    2013-11-01

    Sex estimation is the first biological attribute needed for personal identification from mutilated and amputated limbs or body parts in medical-legal autopsies. Populations have different sizes and proportions that affect the anthropometric assessment of sex. Relatively few published works assess the accuracy of sex estimation from soft tissue measurements of upper limb parts, except for the hand and its components, but these studies involve a limited range of global populations. The current study aimed to assess the degree of sexual dimorphism in upper limb measurements and the accuracy of using these measurements for sex estimation in a contemporary adult Sudanese population. The upper arm length, ulnar length, wrist breadth, hand length, and hand breadth of 240 right-handed Sudanese subjects (120 males and 120 females) aged between 25 and 30 years were measured by international anthropometric standards. Demarking points, sexual dimorphism indices and discriminant functions were developed from 200 subjects (100 males and 100 females) who composed the study group. All variables were sexually dimorphic. The ulnar length, wrist breadth and hand breadth significantly contributed to sex estimation. Forearm dimensions showed a higher accuracy for sex estimation than hand dimensions. Cross-validated sex classification accuracy ranged between 78.5% and 89.5%. The reliability of these standards was assessed in a test sample of 20 males and 20 females, and the results showed accuracy between 77.5% and 90%. This study provides new forensic standards for sex estimation from upper limb measurements of Sudanese adults. PMID:24237816

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

    PubMed Central

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

    2013-01-01

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

  18. IN-VIVO ESTIMATION OF UNKNOWN UPPER-LIMB KINEMATIC PARAMETERS

    E-print Network

    Krovi, Venkat

    prescribed movement patterns to create a sensitive and quantitative assessment/diagnostic tool. In this paper impairment. Current functional assessment methods involve clinician/therapist based evaluation the functional recovery of people with Upper Limb (UL) dysfunction. Our framework, implemented in the form

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    SciTech Connect

    Madaric, Juraj; Klepanec, Andrej; Mistrik, Martin; Altaner, Cestmir; Vulev, Ivan

    2013-04-15

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

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

    NASA Astrophysics Data System (ADS)

    Neri, Gianluca; Zolesi, Valfredo

    2000-01-01

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

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

    PubMed

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

    1994-10-01

    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 had its own distinct identity. Our results indicated the presence of a previously undetected fast myosin heavy chain isoform in the oro-facial type II fibre population, tentatively termed 'fast F'. The masseter contained aberrant myosin isoforms, such as foetal myosin heavy chain and alpha-cardiac myosin heavy chain and unique combinations of myosin heavy chain isoforms which were not found in the limb or oro-facial muscles. The type IM and IIC fibres coexpressed slow and fast A myosin heavy chains in the oro-facial and limb muscles but slow and a fast B like myosin heavy chain in the masseter. While single oro-facial and limb muscle fibres contained one or two myosin heavy chain types, single masseter fibres coexpressed up to four different myosin heavy chain isoforms. Describing the fibres according to their expression of myosin heavy chain isozymes, up to five fibre types could be distinguished in the oro-facial and limb muscles and eight in the masseter. Oro-facial and limb muscles expressed five myosin light chains, MLC1S, MLC2S, MLC1F, MLC2F and MLC3F, and the masseter four, MLC1S, MLC2S, MLC1F, and, in addition, an embryonic myosin light chain, MLC1emb, which is usually not present in normal adult skeletal muscle. These results probably reflect the way the muscles have evolved to meet the specialized functional requirements imposed upon them and are in agreement with the previously proposed concept that jaw and limb muscles belong to two distinct allotypes. PMID:7860700

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

    NASA Technical Reports Server (NTRS)

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

    1988-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  6. Normative Data for an Instrumental Assessment of the Upper-Limb Functionality

    PubMed Central

    Caimmi, Marco; Guanziroli, Eleonora; Malosio, Matteo; Pedrocchi, Nicola; Vicentini, Federico; Molinari Tosatti, Lorenzo; Molteni, Franco

    2015-01-01

    Upper-limb movement analysis is important to monitor objectively rehabilitation interventions, contributing to improving the overall treatments outcomes. Simple, fast, easy-to-use, and applicable methods are required to allow routinely functional evaluation of patients with different pathologies and clinical conditions. This paper describes the Reaching and Hand-to-Mouth Evaluation Method, a fast procedure to assess the upper-limb motor control and functional ability, providing a set of normative data from 42 healthy subjects of different ages, evaluated for both the dominant and the nondominant limb motor performance. Sixteen of them were reevaluated after two weeks to perform test-retest reliability analysis. Data were clustered into three subgroups of different ages to test the method sensitivity to motor control differences. Experimental data show notable test-retest reliability in all tasks. Data from older and younger subjects show significant differences in the measures related to the ability for coordination thus showing the high sensitivity of the method to motor control differences. The presented method, provided with control data from healthy subjects, appears to be a suitable and reliable tool for the upper-limb functional assessment in the clinical environment. PMID:26539500

  7. A Neuroanatomical Framework for Upper Limb Synergies after Stroke

    PubMed Central

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

    2015-01-01

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

  8. Upper Limb Biomechanics During the Volleyball Serve and Spike

    PubMed Central

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

    2010-01-01

    Background: The shoulder is the third-most commonly injured body part in volleyball, with the majority of shoulder problems resulting from chronic overuse. Hypothesis: Significant kinetic differences exist among specific types of volleyball serves and spikes. Study Design: Controlled laboratory study. Methods: Fourteen healthy female collegiate volleyball players performed 5 successful trials of 4 skills: 2 directional spikes, an off-speed roll shot, and the float serve. Volunteers who were competent in jump serves (n, 5) performed 5 trials of that skill. A 240-Hz 3-dimensional automatic digitizing system captured each trial. Multivariate analysis of variance and post hoc paired t tests were used to compare kinetic parameters for the shoulder and elbow across all the skills (except the jump serve). A similar statistical analysis was performed for upper extremity kinematics. Results: Forces, torques, and angular velocities at the shoulder and elbow were lowest for the roll shot and second-lowest for the float serve. No differences were detected between the cross-body and straight-ahead spikes. Although there was an insufficient number of participants to statistically analyze the jump serve, the data for it appear similar to those of the cross-body and straight-ahead spikes. Shoulder abduction at the instant of ball contact was approximately 130° for all skills, which is substantially greater than that previously reported for female athletes performing tennis serves or baseball pitches. Conclusion: Because shoulder kinetics were greatest during spiking, the volleyball player with symptoms of shoulder overuse may wish to reduce the number of repetitions performed during practice. Limiting the number of jump serves may also reduce the athlete’s risk of overuse-related shoulder dysfunction. Clinical Relevance: Volleyball-specific overhead skills, such as the spike and serve, produce considerable upper extremity force and torque, which may contribute to the risk of shoulder injury. PMID:23015961

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

    PubMed

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

    1991-01-01

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

  10. Comparison of sEMG-Based Feature Extraction and Motion Classification Methods for Upper-Limb Movement.

    PubMed

    Guo, Shuxiang; Pang, Muye; Gao, Baofeng; Hirata, Hideyuki; Ishihara, Hidenori

    2015-01-01

    The surface electromyography (sEMG) technique is proposed for muscle activation detection and intuitive control of prostheses or robot arms. Motion recognition is widely used to map sEMG signals to the target motions. One of the main factors preventing the implementation of this kind of method for real-time applications is the unsatisfactory motion recognition rate and time consumption. The purpose of this paper is to compare eight combinations of four feature extraction methods (Root Mean Square (RMS), Detrended Fluctuation Analysis (DFA), Weight Peaks (WP), and Muscular Model (MM)) and two classifiers (Neural Networks (NN) and Support Vector Machine (SVM)), for the task of mapping sEMG signals to eight upper-limb motions, to find out the relation between these methods and propose a proper combination to solve this issue. Seven subjects participated in the experiment and six muscles of the upper-limb were selected to record sEMG signals. The experimental results showed that NN classifier obtained the highest recognition accuracy rate (88.7%) during the training process while SVM performed better in real-time experiments (85.9%). For time consumption, SVM took less time than NN during the training process but needed more time for real-time computation. Among the four feature extraction methods, WP had the highest recognition rate for the training process (97.7%) while MM performed the best during real-time tests (94.3%). The combination of MM and NN is recommended for strict real-time applications while a combination of MM and SVM will be more suitable when time consumption is not a key requirement. PMID:25894941

  11. Comparison of sEMG-Based Feature Extraction and Motion Classification Methods for Upper-Limb Movement

    PubMed Central

    Guo, Shuxiang; Pang, Muye; Gao, Baofeng; Hirata, Hideyuki; Ishihara, Hidenori

    2015-01-01

    The surface electromyography (sEMG) technique is proposed for muscle activation detection and intuitive control of prostheses or robot arms. Motion recognition is widely used to map sEMG signals to the target motions. One of the main factors preventing the implementation of this kind of method for real-time applications is the unsatisfactory motion recognition rate and time consumption. The purpose of this paper is to compare eight combinations of four feature extraction methods (Root Mean Square (RMS), Detrended Fluctuation Analysis (DFA), Weight Peaks (WP), and Muscular Model (MM)) and two classifiers (Neural Networks (NN) and Support Vector Machine (SVM)), for the task of mapping sEMG signals to eight upper-limb motions, to find out the relation between these methods and propose a proper combination to solve this issue. Seven subjects participated in the experiment and six muscles of the upper-limb were selected to record sEMG signals. The experimental results showed that NN classifier obtained the highest recognition accuracy rate (88.7%) during the training process while SVM performed better in real-time experiments (85.9%). For time consumption, SVM took less time than NN during the training process but needed more time for real-time computation. Among the four feature extraction methods, WP had the highest recognition rate for the training process (97.7%) while MM performed the best during real-time tests (94.3%). The combination of MM and NN is recommended for strict real-time applications while a combination of MM and SVM will be more suitable when time consumption is not a key requirement. PMID:25894941

  12. An analysis on muscle tone of lower limb muscles on flexible flat foot

    PubMed Central

    Um, Gi-Mai; Wang, Joong-San; Park, Si-Eun

    2015-01-01

    [Purpose] The aim of this study was to examine differences in the muscle tone and stiffness of leg muscles according to types of flexible flat foot. [Subjects and Methods] For 30 subjects 10 in a normal foot group (NFG), 10 in group with both flexible flat feet (BFFG), and 10 in a group with flexible flat feet on one side (OFFG), myotonometry was used to measure the muscle tone and stiffness of the tibialis anterior muscle (TA), the rectus femoris muscle (RF), the medial gastrocnemius (MG), and the long head of the biceps femoris muscle (BF) of both lower extremities. [Results] In the measurement results, only the stiffness of TA and MG of the NFG and the BFFG showed significant differences. The muscle tone and stiffness were highest in the BFFG, followed by the OFFG and NFG, although the difference was insignificant. In the case of the OFFG, there was no significant difference in muscle tone and stiffness compared to that in the NGF and the BFFG. Furthermore, in the NFG, the non-dominant leg showed greater muscle tone and stiffness than the dominant leg, although the difference was insignificant. [Conclusion] During the relax condition, the flexible flat foot generally showed a greater muscle tone and stiffness of both lower extremities compared to the normal foot. The stiffness was particularly higher in the TA and MG muscles. Therefore, the muscle tone and stiffness of the lower extremity muscles must be considered in the treatment of flat foot. PMID:26644650

  13. An analysis on muscle tone of lower limb muscles on flexible flat foot.

    PubMed

    Um, Gi-Mai; Wang, Joong-San; Park, Si-Eun

    2015-10-01

    [Purpose] The aim of this study was to examine differences in the muscle tone and stiffness of leg muscles according to types of flexible flat foot. [Subjects and Methods] For 30 subjects 10 in a normal foot group (NFG), 10 in group with both flexible flat feet (BFFG), and 10 in a group with flexible flat feet on one side (OFFG), myotonometry was used to measure the muscle tone and stiffness of the tibialis anterior muscle (TA), the rectus femoris muscle (RF), the medial gastrocnemius (MG), and the long head of the biceps femoris muscle (BF) of both lower extremities. [Results] In the measurement results, only the stiffness of TA and MG of the NFG and the BFFG showed significant differences. The muscle tone and stiffness were highest in the BFFG, followed by the OFFG and NFG, although the difference was insignificant. In the case of the OFFG, there was no significant difference in muscle tone and stiffness compared to that in the NGF and the BFFG. Furthermore, in the NFG, the non-dominant leg showed greater muscle tone and stiffness than the dominant leg, although the difference was insignificant. [Conclusion] During the relax condition, the flexible flat foot generally showed a greater muscle tone and stiffness of both lower extremities compared to the normal foot. The stiffness was particularly higher in the TA and MG muscles. Therefore, the muscle tone and stiffness of the lower extremity muscles must be considered in the treatment of flat foot. PMID:26644650

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

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2008-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-12-01

    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.

  17. Cumulative trauma disorders of the upper limbs in workers on an agricultural farm.

    PubMed

    Raffi, G B; Lodi, V; Malenchini, G; Missere, M; Naldi, M; Tabanelli, S; Violante, F; Minak, G J; D'elia, V; Montesi, M

    1996-03-01

    The work associated with repetitive efforts and inadequate resting periods, strong physical exertion, awkward postures or static positioning exposes workers to the risk of cumulative trauma disorders of the upper limbs. These risk factors are present in many agricultural activities. A study was carried out among workers on an agricultural farm. The workers' histories were taken and they were given periodical medical check-ups. The presence of upper limb disorders was shown in a group of workers. A sample of 42 people was selected for the study by means of specific tests: electromyography, ultrasonography and laser-doppler flowmetry. The tests showed a high incidence of carpal tunnel syndrome and microcirculation disorders. The study confirmed that electromyography, ultrasonography and/or laser-doppler flowmetry are highly useful tools for identifying cumulative trauma disorders. PMID:8768444

  18. A Case of Upper Limb Compartment Syndrome following Snake Envenomation: Measure Twice, Cut Once.

    PubMed

    Thomas, D K; Budhoo, E J; Mencia, M M; Ali, T F; Santana, D

    2014-08-01

    We report a case of a 16-year old male patient who sustained a poisonous bite from a mapepire balsain snake on the dorsum of his left hand. The subject presented within one hour of envenomation and subsequently developed clinical features of acute compartment syndrome in the involved upper limb. Early diagnosis and emergency fasciotomy effectively treated his condition. Aggressive physiotherapy coupled with this ensured best functional outcome. PMID:25429488

  19. A Case of Upper Limb Compartment Syndrome following Snake Envenomation Measure Twice, Cut Once

    PubMed Central

    Thomas, DK; Budhoo, EJ; Mencia, MM; Ali, TF; Santana, D

    2014-01-01

    We report a case of a 16-year old male patient who sustained a poisonous bite from a mapepire balsain snake on the dorsum of his left hand. The subject presented within one hour of envenomation and subsequently developed clinical features of acute compartment syndrome in the involved upper limb. Early diagnosis and emergency fasciotomy effectively treated his condition. Aggressive physiotherapy coupled with this ensured best functional outcome. PMID:25429488

  20. Risk of upper limb injury in left handed children: a study in Greece

    PubMed Central

    Skalkidou, A.; Petridou, E.; Dessypris, N.; Karanikas, E.; Pistevos, G.; Trichopoulos, D.

    1999-01-01

    Setting—Athens, Greece, during a six month period in 1995–96. Methods—Cases were 129 children 4–14 years old with unintentional upper limb injuries from a population based injury database. Two control children matched for gender and age were selected from among those seen at the same medical institution for minor, non-injury ailments. On the basis of information provided by the children and their guardians, sociodemographic variables were recorded, hand preference was assessed, and each child's activity score was calculated through an abbreviated version of Achenbach's scale. Results—Left handed children have a moderately increased upper limb injury risk with a tendency of recurrence of this injury. The risk of upper limb injury is also raised among children of young fathers, whereas it appears to be inversely related to crowding index and activity score—three variables that were controlled for as potential confounders. Conclusions—This study provides limited support for the hypothesis that left handed children are at increased risk for injury. The excess risk, if genuine, is likely to be limited to cultural settings in which right handedness is perceived as the norm. PMID:10323575

  1. The Importance of Technical Devices in the Self-care of Upper Limbs Amputees.

    PubMed

    Mészáros, Gabriella; Vén, Ildikó

    2015-01-01

    The National Institute of Medical Rehabilitation (NIMR) is engaged in the rehabilitation of posttraumatic patients, including also attending traumatic cases with amputated upper limbs. The lack of upper limbs is a great obstacle in essential functioning for the injured, and that is why we give high priority to planning, constructing and individually adopting appliances for aiding everyday life. Special literature gives distinguished attention to operative techniques and the possibilities of prosthetic devices, but no professional articles present any special devices needed for discharging everyday vital functions. The purpose of this lecture is to present the results of our follow-up examination aimed at upper limbs amputees reeducated since 1994 at the NIMR (9 patients). Case studies conclude that the prosthetic care plays a surprisingly small part in the self-sufficiency of the injured. Claims to individual appliances are already more considerable but these cannot be obtained in normal commerce because of unprofitable production in view of users so few in number. PMID:26294571

  2. Sexual dimorphism in directional asymmetry of the upper limb bones among Khoe-San skeletons.

    PubMed

    Waidhofer, M; Kirchengast, S

    2015-12-01

    Right side-biased directional asymmetries in upper limb bones are described for non-human primates, modern humans and also for historical populations. According to numerous studies the degree of bilateral asymmetries varies by sex, possibly due to sex-typical labor division. The present study focused on sexual dimorphism in bilateral asymmetries of the upper limb bones among a historical Khoe-San skeletal sample, the Pöch Collection housed at the Department of Anthropology at the University of Vienna. Forty metric dimensions of humeri, ulnae, radii and clavicles of 83 adult Khoe-San individuals were measured. Directional and absolute asymmetries of each measurement were calculated. With the exception of maximal clavicle length, a significant right-biased asymmetry could be documented for both sexes. Regarding sex differences, it could be shown that a markedly greater percentage of right side dominant asymmetry of humerus length and upper limb length was found among females, while male skeletons exhibited a significantly greater percentage of absolute asymmetry in breadth and circumference dimensions, indicating a greater asymmetry in traits of robustness. These sex differences can be interpreted as a result of sex-typical labor division in this traditional historical population. PMID:26342439

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

    PubMed

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

    2014-01-01

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

  4. Action observation for upper limb function after stroke: evidence-based review of randomized controlled trials

    PubMed Central

    Kim, KyeongMi

    2015-01-01

    [Purpose] The purpose of this study was to suggest evidenced information about action observation to improve upper limb function after stroke. [Methods] A systematic review of randomized controlled trials involving adults aged 18?years or over and including descriptions of action observation for improving upper limb function was undertaken. Electronic databases were searched, including MEDLINE, CINAHL, and PEDro (the Physiotherapy Evidence Database), for articles published between 2000 to 2014. Following completion of the searches, two reviewers independently assessed the trials and extracted data using a data extraction form. The same two reviewers independently documented the methodological quality of the trials by using the PEDro scale. [Results] Five randomized controlled trials were ultimately included in this review, and four of them (80%) reported statistically significant effects for motor recovery of upper limb using action observation intervention in between groups. [Conclusion] This review of the literature presents evidence attesting to the benefits conferred on stroke patints resulting from participation in an action observation intervention. The body of literature in this field is growing steadily. Further work needs to be done to evaluate the evidence for different conditions after stroke and different duration of intervention. PMID:26644700

  5. A Framework to Automate Assessment of Upper-Limb Motor Function Impairment: A Feasibility Study

    PubMed Central

    Otten, Paul; Kim, Jonghyun; Son, Sang Hyuk

    2015-01-01

    Standard upper-limb motor function impairment assessments, such as the Fugl-Meyer Assessment (FMA), are a critical aspect of rehabilitation after neurological disorders. These assessments typically take a long time (about 30 min for the FMA) for a clinician to perform on a patient, which is a severe burden in a clinical environment. In this paper, we propose a framework for automating upper-limb motor assessments that uses low-cost sensors to collect movement data. The sensor data is then processed through a machine learning algorithm to determine a score for a patient’s upper-limb functionality. To demonstrate the feasibility of the proposed approach, we implemented a system based on the proposed framework that can automate most of the FMA. Our experiment shows that the system provides similar FMA scores to clinician scores, and reduces the time spent evaluating each patient by 82%. Moreover, the proposed framework can be used to implement customized tests or tests specified in other existing standard assessment methods. PMID:26287206

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

    PubMed Central

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

    2014-01-01

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

  7. A Framework to Automate Assessment of Upper-Limb Motor Function Impairment: A Feasibility Study.

    PubMed

    Otten, Paul; Kim, Jonghyun; Son, Sang Hyuk

    2015-01-01

    Standard upper-limb motor function impairment assessments, such as the Fugl-Meyer Assessment (FMA), are a critical aspect of rehabilitation after neurological disorders. These assessments typically take a long time (about 30 min for the FMA) for a clinician to perform on a patient, which is a severe burden in a clinical environment. In this paper, we propose a framework for automating upper-limb motor assessments that uses low-cost sensors to collect movement data. The sensor data is then processed through a machine learning algorithm to determine a score for a patient's upper-limb functionality. To demonstrate the feasibility of the proposed approach, we implemented a system based on the proposed framework that can automate most of the FMA. Our experiment shows that the system provides similar FMA scores to clinician scores, and reduces the time spent evaluating each patient by 82%. Moreover, the proposed framework can be used to implement customized tests or tests specified in other existing standard assessment methods. PMID:26287206

  8. Response to upper-limb robotics and functional neuromuscular stimulation following stroke.

    PubMed

    Daly, Janis J; Hogan, Neville; Perepezko, Elizabeth M; Krebs, Hermano I; Rogers, Jean M; Goyal, Kanu S; Dohring, Mark E; Fredrickson, Eric; Nethery, Joan; Ruff, Robert L

    2005-01-01

    Twelve moderately to severely involved chronic stroke survivors (>12 mo) were randomized to one of two treatments: robotics and motor learning (ROB-ML) or functional neuromuscular stimulation and motor learning (FNS-ML). Treatment was 5 h/d, 5 d/wk for 12 wk. ROB-ML group had 1.5 h per session devoted to robotics shoulder and elbow (S/E) training. FNS-ML had 1.5 h per session devoted to functional neuromuscular stimulation (surface electrodes) for wrist and hand (W/H) flexors/extensors. The primary outcome measure was the functional measure Arm Motor Ability Test (AMAT). Secondary measures were AMAT-S/E and AMAT-W/H, Fugl-Meyer (FM) upper-limb coordination, and the motor control measures of target accuracy (TA) and smoothness of movement (SM). ROB-ML produced significant gains in AMAT, AMAT-S/E, FM upper-limb coordination, TA, and SM. FNS-ML produced significant gains in AMAT-W/H and FM upper-limb coordination. PMID:16680610

  9. Design of a wrist and gripping mechanism for an upper limb prosthesis specifically for the game of golf

    E-print Network

    Yoder, Michael D

    2009-01-01

    An upper limb prosthesis used for the game of golf was designed. More specifically, the wrist and gripping mechanism was designed. The motivating factor behind his project was to improve a player's ability to make a smooth, ...

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

    PubMed

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

    2014-11-01

    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. PMID:25371469

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  12. Central Sensitization and Perceived Indoor Climate among Workers with Chronic Upper-Limb Pain: Cross-Sectional Study

    PubMed Central

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

    2015-01-01

    Monitoring of indoor climate is an essential part of occupational health and safety. While questionnaires are commonly used for surveillance, not all workers may perceive an identical indoor climate similarly. The aim of this study was to evaluate perceived indoor climate among workers with chronic pain compared with pain-free colleagues and to determine the influence of central sensitization on this perception. Eighty-two male slaughterhouse workers, 49 with upper-limb chronic pain and 33 pain-free controls, replied to a questionnaire with 13 items of indoor climate complaints. Pressure pain threshold (PPT) was measured in muscles of the arm, shoulder, and lower leg. Cross-sectional associations were determined using general linear models controlled for age, smoking, and job position. The number of indoor climate complaints was twice as high among workers with chronic pain compared with pain-free controls (1.8 [95% CI: 1.3–2.3] versus 0.9 [0.4–1.5], resp.). PPT of the nonpainful leg muscle was negatively associated with the number of complaints. Workers with chronic pain reported more indoor climate complaints than pain-free controls despite similar actual indoor climate. Previous studies that did not account for musculoskeletal pain in questionnaire assessment of indoor climate may be biased. Central sensitization likely explains the present findings. PMID:26425368

  13. The influence of wheelchair propulsion technique on upper extremity muscle demand: A simulation study

    E-print Network

    increased average muscle stress. Maximizing contact angle increased muscle stress and had the highest muscleThe influence of wheelchair propulsion technique on upper extremity muscle demand: A simulation influence individual muscle demand. Methods: Forward dynamics simulations of wheelchair propulsion were

  14. Reliability and sensitivity of a simple isometric posterior lower limb muscle test in professional football players.

    PubMed

    McCall, Alan; Nedelec, Mathieu; Carling, Christopher; Le Gall, Franck; Berthoin, Serge; Dupont, Gregory

    2015-01-01

    This study aimed (1) to determine the reliability of a simple and quick test to assess isometric posterior lower limb muscle force in professional football players and (2) verify its sensitivity to detect reductions in force following a competitive match. Twenty-nine professional football players performed a 3-s maximal isometric contraction of the posterior lower limb muscles for both legs with players lying supine. Both legs were tested using a knee angle of 90° and 30° measured on a force plate. Players were tested twice with one week between sessions to verify reliability. Sensitivity was tested following a full competitive football match. The test showed high reliability for dominant leg at 90° (CV = 4.3%, ICC = 0.95, ES = 0.15), non-dominant leg at 90° (CV = 5.4%, ICC = 0.95, ES = 0.14), and non-dominant leg at 30° (CV = 4.8%, ICC = 0.93, ES = 0.30) and good reliability for dominant leg at 30° (CV = 6.3%, ICC = 0.86, ES = 0.05). The measure was sensitive enough to detect reductions in force for dominant leg at 90° (P = 0.0006, ES > 1), non-dominant leg at 90° (P = 0.0142, ES = 1), and non-dominant leg at 30° (P = 0.0064, ES > 1) and for dominant leg at 30° (P = 0.0016, ES > 1). In conclusion, the present test represents a useful and practical field tool to determine the magnitude of match-induced fatigue of the posterior lower limb muscles and potentially to track their recovery. PMID:25845799

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

    PubMed Central

    2014-01-01

    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

  16. Correlation between upper limb function and oral health impact in stroke survivors

    PubMed Central

    da Silva, Fernanda C.; da Silva, Daniela F. T.; Mesquita-Ferrari, Raquel A.; Fernandes, Kristianne P. S.; Bussadori, Sandra K.

    2015-01-01

    [Purpose] The aim of the present study was to evaluate the relationship between upper limb impairment and oral health impact in individuals with hemiparesis stemming from a stroke. [Subjects and Methods] The study subjects were conducted with a sample of 27 stroke survivors with complete or partial hemiparesis with brachial or crural predominance. The 14-item short version of the Oral Health Impact Profile was used to evaluate perceptions of oral health. The Brazilian version of the Stroke Specific Quality of Life Scale was used to evaluate perceptions regarding quality of life. [Results] A statistically significant association was found between the upper extremity function subscale of the SSQOL-Brazil and the impact of oral health evaluated using the OHIP-14, with a strong correlation found for the physical pain subscale, moderate correlations with the functional limitation, psychological discomfort, physical disability, social disability and social handicap subscales as well as a weak correlation with the psychological disability subscale. Analyzing the OHIP-14 scores with regard to the impact of oral health on quality of life, the most frequent classification was weak impact, with small rates of moderate and strong impact. [Conclusion] Compromised upper limb function and self-perceived poor oral health, whether due to cultural resignation or functional disability, exert a negative impact on the quality of life of individuals with hemiparesis stemming from a stroke. PMID:26310352

  17. Muscle tone changes in the lower limbs of stroke patients induced by trunk stabilization exercises

    PubMed Central

    Rhee, Min-Hyung; Kim, Laurentius Jongsoon

    2015-01-01

    bstract. [Purpose] The purpose of this study was to identify the effects of trunk stabilization exercises on the spasticity of the lower limbs in stroke patients. [Subject] The subject of this study was a 38-year-old male patient who experienced a spontaneous intracranial hemorrhage, and had motor paralysis symptoms and spasticity on the left side. [Methods] The Hmax/Mmax ratio was measured before and after the trunk stabilization exercises, by using proprioceptive neuromuscular facilitation techniques. [Results] The Hmax/Mmax ratio changed from 37% to 20%. [Conclusion] Trunk stabilization exercises help control the muscle tone in stroke patients. PMID:26357455

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

    PubMed Central

    Schultz, Aimee E.; Kuiken, Todd A.

    2009-01-01

    Targeted reinnervation is a new neural-machine interface that has been developed to help improve the function of new-generation prosthetic limbs. Targeted reinnervation is a surgical procedure that takes the nerves that once innervated a severed limb and redirects them to proximal muscle and skin sites. The sensory afferents of the redirected nerves reinnervate the skin overlying the transfer site. This creates a sensory expression of the missing limb in the amputee's reinnervated skin. When these individuals are touched on this reinnervated skin they feel as though they are being touched on their missing limb. Targeted reinnervation takes nerves that once served the hand, a skin region of high functional importance, and redirects them to less functionally relevant skin areas adjacent to the amputation site. In an effort to better understand the sensory capacity of the reinnervated target skin following this procedure, we examined grating orientation thresholds and point localization thresholds on two amputees who had undergone the targeted reinnervation surgery. Grating orientation thresholds and point localization thresholds were also measured on the contralateral normal skin of the targeted reinnervation amputees and on analogous sites in able-bodied controls. Grating orientation thresholds for the reinnervated skin of the targeted reinnervation amputees were found to be similar to normal ranges for both the amputees’ contralateral skin and also for the control population. Point localization thresholds for these amputees were found to be lower for their reinnervated skin than for their contralateral skin. Reinnervated point localization thresholds values were also lower in comparison to homologous chest sites on the control population. Mechanisms appear to be in place to maximize re-established touch input in targeted reinnervation amputees. It seems that sound sensory function is provided to the denervated skin of the residual limb when connected to afferent pathways once serving highly functionally relevant regions of the brain. This suggests that tactile interface devices could be used to give a physiologically appropriate sense of touch to a prosthetic limb, which would likely help with better functional utilization of the prosthetic device and possibly help to more effectively integrate the device with the user's self-image. PMID:19369486

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

    PubMed

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

    2013-11-01

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

  20. Upper limb reinnervation in C6 tetraplegia using a triple nerve transfer: case report.

    PubMed

    van Zyl, Natasha; Hahn, Jodie B; Cooper, Catherine A; Weymouth, Michael D; Flood, Stephen J; Galea, Mary P

    2014-09-01

    Restoration of elbow extension, grasp, key pinch, and release are major goals in low-level tetraplegia. Traditionally, these functions are achieved using tendon transfers. In this case these goals were achieved using nerve transfers. We present a 21-year-old man with a C6 level of tetraplegia. The left upper limb was treated 6 months after injury with a triple nerve transfer. A teres minor nerve branch to long head of triceps nerve branch, brachialis nerve branch to anterior interosseous nerve, and supinator nerve branch to posterior interosseous nerve transfer were used successfully to reconstruct elbow extension, key pinch, grasp, and release simultaneously. PMID:25063391

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

    NASA Astrophysics Data System (ADS)

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

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

  2. Inverse dynamics modelling of upper-limb tremor, with cross-correlation analysis

    PubMed Central

    Ketteringham, Laurence P.; Neild, Simon A.; Hyde, Richard A.; Jones, Rosie J.S.; Davies-Smith, Angela M.

    2014-01-01

    A method to characterise upper-limb tremor using inverse dynamics modelling in combination with cross-correlation analyses is presented. A 15 degree-of-freedom inverse dynamics model is used to estimate the joint torques required to produce the measured limb motion, given a set of estimated inertial properties for the body segments. The magnitudes of the estimated torques are useful when assessing patients or evaluating possible intervention methods. The cross-correlation of the estimated joint torques is proposed to gain insight into how tremor in one limb segment interacts with tremor in another. The method is demonstrated using data from a single patient presenting intention tremor because of multiple sclerosis. It is shown that the inertial properties of the body segments can be estimated with sufficient accuracy using only the patient's height and weight as a priori knowledge, which ensures the method's practicality and transferability to clinical use. By providing a more detailed, objective characterisation of patient-specific tremor properties, the method is expected to improve the selection, design and assessment of treatment options on an individual basis.

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

    PubMed Central

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

    2015-01-01

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

  4. Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT.

    PubMed

    Cluzan, R V; Alliot, F; Ghabboun, S; Pascot, M

    1996-03-01

    Fifty seven patients with secondary lymphedema of the upper limb after previous treatment for breast cancer were treated for 3 months with an extract of Ruscus + Hesperidin Methyl Chalcone (CYCLO 3 FORT) or placebo according to a double-blind protocol in the context of a controlled clinical trial. All patients also underwent manual lymphatic drainage twice a week for at least one month. With CYCLO 3 FORT, the reduction in volume of arm edema, the main assessment criteria, was 12.9% after 3 months of treatment as compared with a placebo (p=0.009). Decreased edema tended to be more marked in the forearm compared with the upper arm where excess fat deposition seemed to dominate over excess fluid accumulation. CYCLO 3 FORT was well tolerated with minimal adverse reaction. PMID:8721977

  5. System identification of muscle-joint interactions of the cat hind limb during locomotion.

    PubMed

    Harischandra, Nalin; Ekeberg, Orjan

    2008-08-01

    Neurophysiological experiments in walking cats have shown that a number of neural control mechanisms are involved in regulating the movements of the hind legs during locomotion. It is experimentally hard to isolate individual mechanisms without disrupting the natural walking pattern and we therefore introduce a different approach where we use a model to identify what control is necessary to maintain stability in the musculo-skeletal system. We developed a computer simulation model of the cat hind legs in which the movements of each leg are produced by eight limb muscles whose activations follow a centrally generated pattern with no proprioceptive feedback. All linear transfer functions, from each muscle activation to each joint angle, were identified using the response of the joint angle to an impulse in the muscle activation at 65 postures of the leg covering the entire step cycle. We analyzed the sensitivity and stability of each muscle action on the joint angles by studying the gain and pole plots of these transfer functions. We found that the actions of most of the hindlimb muscles display inherent stability during stepping, even without the involvement of any proprioceptive feedback mechanisms, and that those musculo-skeletal systems are acting in a critically damped manner, enabling them to react quickly without unnecessary oscillations. We also found that during the late swing, the activity of the posterior biceps/semitendinosus (PB/ST) muscles causes the joints to be unstable. In addition, vastus lateralis (VL), tibialis anterior (TA) and sartorius (SAT) muscle-joint systems were found to be unstable during the late stance phase, and we conclude that those muscles require neuronal feedback to maintain stable stepping, especially during late swing and late stance phases. Moreover, we could see a clear distinction in the pole distribution (along the step cycle) for the systems related to the ankle joint from that of the other two joints, hip or knee. A similar pattern, i.e., a pattern in which the poles were scattered over the s-plane with no clear clustering according to the phase of the leg position, could be seen in the systems related to soleus (SOL) and TA muscles which would indicate that these muscles depend on neural control mechanisms, which may involve supraspinal structures, over the whole step cycle. PMID:18648849

  6. Botulinum toxin, physical and occupational therapy, and neuromuscular electrical stimulation to treat spastic upper limb of children with cerebral palsy: a pilot study.

    PubMed

    Rodríguez-Reyes, Gerardo; Alessi-Montero, Aldo; Díaz-Martínez, Leticia; Miranda-Duarte, Antonio; Pérez-Sanpablo, Alberto Isaac

    2010-03-01

    Spasticity has been successfully managed with different treatment modalities or combinations. No information is available on the effectiveness or individual contribution of botulinum toxin type A (BTA) combined with physical and occupational therapy and neuromuscular electrical stimulation to treat spastic upper limb. The purpose of this study was to assess the effects of such treatment and to inform sample-size calculations for a randomized controlled trial. BTA was injected into spastic upper limb muscles of 10 children. They received 10 sessions of physical and occupational therapy followed by 10 sessions of neuromuscular electrical stimulation on the wrist extensors (antagonist muscles). Degree of spasticity using the Modified Ashworth scale, active range of motion, and manual function with the Jebsen hand test, were assessed. Meaningful improvement was observed in hand function posttreatment (P = 0.03). Median spasticity showed a reduction trend and median amplitude of wrist range of motion registered an increase; however, neither of these were significant (P > 0.05). There is evidence of a beneficial effect of the combined treatment. Adequate information has been obtained on main outcome-measurement variability for calculating sample size for a subsequent study to quantify the treatment effect precisely. PMID:20447049

  7. Relationship between Lower Limb Muscle Structure and Function in Cerebral Palsy.

    PubMed

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

    2014-01-01

    [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

  8. Relationship between Lower Limb Muscle Structure and Function in Cerebral Palsy

    PubMed Central

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

    2014-01-01

    [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

  9. Normal and sonographic anatomy of selected peripheral nerves. Part II: Peripheral nerves of the upper limb.

    PubMed

    Kowalska, Berta; Sudo?-Szopi?ska, Iwona

    2012-06-01

    The ultrasonographic examination is frequently used for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive, well-tolerated by patients, and relatively inexpensive. Part I of this article series described in detail the characteristic USG picture of peripheral nerves and the proper examination technique, following the example of the median nerve. This nerve is among the most often examined peripheral nerves of the upper limb. This part presents describes the normal anatomy and ultrasound picture of the remaining large nerve branches in the upper extremity and neck - the spinal accessory nerve, the brachial plexus, the suprascapular, axillary, musculocutaneous, radial and ulnar nerves. Their normal anatomy and ultrasonographic appearance have been described, including the division into individual branches. For each of them, specific reference points have been presented, to facilitate the location of the set trunk and its further monitoring. Sites for the application of the ultrasonographic probe at each reference point have been indicated. In the case of the ulnar nerve, the dynamic component of the examination was emphasized. The text is illustrated with images of probe positioning, diagrams of the normal course of the nerves as well as a series of ultrasonographic pictures of normal nerves of the upper limb. This article aims to serve as a guide in the ultrasound examination of the peripheral nerves of the upper extremity. It should be remembered that a thorough knowledge of the area's topographic anatomy is required for this type of examination. PMID:26674017

  10. Normal and sonographic anatomy of selected peripheral nerves. Part II: Peripheral nerves of the upper limb

    PubMed Central

    Sudo?-Szopi?ska, Iwona

    2012-01-01

    The ultrasonographic examination is frequently used for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive, well-tolerated by patients, and relatively inexpensive. Part I of this article series described in detail the characteristic USG picture of peripheral nerves and the proper examination technique, following the example of the median nerve. This nerve is among the most often examined peripheral nerves of the upper limb. This part presents describes the normal anatomy and ultrasound picture of the remaining large nerve branches in the upper extremity and neck – the spinal accessory nerve, the brachial plexus, the suprascapular, axillary, musculocutaneous, radial and ulnar nerves. Their normal anatomy and ultrasonographic appearance have been described, including the division into individual branches. For each of them, specific reference points have been presented, to facilitate the location of the set trunk and its further monitoring. Sites for the application of the ultrasonographic probe at each reference point have been indicated. In the case of the ulnar nerve, the dynamic component of the examination was emphasized. The text is illustrated with images of probe positioning, diagrams of the normal course of the nerves as well as a series of ultrasonographic pictures of normal nerves of the upper limb. This article aims to serve as a guide in the ultrasound examination of the peripheral nerves of the upper extremity. It should be remembered that a thorough knowledge of the area's topographic anatomy is required for this type of examination. PMID:26674017

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

    PubMed

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

    2013-12-28

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

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

    PubMed Central

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

    2015-01-01

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

  13. Chondroitinase gene therapy improves upper limb function following cervical contusion injury.

    PubMed

    James, Nicholas D; Shea, Jessie; Muir, Elizabeth M; Verhaagen, Joost; Schneider, Bernard L; Bradbury, Elizabeth J

    2015-09-01

    Chondroitin sulphate proteoglycans (CSPGs) are known to be important contributors to the intensely inhibitory environment that prevents tissue repair and regeneration following spinal cord injury. The bacterial enzyme chondroitinase ABC (ChABC) degrades these inhibitory molecules and has repeatedly been shown to promote functional recovery in a number of spinal cord injury models. However, when used to treat more traumatic and clinically relevant spinal contusion injuries, findings with the ChABC enzyme have been inconsistent. We recently demonstrated that delivery of mammalian-compatible ChABC via gene therapy led to sustained and widespread digestion of CSPGs, resulting in significant functional repair of a moderate thoracic contusion injury in adult rats. Here we demonstrate that chondroitinase gene therapy significantly enhances upper limb function following cervical contusion injury, with improved forelimb ladder performance and grip strength as well as increased spinal conduction through the injury site and reduced lesion pathology. This is an important addition to our previous findings as improving upper limb function is a top priority for spinal injured patients. Additionally great importance is placed on replication in the spinal cord injury field. That chondroitinase gene therapy has now been shown to be efficacious in contusion models at either thoracic or cervical level is an important step in the further development of this promising therapeutic strategy towards the clinic. PMID:26044197

  14. Chondroitinase gene therapy improves upper limb function following cervical contusion injury

    PubMed Central

    James, Nicholas D.; Shea, Jessie; Muir, Elizabeth M.; Verhaagen, Joost; Schneider, Bernard L.; Bradbury, Elizabeth J.

    2015-01-01

    Chondroitin sulphate proteoglycans (CSPGs) are known to be important contributors to the intensely inhibitory environment that prevents tissue repair and regeneration following spinal cord injury. The bacterial enzyme chondroitinase ABC (ChABC) degrades these inhibitory molecules and has repeatedly been shown to promote functional recovery in a number of spinal cord injury models. However, when used to treat more traumatic and clinically relevant spinal contusion injuries, findings with the ChABC enzyme have been inconsistent. We recently demonstrated that delivery of mammalian-compatible ChABC via gene therapy led to sustained and widespread digestion of CSPGs, resulting in significant functional repair of a moderate thoracic contusion injury in adult rats. Here we demonstrate that chondroitinase gene therapy significantly enhances upper limb function following cervical contusion injury, with improved forelimb ladder performance and grip strength as well as increased spinal conduction through the injury site and reduced lesion pathology. This is an important addition to our previous findings as improving upper limb function is a top priority for spinal injured patients. Additionally great importance is placed on replication in the spinal cord injury field. That chondroitinase gene therapy has now been shown to be efficacious in contusion models at either thoracic or cervical level is an important step in the further development of this promising therapeutic strategy towards the clinic. PMID:26044197

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

    PubMed Central

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

    2005-01-01

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

  16. Inadvertent recovery in communication deficits following the upper limb mirror therapy in stroke: A case report.

    PubMed

    Arya, Kamal Narayan; Pandian, Shanta

    2014-10-01

    Broca's aphasia is the most challenging communication deficit in stroke. Left inferior frontal gyrus (IFG), a key region of the mirror-neuron system, gets lesioned in Broca's aphasia. Mirror therapy (MT), a form of action-observation, may trigger the mirror neurons. The aim of this study was to report a case of poststroke subject with Broca's aphasia, who exhibited an inadvertent and significant improvement in speech after MT for the paretic upper limb. The 20-month old stroke patient underwent MT through goal-directed tasks. He received a total absence of spontaneous speech, writing, and naming. After 45 sessions of task-based MT for the upper limb, he showed tremendous recovery in expressive communication. He had fluent and comprehensive communication; however, with a low pitch and minor pronunciation errors. He showed a substantial change (from 18/100 to 79/100) on the Communicative Effective Index, particularly, on items such as expressing emotions, one-to-one conversation, naming, and spontaneous conversation. PMID:25440208

  17. Impact of tactile function on upper limb motor function in children with Developmental Coordination Disorder.

    PubMed

    Cox, Lauren E; Harris, Elizabeth C; Auld, Megan L; Johnston, Leanne M

    2015-01-01

    This study investigated the presence of, and relationship between tactile dysfunction and upper limb motor function in children with Developmental Coordination Disorder (DCD) compared to typical developing (TD) children. Participants were 36 children aged 6-12 years. Presence of DCD (n=20) or TD (n=16) was confirmed using the Movement Assessment Battery for Children, second edition. All children participated in a comprehensive assessment of tactile registration (Semmes Weinstein Monofilaments); tactile spatial perception (Single Point Localisation (SPL) and two-point discrimination (2PD)); haptic perception (Stereognosis); speed of simple everyday manual tasks (Jebsen-Taylor Test of Hand Function (JTTHF)); and handwriting speed and accuracy (Evaluation Tool of Children's Handwriting (ETCH)). Compared to TD children, children with DCD demonstrated poorer localisation of touch in the non-dominant hand (p=0.04), slower speed of alphabet writing (p<0.05) and less legible handwriting (p<0.01), but no difference in speed of simple everyday manual tasks (JTTHF: p>0.05). Regression analysis showed that spatial tactile perception (SPL) predicted handwriting legibility (ETCH: r=0.11) and speed of functional tasks (JTTHF: r=0.33). These results suggest that tactile function, specifically single point localisation, should be a primary tactile assessment employed to determine reasons for upper limb motor difficulties experienced by children with DCD. PMID:26299639

  18. A Serious Game for Upper Limb Stroke Rehabilitation Using Biofeedback and Mirror-Neurons Based Training.

    PubMed

    Cargnin, Diego João; Cordeiro d'Ornellas, Marcos; Cervi Prado, Ana Lúcia

    2015-01-01

    Upper limb stroke rehabilitation requires early, intensive and repetitive practice to be effective. Consequently, it is often difficult to keep patients committed to their rehabilitation regimen. In addition to direct measures of rehabilitation achievable through targeted assessments, other factors can indirectly lead to rehabilitation. Current levels of integration between commodity graphics software, hardware, and body-tracking devices have provided a reliable tool to build what are referred to as serious games, focusing on the rehabilitation paradigm. More specifically, serious games can captivate and engage players for a specific purpose such as developing new knowledge or skills. This paper discusses a serious game application with a focus on upper limb rehabilitation in patients with hemiplegia or hemiparesis. The game makes use of biofeedback and mirror-neurons to enhance the patient's engagement. Results from the application of a quantitative self-report instrument to assess in-game engagement suggest that the serious game is a viable instructional approach rather than an entertaining novelty and, furthermore, demonstrates the future potential for dual action therapy-focused games. PMID:26262069

  19. Effects of upper limb robot-assisted therapy in the rehabilitation of stroke patients

    PubMed Central

    Yoo, Doo Han; Kim, Se Yun

    2015-01-01

    [Purpose] The aim of this study was to examine the effects of upper limb robot-assisted therapy in the rehabilitation of stroke patients. [Subjects and Methods] Fifteen stroke patients with no visual or cognitive problems were enrolled. All subjects received robot-assisted therapy and comprehensive rehabilitation therapy for 30 minutes each. The experimental group received a conventional therapy and an additional half hour per weekday of robot therapy. The patients participated in a total of 20 sessions, each lasting 60 minutes (conventional therapy 30?min, robot-assisted therapy 30?min), which were held 5 days a week for 4 weeks. [Result] The patients showed a significant difference in smoothness and reach error of the point to point test, circle size and independence of the circle in the circle test, and hold deviation of the playback static test between before and after the intervention. On the other hand, no significant difference was observed in the displacement of the round dynamic test. The patients also showed significant improvement in the Fugl-Meyer Assessment and Modified Barthel Index after the intervention. [Conclusion] These kinematic factors can provide good information when analyzing the upper limb function of stroke patients in robot-assisted therapy. Nevertheless, further research on technology-based kinematic information will be necessary. PMID:25931706

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

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  1. The design of a five-degree-of-freedom powered orthosis for the upper limb.

    PubMed

    Johnson, G R; Carus, D A; Parrini, G; Scattareggia Marchese, S; Valeggi, R

    2001-01-01

    In response to the need for a sophisticated powered upper-limb orthosis for use by people with disabilities and/or limb weakness or injury, the MULOS (motorized upper-limb orthotic system) has been developed. This is a five-degree-of-freedom electrically powered device having three degrees of freedom at the shoulder, one at the elbow and one to provide pronation/supination. The shoulder mechanism consists of a serial linkage having an equivalent centre of rotation close to that of the anatomical shoulder; this is a self-contained module in which power transmission is provided by tensioned cables. The elbow and pronation/supination modules are also self-contained. The system has been designed to operate under three modes of control: 1. As an assistive robot attached directly to the arm to provide controlled movements for people with severe disability. In this case, it can be operated by a variety of control interfaces, including a specially designed five-degree-of-freedom joystick. 2. Continuous passive motion for the therapy of joints after injury. The trajectory of the joints is selected by 'walk-through' programming and can be replayed for a given number of cycles at a chosen speed. 3. As an exercise device to provide strengthening exercises for elderly people or those recovering from injury or surgery. This mode has not been fully implemented at this stage. In assistive mode, prototype testing has demonstrated that the system can provide the movements required for a range of simple tasks and, in continuous passive motion (CPM) mode, the programming system has been successfully implemented. Great attention has been paid to all aspects of safety. Future work is required to identify problems of operation, and to develop new control interfaces. PMID:11436270

  2. Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

    PubMed Central

    Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme

    2015-01-01

    Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice. PMID:26495971

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

  5. Musculoskeletal stress markers in Natufian hunter-gatherers and Neolithic farmers in the Levant: the upper limb.

    PubMed

    Eshed, Vered; Gopher, Avi; Galili, Ehud; Hershkovitz, Israel

    2004-04-01

    This paper attempts to quantify the changes in activity patterns of early farming populations in the Levant through the musculoskeletal stress markers (MSM) of the upper limb as seen in skeletal remains. The transition to an agricultural way of life resulted in higher loads on the upper limb in Neolithic populations compared to the Natufian hunter-gatherer populations that preceded them. The MSM pattern for males and females indicates a gender-based division of labor both in the Natufian and the Neolithic. It may also suggest that people in the Neolithic period were engaged in different (new) activities and occupations compared to the Natufian. PMID:15022359

  6. A Wrist and Finger Force Sensor Module for Use During Movements of the Upper Limb in Chronic Hemiparetic Stroke

    PubMed Central

    Miller, Laura C.; Ruiz-Torres, Ricardo; Stienen, Arno H. A.

    2010-01-01

    Previous studies using robotic devices that focus on the wrist/fingers following stroke provide an incomplete picture of movement dysfunction because they do not consider the abnormal joint torque coupling that occurs during progressive shoulder abduction loading in the paretic upper limb. This letter introduces a device designed to measure isometric flexion/extension forces generated by the fingers, wrist, and thumb during robot-mediated 3-D dynamic movements of the upper limb. Validation data collected from eight participants with chronic hemiparetic stroke are presented in this paper. PMID:19567336

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

    PubMed

    Price, R F; Dutia, M B

    1989-01-01

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

  8. Range of Motion Requirements for Upper-Limb Activities of Daily Living

    PubMed Central

    Walters, Lisa Smurr; Cowley, Jeffrey; Wilken, Jason M.; Resnik, Linda

    2016-01-01

    OBJECTIVE. We quantified the range of motion (ROM) required for eight upper-extremity activities of daily living (ADLs) in healthy participants. METHOD. Fifteen right-handed participants completed several bimanual and unilateral basic ADLs while joint kinematics were monitored using a motion capture system. Peak motions of the pelvis, trunk, shoulder, elbow, and wrist were quantified for each task. RESULTS. To complete all activities tested, participants needed a minimum ROM of ?65°/0°/105° for humeral plane angle (horizontal abduction–adduction), 0°–108° for humeral elevation, ?55°/0°/79° for humeral rotation, 0°–121° for elbow flexion, ?53°/0°/13° for forearm rotation, ?40°/0°/38° for wrist flexion–extension, and ?28°/0°/38° for wrist ulnar–radial deviation. Peak trunk ROM was 23° lean, 32° axial rotation, and 59° flexion–extension. CONCLUSION. Full upper-limb kinematics were calculated for several ADLs. This methodology can be used in future studies as a basis for developing normative databases of upper-extremity motions and evaluating pathology in populations. PMID:26709433

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

    PubMed

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

    2008-11-01

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

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

    NASA Astrophysics Data System (ADS)

    Burkholder, Kristin C.; Lozier, M. Susan

    2014-06-01

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

  11. Hematuria following Botox treatment for upper limb spasticity: a case report

    PubMed Central

    Lo, Tony CT; Yeung, Stephen T; Lee, Sujin; Chang, Eric Y

    2015-01-01

    Hematuria is a documented side effect of botulinum toxin injection and has only been reported when it is used for overactive bladder. Here we report a rare case of hematuria following onabotulinumtoxin A (Botox) injection for upper limb spasticity in a 29-year-old male with a history of traumatic brain injury and hemophilia. Hematuria resolved without further complication after self-injection of factor VIII as recommended by his hematologist. Botulinum toxin binds peripheral cholinergic nerve endings to prevent acetylcholine and norepinephrine exocytosis. Studies have shown that both of these compounds are involved in antifibrinolytic activation, suggesting botulinum toxin may play a role in the coagulation cascade by preventing formation of fibrin. This is further supported by resolution of hematuria in our patient after self-injection of factor VIII. As such, botulinum toxin injection may result in mild spontaneous hemorrhage in patients with underlying hematological deficiencies. Further studies are needed to elucidate its effects in coagulation. PMID:26396542

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

    PubMed

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

    2012-01-01

    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

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

    PubMed Central

    2012-01-01

    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

  14. Unconstrained muscle-tendon workloops indicate resonance tuning as a mechanism for elastic limb behavior during terrestrial locomotion.

    PubMed

    Robertson, Benjamin D; Sawicki, Gregory S

    2015-10-27

    In terrestrial locomotion, there is a missing link between observed spring-like limb mechanics and the physiological systems driving their emergence. Previous modeling and experimental studies of bouncing gait (e.g., walking, running, hopping) identified muscle-tendon interactions that cycle large amounts of energy in series tendon as a source of elastic limb behavior. The neural, biomechanical, and environmental origins of these tuned mechanics, however, have remained elusive. To examine the dynamic interplay between these factors, we developed an experimental platform comprised of a feedback-controlled servo-motor coupled to a biological muscle-tendon. Our novel motor controller mimicked in vivo inertial/gravitational loading experienced by muscles during terrestrial locomotion, and rhythmic patterns of muscle activation were applied via stimulation of intact nerve. This approach was based on classical workloop studies, but avoided predetermined patterns of muscle strain and activation-constraints not imposed during real-world locomotion. Our unconstrained approach to position control allowed observation of emergent muscle-tendon mechanics resulting from dynamic interaction of neural control, active muscle, and system material/inertial properties. This study demonstrated that, despite the complex nonlinear nature of musculotendon systems, cyclic muscle contractions at the passive natural frequency of the underlying biomechanical system yielded maximal forces and fractions of mechanical work recovered from previously stored elastic energy in series-compliant tissues. By matching movement frequency to the natural frequency of the passive biomechanical system (i.e., resonance tuning), muscle-tendon interactions resulting in spring-like behavior emerged naturally, without closed-loop neural control. This conceptual framework may explain the basis for elastic limb behavior during terrestrial locomotion. PMID:26460038

  15. The Physical and Psychosocial Benefits of Upper-Limb Transplantation: A Case Series of 5 Polish Patients.

    PubMed

    Che?mo?ski, Adam; Kowal, Katarzyna; Jab?ecki, Jerzy

    2015-01-01

    BACKGROUND Although upper-limb transplantation is not a life-saving procedure, every year more and more patients are ready to undergo this surgery. Conventional methods of treatment performed earlier have not brought the expected functional and aesthetic results. Patients who have received upper-limb transplantation (HTx) enjoy, in addition to the physical benefits associated with good functional effect, numerous benefits of a psychological and social nature. Investigation of these benefits was the aim of this interdisciplinary research. CASE REPORT The wide spectrum of physical, psychological, and social benefits derived by recipients of limb transplantation include: improved physical fitness, recovery of the complete body form, corporeal well-being, enhanced self-esteem, recovery of self-confidence, a stable feeling of personal and social identity, higher integration of the body with performed social roles, greater confidence in the ability to act and have control over life, a feeling of greater security, the ability to return to work, restoration of social position, and positive personality changes. CONCLUSIONS Potential benefits which may be derived by future upper limb recipients are manifested in the good functional effect of the transplantation, enhanced life satisfaction, and better functioning in society. It does not mean, however, restoration of 100% of fitness or absolutely problem-free functioning in everyday life, which is extremely important in the context of prevention of possible disappointment to future limb recipients. PMID:26502835

  16. Amplitude Manipulation Evokes Upper Limb Freezing during Handwriting in Patients with Parkinson’s Disease with Freezing of Gait

    PubMed Central

    Heremans, Elke; Nackaerts, Evelien; Vervoort, Griet; Vercruysse, Sarah; Broeder, Sanne; Strouwen, Carolien; Swinnen, Stephan P.; Nieuwboer, Alice

    2015-01-01

    Background Recent studies show that besides freezing of gait (FOG), many people with Parkinson’s disease (PD) also suffer from freezing in the upper limbs (FOUL). Up to now, it is unclear which task constraints provoke and explain upper limb freezing. Objective To investigate whether upper limb freezing and other kinematic abnormalities during writing are provoked by (i) gradual changes in amplitude or by (ii) sustained amplitude generation in patients with and without freezing of gait. Methods Thirty-four patients with PD, including 17 with and 17 without FOG, performed a writing task on a touch-sensitive writing tablet requiring writing at constant small and large size as well as writing at gradually increasing and decreasing size. Patients of both groups were matched for disease severity, tested while ‘on’ medication and compared to healthy age-matched controls. Results Fifty upper limb freezing episodes were detected in 10 patients, including 8 with and 2 without FOG. The majority of the episodes occurred when participants had to write at small or gradually decreasing size. The occurrence of FOUL and the number of FOUL episodes per patient significantly correlated with the occurrence and severity of FOG. Patients with FOUL also showed a significantly smaller amplitude in the writing parts outside the freezing episodes. Conclusions Corroborating findings of gait research, the current study supports a core problem in amplitude control underlying FOUL, both in maintaining as well as in flexibly adapting the cycle size. PMID:26580556

  17. Emergence of Virtual Reality as a Tool for Upper Limb Rehabilitation: Incorporation of Motor Control and Motor Learning Principles

    PubMed Central

    Weiss, Patrice L.; Keshner, Emily A.

    2015-01-01

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

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

    E-print Network

    Popovic, Milos R.

    Feasibility and efficacy of upper limb robotic rehabilitation in a1 sub-acute cervical spinal cord and Rehabilitation, University of British Columbia, Vancouver12 5. Spinal Cord Injury Center, University Hospital Spinal Cord Centre26 Vancouver General Hospital27 818 West 10th Avenue28 Vancouver, V5Z 1M9, Canada29 Tel

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  20. Electroencephalographic Changes of Brain Oscillatory Activity After Upper Limb Somatic Sensation Training in a Patient With Somatosensory Deficit After Stroke.

    PubMed

    Gandolfi, Marialuisa; Formaggio, Emanuela; Geroin, Christian; Storti, Silvia Francesca; Boscolo Galazzo, Ilaria; Waldner, Andreas; Manganotti, Paolo; Smania, Nicola

    2015-10-01

    The development of an innovative functional assessment procedure based on the combination of electroencephalography (EEG) and robot-assisted upper limb devices may provide new insights into the dynamics of cortical reorganization promoted by rehabilitation. The aim of this study was to evaluate changes in event-related synchronization/desynchronization (ERS/ERD) in alpha and beta bands in a patient with pure sensory stroke who underwent a specific rehabilitation program for somatic sensation recovery. A 49-year-old, right-handed woman (time since stroke, 12 months) with severe upper limb somatic sensation deficits was tested using validated clinical scales and a standardized video-EEG system combined with the Bi-Manu-Track robot-assisted arm trainer protocol. The patient underwent a 3-month home-based rehabilitation program for promoting upper limb recovery (1 hour a day for 5 days a week). She was tested before treatment, at 1-month, and at 3-month during treatment. Results showed progressive recovery of upper limb function over time. These effects were associated with specific changes in the modulation of alpha and beta event-related synchronization/desynchronization. This unique study provides new perspectives for the assessment of functional deficits and changes in cortical activity promoted by rehabilitation in poststroke patients. PMID:25185438

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

    ERIC Educational Resources Information Center

    Craje, Celine

    2010-01-01

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

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2013-10-01

    [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

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

    PubMed Central

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

    2013-01-01

    [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

  5. Postoperative Development of Bone Mineral Density and Muscle Strength in the Lower Limb After Cemented and Uncemented Total Hip Replacement

    PubMed Central

    Lindner, Tobias; Krüger, Christine; Kasch, Cornelius; Finze, Susanne; Steens, Wolfram; Mittelmeier, Wolfram; Skripitz, Ralf

    2014-01-01

    Background : Numerous studies have shown reduction of periprosthetic bone mineral density (BMD) after hip replacement. The effect on the whole limb, however, is still unexplored. This study’s objective was to analyse the postoperative development of BMD and muscle strength of the limb after total hip replacement (THR) and to determine links between these parameters. Methods : 55 patients, who underwent THR, were included. Depending on therapeutic indication, either an uncemented stem (Group A, n=30) or a cemented stem (Group B, n=25) has been implanted. In the limbs, the measurement of BMD using DEXA and the maximum isometric muscle strength, detected by a leg press, were undertaken preoperatively and after 3, 6 and 12 months. Results : A total of 12 patients (Group A: n = 6, Group B: n = 6) were excluded due to reasons which were not relevant to the study. So, the results refer to the data of 43 patients. In Group A (uncemented, n = 24), a significant decrease of BMD on the operated extremity was seen after 3, 6 and 12 months compared with preoperative values. Isometric muscle strength on the affected extremity increased significantly after 6 and 12 months. In Group B (cemented, n = 19), with a lower baseline compared to group A, an increase in BMD of the affected limb was seen postoperatively. This rise was significant after 12 months. With regard to the isometric muscle strength, a significant increase could be observed in this group after 6 and 12 months. Conclusion : Analogous to postoperative reduction of periprosthetic bone density, a decrease of the entire limb BMD on the operated leg occurred after implantation of uncemented hip stems. In contrast, an increase in BMD was recorded for cemented stems. Regardless of the type of anchoring, a substantial increase in muscular strength could be observed postoperatively in both groups. PMID:25246993

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

    PubMed

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

    2010-01-01

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

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

    PubMed

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

    2014-12-01

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

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

    PubMed Central

    2013-01-01

    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

  9. Upper-limb kinematic reconstruction during stroke robot-aided therapy.

    PubMed

    Papaleo, E; Zollo, L; Garcia-Aracil, N; Badesa, F J; Morales, R; Mazzoleni, S; Sterzi, S; Guglielmelli, E

    2015-09-01

    The paper proposes a novel method for an accurate and unobtrusive reconstruction of the upper-limb kinematics of stroke patients during robot-aided rehabilitation tasks with end-effector machines. The method is based on a robust analytic procedure for inverse kinematics that simply uses, in addition to hand pose data provided by the robot, upper arm acceleration measurements for computing a constraint on elbow position; it is exploited for task space augmentation. The proposed method can enable in-depth comprehension of planning strategy of stroke patients in the joint space and, consequently, allow developing therapies tailored for their residual motor capabilities. The experimental validation has a twofold purpose: (1) a comparative analysis with an optoelectronic motion capturing system is used to assess the method capability to reconstruct joint motion; (2) the application of the method to healthy and stroke subjects during circle-drawing tasks with InMotion2 robot is used to evaluate its efficacy in discriminating stroke from healthy behavior. The experimental results have shown that arm angles are reconstructed with a RMSE of 8.3 × 10(-3) rad. Moreover, the comparison between healthy and stroke subjects has revealed different features in the joint space in terms of mean values and standard deviations, which also allow assessing inter- and intra-subject variability. The findings of this study contribute to the investigation of motor performance in the joint space and Cartesian space of stroke patients undergoing robot-aided therapy, thus allowing: (1) evaluating the outcomes of the therapeutic approach, (2) re-planning the robotic treatment based on patient needs, and (3) understanding pathology-related motor strategies. PMID:25861746

  10. Usability testing of gaming and social media applications for stroke and cerebral palsy upper limb rehabilitation.

    PubMed

    Valdés, Bulmaro A; Hilderman, Courtney G E; Hung, Chai-Ting; Shirzad, Navid; Van der Loos, H F Machiel

    2014-01-01

    As part of the FEATHERS (Functional Engagement in Assisted Therapy Through Exercise Robotics) project, two motion tracking and one social networking applications were developed for upper limb rehabilitation of stroke survivors and teenagers with cerebral palsy. The project aims to improve the engagement of clients during therapy by using video games and a social media platform. The applications allow users to control a cursor on a personal computer through bimanual motions, and to interact with their peers and therapists through the social media. The tracking applications use either a Microsoft Kinect or a PlayStation Eye camera, and the social media application was developed on Facebook. This paper presents a usability testing of these applications that was conducted with therapists from two rehabilitation clinics. The "Cognitive Walkthrough" and "Think Aloud" methods were used. The objectives of the study were to investigate the ease of use and potential issues or improvements of the applications, as well as the factors that facilitate and impede the adoption of technology in current rehabilitation programs. PMID:25570770

  11. Utilization of upper limb joint replacements during 1972-90: the Mayo Clinic experience.

    PubMed

    Madhok, R; Lewallen, D G; Wallrichs, S L; Ilstrup, D M; Melton, L J

    1993-01-01

    Increasing application of expensive medical technologies, including joint replacement, is of concern in the current economic climate. Successful upper limb joint replacements (ULJRs) are being performed, but few detailed data about their utilization are available. To explore the resource implications of such surgery, the utilization of total shoulder replacement (TSR), total elbow replacement (TER) and total wrist replacement (TWR) were examined from the time these procedures first became available at the Mayo Clinic up to 1990. The age- and sex-adjusted utilization rate for TSR among Olmsted County, Minnesota, residents was 1.8 per 100,000 person-years (p-y), 0.8 per 100,000 p-y for TER and 1.1 per 100,000 p-y for TWR. Overall utilization of primary ULJR among Olmsted County residents during the 19-year study period was 3.8 per 100,000 p-y. The commonest indication for TSR was osteoarthritis (46 per cent) and for TER and TWR was rheumatoid arthritis (50 and 81 per cent respectively). There was no consistent trend in the utilization of these procedures among Olmsted County residents, but the number of referral patients receiving a ULJR at the Mayo Clinic increased steadily during the study period. The Mayo Clinic experience suggests an increasing demand for ULJR, particularly TSR and TER. With continued advances in, and diffusion of, the technology this demand may increase further. PMID:7802875

  12. Upper limb reconstruction with reverse flaps: a review of 52 patients with emphasis on flap selection.

    PubMed

    Kostako?lu, N; Keçik, A

    1997-10-01

    Reverse flaps lend themselves to transposition from proximal to distal locations in the extremities. This series comprised 18 radial forearm flaps, 17 digital artery flaps, 13 posterior interosseous flaps, 3 lateral arm flaps, 2 dorsal digital flaps, and 1 dorsal metacarpal flap, all of which were utilized in a reverse pattern. The radial forearm flap was mainly chosen for defects involving part of the palm and the palmar aspect of the first web space. The posterior interosseous flap was more commonly utilized for resurfacing the dorsum, dorsal aspect of the first web space, and especially the hypothenar aspect of the hand. The lateral arm flap was used to reconstruct antecubital fossa and proximal forearm defects. All posterior interosseous and lateral arm donor areas were closed primarily. Sensate digital artery flaps yielded 5 mm on average static two-point discrimination in 6 to 18 months of follow-up. Functional and cosmetic results concerning the recipient and donor areas were found to be satisfactory. It was concluded that reverse flaps are versatile tools in the coverage of all kind of defects in the upper limb and should be thought of in the first place. PMID:9339281

  13. Non-target stimuli in the visual field influence movement preparation in upper-limb reaching.

    PubMed

    Neely, Kristina A; Morris, Laura J

    2015-09-14

    The present work provides an empirical test of the Dynamic Field Theory of visuospatial cognition. The Dynamic Field Theory is a bi-stable neural network model applied to explain how visual information is integrated during the preparation of reaching responses (Erlhagen and Schöner). The dynamic field theory posits that motor cortices develop peaks of activation for each possible target in the visual field. Targets that are close in space produce neural peaks with overlapping distributions, whereas targets that are far apart produce distinct peaks with non-overlapping distributions. As such, the Dynamic Field Theory predicts reaction times to potential targets that are close in space will be faster than those to targets that are far apart. The present work examined how proximal and distal distractors impact reaction time in an upper-limb reaching task. The results demonstrated that distal distractors result in prolonged reaction times compared to proximal distractors. We suggest that reaction time represents the time required to inhibit neural activity representing the location of the distractor. Thus, prolonged reaction times observed for distal distractors reflect the temporal demands associated with the competition of two non-overlapping distributions of activity in the brain. These findings support the tenets of the Dynamic Field Theory and demonstrate that non-target stimuli in the visual field can influence movement preparation. PMID:26222255

  14. Upper Limb Kinematics Using Inertial and Magnetic Sensors: Comparison of Sensor-to-Segment Calibrations

    PubMed Central

    Bouvier, Brice; Duprey, Sonia; Claudon, Laurent; Dumas, Raphaël; Savescu, Adriana

    2015-01-01

    Magneto-Inertial Measurement Unit sensors (MIMU) display high potential for the quantitative evaluation of upper limb kinematics, as they allow monitoring ambulatory measurements. The sensor-to-segment calibration step, consisting of establishing the relation between MIMU sensors and human segments, plays an important role in the global accuracy of joint angles. The aim of this study was to compare sensor-to-segment calibrations for the MIMU-based estimation of wrist, elbow, and shoulder joint angles, by examining trueness (“close to the reference”) and precision (reproducibility) validity criteria. Ten subjects performed five sessions with three different operators. Three classes of calibrations were studied: segment axes equal to technical MIMU axes (TECH), segment axes generated during a static pose (STATIC), and those generated during functional movements (FUNCT). The calibrations were compared during the maximal uniaxial movements of each joint, plus an extra multi-joint movement. Generally, joint angles presented good trueness and very good precision in the range 5°–10°. Only small discrepancy between calibrations was highlighted, with the exception of a few cases. The very good overall accuracy (trueness and precision) of MIMU-based joint angle data seems to be more dependent on the level of rigor of the experimental procedure (operator training) than on the choice of calibration itself. PMID:26263993

  15. Direct kinematic modeling of the upper limb during trunk-assisted reaching.

    PubMed

    Hanneton, Sylvain; Dedobbeler, Svetlana; Hoellinger, Thomas; Roby-Brami, Agnes

    2011-08-01

    The study proposes a rigid-body biomechanical model of the trunk and whole upper limb including scapula and the test of this model with a kinematic method using a six-dimensional (6-D) electromagnetic motion capture (mocap) device. Large unconstrained natural trunk-assisted reaching movements were recorded in 7 healthy subjects. The 3-D positions of anatomical landmarks were measured and then compared to their estimation given by the biomechanical chain fed with joint angles (the direct kinematics). Thus, the prediction errors was attributed to the different joints and to the different simplifications introduced in the model. Large (approx. 4 cm) end-point prediction errors at the level of the hand were reduced (to approx. 2 cm) if translations of the scapula were taken into account. As a whole, the 6-D mocap seems to give accurate results, except for prono-supination. The direct kinematic model could be used as a virtual mannequin for other applications, such as computer animation or clinical and ergonomical evaluations. PMID:21844617

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-11-01

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

  18. Upper Limb Kinematics Using Inertial and Magnetic Sensors: Comparison of Sensor-to-Segment Calibrations.

    PubMed

    Bouvier, Brice; Duprey, Sonia; Claudon, Laurent; Dumas, Raphaël; Savescu, Adriana

    2015-01-01

    Magneto-Inertial Measurement Unit sensors (MIMU) display high potential for the quantitative evaluation of upper limb kinematics, as they allow monitoring ambulatory measurements. The sensor-to-segment calibration step, consisting of establishing the relation between MIMU sensors and human segments, plays an important role in the global accuracy of joint angles. The aim of this study was to compare sensor-to-segment calibrations for the MIMU-based estimation of wrist, elbow, and shoulder joint angles, by examining trueness ("close to the reference") and precision (reproducibility) validity criteria. Ten subjects performed five sessions with three different operators. Three classes of calibrations were studied: segment axes equal to technical MIMU axes (TECH), segment axes generated during a static pose (STATIC), and those generated during functional movements (FUNCT). The calibrations were compared during the maximal uniaxial movements of each joint, plus an extra multi-joint movement. Generally, joint angles presented good trueness and very good precision in the range 5°-10°. Only small discrepancy between calibrations was highlighted, with the exception of a few cases. The very good overall accuracy (trueness and precision) of MIMU-based joint angle data seems to be more dependent on the level of rigor of the experimental procedure (operator training) than on the choice of calibration itself. PMID:26263993

  19. Current Trends in Robot-Assisted Upper-Limb Stroke Rehabilitation: Promoting Patient Engagement in Therapy

    PubMed Central

    Blank, Amy A.; French, James A.; Pehlivan, Ali Utku

    2015-01-01

    Stroke is one of the leading causes of long-term disability today; therefore, many research efforts are focused on designing maximally effective and efficient treatment methods. In particular, robotic stroke rehabilitation has received significant attention for upper-limb therapy due to its ability to provide high-intensity repetitive movement therapy with less effort than would be required for traditional methods. Recent research has focused on increasing patient engagement in therapy, which has been shown to be important for inducing neural plasticity to facilitate recovery. Robotic therapy devices enable unique methods for promoting patient engagement by providing assistance only as needed and by detecting patient movement intent to drive to the device. Use of these methods has demonstrated improvements in functional outcomes, but careful comparisons between methods remain to be done. Future work should include controlled clinical trials and comparisons of effectiveness of different methods for patients with different abilities and needs in order to inform future development of patient-specific therapeutic protocols. PMID:26005600

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2014-09-01

    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

  2. Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles during Different Sit-To-Stand Tests

    PubMed Central

    Roldán-Jiménez, Cristina; Bennett, Paul; Cuesta-Vargas, Antonio I.

    2015-01-01

    Sit-to-stand (STS) tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG), biceps femoris (BF), vastus medialis of the quadriceps (QM), the abdominal rectus (AR), erector spinae (ES), rectus femoris (RF), soleus (SO) and the tibialis anterior (TA). Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects. PMID:26506612

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

    PubMed

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

    2015-05-01

    [Purpose] To investigate the effects of progressive functional training on lower limb muscle architecture and motor function of children with spastic cerebral palsy (CP). [Subjects] The subjects of this study were 26 children with spastic CP. [Methods] Thirteen subjects in the experimental group performed general neurodevelopmental treatment (NDT) and additional progressive functional trainings and 13 subjects in the control group performed only general NDT 3 times a week for 6 weeks. Ultrasonography, gross motor function measurement (GMFM) and the mobility questionnaire (MobQue) were evaluated. [Results] After the intervention, the muscle thickness of the quadriceps femoris (QF), cross-sectional area of the rectus femoris (RF), pennation angle of the gastrocnemius (GCM) and the MobQue score of the experimental group were significantly greater than those of the control group. The muscle thickness of QF correlated with the cross-sectional area (CSA) of RF and the pennation angle of GCM, and GMFM score correlated with the pennation angle of GCM. [Conclusion] Progressive functional training can increase muscle thickness, CSA, and the pennation angle of the lower limb muscles, and improve the mobility of spastic CP children making it useful as a practical adjunct to rehabilitation therapy. PMID:26157267

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

    PubMed Central

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

    2015-01-01

    [Purpose] To investigate the effects of progressive functional training on lower limb muscle architecture and motor function of children with spastic cerebral palsy (CP). [Subjects] The subjects of this study were 26 children with spastic CP. [Methods] Thirteen subjects in the experimental group performed general neurodevelopmental treatment (NDT) and additional progressive functional trainings and 13 subjects in the control group performed only general NDT 3 times a week for 6 weeks. Ultrasonography, gross motor function measurement (GMFM) and the mobility questionnaire (MobQue) were evaluated. [Results] After the intervention, the muscle thickness of the quadriceps femoris (QF), cross-sectional area of the rectus femoris (RF), pennation angle of the gastrocnemius (GCM) and the MobQue score of the experimental group were significantly greater than those of the control group. The muscle thickness of QF correlated with the cross-sectional area (CSA) of RF and the pennation angle of GCM, and GMFM score correlated with the pennation angle of GCM. [Conclusion] Progressive functional training can increase muscle thickness, CSA, and the pennation angle of the lower limb muscles, and improve the mobility of spastic CP children making it useful as a practical adjunct to rehabilitation therapy. PMID:26157267

  5. Corticospinal excitability modulation in resting digit muscles during cyclical movement of the digits of the ipsilateral limb

    PubMed Central

    Muraoka, Tetsuro; Sakamoto, Masanori; Mizuguchi, Nobuaki; Nakagawa, Kento; Kanosue, Kazuyuki

    2015-01-01

    We investigated how corticospinal excitability of the resting digit muscles was modulated by the digit movement in the ipsilateral limb. Subjects performed cyclical extension-flexion movements of either the right toes or fingers. To determine whether corticospinal excitability of the resting digit muscles was modulated on the basis of movement direction or action coupling between ipsilateral digits, the right forearm was maintained in either the pronated or supinated position. During the movement, the motor evoked potential (MEP) elicited by transcranial magnetic stimulation (TMS) was measured from either the resting right finger extensor and flexor, or toe extensor and flexor. For both finger and toe muscles, independent of forearm position, MEP amplitude of the flexor was greater during ipsilateral digit flexion as compared to extension, and MEP amplitude of the extensor was greater during ipsilateral digit extension as compared to flexion. An exception was that MEP amplitude of the toe flexor with the supinated forearm did not differ between during finger extension and flexion. These findings suggest that digit movement modulates corticospinal excitability of the digits of the ipsilateral limb such that the same action is preferred. Our results provide evidence for a better understanding of neural interactions between ipsilateral limbs, and may thus contribute to neurorehabilitation after a stroke or incomplete spinal cord injury. PMID:26582985

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

    NASA Astrophysics Data System (ADS)

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

    2011-11-01

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

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

    NASA Astrophysics Data System (ADS)

    Pourmahabadian, Mohammad; Akhavan, Mehdi; Azam, Kamal

    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.

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

    PubMed Central

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

    2014-01-01

    [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

  9. Safety, Feasibility, and Efficacy of Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Ischemic Stroke

    PubMed Central

    Pierce, David; Dixit, Anand; Kimberley, Teresa J.; Robertson, Michele; Tarver, Brent; Hilmi, Omar; McLean, John; Forbes, Kirsten; Kilgard, Michael P.; Rennaker, Robert L.; Cramer, Steven C.; Walters, Matthew; Engineer, Navzer

    2016-01-01

    Background and Purpose— Recent animal studies demonstrate that vagus nerve stimulation (VNS) paired with movement induces movement-specific plasticity in motor cortex and improves forelimb function after stroke. We conducted a randomized controlled clinical pilot study of VNS paired with rehabilitation on upper-limb function after ischemic stroke. Methods— Twenty-one participants with ischemic stroke >6 months before and moderate to severe upper-limb impairment were randomized to VNS plus rehabilitation or rehabilitation alone. Rehabilitation consisted of three 2-hour sessions per week for 6 weeks, each involving >400 movement trials. In the VNS group, movements were paired with 0.5-second VNS. The primary objective was to assess safety and feasibility. Secondary end points included change in upper-limb measures (including the Fugl–Meyer Assessment-Upper Extremity). Results— Nine participants were randomized to VNS plus rehabilitation and 11 to rehabilitation alone. There were no serious adverse device effects. One patient had transient vocal cord palsy and dysphagia after implantation. Five had minor adverse device effects including nausea and taste disturbance on the evening of therapy. In the intention-to-treat analysis, the change in Fugl–Meyer Assessment-Upper Extremity scores was not significantly different (between-group difference, 5.7 points; 95% confidence interval, ?0.4 to 11.8). In the per-protocol analysis, there was a significant difference in change in Fugl–Meyer Assessment-Upper Extremity score (between-group difference, 6.5 points; 95% confidence interval, 0.4 to 12.6). Conclusions— This study suggests that VNS paired with rehabilitation is feasible and has not raised safety concerns. Additional studies of VNS in adults with chronic stroke will now be performed. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique identifier: NCT01669161. PMID:26645257

  10. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study

    PubMed Central

    Perraton, Luke G.; Bower, Kelly J.; Adair, Brooke; Pua, Yong-Hao; Williams, Gavin P.; McGaw, Rebekah

    2015-01-01

    Introduction Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power. Methods 30 healthy young adults (age: 23±5yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change. Results Comparison of RFD methods revealed that a peak 200ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ? 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ? 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31–0.79). Conclusions Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in clinical populations. PMID:26509265

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

    PubMed

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

    2012-01-01

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

  12. Limb Dystonia

    MedlinePLUS

    ... scans of the affected limb or head, or electrical tests of the affected muscles. Are there treatments ... NCATS). Funding and/or programmatic support for this project has been provided by the National Institute of ...

  13. Upper extremity muscle activation during drinking from a glass in subjects with chronic stroke

    PubMed Central

    Lee, Jung Ah; Hwang, Pil Woo; Kim, Eun Joo

    2015-01-01

    [Purpose] The purpose of this study was to compare the muscle activities of upper extremities during a drinking task between the stroke-affected and less-affected sides. [Subjects] Eight stroke patients (8 men; age 45.3?years; stroke duration 21.9 months) participated in this study. [Methods] Electromyography (EMG) was used to measure nine muscle activities of the upper extremity. The drinking task was divided into 5 phases. [Results] Analysis of the EMG data showed that the percentage of maximum voluntary isometric contraction (%MVIC) across all phases of drinking differed between the affected and less-affected sides. Participants used relatively higher levels of %MVIC in the anterior deltoid, flexor muscles, brachioradialis, and infraspinatus on the stoke-affected side. [Conclusion] The difference in muscle activation across all phases of the drinking movement allowed us to determine how upper extremity muscle activation may influence drinking performance on the stroke-affected and less-affected sides. PMID:25931712

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

    PubMed Central

    2014-01-01

    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

  15. Upper limb aerobic training improves aerobic fitness and all-out performance of America's Cup grinders.

    PubMed

    Adami, Paolo Emilio; Delussu, Anna Sofia; Rodio, Angelo; Squeo, Maria Rosaria; Corsi, Loretta; Quattrini, Filippo Maria; Fattorini, Luigi; Bernardi, Marco

    2015-01-01

    This research on "America's Cup" grinders investigated the effects of a specific eight-week long-arm cranking ergometer (ACE) training on upper body (UB) aerobic fitness (ventilatory threshold - Tvent, respiratory compensation point- RCP, -oxygen uptake peak - VO?peak) and high intensity working capacity. The training consisted of sessions carried out for 20-30 mins, three times per week, at an intensity between the UB-Tvent and UB-RCP, and replaced part of a typical lower limb aerobic training whilst maintaining the usual weekly schedule of callisthenics, resistance training and sailing. Seven sailors, including four grinders and three mastmen (age 30 ± 5.5 years, height 1.9 ± 0.04 m, body mass 102 ± 3.6 kg), were evaluated through both an ACE cardiopulmonary maximal exercise test (CPET) and an ACE all-out up to exhaustion exercise test, before and after the ACE training. UB aerobic fitness improved significantly: UB-VO?peak increased from 4.29 ± 0.442 to 4.52 ± 0.522 l·min(-1) (6.4 ± 3.66%), VO? at UB-Tvent from 2.42 ± 0.282 to 2.97 ± 0.328 l·min(-1) (22.8 ± 5.09%) and VO? at UB-RCP from 3.25 ± 0.402 to 3.75 ± 0.352 l·min(-1) (16.1 ± 10.83%). Peak power at the ACE CPET increased from 351 ± 27.5 to 387 ± 33.5 W (10.5 ± 6.93%). The all-out test total mechanical work increased from 28.9 ± 2.35 to 40.1 ± 3.76 kJ (72.1 ± 4.67%). In conclusion, a high intensity aerobic ACE training can be effective in improving grinding performance by increasing UB aerobic fitness and all-out working capacity. PMID:25357134

  16. Characterising Upper Limb Movements in Huntington's Disease and the Impact of Restricted Visual Cues

    PubMed Central

    Despard, Jessica; Ternes, Anne-Marie; Dimech-Betancourt, Bleydy; Poudel, Govinda; Churchyard, Andrew; Georgiou-Karistianis, Nellie

    2015-01-01

    Background Voluntary motor deficits are a common feature in Huntington's disease (HD), characterised by movement slowing and performance inaccuracies. This deficit may be exacerbated when visual cues are restricted. Objective To characterize the upper limb motor profile in HD with various levels of difficulty, with and without visual targets. Methods Nine premanifest HD (pre-HD), nine early symptomatic HD (symp-HD) and nine matched controls completed a motor task incorporating Fitts' law, a model of human movement enabling the quantification of movement timing, via the manipulation of task difficulty (i.e., target size, and distance between targets). The task required participants to make reciprocal movements under cued and blind conditions. Dwell times (time stationary between movements), speed, accuracy and variability of movements were compared between groups. Results Symp-HD showed significantly prolonged and less consistent movement times, compared with controls and pre-HD. Furthermore, movement planning and online control were significantly impaired in symp-HD, compared with controls and pre-HD, evidenced by prolonged dwell times and deceleration times. Speed and accuracy were comparable across groups, suggesting that group differences observed in movement time, variability, dwell time and deceleration time were evident over and above simple performance measures. The presence of cues resulted in greater movement time variability in symp-HD, compared with pre-HD and controls, suggesting that the deficit in movement consistency manifested only in response to targeted movements. Conclusions Collectively, these findings provide evidence of a deficiency in both motor planning, particularly in relation to movement timing and online control, which became exacerbated as a function of task difficulty during symp-HD stages. These variables may provide a more sensitive measure of motor dysfunction than speed and/or accuracy alone in symp-HD. PMID:26248012

  17. Therapists’ Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation

    PubMed Central

    Shirzad, Navid; Lohse, Keith R; Virji-Babul, Naznin; Hoens, Alison M; Holsti, Liisa; Li, Linda C; Miller, Kimberly J; Lam, Melanie Y; Van der Loos, HF Machiel

    2015-01-01

    Background The application of technologies, such as video gaming and social media for rehabilitation, is garnering interest in the medical field. However, little research has examined clinicians’ perspectives regarding technology adoption by their clients. Objective The objective of our study was to explore therapists’ perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these technologies in rehabilitation. Methods We conducted two focus groups comprised of ten occupational therapists/physiotherapists who provide neurorehabilitation to individuals with hemiplegia secondary to stroke or cerebral palsy. Data was analyzed using inductive thematic analysis. The diffusion of innovations theory provided a framework to interpret emerging themes. Results Therapists were using technology in a limited capacity. They identified barriers to using social media and gaming technology with their clients, including a lack of age appropriateness, privacy issues with social media, limited transfer of training, and a lack of accessibility of current systems. Therapists also questioned their role in the context of technology-based interventions. The opportunity for social interaction was perceived as a major benefit of integrated gaming and social media. Conclusions This study reveals the complexities associated with adopting new technologies in clinical practice, including the need to consider both client and clinician factors. Despite reporting several challenges with applying gaming and social media technology with clinical populations, therapists identified opportunities for increased social interactions and were willing to help shape the development of an upper limb training system that could more readily meet the needs of clients with hemiplegia. By considering the needs of both therapists and clients, technology developers may increase the likelihood that clinicians will adopt innovative technologies. PMID:25759148

  18. Brain Function and Upper Limb Outcome in Stroke: A Cross-Sectional fMRI Study

    PubMed Central

    Buma, Floor E.; Raemaekers, Mathijs; Kwakkel, Gert; Ramsey, Nick F.

    2015-01-01

    Objective The nature of changes in brain activation related to good recovery of arm function after stroke is still unclear. While the notion that this is a reflection of neuronal plasticity has gained much support, confounding by compensatory strategies cannot be ruled out. We address this issue by comparing brain activity in recovered patients 6 months after stroke with healthy controls. Methods We included 20 patients with upper limb paresis due to ischemic stroke and 15 controls. We measured brain activation during a finger flexion-extension task with functional MRI, and the relationship between brain activation and hand function. Patients exhibited various levels of recovery, but all were able to perform the task. Results Comparison between patients and controls with voxel-wise whole-brain analysis failed to reveal significant differences in brain activation. Equally, a region of interest analysis constrained to the motor network to optimize statistical power, failed to yield any differences. Finally, no significant relationship between brain activation and hand function was found in patients. Patients and controls performed scanner task equally well. Conclusion Brain activation and behavioral performance during finger flexion-extensions in (moderately) well recovered patients seems normal. The absence of significant differences in brain activity even in patients with a residual impairment may suggest that infarcts do not necessarily induce reorganization of motor function. While brain activity could be abnormal with higher task demands, this may also introduce performance confounds. It is thus still uncertain to what extent capacity for true neuronal repair after stroke exists. PMID:26440276

  19. Selected questions on biomechanical exposures for surveillance of upper-limb work-related musculoskeletal disorders

    PubMed Central

    Descatha, Alexis; Roquelaure, Yves; Evanoff, Bradley; Niedhammer, Isabelle; Chastang, Jean François; Mariot, Camille; Ha, Catherine; Imbernon, Ellen; Goldberg, Marcel; Leclerc, Annette

    2007-01-01

    Objective Questionnaires for assessment of biomechanical exposure are frequently used in surveillance programs, though few studies have evaluated which key questions are needed. We sought to reduce the number of variables on a surveillance questionnaire by identifying which variables best summarized biomechanical exposure in a survey of the French working population. Methods We used data from the 2002–2003 French experimental network of Upper-limb work-related musculoskeletal disorders (UWMSD), performed on 2685 subjects in which 37 variables assessing biomechanical exposures were available (divided into four ordinal categories, according to the task frequency or duration). Principal Component Analysis (PCA) with orthogonal rotation was performed on these variables. Variables closely associated with factors issued from PCA were retained, except those highly correlated to another variable (rho>0.70). In order to study the relevance of the final list of variables, correlations between a score based on retained variables (PCA score) and the exposure score suggested by the SALTSA group were calculated. The associations between the PCA score and the prevalence of UWMSD were also studied. In a final step, we added back to the list a few variables not retained by PCA, because of their established recognition as risk factors. Results According to the results of the PCA, seven interpretable factors were identified: posture exposures, repetitiveness, handling of heavy loads, distal biomechanical exposures, computer use, forklift operator specific task, and recovery time. Twenty variables strongly correlated with the factors obtained from PCA were retained. The PCA score was strongly correlated both with the SALTSA score and with UWMSD prevalence (p<0.0001). In the final step, six variables were reintegrated. Conclusion Twenty-six variables out of 37 were efficiently selected according to their ability to summarize major biomechanical constraints in a working population, with an approach combining statistical analyses and existing knowledge. PMID:17476519

  20. Upper limb kinematic differences between breathing and non-breathing conditions in front crawl sprint swimming.

    PubMed

    McCabe, Carla B; Sanders, Ross H; Psycharakis, Stelios G

    2015-11-26

    The purpose of this study was to determine whether the breathing action in front crawl (FC) sprint swimming affects the ipsilateral upper limb kinematics relative to a non-breathing stroke cycle (SC). Ten male competitive swimmers performed two 25m FC sprints: one breathing to their preferred side (Br) and one not breathing (NBr). Both swim trials were performed through a 6.75m(3) calibrated space and recorded by six gen-locked JVC KY32 CCD cameras. A paired t-test was used to assess statistical differences between the trials, with a confidence level of p<0.05 accepted as significant. Swimmers were slower (3%) when breathing. Within the entry phase, swimmers had a slower COM horizontal velocity (3.3%), less shoulder flexion (8%), abduction (33%) and roll (4%) when breathing. The pull phase was longer in duration (14%) swimmers had a shallower hand path (11%), less shoulder abduction (11%), a slower hand vertical acceleration (30%) and slower centre of mass (COM) horizontal velocity (3%) when breathing. In the push phase, swimmers had a smaller elbow range of motion (ROM) (38%), faster backwards hand speed (25%) and faster hand vertical acceleration (33%) when breathing. Swimmers rolled their shoulders more (12%) in the recovery phase when breathing. This study confirms that swim performance is compromised by the inclusion of taking a breath in sprint FC swimming. It was proposed that swimmers aim to orient their ipsilateral shoulder into a stronger position by stretching and rolling the shoulders more in the entry phase whilst preparing to take a breath. Swimmers should focus on lengthening the push phase by extending the elbow more and not accelerating the hand too quickly upwards when preparing to inhale. PMID:26456423

  1. Thoracic origin of a sympathetic supply to the upper limb: the ‘nerve of Kuntz’ revisited

    PubMed Central

    RAMSAROOP, L.; PARTAB, P.; SINGH, B.; SATYAPAL, K. S.

    2001-01-01

    An understanding of the origin of the sympathetic innervation of the upper limb is important in surgical sympathectomy procedures. An inconstant intrathoracic ramus which joined the 2nd intercostal nerve to the ventral ramus of the 1st thoracic nerve, proximal to the point where the latter gave a large branch to the brachial plexus, has become known as the ‘nerve of Kuntz’ (Kuntz, 1927). Subsequently a variety of sympathetic interneuronal connections down to the 5th intercostal space were reported and also described as the nerve of Kuntz. The aim of this study was to determine: (1) the incidence, location and course of the nerve of Kuntz; (2) the relationship of the nerve of Kuntz to the 2nd thoracic ganglion; (3) the variations of the nerve of Kuntz in the absence of a stellate ganglion; (4) to compare the original intrathoracic ramus with sympathetic variations at other intercostal levels; and (5) to devise an appropriate anatomical classification of the nerves of Kuntz. Bilateral microdissection of the sympathetic chain and somatic nerves of the upper 5 intercostal spaces was undertaken in 32 fetuses (gestational age, 18 wk to full term) and 18 adult cadavers. The total sample size comprised 99 sides. Sympathetic contributions to the first thoracic nerve were found in 60 of 99 sides (left 32, right 28). Of these, 46 were confined to the 1st intercostal space only. The nerve of Kuntz (the original intrathoracic ramus) of the 1st intercostal space had a demonstrable sympathetic connection in 34 cases, and an absence of macroscopic sympathetic connections in 12. In the remaining intercostal spaces, intrathoracic rami uniting intercostal nerves were not observed. Additional sympathetic contributions (exclusive of rami communicantes) were noted between ganglia, interganglionic segments and intercostal nerves as additional rami communicantes. The eponym nerve of Kuntz should be restricted to descriptions of the intrathoracic ramus of the 1st intercostal space. Any of these variant sympathetic pathways may be responsible for the recurrence of symptoms after sympathectomy surgery. PMID:11787821

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

    NASA Astrophysics Data System (ADS)

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

    1997-05-01

    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.

  3. Electroencephalographic markers of robot-aided therapy in stroke patients for the evaluation of upper limb rehabilitation.

    PubMed

    Sale, Patrizio; Infarinato, Francesco; Del Percio, Claudio; Lizio, Roberta; Babiloni, Claudio; Foti, Calogero; Franceschini, Marco

    2015-12-01

    Stroke is the leading cause of permanent disability in developed countries; its effects may include sensory, motor, and cognitive impairment as well as a reduced ability to perform self-care and participate in social and community activities. A number of studies have shown that the use of robotic systems in upper limb motor rehabilitation programs provides safe and intensive treatment to patients with motor impairments because of a neurological injury. Furthermore, robot-aided therapy was shown to be well accepted and tolerated by all patients; however, it is not known whether a specific robot-aided rehabilitation can induce beneficial cortical plasticity in stroke patients. Here, we present a procedure to study neural underpinning of robot-aided upper limb rehabilitation in stroke patients. Neurophysiological recordings use the following: (a) 10-20 system electroencephalographic (EEG) electrode montage; (b) bipolar vertical and horizontal electrooculographies; and (c) bipolar electromyography from the operating upper limb. Behavior monitoring includes the following: (a) clinical data and (b) kinematic and dynamic of the operant upper limb movements. Experimental conditions include the following: (a) resting state eyes closed and eyes open, and (b) robotic rehabilitation task (maximum 80?s each block to reach 4-min EEG data; interblock pause of 1?min). The data collection is performed before and after a program of 30 daily rehabilitation sessions. EEG markers include the following: (a) EEG power density in the eyes-closed condition; (b) reactivity of EEG power density to eyes opening; and (c) reactivity of EEG power density to robotic rehabilitation task. The above procedure was tested on a subacute patient (29 poststroke days) and on a chronic patient (21 poststroke months). After the rehabilitation program, we observed (a) improved clinical condition; (b) improved performance during the robotic task; (c) reduced delta rhythms (1-4?Hz) and increased alpha rhythms (8-12?Hz) during the resting state eyes-closed condition; (d) increased alpha desynchronization to eyes opening; and (e) decreased alpha desynchronization during the robotic rehabilitation task. We conclude that the present procedure is suitable for evaluation of the neural underpinning of robot-aided upper limb rehabilitation. PMID:26317486

  4. Limitations to systemic and locomotor limb muscle oxygen delivery and uptake during maximal exercise in humans.

    PubMed

    Mortensen, Stefan P; Dawson, Ellen A; Yoshiga, Chie C; Dalsgaard, Mads K; Damsgaard, Rasmus; Secher, Niels H; González-Alonso, José

    2005-07-01

    Reductions in systemic and locomotor limb muscle blood flow and O2 delivery limit aerobic capacity in humans. To examine whether O2 delivery limits both aerobic power and capacity, we first measured systemic haemodynamics, O2 transport and O2 uptake during incremental and constant (372 +/- 11 W; 85% of peak power; mean +/- S.E.M.) cycling exercise to exhaustion (n = 8) and then measured systemic and leg haemodynamics and during incremental cycling and knee-extensor exercise in male subjects (n = 10). During incremental cycling, cardiac output and systemic O2 delivery increased linearly to 80% of peak power (r2 = 0.998, P < 0.001) and then plateaued in parallel to a decline in stroke volume (SV) and an increase in central venous and mean arterial pressures (P < 0.05). In contrast, heart rate and increased linearly until exhaustion (r2 = 0.993; P < 0.001) accompanying a rise in systemic O2 extraction to 84 +/- 2%. In the exercising legs, blood flow and O2 delivery levelled off at 73-88% of peak power, blunting leg per unit of work despite increasing O2 extraction. When blood flow increased linearly during one-legged knee-extensor exercise, per unit of work was unaltered on fatigue. During constant cycling, , SV, systemic O2 delivery and reached maximal values within approximately 5 min, but dropped before exhaustion (P < 0.05) despite increasing or stable central venous and mean arterial pressures. In both types of maximal cycling, the impaired systemic O2 delivery was due to the decline or plateau in because arterial O2 content continued to increase. These results indicate that an inability of the circulatory system to sustain a linear increase in O2 delivery to the locomotor muscles restrains aerobic power. The similar impairment in SV and O2 delivery during incremental and constant load cycling provides evidence for a central limitation to aerobic power and capacity in humans. PMID:15860533

  5. Electrical activity and relative length changes of dog limb muscles as a function of speed and gait.

    PubMed

    Goslow, G E; Seeherman, H J; Taylor, C R; McCutchin, M N; Heglund, N C

    1981-10-01

    Electrical activity and length changes of 11 muscles of the fore- and hind- limbs of dogs walking, running, and galloping on a treadmill, were measured as a function of forward speed and gait. Our purpose was to find out whether the activity patterns of the major limb muscles were consistent with the two mechanisms proposed for storage and recovery of energy within a stride: a 'pendulum-like' mechanism during a walk, and a 'spring-like' mechanism during a run. In the stance phase of the walking dog, we found that the supraspinatus, long head of the triceps brachii, biceps brachii, vastus lateralis, and gastrocnemius underwent only minor length changes during a relatively long portion of their activity, Thus, a major part of their activity during the walk seems consistent with a role in stabilization of the joints as the dog 'pole-vaulted' over its limbs (and thereby conserved energy). In the stance phase of trotting and/or galloping dogs, we found that the supraspinatus, lateral head of the triceps, vastus lateralis, and gastrocnemius were active while being stretched prior to shortening (as would be required for elastic storage of energy), and that this type of activity increased with increasing speed. We also found muscular activity in the select limb flexors that was consistent with storage of kinetic energy at the end of the swing phase and recovery during the propulsive stroke. This activity pattern was apparent in the latissimus dorsi during a walk and trot, and in the biceps femoris during a trot and gallop. We conclude that, during locomotion, a significant fraction of the electrical activity of a number of limbs muscles occurs while they undergo little or no length change or are being stretched prior to shortening and that these types of activities occur in a manner that would enable the operation of pendulum-like and spring-like mechanisms for conserving energy within a stride. Therefore these forms of muscular activity, in addition to the more familiar activity associated with muscle shortening, should be considered to be important during locomotion. PMID:7310312

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

    PubMed

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

    2015-09-01

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

  7. Side-to-side comparisons of bone mineral density in upper and lower limbs of collegiate athletes.

    PubMed

    McClanahan, Barbara S; Harmon-Clayton, Karen; Ward, Kenneth D; Klesges, Robert C; Vukadinovich, Christopher M; Cantler, Edwin D

    2002-11-01

    This cross-sectional study investigated the effects of participation in various sports on side-to-side (contralateral) differences in bone mineral density (BMD) of the upper and lower limbs. The BMD of the arms and legs was measured using dual energy X-ray absorptiometry. The subjects were 184 collegiate athletes, both men and women, who participated in NCAA Division I-A baseball, basketball, football, golf, soccer, tennis, cross-country, indoor/outdoor track, and volleyball. Results revealed greater BMD of the right arms compared with the left arms for all teams, with the most pronounced differences observed in men's and women's tennis and men's baseball. Differences in the lower limbs were less common. No significant differences in lower limb BMD were found in the women. In men, differences in lower limb BMD were found in the football and tennis teams, with the nondominant leg having greater bone mass. Recognition of contralateral differences in bone density may be of particular interest to strength and conditioning professionals as they consider the need to include bilateral and unilateral training programs in an effort to maximize performance and minimize stress-related injuries. PMID:12423190

  8. Epidemiology of Congenital Upper Limb Anomalies in a Midwest United States Population: An Assessment Using the OMT Classification

    PubMed Central

    Goldfarb, Charles A.; Wall, Lindley B.; Bohn, Deborah C.; Moen, Patrick; Van Heest, Ann E.

    2014-01-01

    Purpose To examine the relative presentation frequency of children with upper limb congenital anomalies at 3 Midwestern referral centers using the Oberg, Manske, and Tonkin (OMT) classification and to assess the utility of this new classification system. Methods 641 individuals with 653 congenital upper extremity anomalies were identified at 3 hospitals in 2 large metropolitan areas during a 1-year interval. Patients were identified prospectively and the specific upper extremity anomaly and any associated syndromes were confirmed using medical records and radiographs. We applied the OMT classification that categorizes anomalies using a dysmorphology outline as malformations, dysplasias, deformations, and syndromes, and assessed its utility and ease of use. Results There were 480 extremities (74%) with a limb malformation including 184 involving the entire limb. Arthrogryposis was the most common of these (53 extremities). Anomalies affecting only the hand plate accounted for 62% (296) of the malformations. Of these, radial polydactyly (15%) was the most common specific anomaly, followed by symbrachydactyly (13%) and cleft hand (11%). Dysplasias were noted in 86 extremities; 55 of these were multiple hereditary exostoses. There were 87 extremities with deformations and 58 of these were trigger digits. A total of 98 children had a syndrome or association. Constriction ring sequence was most common. The OMT was straightforward to use and most anomalies could be easily assigned. There were a few conditions, such as Madelung deformity and symbrachydactyly, that would benefit from clarification on how to best classify them. Conclusions Malformations were the most common congenital anomalies in the 653 upper extremities evaluated over a 1-year period at 3 institutions. We were able to classify all individuals using the OMT classification system. PMID:25534840

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2012-01-01

    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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. Modulation of interhemispheric inhibition during passive movement of the upper limb reflects changes in motor cortical excitability.

    PubMed

    Warbrooke, Shane A; Byblow, Winston D

    2004-05-01

    We investigated modulation of inhibition of motor evoked potentials in the left forearm musculature attributable to changes in corticomotor excitability induced by passive rhythmic movement of the right limb. In the first experiment, eight healthy volunteers pre-activated their left flexor carpi radialis (FCR) in a simple isometric contraction (2.5-7.5% MVC) while their right hand underwent passive wrist flexion-extension. Transcranial magnetic (TMS) or electrical (TES) stimulation was applied to the right motor cortex and responses recorded from the test (left) limb in eight phases of the wrist flexion-extension cycle of the passively driven right limb. In half of the trials TMS conditioning was applied to the left motor cortex. The conditioning stimulus significantly inhibited TMS-evoked responses in the test FCR muscle, whereas TES-evoked responses did not appear to be inhibited. For TMS-evoked responses only, inhibition in the static pre-activated left FCR was modulated such that inhibition was greater when the right wrist was passively flexing than when it was extending. In the second experiment TMS was applied to the right motor cortex, contralateral to the test (left) limb, with the right hand either passively extending or flexing through the neutral position. Conditioning was applied to the left motor cortex at a range of intensities adjusted to threshold for flexion and extension movements. No difference was evident in the maximum magnitude of inhibition between the extension and flexion conditions. We propose there is an increased absolute threshold for recruitment and a decreased gain of inhibitory callosal pathways during extension phases of the wrist flexion-extension cycle. PMID:14685808

  14. [160 activities analyzed by the risk of biomechanical overload on the upper limbs in small industry, handicrafts, services and agriculture].

    PubMed

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

    2014-01-01

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

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

    PubMed

    Daly, Janis J; Ruff, Robert L

    2007-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Komada, Satoshi; Murakami, Yosuke; Hirai, Junji

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

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

    PubMed Central

    Kreissl, S.; Uber, A.

    2008-01-01

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

  18. Upper Extremity Muscle Activation during Recovery of Reaching in Subjects with Post-stroke Hemiparesis

    PubMed Central

    Wagner, Joanne M.; Dromerick, Alexander W.; Sahrmann, Shirley A.; Lang, Catherine E.

    2007-01-01

    Objective To investigate upper extremity muscle activation and recovery during the first few months after stroke. Methods Subjects with hemiparesis following stroke were studied performing a reaching task at an acute time point (mean = 9 days post-stroke) and then again at a subacute time point (mean = 109 days post-stroke). We recorded kinematics and electromyographic activity of 6 upper extremity muscles. Results At the acute time point, the hemiparetic group had delayed muscle onsets, lower modulation ratios, and higher relative levels of muscle activation (%MVIC) during reaching than controls. From the acute to the subacute time points, improvements were noted in all three variables. By the subacute phase, muscle onsets were similar to controls, while modulation ratios remained lower than controls and %MVIC showed a trend toward being greater in the hemiparetic group. Changes in muscle activation were differentially related to changes in reaching performance. Conclusions Our data show that improvements in muscle timing and decreases in the relative level of volitional activation may underlie improved reaching performance in the early months after stroke. Significance Given that stroke is one of the leading causes of persistent physical disability, it is important to understand how the ability to activate muscles changes during the early phases of recovery after injury. PMID:17097340

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

    PubMed

    Pinchuk, V D; Tkach, O S

    2013-08-01

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

  20. Human upper-limb force capacities evaluation with robotic models for ergonomic applications: effect of elbow flexion.

    PubMed

    Hernandez, Vincent; Rezzoug, Nasser; Jacquier-Bret, Julien; Gorce, Philippe

    2016-03-01

    The aim of this study was to apply models derived from the robotics field to evaluate the human upper-limb force generation capacity. Four models were compared: the force ellipsoid (FE) and force polytope (FP) based on unit joint torques and the scaled FE (SFE) and scaled FP (SFP) based on maximum isometric joint torques. The four models were assessed from four upper-limb postures with varying elbow flexion (40°, 60°, 80° and 100°) measured by an optoelectronic system and their corresponding isometric joint torques. Ten subjects were recruited. Three specific ellipsoids and polytopes parameters were compared: isotropy, principal force orientation and volume. Isotropy showed that the ellipsoids and polytopes were elongated. The angle between the two ellipsoids main axis and the two polytopes remained low but increased with the elbow flexion. The FE and FP volumes increased and those of SFE and SFP decreased with the elbow flexion. The interest and limits of such models are discussed in the framework of ergonomics and rehabilitation. PMID:26214374

  1. Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work

    PubMed Central

    Yoo, Won-gyu

    2015-01-01

    [Purpose] Activation and changes in parts of the upper trapezius muscle during painful and non-painful computer work were compared. [Subjects] Ten male computer workers were recruited. [Methods] Surface electromyography was used to compare upper trapezius muscle activation and changes (difference between minimum and maximum activation) during painful and non-painful computer work. [Results] Mean normalized upper trapezius muscle activity did not differ between the “feel-pain” and “non-feel-pain” muscle sections. The mean change in upper trapezius muscle activity in the feel-pain section decreased significantly compared to the non-feel-pain section. [Conclusion] Measuring changes in the activity of muscle sections was useful to study static and sustained muscle stress during computer work.

  2. Finger Muscle Attachments for an OpenSim Upper-Extremity Model

    PubMed Central

    Lee, Jong Hwa; Asakawa, Deanna S.; Dennerlein, Jack T.; Jindrich, Devin L.

    2015-01-01

    We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms). Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic finger muscles. Therefore, it was necessary to scale and translate muscle attachments from one experimental or model environment to another while preserving mechanical function. We used a two-step process. First, we estimated muscle function by calculating moment arms for all intrinsic and extrinsic muscles using the partial velocity method. Second, optimization using Simulated Annealing and Hooke-Jeeves algorithms found muscle-tendon paths that minimized root mean square (RMS) differences between experimental and modeled moment arms. The partial velocity method resulted in variance accounted for (VAF) between measured and calculated moment arms of 75.5% on average (range from 48.5% to 99.5%) for intrinsic and extrinsic index finger muscles where measured data were available. RMS error between experimental and optimized values was within one standard deviation (S.D) of measured moment arm (mean RMS error = 1.5 mm < measured S.D = 2.5 mm). Validation of both steps of the technique allowed for estimation of muscle attachment points for muscles whose moment arms have not been measured. Differences between modeled and experimentally measured muscle attachments, averaged over all finger joints, were less than 4.9 mm (within 7.1% of the average length of the muscle-tendon paths). The resulting non-proprietary musculoskeletal model of the human fingers could be useful for many applications, including better understanding of complex multi-touch and gestural movements. PMID:25853869

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Relationships between lower limb muscle architecture and activities and participation of children with cerebral palsy

    PubMed Central

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

    2013-01-01

    The purpose of this study was to determine the effects of the structure of skeletal muscle of lower extremities on function, activity, and participation of children with cerebral palsy. The subjects were 38 hospitalized patients and 13 infants with normal development. The following clinical measures were used for assessment of activity daily living and functional level of gross motor: Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Wee Functional Independence Measure (WeeFIM), International Classification of Functioning Child and Youth (ICF CY). Muscle thickness and strength of knee extensor and ankle extensor were collected using ultrasonography and manual muscle tester. Following the results of ICF CY evaluation for body function, activity, learning and application of knowledge, communication and environmental factors showed a decline (P< 0.05). Significant differences in the thickness of muscle was observed according to the GMFCS level, thickness of knee extensor and ankle extensor of cerebral palsy (P< 0.05), and clauses of self-care, activity, mobility, ambulation, communication, and social acknowledgement (P< 0.05). Following analysis, results showed negative correlation in the thickness of muscle, muscle strength, major motor function, daily activity and participation; the score of ICF-CY was shown to decline due to the high score for differences in thickness of muscle, muscle strength, WeeFIM, and GMFM. The thickness and muscle strength of lower extremities affect main functions of the body and improvement of muscle strength of lower extremities may have positive effects on social standards such as activity and participation of cerebral palsy. PMID:24278886

  6. Relationships between lower limb muscle architecture and activities and participation of children with cerebral palsy.

    PubMed

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

    2013-01-01

    The purpose of this study was to determine the effects of the structure of skeletal muscle of lower extremities on function, activity, and participation of children with cerebral palsy. The subjects were 38 hospitalized patients and 13 infants with normal development. The following clinical measures were used for assessment of activity daily living and functional level of gross motor: Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Wee Functional Independence Measure (WeeFIM), International Classification of Functioning Child and Youth (ICF CY). Muscle thickness and strength of knee extensor and ankle extensor were collected using ultrasonography and manual muscle tester. Following the results of ICF CY evaluation for body function, activity, learning and application of knowledge, communication and environmental factors showed a decline (P< 0.05). Significant differences in the thickness of muscle was observed according to the GMFCS level, thickness of knee extensor and ankle extensor of cerebral palsy (P< 0.05), and clauses of self-care, activity, mobility, ambulation, communication, and social acknowledgement (P< 0.05). Following analysis, results showed negative correlation in the thickness of muscle, muscle strength, major motor function, daily activity and participation; the score of ICF-CY was shown to decline due to the high score for differences in thickness of muscle, muscle strength, WeeFIM, and GMFM. The thickness and muscle strength of lower extremities affect main functions of the body and improvement of muscle strength of lower extremities may have positive effects on social standards such as activity and participation of cerebral palsy. PMID:24278886

  7. Reduction of the muscle activity associated with self-imposed electrical stimulation of mixed nerves supplying lower limb muscles in man.

    PubMed

    Gerilovsky, L; Philipova, D; Georgieva, S

    2002-08-01

    Similarly to brief hammer taps self-imposed on the limb segments, self-triggered electrical stimulation delivered to the tibial, femoral or peroneal nerves are associated with anticipatory reduction in the muscle activity (RMA) of the target leg muscles. The anticipatory RMA starts shortly before the expected perturbation and lasts until the onset of the impact. The purpose of the present work is to study to what extent the selective activation of the different homonymous and heteronymous afferents could modify the central programs and the associated time and space distribution of the anticipatory RMA pattern in the target leg muscles. Our results show that the anticipatory RMA pattern is a result mainly of a pre-programmed non-specific central command, rather than consequence of the specific composition of the afferent volleys originating from different homonymous and heteronymous nerves. The commands for the voluntary movement triggering the stimulation and the associated anticipatory RMA are closely linked but independently controlled. By their synchronisation and co-ordination the central nervous system accounts the differences in length of the particular motor pathways. It is suggested, that in contrast to the classic anticipatory postural adjustments, the anticipatory RMA is presumably an alternative mode of feed-forward control diminishing the undesired effects of the afferent inputs. PMID:12121681

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

    NASA Technical Reports Server (NTRS)

    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

    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.

  9. Development and preliminary evaluation of a novel low cost VR-based upper limb stroke rehabilitation platform using Wii technology.

    PubMed

    Tsekleves, Emmanuel; Paraskevopoulos, Ioannis Theoklitos; Warland, Alyson; Kilbride, Cherry

    2014-11-13

    Abstract Purpose: This paper proposes a novel system (using the Nintendo Wii remote) that offers customised, non-immersive, virtual reality-based, upper-limb stroke rehabilitation and reports on promising preliminary findings with stroke survivors. Method: The system novelty lies in the high accuracy of the full kinematic tracking of the upper limb movement in real-time, offering strong personal connection between the stroke survivor and a virtual character when executing therapist prescribed adjustable exercises/games. It allows the therapist to monitor patient performance and to individually calibrate the system in terms of range of movement, speed and duration. Results: The system was tested for acceptability with three stroke survivors with differing levels of disability. Participants reported an overwhelming connection with the system and avatar. A two-week, single case study with a long-term stroke survivor showed positive changes in all four outcome measures employed, with the participant reporting better wrist control and greater functional use. Activities, which were deemed too challenging or too easy were associated with lower scores of enjoyment/motivation, highlighting the need for activities to be individually calibrated. Conclusions: Given the preliminary findings, it would be beneficial to extend the case study in terms of duration and participants and to conduct an acceptability and feasibility study with community dwelling survivors. Implications for Rehabilitation Low-cost, off-the-shelf game sensors, such as the Nintendo Wii remote, are acceptable by stroke survivors as an add-on to upper limb stroke rehabilitation but have to be bespoked to provide high-fidelity and real-time kinematic tracking of the arm movement. Providing therapists with real-time and remote monitoring of the quality of the movement and not just the amount of practice, is imperative and most critical for getting a better understanding of each patient and administering the right amount and type of exercise. The ability to translate therapeutic arm movement into individually calibrated exercises and games, allows accommodation of the wide range of movement difficulties seen after stroke and the ability to adjust these activities (in terms of speed, range of movement and duration) will aid motivation and adherence - key issues in rehabilitation. With increasing pressures on resources and the move to more community-based rehabilitation, the proposed system has the potential for promoting the intensity of practice necessary for recovery in both community and acute settings. PMID:25391221

  10. Tensiomyography of selected lower-limb muscles in professional soccer players.

    PubMed

    Rey, Ezequiel; Lago-Peñas, Carlos; Lago-Ballesteros, Joaquín

    2012-12-01

    Tensiomyography is a non-invasive method of neuromuscular assessment used to measure muscle action characteristics, muscle tone, and muscle fiber type, and provides information on acute and chronic responses of muscle to different training loads. The aims of the present study were: to analyse differences in muscle response and mechanical characteristics of two major muscles of the lower extremity in a large group of Spanish soccer players according to playing position, and to provide group norms against which clinical findings may be compared. Data were collected from 78 professional soccer players (age 26.6 ± 4.4 years; height: 179.2 ± 5.3 cm; body mass: 75.8 ± 5.3 kg). Tensiomyography was recorded from the rectus femoris (RF) and biceps femoris (BF) muscles after 2 days without take part in any strenuous exercise or training. Five tensiomyographic parameters were analyzed: maximal displacement (D(m)), contraction time (T(c)), sustain time (T(s)), delay time (T(d)), and half-relaxation time (T(r)). A good to excellent intra-session reliability was found for all contractile parameters (ICC ranged from 0.78 to 0.95). No significant differences between players of any position were observed in absolute values of BF. However, significant differences were observed for T(c), T(r) and T(s) between the different playing positions on RF (P < 0.05, effect size ranged from 1.3 to 1.6). Professional soccer players showed muscles with ability to rapidly generate force during contractions. The neuromuscular profile provided could help in identifying the normative data that are important for the different positions in order to optimize the training and recovery process of each individual player. PMID:22776612

  11. A new calibration methodology for thorax and upper limbs motion capture in children using magneto and inertial sensors.

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. Current evaluation of hydraulics to replace the cable force transmission system for body-powered upper-limb prostheses.

    PubMed

    LeBlanc, M

    1990-01-01

    Present body-powered upper-limb prostheses use a cable control system employing World War II aircraft technology to transmit force from the body to the prosthesis for operation. The cable and associated hardware are located outside the prosthesis. Because individuals with arm amputations want prostheses that are natural looking with a smooth, soft outer surface, a design and development project was undertaken to replace the cable system with hydraulics located inside the prosthesis. Three different hydraulic transmission systems were built for evaluation, and other possibilities were explored. Results indicate that a hydraulic force transmission system remains an unmet challenge as a practical replacement for the cable system. The author was unable to develop a hydraulic system that meets the necessary dynamic requirements and is acceptable in size and appearance. PMID:10149042

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

    NASA Astrophysics Data System (ADS)

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

    2009-08-01

    In this article, the stress-shielding effect of a Nitinol swan-like memory compressive connector (SMC) is evaluated. Patients with fracture healing of an upper limb after SMC internal fixation or stainless steel plate fixation were randomly selected and observed comparatively. With the informed consent of the SMC group, minimal cortical bone under the swan-body and swan-neck was harvested; and in the steel plate fixation group, minimal cortical bone under the steel plate and opposite side to the steel plate was also harvested for observation. Main outcome measurements were taken such as osteocyte morphology, Harversian canal histological observation under light microscope; radiographic observation of fracture healing, and computed tomography quantitative scanning of cortical bone. As a conclusion, SMC has a lesser stress-shielding effect to fixed bone than steel plate. Finally, the mechanism of the lesser stress-shielding effect of SMC is discussed.

  15. The relationship between lower-limb strength and match-related muscle damage in elite level professional European soccer players.

    PubMed

    Owen, Adam; Dunlop, Gordon; Rouissi, Mehdi; Chtara, Moktar; Paul, Darren; Zouhal, Hassane; Wong, Del P

    2015-12-01

    In professional soccer, the benefits of lower limb strength training have been advocated. However, from an aspect of performance development, specifically with respect to expression of fatigue and injury prevention, the advantages of increased lower body strength have received limited attention at the elite level of the game. The primary aim of this cross-sectional investigation was to examine the association between lower body strength and the expression of markers of fatigue as evaluated through muscle damage assessment following match play in professional soccer players. Ten male professional soccer players participated in this investigation (mean ± SD age 26.2 ± 4.3 years, height 181.6 ± 4.8 cm and body mass 78.7 ± 6.1 kg); creatine kinase (CK) was collected 2-days post-match for a 5-month period and at three different time points (Phase 1, Phase 2 and Phase 3); muscular strength (e.g. 4 repetition half-squat) was measured 3-day post-match. No significant change in CK and muscular force across three time points was found (F = 0.60, P = 0.56, ?(2) = 0.06 and F = 2.65, P = 0.10, ?(2) = 0.23, respectively). Muscular force was negatively correlated (moderate to very large) with CK. It can be concluded that players who produce greater lower body force as a result of being stronger in the lower limbs show reduced levels of CK 48 h post-match. PMID:26158195

  16. The organization of the posterior parietal cortex devoted to upper limb actions: An fMRI study.

    PubMed

    Ferri, Stefania; Rizzolatti, Giacomo; Orban, Guy A

    2015-10-01

    The present fMRI study examined whether upper-limb action classes differing in their motor goal are encoded by different PPC sectors. Action observation was used as a proxy for action execution. Subjects viewed actors performing object-related (e.g., grasping), skin-displacing (e.g., rubbing the skin), and interpersonal upper limb actions (e.g., pushing someone). Observation of the three action classes activated a three-level network including occipito-temporal, parietal, and premotor cortex. The parietal region common to observing all three action classes was located dorsally to the left intraparietal sulcus (DIPSM/DIPSA border). Regions specific for observing an action class were obtained by combining the interaction between observing action classes and stimulus types with exclusive masking for observing the other classes, while for regions considered preferentially active for a class the interaction was exclusively masked with the regions common to all observed actions. Left putative human anterior intraparietal was specific for observing manipulative actions, and left parietal operculum including putative human SII region, specific for observing skin-displacing actions. Control experiments demonstrated that this latter activation depended on seeing the skin being moved and not simply on seeing touch. Psychophysiological interactions showed that the two specific parietal regions had similar connectivities. Finally, observing interpersonal actions preferentially activated a dorsal sector of left DIPSA, possibly the homologue of ventral intraparietal coding the impingement of the target person's body into the peripersonal space of the actor. These results support the importance of segregation according to the action class as principle of posterior parietal cortex organization for action observation and by implication for action execution. PMID:26129732

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

    PubMed

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

    2014-11-01

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

  18. Exploring the bases for a mixed reality stroke rehabilitation system, Part II: Design of Interactive Feedback for upper limb rehabilitation

    PubMed Central

    2011-01-01

    Background Few existing interactive rehabilitation systems can effectively communicate multiple aspects of movement performance simultaneously, in a manner that appropriately adapts across various training scenarios. In order to address the need for such systems within stroke rehabilitation training, a unified approach for designing interactive systems for upper limb rehabilitation of stroke survivors has been developed and applied for the implementation of an Adaptive Mixed Reality Rehabilitation (AMRR) System. Results The AMRR system provides computational evaluation and multimedia feedback for the upper limb rehabilitation of stroke survivors. A participant's movements are tracked by motion capture technology and evaluated by computational means. The resulting data are used to generate interactive media-based feedback that communicates to the participant detailed, intuitive evaluations of his performance. This article describes how the AMRR system's interactive feedback is designed to address specific movement challenges faced by stroke survivors. Multimedia examples are provided to illustrate each feedback component. Supportive data are provided for three participants of varying impairment levels to demonstrate the system's ability to train both targeted and integrated aspects of movement. Conclusions The AMRR system supports training of multiple movement aspects together or in isolation, within adaptable sequences, through cohesive feedback that is based on formalized compositional design principles. From preliminary analysis of the data, we infer that the system's ability to train multiple foci together or in isolation in adaptable sequences, utilizing appropriately designed feedback, can lead to functional improvement. The evaluation and feedback frameworks established within the AMRR system will be applied to the development of a novel home-based system to provide an engaging yet low-cost extension of training for longer periods of time. PMID:21899779

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

    PubMed Central

    2014-01-01

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

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

    PubMed

    Gates, Deanna H; Dingwell, Jonathan B

    2010-03-22

    Muscle fatigue alters neuromuscular responses. This may lead to increased sensitivity to perturbations and possibly to subsequent injury risk. We studied the effects of muscle fatigue on movement stability during a repetitive upper extremity task. Twenty healthy young subjects performed a repetitive work task, similar to sawing, synchronized with a metronome before and after performing each of two fatiguing tasks. The first fatigue task (LIFT) primarily fatigued the shoulder flexor muscles, while the second fatigue task (SAW) fatigued all of the muscles of the arm. Subjects performed each task in random order on two different days at least seven days apart. Instantaneous mean EMG frequencies (IMNF) decreased over both fatiguing tasks indicating that subjects did experience significant muscle fatigue. The slopes of the IMNF over time and the decreases in maximum force measurements demonstrated that the LIFT fatigue task successfully fatigued the shoulder flexors to a greater extent than any other muscle. On average, subjects exhibited more locally stable shoulder movements after the LIFT fatigue task (p=0.035). They also exhibited more orbitally stable shoulder (p=0.021) and elbow (p=0.013) movements after the SAW fatigue task. Subjects also had decreased cocontraction at the wrist post-fatigue for both tasks (p=0.001) and at the shoulder (p<0.001) for the LIFT fatigue task. Therefore, increased dynamic stability of these repeated movements cannot be explained by increased muscle cocontraction. Possible alternative mechanisms are discussed. PMID:19942220

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

    PubMed Central

    Nikolaidis, Pantelis Theo

    2012-01-01

    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

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

    PubMed Central

    Richards, Christopher T.; Clemente, Christofer J.

    2013-01-01

    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

  3. Projections of pyramidal tract cells to alpha-motoneurones innervating hind-limb muscles in the monkey.

    PubMed

    Jankowska, E; Padel, Y; Tanaka, R

    1975-08-01

    1. We have investigated the spatial organization of monosynaptic corticospinal projections to hind-limb motoneurones, using near threshold stimulation of the surface of the precentral gyrus to activate pyramidal tract (PT) cells and intracellular recording from motoneurones to detect the resulting e.p.s.p.s. 2. Monosynaptic e.p.s.p.s. of cortical origin were seen in all motoneurone species investigated, those of distal as well as of proximal hind-limb muscles. The proportion of motoneurones in which the e.s.p.s. were evoked and the amplitudes of the latter indicated a more extensive cortical projection to motor nuclei for distal than for proximal muscles, as previously found for forelimb motoneurones. 3. Cortical areas from which monosynaptic e.p.s.p.s. were evoked in individual motoneurones were remarkably large, most often between 3 and 7 mm2. Several motoneurones appeared to have two or three separate areas within the hind-limb division of the motor cortex. 4. Areas of location of pyramidal tract cells projecting to various motoneurones innervating one muscle were usually not identical. They overlapped often only partially or did not overlap at all. 5. Areas of location of pyramidal tract cells projecting to motor nuclei for different muscles often showed an extensive overlap. When it occurred, various motoneurones of a given motor nucleus had common cortical projection areas with motoneurones of other motor nuclei, either to synergistic or to antagonistic muscles. Our results give further evidence for overlapping of areas of cortical projections to motoneurones and speak against a mosaic-like organization of pyramidal tract cells projecting to different motor nuclei. 6. The rise times of cortically evoked e.p.s.p.s. indicate that the corticospinal tract fibres terminate on motoneurones at approximately similar distances from the soma as group Ia afferents. The small amplitudes of the majority of e.p.s.p.s. evoked by near threshold cortical stimulation therefore suggest that unitary e.p.s.p.s of cortical origin are small and that the density of pyramidal tract cells projecting to individual motoneurones is usually low, even in the centrum of projection areas. 7. Effects of intracortical stimulation depended on the stimulus strength. With currents of 2-3 muA, e.p.s.p.s were usually evoked in one motoneurone species or in close synergists. With currents of 5-10 muA, largest e.p.s.p.s a number of other motoneurones. Latencies of descending volleys in the lumbar corticospinal tract indicated that intracortical stimuli activated pyramidal tract cells indirectly; the effects of these stimuli could thus not be used to indicate the location of pyramidal tract cells responsible for them. PMID:1177109

  4. Treatment of physiotherapy-refractory secondary upper limb lymphedema with vascularized lymph node transfer: A case report with clinical and bioimpedance analysis correlation.

    PubMed

    Wong, Melody Man-Kuen; Liu, Hin-Lun

    2015-11-17

    With radical treatment of cancer, lymphedema of limb has become a commonly faced adverse effect. The introduction of vascularized lymph node transfer (VLNT) has provided a possible treatment option for this troublesome condition. In this case report, we describe a 66-year-old lady who developed upper limb lymphedema after operation and radiotherapy for the cancer of her left breast. Her lymphedema did not improve despite wearing pressure garment and receiving six months of regular decongestive physiotherapy. VLNT was performed for this patient, the pre- and post-operative limb circumference and bioimpedance measurements were compared. After operation, the patient continued with her previous physiotherapy regimen. Complete resolution of pitting edema was demonstrated five months after VLNT. In addition, there was a marked improvement in both limb circumference and bioimpedance measurements. From this case report, VLNT appears to be a promising treatment option for secondary lymphedema. We suggest this case report can serve as a model for future studies. PMID:26397769

  5. [Evaluation of the exposure to biomechanical overload of the upper limbs and clinical investigation in a female population employed in the manual loading of production lines in 2 ceramics factories].

    PubMed

    Martinelli, M; Carri, M G

    1996-01-01

    The aim of this study was to assess the presence of an increased risk of biomechanical overload of the upper limbs in the ceramics industry, among workers manually loading production lines. The study focused on two factories: in the first, most of the work was performed manually, whilst in the second the manufacturing process had been almost entirely automated. A total of 46 female workers were examined in both factories, to check for the presence of any disorders of the shoulder, elbow and wrist, as well as for any signs of carpal tunnel medial nerve pain. Approximately two thirds of the workers had positive results of the examinations and went on to undergo 2nd level testing (physiatric examination, muscle tendon US, electromyography) to confirm the diagnosis. In both factories, an increased risk was detected in terms of intensity of exertion, frequency of actions and inadequate recovery times. The posture and movements analysis showed that each of the segments of the upper limbs studied were involved. In both factories, at least 3 out of every 4 workers tested positive for a disorder of at least one segment. Diagnoses were almost invariably confirmed by the 2nd level tests. The progressive automation of the ceramics industry over recent years does not seem therefore to have reduced the risk of biomechanical overload disorders in the upper limbs, at least in relation to those jobs which still feature manual tasks. In view of the social costs associated with such disorders, it would appear mandatory to pursue the investigation further, particularly focusing on those jobs (e.g. polishing, cutting, special shapes, etc.) which can be expected to feature manual tasks. PMID:9148124

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

    PubMed Central

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

    2015-01-01

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

  7. Upper Extremity Artificial Limb Control as an Issue Related to Movement and Mobility in Daily Living

    ERIC Educational Resources Information Center

    Wallace, Steve; Anderson, David I.; Trujillo, Michael; Weeks, Douglas L.

    2005-01-01

    The 1992 NIH Research Planning Conference on Prosthetic and Orthotic Research for the 21st Century (Childress, 1992) recognized that the field of prosthetics lacks theoretical understanding and empirical studies on learning to control an upper-extremity prosthesis. We have addressed this problem using a novel approach in which persons without…

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

    E-print Network

    Krovi, Venkat

    -based diagnostic and rehabilitation tool (see video) to assist the rapid functional recovery of people with Upper framework takes advantage of manipulation of an instrumented manipulandum along prescribed movement patterns to create a sensitive, quantitative, computer-based assessment/diagnostic tool. Specifically, in this paper

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

    E-print Network

    Perreault, Eric J.

    ,c,d , James W. Stinear b,c,f a Environment and Ergonomics Research Group, Autodesk Research, Toronto, ON. Methods: The amplitude of individual motor evoked potentials (MEPs) was evaluated in each of thirteen lengths were assessed using a biomechanical arm model. Additionally, M-waves were evoked in the BIC

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  11. Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature

    PubMed Central

    RODRÍGUEZ-NIEDENFÜHR, M.; VÁZQUEZ, T.; NEARN, L.; FERREIRA, B.; PARKIN, I.; SAÑUDO, J. R.

    2001-01-01

    A total of 192 embalmed cadavers were examined in order to present a detailed study of arterial variations in the upper limb and a meta-analysis of them. The variable terminology previously used was unified into a homogenous and complete classification, with 12 categories covering all the previously reported variant patterns of the arm and forearm. PMID:11760886

  12. Mitochondrial and myoplasmic [Ca2+] in single fibres from mouse limb muscles during repeated tetanic contractions.

    PubMed

    Bruton, Joseph; Tavi, Pasi; Aydin, Jan; Westerblad, Håkan; Lännergren, Jan

    2003-08-15

    Previous studies on single fast-twitch fibres from mouse toe muscles have shown marked fatigue-induced changes in the free myoplasmic [Ca2+] ([Ca2+]i), while mitochondrial [Ca2+] remained unchanged. We have now investigated whether muscle fibres from the legs of mice respond in a similar way. Intact, single fibres were dissected from the soleus and extensor digitorum longus (EDL) muscles of adult mice. To measure [Ca2+]i, indo-1 was injected into the isolated fibres. Mitochondrial [Ca2+] was measured using Rhod-2 and confocal laser microscopy. Fatigue was induced by up to 1000 tetanic contractions (70 Hz) given at 2 s intervals. In soleus fibres, there was no significant decrease in tetanic [Ca2+]i at the end of the fatiguing stimulation, whereas tetanic force was significantly reduced by about 30 %. In 10 out of 14 soleus fibres loaded with Rhod-2 and subjected to fatigue, mitochondrial [Ca2+] increased to a maximum after about 50 tetani; this increase was fully reversed within 20 min after the end of stimulation. The force-frequency curve of the non-responding soleus fibres was shifted to higher frequencies compared to that of the responding fibres. In addition, eight out of nine Rhod-2-loaded EDL fibres showed similar changes in mitochondrial [Ca2+] during and after a period of fatiguing stimulation. The stimulation-induced increase in mitochondrial [Ca2+] was reduced when mitochondria were depolarised by application of carbonyl cyanide 4-(trifluoromethoxy)phenylhydrazone, whereas it was increased by application of an inhibitor of the mitochondrial Na+/Ca2+ exchange (CGP-37157). In conclusion, isolated slow-twitch muscle fibres show only modest changes in tetanic force and [Ca2+]i during repeated contractions. The increase in mitochondrial Ca2+ does not appear to be essential for activation of mitochondrial ATP production, nor does it cause muscle damage. PMID:12815178

  13. Patterns of neuromuscular activity following tendon transfer in the upper limb: a preliminary study.

    PubMed

    Leffert, R D; Meister, M

    1976-11-01

    Early results of a continuing study of the electrical activity of muscles after transfer, with an integrated system of electromyographic and video tape recording, recorded motions of the simple voluntary type, mostly with isometric contractions. A triceps-to-biceps transfer showed activity in the new motion one day after operation. A partial transfer of the pectoralis major (Clark) demonstrated isolated activity of the transfer after one year. A superficialis transfer to clawed ring and little fingers functioned to flex the metacarpophalangeal joints and to extend the interphalangeal joints. Transfer of superficialis to finger extensors showed that antagonists acted to provide unresisted extension. The original phasic activity of a muscle was retained in a study of extensor indicis proprius to thumb for opposition. New phasic activity was shown in transfer of extensor carpi radialis longus to digital flexors. In two instances of transfer of spastic wrist flexors to wrist extensors, the original phasic activity was retained, but in only one was the function assumed by the transfer even though wrist extension was improved. PMID:1018085

  14. The Accuracy of Conventional 2D Video for Quantifying Upper Limb Kinematics in Repetitive Motion Occupational Tasks

    PubMed Central

    Chen, Chia-Hsiung; Azari, David; Hu, Yu Hen; Lindstrom, Mary J.; Thelen, Darryl; Yen, Thomas Y.; Radwin, Robert G.

    2015-01-01

    Objective Marker-less 2D video tracking was studied as a practical means to measure upper limb kinematics for ergonomics evaluations. Background Hand activity level (HAL) can be estimated from speed and duty cycle. Accuracy was measured using a cross correlation template-matching algorithm for tracking a region of interest on the upper extremities. Methods Ten participants performed a paced load transfer task while varying HAL (2, 4, and 5) and load (2.2 N, 8.9 N and 17.8 N). Speed and acceleration measured from 2D video were compared against ground truth measurements using 3D infrared motion capture. Results The median absolute difference between 2D video and 3D motion capture was 86.5 mm/s for speed, and 591 mm/s2 for acceleration, and less than 93 mm/s for speed and 656 mm/s2 for acceleration when camera pan and tilt were within ±30 degrees. Conclusion Single-camera 2D video had sufficient accuracy (< 100 mm/s) for evaluating HAL. Practitioner Summary This study demonstrated that 2D video tracking had sufficient accuracy to measure HAL for ascertaining the American Conference of Government Industrial Hygienists Threshold Limit Value® for repetitive motion when the camera is located within ±30 degrees off the plane of motion when compared against 3D motion capture for a simulated repetitive motion task. PMID:25978764

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

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

    The "4-day wave" is an eastward moving quasi-nondispersive feature with period near 4 days occurring near the winter polar stratopause. This paper presents evidence of the 4-day feature in Microwave Limb Sounder (MLS) temperature, geopotential height, and ozone data from the late southern winters of 1992 and 1993. Space-time spectral analyses reveal a double-peaked temperature structure consisting of one peak near the stratopause and another in the lower mesosphere, with an out-of-phase relationship between the two peaks. This double- peaked structure is reminiscent of recent three-dimensional barotropic/baroclinic instability model predictions and is observed here for the first time. The height variation of the 4-day ozone signal is shown to compare well with a linear advective-photochemical tracer model. Negative regions of quasigeostrophic potential vorticity (PV) gradient and positive Eliassen-Palm flux divergence are shown to occur, consistent with instability dynamics playing a role in wave forcing. Spectral analyses of PV derived from MLS geopotential height fields reveal a 4-day signal peaking near the polar stratopause. The three-dimensional structure of the 4-day wave resembles the potential vorticity "charge" concept, wherein a PV anomaly in the atmosphere (analogous to an electrical charge in a dielectric material) induces a geopotential field, a vertically oriented temperature dipole, and circulation about the vertical axis.

  16. Evaluating Functional Outcomes of Botulinum Toxin Type A Injection Combined with Occupational Therapy in the Upper Limbs of Children with Cerebral Palsy: A 9-Month Follow-Up from the Perspectives of Both Child and Caregiver

    PubMed Central

    Lin, Yu-Ching; Huang, Chien-Yu; Lin, I-Ling; Shieh, Jeng-Yi; Chung, Yu-Ting; Chen, Kuan-Lin

    2015-01-01

    Objective To assess the effectiveness of combining botulinum toxin type A (BoNT-A) with functional occupational therapy (OT) at 9-month follow-up in children with cerebral palsy (CP) with bilateral upper limb impairments from the perspectives of both child and caregiver. Methods Twelve children with CP and their caregivers were assessed across 5 time points over 9 months based on the ICF after BoNT-A injection and functional OT in this open-label study. Results Significant differences were found across the 5 time points (p < .05) for both grasp and visual-motor integration with small effects (effect sizes = 0.12–0.24) and the self-care capability and performance of social function (p < .05). However, based on the effect sizes (0.02–0.14), no significant effects were found at the 4 post-test time points. Small effects were found on the psychological domain (effect sizes = 0.25–0.37) and environmental domains (effect size = 0.27) at follow-ups. Conclusion Combining a BoNT-A injection with OT not only reduced the muscle tone and increased ROM but also improved the upper limb function and self-care capability in children with CP. More importantly, these effects persisted for up to 9 months. Functional OT extends the effectiveness of a BoNT-A injection. PMID:26599003

  17. EMG spectral characteristics of masticatory muscles and upper trapezius during maximum voluntary teeth clenching.

    PubMed

    Lodetti, Gianluigi; Mapelli, Andrea; Musto, Federica; Rosati, Riccardo; Sforza, Chiarella

    2012-02-01

    To assess the surface electromyographic spectral characteristics of masticatory and neck muscles during the performance of maximum voluntary clench (MVC) tasks, 29 healthy young adults (15 men, 14 women, mean age 22years) were examined. Electromyography of masseter, temporalis and upper trapezius muscles was performed during 5-s MVCs either on cotton rolls or in intercuspal position. Using a fast Fourier transform, the median power frequency (MPF) was obtained for the first and last seconds of clench, and compared between sexes, muscles, sides, tests and time intervals using ANOVAs. On average, the MPFs did not differ between sexes or sides (p>0.05), but significant effects of muscle (MPF temporalis larger than masseter, larger than trapezius muscles), test (larger MPFs when clenching in intercuspal position than when clenching on cotton rolls) and time (larger MPFs in the first than in the fifth second of clench) were found. In conclusion, a set of data to characterize the sEMG spectral characteristics of jaw and neck muscles in young adult subjects performing MVC tasks currently in use within the dental field was obtained. Reference values may assist in the assessment of patients with alterations in the cranio-cervical-mandibular system. PMID:22100151

  18. Soft Tissue Reconstruction of Open Fractures of the Lower Limb: muscle versus fasciocutaneous flaps

    PubMed Central

    Chan, James K-K; Harry, Lorraine; Williams, Garry; Nanchahal, Jagdeep

    2012-01-01

    Early vascularized soft tissue closure has long been recognized to be essential in achieving eventual infection free union. The question of whether muscle or fasciocutaneous tissue is superior in terms of promoting fracture healing remains unresolved. Here we review the experimental and clinical evidence for the different tissue types and advocate that the biological role of flaps should be included as a key consideration during flap selection. PMID:22842425

  19. GROUP III/IV MUSCLE AFFERENTS IMPAIR LIMB BLOOD IN PATIENTS WITH CHRONIC HEART FAILURE

    PubMed Central

    Amann, Markus; Venturelli, Massimo; Ives, Stephen J.; Morgan, David E.; Gmelch, Benjamin; Witman, Melissa A.H.; Groot, H. Jonathan; Wray, D. Walter; Stehlik, Josef; Richardson, Russell S.

    2014-01-01

    Objective To better understand the hemodynamic and autonomic reflex abnormalities in heart-failure patients (HF), we investigated the influence of group III/IV muscle afferents on their cardiovascular response to rhythmic exercise. Methods Nine HF-patients (NYHA class-II, mean left ventricular ejection-fraction: 27±3%) performed single leg knee-extensor exercise (25/50/80% peak-workload) under control conditions and with lumbar intrathecal fentanyl impairing ?-opioid receptor-sensitive muscle afferents. Results Cardiac-output (Q) and femoral blood-flow (QL) were determined, and arterial/venous blood samples collected at each workload. Exercise-induced fatigue was estimated via pre/post-exercise changes in quadriceps strength. There were no hemodynamic differences between conditions at rest. During exercise, Q was 8–13% lower with Fentanyl-blockade, secondary to significant reductions in stroke volume and heart rate. Lower norepinephrine spillover during exercise with Fentanyl revealed an attenuated sympathetic outflow that likely contributed to the 25% increase in leg vascular conductance (p<0.05). Despite a concomitant 4% reduction in blood pressure, QL was 10–14% higher and end-exercise fatigue attenuated by 30% with Fentanyl-blockade (p<0.05). Conclusion/Practice/Implications Although group III/IV muscle afferents play a critical role for central hemodynamics in HF-patients, it also appears that these sensory neurons cause excessive sympatho-excitation impairing QL which likely contributes to the exercise intolerance in this population. PMID:24794967

  20. A Robot Hand Testbed Designed for Enhancing Embodiment and Functional Neurorehabilitation of Body Schema in Subjects with Upper Limb Impairment or Loss

    PubMed Central

    Hellman, Randall B.; Chang, Eric; Tanner, Justin; Helms Tillery, Stephen I.; Santos, Veronica J.

    2015-01-01

    Many upper limb amputees experience an incessant, post-amputation “phantom limb pain” and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF), rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech “rubber hand” illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the “BairClaw” presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger–object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced cognitive burden. PMID:25745391

  1. The Relationship between Independent Transfer Skills and Upper Limb Kinetics in Wheelchair Users

    PubMed Central

    Boninger, Michael L.; Koontz, Alicia M.

    2014-01-01

    Transfers are one of the most physically demanding wheelchair activities. The purpose of this study was to determine if using proper transfer skills as measured by the Transfer Assessment Instrument (TAI) is associated with reduced loading on the upper extremities. Twenty-three wheelchair users performed transfers to a level-height bench while a series of forces plates, load cells, and a motion capture system recorded the biomechanics of their natural transferring techniques. Their transfer skills were simultaneously evaluated by two study clinicians using the TAI. Logistic regression and multiple linear regression models were used to determine the relationships between TAI scores and the kinetic variables on both arms across all joints. The results showed that the TAI measured transfer skills were closely associated with the magnitude and timing of joint moments (P < .02, model R2 values ranged from 0.27 to 0.79). Proper completion of the skills which targeted the trailing arm was associated with lower average resultant moments and rates of rise of resultant moments at the trailing shoulder and/or elbow. Some skills involving the leading side had the effect of increasing the magnitude or rate loading on the leading side. Knowledge of the kinetic outcomes associated with each skill may help users to achieve the best load-relieving effects for their upper extremities. PMID:25162039

  2. Experience of using vascularized bone grafts in reconstructive surgery of the upper limbs

    NASA Astrophysics Data System (ADS)

    Atamanov, E. A.; Keosyan, V. T.; Bryukhanov, A. V.; Tsaregorodtseva, E. M.; Danilov, A. V.

    2015-11-01

    The article describes the results of treatment patients with defects and diseases of bone tissue using bone grafting with vascularized bone grafts from different areas of the body. The results of treatment of 27 patients with bone tissue defects of the upper extremities are demonstrated. 16 of patients had scaphoid nonunion. 2 cases of nonunion were reported: one scaphoid nonunion due to unstable osteosynthesis and one lunate fragmentation nonunion in patient with late stage Kienbock`s disease. Vascularized bone graft from distal radius was used in both cases. We had two cases of delayed union at 18 months in surgical treatment of scaphoid. 2 patients had metacarpal bone defect, 1 patient with radius bone defect, 2 patients with SLAC (scapholunate advanced collapse), 2 patients with bone defect of the humerus, 1 patient with bone defect of the ulna. In all cases we used vascularized bone crafts from various anatomical areas. We achieved union in all other cases. The study shows high efficiency of upper extremity bone defect replacement methods.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    2002-01-01

    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

  6. Pattern of cutaneous inhibition of the propriospinal-like excitation to human upper limb motoneurones.

    PubMed Central

    Nielsen, J; Pierrot-Deseilligny, E

    1991-01-01

    1. The pattern of cutaneous inhibition of non-monosynaptic excitation (or 'propriospinal-like' excitation) to various species of motoneurones-wrist flexors and extensors, biceps and deltoid - was investigated in man. 2. Changes in the firing probability of individual voluntarily activated motor units were studied following various stimuli. The effects of weak cutaneous stimuli applied to the skin of either the palmar or the dorsal side of the fingers on propriospinal-like excitation evoked by stimulation of different mixed nerves (median, radial, musculo-cutaneous) were investigated. 3. Cutaneous stimuli were found to produce an inhibition with a very specific pattern, which depended on the afferent input evoking the excitation. Thus, the median nerve-induced excitation of wrist and elbow flexors was depressed by cutaneous afferents from the palmar side but not from the dorsal side of the fingers; the radial nerve-induced excitation of wrist extensors was only depressed from the dorsal side: the musculo-cutaneous nerve-induced excitation of motor units of various wrist, elbow and shoulder muscles was depressed from both sides. 4. It is argued that this pattern implies that the excitation is mediated to the motoneurones through different subsets of neurones, organized according to the afferent input. 5. The functional significance of the pattern of cutaneous inhibition is discussed and it is argued that it could contribute to an appropriately timed termination of a movement mediated through the propriospinal system. PMID:2023117

  7. A modified multi-channel EMG feature for upper limb motion pattern recognition.

    PubMed

    Tsai, An-Chih; Luh, Jer-Junn; Lin, Ta-Te

    2012-01-01

    The EMG signal is a well-known and useful biomedical signal. Much information related to muscles and human motions is included in EMG signals. Many approaches have proposed various methods that tried to recognize human motion via EMG signals. However, one of the critical problems of motion pattern recognition is that the performance of recognition is easily affected by the normalization procedure and may not work well on different days. In this paper, a modified feature of the multi-channel EMG signal is proposed and the normalization procedure is also simplified by using this modified feature. To recognize motion pattern, we applied the support vector machine (SVM) to build the motion pattern recognition model. In training and validation procedures, we used the 2-DoF exoskeleton robot arm system to do the designed pose, and the multi-channel EMG signals were obtained while the user resisted the robot. Experiment results indicate that the performance of applying the proposed feature (94.9%) is better than that of conventional features. Moreover, the performances of the recognition model, which applies the modified feature to recognize the motions on different days, are more stable than other conventional features. PMID:23366705

  8. Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage—a feasibility study protocol

    PubMed Central

    Street, Alexander J.; Magee, Wendy L.; Odell-Miller, Helen; Bateman, Andrew; Fachner, Jorg C.

    2015-01-01

    Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3–60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes. PMID:26441586

  9. Pattern of propriospinal-like excitation to different species of human upper limb motoneurones.

    PubMed Central

    Gracies, J M; Meunier, S; Pierrot-Deseilligny, E; Simonetta, M

    1991-01-01

    1. The pattern of distribution of non-monosynaptic (propriospinal-like) excitation to various motor nuclei (deltoid, extensors and flexors of the elbow, the wrist and the fingers) was investigated. 2. Changes in the firing probability of individual voluntarily activated motor units were studied following conditioning stimuli. Conditioning volleys were evoked by weak electrical stimuli applied to various mixed nerves (circumflex, musculocutaneous, median, radial, ulnar) and to the skin. 3. In all investigated nuclei stimulation of the 'homonymous' nerve evoked a peak of increased firing probability with a latency which was 2-7 ms longer than the monosynaptic Ia latency. The average central delay of the late excitation, measured from monosynaptic latency, seems to depend only on the segmental level of the motor nucleus: the more caudal the nucleus the longer the latency. This strongly suggest a transmission through neurones located above the cervical enlargement, as are C3--C4 propriospinal neurones in the cat. 4. Both group I muscle and cutaneous afferents were shown to contribute to propriospinal-like excitation. It is argued that a spatial facilitation of the effects evoked by these two inputs might explain why the threshold of late excitation is always below that of the monosynaptic Ia excitation in motoneurones. 5. The pattern of distribution of propriospinal-like excitation was diffuse: stimulation of each mixed nerve was able to evoke excitation in all investigated motor nuclei. Similarly, stimulation of a given skin field could produce excitation of biceps and wrist flexor and extensor units. 6. Each motor nucleus therefore receives excitation from a multimodal and wide range peripheral input. However, it is argued that what appears as a diffuse pattern might simply reflect connections which are not used in each movement but appropriately selected by higher centres. PMID:2023116

  10. Organization of pontine reticulospinal inputs to motoneurons controlling axial and limb muscles in the neonatal mouse

    PubMed Central

    Sivertsen, Magne S.; Glover, Joel C.

    2014-01-01

    Using optical recording of synaptically mediated calcium transients and selective spinal lesions, we investigated the pattern of activation of spinal motoneurons (MNs) by the pontine reticulospinal projection in isolated brain stem-spinal cord preparations from the neonatal mouse. Stimulation sites throughout the region where the pontine reticulospinal neurons reside reliably activated MNs at cervical, thoracic, and lumbar levels. Activation was similar in MNs ipsi- and contralateral to the stimulation site, similar in medial and lateral motor columns that contain trunk and limb MNs, respectively, and similar in the L2 and L5 segments that predominantly contain flexor and extensor MNs, respectively. In nonlesioned preparations, responses in both ipsi- and contralateral MNs followed individual stimuli in stimulus trains nearly one-to-one (with few failures). After unilateral hemisection at C1 on the same side as the stimulation, responses had substantially smaller magnitudes and longer latencies and no longer followed individual stimuli. After unilateral hemisection at C1 on the side opposite to the stimulation, the responses were also smaller, but their latencies were not affected. Thus we distinguish two pontine reticulospinal pathways to spinal MNs, one uncrossed and the other crossed, of which the uncrossed pathway transmits more faithfully and appears to be more direct. PMID:24944221

  11. Effects of wearing gumboots and leather lace-up boots on lower limb muscle activity when walking on simulated underground coal mine surfaces.

    PubMed

    Dobson, Jessica A; Riddiford-Harland, Diane L; Steele, Julie R

    2015-07-01

    This study aimed to investigate the effects of wearing two standard underground coal mining work boots (a gumboot and a leather lace-up boot) on lower limb muscle activity when participants walked across simulated underground coal mining surfaces. Quadriceps (rectus femoris, vastus medialis, vastus lateralis) and hamstring (biceps femoris, semitendinosus) muscle activity were recorded as twenty male participants walked at a self-selected pace around a circuit while wearing each boot type. The circuit consisted of level, inclined and declined surfaces composed of rocky gravel and hard dirt. Walking in a leather lace-up boot, compared to a gumboot, resulted in increased vastus lateralis and increased biceps femoris muscle activity when walking on sloped surfaces. Increased muscle activity appears to be acting as a slip and/or trip prevention strategy in response to challenging surfaces and changing boot features. PMID:25766420

  12. The Effects of PNF Techniques on Lymphoma in the Upper Limbs.

    PubMed

    Hwang, Okchul; Ha, Kyungjin; Choi, Seungjun

    2013-07-01

    [Purpose] The purpose of this study were to identify whether painless dynamic PNF techniques can reduce lymphedema, and to provide basic reference data for use in the treatment of lymphedema patients. [Subjects] This experiment was conducted from March 2012 to July 2012 at Busan University Hospital D. The subjects were upper extremity lymphedema patients who were receiving rehabilitation treatment. Those with dual lymphedema site pain or who did not want to participate in the experiment were excluded. [Methods] A total of 40 women participated in this study, and they received PNF techniques before the application of lymph compression bandages. Group 1 of 20 subjects were adminstered PNF techniques three times a week for 30 minutes each time. Group 2 of 20 subjects only edema reducing massage for 30 minutes. [Results] The interaction between treatment method and treatment time was significant, which indicates that the change in edema at different measurement times was different according to treatment methods. In this study, Group 1 had a steeper rate of decline in edema than Group 2. [Conclusion] In conclusion, both massage and PNF techniques helped to lower edema rates. Four weeks after the beginning of treatment, a larger degree of decline in edema was exhibited in the PNF group than in the massage group. PMID:24259865

  13. Integrated vision-based robotic arm interface for operators with upper limb mobility impairments.

    PubMed

    Jiang, Hairong; Wachs, Juan P; Duerstock, Bradley S

    2013-06-01

    An integrated, computer vision-based system was developed to operate a commercial wheelchair-mounted robotic manipulator (WMRM). In this paper, a gesture recognition interface system developed specifically for individuals with upper-level spinal cord injuries (SCIs) was combined with object tracking and face recognition systems to be an efficient, hands-free WMRM controller. In this test system, two Kinect cameras were used synergistically to perform a variety of simple object retrieval tasks. One camera was used to interpret the hand gestures to send as commands to control the WMRM and locate the operator's face for object positioning. The other sensor was used to automatically recognize different daily living objects for test subjects to select. The gesture recognition interface incorporated hand detection, tracking and recognition algorithms to obtain a high recognition accuracy of 97.5% for an eight-gesture lexicon. An object recognition module employing Speeded Up Robust Features (SURF) algorithm was performed and recognition results were sent as a command for "coarse positioning" of the robotic arm near the selected daily living object. Automatic face detection was also provided as a shortcut for the subjects to position the objects to the face by using a WMRM. Completion time tasks were conducted to compare manual (gestures only) and semi-manual (gestures, automatic face detection and object recognition) WMRM control modes. The use of automatic face and object detection significantly increased the completion times for retrieving a variety of daily living objects. PMID:24187264

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

    PubMed

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

    2012-02-01

    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

  15. Validation of Aura Microwave Limb Sounder O3 and CO Observations in the Upper Troposphere and Lower Stratosphere

    NASA Technical Reports Server (NTRS)

    Livesey, N. J.; Filipiak, M. J.; Froidevaux, L.; Read, W. G.; Lambert, A.; Santee, J. L.; Jiang, J. H.; Pumphrey, H. C.; Waters, J. W.; Cofield, R. E.; Cuddy, D. T.; Daffer, W. H.; Drouin, B. J.; Fuller, R. A.; Jarnot, R. F.; Jiang, Y. B.; Knosp, B. W.; Li, Q. B.; Perun, V. S.; Schwartz, M. J.; Snyder, W. V.; Stek, P. C.; Thurstans, R. P.; Wagner, P. A.; Avery, M.

    2008-01-01

    Global satellite observations of ozone and carbon monoxide from the Microwave Limb Sounder (MLS) on the EOS Aura spacecraft are discussed with emphasis on those observations in the 2 15 - 100 hPa region (the upper troposphere and lower stratosphere). The precision, resolution and accuracy of the data produced by the MLS "version 2.2" processing algorithms are discussed and quantified. O3 accuracy is estimated at approx.40 ppbv +5% (approx.20 ppbv +20% at 215 hPa) while the CO accuracy is estimated at approx.30 ppbv +30% for pressures of 147 hPa and less. Comparisons with expectations and other observations show good agreements for the O3 product, generally consistent with the systematic errors quoted above. In the case of COY a persistent factor of approx.2 high bias is seen at 215 hPa. However, the morphology is shown to be realistic, consistent with raw MLS radiance data, and useful for scientific study. The MLS CO data at higher altitudes are shown to be consistent with other observations.

  16. Development of a model osseo-magnetic link for intuitive rotational control of upper-limb prostheses.

    PubMed

    Rouse, Elliott J; Nahlik, David C; Peshkin, Michael A; Kuiken, Todd A

    2011-04-01

    The lack of proprioceptive feedback is a serious deficiency of current prosthetic control systems. The Osseo-Magnetic Link (OML) is a novel humeral or wrist rotation control system that could preserve proprioception. It utilizes a magnet implanted within the residual bone and sensors mounted in the prosthetic socket to detect magnetic field vectors and determine the bone's orientation. This allows the use of volitional bone rotation to control a prosthetic rotator. We evaluated the performance of the OML using a physical model of a transhumeral residual limb. A small Neodymium-Iron-Boron magnet was placed in a model humerus, inside a model upper arm. Four three-axis Hall-effect sensors were mounted on a ring 3 cm distal to the magnet. An optimization algorithm based on Newton's method determined the position and orientation of the magnet within the model humerus under various conditions, including bone translations, interference, and magnet misalignment. The orientation of the model humerus was determined within 3° for rotations centered in the arm; an additional 6° error was found for translations 20 mm from center. Adjustments in sensor placement may reduce these errors. The results demonstrate that the OML is a feasible solution for providing prosthesis rotation control while preserving rotational proprioception. PMID:21193382

  17. Measurement of the effect of playground surface materials on hand impact forces during upper limb fall arrests.

    PubMed

    Choi, Woochol J; Kaur, Harjinder; Robinovitch, Stephen N

    2014-04-01

    Distal radius fractures are common on playgrounds. Yet current guidelines for the selection of playground surface materials are based only on protection against fall-related head injuries. We conducted "torso release" experiments to determine how common playground surface materials affect impact force applied to the hand during upper limb fall arrests. Trials were acquired for falls onto a rigid surface, and onto five common playground surface materials: engineered wood fiber, gravel, mulch, rubber tile, and sand. Measures were acquired for arm angles of 20 and 40 degrees from the vertical. Playground surface materials influenced the peak resultant and vertical force (P<.001), but not the peak horizontal force (P=.159). When compared with the rigid condition, peak resultant force was reduced 17% by sand (from 1039 to 864 N), 16% by gravel, 7% by mulch, 5% by engineered wood fiber, and 2% by rubber tile. The best performing surface provided only a 17% reduction in peak resultant force. These results help to explain the lack of convincing evidence from clinical studies on the effectiveness of playground surface materials in preventing distal radius fractures during playground falls, and highlight the need to develop playground surface materials that provide improved protection against these injuries. PMID:24347512

  18. Recent progress in physical therapy of the upper-limb rehabilitation after stroke: emphasis on thermal intervention.

    PubMed

    Chen, Jia-Ching; Shaw, Fu-Zen

    2006-01-01

    Poor recovery of arm function after stroke can often have a negative impact on the patient and his/her family. These patients often need assistance from the society and may need to rely on government resources. Numerous therapeutic treatments are currently available for stroke rehabilitation. Traditional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, and motor relearning) have been used for many years. However, few of these interventions have been tested in clinical trials and are thus practiced on an empirical basis. Various evidence-based therapies (electric stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotic aided system, and virtual reality) have been added to classic rehabilitation approaches and seem to improve function. Recently, we demonstrated that a novel intervention, thermal stimulation, facilitated upper-limb functional recovery after acute stroke. In this review, we describe detailed thermal stimulation procedures and outcomes in stroke patients. We found that thermal stimulation in combination with other physiotherapies or chemotherapies was of great benefit to stroke patients. Development of a better rehabilitation paradigm that maximizes rapid recovery of arm function is a priority to help stroke patients and society. PMID:17293737

  19. In vivo Monitoring of Transcriptional Dynamics After Lower-Limb Muscle Injury Enables Quantitative Classification of Healing

    PubMed Central

    Aguilar, Carlos A.; Shcherbina, Anna; Ricke, Darrell O.; Pop, Ramona; Carrigan, Christopher T.; Gifford, Casey A.; Urso, Maria L.; Kottke, Melissa A.; Meissner, Alexander

    2015-01-01

    Traumatic lower-limb musculoskeletal injuries are pervasive amongst athletes and the military and typically an individual returns to activity prior to fully healing, increasing a predisposition for additional injuries and chronic pain. Monitoring healing progression after a musculoskeletal injury typically involves different types of imaging but these approaches suffer from several disadvantages. Isolating and profiling transcripts from the injured site would abrogate these shortcomings and provide enumerative insights into the regenerative potential of an individual’s muscle after injury. In this study, a traumatic injury was administered to a mouse model and healing progression was examined from 3?hours to 1 month using high-throughput RNA-Sequencing (RNA-Seq). Comprehensive dissection of the genome-wide datasets revealed the injured site to be a dynamic, heterogeneous environment composed of multiple cell types and thousands of genes undergoing significant expression changes in highly regulated networks. Four independent approaches were used to determine the set of genes, isoforms, and genetic pathways most characteristic of different time points post-injury and two novel approaches were developed to classify injured tissues at different time points. These results highlight the possibility to quantitatively track healing progression in situ via transcript profiling using high- throughput sequencing. PMID:26381351

  20. Stable human standing with lower-limb muscle afferents providing the only sensory input.

    PubMed Central

    Fitzpatrick, R; Rogers, D K; McCloskey, D I

    1994-01-01

    1. This study investigated the sources of sensory information upon which normal subjects' ability to stand depends. 2. An 'equivalent body' was used to simulate the physical properties of each subject's body during standing. The modulation of ankle torque required to support the equivalent body in an upright position was similar to that required to support the subject's own body when standing. However, when balancing the equivalent body, vestibular inputs were excluded from directing the appropriate changes in ankle torque. Thus, stability of stance could be studied with (normal stance) and without (balancing equivalent body) modulation by vestibular inputs. Vision could be excluded by closing the eyes. Sensory input from the feet and ankles could be removed by local anaesthesia from prolonged ischaemia, induced by occluding blood flow with inflated pneumatic cuffs just above the ankles. With vestibular, visual and peripheral sensory inputs negated, standing could rely only upon remaining sensory inputs, notably those from sensory receptors in the leg muscles. 3. Unlike the human body, the equivalent body used to negate vestibular inputs is not segmented. Therefore, the effects on stability of having a segmented body were determined by splinting subjects during standing so that only ankle movement was possible. This was done in the presence and absence of visual stabilization. 4. For each experimental task, either standing or balancing the equivalent body, sway was recorded while posture was unperturbed. Root mean square values of sway amplitude and power spectra were used to compare conditions. 5. Every subject could balance the equivalent body in a stable way when the eyes were closed, and when the feet were anaesthetized.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 1 Figure 3 PMID:7869254

  1. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test

    PubMed Central

    Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

    2015-01-01

    The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p?upper limb function. PMID:26248957

  2. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test.

    PubMed

    Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

    2015-10-01

    The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p?upper limb function. PMID:26248957

  3. The effects of cognitive exercise therapy on chronic stroke patients’ upper limb functions, activities of daily living and quality of life

    PubMed Central

    Lee, Sunghee; Bae, Seahyun; Jeon, Daejung; Kim, Kyung Yoon

    2015-01-01

    This study aimed to examine the effects of task-oriented exercise therapy and cognitive exercise therapy on the recovery of hand function and the quality of life in chronic stroke patients. [Subjects and Methods] A total of 16 patients with chronic stroke were selected and divided into two groups. Group I (n = 8) received task-oriented exercise therapy and Group II (n = 8) received cognitive exercise therapy. This study was conducted for eight weeks. Upper limb function was assessed using the Fugl-Meyer assessment (FMA) and manual function test (MFT); activities of daily living were assessed using the motor activity log (MAL); and the quality of life was assessed using the stroke impact scale (SIS). The pre- and post-intervention results of these tests were analyzed. [Results] There were significant differences in all areas of upper limb function, activities of daily living, and quality of life between the two groups. There were significant differences between the two groups in the post-intervention upper limb function and quality of life. [Conclusion] Application of cognitive exercise therapy was found to effect functional recovery in stroke patients. Future research should focus on application of cognitive exercise therapy in diverse populations, and assess its clinical utilization. PMID:26504294

  4. Assessment of grip strength with the modified sphygmomanometer test: association between upper limb global strength and motor function

    PubMed Central

    Martins, Júlia C.; Aguiar, Larissa T.; Lara, Eliza M.; Teixeira-Salmela, Luci F.; Faria, Christina D. C. M.

    2015-01-01

    ABSTRACT Background: Grip strength, commonly evaluated with the handgrip dynamometer, is a good indicator of upper limb (UL) function in stroke subjects and may reflect the global strength deficits of the whole paretic UL. The Modified Sphygmomanometer Test (MST) also provides objective and adequate measures at low-cost. Objective: To assess whether grip strength values obtained by using the MST and those obtained by using a handgrip dynamometer would present similar correlations with the global strength and motor function of the paretic UL in subjects with stroke, both in the subacute and chronic phases. Method: Measures of grip strength (MST and handgrip dynamometer), UL global strength (MST and hand-held dynamometer), and UL motor function (Fugl-Meyer motor assessment scale) were obtained with 33 subacute and 44 chronic stroke subjects. Pearson and Spearman correlation coefficients were calculated and Stepwise multiple regression analyses were performed to investigate predictor variables of grip strength (?=0.05). Results: Significant correlations of similar magnitude were found between measures of global strength of the paretic UL and grip strength assessed with both the MST (0.66?r?0.78) and handgrip dynamometer (0.66?r?0.78) and between UL motor function and grip strength assessed with both the MST (0.50?rs?0.51) and hand-held dynamometer (0.50?rs?0.63) in subacute and chronic stroke subjects. Only global strength remained as a significant predictor variable of grip strength for the MST (0.43?R2?0.61) and for the handgrip dynamometer (0.44?R2?0.61) for both stroke subgroups. Conclusion: Grip strength assessed with the MST could be used to report paretic UL global strength. PMID:26647752

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

    PubMed Central

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

    2014-01-01

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

  6. Out on a Limb: Investigating the Anatomy of Tree Limbs

    ERIC Educational Resources Information Center

    Shaw, Edward L.

    2008-01-01

    The author presents several upper elementary science activities involving tree limbs that were collected after severe weather conditions. The activities involved 3rd-grade students arranging tree limb pieces in the correct order from the trunk to the tip of the limb, measuring the pieces, determining the age of a tree limb by its rings,…

  7. Is salamander limb regeneration really perfect? Anatomical and morphogenetic analysis of forelimb muscle regeneration in GFP-transgenic axolotls as a basis for regenerative, developmental, and evolutionary studies.

    PubMed

    Diogo, R; Nacu, E; Tanaka, E M

    2014-06-01

    The axolotl Ambystoma mexicanum is one of the most commonly used model organisms in developmental and regenerative studies because it can reconstitute what is believed to be a completely normal anatomical and functional forelimb/hindlimb after amputation. However, to date it has not been confirmed whether each regenerated forelimb muscle is really a "perfect" copy of the original muscle. This study describes the regeneration of the arm, forearm, hand, and some pectoral muscles (e.g., coracoradialis) in transgenic axolotls that express green fluorescent protein (GFP) in muscle fibers. The observations found that: (1) there were muscle anomalies in 43% of the regenerated forelimbs; (2) however, on average in each regenerated forelimb there are anomalies in only 2.5% of the total number of muscles examined, and there were no significant differences observed in the specific insertion and origin of the other muscles analyzed; (3) one of the most notable and common anomalies (seen in 35% of the regenerated forelimbs) was the presence of a fleshy coracoradialis at the level of the arm; this is a particularly outstanding configuration because in axolotls and in urodeles in general this muscle only has a thin tendon at the level of the arm, and the additional fleshy belly in the regenerated arms is strikingly similar to the fleshy biceps brachii of amniotes, suggesting a remarkable parallel between a regeneration defect and a major phenotypic change that occurred during tetrapod limb evolution; (4) during forelimb muscle regeneration there was a clear proximo-distal and radio-ulnar morphogenetic gradient, as seen in normal development, but also a ventro-dorsal gradient in the order of regeneration, which was not previously described in the literature. These results have broader implications for regenerative, evolutionary, developmental and morphogenetic studies. PMID:24692358

  8. Muscle and Heart Function Restoration in a Limb Girdle Muscular Dystrophy 2I (LGMD2I) Mouse Model by Systemic FKRP Gene Delivery

    PubMed Central

    Qiao, Chunping; Wang, Chi-Hsien; Zhao, Chunxia; Lu, Peijuan; Awano, Hiroyuki; Xiao, Bin; Li, Jianbin; Yuan, Zhenhua; Dai, Yi; Martin, Carrie Bette; Li, Juan; Lu, Qilong; Xiao, Xiao

    2014-01-01

    Mutations in fukutin-related protein (FKRP) gene cause a wide spectrum of disease phenotypes including the mild limb-girdle muscular dystrophy 2I (LGMD2I), the severe Walker-Warburg syndrome, and muscle-eye-brain disease. FKRP deficiency results in ?-dystroglycan (?-DG) hypoglycosylation in the muscle and heart, which is a biochemical hallmark of dystroglycanopathies. To study gene replacement therapy, we generated and characterized a new mouse model of LGMD2I harboring the human mutation leucine 276 to isoleucine (L276I) in the mouse alleles. The homozygous knock-in mice (L276IKI) mimic the classic late onset phenotype of LGMD2I in both skeletal and cardiac muscles. Systemic delivery of human FKRP gene by AAV9 vector in the L276IKI mice, at either neonatal age or at the age of 9 months, rendered body wide FKRP expression and restored glycosylation of ?-DG in both skeletal and cardiac muscles. FKRP gene therapy ameliorated dystrophic pathology and cardiomyopathy such as muscle degeneration, fibrosis, and myofiber membrane leakage, resulting in restoration of muscle and heart contractile functions. Thus, these results demonstrated that the treatment based on FKRP gene replacement was effective. PMID:25048216

  9. Botulinum Toxin Type a Injection, Followed by Home-Based Functional Training for Upper Limb Hemiparesis after Stroke

    ERIC Educational Resources Information Center

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

    2012-01-01

    Botulinum toxin type A (BoNT-A) has been reported to be an effective treatment for limb spasticity after stroke. However, the reduction in the spasticity after BoNT-A injection alone does not ensure an improvement in the active motor function of the affected limb. The aim of this study was to clarify the clinical effects of a BoNT-A injection,…

  10. Age-Specific Effects of Mirror-Muscle Activity on Cross-Limb Adaptations Under Mirror and Non-Mirror Visual Feedback Conditions

    PubMed Central

    Reissig, Paola; Stöckel, Tino; Garry, Michael I.; Summers, Jeffery J.; Hinder, Mark R.

    2015-01-01

    Cross-limb transfer (CLT) describes the observation of bilateral performance gains due to unilateral motor practice. Previous research has suggested that CLT may be reduced, or absent, in older adults, possibly due to age-related structural and functional brain changes. Based on research showing increases in CLT due to the provision of mirror visual feedback (MVF) during task execution in young adults, our study aimed to investigate whether MVF can facilitate CLT in older adults, who are known to be more reliant on visual feedback for accurate motor performance. Participants (N = 53) engaged in a short-term training regime (300 movements) involving a ballistic finger task using their dominant hand, while being provided with either visual feedback of their active limb, or a mirror reflection of their active limb (superimposed over the quiescent limb). Performance in both limbs was examined before, during and following the unilateral training. Furthermore, we measured corticospinal excitability (using TMS) at these time points, and assessed muscle activity bilaterally during the task via EMG; these parameters were used to investigate the mechanisms mediating and predicting CLT. Training resulted in significant bilateral performance gains that did not differ as a result of age or visual feedback (both p > 0.1). Training also elicited bilateral increases in corticospinal excitability (p < 0.05). For younger adults, CLT was significantly predicted by performance gains in the trained hand (? = 0.47), whereas for older adults it was significantly predicted by mirror activity in the untrained hand during training (? = 0.60). The present study suggests that older adults are capable of exhibiting CLT to a similar degree to younger adults. The prominent role of mirror activity in the untrained hand for CLT in older adults indicates that bilateral cortical activity during unilateral motor tasks is a compensatory mechanism. In this particular task, MVF did not facilitate the extent of CLT. PMID:26648867

  11. Quantification of muscle-derived signal interference during monopolar needle electromyography of a peripheral nerve interface in the rat hind limb.

    PubMed

    Woo, Shoshana L; Urbanchek, Melanie G; Leach, Michelle K; Moon, Jana D; Cederna, Paul; Langhals, Nicholas B

    2014-01-01

    High-fidelity signal acquisition is critical for the fundamental control of a neuroprosthesis. Our group has developed a bio-artificial interface consisting of a muscle graft neurotized by a severed nerve in a rat hind limb model. This regenerative peripheral nerve interface (RPNI) permits nerve signal transmission, amplification, and detection via in situ electromyography (EMG). Our study examined the magnitude of signal interference from simultaneously contracting muscles adjacent to our muscle of interest. In eighteen F344 rats, the extensor digitorum longus (EDL) muscle was used to fabricate simulated RPNI constructs of various sizes in which the neurovascular pedicle was preserved, obviating the need for reinnervation or revascularization. After 3 weeks of recovery, in situ EMG testing was performed using electrical stimulation of the common peroneal nerve. A recording needle was placed in the EDL muscle with a reference/ground electrode in the contralateral toe webspace, comprising a monopolar recording configuration. The superficial peroneal nerve was transected to further isolate stimulation of the anterior compartment. Recordings from the EDL were performed before and after excision of the tibialis anterior (TA) and extensor hallucis longus (EHL) muscles. After TA/EHL excision, EDL compound muscle action potential (CMAP) peak-to-peak amplitudes were significantly lower by an average of 7.4±5.6(SD) mV, or 32±18%, (paired t(17)=-5.7, p<;0.0001). A significant positive linear correlation was seen between CMAP amplitude and EDL mass both before TA/EHL excision (r=0.68, n=18, p<;0.01) and after TA/EHL excision (r=0.79, n=18, p<;0.0001). EDL mass did not correlate with differences in CMAP amplitude or area caused by TA/EHL excision. Monopolar needle EMG recordings from the EDL muscle are significantly, but predictively, contaminated by concomitant muscular contractions in the anterior compartment of the rat hind limb. Further investigation of strategies to reduce this signal interference, including electrode choice or configuration, use of bioelectrical insulators, and filtering methods, is warranted to promote high-fidelity signal acquisition for prosthetic control. PMID:25570963

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

    PubMed Central

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

    2008-01-01

    Background Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and cost effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post stroke upper limb spasticity. Methods Trial design : A multi-centre open label parallel group randomised controlled trial and economic evaluation. Participants : Adults with upper limb spasticity at the shoulder, elbow, wrist or hand and reduced upper limb function due to stroke more than 1 month previously. Interventions : Botulinum toxin type A plus upper limb therapy (intervention group) or upper limb therapy alone (control group). Outcomes : Outcome assessments are undertaken at 1, 3 and 12 months. The primary outcome is upper limb function one month after study entry measured by the Action Research Arm Test (ARAT). Secondary outcomes include: spasticity (Modified Ashworth Scale); grip strength; dexterity (Nine Hole Peg Test); disability (Barthel Activities of Daily Living Index); quality of life (Stroke Impact Scale, Euroqol EQ-5D) and attainment of patient-selected goals (Canadian Occupational Performance Measure). Health and social services resource use, adverse events, use of other antispasticity treatments and patient views on the treatment will be compared. Participants are clinically reassessed at 3, 6 and 9 months to determine the need for repeat botulinum toxin type A and/or therapy. Randomisation : A web based central independent randomisation service. Blinding : Outcome assessments are undertaken by an assessor who is blinded to the randomisation group. Sample size : 332 participants provide 80% power to detect a 15% difference in treatment successes between intervention and control groups. Treatment success is defined as improvement of 3 points for those with a baseline ARAT of 0–3 and 6 points for those with ARAT of 4–56. Trial registration ISRCTN78533119 EudraCT 2004-002427-40 CTA 17136/0230/001 Funding National Institute for Health Research, Health Technology Assessment Programme. Ipsen Ltd provide botulinum toxin type A (Dysport®). PMID:18947418

  13. Evaluation of upper body muscle activity during cardiopulmonary resuscitation performance in simulated microgravity

    NASA Astrophysics Data System (ADS)

    Waye, A. B.; Krygiel, R. G.; Susin, T. B.; Baptista, R.; Rehnberg, L.; Heidner, G. S.; de Campos, F.; Falcão, F. P.; Russomano, T.

    2013-09-01

    Performance of efficient single-person cardiopulmonary resuscitation (CPR) is vital to maintain cardiac and cerebral perfusion during the 2-4 min it takes for deployment of advanced life support during a space mission. The aim of the present study was to investigate potential differences in upper body muscle activity during CPR performance at terrestrial gravity (+1Gz) and in simulated microgravity (?G). Muscle activity of the triceps brachii, erector spinae, rectus abdominis and pectoralis major was measured via superficial electromyography in 20 healthy male volunteers. Four sets of 30 external chest compressions (ECCs) were performed on a mannequin. Microgravity was simulated using a body suspension device and harness; the Evetts-Russomano (ER) method was adopted for CPR performance in simulated microgravity. Heart rate and perceived exertion via Borg scores were also measured. While a significantly lower depth of ECCs was observed in simulated microgravity, compared with +1Gz, it was still within the target range of 40-50 mm. There was a 7.7% decrease of the mean (±SEM) ECC depth from 48 ± 0.3 mm at +1Gz, to 44.3 ± 0.5 mm during microgravity simulation (p < 0.001). No significant difference in number or rate of compressions was found between the two conditions. Heart rate displayed a significantly larger increase during CPR in simulated microgravity than at +1Gz, the former presenting a mean (±SEM) of 23.6 ± 2.91 bpm and the latter, 76.6 ± 3.8 bpm (p < 0.001). Borg scores were 70% higher post-microgravity compressions (17 ± 1) than post +1Gz compressions (10 ± 1) (p < 0.001). Intermuscular comparisons showed the triceps brachii to have significantly lower muscle activity than each of the other three tested muscles, in both +1Gz and microgravity. As shown by greater Borg scores and heart rate increases, CPR performance in simulated microgravity is more fatiguing than at +1Gz. Nevertheless, no significant difference in muscle activity between conditions was found, a result that is favourable for astronauts, given the inevitable muscular and cardiovascular deconditioning that occurs during space travel.

  14. Evaluating potential biomarkers of cachexia and survival in skeletal muscle of upper gastrointestinal cancer patients

    PubMed Central

    Stephens, Nathan A; Skipworth, Richard J E; Gallagher, Iain J; Greig, Carolyn A; Guttridge, Denis C; Ross, James A; Fearon, Kenneth C H

    2015-01-01

    Background In order to grow the potential therapeutic armamentarium in the cachexia domain of supportive oncology, there is a pressing need to develop suitable biomarkers and potential drug targets. This pilot study evaluated several potential candidate biomarkers in skeletal muscle biopsies from a cohort of upper gastrointestinal cancer (UGIC) patients. Methods One hundred seven patients (15 weight-stable healthy controls (HC) and 92 UGIC patients) were recruited. Mean (standard deviation) weight-loss of UGIC patients was 8.1 (9.3%). Cachexia was defined as weight-loss ?5%. Rectus?abdominis muscle was obtained at surgery and was analysed by western blotting or quantitative real-time–polymerase chain reaction. Candidate markers were selected according to previous literature and included Akt and phosphorylated Akt (pAkt, n?=?52), forkhead box O transcription factors (n?=?59), ubiquitin E3 ligases (n?=?59, control of muscle anabolism/catabolism), BNIP3 and GABARAPL1 (n?=?59, as markers of autophagy), myosin heavy-chain (MyHC, n?=?54), dystrophin (n?=?39), ?-dystroglycan (n?=?52), and ?-sarcoglycan (n?=?52, as markers of structural alteration in a muscle). Patients were followed up for an average of 1255?days (range 581–1955?days) or until death. Patients were grouped accordingly and analysed by (i) all cancer patients vs. HC; (ii) cachectic vs. non-cachectic cancer patients; and (iii) cancer patients surviving ?1 vs. >1?year post operatively. Results Cancer compared with HC patients had reduced mean (standard deviation) total Akt protein [0.49 (0.31) vs. 0.89 (0.17), P?=?0.001], increased ratio of phosphorylated to total Akt [1.33 (1.04) vs. 0.32 (0.21), P?=?0.002] and increased expression of GABARAPL1 [1.60 (0.76) vs. 1.10 (0.57), P?=?0.024]. ?-Dystroglycan levels were higher in cachectic compared with non-cachectic cancer patients [1.01 (0.16) vs. 0.87 (0.20), P?=?0.007]. Survival was shortened in patients with low compared with high MyHC levels (median 316 vs. 1326?days, P?=?0.023) and dystrophin levels (median 341 vs. 660?days, P?=?0.008). Conclusions The present study has identified intramuscular protein level of ?-dystroglycan as a potential biomarker of cancer cachexia. Changes in the structural elements of muscle (MyHC or dystrophin) appear to be survival biomarkers. PMID:26136412

  15. Prevalence of work related upper limb disorders in hairdressers: a cross sectional study on the influence of working conditions and psychological, ergonomic and physical factors.

    PubMed

    De Smet, E; Germeys, F; De Smet, L

    2009-01-01

    A cross sectional study where 145 hairdressers were interviewed for the occurrence of work related upper limb disorders (WRULD). The interview features for engagement, burnout and workaholism, as well as asks for general health and working conditions. The BMI, the hand size and gripping force of each worker was obtained. WRULD was present in 41%. It was significantly correlated with burnout and workaholism. Surprisingly it was not altered by engagement or by the use of ergonomic equipment. Morphological features (BMI), hand size and gripping force, were not related to the occurrence of WRULD. PMID:20037247

  16. Hormonal and Neuromuscular Responses to Mechanical Vibration Applied to Upper Extremity Muscles

    PubMed Central

    Di Giminiani, Riccardo; Fabiani, Leila; Baldini, Giuliano; Cardelli, Giovanni; Giovannelli, Aldo; Tihanyi, Jozsef

    2014-01-01

    Objective To investigate the acute residual hormonal and neuromuscular responses exhibited following a single session of mechanical vibration applied to the upper extremities among different acceleration loads. Methods Thirty male students were randomly assigned to a high vibration group (HVG), a low vibration group (LVG), or a control group (CG). A randomized double-blind, controlled-parallel study design was employed. The measurements and interventions were performed at the Laboratory of Biomechanics of the University of L'Aquila. The HVG and LVG participants were exposed to a series of 20 trials ×10 s of synchronous whole-body vibration (WBV) with a 10-s pause between each trial and a 4-min pause after the first 10 trials. The CG participants assumed an isometric push-up position without WBV. The outcome measures were growth hormone (GH), testosterone, maximal voluntary isometric contraction during bench-press, maximal voluntary isometric contraction during handgrip, and electromyography root-mean-square (EMGrms) muscle activity (pectoralis major [PM], triceps brachii [TB], anterior deltoid [DE], and flexor carpi radialis [FCR]). Results The GH increased significantly over time only in the HVG (P?=?0.003). Additionally, the testosterone levels changed significantly over time in the LVG (P?=?0.011) and the HVG (P?=?0.001). MVC during bench press decreased significantly in the LVG (P?=?0.001) and the HVG (P?=?0.002). In the HVG, the EMGrms decreased significantly in the TB (P?=?0.006) muscle. In the LVG, the EMGrms decreased significantly in the DE (P?=?0.009) and FCR (P?=?0.006) muscles. Conclusion Synchronous WBV acutely increased GH and testosterone serum concentrations and decreased the MVC and their respective maximal EMGrms activities, which indicated a possible central fatigue effect. Interestingly, only the GH response was dependent on the acceleration with respect to the subjects' responsiveness. PMID:25368995

  17. The effect of breast support on upper body muscle activity during 5 km treadmill running.

    PubMed

    Milligan, Alexandra; Mills, Chris; Scurr, Joanna

    2014-12-01

    Breast support has previously been shown to influence surface EMG of the pectoralis major during running. Reductions in muscle activity have previously been associated with a reduction in energy cost, which may be advantageous for female runners. Ten female participants performed two self-paced (average pace 9 km h(-1)) 5 km treadmill runs under two breast support conditions (low and high); an additional bare-breasted 2 min run was also conducted. Surface EMG electrodes were positioned on the pectoralis major, anterior deltoid, medial deltoid, and upper trapezius, with data collected during the first 2 min of running and each kilometer interval thereafter. Reductions in peak EMG of the pectoralis major, anterior and medial deltoid were reported when participants ran in the high breast support during the initial intervals of the run (up to the second kilometer). The increased activation in the pectoralis major, anterior and medial deltoid in the low breast support may be due to increased tension within these muscles, induced by the greater breast pain experienced in the low breast support. This may be a strategy to reduce the independent breast movement causing the pain through increased muscular activation. This study further promotes the use of a high breast support during running with potential benefits for treadmill running associated with reductions in muscular demand during a 5 km run. PMID:25255202

  18. Locomotor muscle fatigue is not critically regulated after prior upper body exercise.

    PubMed

    Johnson, M A; Sharpe, G R; Williams, N C; Hannah, R

    2015-10-01

    This study examined the effects of prior upper body exercise on subsequent high-intensity cycling exercise tolerance and associated changes in neuromuscular function and perceptual responses. Eight men performed three fixed work-rate (85% peak power) cycling tests: 1) to the limit of tolerance (CYC); 2) to the limit of tolerance after prior high-intensity arm-cranking exercise (ARM-CYC); and 3) without prior exercise and for an equal duration as ARM-CYC (ISOTIME). Peripheral fatigue was assessed via changes in potentiated quadriceps twitch force during supramaximal electrical femoral nerve stimulation. Voluntary activation was assessed using twitch interpolation during maximal voluntary contractions. Cycling time during ARM-CYC and ISOTIME (4.33 ± 1.10 min) was 38% shorter than during CYC (7.46 ± 2.79 min) (P < 0.001). Twitch force decreased more after CYC (-38 ± 13%) than ARM-CYC (-26 ± 10%) (P = 0.004) and ISOTIME (-24 ± 10%) (P = 0.003). Voluntary activation was 94 ± 5% at rest and decreased after CYC (89 ± 9%, P = 0.012) and ARM-CYC (91 ± 8%, P = 0.047). Rating of perceived exertion for limb discomfort increased more quickly during cycling in ARM-CYC [1.83 ± 0.46 arbitrary units (AU)/min] than CYC (1.10 ± 0.38 AU/min, P = 0.003) and ISOTIME (1.05 ± 0.43 AU/min, P = 0.002), and this was correlated with the reduced cycling time in ARM-CYC (r = -0.72, P = 0.045). In conclusion, cycling exercise tolerance after prior upper body exercise is potentially mediated by central fatigue and intolerable levels of sensory perception rather than a critical peripheral fatigue limit. PMID:26272315

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

    PubMed Central

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

    2015-01-01

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

  20. Upper extremity muscle tone and response of tidal volume during manually assisted breathing for patients requiring prolonged mechanical ventilation

    PubMed Central

    Morino, Akira; Shida, Masahiro; Tanaka, Masashi; Sato, Kimihiro; Seko, Toshiaki; Ito, Shunsuke; Ogawa, Shunichi; Yokoi, Yuka; Takahashi, Naoaki

    2015-01-01

    [Purpose] The aim of the present study was to examine, in patients requiring prolonged mechanical ventilation, if the response of tidal volume during manually assisted breathing is dependent upon both upper extremity muscle tone and the pressure intensity of manually assisted breathing. [Subjects] We recruited 13 patients on prolonged mechanical ventilation, and assessed their upper extremity muscle tone using the modified Ashworth scale (MAS). The subjects were assigned to either the low MAS group (MAS?2, n=7) or the high MAS group (MAS?3, n=6). [Methods] The manually assisted breathing technique was applied at a pressure of 2 kgf and 4 kgf. A split-plot ANOVA was performed to compare the tidal volume of each pressure during manually assisted breathing between the low and the high MAS groups. [Results] Statistical analysis showed there were main effects of the upper extremity muscle tone and the pressure intensity of the manually assisted breathing technique. There was no interaction between these factors. [Conclusion] Our findings reveal that the tidal volume during the manually assisted breathing technique for patients with prolonged mechanical ventilation depends upon the patient’s upper extremity muscle tone and the pressure intensity. PMID:26357431

  1. Effect of intermittent, supine cervical traction on the myoelectric activity of the upper trapezius muscle in subjects with neck pain.

    PubMed

    Jette, D U; Falkel, J E; Trombly, C

    1985-08-01

    This study was undertaken to compare the myoelectric activity of the upper trapezius muscle before, during, and after intermittent, supine cervical traction. Twelve people with diagnosed disease or injury of the cervical spine served as subjects. Electromyographic recordings were taken from the upper trapezius muscle with bipolar surface electrodes. The subjects were treated with 20 minutes of intermittent, cervical traction at a force of 8% of their body weight. Recordings were taken with the subjects in the supine position before the traction, during one pull and release phase of the 10th and 20th minutes of traction, and after completion of the traction treatment. An analysis of variance with repeated measures showed no significant differences in the myoelectrical activity during the six time periods measured. The results of this study do not support the clinical use of intermittent, supine traction to produce cervical muscle relaxation. PMID:4023062

  2. Attenuation of Skeletal Muscle and Renal Injury to the Lower Limb following Ischemia-Reperfusion Using mPTP Inhibitor NIM-811

    PubMed Central

    Garbaisz, David; Turoczi, Zsolt; Aranyi, Peter; Fulop, Andras; Rosero, Oliver; Hermesz, Edit; Ferencz, Agnes; Lotz, Gabor; Harsanyi, Laszlo; Szijarto, Attila

    2014-01-01

    Introduction Operation on the infrarenal aorta and large arteries of the lower extremities may cause rhabdomyolysis of the skeletal muscle, which in turn may induce remote kidney injury. NIM-811 (N-metyl-4-isoleucine-cyclosporine) is a mitochondria specific drug, which can prevent ischemic-reperfusion (IR) injury, by inhibiting mitochondrial permeability transition pores (mPTP). Objectives Our aim was to reduce damages in the skeletal muscle and the kidney after IR of the lower limb with NIM-811. Materials and methods Wistar rats underwent 180 minutes of bilateral lower limb ischemia and 240 minutes of reperfusion. Four animal groups were formed called Sham (receiving vehicle and sham surgery), NIM-Sham (receiving NIM-811 and sham surgery), IR (receiving vehicle and surgery), and NIM-IR (receiving NIM-811 and surgery). Serum, urine and histological samples were taken at the end of reperfusion. NADH-tetrazolium staining, muscle Wet/Dry (W/D) ratio calculations, laser Doppler-flowmetry (LDF) and mean arterial pressure (MAP) monitoring were performed. Renal peroxynitrite concentration, serum TNF-? and IL-6 levels were measured. Results Less significant histopathological changes were observable in the NIM-IR group as compared with the IR group. Serum K+ and necroenzyme levels were significantly lower in the NIM-IR group than in the IR group (LDH: p<0.001; CK: p<0.001; K+: p?=?0.017). Muscle mitochondrial viability proved to be significantly higher (p?=?0.001) and renal function parameters were significantly better (creatinine: p?=?0.016; FENa: p<0.001) in the NIM-IR group in comparison to the IR group. Serum TNF-? and IL-6 levels were significantly lower (TNF-?: p?=?0.003, IL-6: p?=?0.040) as well as W/D ratio and peroxynitrite concentration were significantly lower (p?=?0.014; p<0.001) in the NIM-IR group than in the IR group. Conclusion NIM-811 could have the potential of reducing rhabdomyolysis and impairment of the kidney after lower limb IR injury. PMID:24968303

  3. [Analysis of the Cochrane Review: Interventions for Improving Upper Limb Function after Stroke. Cochrane Database Syst Rev. 2014,11:CD010820].

    PubMed

    Sousa Nanji, Liliana; Torres Cardoso, André; Costa, João; Vaz-Carneiro, António

    2015-01-01

    Impairment of the upper limbs is quite frequent after stroke, making rehabilitation an essential step towards clinical recovery and patient empowerment. This review aimed to synthetize existing evidence regarding interventions for upper limb function improvement after Stroke and to assess which would bring some benefit. The Cochrane Database of Systematic Reviews, the Database of Reviews of Effects and PROSPERO databases were searched until June 2013 and 40 reviews have been included, covering 503 studies, 18 078 participants and 18 interventions, as well asdifferent doses and settings of interventions. The main results were: 1- Information currently available is insufficient to assess effectiveness of each intervention and to enable comparison of interventions; 2- Transcranial direct current stimulation brings no benefit for outcomes of activities of daily living; 3- Moderate-quality evidence showed a beneficial effect of constraint-induced movement therapy, mental practice, mirror therapy, interventions for sensory impairment, virtual realityand repetitive task practice; 4- Unilateral arm training may be more effective than bilateral arm training; 5- Moderate-quality evidence showed a beneficial effect of robotics on measures of impairment and ADLs; 6- There is no evidence of benefit or harm for technics such as repetitive transcranial magnetic stimulation, music therapy, pharmacological interventions, electrical stimulation and other therapies. Currently available evidence is insufficient and of low quality, not supporting clear clinical decisions. High-quality studies are still needed. PMID:26667856

  4. Use of a Robotic Device for the Rehabilitation of Severe Upper Limb Paresis in Subacute Stroke: Exploration of Patient/Robot Interactions and the Motor Recovery Process

    PubMed Central

    Courtial, Ophélie; Grosmaire, Anne-Gaëlle; Hutin, Emilie

    2015-01-01

    This pioneering observational study explored the interaction between subacute stroke inpatients and a rehabilitation robot during upper limb training. 25 stroke survivors (age 55 ± 17 years; time since stroke, 52 ± 21 days) with severe upper limb paresis carried out 16 sessions of robot-assisted shoulder/elbow training (InMotion 2.0, IMT, Inc., MA, USA) combined with standard therapy. The values of 3 patient/robot interaction parameters (a guidance parameter: Stiffness, a velocity-related parameter: Slottime, and Robotic Power) were compared between sessions 1 (S1), 4 (S4), 8 (S8), 12 (S12), and 16 (S16). Pre/post Fugl-Meyer Assessment (FMA) scores were compared in 18 patients. Correlations between interaction parameters and clinical and kinematic outcome measures were evaluated. Slottime decreased at S8 (P = 0.003), while Guidance decreased at S12 (P = 0.008). Robotic Power tended to decrease until S16. FMA scores improved from S1 to S16 (+49%, P = 0.002). Changes in FMA score were correlated with the Stiffness parameter (R = 0.4, P = 0.003). Slottime was correlated with movement velocity. This novel approach demonstrated that a robotic device is a useful and reliable tool for the quantification of interaction parameters. Moreover, changes in these parameters were correlated with clinical and kinematic changes. These results suggested that robot-based recordings can provide new insights into the motor recovery process. PMID:25821804

  5. The effect of muscle weakness on the capability gap during gross motor function: a simulation study supporting design criteria for exoskeletons of the lower limb

    PubMed Central

    2014-01-01

    Background Enabling persons with functional weaknesses to perform activities of daily living (ADL) is one of the main challenges for the aging society. Powered orthoses, or exoskeletons, have the potential to support ADL while promoting active participation of the user. For this purpose, assistive devices should be designed and controlled to deliver assistance as needed (AAN). This means that the level of assistance should bridge the capability gap, i.e. the gap between the capabilities of the subjects and the task requirements. However, currently the actuators of exoskeletons are mainly designed using inverse dynamics (ID) based calculations of joint moments. The goal of the present study is to calculate the capability gap for the lower limb during ADL when muscle weakness is present, which is needed for appropriate selection of actuators to be integrated in exoskeletons. Methods A musculoskeletal model (MM) is used to calculate the joint kinematics, joint kinetics and muscle forces of eight healthy subjects during ADL (gait, sit-to-stand, stand-to-sit, stair ascent, stair descent). Muscle weakness was imposed to the MM by a stepwise decrease in maximal isometric force imposed to all muscles. Muscle forces were calculated using static optimization. In order to compensate for muscle weakness, ideal moment actuators that represent the motors of an exoskeleton in the simulation were added to deliver AAN required to perform the task. Results The ID approach overestimates the required assistance since it relies solely on the demands of the task, whereas the AAN approach incorporates the capabilities of the subject. Furthermore, the ID approach delivers continuous support whereas the AAN approach targets the period where a capability gap occurs. The level of muscle weakness for which the external demands imposed by ADL can no longer be met by active muscle force production, is respectively 40%, 70%, 80% and 30%. Conclusions The present workflow allows estimating the AAN during ADL for different levels of muscle weakness, which can be used in the mechatronic design and control of powered exoskeletons. The AAN approach is a more physiological approach than the ID approach, since the MM accounts for the subject-specific capabilities of the user. PMID:25092209

  6. Intensity of activation and timing of deactivation modulate elastic energy storage and release in a pennate muscle and account for gait-specific initiation of limb protraction in the horse.

    PubMed

    Lichtwark, Glen A; Watson, Johanna C; Mavrommatis, Sophia; Wilson, Alan M

    2009-08-01

    The equine biceps brachii (biceps) initiates rapid limb protraction through a catapult mechanism. Elastic strain energy is slowly stored in an internal tendon and is then rapidly released to protract the forelimb. The muscle fibres are short, have little scope for length change and can therefore only shorten slowly compared with the speed at which the whole muscle must shorten, which makes them poor candidates for driving rapid limb protraction. We suggest that the muscle fibres in the biceps act to modulate the elastic energy output of the muscle-tendon unit (MTU) to meet the demands of locomotion under different conditions. We hypothesise that more elastic strain energy is stored and released from the biceps MTU during higher speed locomotion to accommodate the increase in energy required to protract the limb and that this can be achieved by varying the length change and activation conditions of the muscle. We examined the work performed by the biceps during trot and canter using an inverse dynamics analysis (IDA). We then used excised biceps muscles to determine how much work could be performed by the muscle in active and passive stretch-shorten cycles. A muscle model was developed to investigate the influence of changes in activation parameters on energy storage and energy return from the biceps MTU. Increased biceps MTU length change and increased work performed by the biceps MTU were found at canter compared with at trot. More work was performed by the ex vivo biceps MTU following activation of the muscle and by increasing muscle length change. However, the ratio of active to passive work diminished with increasing length change. The muscle model demonstrated that duration and timing of activation during stretch-shorten cycles could modulate the elastic energy storage and return from the biceps. We conclude that the equine biceps MTU acts as a tuneable spring and the contractile component functions to modulate the energy required for rapid forelimb protraction at different speeds. PMID:19617439

  7. Influence of duty cycle on the time course of muscle fatigue and the onset of neuromuscular compensation during exhaustive dynamic isolated limb exercise.

    PubMed

    Sundberg, Christopher W; Bundle, Matthew W

    2015-07-01

    We investigated the influence of altered muscle duty cycle on the performance decrements and neuromuscular responses occurring during constant-load, fatiguing bouts of knee extension exercise. We experimentally altered the durations of the muscularly inactive portion of the limb movement cycle and hypothesized that greater relative durations of inactivity within the same movement task would 1) reduce the rates and extent of muscle performance loss and 2) increase the forces necessary to trigger muscle fatigue. In each condition (duty cycle = 0.6 and 0.3), male subjects [age = 25.9 ± 2.0 yr (SE); mass = 85.4 ± 2.6 kg], completed 9-11 exhaustive bouts of two-legged knee extension exercise, at force outputs that elicited failure between 4 and 290 s. The novel duty cycle manipulation produced two primary results; first, we observed twofold differences in both the extent of muscle performance lost (DC0.6 = 761 ± 35 N vs. DC0.3 = 366 ± 49 N) and the time course of performance loss. For example, exhaustive trials at the midpoint of these force ranges differed in duration by more than 30 s (t0.6 = 36 ± 2.6 vs. t0.3 = 67 ± 4.3 s). Second, both the minimum forces necessary to exceed the peak aerobic capacity and initiate a reliance on anaerobic metabolism, and the forces necessary to elicit compensatory increases in electromyogram activity were 300% greater in the lower vs. higher duty cycle condition. These results indicate that the fatigue-induced compensatory behavior to recruit additional motor units is triggered by a reliance on anaerobic metabolism for ATP resynthesis and is independent of the absolute level or fraction of the maximum force produced by the muscle. PMID:25876654

  8. The Effects of Inclination (Up and Down) of the Treadmill on the Electromyogram Activities of the Forelimb and Hind limb Muscles at a Walk and a Trot in Thoroughbred Horses

    PubMed Central

    TAKAHASHI, Toshiyuki; MATSUI, Akira; MUKAI, Kazutaka; OHMURA, Hajime; HIRAGA, Atsushi; AIDA, Hiroko

    2014-01-01

    ABSTRACT It is important to know the effects of the inclination of a slope on the activity of each muscle, because training by running on a sloped track is commonly used for Thoroughbred racehorses. The effects of incline (from ?6 to +6%) on the forelimbs and hind limbs during walking and trotting on a treadmill were evaluated by an integrated electromyogram (iEMG). The muscle activities in the forelimbs (5 horses) and hind limbs (4 horses) were measured separately. Two stainless steel wires were inserted into each of the brachiocephalicus (Bc), biceps brachii (BB), splenius (Sp), and pectoralis descendens (PD) in the forelimb experiment and into the longissimus dorsi (LD), vastus lateralis (VL), gluteus medius (GM), and biceps femoris (BF) in the hind limb experiment. The EMG recordings were taken at a sampling rate of 1,000 Hz. At a walk, the iEMG values for the forelimb were not significantly different under any of the inclinations. In the hind limb, the iEMG values for the GM and BF significantly decreased as the inclination decreased. At a trot, the iEMG values for the Bc in the forelimb significantly decreased as the inclination of the treadmill decreased. In the hind limb, the iEMG values for the LD, GM, and BF significantly decreased as the inclination decreased. Uphill exercise increased the iEMG values for the Bc, LD, GM, and BF, while downhill exercise resulted in little increase in the iEMG values. It was concluded that the effects of inclination on the muscle activities were larger for the uphill exercises, and for the hind limb muscles compared with the forelimb muscles. PMID:25558180

  9. Muscle strength is a determinant of bone mineral content in the hemiparetic upper extremity: Implications for stroke rehabilitation

    PubMed Central

    Pang, Marco YC; Eng, Janice J

    2011-01-01

    Individuals with stroke have a high incidence of bone fractures and approximately 30% of these fractures occur in the upper extremity. The high risk of falls and the decline in bone and muscle health make the chronic stroke population particularly prone to upper extremity fractures. This was the first study to investigate the bone mineral content (BMC), bone mineral density (BMD) and soft tissue composition of the upper extremities and their relationship to stroke-related impairments in ambulatory individuals with chronic stroke (onset >1 year). Dual-energy X-ray absorptiometry (DXA) was used to acquire total body scans on 56 (22 women) community-dwelling individuals (?50 years of age) with chronic stroke. BMC (g) and BMD (g/cm2), lean mass (g) and fat mass (g) for each arm were derived from the total body scans. The paretic upper extremity was evaluated for muscle strength (hand-held dynamometry), spasticity (Modified Ashworth Scale), impairment of motor function (Fugl-Meyer Motor Assessment) and amount of use of the paretic arm in daily activities (Motor Activity Log). Results showed that the paretic arm had significantly lower BMC (13.8%, p<0.001), BMD (4.5%, p<0.001) and lean mass (9.0%, p<0.001) but higher fat mass (6.3%, p=0.028) than the non-paretic arm. Multiple regression analysis showed that lean mass in the paretic arm, height and muscle strength were significant predictors (R2=0.810, p<0.001) of the paretic arm BMC. Height, muscle strength and gender were significant predictors (R2=0.822, p<0.001) of lean mass in the paretic arm. These results highlight the potential of muscle strengthening to promote bone health of the paretic arm in individuals with chronic stroke. PMID:15869927

  10. Abnormal Cortex-Muscle Interactions in Subjects with X-linked Kallmann's Syndrome and Mirror Movements

    ERIC Educational Resources Information Center

    Farmer, S. F.; Harrison, L. M.; Mayston, M. J.; Parekh, A.; James, L. M.; Stephens, J. A.

    2004-01-01

    X-linked Kallmann's (XKS) subjects, who display mirror movements, have abnormal corticospinal tracts which innervate motoneurons of the left and right distal muscles of the upper limb. The size of the abnormal ipsilateral projection is variable. We have used coherence and cumulant analysis between EEG and first dorsal interosseous muscle (1DI) EMG…

  11. Phosphorus-31 NMR magnetization-transfer measurements of ATP turnover during steady-state isometric muscle contraction in the rat hind limb in vivo

    SciTech Connect

    Brindle, K.M.; Blackledge, M.J.; Challiss, R.A.J.; Radda, G.K. )

    1989-05-30

    Phosphorus-31 NMR magnetization-transfer measurement have been used to measure the flux between ATP and inorganic phosphate during steady-state isometric muscle contraction in the rat hind limb in vivo. Steady-state contraction was obtained by supramaximal sciatic nerve stimulation. Increasing the stimulation pulse width from 10 to 90 ms, at a pulse frequency of 1 Hz, or increasing the frequency of a 10-ms pulse from 0.5 to 2 Hz resulted in an increase in the flux which was an approximately linear function of the increase in the tension-time integral. The flux showed an approximately linear dependence on the calculated free cytosolic ADP concentration up to an ADP concentration of about 90 {mu}M. The data are consistent with control of mitochondrial ATP synthesis by the cytosolic ADP concentration and indicate that the apparent K{sub m} of the mitochondria for ADP is at least 30 {mu}M.

  12. Kinematic Metrics Based on the Virtual Reality System Toyra as an Assessment of the Upper Limb Rehabilitation in People with Spinal Cord Injury

    PubMed Central

    Trincado-Alonso, Fernando; Dimbwadyo-Terrer, Iris; de los Reyes-Guzmán, Ana; López-Monteagudo, Patricia; Bernal-Sahún, Alberto; Gil-Agudo, Ángel

    2014-01-01

    The aim of this study was to develop new strategies based on virtual reality that can provide additional information to clinicians for the rehabilitation assessment. Virtual reality system Toyra has been used to record kinematic information of 15 patients with cervical spinal cord injury (SCI) while performing evaluation sessions using the mentioned system. Positive correlation, with a moderate and very strong association, has been found between clinical scales and kinematic data, considering only the subscales more closely related to the upper limb function. A set of metrics was defined combining these kinematic data to obtain parameters of reaching amplitude, joint amplitude, agility, accuracy, and repeatability during the evaluation sessions of the virtual reality system Toyra. Strong and moderate correlations have been also found between the metrics reaching and joint amplitude and the clinical scales. PMID:24895627

  13. Enhanced Upper-Airway Muscle Responsiveness Is a Distinct Feature of Overweight/Obese Individuals without Sleep Apnea

    PubMed Central

    Eckert, Danny J.; Jordan, Amy S.; Edwards, Bradley A.; Owens, Robert L.; Butler, James P.; Schwab, Richard J.; Loring, Stephen H.; Malhotra, Atul; White, David P.; Wellman, Andrew

    2014-01-01

    Rationale: Body habitus is a major determinant of obstructive sleep apnea (OSA). However, many individuals do not have OSA despite being overweight/obese (body mass index > 25 kg/m2) for reasons that are not fully elucidated. Objectives: To determine the key physiologic traits (upper-airway anatomy/collapsibility, upper-airway muscle responsiveness, chemoreflex control of ventilation, arousability from sleep) responsible for the absence of OSA in overweight/obese individuals. Methods: We compared key physiologic traits in 18 overweight/obese subjects without apnea (apnea–hypopnea index < 15 events per hour) with 25 overweight/obese matched patients with OSA (apnea–hypopnea index ? 15 events per hour) and 11 normal-weight nonapneic control subjects. Traits were measured by repeatedly lowering continuous positive airway pressure to subtherapeutic levels for 3 minutes during non-REM sleep. Measurements and Main Results: Overweight/obese subjects without apnea exhibited a less collapsible airway than overweight/obese patients with apnea (critical closing pressure: ?3.7 ± 1.9 vs. 0.6 ± 1.2 cm H2O; P = 0.003; mean ± 95% confidence interval), but a more collapsible airway relative to normal-weight control subjects (?8.8 ± 3.1 cm H2O; P < 0.001). Notably, overweight/obese subjects without apnea exhibited a threefold greater upper-airway muscle responsiveness than both overweight/obese patients with apnea (?genioglossus EMG/?epiglottic pressure: ?0.49 [?0.22 to ?0.79] vs. ?0.15 [?0.09 to ?0.22] %max/cm H2O; P = 0.008; mean [95% confidence interval]) and normal-weight control subjects (?0.16 [?0.04 to ?0.30] %max/cm H2O; P = 0.02). Loop gain was elevated (more negative) in both overweight/obese groups and normal-weight control subjects (P = 0.02). Model-based analysis demonstrated that overweight/obese individuals without apnea rely on both more favorable anatomy and collapsibility and enhanced upper-airway dilator muscle responses to avoid OSA. Conclusions: Overweight/obese individuals without apnea have a moderately compromised upper-airway structure that is mitigated by highly responsive upper-airway dilator muscles to avoid OSA. Elucidating the mechanisms underlying enhanced muscle responses in this population may provide clues for novel OSA interventions. PMID:25191791

  14. Contribution of hind limb flexor muscle afferents to the timing of phase transitions in the cat step cycle.

    PubMed

    Hiebert, G W; Whelan, P J; Prochazka, A; Pearson, K G

    1996-03-01

    1. In this investigation, we tested the hypothesis that muscle spindle afferents signaling the length of hind-leg flexor muscles are involved in terminating extensor activity and initiating flexion during walking. The hip flexor muscle iliopsoas (IP) and the ankle flexors tibialis anterior (TA) and extensor digitorum longus (EDL) were stretched or vibrated at various phases of the step cycle in spontaneously walking decerebrate cats. Changes in electromyogram amplitude, duration, and timing were then examined. The effects of electrically stimulating group I and II afferents in the nerves to TA and EDL also were examined. 2. Stretch of the individual flexor muscles (IP, TA, or EDL) during the stance phase reduced the duration of extensor activity and promoted the onset of flexor burst activity. The contralateral step cycle also was affected by the stretch, the duration of flexor activity being shortened and extensor activity occurring earlier. Therefore, stretch of the flexor muscles during the stance phase reset the locomotor rhythm to flexion ipsilaterally and extension contralaterally. 3. Results of electrically stimulating the afferents from the TA and EDL muscles suggested that different groups of afferents were responsible for the resetting of the step cycle. Stimulation of the TA nerve reset the locomotor step cycle when the stimulus intensity was in the group II range (2-5 xT). By contrast, stimulation of the EDL nerve generated strong resetting of the step cycle in the range of 1.2-1.4 xT, where primarily the group Ia afferents from the muscle spindles would be activated. 4. Vibration of IP or EDL during stance reduced the duration of the extensor activity by similar amounts to that produced by muscle stretch or by electrical stimulation of EDL at group Ia strengths. This suggests that the group Ia afferents from IP and EDL are capable of resetting the locomotor pattern generator. Vibration of TA did not affect the locomotor rhythm. 5. Stretch of IP or electrical stimulation of TA afferents (5 xT) during the flexion phase did not change the duration of the flexor activity. Stimulation of the EDL nerve at 1.8-5 xT during flexion increased the duration of the flexor activity. In none of our preparations did we observe resetting to extension when the flexor afferents were activated during flexion. 6. We conclude that as the flexor muscles lengthen during the stance phase of gait, their spindle afferents (group Ia afferents for EDL and IP, group II afferents for TA) act to inhibit the spinal center generating extensor activity thus facilitating the initiation of swing. PMID:8867123

  15. Upper Limb Strength and Function Changes during a One-Year Follow-Up in Non-Ambulant Patients with Duchenne Muscular Dystrophy: An Observational Multicenter Trial

    PubMed Central

    Seferian, Andreea Mihaela; Moraux, Amélie; Annoussamy, Mélanie; Canal, Aurélie; Decostre, Valérie; Diebate, Oumar; Le Moing, Anne-Gaëlle; Gidaro, Teresa; Deconinck, Nicolas; Van Parys, Frauke; Vereecke, Wendy; Wittevrongel, Sylvia; Mayer, Michèle; Maincent, Kim; Desguerre, Isabelle; Thémar-Noël, Christine; Cuisset, Jean-Marie; Tiffreau, Vincent; Denis, Severine; Jousten, Virginie; Quijano-Roy, Susana; Voit, Thomas; Hogrel, Jean-Yves; Servais, Laurent

    2015-01-01

    Introduction Upper limb evaluation of patients with Duchenne Muscular Dystrophy is crucially important to evaluations of efficacy of new treatments in non-ambulant patients. In patients who have lost ambulation, there are few validated and informative outcome measures. In addition, longitudinal data demonstrating sensitivity to clinical evolution of outcome measures over short-term periods are lacking. Patients and Methods We report here the results of a one-year multicenter study using specifically designed tools to assess grip, pinch strength, and hand function in wheelchair-bound patients. Our study assessed 53 non-ambulant patients with Duchenne muscular dystrophy aged 17.1 ± 4.8 years (range: 9 – 28.1 years). The average Brooke functional score of these patients was 4.6 ± 1.1. The average forced vital capacity was 44.5% predicted and 19 patients used non-invasive ventilation. Patients were assessed at baseline, 6 months, and one year using the Motor Function Measure and innovative devices (namely the MyoSet composed of MyoGrip, MyoPinch, and MoviPlate). Results Our study confirmed preliminary data previously reported regarding feasibility of use and of reliability of the MyoSet and the correlation at baseline between distal strength and clinical outcomes such as FVC, Brooke score, age, and duration since loss of ambulation. A significant correlation was observed between the distal upper limb strength and clinical variables. The sensitive dynamometers (MyoGrip and MyoPinch) and MoviPlate captured a 12-month change in non-ambulant Duchenne muscular dystrophy patients of all ages. Trial Registration ClinicalTrials.gov NCT00993161 NCT00993161 PMID:25643053

  16. Intensive upper limb intervention with self-management training is feasible and promising for older children and adolescents with unilateral cerebral palsy.

    PubMed

    Geerdink, Yvonne; Aarts, Pauline; van der Burg, Jan; Steenbergen, Bert; Geurts, Alexander

    2015-01-01

    This study explored the feasibility and preliminary effectiveness of a short (one week) intensive intervention combining Constraint Induced Movement Therapy (CIMT) and bimanual training (BiT) to improve upper limb capacity and bimanual performance guided by individual goal setting in children and adolescents with unilateral cerebral palsy aged 8-18 years. Self-management training was added to the intervention to maximize the effect of training and to empower the participants in self-monitoring the effective use of their affected hand. Functional goals (Canadian Occupational Performance Measure), unimanual capacity (Box and Block Test), bimanual performance (ABILHAND-Kids, Children's Hand-use Experience Questionnaire (CHEQ)) and amount of use (Video Observation Aarts and Aarts - determine developmental disregard (VOAA-DDD-R)) were measured at baseline, one week and four months post intervention. Twenty children (mean age 9.5 years) participated. Repeated measures ANOVA was used to measure effects over time. Compared to baseline, there were significant improvements on all outcome measures. The largest effect sizes were found for the COPM-performance and COPM-satisfaction (Cohen's d=2.09 and d=2.42, respectively). The effect size was large for the ABILHAND-Kids (d=0.86), moderate for the CHEQ (d=0.70) and Box and Block Test (d=0.56), and small for the VOAA-DDD-R (d=0.33). All effects were retained at the four months post intervention assessment. The results of this study indicate that one-week (36h) intensive CIMT-BiT combined with self-management training is a feasible and promising intervention for improving the capacity of the upper limb and its use in bimanual activities in older children and adolescents with unilateral CP. PMID:26164301

  17. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    ERIC Educational Resources Information Center

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

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

    PubMed

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

    2015-03-01

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

  19. Prolonged mechanical and physiological changes in the upper extremity following short-term simulated power hand tool use

    E-print Network

    Radwin, Robert G.

    -induced micro-injury in muscles during repetitive skeletal muscle loading. If the external forces from power indicate increased strain on the upper limb and may negatively affect ability to react during rapid the damaging effects of exposure to specific levels of reaction force, build-up time and repetition, as well

  20. Functional specialisation of pelvic limb anatomy in horses (Equus caballus)

    PubMed Central

    Payne, RC; Hutchinson, JR; Robilliard, JJ; Smith, NC; Wilson, AM

    2005-01-01

    We provide quantitative anatomical data on the muscle–tendon units of the equine pelvic limb. Specifically, we recorded muscle mass, fascicle length, pennation angle, tendon mass and tendon rest length. Physiological cross sectional area was then determined and maximum isometric force estimated. There was proximal-to-distal reduction in muscle volume and fascicle length. Proximal limb tendons were few and, where present, were relatively short. By contrast, distal limb tendons were numerous and long in comparison to mean muscle fascicle length, increasing potential for elastic energy storage. When compared with published data on thoracic limb muscles, proximal pelvic limb muscles were larger in volume and had shorter fascicles. Distal limb muscle architecture was similar in thoracic and pelvic limbs with the exception of flexor digitorum lateralis (lateral head of the deep digital flexor), the architecture of which was similar to that of the pelvic and thoracic limb superficial digital flexors, suggesting a functional similarity. PMID:15960766

  1. Human Muscle Power Output during Upper- and Lower-Body Exercises.

    ERIC Educational Resources Information Center

    Siegel, Judith A.; Gilders, Roger M.; Staron, Robert S.; Hagerman, Fredrick C.

    2002-01-01

    Evaluated the use of traditional resistance training equipment in measuring muscular power, measuring the velocity of movement through a measured distance during maximal effort lifts using a Smith rack. Data collected on male volunteers indicated that this method of evaluating muscle power was reliable, although it was not predictive of muscle

  2. Upper limb entheseal change with the transition to agriculture in the Southeastern United States: a view from Moundville and the central Tombigbee River valley.

    PubMed

    Shuler, K A; Zeng, P; Danforth, M E

    2012-12-01

    We analyzed entheseal change in 159 skeletons from Moundville and surrounding settlements using primary fibrocartilaginous attachments of the upper limbs. Risk of entheseal change did not differ bilaterally, suggesting a wide variety of activities were used to exploit a diverse ecosystem. Consistent with predictions, Mississippian (1000-1500 CE) agriculturalists experienced greater risk of entheseal change than did Late Woodland (500-900 CE) hunter-gatherers. Attachments used in arm flexion were most affected, while rotator cuff entheses remained consistent over time. A temporal increase in muscular changes in males in concert with faunal evidence for resurgence of larger game (e.g., deer) is consistent with continued reliance on hunting alongside domestication of maize. Among Mississippians, younger males appear to have been carrying out the most strenuous tasks, contrary to earlier studies that suggested a decline in male activities with domestication. Mound centers consistently experienced the greatest upper body changes, in spite of faunal and botanical data supporting provisioning of elites by outlying sites. Center males, respectively, experienced more than 26 and 12 times greater changes at elbow extensors and brachialis than those from outlying settlements, with a significant decline from young to middle age among adults. Center females experienced increased risk at biceps insertions and common extensors of the humeri - trends that disappeared with age. Overall findings suggest increased upper body demands and shifting sex and age-dependent divisions of labor with maize intensification, but trends across settlements point to significant status-related body size selection in center males, with fewer differences among females. PMID:23084369

  3. Corticospinal excitability as a predictor of functional gains at the affected upper limb following robotic training in chronic stroke survivors

    PubMed Central

    Milot, Marie-Hélène; Spencer, Steven J.; Chan, Vicky; Allington, James P.; Klein, Julius; Chou, Cathy; Pearson-Fuhrhop, Kristin; Bobrow, James E.; Reinkensmeyer, David J.; Cramer, Steven C.

    2014-01-01

    Background Robotic training can help improve function of a paretic limb following a stroke, but individuals respond differently to the training. A predictor of functional gains might improve the ability to select those individuals more likely to benefit from robot based therapy. Studies evaluating predictors of functional improvement after a robotic training are scarce. One study has found that white matter tract integrity predicts functional gains following a robotic training of the hand and wrist. Objective Determine the predictive ability of behavioral and brain measures to improve selection of individuals for robotic training. Methods Twenty subjects with chronic stroke participated in an 8-week course of robotic exoskeletal training for the arm. Before training, a clinical evaluation, fMRI, diffusion tensor imaging, and transcranial magnetic stimulation (TMS) were each measured as predictors. Final functional gain was defined as change in the Box and Block Test (BBT). Measures significant in bivariate analysis were fed into a multivariate linear regression model. Results Training was associated with an average gain of 6±5 blocks on the BBT (p<0.0001). Bivariate analysis revealed that lower baseline motor evoked potential (MEP) amplitude on TMS, and lower laterality M1 index on fMRI each significantly correlated with greater BBT change. In the multivariate linear regression analysis, baseline MEP magnitude was the only measure that remained significant. Conclusion Subjects with lower baseline MEP magnitude benefited the most from robotic training of the affected arm. These subjects might have reserve remaining for the training to boost corticospinal excitability, translating into functional gains. PMID:24642382

  4. Aesthetic and Functional Outcomes of the Innervated and Thinned Anterolateral Thigh Flap in Reconstruction of Upper Limb Defects

    PubMed Central

    Torres-Ortíz Zermeño, Carlos Alberto; López Mendoza, Javier

    2014-01-01

    Background. The anterolateral thigh (ALT) flap has been widely described in reconstruction of the upper extremity. However, some details require refinement to improve both functional and aesthetic results. Methods. After reconstruction of upper extremity defects using thinned and innervated ALT flaps, functional and aesthetic outcomes were evaluated with the QuickDASH scale and a Likert scale for aesthetic assessment of free flaps, respectively. Results. Seven patients with a mean follow-up of 11.57 months and average flap thickness of 5?mm underwent innervation by an end-to-end neurorrhaphy. The average percentage of disability (QuickDASH) was 21.88% with tenderness, pain, temperature, and two-point discrimination present in 100% of cases, and the aesthetic result gave an overall result of 15.40 (good) with the best scores in color and texture. Conclusions. Simultaneous thinning and innervation of the ALT flap lead to a good cosmetic result and functional outcome with a low percentage of disability, which could result in minor surgical procedures and better recovery of motor and sensory function. Level of Evidence. IV. PMID:25478219

  5. Dose-response effects of customised foot orthoses on lower limb muscle activity and plantar pressures in pronated foot type.

    PubMed

    Telfer, Scott; Abbott, Mandy; Steultjens, Martijn; Rafferty, Daniel; Woodburn, James

    2013-07-01

    Customised foot orthoses (FOs) featuring extrinsic rearfoot posting are commonly prescribed for individuals with a symptomatic pronated foot type. By altering the angle of the posting it is purported that a controlled dose-response effect during the stance phase of gait can be achieved, however these biomechanical changes have yet to be characterised. Customised FOs were administered to participant groups with symptomatic pronated foot types and asymptomatic normal foot types. The electromyographic (EMG) and plantar pressure effects of varying the dose were measured. Dose was varied by changing the angle of posting from 6° lateral to 10° medial in 2° steps on customised devices produced using computer aided orthoses design software. No effects due to posting level were found for EMG variables. Significant group effects were seen with customised FOs reducing above knee muscle activity in pronated foot types compared to normal foot types (biceps femoris p=0.022; vastus lateralis p<0.001; vastus medialis p=0.001). Interaction effects were seen for gastrocnemius medialis and soleus. Significant linear effects of posting level were seen for plantar pressure at the lateral rearfoot (p=0.001), midfoot (p<0.001) and lateral forefoot (p=0.002). A group effect was also seen for plantar pressure at the medial heel (p=0.009). This study provides evidence that a customised FOs can provide a dose response effect for selected plantar pressure variables, but no such effect could be identified for muscle activity. Foot type may play an important role in the effect of customised orthoses on activity of muscles above the knee. PMID:23391752

  6. Exome sequencing identifies a DNAJB6 mutation in a family with dominantly-inherited limb-girdle muscular dystrophy

    E-print Network

    Straight, Aaron

    . Introduction Autosomal dominant limb-girdle muscular dystrophies (LGMD1) are a genetically and clinically heterogeneous group of disorders. LGMD1 often presents with progressive proximal muscle weakness of the upper associated with LGMD1, including the MYOT gene encoding myotilin in LGMD1A [2], the LMNA gene encoding lamin

  7. Comparison of dexamethasone and clonidine as an adjuvant to 1.5% lignocaine with adrenaline in infraclavicular brachial plexus block for upper limb surgeries

    PubMed Central

    Shah, Dipal Mahendra; Arora, Mahesh; Trikha, Anjan; Prasad, Ganga; Sunder, Rani; Kotwal, Prakash; Singh, Preet Mohinder

    2015-01-01

    Background and Aims: The role of clonidine as an adjuvant to regional blocks to hasten the onset of the local anesthetics or prolong their duration of action is proven. The efficacy of dexamethasone compared to clonidine as an adjuvant is not known. We aimed to compare the efficacy of dexamethasone versus clonidine as an adjuvant to 1.5% lignocaine with adrenaline in infraclavicular brachial plexus block for upper limb surgeries. Material and Methods: Fifty three American Society of Anaesthesiologists-I and II patients aged 18-60 years scheduled for upper limb surgery were randomized to three groups to receive 1.5% lignocaine with 1:200,000 adrenaline and the study drugs. Group S (n = 13) received normal saline, group D (n = 20) received dexamethasone and group C (n = 20) received clonidine. The time to onset and peak effect, duration of the block (sensory and motor) and postoperative analgesia requirement were recorded. Chi-square and ANOVA test were used for categorical and continuous variables respectively and Bonferroni or post-hoc test for multiple comparisons. P < 0.05 was considered significant. Results: The three groups were comparable in terms of time to onset and peak action of motor and sensory block, postoperative analgesic requirements and pain scores. 90% of the blocks were successful in group C compared to only 60% in group D (P = 0.028). The duration of sensory and motor block in group S, D and C were 217.73 ± 61.41 min, 335.83 ± 97.18 min and 304.72 ± 139.79 min and 205.91 ± 70.1 min, 289.58 ± 78.37 min and 232.5 ± 74.2 min respectively. There was significant prolongation of sensory and motor block in group D as compared to group S (P < 0.5). Time to first analgesic requirement was significantly more in groups C and D as compared with group S (P < 0.5). Clinically significant complications were absent. Conclusions: We conclude that clonidine is more efficacious than dexamethasone as an adjuvant to 1.5% lignocaine in brachial plexus blocks. PMID:26330715

  8. Evidence for altered upper extremity muscle synergies in chronic stroke survivors with mild and moderate impairment

    PubMed Central

    Roh, Jinsook; Rymer, William Z.; Beer, Randall F.

    2015-01-01

    Previous studies indicate that motor coordination may be achieved by assembling task-dependent combinations of a few muscle synergies, defined here as fixed patterns of activation across a set of muscles. Our recent study of severely impaired chronic stroke survivors showed that some muscle synergies underlying isometric force generation at the hand are altered in the affected arm. However, whether similar alterations are evident in stroke survivors with lesser impairment remains unclear. Accordingly, we examined muscle synergies underlying spatial patterns of elbow and shoulder muscle activation recorded during an isometric force target matching protocol performed by 16 chronic stroke survivors, evenly divided across mild and moderate impairment levels. We applied non-negative matrix factorization to identify the muscle synergies and compared their structure across groups, including previously collected data from six age-matched control subjects and eight severely impaired stroke survivors. For all groups, EMG spatial patterns were well explained by task-dependent combinations of only a few (typically 4) muscle synergies. Broadly speaking, elbow-related synergies were conserved across stroke survivors, regardless of impairment level. In contrast, the shoulder-related synergies of some stroke survivors with mild and moderate impairment differed from controls, in a manner similar to severely impaired subjects. Cluster analysis of pooled synergies for the 30 subjects identified seven distinct clusters (synergies). Subsequent analysis confirmed that the incidences of three elbow-related synergies were independent of impairment level, while the incidences of four shoulder-related synergies were systematically correlated with impairment level. Overall, our results suggest that alterations in the shoulder muscle synergies underlying isometric force generation appear prominently in mild and moderate stroke, as in most cases of severe stroke, in an impairment level-dependent manner. PMID:25717296

  9. Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle

    PubMed Central

    Dibai-Filho, Almir V.; Guirro, Elaine C. O.; Ferreira, Vânia T. K.; Brandino, Hugo E.; Vaz, Maíta M. O. L. L.; Guirro, Rinaldo R. J.

    2015-01-01

    BACKGROUND: Infrared thermography is recognized as a viable method for evaluation of subjects with myofascial pain. OBJECTIVE: The aim of the present study was to assess the intra- and inter-rater reliability of infrared image analysis of myofascial trigger points in the upper trapezius muscle. METHOD: A reliability study was conducted with 24 volunteers of both genders (23 females) between 18 and 30 years of age (22.12±2.54), all having cervical pain and presence of active myofascial trigger point in the upper trapezius muscle. Two trained examiners performed analysis of point, line, and area of the infrared images at two different periods with a 1-week interval. The intra-class correlation coefficient (ICC2,1) was used to assess the intra- and inter-rater reliability. RESULTS: With regard to the intra-rater reliability, ICC values were between 0.591 and 0.993, with temperatures between 0.13 and 1.57 °C for values of standard error of measurement (SEM) and between 0.36 and 4.35 °C for the minimal detectable change (MDC). For the inter-rater reliability, ICC ranged from 0.615 to 0.918, with temperatures between 0.43 and 1.22 °C for the SEM and between 1.19 and 3.38 °C for the MDC. CONCLUSION: The methods of infrared image analyses of myofascial trigger points in the upper trapezius muscle employed in the present study are suitable for clinical and research practices. PMID:25993626

  10. Unilateral lower limb suspension does not mimic bed rest or spaceflight effects on human muscle fiber function

    NASA Technical Reports Server (NTRS)

    Widrick, J. J.; Trappe, S. W.; Romatowski, J. G.; Riley, D. A.; Costill, D. L.; Fitts, R. H.

    2002-01-01

    We used Ca2+-activated skinned muscle fibers to test the hypothesis that unilateral lower leg suspension (ULLS) alters cross-bridge mechanisms of muscle contraction. Soleus and gastrocnemius biopsies were obtained from eight subjects before ULLS, immediately after 12 days of ULLS (post-0 h), and after 6 h of reambulation (post-6 h). Post-0 h soleus fibers expressing type I myosin heavy chain (MHC) showed significant reductions in diameter, absolute and specific peak Ca2+-activated force, unloaded shortening velocity, and absolute and normalized peak power. Fibers obtained from the gastrocnemius were less affected by ULLS, particularly fibers expressing fast MHC isoforms. Post-6 h soleus fibers produced less absolute and specific peak force than did post-0 h fibers, suggesting that reambulation after ULLS induced cell damage. Like bed rest and spaceflight, ULLS primarily affects soleus over gastrocnemius fibers. However, in contrast to these other models, slow soleus fibers obtained after ULLS showed a decrease in unloaded shortening velocity and a greater reduction in specific force.

  11. Enhancements in lower stratospheric CH3CN observed by the Upper Atmosphere Research Satellite Microwave Limb Sounder following boreal forest fires

    NASA Astrophysics Data System (ADS)

    Livesey, Nathaniel J.; Fromm, Michael D.; Waters, Joe W.; Manney, Gloria L.; Santee, Michelle L.; Read, William G.

    2004-03-01

    On 25 August 1992, the Microwave Limb Sounder (MLS) on the Upper Atmosphere Research Satellite observed a significant enhancement in the abundance of lower stratospheric methyl cyanide (CH3CN) at 100-68 hPa (˜16-19 km altitude) in a small region off the east coast of Florida. The enhancement was seen to decay and move generally westward over ˜6 days. Concentrations up to ˜1500 parts per trillion by volume (pptv) were observed, compared to a typical stratospheric background level of 30 pptv. Aerosol index data from the Nimbus 7 Total Ozone Mapping Spectrometer (TOMS) instrument, together with trajectory calculations, provide strong evidence that the enhancement arose from the stratospheric injection, associated with strong thunderstorms, of tropospheric air with high CH3CN concentrations, originating in regions of extensive forest fire activity in Idaho (not observed by MLS in this period because of orbital geometry). After being lofted into the lower stratosphere, this air was advected into the regions observed by MLS and subsequently dispersed. These MLS enhanced CH3CN observations add to the growing body of evidence for the occurrence of such episodic injections of tropospheric air into the stratosphere.

  12. Kinematic Robot-Based Evaluation Scales and Clinical Counterparts to Measure Upper Limb Motor Performance in Patients With Chronic Stroke

    PubMed Central

    Bosecker, Caitlyn; Dipietro, Laura; Volpe, Bruce; Krebs, Hermano Igo

    2015-01-01

    Background Human-administered clinical scales are the accepted standard for quantifying motor performance of stroke subjects. Though widely accepted, these measurement tools are limited by interrater and intrarater reliability and are time consuming to apply. In contrast, robot-based measures are highly repeatable, have high resolution, and could potentially reduce assessment time. Although robotic and other objective metrics have proliferated in the literature, they are not as well established as clinical scales and their relationship to clinical scales is mostly unknown. Objective Test the performance of linear regression models to estimate clinical scores for the upper extremity from systematic robot-based metrics. Methods Twenty kinematic and kinetic metrics derived from movement data recorded with the shoulder-and-elbow InMotion2 robot (Interactive Motion Technologies, Inc), a commercial version of the MIT-Manus. Kinematic metrics were aggregated into macro-metrics and micrometrics and collected from 111 chronic stroke subjects. Multiple linear regression models were developed to calculate Fugl-Meyer Assessment, Motor Status Score, Motor Power, and Modified Ashworth Scale from these robot-based metrics. Results Best performance–complexity trade-off was achieved by the Motor Status Score model with 8 kinematic macro-metrics (R = .71 for training; R = .72 for validation). Models including kinematic micro-metrics did not achieve significantly higher performance. Performances of the Modified Ashworth Scale models were consistently low (R = .35–.42 for training; R = .08–.17 for validation). Conclusions The authors identified a set of kinetic and kinematic macro-metrics that may be used for fast outcome evaluations. These metrics represent a first step toward the development of unified, automated measures of therapy outcome. PMID:19684304

  13. Artificial Limbs

    MedlinePLUS

    ... you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which ... activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as ...

  14. Deficits in the coordination of multijoint arm movements in patients with hemiparesis: evidence for disturbed control of limb dynamics.

    PubMed

    Beer, R F; Dewald, J P; Rymer, W Z

    2000-04-01

    This study provides a detailed analysis of disturbances in the kinematics and dynamics of the acceleration phase of multijoint arm movements in six patients with chronic hemiparesis. Movements of the dominant and nondominant limbs were also examined in three control subjects. Subjects performed rapid movements from a central starting point to 16 targets located equidistantly around the circumference of a circle. Support of the upper limb was provided by an air-bearing apparatus, which allowed very low friction movements in the horizontal plane. We found that patients retained the capacity to modulate, in response to target direction, the initial direction of movements performed with the paretic limb. However, in comparison to the nonparetic limb or control subjects, movements of the paretic limb were misdirected systematically. An inverse dynamics analysis revealed an abnormal spatial tuning of the muscle torque at the elbow used to initiate movements of the paretic limb. Based on electromyographic recordings, similar spatial abnormalities were also apparent in the initial activations of elbow muscles. We argue that these spatial abnormalities result from a systematic disturbance in the control signal to limb muscles that cannot be attributed to previously identified mechanisms such as weakness, spasticity mediated restraint, or stereotypic muscle activation patterns (muscle synergies). Instead, our analysis of movement dynamics and simulation studies demonstrate that the spatial abnormalities are consistent with an impaired feedforward control of the passive interaction torques which arise during multijoint movements. This impaired control is hypothesized to reflect a degradation of the internal representation of limb dynamics that occurs either as a primary consequence of brain injury or secondary to disuse. PMID:10789946

  15. Upper Limb Evaluation and One-Year Follow Up of Non-Ambulant Patients with Spinal Muscular Atrophy: An Observational Multicenter Trial

    PubMed Central

    Canal, Aurélie; Decostre, Valérie; Diebate, Oumar; Le Moing, Anne Gaëlle; Gidaro, Teresa; Deconinck, Nicolas; Van Parys, Frauke; Vereecke, Wendy; Wittevrongel, Sylvia; Annoussamy, Mélanie; Mayer, Michèle; Maincent, Kim; Cuisset, Jean-Marie; Tiffreau, Vincent; Denis, Severine; Jousten, Virginie; Quijano-Roy, Susana; Voit, Thomas; Hogrel, Jean-Yves; Servais, Laurent

    2015-01-01

    Assessment of the upper limb strength in non-ambulant neuromuscular patients remains challenging. Although potential outcome measures have been reported, longitudinal data demonstrating sensitivity to clinical evolution in spinal muscular atrophy patients are critically lacking. Our study recruited 23 non-ambulant patients, 16 patients (males/females = 6/10; median age 15.4 years with a range from 10.7 to 31.1 years) with spinal muscular atrophy type II and 7 patients (males/females = 2/5; median age 19.9 years with a range from 8.3 to 29.9 years) with type III. The Brooke functional score was on median 3 with a range from 2 to 6. The average total vital capacity was 46%, and seven patients required non-invasive ventilation at night. Patients were assessed at baseline, 6 months, and 1 year using the Motor Function Measure and innovative devices MyoGrip, MyoPinch, and MoviPlate, which assess handgrip strength, key pinch strength, and hand/finger extension-flexion function, respectively. The study demonstrated the feasibility and reliability of these measures for all patients, and sensitivity to negative changes after the age of 14 years. The younger patients showed an increase of the distal force in the follow-up period. The distal force measurements and function were correlated to different functional scales. These data represent an important step in the process of validating these devices as potential outcome measures for future clinical trials. Trial Registration ClinicalTrials.gov NCT00993161 PMID:25861036

  16. Contrasting alterations to synaptic and intrinsic properties in upper-cervical superficial dorsal horn neurons following acute neck muscle inflammation

    PubMed Central

    2014-01-01

    Background Acute and chronic pain in axial structures, like the back and neck, are difficult to treat, and have incidence as high as 15%. Surprisingly, most preclinical work on pain mechanisms focuses on cutaneous structures in the limbs and animal models of axial pain are not widely available. Accordingly, we developed a mouse model of acute cervical muscle inflammation and assessed the functional properties of superficial dorsal horn (SDH) neurons. Results Male C57/Bl6 mice (P24-P40) were deeply anaesthetised (urethane 2.2 g/kg i.p) and the rectus capitis major muscle (RCM) injected with 40 ?l of 2% carrageenan. Sham animals received vehicle injection and controls remained anaesthetised for 2 hrs. Mice in each group were sacrificed at 2 hrs for analysis. c-Fos staining was used to determine the location of activated neurons. c-Fos labelling in carrageenan-injected mice was concentrated within ipsilateral (87% and 63% of labelled neurons in C1 and C2 segments, respectively) and contralateral laminae I - II with some expression in lateral lamina V. c-Fos expression remained below detectable levels in control and sham animals. In additional experiments, whole cell recordings were obtained from visualised SDH neurons in transverse slices in the ipsilateral C1 and C2 spinal segments. Resting membrane potential and input resistance were not altered. Mean spontaneous EPSC amplitude was reduced by ~20% in neurons from carrageenan-injected mice versus control and sham animals (20.63?±?1.05 vs. 24.64?±?0.91 and 25.87?±?1.32 pA, respectively). The amplitude (238?±?33 vs. 494?±?96 and 593?±?167 pA) and inactivation time constant (12.9?±?1.5 vs. 22.1?±?3.6 and 15.3?±?1.4 ms) of the rapid A type potassium current (IAr), the dominant subthreshold current in SDH neurons, were reduced in carrageenan-injected mice. Conclusions Excitatory synaptic drive onto, and important intrinsic properties (i.e., IAr) within SDH neurons are reduced two hours after acute muscle inflammation. We propose this time point represents an important transition period between peripheral and central sensitisation with reduced excitatory drive providing an initial neuroprotective mechanism during the early stages of the progression towards central sensitisation. PMID:24725960

  17. Effect of the cervical flexion angle during smart phone use on muscle fatigue of the cervical erector spinae and upper trapezius.

    PubMed

    Lee, Sangyong; Lee, Daehee; Park, Jungseo

    2015-06-01

    [Purpose] The purpose of this study was to examine the influence of the cervical flexion angle when using a smart phone on muscle fatigue of the cervical erector spinae (CES) and upper trapezius (UT). [Subjects] This study recruited 12 healthy adults. [Methods] Each subject sat on a chair, with his/her back against the wall and held a smart phone with both hands. Fatigue of the neck and shoulder muscles at different cervical flexion angles (0°, 30°, and 50°) was measured by electromyography. The following muscles were assessed: the right upper trapezius (RtUT), left upper trapezius (LtUT), right cervical erector spinae (RtCES), and left cervical erector spinae (LtCES). A cervical range of motion instrument was attached to the subjects' heads to measure the cervical angle during the experiment. [Results] The RtUT and LtUT showed the highest muscle fatigue at a cervical flexion angle of 50° and the lowest fatigue at an angle of 30°. There was no significant difference in the muscle fatigue of the RtCES and LtCES at any of the cervical flexion angles. [Conclusion] UT muscle fatigue depends on the cervical flexion angle when using a smart phone. PMID:26180333

  18. Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke

    PubMed Central

    Jeong, Hee-won; Chon, Seung-chul

    2015-01-01

    [Purpose] This research demonstrated a forced intensive strength technique as a novel treatment for muscle power and function in the affected upper extremity muscle to determine the clinical feasibility with respect to upper extremity performance in a stroke hemiparesis. [Subject and Methods] The subject was a patient with chronic stroke who was dependent on others for performing the functional activities of his affected upper extremity. The technique incorporates a comprehensive approach of forced, intensive, and strength-inducing activities to enhance morphological changes associated with motor learning of the upper extremity. The forced intensive strength technique consisted of a 6-week course of sessions lasting 60 minutes per day, five times a week. [Results] After the 6-week intervention, the difference between relaxation and contraction of the affected extensor carpi radialis muscle increased from 0.28 to 0.63?cm2, and that of the affected triceps brachii muscle increased from 0.30 to 0.90?cm2. The results of clinical tests including the modified Ashworth scale (MAS; from 1+ to 1), muscle strength (from 15 to 32?kg), the manual function test (MFT; scores of 16/32 to 27/32 score), the Fugl-Meyer assessment (FMA; scores of 29/66 to 49/66 score), and the Jebsen-Taylor hand function test (JTHFT; from 38/60 to 19/60 sec) were improved. [Conclusion] Our results suggest that the forced intensive strength technique may have a beneficial effect on the muscle size of the upper extremity and motor function in patients with chronic stroke. PMID:26696748

  19. Shoulder muscle forces during driving: Sudden steering can load the rotator cuff beyond its repair limit

    PubMed Central

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

    2015-01-01

    Background Driving is one of the most common everyday tasks and the rotator cuff muscles are the primary shoulder stabilisers. Muscle forces during driving are not currently known, yet knowledge of these would influence important clinical advice such as return to activities after surgery. The aim of this study is to quantify shoulder and rotator cuff muscle forces during driving in different postures. Methods A musculoskeletal modelling approach is taken, using a modified driving simulator in combination with an upper limb musculoskeletal model (UK National Shoulder Model). Motion data and external force vectors were model inputs and upper limb muscle and joint forces were the outputs. Findings Comparisons of the predicted glenohumeral joint forces were compared to in vivo literature values, with good agreement demonstrated (61 SD 8% body weight mean peak compared to 60 SD 1% body weight mean peak). High muscle activation was predicted in the rotator cuff muscles; particularly supraspinatus (mean 55% of the maximum and up to 164 SD 27 N). This level of loading is up to 72% of mean failure strength for supraspinatus repairs, and could therefore be dangerous for some cases. Statistically significant and large differences are shown to exist in the joint and muscle forces for different driving positions as well as steering with one or both hands (up to 46% body weight glenohumeral joint force). Interpretation These conclusions should be a key consideration in rehabilitating the shoulder after surgery, preventing specific upper limb injuries and predicting return to driving recommendations. PMID:26139549

  20. Muscle pathology, limb strength, walking gait, respiratory function and neurological impairment establish disease progression in the p.N155K canine model of X-linked myotubular myopathy

    PubMed Central

    Goddard, Melissa A.; Mack, David L.; Czerniecki, Stefan M.; Kelly, Valerie E.; Snyder, Jessica M.; Grange, Robert W.; Lawlor, Michael W.; Smith, Barbara K.; Beggs, Alan H.

    2015-01-01

    Background Loss-of-function mutations in the myotubularin (MTM1) gene cause X-linked myotubular myopathy (XLMTM), a fatal, inherited pediatric disease that affects the entire skeletal musculature. Labrador retriever dogs carrying an MTM1 missense mutation exhibit strongly reduced synthesis of myotubularin, the founder member of a lipid phosphatase required for normal skeletal muscle function. The resulting canine phenotype resembles that of human patients with comparably severe mutations, and survival does not normally exceed 4 months. Methods We studied MTM1 mutant dogs (n=7) and their age-matched control littermates (n=6) between the ages of 10 and 25 weeks. Investigators blinded to the animal identities sequentially measured limb muscle pathology, fore- and hind limb strength, walking gait, respiratory function and neurological impairment. Results MTM1-mutant puppies display centrally-nucleated myofibers of reduced size and disrupted sarcotubular architecture progressing until the end of life, an average of 17 weeks. In-life measures of fore- and hind limb strength establish the rate at which XLMTM muscles weaken, and their corresponding decrease in gait velocity and stride length. Pulmonary function tests in affected dogs reveal a right-shifted relationship between peak inspiratory flow (PIF) and inspiratory time (TI); neurological assessments indicate that affected puppies as young as 10 weeks show early signs of neurological impairment (neurological severity score, NSS =8.6±0.9) with progressive decline (NSS =5.6±1.7 at 17 weeks-of-age). Conclusions Our findings document the rate of disease progression in a large animal model of XLMTM and lay a foundation for preclinical studies. PMID:26605308

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

    PubMed

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

    2015-09-01

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

  2. COMBIT: protocol of a randomised comparison trial of COMbined modified constraint induced movement therapy and bimanual intensive training with distributed model of standard upper limb rehabilitation in children with congenital hemiplegia

    PubMed Central

    2013-01-01

    Introduction Children with congenital hemiplegia often present with limitations in using their impaired upper limb which impacts on independence in activities of daily living, societal participation and quality of life. Traditional therapy has adopted a bimanual training approach (BIM) and more recently, modified constraint induced movement therapy (mCIMT) has emerged as a promising unimanual approach. Evidence of enhanced neuroplasticity following mCIMT suggests that the sequential application of mCIMT followed by bimanual training may optimise outcomes (Hybrid CIMT). It remains unclear whether more intensely delivered group based interventions (hCIMT) are superior to distributed models of individualised therapy. This study aims to determine the optimal density of upper limb training for children with congenital hemiplegia. Methods and analyses A total of 50 children (25 in each group) with congenital hemiplegia will be recruited to participate in this randomized comparison trial. Children will be matched in pairs at baseline and randomly allocated to receive an intensive block group hybrid model of combined mCIMT followed by intensive bimanual training delivered in a day camp model (COMBiT; total dose 45 hours direct, 10 hours of indirect therapy), or a distributed model of standard occupational therapy and physiotherapy care (SC) over 12 weeks (total 45 hours direct and indirect therapy). Outcomes will be assessed at 13 weeks after commencement, and retention of effects tested at 26 weeks. The primary outcomes will be bimanual coordination and unimanual upper-limb capacity. Secondary outcomes will be participation and quality of life. Advanced brain imaging will assess neurovascular changes in response to treatment. Analysis will follow standard principles for RCTs, using two-group comparisons on all participants on an intention-to-treat basis. Comparisons will be between treatment groups using generalized linear models. Trial registration ACTRN12613000181707 PMID:23809257

  3. Skeletal muscle responses to unloading with special reference to man

    NASA Technical Reports Server (NTRS)

    Dudley, G. A.; Hather, B. M.; Buchanan, P.

    1992-01-01

    The limited space flight data suggest that exposure to microgravity decreases muscle strength in humans and muscle mass in lower mammals. Several earth-based models have been used to address the effect of unloading on the human neuromuscular system due to the limited access of biological research to long-term space flight. Bedrest eliminates body weight bearing of both lower limbs. Unilateral lower limb suspension (ULLS), where all ambulatory activity is performed on crutches with an elevated sole on the shoe of one foot, has recently been used to unload one lower limb. The results from studies using these two models support their efficacy. The decrease in strength of m. quadriceps femoris, for example, after four to six weeks of bedrest, ULLS or space flight is 20 to 25 percent. The results from the earth-based studies show that this response can be attributed in part to a decrease in the cross-sectional area of the KE which reflects muscle fiber atrophy. The results from the ground based studies also support the limited flight data and show that reductions in strength are larger in lower than upper limbs and in extensor than flexor muscle groups. They also raise issue with the generally held concept that postural muscle is most affected by unweighting. Slow-twitch fibers in lower limb muscles of mixed fiber type composition and muscle composed mainly of slow-twitch fibers do not preferentially atrophy after bedrest or ULLS. Taken together, the data suggest that unloading causes remarkable adaptations in the neuromuscular system of humans. It should be appreciated, however, that this area of research is in its infancy.

  4. Arousal from Sleep Does Not Lead to Reduced Dilator Muscle Activity or Elevated Upper Airway Resistance on Return to Sleep in Healthy Individuals

    PubMed Central

    Jordan, Amy S.; Cori, Jennifer M.; Dawson, Andrew; Nicholas, Christian L.; O'Donoghue, Fergal J.; Catcheside, Peter G.; Eckert, Danny J.; McEvoy, R. Doug; Trinder, John

    2015-01-01

    Study Objectives: To compare changes in end-tidal CO2, genioglossus muscle activity and upper airway resistance following tone-induced arousal and the return to sleep in healthy individuals with small and large ventilatory responses to arousal. Design: Observational study. Setting: Two sleep physiology laboratories. Patients or Participants: 35 men and 25 women with no medical or sleep disorders. Interventions: Auditory tones to induce 3-s to 15-s cortical arousals from sleep. Measurements and Results: During arousal from sleep, subjects with large ventilatory responses to arousal had higher ventilation (by analytical design) and tidal volume, and more marked reductions in the partial pressure of end-tidal CO2 compared to subjects with small ventilatory responses to arousal. However, following the return to sleep, ventilation, genioglossus muscle activity, and upper airway resistance did not differ between high and low ventilatory response groups (Breath 1 on return to sleep: ventilation 6.7 ± 0.4 and 5.5 ± 0.3 L/min, peak genioglossus activity 3.4% ± 1.0% and 4.8% ± 1.0% maximum, upper airway resistance 4.7 ± 0.7 and 5.5 ± 1.0 cm H2O/L/s, respectively). Furthermore, dilator muscle activity did not fall below the pre-arousal sleeping level and upper airway resistance did not rise above the pre-arousal sleeping level in either group for 10 breaths following the return to sleep. Conclusions: Regardless of the magnitude of the ventilatory response to arousal from sleep and subsequent reduction in PETCO2, healthy individuals did not develop reduced dilator muscle activity nor increased upper airway resistance, indicative of partial airway collapse, on the return to sleep. These findings challenge the commonly stated notion that arousals predispose to upper airway obstruction. Citation: Jordan AS, Cori JM, Dawson A, Nicholas CL, O'Donoghue FJ, Catcheside PG, Eckert DJ, McEvoy RD, Trinder J. Arousal from sleep does not lead to reduced dilator muscle activity or elevated upper airway resistance on return to sleep in healthy individuals. SLEEP 2015;38(1):53–59. PMID:25325511

  5. Taping across the upper trapezius muscle reduces activity during a standardized typing task - an assessor-blinded randomized cross-over study.

    PubMed

    Takasaki, Hiroshi; Delbridge, Blane Michael; Johnston, Venerina

    2015-02-01

    Clinically, taping is believed to alter muscle activity. The purpose of this study was to investigate: (1) whether taping across the upper trapezius (UT) muscle influenced the level of UT and lower trapezius (LT) muscle activity and the ratio of these activities (UT/LT ratio) during a static typing task; and (2) if the activity of these muscles varied with the application of tensioned taping. Forty-two healthy participants performed a 15-min typing task on three separate occasions under one of three conditions: taping applied perpendicular to the UT fibers with tension; taping without tension; and no taping. Activity of the UT and LT muscles was assessed using surface electromyography. Between conditions, significant differences were found in the change of the normalized amplitude in the UT activity (p=.027) and UT/LT ratio (p=.024) but not in the LT activity (p=.93). Compared with the no taping condition, the UT activity was less in both the tensioned taping (p=.009) and the non-tensioned taping (p=.004). There was no difference between the two taping conditions in the change of the UT (p=.91) activity and the UT/LT ratio (p=.92). In conclusion, both tensioned and non-tensioned taping across the UT muscle reduces its activity during a typing task. PMID:25454291

  6. The effects of finger extension on shoulder muscle activity

    PubMed Central

    Yi, Chae-Woo; Shin, Ju-Yong; Kim, Youn-Joung

    2015-01-01

    [Purpose] This study aims to examine the effects of the extension of the fingers (distal upper limb) on the activity of the shoulder muscles (proximal upper limb). [Subjects and Methods] This study involved 14 healthy male adults with no musculoskeletal disorder or pain related to the shoulders and hands. The subjects in a sitting posture abducted the angle of the shoulder joints at 60° and had their palms in the front direction. Electromyography (EMG) was comparatively analyzed to look at the activities of the infraspinatus (IS) and rhomboid major (RM) when the fingers were extended and relaxed. [Results] The activity of the IS was statistically significantly higher when the fingers were extended than when they were relaxed. [Conclusion] According to the result of this study, finger extension is considered to affect the muscles for connected shoulder joint stability. PMID:26504277

  7. Comparison of the Short-Term Outcomes after Postisometric Muscle Relaxation or Kinesio Taping Application for Normalization of the Upper Trapezius Muscle Tone and the Pain Relief: A Preliminary Study

    PubMed Central

    Ptaszkowski, Kuba; Slupska, Lucyna; Paprocka-Borowicz, Ma?gorzata; Ko?cz-Trz?sicka, Anna; Zwierzchowski, Kamil; Halska, Urszula; Przestrzelska, Monika; Mucha, Dariusz; Rosi?czuk, Joanna

    2015-01-01

    The main purpose of the study was to evaluate the resting bioelectrical activity of the upper trapezius muscle (the UT muscle) before and after one of the two interventions: postisometric muscle relaxation (PIR) and Kinesio Taping (KT). Moreover a comparison between group results was conducted. From the initial 61 volunteers, 52 were selected after exclusion criteria and were allocated randomly to 2 groups: PIR group and KT group. Outcome measures were assessed at baseline and completion of the intervention. The primary outcome measure was change in bioelectrical activity of UT muscle evaluated by surface electromyography (sEMG). Secondary outcomes included subjective assessment of pain using visual analogue scale (VAS). Significant differences were found only in KT group: the average resting bioelectrical activity decreased by 0.8 ?V (p = 0.0237) and the average VAS result reduced by 2.0 points (p = 0.0001). Greater decrease of VAS results was recorded in KT group compared to PIR group (p = 0.0010). Both PIR and KT intervention did not influence significantly the resting bioelectrical activity of UT muscle. KT application was better for pain relief in the studied sample compared with PIR intervention. PMID:26347792

  8. One: Microphysics of frost metamorphism: Applications to Triton and Mars. Two: A global analysis of the ozone deficit in the upper stratosphere and lower mesosphere. Three: The diabatic circulation in the stratosphere as diagnosed from Microwave Limb Sounder data

    SciTech Connect

    Eluszkiewicz, J.B.

    1993-01-01

    The present thesis is devoted to two broad subjects, planetary frost metamorphism and the terrestrial middle atmosphere, and consists of three papers. Paper 1 considers frost metamorphism on the surfaces of Triton and Mars. Based on an analysis of the microphysical processes involved in the pressureless sintering, it is concluded that fine-grained nitrogen and carbon dioxide frosts can undergo seasonal metamorphism into semitransparent layers on the surface of Triton and in the Martian seasonal polar caps, respectively. The presence of such layers explains a host of facts about Triton's surface and about the Martian seasonal caps. Paper 2 is devoted to elucidating a long-standing issue in the terrestrial middle atmosphere chemistry, the so-called 'ozone deficit problem.' Based on an analysis of data acquired by the Limb Infrared Monitor of the Stratosphere (LIMS) instrument between October 1978 and May 1979, it is concluded that current photochemical models systematically underestimate observed ozone abundances in the upper stratosphere and lower mesosphere. Three modifications to the accepted photochemical scheme, capable of providing a global solution to this problem, are proposed and discussed. Paper 3 differs from the other two in that it reports on results from an ongoing research effort. It considers the diabatic circulation in the stratosphere and lower mesosphere, using ozone and temperature measurements acquired by the Microwave Limb Sounder (MLS) instrument onboard the Upper Atmosphere Research Satellite (UARS). The present study extends past analyses of the diabatic circulation by considering a full annual cycle, November 1991-November 1992, and by taking advantage of the high vertical resolution of MLS data. In the tropical upper stratosphere and lower mesosphere, a semiannual oscillation (SAO) is observed in the computed circulation, with the region of downwelling reaching maximum spatial extent approximately 1 month before the equinox.

  9. Lipotyphla limb myology comparison.

    PubMed

    Neveu, Pauline; Gasc, Jean-Pierre

    2002-05-01

    Fore- and hindlimb muscles were dissected in four species of Lipotyphla: the western European hedgehog Erinaceus europaeus (Erinaceidae, Erinaceinae); the moonrat Echinosorex gymnura (Erinaceidae, Hylomyinae or Galericinae); the tailless tenrec Tenrec ecaudatus (Tenrecidae, Tenrecinae); and the common European white-toothed shrew Crocidura russula (Soricidae, Soricinae). This work completely reviews the limb musculature of these walking mammals. Twelve myological characters were evaluated in order to disclose phylogenetic relationships. The cladogram obtained supported previous ones based on cranial and dental characters. This study shows that myological characters are valuable in phylogenetic analyses. PMID:11921044

  10. Caring for muscle spasticity or spasms

    MedlinePLUS

    High muscle tone - care; Increased muscle tension - care; Upper motor neuron syndrome - care; Muscle stiffness - care ... Muscle spasticity, or spasms, causes your muscles to become stiff or rigid. It can also cause exaggerated, ...

  11. Skeletal muscle contractility, self-reported pain and tissue sensitivity in females with neck/shoulder pain and upper Trapezius myofascial trigger points– a randomized intervention study

    PubMed Central

    2012-01-01

    Background In relation to Myofascial Triggerpoints (MFTrPs) of the upper Trapezius, this study explored muscle contractility characteristics, the occurrence of post-intervention muscle soreness and the effect of dry needling on muscle contractile characteristics and clinical outcomes. Methods Seventy-seven female office workers (25-46yrs) with and without neck/shoulder pain were observed with respect to self-reported pain (NRS-101), pressure-pain threshold (PPT), maximum voluntary contraction (Fmax) and rate of force development (RFD) at baseline (pre-intervention), immediately post-intervention and 48 hours post-intervention. Symptomatic and asymptomatic participant groups were each randomized into two treatment sub-groups (superficial (SDN) and deep dry needling (DDN)) after baseline testing. At 48 hours post-intervention participants were asked whether delayed onset muscle soreness (DOMS) and/or post-needling soreness had developed. Results Muscle contractile characteristics did not differ between groups at baseline. Forty-six individuals developed muscle soreness (39 from mechanical testing and seven from needling). No inter-group differences were observed post-intervention for Fmax or RFD for the four sub-groups. Over the observation period, symptomatic participants reported less pain from both SDN (p= 0.003) and DDN (p=0.011). However, PPT levels were reduced for all participants (p=0.029). Those reporting DOMS experienced significant decreases in PPT, irrespective of symptom state or intervention (p=0.001). Conclusions In selected female neck/shoulder pain sufferers, maximum voluntary contraction and rapid force generation of the upper Trapezius was not influenced by clinically relevant self-reported pain or the presence of diagnostically relevant MFTrPs. Dry needling, deep or superficial, did not affect measured functional outcomes over the 48-hour observation period. DOMS affected participants uniformly irrespective of pain, MFTrP status or intervention type and therefore is like to act as a modifier. Trial registration Clinical Trials.gov- NCT01710735 Significance and Innovations The present investigation is one of the first to examine the hypothesis of gross muscle contractile inhibition due to the presence of diagnostically relevant MFTrPs. Individuals suffering from clinically relevant levels of self-reported pain are able to tolerate maximum voluntary contraction testing, but delayed onset muscle soreness (DOMS) is a likely side-effect irrespective of symptom status. As a consequence, its confounding effect during subsequent testing must be taken into account. PMID:23176709

  12. Detection of movements with attention or distraction to the motor task during robot-assisted passive movements of the upper limb

    E-print Network

    Minguez, Javier

    , or information from the peripheral nervous system (PNS) such as muscle activity (EMG), to drive and control rehabilitation strategy; this information can be directly measured from the central nervous system (CNS between the two conditions. I. INTRODUCTION Neurological disorders or brain lesions such as stroke

  13. Limb bud and flank mesoderm have distinct "physical phenotypes" that may contribute to limb budding

    E-print Network

    Newman, Stuart A.

    2008 Available online 20 June 2008 Keywords: Limb bud Surface tension Active response -smooth muscle actin Limb bud outgrowth in chicken embryos is initiated during the third day of development, of 4-day embryonic chicken wing and leg bud mesenchymal tissue, and adjacent flank mesoderm

  14. Terrestrial tetrapods use diverse limb postures during locomotion, ranging from the highly sprawling posture of

    E-print Network

    Blob, Richard W.

    .g. the femora of chickens; Carrano, 1998), the limb bones of species using parasagittal limb movements parasagittal limb movements. The present study integrates new data on hindlimb muscle function with previously (GRF) and caudofemoralis (CFL) muscles generated opposing moments about the femur. Hindlimb retraction

  15. INTRODUCTION The dependence of muscle force on the length and velocity of muscle

    E-print Network

    Delp, Scott

    2150 INTRODUCTION The dependence of muscle force on the length and velocity of muscle fibers has that the length and velocity of muscle fibers can have a large effect on muscle force generation in various of lower limb muscles affect force generation during human locomotion. Understanding how the muscle forces

  16. Contralateral effects of upper extremity proprioceptive neuromuscular facilitation patterns.

    PubMed

    Pink, M

    1981-08-01

    Electromyography was used to determine the presence of electrical activity in the nonexercised latissimus dorsi, infraspinatus, and pectoralis major muscles while the contralateral limb underwent the proprioceptive neuromuscular facilitation pattern of flexion, abduction, external rotation with elbow straight and extension, adduction, internal rotation with elbow straight. Activity was present in all of these muscles during both components of the pattern. There was no significant difference in activity for the pectoralis major muscle during the flexor as compared to extensor component. The infraspinatus was more active during the flexor component, while the latissimus dorsi was more active during the extensor component. These results could be used in planning a treatment program for patients who are unable to exercise one of their upper extremities and who could benefit from the contralateral effects of upper extremity proprioceptive neuromuscular facilitation patterns. PMID:7267706

  17. Analysis of isokinetic muscle strength for sports physiotherapy research in Korean ssireum athletes.

    PubMed

    Noh, Ji-Woong; Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-10-01

    [Purpose] The purpose of the present study was to elucidate the muscle conditions such as the isokinetic muscle of Korean ssireum athletes. [Subjects and Methods] This study enrolled 25 elite ssireum athletes. We measured body composition and peak torque at an angular speed at 60°/s using an isokinetic muscle strength dynamometer. [Results] The lean body mass of the left upper limb was significantly higher than that of the right upper limb. However, the lean body mass of the left lower limb was significantly lower than that of the right lower limb. The peak torque for left elbow flexion was significantly higher than that for right elbow flexion. Conversely, the peak torque for left elbow extension was significantly lower than that for right elbow extension. Furthermore, the peak torque for the left knee was significantly lower than that for the right knee for both flexion and extension. [Conclusion] The data from this study elucidate in part the muscle conditions of Korean ssireum athletes, which can be used to establish a reference for the scientific study of sports physiotherapy. PMID:26644679

  18. Analysis of isokinetic muscle strength for sports physiotherapy research in Korean ssireum athletes

    PubMed Central

    Noh, Ji-Woong; Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-01-01

    [Purpose] The purpose of the present study was to elucidate the muscle conditions such as the isokinetic muscle of Korean ssireum athletes. [Subjects and Methods] This study enrolled 25 elite ssireum athletes. We measured body composition and peak torque at an angular speed at 60°/s using an isokinetic muscle strength dynamometer. [Results] The lean body mass of the left upper limb was significantly higher than that of the right upper limb. However, the lean body mass of the left lower limb was significantly lower than that of the right lower limb. The peak torque for left elbow flexion was significantly higher than that for right elbow flexion. Conversely, the peak torque for left elbow extension was significantly lower than that for right elbow extension. Furthermore, the peak torque for the left knee was significantly lower than that for the right knee for both flexion and extension. [Conclusion] The data from this study elucidate in part the muscle conditions of Korean ssireum athletes, which can be used to establish a reference for the scientific study of sports physiotherapy. PMID:26644679

  19. Aberrant muscle syndrome: hypertrophy of the hand and arm due to aberrant muscles with or without hypertrophy of the muscles.

    PubMed

    Ogino, Toshihiko; Satake, Hiroshi; Takahara, Masatoshi; Kikuchi, Noriaki; Watanabe, Tadayosi; Iba, Kousuke; Ishii, Seiichi

    2010-06-01

    Five patients were reported in our congenital anomaly registry who had six hands in total with muscular hyperplasia, aberrant muscles, ulnar drift of the fingers in the metacarpophalangeal (MP) joints, flexion contractures of the MP joints, and enlargement of the metacarpal spaces. Thirty patients with unilateral involvement of this condition have been reported previously. We reviewed these cases and found that the condition varied in severity and that it was reported using different names. However, this condition seems different from true macrodactyly and multiple camptodactyly, including windblown hand, and seems to be an isolated entity of congenital upper limb anomaly. The authors recommend 'aberrant muscle syndrome' or 'accessory muscle syndrome' as a diagnostic name, because this seems to be the most common pathological finding in this condition. PMID:20214671

  20. Extracellular Control of Limb Regeneration

    NASA Astrophysics Data System (ADS)

    Calve, S.; Simon, H.-G.

    Adult newts possess the ability to completely regenerate organs and appendages. Immediately after limb loss, the extracellular matrix (ECM) undergoes dramatic changes that may provide mechanical and biochemical cues to guide the formation of the blastema, which is comprised of uncommitted stem-like cells that proliferate to replace the lost structure. Skeletal muscle is a known reservoir for blastema cells but the mechanism by which it contributes progenitor cells is still unclear. To create physiologically relevant culture conditions for the testing of primary newt muscle cells in vitro, the spatio-temporal distribution of ECM components and the mechanical properties of newt muscle were analyzed. Tenascin-C and hyaluronic acid (HA) were found to be dramatically upregulated in the amputated limb and were co-expressed around regenerating skeletal muscle. The transverse stiffness of muscle measured in situ was used as a guide to generate silicone-based substrates of physiological stiffness. Culturing newt muscle cells under different conditions revealed that the cells are sensitive to both matrix coating and substrate stiffness: Myoblasts on HA-coated soft substrates display a rounded morphology and become more elongated as the stiffness of the substrate increases. Coating of soft substrates with matrigel or fibronectin enhanced cell spreading and eventual cell fusion.

  1. Deficits in Lower Limb Muscle Reflex Contraction Latency and Peak Force Are Associated With Impairments in Postural Control and Gross Motor Skills of Children With Developmental Coordination Disorder

    PubMed Central

    Fong, Shirley S.M.; Ng, Shamay S.M.; Guo, X.; Wang, Yuling; Chung, Raymond C.K.; Stat, Grad; Ki, W.Y.; Macfarlane, Duncan J.

    2015-01-01

    Abstract This cross-sectional, exploratory study aimed to compare neuromuscular performance, balance and motor skills proficiencies of typically developing children and those with developmental coordination disorder (DCD) and to determine associations of these neuromuscular factors with balance and motor skills performances in children with DCD. One hundred thirty children with DCD and 117 typically developing children participated in the study. Medial hamstring and gastrocnemius muscle activation onset latencies in response to an unexpected posterior-to-anterior trunk perturbation were assessed by electromyography and accelerometer. Hamstring and gastrocnemius muscle peak force and time to peak force were quantified by dynamometer, and balance and motor skills performances were evaluated with the Movement Assessment Battery for Children (MABC). Independent t tests revealed that children with DCD had longer hamstring and gastrocnemius muscle activation onset latencies (P??0.025), than the controls. Multiple regression analysis accounting for basic demographics showed that gastrocnemius peak force was independently associated with the MABC balance subscore and ball skills subscore, accounting for 5.7% (P?=?0.003) and 8.5% (P?=?0.001) of the variance, respectively. Gastrocnemius muscle activation onset latency also explained 11.4% (P?muscle activation onset times and lower isometric peak forces. Gastrocnemius peak force was associated with balance and ball skills performances, whereas timing of gastrocnemius muscle activation was a determinant of ball skill performance in the DCD population. PMID:26469921

  2. Learning about Vertebrate Limb Development

    ERIC Educational Resources Information Center

    Liang, Jennifer O.; Noll, Matthew; Olsen, Shayna

    2014-01-01

    We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every…

  3. Influence of load and stretch shortening cycle on the kinematics, kinetics and muscle activation that occurs during explosive upper-body movements.

    PubMed

    Newton, R U; Murphy, A J; Humphries, B J; Wilson, G J; Kraemer, W J; Häkkinen, K

    1997-01-01

    Although explosive power in lower-body movements has been extensively studied, there is a paucity of research examining such movements in the upper body. This study aimed to investigate the influence of load and the stretch shortening cycle (SSC) on the kinematics, kinetics, and muscle activation that occurs during maximal effort throws. A total of 17 male subjects performed SSC and concentric only (CO) bench throws using loads of 15%, 30%, 45%, 60%, 75%, 90% and 100% of their previously determined one repetition maximum bench press. The displacement, velocity, acceleration, force and power output as well as the electromyogram (EMG) from pectoralis major, anterior deltoid, and triceps brachii were recorded for each throw. The results were compared using multivariate analysis of variance with repeated measures. A criterion alpha level of P < or = 0.05 was used. Similar force velocity power relationships were determined for this multijoint upper-body movement as has been found for isolated muscles, single joint movements, and vertical jumping. The highest power output was produced at the 30% [563 (104) W] and 45% [560 (86) W] loads during the SSC throws. Force output increased as a function of load; however, even the lighter loads resulted in considerable force due to the high accelerations produced. Average velocity, average and peak force, and average and peak power output were significantly higher for the SSC throws compared to the CO throws. However, peak velocity and height thrown were not potentiated by performing the pre-stretch because the duration and range of movement allowed the ability of the muscle to generate force at high shortening velocities to dominate the resulting throw. As such, explosive movements involving longer concentric actions than experienced during brief SSC movements may be limited by the ability of the muscle to produce force during fast contraction velocities. PMID:9134365

  4. Adolescents with Intellectual Disability Have Reduced Postural Balance and Muscle Performance in Trunk and Lower Limbs Compared to Peers without Intellectual Disability

    ERIC Educational Resources Information Center

    Blomqvist, Sven; Olsson, Josefine; Wallin, Louise; Wester, Anita; Rehn, Borje

    2013-01-01

    For adolescent people with ID, falls are more common compared to peers without ID. However, postural balance among this group is not thoroughly investigated. The aim of this study was to compare balance and muscle performance among adolescents aged between 16 and 20 years with a mild to moderate intellectual disability (ID) to age-matched…

  5. Integration of biomechanical compliance, leverage, and power in elephant limbs.

    PubMed

    Ren, Lei; Miller, Charlotte E; Lair, Richard; Hutchinson, John R

    2010-04-13

    The structure and motion of elephant limbs are unusual compared with those of other animals. Elephants stand and move with straighter limbs (at least when walking), and have limited speed and gait. We devised novel experiments to examine how the limbs of elephants support and propel their mass and to explore the factors that may constrain locomotor performance in these largest of living land animals. We demonstrate that elephant limbs are remarkably compliant even in walking, which maintains low peak forces. Dogma defines elephant limbs as extremely "columnar" for effective weight support, but we demonstrate that limb effective mechanical advantage (EMA) is roughly one-third of that predicted for their size. EMA in elephants is actually smaller than that in horses, which are only one-tenth their mass; it is comparable to human limb values. EMA drops sharply with speed in elephants, as it does in humans. Muscle forces therefore must increase as the limbs become more flexed, and we show how this flexion translates to greater volumes of muscle recruited for locomotion and hence metabolic cost. Surprisingly, elephants use their forelimbs and hindlimbs in similar braking and propulsive roles, not dividing these functions among limbs as was previously assumed or as in other quadrupeds. Thus, their limb function is analogous to four-wheel-drive vehicles. To achieve the observed limb compliance and low peak forces, elephants synchronize their limb dynamics in the vertical direction, but incur considerable mechanical costs from limbs working against each other horizontally. PMID:20351297

  6. Demonstration of a Semi-Autonomous Hybrid Brain-Machine Interface using Human Intracranial EEG, Eye Tracking, and Computer Vision to Control a Robotic Upper Limb Prosthetic

    PubMed Central

    McMullen, David P.; Hotson, Guy; Katyal, Kapil D.; Wester, Brock A.; Fifer, Matthew S.; McGee, Timothy G.; Harris, Andrew; Johannes, Matthew S.; Vogelstein, R. Jacob; Ravitz, Alan D.; Anderson, William S.; Thakor, Nitish V.; Crone, Nathan E.

    2014-01-01

    To increase the ability of brain-machine interfaces (BMIs) to control advanced prostheses such as the modular prosthetic limb (MPL), we are developing a novel system: the Hybrid Augmented Reality Multimodal Operation Neural Integration Environment (HARMONIE). This system utilizes hybrid input, supervisory control, and intelligent robotics to allow users to identify an object (via eye tracking and computer vision) and initiate (via brain-control) a semi-autonomous reach-grasp-and-drop of the object by the MPL. Sequential iterations of HARMONIE were tested in two pilot subjects implanted with electrocorticographic (ECoG) and depth electrodes within motor areas. The subjects performed the complex task in 71.4% (20/28) and 67.7% (21/31) of trials after minimal training. Balanced accuracy for detecting movements was 91.1% and 92.9%, significantly greater than chance accuracies (p < 0.05). After BMI-based initiation, the MPL completed the entire task 100% (one object) and 70% (three objects) of the time. The MPL took approximately 12.2 seconds for task completion after system improvements implemented for the second subject. Our hybrid-BMI design prevented all but one baseline false positive from initiating the system. The novel approach demonstrated in this proof-of-principle study, using hybrid input, supervisory control, and intelligent robotics, addresses limitations of current BMIs. PMID:24760914

  7. Demonstration of a semi-autonomous hybrid brain-machine interface using human intracranial EEG, eye tracking, and computer vision to control a robotic upper limb prosthetic.

    PubMed

    McMullen, David P; Hotson, Guy; Katyal, Kapil D; Wester, Brock A; Fifer, Matthew S; McGee, Timothy G; Harris, Andrew; Johannes, Matthew S; Vogelstein, R Jacob; Ravitz, Alan D; Anderson, William S; Thakor, Nitish V; Crone, Nathan E

    2014-07-01

    To increase the ability of brain-machine interfaces (BMIs) to control advanced prostheses such as the modular prosthetic limb (MPL), we are developing a novel system: the Hybrid Augmented Reality Multimodal Operation Neural Integration Environment (HARMONIE). This system utilizes hybrid input, supervisory control, and intelligent robotics to allow users to identify an object (via eye tracking and computer vision) and initiate (via brain-control) a semi-autonomous reach-grasp-and-drop of the object by the MPL. Sequential iterations of HARMONIE were tested in two pilot subjects implanted with electrocorticographic (ECoG) and depth electrodes within motor areas. The subjects performed the complex task in 71.4% (20/28) and 67.7% (21/31) of trials after minimal training. Balanced accuracy for detecting movements was 91.1% and 92.9%, significantly greater than chance accuracies (p < 0.05). After BMI-based initiation, the MPL completed the entire task 100% (one object) and 70% (three objects) of the time. The MPL took approximately 12.2 s for task completion after system improvements implemented for the second subject. Our hybrid-BMI design prevented all but one baseline false positive from initiating the system. The novel approach demonstrated in this proof-of-principle study, using hybrid input, supervisory control, and intelligent robotics, addresses limitations of current BMIs. PMID:24760914

  8. Relationship between performance-based and laboratory tests for lower-limb muscle strength and power assessment in healthy older women.

    PubMed

    Forte, Roberta; Macaluso, Andrea

    2008-11-01

    The aim of the study was to assess the relationship between performance-based and laboratory tests for muscular strength and power assessment in older women. Thirty-two women aged 68.8 +/- 2.8 years were recruited. All participants were asessed for: (a) two performance-based tests--the box-stepping test (mean 296 +/- 51 J) and two-revolution maximum test (mean 7.1 +/- 2 kg) performed while pedalling on a cycle ergometer; and (b) muscular function tests--maximal instantaneous peak power jumping on a force platform (mean 1528 +/- 279 W); maximal voluntary contraction (MVC) during knee extension (mean 601 +/- 571 N) and leg press (mean 626 +/- 126 N), and leg press power (mean 483 +/- 98 W) on a dynamometer. Using univariate analysis, performance-based tests were compared with laboratory muscle strength and power measurements. Muscle power correlated most strongly with the performance-based tests for both jumping and leg press power (r-values between 0.67 and 0.75; P < 0.01). The correlation with muscle strength measures ranged between 0.48 and 0.61 (P < 0.01). The proposed tests may have particular relevance in geriatric and rehabilitation environments as they represent an easy, practical, and inexpensive alternative for the assessment of muscular strength and power. PMID:18923959

  9. Congenital bilateral agenesis of the tibialis anterior muscles: a rare case report.

    PubMed

    Htwe, Ohnmar; Swarhib, M; Pei, Tan Sook; Naicker, Amaramalar Selvi; Das, S

    2012-01-01

    Congenital bilateral agenesis of the tibialis anterior muscles is a rare condition. We present a case of congenital absence of bilateral tibialis anterior muscles in a 6-year-old boy who presented with an abnormal gait. He was previously diagnosed to have bilateral congenital talipes equinovarus (CTEV) deformity for which he underwent corrective surgery two times. However, he still had a residual foot problem and claimed to have difficulty in walking. On examination, he walked with a high stepping gait and muscle power of both lower limbs was 5/5 on the medical research council scale (MRCS) except for both ankle dorsiflexors and long toe extensors. The sensation was intact. Magnetic Resonance Imaging (MRI) study of both legs revealed that tibialis anterior muscles were not visualized on both sides suggestive of agenesis of the tibialis anterior muscles. The rest of the muscles appeared mildly atrophied. The electrophysiological study showed normal motor and sensory conduction in both upper and lower limbs. Electromyographic (EMG) study of the vastus medialis was within normal limit and no response could be elicited for EMG of tibialis anterior muscles suggesting possible absence of tibialis anterior muscles, bilaterally. The patient underwent split tibialis posterior tendon transfer to achieve a balanced and functional foot and was well on discharge. The present case describes the normal anatomy and embryology of tibialis anterior muscles as well as possible causes of its agenesis along with its clinical implications. PMID:22990563

  10. Effect of Posture during Trumpet and Marching Euphonium Performance on the Trunk and Lower Limb Musculoskeletal System

    PubMed Central

    Mitani, Yasuhiro; Kitagawa, Tomomi; Matsugi, Akiyoshi; Mukai, Kouichi

    2013-01-01

    [Purpose] The purpose of the present study was to investigate the effect of trumpet and marching euphonium performance posture on the trunk and lower limb musculoskeletal system. [Subjects] The subjects were 10 female university students. [Methods] Subjects maintained a resting position, a trumpet performance posture, and a marching euphonium performance posture. The angles and muscle activities of the trunk and lower limbs were then measured. [Results] The anterior tilt angle of the trunk decreased significantly in the trumpet and marching euphonium performance postures compared with the resting standing position, as well as in the marching euphonium performance posture compared with the trumpet performance posture. The muscle activity of the cervical paraspinal muscles, upper fibers of the trapezius, and lumbar paraspinal muscles increased significantly in the marching euphonium performance posture compared with the resting standing position, as well as in the marching euphonium performance posture compared with the trumpet performance posture. [Conclusion] The results suggest that the performance position for trumpet and the marching euphonium performance increases the load on the cervical and thoracic musculoskeletal system, which increases with greater instrument weight. However, the same instrument performance postures had no affect on the musculoskeletal system of the lower limbs. PMID:24259926

  11. Robotic Powered Transfer Mechanism modeling on Human Muscle Structure

    NASA Astrophysics Data System (ADS)

    Saito, Yukio

    It is considered in engineering that one power source can operate one joint. However, support movement mechanism of living organism is multi joint movement mechanism. Considerably different from mechanical movement mechanism, two pairs of uni-articular muscles and a pair of bi-articular muscles are involved in it. In leg, movements observed in short run including leg idling, heel contact and toeing are operated by bi-articular muscles of the thigh showing strong legs to support body weight. Pursuit of versatility in welfare robot brings its comparison with conventional machinery or industrial robot to the fore. Request for safety and technology allowing elderly people to operate the robot is getting stronger in the society. The robot must be safe when it is used together with other welfare equipment and simpler system avoiding difficult operation has to be constructed. Appearance of recent care and assistance robot is getting similar to human arm in comparison with industrial robot. Being easily able to imagine from industrial robot, mid-heavyweight articulated robot to support 60-70kgf combined with large output motor and reduction gears is next to impossible to be installed in the bath room. This research indicated that upper limb arm and lower limb thigh of human and animals are holding coalitional muscles and movement of uni-artcular muscle and bi-articular muscle conjure the image of new actuators.

  12. Flexible cortical control of task-specific muscle synergies

    PubMed Central

    Nazarpour, Kianoush; Barnard, Amy; Jackson, Andrew

    2012-01-01

    Correlation structure in the activity of muscles across movements is often interpreted as evidence for low-level, hard-wired constraints on upper-limb function. However, muscle synergies may also emerge from optimal strategies to achieve high-level task goals within a redundant control space. To distinguish these contrasting interpretations, we examined the structure of muscle variability during operation of a myoelectric interface in which task constraints were dissociated from natural limb biomechanics. We found that with practice, human subjects learned to shape patterns of covariation between arbitrary pairs of hand and forearm muscles appropriately for elliptical targets whose orientation varied on a trial-by-trial basis. Thus, despite arriving at the same average location in the effector space, performance was improved by buffering variability into those dimensions that least impacted task success. Task-modulation of beta-frequency inter-muscular coherence indicated that differential recruitment of divergent corticospinal pathways contributed to positive correlations amongst muscles. However, this feed-forward mechanism could not account for negative correlations observed in the presence of visual feedback. A second experiment revealed the development of fast, target-dependent visual responses consistent with ‘minimum intervention’ control correcting predominantly task-relevant errors. Together, these mechanisms contribute to the dynamic emergence of task-specific muscle synergies appropriate for a wide range of abstract task goals. PMID:22956825

  13. UP-BEAT (Upper Limb Baby Early Action–observation Training): protocol of two parallel randomised controlled trials of action–observation training for typically developing infants and infants with asymmetric brain lesions

    PubMed Central

    Guzzetta, Andrea; Boyd, Roslyn N; Perez, Micah; Ziviani, Jenny; Burzi, Valentina; Slaughter, Virginia; Rose, Stephen; Provan, Kerry; Findlay, Lisa; Fisher, Imogen; Colombini, Francesca; Tealdi, Gessica; Marchi, Viviani; Whittingham, Koa

    2013-01-01

    Introduction Infants with asymmetric brain lesions are at high risk of developing congenital hemiplegia. Action–observation training (AOT) has been shown to effectively improve upper limb motor function in adults with chronic stroke. AOT is based on action observation, whereby new motor skills can be learnt by observing motor actions. This process is facilitated by the Mirror Neuron System, which matches observed and performed motor actions. This study aims to determine the efficacy of AOT in: (1) influencing the early development of reaching and grasping of typically developing infants and (2) improving the upper limb activity of infants with asymmetric brain lesions. Methods and analysis This study design comprises two parallel randomised sham-controlled trials (RCTs) in: (1) typically developing infants (cohort I) and (2) infants with asymmetric brain lesions (eg, arterial stroke, venous infarction, intraventricular haemorrhage or periventricular leukomalacia; cohort II). Cohort II will be identified through a neonatal ultrasound or neonatal MRI. A sham control will be used for both RCTs, taking into consideration that it would be unethical to give no intervention to an at-risk population. Based on a two-tailed t test of two independent means, with a significance (?) level of 0.05, 80% power, predicted effect size of 0.8 and a 90% retention rate, we require 20 participants in each group (total sample of 40) for cohort I. The sample size for cohort II was based on the assumption that the effect size of the proposed training would be similar to that found by Heathcock et al in preterm born infants (n=26) with a mean effect size of 2.4. Given the high effect size, the calculation returned a sample of only four participants per group, on a two-tailed t test, with a significance (?) level of 0.05 and 80% power. As cohort II will consist of two subgroups of lesion type (ie, arterial stroke and venous infarction), we have quadrupled the sample to include 16 participants in each group (total sample of 32). Infants will be randomised to receive either AOT or standard Toy Observation Training (TOT). Both interventions will be of 4?weeks’ duration, from the infant's 9th–13th post-term week of age. Three sessions of 5?min each will be performed each day for 6?days/week (total of 6?h over 28?days). Parents of the AOT group will repeatedly show the infant a grasping action on a set of three toys, presented in random order. Parents of the TOT group will show the infant the same set of three toys, in random order, without demonstrating the grasping action. At 14, 16 and 18?weeks, the quantity and quality of reaching and grasping will be measured using the Grasping and Reaching Assessment of Brisbane; symmetry of reaching and grasping will be measured using the Hand Assessment of Infants (HAI) and pressure of grasping for each hand with a customised pressure sensor. At 6?months’ corrected age, the primary outcome measures will be the HAI and Bayley Scales of Infant and Toddler Development (third edition; BSID III), to measure cognitive and motor development. At 8?months, HAI and EEG will be used to measure brain activity and cortical coherence. At 12?months, the primary outcome measures will again be HAI and BSID III. Dissemination This paper outlines the theoretical basis, study hypotheses and outcome measures for two parallel RCTs comparing the novel intervention Action–observation training with standard TOT in: (1) influencing the early development of reaching and grasping of typically developing infants and (2) improving the upper limb motor activity of infants with asymmetric brain lesions. Trial Registration ACTRN1261100991910. Web address of trial http://www.ANZCTR.org.au/ACTRN12611000991910.aspx PMID:23418301

  14. Cortex Integrity Relevance in Muscle Synergies in Severe Chronic Stroke

    PubMed Central

    García-Cossio, Eliana; Broetz, Doris; Birbaumer, Niels; Ramos-Murguialday, Ander

    2014-01-01

    Background: Recent experimental evidence has indicated that the motor system coordinates muscle activations through a linear combination of muscle synergies that are specified at the spinal or brainstem networks level. After stroke upper limb impairment is characterized by abnormal patterns of muscle activations or synergies. Objective: This study aimed at characterizing the muscle synergies in severely affected chronic stroke patients. Furthermore, the influence of integrity of the sensorimotor cortex on synergy modularity and its relation with motor impairment was evaluated. Methods: Surface electromyography from 33 severely impaired chronic stroke patients was recorded during 6 bilateral movements. Muscle synergies were extracted and synergy patterns were correlated with motor impairment scales. Results: Muscle synergies extracted revealed different physiological patterns dependent on the preservation of the sensorimotor cortex. Patients without intact sensorimotor cortex showed a high preservation of muscle synergies. On the contrary, patients with intact sensorimotor cortex showed poorer muscle synergies preservation and an increase in new generated synergies. Furthermore, the preservation of muscle synergies correlated positively with hand functionality in patients with intact sensorimotor cortex and subcortical lesions only. Conclusion: Our results indicate that severely paralyzed chronic stroke patient with intact sensorimotor cortex might sculpt new synergy patterns as a response to maladaptive compensatory strategies. PMID:25294998

  15. The functional anatomy of suggested limb paralysis.

    PubMed

    Deeley, Quinton; Oakley, David A; Toone, Brian; Bell, Vaughan; Walsh, Eamonn; Marquand, Andre F; Giampietro, Vincent; Brammer, Michael J; Williams, Steven C R; Mehta, Mitul A; Halligan, Peter W

    2013-02-01

    Suggestions of limb paralysis in highly hypnotically suggestible subjects have been employed to successfully model conversion disorders, revealing similar patterns of brain activation associated with attempted movement of the affected limb. However, previous studies differ with regard to the executive regions involved during involuntary inhibition of the affected limb. This difference may have arisen as previous studies did not control for differences in hypnosis depth between conditions and/or include subjective measures to explore the experience of suggested paralysis. In the current study we employed functional magnetic resonance imaging (fMRI) to examine the functional anatomy of left and right upper limb movements in eight healthy subjects selected for high hypnotic suggestibility during (i) hypnosis (NORMAL) and (ii) attempted movement following additional left upper limb paralysis suggestions (PARALYSIS). Contrast of left upper limb motor function during NORMAL relative to PARALYSIS conditions revealed greater activation of contralateral M1/S1 and ipsilateral cerebellum, consistent with the engagement of these regions in the completion of movements. By contrast, two significant observations were noted in PARALYSIS relative to NORMAL conditions. In conjunction with reports of attempts to move the paralysed limb, greater supplementary motor area (SMA) activation was observed, a finding consistent with the role of SMA in motor intention and planning. The anterior cingulate cortex (ACC, BA 24) was also significantly more active in PARALYSIS relative to NORMAL conditions - suggesting that ACC (BA 24) may be implicated in involuntary, as well as voluntary inhibition of prepotent motor responses. PMID:23351848

  16. [The Italian version of "OREGE" (Outil de Repérage et d'Evaluation des Gestes) of the INRS (Institut national de recherche et de sécurité) for the assessment of musculoskeletal disorders of the upper limb].

    PubMed

    Apostoli, P; Bazzini, G; Sala, E; Imbriani, M

    2002-01-01

    The upper extremity work-related musculoskeletal disorders (UEWMSDs) are a heterogeneous group of disorders not yet standardised mainly epidemiological criteria for case definition. They are multifactorial, often they are work related even if sometimes they show an individual origin. In recent years they show a rapid increase but it's worth noting that this trend is also affected by a more widespread and easy recognition as work related diseases. There are many ergonomic analysis tools, currently available, that claim to accurately measure variables associated with UEWMSDs. They are essentially based on biomechanical, epidemiological and physiological approaches and identify work activities at risk of developing: OSHA's checklist, Strain Index, OCRA Index, ACGIH (Hand Activity Level). A method for the study of musculoskeletal disorders of the upper limb has been proposed by French INRS (National de Recherche et de Sécurité). It is defined as a project based on ergonomics applied to occupational medicine and it includes: (1) OSHA's checklist as a screening tool; (2) MSDs questionnaire for standardised record of symptoms and of worker's opinions (3) OREGE, (Outil de Repérage et d'Evaluation des Gestes) a exhaustive evaluation tool to be used by ergonomics-trained personnel, aimed to identify risk factors to be considered for preventive and corrective actions. OREGE includes: force evaluation through Latko's scale (which take into account: weight of objects and tools, kind of hold, pressure, vibration, temperature, use of gloves), articular position analysis, repetition analysis, synthesis of the different biomechanical risk factors, calculation of an index of risk. The authors have considered of interest to provide occupational physicians and ergonomic professionals with an Italian version of OREGE. The expected results are: a critical review of the method, a comparison with the other most known evaluation methods and the selection of the best method for specific work activity. PMID:11892413

  17. Comparison of neuromuscular adjustments associated with sustained isometric contractions of four different muscle groups.

    PubMed

    Neyroud, Daria; Rüttimann, Jennifer; Mannion, Anne F; Millet, Guillaume Y; Maffiuletti, Nicola A; Kayser, Bengt; Place, Nicolas

    2013-05-15

    The extent and characteristics of muscle fatigue of different muscle groups when subjected to a similar fatiguing task may differ. Thirteen healthy young men performed sustained contractions at 50% maximal voluntary contraction (MVC) force until task failure, with four different muscle groups, over two sessions. Per session, one upper limb and one lower limb muscle group were tested (knee extensors and thumb adductor, or plantar and elbow flexors). Changes in voluntary activation level and contractile properties were derived from doublet responses evoked during and after MVCs before and after exercise. Time to task failure differed (P < 0.05) between muscle groups (220 ± 64 s for plantar flexors, 114 ± 27 s for thumb adductor, 77 ± 25 s for knee extensors, and 72 ± 14 s for elbow flexors). MVC force loss immediately after voluntary task failure was similar (-30 ± 11% for plantar flexors, -37 ± 13% for thumb adductor, -34 ± 15% for knee extensors, and -40 ± 12% for elbow flexors, P > 0.05). Voluntary activation was decreased for plantar flexors only (from 95 ± 5% to 82 ± 9%, P < 0.05). Potentiated evoked doublet amplitude was more depressed for upper limb muscles (-59.3 ± 14.7% for elbow flexors and -60.1 ± 24.1% for thumb adductor, P < 0.05) than for knee extensors (-28 ± 15%, P < 0.05); no reduction was found in plantar flexors (-7 ± 12%, P > 0.05). In conclusion, despite different times to task failure when sustaining an isometric contraction at 50% MVC force for as long as possible, diverse muscle groups present similar loss of MVC force after task failure. Thus the extent of muscle fatigue is not affected by time to task failure, whereas this latter determines the etiology of fatigue. PMID:23471948

  18. Tendon palpation during agonist contraction and antagonist co-contraction to assess wrist flexor and extensor muscle function.

    PubMed

    Bertelli, J A

    2015-04-01

    The aim of this study was to validate direct tendon palpation during agonist contraction and antagonist co-contraction as a method to assess wrist flexor and extensor muscle function in cases of upper limb paralysis. On one occasion, five doctors examined 17 patients with partial paralysis of the upper limb resulting from brachial plexus or cervical spinal cord injury. We asked examiners to determine if the extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor carpi ulnaris (ECU), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU) and palmaris longus (PL) were paralyzed, weak or strong in each patient. Examiners tested flexion - extension and radial - ulnar deviation against resistance and palpated wrist motor tendons. While palpating tendons, co-contractions were encouraged by soliciting finger extension to evaluate the FCU, thumb extension to evaluate the ECU, and finger flexion to evaluate the ECRB. Kappa values were 0.8 for the ECRL, 0.7 for the ECRB, 0.5 for the ECU, 0.8 for the FCR, 0.6 for the PL, and 0.8 for the FCU, indicating moderate to almost perfect agreement between examiners. Tendon palpation during muscle examination was adequate to identify complete paralysis, as well as weak and strong muscle contractions. This assessment helps to identify muscles that could be used during nerve or tendon transfer for reconstruction of extensive upper limb paralysis. PMID:25765117

  19. Muscle variations and abnormal branching and course of the ulnar nerve in the forearm and hand.

    PubMed

    Bozkurt, M C; Tagil, S M; Ersoy, M; Tekdemir, I

    2004-01-01

    During dissection of the right forearm of a 27-year-old female cadaver, variations in the form and insertion of the palmaris longus muscle were observed. The tendon of the palmaris longus muscle, which demonstrated a centrally placed belly, split into two tendons: one inserted into the palmar aponeurosis and the other into the proximal part of the flexor retinaculum. Additionally, we found an accessory muscle extending between the flexor retinaculum and the tendon of the abductor digiti minimi muscle. This accessory muscle was located deep to the ulnar artery but superficial to the superficial and deep branches of the ulnar nerve at the wrist. Finally, an aberrant branch of the ulnar nerve was identified in the forearm; it traveled distally alongside the ulnar artery and in the palm demonstrated communications with common palmar digital nerves from the ulnar and the median nerves. No variations were observed in the contralateral upper limb. PMID:14695591

  20. The effects of adding single-joint exercises to a multi-joint exercise resistance training program on upper body muscle strength and size in trained men.

    PubMed

    de França, Henrique Silvestre; Branco, Paulo Alexandre Nordeste; Guedes Junior, Dilmar Pinto; Gentil, Paulo; Steele, James; Teixeira, Cauê Vazquez La Scala

    2015-08-01

    The aim of this study was compare changes in upper body muscle strength and size in trained men performing resistance training (RT) programs involving multi-joint plus single-joint (MJ+SJ) or only multi-joint (MJ) exercises. Twenty young men with at least 2 years of experience in RT were randomized in 2 groups: MJ+SJ (n = 10; age, 27.7 ± 6.6 years) and MJ (n = 10; age, 29.4 ± 4.6 years). Both groups trained for 8 weeks following a linear periodization model. Measures of elbow flexors and extensors 1-repetition maximum (1RM), flexed arm circumference (FAC), and arm muscle circumference (AMC) were taken pre- and post-training period. Both groups significantly increased 1RM for elbow flexion (4.99% and 6.42% for MJ and MJ+SJ, respectively), extension (10.60% vs 9.79%, for MJ and MJ+SJ, respectively), FAC (1.72% vs 1.45%, for MJ and MJ+SJ, respectively), and AMC (1.33% vs 3.17% for MJ and MJ+SJ, respectively). Comparison between groups revealed no significant difference in any variable. In conclusion, 8 weeks of RT involving MJ or MJ+SJ resulted in similar alterations in muscle strength and size in trained participants. Therefore, the addition of SJ exercises to a RT program involving MJ exercises does not seem to promote additional benefits to trained men, suggesting MJ-only RT to be a time-efficient approach. PMID:26244600

  1. Mimicking muscle activity with electrical stimulation

    NASA Astrophysics Data System (ADS)

    Johnson, Lise A.; Fuglevand, Andrew J.

    2011-02-01

    Functional electrical stimulation is a rehabilitation technology that can restore some degree of motor function in individuals who have sustained a spinal cord injury or stroke. One way to identify the spatio-temporal patterns of muscle stimulation needed to elicit complex upper limb movements is to use electromyographic (EMG) activity recorded from able-bodied subjects as a template for electrical stimulation. However, this requires a transfer function to convert the recorded (or predicted) EMG signals into an appropriate pattern of electrical stimulation. Here we develop a generalized transfer function that maps EMG activity into a stimulation pattern that modulates muscle output by varying both the pulse frequency and the pulse amplitude. We show that the stimulation patterns produced by this transfer function mimic the active state measured by EMG insofar as they reproduce with good fidelity the complex patterns of joint torque and joint displacement.

  2. Limb Girdle Muscular Dystrophy (LGMD): Case Report.

    PubMed

    Kanitkar, Shubhangi A; Kalyan, Meenakshi; Gaikwad, Anu N; Makadia, Ankit; Shah, Harshad

    2015-01-01

    We report a young male of autosomal recessive limb girdle muscular dystrophy (LGMD) with positive family history presented with gradual onset proximal muscle weakness in all four limbs since eight years and thinning of shoulders, arms and thighs. Neurological examination revealed atrophy of both shoulders with wasting of both deltoids thinning of thighs and pseudo hypertrophy of both calves, hypotonia in all four limbs. Gower's sign was positive. Winging of scapula was present. Power was 3/5 at both shoulders, 4/5 at both elbows, 5/5 at both wrists, 3/5 at both hip joints, 3/5 at both knees, 5/5 at both ankles. All deep tendon reflexes and superficial reflexes were present with plantars bilateral flexors. Electromyography (EMG) showed myopathic pattern. He had elevated creatinine phosphokinase levels and muscle biopsy findings consistent with muscular dystrophy. PMID:25738022

  3. Limb Girdle Muscular Dystrophy (LGMD): Case Report

    PubMed Central

    Kalyan, Meenakshi; Gaikwad, Anu N.; Makadia, Ankit; Shah, Harshad

    2015-01-01

    We report a young male of autosomal recessive limb girdle muscular dystrophy (LGMD) with positive family history presented with gradual onset proximal muscle weakness in all four limbs since eight years and thinning of shoulders, arms and thighs. Neurological examination revealed atrophy of both shoulders with wasting of both deltoids thinning of thighs and pseudo hypertrophy of both calves, hypotonia in all four limbs. Gower’s sign was positive. Winging of scapula was present. Power was 3/5 at both shoulders, 4/5 at both elbows, 5/5 at both wrists, 3/5 at both hip joints, 3/5 at both knees, 5/5 at both ankles. All deep tendon reflexes and superficial reflexes were present with plantars bilateral flexors. Electromyography (EMG) showed myopathic pattern. He had elevated creatinine phosphokinase levels and muscle biopsy findings consistent with muscular dystrophy. PMID:25738022

  4. Functional and Clinical Outcomes of Upper Extremity Amputation.

    PubMed

    Fitzgibbons, Peter; Medvedev, Gleb

    2015-12-01

    Upper extremity amputation is an uncommon but often necessary procedure. It can be required as a result of trauma, infection, or malignancy. Amputation is a life-changing procedure. Careful planning for it must not only include the level of amputation and assurance of durable soft-tissue coverage of the amputation site, but it must also consider patients' goals and occupations, as well as social factors affecting amputees. The choice of prosthesis is an individual matter, but new technology permits lighter and more multifunctional prostheses. Targeted muscle reinnervation can be used to achieve improved myoelectric signaling and possibly decrease limb pain following amputation. Rehabilitation is crucial to achieving favorable results. PMID:26527583

  5. A Model of the Lower Limb for Analysis of Human Movement

    PubMed Central

    Arnold, Edith M.; Ward, Samuel R.; Lieber, Richard L.; Delp, Scott L.

    2010-01-01

    Computer models that estimate the force generation capacity of lower limb muscles have become widely used to simulate the effects of musculoskeletal surgeries and create dynamic simulations of movement. Previous lower limb models are based on severely limited data describing limb muscle architecture (i.e., muscle fiber lengths, pennation angles, and physiological cross-sectional areas). Here, we describe a new model of the lower limb based on data that quantifies the muscle architecture of 21 cadavers. The model includes geometric representations of the bones, kinematic descriptions of the joints, and Hill-type models of 44 muscle–tendon compartments. The model allows calculation of muscle–tendon lengths and moment arms over a wide range of body positions. The model also allows detailed examination of the force and moment generation capacities of muscles about the ankle, knee, and hip and is freely available at www.simtk.org. PMID:19957039

  6. Voluntary and reactive recruitment of locomotor muscle synergies during perturbed walking.

    PubMed

    Chvatal, Stacie A; Ting, Lena H

    2012-08-29

    The modular control of muscles in groups, often referred to as muscle synergies, has been proposed to provide a motor repertoire of actions for the robust control of movement. However, it is not clear whether muscle synergies identified in one task are also recruited by different neural pathways subserving other motor behaviors. We tested the hypothesis that voluntary and reactive modifications to walking in humans result from the recruitment of locomotor muscle synergies. We recorded the activity of 16 muscles in the right leg as subjects walked a 7.5 m path at two different speeds. To elicit a second motor behavior, midway through the path we imposed ramp and hold translation perturbations of the support surface in each of four cardinal directions. Variations in the temporal recruitment of locomotor muscle synergies could account for cycle-by-cycle variations in muscle activity across strides. Locomotor muscle synergies were also recruited in atypical phases of gait, accounting for both anticipatory gait modifications before perturbations and reactive feedback responses to perturbations. Our findings are consistent with the idea that a common pool of spatially fixed locomotor muscle synergies can be recruited by different neural pathways, including the central pattern generator for walking, brainstem pathways for balance control, and cortical pathways mediating voluntary gait modifications. Together with electrophysiological studies, our work suggests that muscle synergies may provide a library of motor subtasks that can be flexibly recruited by parallel descending pathways to generate a variety of complex natural movements in the upper and lower limbs. PMID:22933805

  7. Musculoskeletal modelling of an ostrich (Struthio camelus) pelvic limb: influence of limb orientation on muscular capacity during locomotion.

    PubMed

    Hutchinson, John R; Rankin, Jeffery W; Rubenson, Jonas; Rosenbluth, Kate H; Siston, Robert A; Delp, Scott L

    2015-01-01

    We developed a three-dimensional, biomechanical computer model of the 36 major pelvic limb muscle groups in an ostrich (Struthio camelus) to investigate muscle function in this, the largest of extant birds and model organism for many studies of locomotor mechanics,